When  I heard that Boomer’s theme this issue was “restore,”  it touched me in many ways — both personally and professionally. 

Having reached my mid-60s, I understand how important it is to review your life priorities and consider how to maximize every day, both spiritually and physically. And, as a dentist with 42 years of experience and having seen many oral conditions, I have a sense of how our health plays a major role in how we move forward.

Good Teeth, Good Health
Our teeth and mouth need to be in great shape. Fillings, crowns, bridges and veneers are called “restorations” by the dental community. They restore teeth to their original conditions, before cavities or fractures. In this way, the patient has the ability to masticate (chew) food and break it down into the various nutrients needed to sustain life. Ask any person with a lower denture if they enjoy eating and most will tell you that it will never be like it was when they had their own teeth. Implants help with stability, but the force is still greatly reduced and the acrylic and/or porcelain changes the taste of food.  

From an emotional standpoint, having a nice smile is very important to one’s presentation and outlook. The first thing we see when we have an encounter with someone else is their teeth and smile. Having focused my practice on cosmetic and restorative dentistry, I can tell you that the most gratifying thing we can hear in our office is a patient’s comment that the veneers and/or crowns we placed on their anterior teeth have “changed their life.” 

As we continue to live longer, which may include working longer and dating at a more mature age, our smile plays a more important role. Just recently, a patient whose daughter was getting married and another who was attending her high school reunion wrote us that they kept getting compliments about how wonderful they looked; both were convinced that their teeth and smiles were the attention-getters.

As we age, it becomes even more important to pay attention to our dental health. After all, all of our nutrition comes from what we take in through our mouth, whether we are drinking or eating – even swallowing vitamins. As AARP Magazine recently noted, without Medicare and limited benefits for dentistry, getting dental work done while being relatively healthy and before retirement can be a lifesaver, both physically and financially.

Early Care Matters

Having practiced dentistry for nearly 40, following three years serving as a captain and dental resident in the United States Air Force, I have followed and cared for many patients and their families. Some of these patients were seen by my late father, Dr. Sam Marsh, and continued in the practice when he retired and when I took over following my military service.

Thankfully, many of these people and their families have remained with us and are dedicated to taking care of their teeth, having them examined, cleaned, and radiographed (x-rayed) on a regular basis, along with routine checks for oral cancer. They not only have beautiful smiles with a full complement of teeth, but also remark that compared to many of their friends and peers, they have had little to no pain with their teeth and can chew quite well – not avoiding any foods because of issues with dentures or partial dentures.  

This consistent care also has saved them money; most have had very few major or expensive procedures. Though dentistry does have a number of options to replace missing teeth, such as implants and bridges, the techniques and materials take time and are costly.  

There also is an emotional component. Many times, I have sat across from a new patient whose chief complaint is that they won’t smile for pictures or when they meet someone because they are ashamed of their smile.

By Dr. Steve Marsh

Many of our parents and their generation thought that over their lifetime it was “natural” to lose some teeth — even all of them. And when they did, they would either get a partial denture or a full denture, or go toothless.

The partial denture replaced the teeth that were missing, with artificial teeth held in by metal wires or clasps. The full denture was all teeth and plastic, with the upper one covering the palate and the lower sitting on the lower ridge, if there were any bone remaining. The upper denture fit fairly well due to suction, but the lower was nearly always a problem — often ending up in a Kleenex or on the nightstand. So where are we today?

Options

We now know that it’s not natural to lose your teeth; they can and should last for a lifetime. With good home care and regular visits to the dentist and dental hygienist, our teeth should serve us into our 80s and beyond. Home care involves both flossing and brushing (we recommend a baking soda/peroxide toothpaste with fluoride), especially after meals. Dental visits should occur three to four times a year.

But what if we’ve already lost some teeth, due to periodontal or gum disease, tooth decay or cavities, or fracturing of old fillings or tooth structure? Today’s partial dentures can be made out of a flexible plastic without any metal. They are comfortable and function well, and they have no unsightly metal clasps.

Bridges, made up of all porcelain/Zirconium, also have no unsightly metal collars and are made up of a series of crowns that go on the teeth adjacent to the space caused by the missing teeth. In addition to filling in space, they may help strengthen the abutments.

The other solution is the dental implant or implants.

I see many new patients who come to our office for “smile makeovers.” Some do it for a special occasion, while others thought it was about time to take care of themselves. Regardless of the reason, they understood the value of healthy teeth and a smile they could be proud of.

A physician in her 50s told us she wanted to look good at her daughter’s wedding and in the wedding photos. She had lost a few upper and lower front teeth as a teenager due to an accident. At the time, the teeth were replaced with permanent bridges made of porcelain on top of a metal framework used for strength.

Though they had lasted many years, they looked their age, with a number of fractures and chips, and some of the metal margins were visible. After exploring her options, we used a combination of all-porcelain bridgework in the front and all-porcelain crowns in the back. She confided in me that she wished she had done the dental work earlier so that she could have been enjoying the benefits, both cosmetically and functionally.

The wedding pushed her into moving forward with treatment. As she also travels frequently with her husband and has a grinding problem, we made her a soft night guard, which will help protect her teeth from grinding and any accident that might occur on the road.

Looking Good, Feeling Great

Another patient, in her mid-80s, was brought in by her daughter — a professor at a northeastern Ohio university — prior to their annual family reunion. “Jackie” had a large space between her front teeth that had bothered her for her entire adult life. After looking at various options, she decided to have four porcelain veneers placed to both close the diastema (space) and to make the proportions of her front teeth appropriate.

As 2018 begins, and we start to work on our resolutions, shouldn’t we spend time on ourselves and our appearance?

With our teeth and lips making up nearly 60 percent of our facial expressions, this is the time to plan on getting our smiles back in shape. Below are some of the options available — many of them done digitally — and information about the time necessary to improve our smiles.

Teeth whitening

Zoom: This can be accomplished with a laser-like, in-office technique. It takes about an hour and a half, and may be followed-up and maintained with at-home whitening.

At Home Method: Whitening your teeth at home involves wearing custom-fitted trays with a gel solution. It takes about two weeks to accomplish the shade change.

Bonding

Tooth-colored composites can be used to fix chips and fractures, as well as to close spaces and change tooth color. Most “repairs” can be done in just one appointment.

Tooth-Colored Fillings

A filling material can be used to fix decayed teeth and to replace old, worn, silver fillings. Depending on the number of restorations to be done, they can often be completed in one day.

Removal of Stains, Tartar and/or White Spots

A dental hygiene appointment, combined with bonding, can eliminate most problems. This can be done in just one visit.

Porcelain Veneers

These tooth-colored restorations can be responsible for a dramatic change in one’s smile, covering the surfaces of the teeth and wrapping slightly over the edge. This conservative treatment generally takes two appointments of a couple of hours each.

Partial or full dentures

Made completely out of a light but strong material, these non-metal prostheses are more comfortable and natural than ever. Impressions, try-ins and placement can require three to four appointments.

Implants

Used to anchor individual teeth and/or dentures, implants resemble natural roots of teeth.