Your consultation visit. This is the time when the entire plan is explained to you in detail. It is important that you understand each part of the treatment and give your consent.

There may be parts of the plan you don't agree with and want altered. To give you the ideal smile somtimes it is necessary to reshape the gums, do some orthodontic alignment or replacing missing may be be accomplished using dental implants. Will you go along with all these treatments.

If you feel parts of the plan are not for you it is important that you understand how the best possible treatment outcome may change (it will not always change, or you may not be concerned about the change).

This is also when scheduling and timing will be reviewed. Once you are happy and ready to go the next step first phase of treatment which is making sure your mouth is healthy.

Okay. So you have decided that it is time to fix you smile. You and your dentist have disussed what you want you new smile to look like. You have an idea of the cost and your are ready to role. You hoping that your new teeth can be completed as soon as possible. You want to know how long it will take and exactly what treatment will be done.

Firstly, each patient is completely different and will require as seperate plan. Some elements can be similar but there are numerous variations.

In general there are a few stages of treatment and they happen in sequence.

Number one is Diagnosis. You will have had a cursory exam to establish some idea at to what is necessary and a cost estimate. Now that you are ready to go a more detail diagnosis is needed. This will include a clinical exam, x-rays, models of your teeth and bites and photos.

Your dentist will study everything and design a detailed treatment plan. Computer imaging may be done to see an estimation of the final result and the final result will be built in wax so it can be seen in 3D and use as a template to form your temporaries.

Next comes the consultation where you are presented with the treatment plan and the necessary consent process is completed....

If your treatment requires modification of the way your teeth fit together it will not be possible to work in one are at a time because by doing so does not allow for bite changes.

If this case what you can to to spread out treatment for cost purposes or scheduling issues is make long term temporary restortions that will include all the necessary teeth. This allows for making the bite fit the way it needs to for success as well as giving you a very good cosmetic outcome.

Once this is complete time is on your side. You can now do the remaining treatment at a pace that is comfortable for you. Treatment will involve replacing sections of your temporary with permanent restorations until you eventually are finished.

Many patients choose this options and are very happy through the entire process.

Once you have established your budget and dealt with scheduling concerns you are ready to go. Here's what you can do.

You can do some of the treatment toward you goal. For example, it may be possible to do your front teeth first if that is you main concern. Or if you are missing teeth in a particular area you can start there.

In some cases where set-up work needs to be done prior to restorative work, such a orthodontic treatment or gum procedures; you can start with these and do the restortive treatment later.

In some very complex cases where the way the upper and lower teeth fit together has to be altered it is not possible to work in different areas at a time. The approach will vary but it is still possilble to phase in the treatment...

Please don't make the mistake of thinking that treatments like this are all or none. The best approach to take is to be honest with your dentist as to what you can manage both financially and time wise. Your dentist can then be upfront with you about what they will be able to achieve and what the limitations may be cosmetically and functionally. You need to work as a team with your dentist. Your dentist needs complete trust in your committment and you need to trust you dentist. Trust your dentist to give you the best result possible at a fair fee. If you don't have complete trust in your dentist think about finding someone you do trust; or maybe it is just that you are not ready for this type if treatment.

Once you have an idea of what the cost may be now you have to decide if it will work for you. There may be part of the idea treatment that you do not agree with or are not willing to accept. And then there is the cost. Can you afford that amount of money right now. Will the treatment time fit into you schedule. Do you have things going on in your life that make this not the opportue time financially, emotionally, scheduling or any other reason that may come before dentistry.

If so, there is nothing wrong with delaying treatment until the time is right for you. In fact, without your complete committment to the treatment, it is hard for you and the dental team to make things work the way they should. So wait!!

What are your options if you can't proceed with the ideal right now?

So now you have decided that you are ready to think about getting that beautiful smile that you have always wanted. How do you decide what that should be? You and your dentist need to start by having conversation about where you are starting from and where you want to get to. Bring pictures from when you were younger. Look in the mirror and point out to your dentist exacly what you don't like. This will give your dentist a good idea of what you are looking for. From there it is possible to estimate what a similar treatment fee as been as an estimate. Keep in mind that each case has its limitations so sometimes perfect is not possible but great improvements always are.

Sometimes this can be quite expensive as there is a lot involved that you really do not get see or appreciate. As dentists we are trained to give you the best treatment possible and to give you the result you are looking for that will be long lasting and healthy.

This ideal treatment is great if it works for you and we will discuss what it may look like but what if the ideal is not possible for you?

If you have been unhappy with the way you teeth look for quite some time or you are starting to notice changes you don't like then it may be time to think about doing some treatment.

Why do I say think about doing some treatment? Beacause treating tooth wear or teeth that are chipped, cracked and mis-aligned can be very complex and it can be time intensive and expensive. The are often ways to spread out the cost of treatment by deciding what the end result needs to be and then moving ahead in phases. A rough idea of treatment cost can be given based on similar treatments for other patients. Before you can do this though, you need to decide what it is that you are after.

There are a number of treatment approaches to dealing with worn teeth and they go from simple to complex.

The simplest, by far, is to wear a "grinding appliance" while sleeping. You may not be aware of it but this is when the most significant grinding occurs. Other examples when this occurs are during intense periods of concentration, driving in heavy traffic and weight lifting. It is during these periods that the subconscious takes over (just like breathing; you don't have to think about it) and a tremendours amount of pressure is placed on the teeth. Sometimes up to 1000psi.

This treatment approach assumes that the overall cosmetic appearance is acceptable or that it is not the right time for you to have more extensive treatment.

One thing that can be done prior to a grinding appliance is some minor reshaping of the teeth if wear is not to severe. This is quite inexpensive and can make a big improvement in appearance.

More complex treatments next...

Dr. Mike

Did you know that changes in hormone levels can affect women’s oral health?

Hormone levels change at 4 main times during a women’s life and include puberty, menstration, pregnancy, and menopause. Changes in oral health can occur during all these times. Oral contraceptives can also have an impact on oral health.

During puberty, hormone fluctuations make the gums more susceptible to gum disease. As a result, the gums may appear more red and swollen, and they can bleed.

During menstration, some women have a tendency to develop canker sores and cold sores and some women even find this becomes a pattern during all menstral cycles.

Another reason why the teeth may look shorter and have that aged appearance is due wear of the teeth. The incisal edges are worn flat and covered more by the upper lip. There are a number of ways to deal with this but the best by far is to prevent the wear from occuring to such an extent.

Improving the position of the upper lip is tough (medical procedure are available) but dentistry can do an awful lot to make aged teeth look younger.

We will dicuss treatment approaches next...

Don't see as much of your Upper front Teeth?

Have you noticed lately that when you smile that you don’t see as much of your upper front teeth as when you were younger or that the edges of your teeth are worn or chipped? Have you wondered why this happens when your teeth looked great in the past? One reason for showing less upper teeth when smiling is aging. The other is the deterioration of the teeth due to wear.

Between the ages of 30 yrs and 70 yrs the muscles of the upper and lower lips become more lax. So what we see is that a 30 year old will show a lot of upper incisor teeth measured in a relaxed position or when speaking; and no lower teeth. A 70 years old will show minimal or no upper teeth and a lot or lower incisor teeth. The change amounts on average to approximately 1 mm per decade between 30 and 70 years. What is lost in appearance by the upper teeth is gained by the lower teeth. A 30 year old female will show roughly 4mm of upper teeth in a relaxed position and the same female will show 4mm of lower incisor teeth at 70 years.

Stay tuned for the solutions...