Dr. Roger Druckman, D.D.S.

The bridge replacement procedure involves removing the old bridge by cutting it off and care must be taken not to damage the underlying tooth structure. It can take approximately 20 to 30 minutes for each abutment of the bridge to be cut away so the bridge can be removed. That procedure alone can take 40 minutes to an hour or longer if the bridge has more than two abutments, support teeth. The removal of the bridge would be part of the first visit. The beginning of the visit should have included x-rays to determine the health of the bone and the roots of the supporting teeth as well as assessment of decay at the margins of the bridge on the support teeth. After the examination an impression should be made to assist in the fabrication of the temporary bridge which will be used while the final bridge is being made.
Therefore, you could have 10 to 15 minutes for x-rays and an exam, another 30 to 60 minutes to remove the old bridge and 30 minutes to make the temporary bridge, or an hour and 45 minutes if the supporting teeth are not in need of cavity removal and fillings to replace the decayed tooth structure. If the abutment teeth, the supporting teeth are not decayed then that could end the first visit. The second visit would involve making an impression of the abutment teeth and the teeth in the opposing arch and that could take 1 to 2 hours depending upon the complexity of the required treatment. The third visit would involve removing the temporary bridge, as was necessary for making the impression, and then cementing the final bridge and adjusting the bite. That third visit could take about an hour.
If any of the abutment teeth require the removal of decay and the placement of fillings that would add extra visits and extra time. If any of the abutments is so badly decayed that they require root canal treatment to be saved that, of course, would require even more visits and more time.
In summary, it might only be a three visit procedure unless extra time is taken to do the impressions at the first visit, in which case it would only take two visits. However, then the first visit could take an extra 30 to 45 minutes.
The reason for a second visit to make the impressions is because the gum tissue is typically going to bleed a little bit and necessitate time to heal. However, if the doctor has a laser to create a trough around the teeth an excellent impression can be made at the first visit unless extra treatment is required for cavity removal.
Sincerely,
Dr. Druckman

The best tooth brush is one with soft bristles. Tooth brushes with medium or hard bristles tend to bounce over the plaque deposits and not brush through them. It’s similar to sweeping a floor. You use a broom with soft bristles to push all the dust. If you use a broom with stiff bristles you have to go over and over it to get all the dirt.
Sincerely,
Dr. Druckman

You should always finish the antibiotics because the last bacteria to be killed are the ones that are the strongest or most resistant. Therefore, you want to make sure that you killed the infection completely.
Sincerely,
Dr. Druckman

Zirconium is an excellent material and will yield excellent results.
Sincerely,
Dr. Druckman

Yes, Invisalign is safe for your teeth but aligners take longer and don’t yield as precise a finished result as regular braces. Nevertheless, I often have patients that want Invisalign.
Sincerely,
Dr. Druckman

For metal frameworks, chromium cobalt castings are best and then anatomical porcelain teeth.
Sincerely,
Dr. Druckman

The best method to straighten your teeth is stainless steel brackets and bands. Porcelain brackets are excellent also but can fracture and therefore; will take longer and add additional expense. I’ve used them both and the stainless steel are clearly superior. I’ve used aligners since they first became available and the finished result is not as well defined or precise as with stainless steel. Moreover, aligners can take much longer to complete treatment and a retainer must be worn for life or you can have a relapse of the positioning of the teeth.
If a patient has crowding of their natural teeth and functional appliances are not used to grow the maxilla (upper jaw) and mandible (lower jaw) to make room for the teeth the case will relapse and aligners can again straighten the teeth. However, without getting the required bone growth in the first place, the case will relapse again and that is why the aligners require life time use of retainers. If functional appliances are used to grow the bone the aligners will do a much better job but not as good as stainless steel brackets.
If there is crowding present, I always use functional appliances to grow the bone and avoid doing extractions to make the required space.
Sincerely,
Dr. Druckman

It is not normal for the color to be different from one side of the tongue to the other. Get an appointment with your dentist or an oral surgeon as soon as possible to get the area evaluated. When getting the appointment you need to stress the fact that you need an emergency appointment. You need to make sure that if it is in need of treatment, you get it done as soon as possible. Also, if it isnt anything serious then at least you know that as soon as possible. Sincerely, Dr. Druckman Roger Druckman, D.D.S. rogerdruckmandds@gmail.com p. 303.691.2860 f. 303.691.2836

Yes, you can. It will help to keep the implants clean. You should be going in once every three months for a prophy of your implants.

You need to wait until the socket completely heals and then get a CT Scan to determine the quality of the bone, the density of the bone and how much bone filled in to the extraction site. If you don't need a bone graft and the density of the bone is good it may be possible to get an implant but usually after around six months. Depending on the size of the roots of the tooth of the extracted tooth and the size of the implant, you can sometimes get an implant placed immediately after the extraction is completed. However, after the implant is placed you typically have to wait six months for the implant to integrate with the bone before a crown can be placed.

Periodontal disease, gum disease, typically causes bad breath but so does stomach problems. If it's only gum disease you need to get a deep scaling and root planning to get the gum disease under control. You should never be brushing your teeth in a way that would cause the recession of your gums. In any event, you need to get to a dentist and get an evaluation of your periodontal health and get it treated and you'll get the bad breath eliminated. Plus, before and after you visit the dentist you need to start flossing everyday. Remember this joke, you only need to floss those you want to keep everyday. Thankfully , your problem should be fixable.

If the partial dentures no longer fit properly they can cause gum pain. You may only have a sore spot that can be corrected by an adjustment of the acrylic that simulates the gum tissue or it could be that a clasp on a tooth is loose and allows the partial to move and rub on the gums instead of holding it firmly in position.

Yes, jaw surgery can fix an open bite but so can functional appliances and braces to make room for the tongue. Plus, a myotherapist, a specialist who works with the tongue, is required to help retrain your tongue to swallow correctly.

Yes, it's ok. I prefer to have the procedure done performed while the patient is still on the antibiotics but if that's not possible then do it as soon as you can.

The best answer to that is to ask your orthopedic surgeon. Many doctors are saying that extended need for antibiotic prophylaxis is not required after a certain period of time. Again, the best thing to do is to ask your doctor.

Braces makes it difficult to clean your teeth but you can still use a water pik and even floss. You might need a floss threader to get the floss under the arch wires but you can also get brushes that can fit between the teeth under the arch wires. In summary: braces cause gum pain because the person with the braces is not taking the time to use a water pik, floss, or interproximal brushes. Therefore, don't worry, you just need to get better with your oral hygiene.

No, you do not need to get a root canal if your tooth only requires a crown.

Yes, you can drink through a straw with a temporary crown.

My advice would be to contact the dental school and Denver General and see what they recommend.

The main disadvantage of Invisalign treatment is that it takes so much longer than regular braces. Another disadvantage is that if you need functional appliances to grow bone, such as a palatal expander, you can’t do them both at the same time. First you would do the palatal expander and then the Invisalign as opposed to doing the regular braces and expander at the same time.

A third disadvantage is that if you require bone growth and you’re in braces the growth is maintained even after the functional appliance is removed because the braces and arch wires maintain everything right to the completion of treatment. There are times that my patient has completed the bone growth and gone into the aligner (Invisalign) phase of treatment and lost some of the growth because the aligners just don’t maintain everything the way regular braces do.

Another disadvantage is that the position of the teeth with Invisalign must be maintained for life with retainers so that the teeth don’t relapse to a crooked position. With regular braces once you finish with the retainers you rarely have a relapse unless functional appliances to grow the bone were never used. If the doctor uses functional appliances to grow the width of the palate and even to grow the front part of the palate forward you don’t have relapses. Invisalign came about because of relapses due to the doctor not using functional appliances to grow the bone to make room for all of the teeth. That’s why there are and were so many orthodontic cases that required teeth to be extracted. You need to find a dentist who was trained in functional appliances so that you can grow the bone and avoid extracting teeth and also have a very stable long term result without relapses. Invisalign was the answer to the problem of an orthodontic relapse because functional appliances were not used and the patient wanting straight teeth without having to go through braces again. Consequently, you can now understand why you need Invisalign retainers for life because without them the teeth will relapse into crowding and rotating similar to how they were before getting braces initially.

It’s a long answer because it’s a complicated question. To review quickly: Invisalign doesn’t align the teeth as precisely as braces and takes longer than braces and a lot longer if the doctor is using functional appliances to grow the bone to avoid extractions and you need retainers for life. Nevertheless, I have patients that only want Invisalign and I’ll use functional appliances where necessary to avoid extractions and to correct cross bites. Therefore, Invisalign definitely has a place in dentistry and I’ve been using them since they came out in the early 2000s. Plus, I’ve been using regular braces and functional appliances since about 1977, 1978 and still use them and especially on patients for whom Invisalign is not an option. There are some things that Invisalign can’t do and/or can’t do very well but the experienced clinician can still overcome many obstacles and challenges with extra time and going back and forth between functional appliances and Invisalign.
Sincerely,
Dr. Druckman