Prosthodontics is the dental specialty primarily concerned with the restoration and replacement of lost or damaged teeth. Sometimes called the “architects of the smile,” prosthodontists are highly trained specialists with a unique understanding of all the elements that go into a beautiful, functional and natural-looking smile—not just the teeth, but also the gums, lips, and facial features. When it comes to planning and carrying out a full-scale smile makeover, a team of dental professionals is often required; many times, that team is captained by a prosthodontist.
What Do Prosthodontists Do?
As their name implies (“prosthesis” = addition or attachment, “odont” = tooth), these specialists plan and carry out procedures related to the replacement of natural teeth, in part or in full, with biocompatible substitutes. Some of these treatments include:
- Porcelain Veneers — wafer-thin shells of ceramic material that cover the front surfaces of teeth, providing a dramatic change in appearance. These are bonded to teeth that have been prepared by having a small amount of enamel removed, so they don’t appear too bulky. Long-lasting veneers can change the size, shape or color of teeth, and even close small gaps between.
- Crowns — artificial covers (sometimes called “caps”) that replace the entire visible surface of a tooth above the gum line. Fabricated of metal, porcelain fused to metal, or all-ceramic (porcelain), crowns are cemented to a prepared tooth with intact roots. They are often needed after a root canal procedure, or to repair fractured, broken or misshapen teeth.
- Dental Implants — when it’s necessary to replace an entire tooth (both roots and crown), this method is considered today’s gold standard. Implants consist of a titanium metal post which is implanted in the jaw in a minor surgical procedure. This screw-like post becomes fused with the jaw bone, providing a solid anchorage for a lifelike crown. Implants can be used to replace single or multiple teeth, or to support other types of dental restorations, such as bridges or dentures. While implant surgery is usually performed by other specialists, prosthodontists often design and place the implant crowns. Implants are initially the most costly tooth replacement method, but may prove an excellent value in the long run, as they can last a lifetime.
- Fixed Bridges — this tooth-replacement method uses the existing, healthy teeth (called abutment teeth) on either side of a gap to support one or more artificial teeth. A series of linked crowns is fabricated as a single unit, which is then attached to the prepared abutment teeth. These work like a roadway-bridge foundation to hold up the crowns for the missing teeth in between. Bridges are a time-tested tooth-replacement method, but require special attention to cleaning, and potentially compromise the structure of the otherwise healthy abutment teeth.
- Dentures — are available in many different types, including full, partial, and implant-supported varieties. They can improve the aesthetics and functionality of an individual who is missing teeth—particularly when the dentures are manufactured to a high standard of workmanship and fitted correctly in the mouth. However, wearing dentures typically requires an adjustment period, and some find them uncomfortable in certain situations.
Post-Surgical Instructions
Brushing and flossing should be avoided over the implant surgical area for a period of two weeks. All other areas may be brushed normally with care taken in areas next to the implant surgical area. No rinses should be used for the first 24 hours after surgery. Warm salt water (1/4sp. salt per cup of water) may be used to gently rinse your mouth in the area of the dressing after 24 hours.
Dressing and Sutures
In order to avoid dislodging the surgical dressing:
- Do not chew in the area of the dressing.
- Do not use your toothbrush on the dressing.
- Do not at any time vigorously rinse your mouth.
- Do not chew hard foods, but do eat a well-balanced soft diet.
A surgical dressing protects the area of surgery and reduces discomfort. It is important that the dressing remain in place until your next appointment. If the dressing, or a portion of the dressing, is lost during the first week following surgery, discard the dressing and contact the office. The surgical dressing you have in your mouth will harden in approximately one-half hour. Do not rinse, drink, or eat during this time.
If no dressing is used you may see sutures between your teeth. They must remain intact until your next appointment. It is important to avoid stretching the tissue around the mouth as this may cause loss of the suture. Do not pull or cut the sutures. Normally, sutures are removed 10 to 14 days following your surgery but may be retained for a longer period.
Home Care
If you have had an implant surgery you should eat a soft diet. If you wear a denture, we ask that you leave it out until your sutures are removed, so there is no pressure on the implant site. The day following the surgery, begin rinsing your mouth with salt water (1/4 tsp. salt in one cup warm water), and brushing and flossing your teeth.
Swelling around your cheeks is normal following certain implant-related surgeries. In some cases, bruising of the tissue can occur and will disappear after around 7-10 days. Call our office if the swelling around your jaw increases; you have a fever, continuous bleeding or numbness; or you have pain in your jaw, mouth or sinuses that is unrelieved by your pain medication.
Special Instructions
If you were treated with immediate implant placement and temporization (an implant with a crown attached after surgery), it is critical that a soft food diet is maintained until healing is complete. No direct forces should be applied to the implant crown for three months.