What composite material do you use to cement in your porcelain veneers?

I have use many different composite luting composites to bond my veneers. Currently I am using Mojo by Generic Pentron. I find it easy to use since it has a relatively low viscosity that makes it easier to seat my veneers.

In my mind a relatively low viscosity for my luting cement is important, because sometimes when using a high viscosity luting cement it can be difficult to tell when my all porcelain bonded restoration is fully seated.

Fully seating veneers is highly desirable, since it makes for a smaller amount of exposed bonding material at the margins of restorations. Exposed luting composite can over time erode and pick up unsightly stains.

Why does your office recommend 'pre-appointing' recall appointments?

We recommend making your next recall appointment before you leave our office after completing your cleaning because in our experience this is the best way to insure that your next recare appointment occurs at the correct interval. All too often our patients ignore this suggestion and ask that we call to remind them when it is time.

We are happy to provide this courteously, but it tends to help delay recare appointments. When our reminder call is placed, all to often my secretary is told that a patient is too busy to schedule now or that their teeth feel fine and that she should call again in a month or so. Instead of helping a patient, the reminder call can sometimes become an aid in procrastinating scheduling a recall appointment. Also patients who wait until their recall is due may have trouble finding a time that they like.

Sometimes,after several reminder calls an appointment is made, but it is scheduled well after their due date. When a patient chooses to pre-appoint, the onus is on them to reschedule, when they receive their reminder call or post card. Hopefully, even if they need to reschedule, it will be sooner than later.

What is the little bump with a hole in it on the inside of my cheek?

Usually when someone asks this question they are referring to Stensen's duct. This bump, located on the inner cheek adjacent to the maxillary first and second molars, is the opening of the duct leading from the parotid salivary gland. It can be seen bilaterally (on both cheeks) and has a little hole in it that the saliva from the parotid gland can emerge from. It is completely 'normal' and usually doesn't indicate any pathology.

Occasionally the duct can get plugged with a salivary stone or localized trauma and can become painful. When this occurs the cheek can be sometimes seen to swell when a patient is eating, since chewing stimulates salivary flow from the Parotid. If the duct does become plugged it may be necessary to visit your dentist or an Oral Surgeon. Most Oral Surgeons know how deal with a blocked Stensen's duct. It may be necessary for them to cannulate it ( they can use a small needle like cannula to re-open the duct) or sometimes prescribe an antibiotic if they suspect an infection.

What can I do if my teeth look too short?

The obvious answer is to make them longer, but how to best accomplish this can get complicated. First a dentist should determine the optimal edge position of the maxillary central teeth. Usually this can be done by having a patient going through a series of lip poses; Lip at rest, lip smiling, and possibly making the sound"eeeeeee". Mock up composite can be added to the edges of the maxillary incisors in order to try out how the incisor edge would look with a slight addition. Photos can be taken of the patient in the various lip poses.

Once the optimum pleasing position of the central incisors is envisioned then the hard part takes place. usually a set of study impressions and a full set of radiographs are taken. Studying these helps a dentist to determine exactly what should be done to achieve the changes needed to the lengthen teeth. Usually most central Incisors should be about 10 mm long but how to create the additional length that is needed? Treatments needed may involve possible orthodontic treatments (including either teeth extrusion or teeth intrusion}, crown lengthening, opening the bite, porcelain veneers, crowns or simple bonding. Often a combination of these treatments may be needed.

Often, when a patient comes to my office with this or another esthetic problem it can take several visits to determine a proposal for their treatment plan. Commonly, specialists need to be consulted in order to come up with the best treatment plan.

I belong to a study club in which a group of experienced dentists get together every month or so and go over case presentations. Among our members, we have an Orthodontist, Periodontist, Oral Surgeon, a Prosthodontist and four or five general dentists. It is often surprising how many ways we can come up to restore the patient's mouths that are being presented. Most often a number of options have to be explored and the pros and cons of each need to be reviewed before we can come to a consensus for a optimal treatment plan.

When are you taking your vacation this year?

Although we are pretty busy at our office in general, things do tend to slow down in during the summer months, especially August. In July and the first three weeks of August we will be maintaining our normal office schedule. We will be open Mon-Thursday 9-6 PM and will be working some Fridays if they are needed.

We are taking vacation from august 20th-Sept 4th. The office will be open again on Tuesday, September 5th. I personally plan on taking some needed R&R with my son in Cape Cod. Swimming, Fishing, and Sailing will hopefully be on our agenda.