Prosthodontics and Dental Blog | Dr. Twomey, DDS, MS

Dental Exams and Cleanings

February 2, 2020 By Dr. Twomey

Portrait of a beautiful woman at the dentist getting her teeth checked – oral health concepts

Although our office specializes in Prosthodontics, we stress the importance of maintaining and scheduling consistent routine dental exams, x-rays, and cleanings. Similar to your annual physical exam, routine visits will help maintain your oral health and hygiene. At our practice, our hygienist will assist you in creating a personalized hygiene routine at home while also establishing an in-office cleaning schedule tailored to fit your dental needs.

Routine dental cleanings are a great asset for both patient and doctor. We are able to monitor bone loss, periodontal conditions, changes in bite, and observe any concerns for decay. Our hygienist will also note any oral tissue changes, such as bleeding or inflammation, and note any appearances of lumps or sores. Many oral health changes can be an indicator of other changes within the body. A routine exam and dental cleaning are important to schedule so we may follow up with your medical history and bodily health changes.

During routine exams and dental cleanings, dental x-rays are periodically taken to show your bone level, areas between the teeth, and to note any changes in recurrent or new decay. It is important to have x-rays taken to help monitor your dental health even if you are not experiencing any symptoms. With the minimal amount of radiation exposure, the doctor is able to diagnose changes in your oral cavity. Combined with a cleaning and exam, dental x-rays will ensure that we are able to treat our patients efficiently and safely.

The Importance of the Patient’s Medical History and Medication List

December 13, 2019 By Dr. Twomey

Many patients wonder – “why do I need to update my medical history and medication list at my dental office?” Your physical health, including current and past, are closely tied to your dental history. There are many scientific correlations between your oral health and your medical health, especially as we age.

Certain medications greatly affect your oral health by causing side effects quite noticeable to the patient such as dry mouth, bleeding gums, or bad breath. For example, blood thinners may cause more bleeding in your gums when you floss and brush at home or during your routine dental cleaning. By providing a medication list with specific names, we are able to recommend specific products or techniques that will help you combat these symptoms at home.

Your clinician can also determine how dental procedures may affect you based on your medical history and medication list. For example – certain medications, for pre-existing or current conditions, can interact differently with local anesthetics used in dental procedures. This also explains why your dental provider will monitor your blood pressure before an appointment begins.

By updating your medical history and medication list periodically, we are able provide you with a comfortable dental experience and treat you safely.

Restoration: Decay and Recurrent Decay

August 16, 2019 By Dr. Twomey

Dental fillings or restorations are one of the most common dental procedures performed. Children and adults are susceptible to cavities and unfortunately, it is not something that lessens with age. Despite the commonality of dental cavities, it can still be unpleasant news to hear as a patient. Several questions we are often asked: how can I have two cavities on the same tooth, what about crowns, how can I have fillings at my age, and how long do they last?

Multiple fillings on the same tooth

Each tooth has two sides of contact and each tooth, typically, has five surface areas. If there is decay on both sides of the tooth or at the two different contact points, the tooth would need two separate restorations. In this scenario, two restorations would help to preserve the strength and integrity of the tooth. For dental fillings, we try to remove as little tooth structure as possible while removing the decay and adding composite (tooth colored) or amalgam (silver) filling. One year, you may need a filling on one surface of the tooth and much later, a different surface may need to be treated.

Decay and Crowns

Larger amounts of decay often require larger fillings. The larger the filling – the more tooth structure is required to be removed. It is often then recommended to have a crown placed rather than a filling. A crown will protect the strength of the tooth when a filling will not suffice. While we hope a crown will last a number of years, decay can occur underneath a crown. Decay, under a crown, is almost impossible to see and access unless the crown is removed. We can make an attempt to fill a cavity at the crown; however, it is often necessary to completely remove the crown if decay is suspected. Unfortunately, we are unable to remove the crown without destroying it.

Decay and age

As we age, we often require more medications to treat a multitude of conditions which becomes a contributing factor in increased tooth decay. While we are making great advancements in medicine, an unfortunate side effect is often dry mouth which means your mouth is not producing enough saliva. Saliva is your natural defense against decay. It also balances your mouth’s pH and washes away plaque and bacteria that may accumulate in the mouth. However, there are many internal and external factors that can contribute to decay as we age which will ultimately affect our ability to floss and brush.

Recurring decay

While we hope a restoration will last many years, we cannot say specifically how long restoration will last. Often times, a person can have recurring decay, and they may need a replacement filling. In time, fillings can break down. We refer to this as “leaking” which will happen before you have a toothache. This evidence is visible and shows around the filling itself, which often starts at the very edge of the filling. This is why it is extremely important to have the necessary x-rays, dental cleanings, and exams. The hygienist and the doctor will often see it before you feel it.

Even though our specialty is prosthodontics, we also provide patients with routine dental care. We would love to help you set up your next hygiene appointment. Please call our office at 952-920-5300.

Traditional Dentures vs. Implant Supported Dentures

June 13, 2019 By Dr. Twomey

Traditional dentures are worn by millions across the world. It is a great option for those who have lost all their teeth or no longer have any healthy teeth left. Even though we take many steps to ensure a proper fit, traditional dentures have their limitations. Due to gravity and the nature of the device, dentures can become loose while chewing or talking. Dentures have limited functionality, which can affect your food choices and create awkward social situations. However, with the use of implant supported dentures using implant technology; we are able to create implant overdentures and fixed implant dentures. It is a terrific solution to many of the common issues with traditional dentures.

An implant overdenture can be created for both top and bottom arches of the mouth. It is a removable denture like the traditional denture; however, with the aid of implants, it snaps in to place to assist in retention and stability. The implant snaps act as a securing device to help increase comfort, create a better fit, allow for more chewing efficiency, and increase confidence in your smile. The implant overdenture is still easily removable at home for sleeping and cleaning.

Implant Supported Dentures

An implant supported denture can be created for both top and bottom arches of the mouth. It is a removable denture like the traditional denture; however, with the aid of implants, it snaps in to place. This greatly improves the retention and stability of the denture. The implant snaps act as a securing device to help increase comfort, create a better fit, allow for more chewing efficiency, and increase confidence in your smile.

The implant supported denture is still easily removable at home for sleeping and cleaning. It is a convenient and easily manageable option.

Fixed Implant Dentures

Lastly, there is also a more permanent implant denture solution. A fixed implant denture utilizes 4 to 6 implants to secure the denture in place, and it can be created for both top and bottom arches of the mouth. It is held in place by implant screws and can only be removed in a dental office for cleaning and maintenance. A fixed implant denture is the most similar to having your natural teeth and the most fitted denture option.

The implant denture process can seem daunting, but is worth the long-term investment. Please contact our office to assist you in creating your new patient appointment. We take pride in helping you understand the process and creating your best smile.

Lastly, there is also a more permanent implant denture solution. A fixed-detachable denture utilizes 4 to 6 implants to secure the denture in place, and it can be created for both top and bottom arches of the mouth. It is held in place by implant screws and can only be removed in a dental office for cleaning and maintenance. A fixed detachable denture is the most similar to having your natural teeth.

The implant denture process can seem daunting but is worth the long-term investment. Please contact our office to assist you in creating your new patient appointment. We take pride in helping you understand the process and creating your best smile.

6 reasons why dental implants in Minneapolis are a good option

March 4, 2019 By Dr. Twomey

Not happy with the shape, look, or color of your teeth? Missing teeth? If you are considering dental implants in Minneapolis, Dr. Twomey is an excellent choice.

In this blog post, we are going to discuss 6 reasons you should consider us as a top choice for dental implants in Minneapolis and Edina, MN.

1. Close to Downtown Minneapolis

We’re located just 15 minutes from the heart of Minneapolis. You can get to our office in Edina, MN quickly by car. We have plenty of parking and generally very little traffic.

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2. Durable design

Dental implants are one of the most durable options available for tooth reparation and restoration. They are not designed to come out like dentures are, so there is no risk of them ever slipping.

Dental implants can last 25-40 years. The other options for dental restoration last a much shorter span of time.

3. Affordable price tag over time

Dental implants have the highest upfront cost of the dental restoration options. When you factor in the length of time they last, though, and break it down over a longer span of time, they are actually the cheapest.

By the time you ever need a dental implant to be replaced, you would have had to change a bridge several times. The teeth that support the bridge could also need dental work due to their support of the problem-tooth.

4. High success rate

The five-year success rate with dental implants is about 95% for the lower jaw and 90% for the upper jaw. If you follow all instructions you receive to go along with your implants to improve their lifespan, your changes are even higher.

Dr. Twomey is a prosthodontist who specializes in all types of cosmetic dentistry and specializes in creating and shaping the crown or tooth replacement above the gum, which sits on top of the implant as well as many other cosmetic dental procedures and products.

5. Adaptable design

Any tooth of any size can be replaced with a custom fitted and shaped dental implant. There are no challenges for teeth that are closer together like you would find with bridges. After an oral surgeon places the implant in your gum, you come back to us and we simply custom fit the crown or tooth replacement to be exactly the size and shape of (the healthy version of) the tooth being replaced.

6. Independent from other teeth

A dental implant is not connected to anything. It is one post placed directly into the jaw by an oral surgeon. Once we determine a dental implant is the best course of action for your specific tooth restoration need, we will refer you to one of the highly trained oral surgeons that we work closely with in order to place the actual post in your gums.

Once the post has been implanted and some time has past to fully heal, you come back for the placement of your crown that acts and appears just like a normal tooth. Other options, like bridges, rely on other teeth as a support. This can cause the need for additional work over time when the teeth being used as supports start to become unhealthy.

Schedule a new patient exam to see if Dental Implants are the right choice to improve your smile.

What is the difference between a Prosthodontist and a General Dentist?

December 20, 2018 By Dr. Twomey

A Prosthodontist is a dental specialist able to diagnose, plan treatments, rehabilitate, and maintain oral functionality, comfort, cosmetic appearance, and health of the teeth in patients who experience missing or deficient teeth health and other oral issues.

How is a prosthodonsits different from any other dentist or dental specialist?

A prosthodontist is an official expert when it comes to replacing the teeth. This can happen for one tooth, many, or all of the teeth and gums. This kind of specialist is needed for cosmetic as well as health reasons. When you are looking to improve the way your teeth look, you should consider talking to one.

Many people have coined prosthodontics “cosmetic dentistry,” for this reason.

Prosthodontists differ from dentists with functionality training to restore and replace the teeth.

Why choose a prosthodontist?

You would choose a prosthodontist for their advanced education and specializations that included additional training and expertise with advanced technology and equipment meant specifically for restoring the appearance of the teeth. Every prosthodontist is trained in techniques and procedures that general dentists typically are not. Procedures are meant to treat complex conditions affecting the teeth and restoring their health while keeping aesthetics in mind.

Prosthodontists have a deep understanding of what makes a smile look healthy and how you can better preserve a healthy mouth and smile.

Additional Education for Prosthodontists

Once you earn a bachelors degree in science, you are required to complete dental school as well as a 3-year residency program focused in prosthodontics.

Once you obtain your certification, you’re required to stay up to date on news and developments in the field. There is a required re-certification once every 8 years.

If you are concerned with a mouth condition that is affecting the appearance of your teeth or gums, get in touch with Dr. Twomey today. A quick consultation is all you need to understand the possibilities you have for seeing a better smile and loving the way you look.

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The beginner’s guide to Veneers. Everything you need to know before your first consultation.

November 19, 2018 By Dr. Twomey

Dental veneers are thin shells of tooth-colored material that covers the front surface of your teeth. They are usually made of porcelain but can be made of some other materials as well. Veneers are desired both for cosmetic reasons and after injuries that alter the appearance of the teeth in an undesirable way.

The following is a guide to the veneer procedure as well as some information about who are good candidates for this procedure. Veneers are one of the most commonly desired products in cosmetic dentistry & prosthodontics.

What is the veneer procedure?

Typically, the entire process requires three visits. First is your consultation followed by two visits to make and apply the veneers. Veneers can be applied to one tooth or many in one session. There are no limitations.

To give you an overview of the process, here is a quick list:

Examination – your teeth are examined. This is where you will talk to Dr. Twomey about your desires and expectations for your teeth. You will talk about color shade and shape. You should take an active role in this process. It is important to determine exactly what you are looking for, as veneers are a permanent modification to the tooth.
Tooth Preparation – Some of the enamel may need to be removed from the tooth. Some added thickness with the veneer needs to be accommodated for in order to ensure you do not notice any difference smiling, chewing, etc. We want for the veneer to be a completely natural extension in the image of the original tooth, assuming that isn’t what we are fixing.
Impressions – Impressions are made of the teeth to produce an exact replica. Impressions are used when creating models. Porcelain veneers are shaped around these models.
Fitting – Dr. Twomey and his team will evaluate the fit of the veneer that has been crafted. At this time, you can check things like the shape, color, fit, and feel of the veneer to make sure you are happy with it. You should have all of your expectations met or explained before the final bonding of the veneer. Once bonded, it is best not to have to adjust them.
Cleaning – Once your veneers are approved by you and they meet Dr. Twomey’s standard, your teeth will be cleaned in preparation for the bonding process (explained below). Cleaning solution consists of a mildly acidic solution.

The bonding process

Veneers are temporarily bonded to the tooth before they are permanently cemented. This is when fit and color are examined to make sure they are perfect. Dr. Twomey will remove and trim down the veneer as needed. The color or shade can be tweaked by using different types of cement.

From there, the tooth will be polished and etched. The etching makes the front of the tooth a little bit rough to allow for a strong bonding process. Cement is placed on the tooth and the veneer is positioned.

Dr. Twomey will apply a special beam of light to the veneer. Chemicals activate in the cement, causing it to harden quickly and permanently.

Sometimes, a follow-up visit may be required so Dr. Twomey can take a look at the gums to see how they are responding to the new veneer.

Life with new veneers

You’ll notice quickly that living with veneers is not much of a hassle at all. Brushing and flossing are exactly the same. There are, however, a few things to keep in mind for taking care of a new (or existing) set of veneers. Here are some of the things that can affect their lifespan:

Advantages

Veneers offer these advantages:

They look just like your natural teeth. Shading, as well as texture, are matched to your underlying and other teeth.
The gums are very tolerant of porcelain.
Porcelain is a stain resistant material. They will last a long time without any need for re-coloring or cleaning.
If your teeth were discolored before or darker than they should be, veneers can correct the coloration and bring a better coloring to your smile.
When compared to crowns, veneers offer an easier approach to changing the tooth’s shape and color. They don’t require the extensive work shaping and coloring that crowns do, yet they offer a stronger alternative.

Risk factors

Cavities

You can still experience tooth decay under a veneer. The natural tooth tissue is still under there and susceptible to the same issues it was before. If you do experience a cavity, the veneer needs to be removed. It will be replaced again once Dr. Twomey is able to ensure the tooth is once again healthy.

Injuries

Physical damage that is dangerous to your natural tooth is even more so when wearing porcelain veneers. Accidents, falls, and hits directly to the teeth can result in veneers being chipped or cracked. They will usually need to be replaced.

Teeth grinding

The habitual grinding or gnashing of one’s teeth is known as bruxism. It happens most while you are asleep if you have this issue. This behavior can wear away at your natural teeth as well as a veneer over time.

Discoloration

Porcelain is used for veneers partially because it is highly stain resistant, just like a natural tooth. However, it is still possible to discolor a veneer over time. Things like smoking, drinking coffee, and lodged food particles can cause discoloration over time. Proper hygiene is just as important with veneers as it is without.

Upkeep

Getting veneers polished

A prosthodontist, like Dr. Twomey, can help preserve the life of your veneers with a simple polish. You can perform this as frequently as every 3 months, but will not need to unless you want to.

You can damage your porcelain veneers over time with bad habits like nail biting or chewing on things you shouldn’t be chewing on (pen caps, water bottle caps, etc.).

Hygiene

Maintaining proper hygiene is especially important in extending the lifespan of your porcelain veneer or veneers. The decay of the tooth may cause them to loosen or need to be replaced. Patients wearing veneers need to be conscious and keep their teeth as clean and healthy as possible. Over time, when cement begins to lose some of its attachment, small crevices can from behind the veneer, allowing food and other objects to be lodged inside. A visit to our office is sometimes required in these instances.

The bottom line here is that you need to be just as conscious of your hygiene and tooth health with veneers as you are with your natural teeth. Brushing and flossing are always essential.

Good candidates for dental veneers

Veneers are not the right solution for every tooth or every patient. Dr. Twomey will work with you to determine if you are a good fit. Veneering the teeth is not something that can be reversed. Some of the tooth structure needs to be removed in order to achieve the proper result and consistency for bonding. Only examination by Dr. Twomey will determine whether this is the right approach for getting the change you want in your teeth.

Some issues that may make veneers NOT your best option include:

Unhealthy teeth
Weak teeth
Teeth lacking proper amounts of enamel
People who habitually grind or gnash their teeth (Bruxism)
Severely misaligned teeth

Summary

You should now be prepared to have a discussion with Dr. Twomey at your consultation for veneers. Of course, if you have any other questions or wish to schedule a consultation for veneers at our office in Edina, get in touch with us. We would be happy to help.

Until next time,

Same Day Dentures vs. Traditional Dentures

August 29, 2018 By Dr. Twomey

Making a set of dentures is akin to rebuilding someone’s complete dentition. Decisions are made on where to arrange teeth so they look good and function well. They also need to fit comfortably. This requires skill, knowledge, and time.

Well-made dentures are customized to the person for whom they are made. Unlike buying a pair of shoes, one cannot simply go to the dentist and ask for a “size 9 denture.” This is a designer product in the truest sense.

This post will present the types of dentures, their differences, and the characteristic of the quality dentures that we create for our patients.

What are “dentures in a day”

The terms “same day dentures” or “dentures in a day” describe a set of dentures that patients are fitted for quickly and can wear home the same or the following day.

The advantage to this is the short turnaround time and lower cost. The downside is that critical steps are skipped resulting in dentures that don’t fit as well and or look as nice as a customized set.

What are immediate dentures

Immediate dentures are a set of false or replacement teeth that are made to be worn the same day that teeth are removed. They are not a definitive solution. Once teeth are extracted the shape of the bones and gums change and the fit of these immediate dentures diminishes. After the bone and tissues heal these dentures are meant to be replaced using the traditional approach.

What is the traditional dentures approach

The traditional approach takes multiple visits and steps to create the final product. There are a series of measurements, concepts, fittings, and prototypes involved before the final denture is created. This is the preferred method as it yields the best result. The denture will be of the highest quality in looks, fit, and function.

Why we recommend traditional dentures

At our office, a set of complete dentures requires a minimum of five appointments. During these visits, impressions are made to ensure the best fit possible. Measurements are made of the face and mouth to aid in selecting the correct tooth size and form. A full try-in of the setup is done to ensure that things are acceptable to the patient prior to fabrication of the dentures.

To make a set of dentures in one day requires several shortcuts and compromises that we are simply not willing to make. We offer a premium product and will not settle for anything less

Meet prosthodontist Dr. Jonathan O. Twomey

August 12, 2014 By Dr. Twomey

Dr. Jonathan O. Twomey brings a wealth of advanced dental care and a premier education to solving your dental issues, creating a memorable smile, and ensuring the vitality of your teeth.
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