Winnie S. Lee, D.D.S.

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simimplants 

Advanced Procedures


IMPLANTS
A dental implant is an option to replace missing teeth that have been lost due to disease or trauma. In this procedure, a small titanium shaft is surgically implanted into the bone and allowed to remain undisturbed for 4-6 months. The bone grows around it forming a tight connection, which additionally slows or stops the bone loss that occurs when the root of a natural tooth is missing. 4-6 months later after surgery, Dr. Winnie Lee will check the area with an x-ray and make arrangement to uncover the implant(s) with a minor surgical procedure.  Then the prosthetic phase can begin, with impressions that are made and sent to the lab.  The prosthesis is either cemented or screwed into place with a special torque wrench.

The benefits of implanted teeth are known to the literature to have several benefits over removable complete or partial dentures.  First, implanted teeth prevent bone atrophy.  Bone atrophies just like muscles waste away if not used.  Prostheses that  rest only on  gum tissue destroy the supporting gum over time, thereby causing damage to the mouth and bone and supporting gum deteriorates with the use of the prostheses.  Second, implants help one's facial profile on the lower part of their face. People that have worn denturs often have a "sunken in" appearance to their mouth as a result of wearing dentures. Third,  implanted teeth chew and cut food into much smaller pieces like normal teeth.  It has been shown that patients wearing dentures cannot chew food efficiency , so most food is swallowed in large pieces.  Since the stomach doesn't have teeth to chew the food, patients wearing dentures can have stomach disturbances.  The ability to chew food properly can affect one's diet and overall health. 

Implants can also be used as support as part of an implant bridge. This is an alternative to removable partial dentures, and has several advantages. First, removable partial dentures have clasps that hinge on other teeth for support for chewing. This hinging action places a lot of chewing stress to already weakened teeth.  The denture clasps are unsightly and cause food entrapment and disease to the remaining teeth. Second, dental implants prevent bone loss due to atrophy. Third, Dr. Winnie's patients often mention that Implants feel even better than their natural teeth after treatment.  

Dr. Winnie Lee can help plan the dental implant treatment for you with digital cone beam technology.  The 3D cone beam x-ray helps to determine bone width, height and density in the proposed implant treatment area. The above photo shows an actual patient of Dr. Winnie Lee.  It is the simulated implant placement in preparation of surgical placement several implants into the lower jawbone.  The implants must be positioned away from the mandibular nerve on both sides, as delineated in orange. 

The photo below is the same actual patient of Dr. Winnie Lee, with her exising lower denture prosthesis in place.  The patient came to Dr. WInnie with a chief concern of not being able to chew food well.  Nowadays, we can take a 3D Cone Beam x-ray with the patient wearing his or her well-fitting denture.  Then, Dr. Winnie can prepare the supporting implants and stragetically and virtually place the implants so that they are in the confines of the intended location of the prosthesis.


CROWNS
Crowns are full coverage restorations that are used to cover a tooth that is likely to break, or is too broken down to be restored with a filling. They are most commonly done after root canal treatment, or when a large filling wears out. The larger the hole made by a cavity that has to be treated, the more likely a crown will be needed. Even after a filling is put in a large cavity, a tooth is more likely to break. Keep in mind that the jaw muscles are the strongest in the human body. Teeth are subjected to tremendous pressures. Crowns ride over the weakened tooth, providing strength and protecting the tooth against breakage. A broken or cracked tooth is a far more serious matter and much more difficult to treat. Crowns prevent this, as well as making for a nice smile.

Crowns are full coverage restorations that are used to cover a tooth that is likely to break, or is too broken down to be restored with a filling. They are most commonly done after root canal treatment, or when a large filling wears out. The larger the hole made by a cavity that has to be treated, the more likely a crown will be needed. Even after a filling is put in a large cavity, a tooth is more likely to break. Keep in mind that the jaw muscles are the strongest in the human body. Teeth are subjected to tremendous pressures. Crowns ride over the weakened tooth, providing strength and protecting the tooth against breakage. A broken or cracked tooth is a far more serious matter and much more difficult to treat. Crowns prevent this, as well as making for a nice smile.

It takes two appointments to restore a tooth with a crown. In the first any decay is removed from the tooth and it is shaped to accept the crown. Then an impression is made of the tooth for use in fabricating a crown. Between the two visits the crown is made, usually of high-strength porcelain over gold alloy, all ceramic material, or gold. During this time a temporary crown is worn. In the second visit this temporary is removed. Then the permanent crown is adjusted as needed and then cemented in place.

DENTURES 
There are different types of dentures, but they share their common function. They replace teeth that have become loose or been lost due to bone loss.

The entire mouth is examined and a determination is made as to which teeth will have to be removed, and which will remain. The loose teeth are then extracted. Dentures are fitted to go over or around whatever teeth remain in the mouth, depending on the type. There is an adjustment period after dentures are placed in the mouth, and it can take some getting used to. Generally, complete upper dentures are 90% trouble free at first due to the face that the palate can help to secure the denture.  Complete lower dentures are 90% trouble because the lower arch has a tongue pushing the denture prosthesis away from the mouth during speech and eating.  Partial and complete dentures need to be annually re-evaluated by a qualified dentist for stability and retention and often need a yearly "reline" procedure to help fill in the continual atrophy that takes place as the prosthesis is used in the mouth.

ROOT CANAL TREATMENT
Root canal treatment (also referred to as root canal therapy or endodontic therapy) is made necessary when a cavity is allowed, through neglect, to reach all the way to this pulp. (Regular cleanings and checkups prevent and detect problems early) Sometimes deep restorations or trauma to a tooth may cause the nerve to be damaged to the point it needs root canal therapy, also. Once this occurs the pulp becomes infected, and can even extend through the root tip and begin to eat away at the surrounding bone (this is an abscess). By the time the pulp is infected it must be treated, and cannot heal on its own. It can even weaken the entire immune system. This is dangerous, not to mention very painful. Symptoms that the pulp has become infected may include sensitivity to hot/cold or sweets, pain, swelling, pain to biting or pressure, and a bad taste in the mouth. Sometimes, however, no symptoms are apparent and the person is unaware of any problem until a checkup.

A root canal is then performed to clean out the infected tooth pulp, and disinfect the canals of the tooth. The only other treatment would be to extract the tooth. Once the infection is resolved, the canal(s) are filled in to prevent any further infection. Usually a core build-up and crown is recommended for restoring a tooth that has had root canal therapy.

BRIDGES
This is an option for filling the space created by a missing tooth. It is formed to look like the missing tooth, and it takes its place in the mouth. The sides of a bridge use the two surrounding teeth for support, hence the name. A bridge replaces the missing tooth, both functionally and cosmetically. Bridge work is as much an art as it is an exact science. The materials used may be gold alloys, porcelain bonded to metal alloy, or all ceramic material. The choice of material depends on requirements for strength, wear, and/or esthetics.

It is important that a missing tooth be replaced as soon as possible for several reasons. If not treated the teeth surrounding the gap begin to shift inward, creating a whole chain reaction of bad things. Teeth use their neighbors for support, and, with one missing, they start to "fall." As this worsens the bite changes in response to the pressure. This can eventually result in problems with the entire jaw, e.g. TMJ. The surrounding teeth deteriorate and it is just a matter of time before they, too, are lost. Gum disease becomes a serious problem, with the difficulty of treatment increasing as the neglect continues.  Dr. Winnie Lee generally recommends implant treatment to replace teeth, but she can evaluate you and tell you if, and which type of conventional fixed bridge restoration is right for you.

TMJ TREATMENT

TMJ stands for temporal-mandibular joint. Temporal, as in temple area of skull; mandibular as in mandible, or lower jaw; joint as in it's where the head and jaw meet. Problems in this joint may be caused by a misalignment of the teeth, trauma, or excess muscle tension. Aside from the two bones that meet there, cartilage buffers them and five muscles are involved in the area. If something goes wrong a good deal of trouble can result.  Do you feel pain to your jaw joint in the morning?  That is usually a sign that you may be clenching or grinding on your teeth at night, unconsciously.  Clenching or grinding your teeth (bruxing) causes damage to your teeth, gums, jaw joint, fillings and crowns.  A dentist or hygienist can look at your teeth and determine if you have these nocturnal habits.   A nightguard is a non-invasive solution that  can help this protect damage to your teeth and restored teeth and jaw joint.  It is a piece of plastic that your wear at night.  When you wear it for a while, you can see marks on the plastic, indicating that some unconscious nocturnal jaw activity has taken place.

Sometimes, your jaw joint can become sore due to opening the mouth too wide, like when yawning or eating a huge hamburger. So try not to do that! :)

 Problems in this area can cause:

  • Headaches
  • Earaches
  • Trouble/soreness in opening and closing the mouth
  • Clicking or popping of the jaw
  • Pain in the jaw muscles
  • Soreness in the area, sometimes extending to the face

Dental treatments for the condition can include replacing missing teeth, moving teeth, adjusting the bite, filling gaps between teeth, etc. There is no one solution that is right for all cases. Sometimes a plastic mouthpiece is used to prevent clenching or grinding that is contributing to the problem. If untreated and taken to extremes, surgery may be required to repair a badly damaged joint.

1698 S Wolfe Rd Ste 108
Winnie Lee
Sunnyvale, CA 94087
(408) 830-0888