Supernumerary teeth chart

An average adult’s permanent teeth are numbered 1-32, with eight incisors, four canines, eight premolars, and 12 molars. Supernumerary teeth are additional teeth beyond the normal dental formula. This is also known as hypodontia—a condition of having supernumerary teeth in the permanent dentition. They are much less likely to be found in primary dentition because they develop late and usually erupt with the primary teeth. 

Hyperdontia is commonly seen and associated with certain congenital genetic disorders, such as cleidocranial dysplasia, Gardner’s syndrome, trichorhinophalangeal syndrome, Ehlers-Danlos syndrome, Ellis-Van Creveld syndrome, Anderson-Fabry disease, and cleft lip and palate. 

The prevalence of these conditions varies widely across populations, studies, and methodologies. In the context of gender, studies suggest a higher prevalence of supernumerary teeth in males compared to females, with an occurrence of  0.3–0.8 % in the primary dentition and 0.1–3.8% in the permanent dentition.

A study of school-aged kids provides a prevalence report of 1–3% in permanent dentition and 0.3–0.6% in primary detention among children between the ages of 6 and 15 years. 

This study from the International Journal of Oral Science says it could vary from region to region between 0.2% and 5.3% and also occurs sporadically or be inherited, with evidence suggesting an individual may have a higher likelihood of having a family history of supernumerary teeth or other dental anomalies.

What are the 4 types of supernumerary teeth, where are they found and what characteristics do they have?

Supernumerary teeth are classified according to morphology and location. In the primary dentition, morphology is usually normal or conical, while the permanent dentition has different morphological types, which are:

Conical

The conical supernumerary is peg-shaped and the most common in permanent dentition. It is usually present between the maxillary central incisors as mesiodens and occasionally found high and inverted into the palate, horizontal position. The conical supernumerary rarely delays eruption and can result in rotation or displacement of the permanent incisor.

Tuberculate 

The tuberculate type of supernumeraries is barrel-shaped (and may be invaginated), larger than the conical type, and are mostly located on the central incisors’ palatal aspect. They rarely erupt into the oral cavity and are frequently associated with delayed eruption of the incisors.

Supplemental

The supplemental supernumerary is shaped like a typical tooth and is found at the end of a tooth series. They are found in addition to the normal set of teeth and look exactly like the permanent teeth (the shape and the anatomical features are the same). There may be variations in size, shape, and structure, and may or may not be fully developed. The most common type is the maxillary lateral incisor, but supplemental premolars and molars also occur. Most supernumeraries found in the primary dentition are of the supplemental type and seldom remain impacted.

Odontoma

The odontoma (also odontome) is a harmless, noncancerous tumor composed of various dental tissues. The two separate types of odontomas are:

• The complex composite odontoma. They are the diffused and disorganized dental tissue masses. They occur in various locations within the jaws and are typically considered developmental anomalies rather than true supernumerary teeth. 

• The compound composite odontoma consists of multiple miniature tooth-like structures, such as enamel, dentin, pulp, and cementum, arranged in an organized pattern and are often found in the anterior maxilla. 

Charting supernumerary primary teeth

The primary dentition consists of 20 total teeth. Usually, dentists divide the whole dentition into four quadrants or sections: two on the maxillary sections (upper right and upper left sections) named first and second quadrants, respectively. The mandibular has the third and fourth quadrants. Each quadrant contains 5 teeth.

In the  Universal/National Tooth Designation System, letters A to T denote the primary teeth, starting with the upper right second molar (A) and proceeding around the arch. In essence, naming starts with the letter A, beginning from the upper right all the way across to the upper left, T. Coming down to the lower left and the lower right, naming also follows a  similar pattern, starting from the letter K to T. However, naming is in reverse alphabetical order around K, designated to the lower second left molar. 

To identify supernumerary teeth in the primary dentition, the letter S is placed adjacent to the letter identifying the primary tooth. For example, supernumerary AS is adjacent to A; supernumerary TS is adjacent to T. This pattern is consistent with other denoted teeth.

Charting supernumerary permanent teeth

In the Universal/National Tooth Designation System for permanent dentition, numbers are also assigned sequentially. Each tooth is sequentially numbered from 1 to 32: 1-16 from the upper right third molar tooth to the left third molar tooth. The lower left third molar is numbered 17 and continues sequentially to the lower right molar tooth, numbered 32. 

Supernumerary teeth in the permanent teeth are identified by the numbers 51 through 82, starting from the upper right third molar, following around the upper arch, and continuing on the lower arch to the area of the lower right third molar. For example, supernumerary 51 is adjacent to the upper right molar 1; supernumerary 82 is adjacent to the lower right third molar 32; supernumerary 61 is between the upper left second molar and first molar; supernumerary 31 is distal to the lower right first molar.

How to code supernumerary teeth on a dental insurance claim

The American Dental Association (ADA) uses a standardized coding system, the Current Dental Terminology (CDT) code.

It’s one thing to know how to chart the supernumerary teeth numbers, and it’s another to code the supernumerary teeth. It is also worth noting that there are no separate CDT codes specifically for supernumerary teeth.  For example, when coding a supernumerary tooth extraction, you may use the following CDT codes: D7140 and D7210. All you need to do is first identify the supernumerary tooth number, then use the appropriate CDT code for the type of extraction. 

Keep in mind the need to have very clear and specific clinical notes with supporting evidence when submitting a dental claim for supernumerary teeth, regardless of the CDT code. Other examples of CDT codes are D0120 for periodic oral evaluation, D1110  for prophylaxis (cleaning), D2140 for amalgam, etc.

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Scanners have enabled dentists to instantly diagnose during examinations and treatment planning sessions. While the 3D models they create do wonders for restorative visualization, wellness scans are an incredible diagnostic tool and some scanners are offering caries detection.

What is caries detection?

Caries (dental cavities) are areas of damage to the teeth’s structure caused by acids produced by bacteria in the mouth. When you eat certain foods, the bacteria on your teeth break them down and produce acids. They (the bacteria) digest the sugars left over from food in the mouth, converting them into acids as a waste product. 

These caries can be detected using several diagnostic tools and techniques. The teeth are observed to note changes or deficiencies in the enamel, dentine, and cementum to detect any signs of demineralization or damage caused by caries.

How was caries detection traditionally done?

Initially, dentists visually examined the teeth’s surface using dental mirrors and bright lighting. They looked for visual changes in the dental structure and any signs of tooth decay, such as discoloration, white spots, brown or black spots, increased opacity and roughness of the enamel, or visible holes (cavities).

Currently, tactile examination, where dental probes are used to gently feel the surfaces of the teeth to assess the texture of the enamel and look for soft, sticky areas, is used by dentists to detect caries. 

There are several other methods in play used to detect caries:

• Laser fluorescence and near-infrared detection
• Dyes
• Radiographic imaging
• The tooth separation method is used to examine any suspicious area on the approximal surface. 

By combining these different methods, dentists could effectively—though painstakingly—detect caries and assess their severity, creating optimal room for appropriate treatment and preventive measures.

How intraoral scanners  now use caries detection 

Through high-resolution imaging, intraoral scanners capture detailed images of dental structures. They can be used to visualize enamel surfaces and potential carious lesions, including early signs of caries, producing clear and precise images that enable dentists to visualize even minor changes in tooth structure.

Some intraoral scanners have software algorithms capable of mapping tooth surfaces and detecting abnormalities. By analyzing the scanned images, they can identify areas of demineralization or enamel degradation indicative of carious lesions.

What intraoral scanners have caries detection

Today, there are a few intraoral scanners with dedicated caries detection capabilities. We have the:

3Shape TRIOS 4 and 5

 3Shape TRIOS 4 and 5 intraoral scanners have built-in fluorescent technology that aids in the identification of possible caries. Using these scanners, dentists can detect surface caries in real-time without needing an additional scanning device. 

They also make patient monitoring easier, as dentists can compare scans over time to access preventive insights, which is important for optimal patient comfort. Get a free 3Shape TRIOS when you work with Dandy.

 iTero 

Some iTero scanners use Near Infrared Imaging (NIRI), a technology that employs near-infrared light in dentistry to detect caries. With one scan, multiple layers of data can be viewed: a 3D model and 2D color images mapped to the 3D model.

You can review the corresponding color and NIRI images to gather a comprehensive view of the situation while building a complete model of the teeth.  

Planmeca

Planmeca intraoral scanners can be used during dental examination procedures to spot cracks and fractures in the patient’s teeth. They are light and ergonomic, with a dual button that lets dentists operate hand-free or control at their fingertips. The scanning tip uses transillumination technology for caries detection.

Advantages of intraoral scanner offering caries detection

Intraoral scanners with caries detection create a streamlined workflow for dentists, and a more accurate and personalized treatment plan, improving patient outcomes and satisfaction. 

Dentists interested in adopting intraoral scanners with caries detection capabilities may consider the need for one of the above mentioned scanners and weigh its price and benefits against the learning curve and ease of your current caries detection techniques.

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Dental burs are useful tools in preparing for most dental procedures, such as removing dental caries, old dental restorations, excess dental materials during restoration, etc. They are small attachments used with a dental handpiece for cutting, shaping, or removing dental hard tissues—tooth or bone. 

Burs date back to ancient civilizations when dental materials were made of bone or animal teeth. Early metal instruments, like bronze and iron, were often used for teeth extraction and other basic dental procedures. This laid the foundation for the development of metal burs. 

Backed by technological progress and the need for precision, materials that exhibited exceptional hardness and durability came to light in the mid-20th century. The materials were made of tungsten carbide, and they significantly enhanced the efficiency and effectiveness of most procedures. Subsequently, other innovations emerged, further enhancing cutting efficiency. Today, burs are fashioned in purposeful shapes and from the varied materials necessary to meet the specific needs of tooth preparation, restoration (direct or indirect), and oral surgery.

Burs are a key tool in dentists shaping and adapting restorative material directly into the patient’s mouth. These restorations are typically done to repair minor to moderate tooth damage, such as cavities or small fractures. During this method of restoration, dental burs are used to:  

• Remove decayed or damaged tooth structures while preparing cavities for direct restorative materials, such as dental amalgam or composite resin. They shape and contour the tooth to ensure proper retention and adaptation of direct materials.
• Prepare tooth surfaces for applying pit and fissure sealants, which are thin, protective coatings applied to the chewing surfaces of molars and premolars to prevent the accumulation of plaque and bacteria in the deep grooves. This provides a protective barrier against decay. 
• Prepare and shape tooth surfaces for dental bonding, such as zirconia crowns, to facilitate the adhesion and application of the bonding material.
• Prepare the tooth for repair or replacement by removing or modifying defective or damaged direct restorations.

Conversely, indirect restorations are carried outside the patient’s mouth— typically in a dental laboratory—and bonded to the tooth during subsequent appointments. The process involves taking impressions or digital scans of the prepared tooth, which are used to create a custom-fitted restoration. Dental burs for this restoration method are mostly used to:

• Shape the teeth in preparation to receive crowns or bridges. They help reduce the tooth’s structure and, in turn, create space for indirect restoration.
• Prepare cavities for the placement of inlays and onlays, which are custom-made to fit into a prepared tooth cavity (inlay) or cover a portion of the tooth’s surface (onlay) to restore its function and appearance.
• Prepare the teeth for veneers, which are thin shells of material (usually porcelain) bonded to the front surfaces of teeth for cosmetic purposes.
• Access and shape the root canals during the preparation of teeth for root canal therapy.
• Prepare the bone and surrounding tissues for the placement of dental implants.
• Adjust the gum tissue and bone level, exposing more of the tooth structure for proper restoration.
• Removal of temporary crowns or bridges to facilitate the placement of permanent restorations.

It’s up to the dentist to choose which bur to use for their procedures. Make sure you’re making the best decision for your next case.

The 5 major bur head shapes

There are various types of bur head shapes in dentistry the most-ubiquitous being: round, pear, cross-cut tapered fissure, cylinder, and inverted cone. Each shape determines the efficiency and precision of several dental procedures and influences dental tissue cutting, shaping, and removal. Which shape is best for which use?

Round

Round heads are used for cavity preparation, creating access points for endodontic treatment, cleaning the tooth structure from caries, and selective grinding. Round heads are also used for bone surgery.

Pear 

Pear-shaped heads are used for cavity preparation, access points, and splitting roots of small teeth. They are also known as 330 burs due to their ISO (International Organization for Standardization) code, a standardized classification system indicating specific dimensions and characteristics for these dental cutting tools. They can also be used for removing caries, as well as trimming and finishing.

Cross-cut tapered fissure

Cross-cut tapered heads come in both short and long shanks, making them suitable for many cavity preparations. They are ideal for various actions during crown removal and are used for sectioning multi-rooted teeth and reducing crown height. They have a low tendency to create undesired tissue residue.

Cylinder

Cylinder-shaped heads usually have a flat or slightly rounded end, especially used for initial tooth preparation and creating straight-line access in dental procedures. They are designed to make the task of crown and bridge preparation simpler and more efficient.

Inverted cone

Inverted cone heads usually come in a variety of lengths and grits and are used in dental surgery to create undercuts for restorations or root canals. They can also be used for the removal of caries.

Dental burs: material vs shape

The material and shape of dental burs are critical factors dentists consider when selecting the appropriate tool for a specific dental procedure. Different materials, such as carbides or diamonds, offer different hardness and wear resistance, influencing the bur’s durability and cutting capabilities. At the same time, the shapes provide specific cutting profiles and angles, allowing you to tailor their use for tasks precisely, especially tooth preparation, restoration, or contouring. 

The materials and shape selection of dental burs are intuitive in determining their cutting precision and suitability for various dental procedures. For instance, harder materials like carbide are often used for shaping teeth, while bur shapes (for example, round, pear, and cross-cut tapered) allow for specific applications such as cavity preparation, contouring, or finishing. This promotes efficiency and optimal performance. The combination of both materials and shapes permits versatility and accommodates the specific needs of each treatment.

Carbide burs

Carbide burs are made from a compound of tungsten and carbon, known as tungsten carbide. This is why they are known for their hardness, rigidity, and durability. 

They are used for many procedures, including cavity preparation, dental decay removal, teeth preparation for restorations, and shaping and contouring dental materials. Due to their precise cutting capabilities, they are often employed in implant overdenture procedures to shape the surrounding bone efficiently, ensuring a perfect fit and stability.

They can generate heat during use, which may be a concern in procedures where excessive heat can damage the tooth pulp. Prolonged use of carbide burs may also cause vibration, making patients uncomfortable. 

Diamond burs

Diamond-coated burs are coated with industrial-grade diamonds. They are exceptionally hard and suitable for cutting through hard substances like enamel and dentin. They are often used in procedures requiring precision, such as zirconia crown preparation and veneer installation. Due to their high precision, they are suitable for fine detailing, shaping, and contouring.  

Like carbide burs, they tend to generate heat during use, and caution should be taken to avoid overheating the tooth. They are more expensive compared to other materials, making them less desirable for routine procedures. They are not very sustainable, as the diamonds on the bur can wear down over time, affecting their cutting efficiency, and they may need more frequent replacement.

Steel burs

Steel burs are typically made from stainless steel, a corrosion-resistant alloy of iron, chromium, and nickel. They are often used for trimming and finishing dental restorations, polishing dental materials and surfaces, and sometimes initial tooth reduction. Please do keep in mind that carbide burs are more commonly employed for this purpose. 

Compared to other materials, steel burs may have lower durability, making them less suitable for extensive tooth reduction. They may not cut as efficiently as carbide burs, especially in harder materials. 

Ceramic burs

Ceramic burs are made from zirconia, aluminum oxide, or similar ceramic materials, known for their hardness, durability, and resistance to wear. They are excellent for finishing and polishing dental restorations due to their fine, abrasive nature. They can be used for some soft tissue procedures because they offer precision and cause minimal trauma, making them great for dental surgery. 

They do not heat up as easily as most other dental burs because of ceramic’s low heat conduction properties. Therefore, they are most suitable for use when cutting bone in a dental implant surgery. However, they can be brittle, and excessive lateral pressure may lead to chipping or breakage. They may be less efficient than diamond or carbide burs in cutting through harder materials. They can be relatively more expensive than other types, impacting their cost-effectiveness.

Overal it’s important for you to consider these factors and choose the appropriate type of bur based on the specific requirements of each dental procedure and your patient’s needs.

Dental bur uses, shapes, and materials

Selecting the right type of bur can help you create a better patient experience. When it comes to gingival retraction techniques, prepping for crown and bridge restorations, making adjustments on partial dentures, or fitting and adjusting Clear Aligners, the right bur can help create a more comfortable patient experience. 

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We understand how important specifics are when it comes to choices and preferences, which is why we offer insight and considerations to guide you through your next selection process between Duraflex and Valplast.

Duraflex vs Valplast partial dentures

Flexible partial dentures are removable dental prosthetics used as a solution to missing or damaged teeth while also enhancing a person’s smile.

You might ask, why not traditional dentures? Here’s the thing: traditional dentures existed long before the emergence of flexible partial dentures. They were made of acrylic bases, which made them rigid and susceptible to breakage, and people found them uncomfortable. In contrast, flexible partial dentures are softer and more bendable. They are made from a limber, nylon-like material that is lightweight, pliable, and far more flexible than the materials used to make traditional dentures. This is what makes them fit much more comfortably, with a more aesthetically pleasing appearance which is an important factor for many patients. They are also less likely to break, cause irritation or any allergic reaction (metal allergies), or cause discomfort. Most importantly, they are cost-effective.  

Flexible partial dentures are often a good option for patients who are missing one or several teeth on their upper or lower arch (row), providing support to the remaining natural teeth. They are designed to replace a single tooth or a few missing teeth rather than full-set teeth replacement—especially for individuals who want to retain as much of their original teeth as possible. Patients who have thin gums or a small mouth may also find it more comfortable than other types of dentures. 

In cases of extensive tooth loss, where a patient is in need of replacing more than a subsection or a complete full set, flexible dentures may not be the right choice. Alternative treatments, such as implant-supported or crown and bridge restorations, may be more appropriate. 

Material overview of flexible partial dentures

Unlike traditional dentures made with porcelain, resin, and chrome cobalt metal materials, flexible partial dentures are made of a flexible thermoplastic material, such as nylon (Valplast), thermoplastic (TCS), Thermoflex, acetal resin, and Duraflex that conforms to the shape of your patient’s mouth. The materials are made to look realistic, natural, and aesthetically pleasing. The materials plus fit effectively help dentures stay in place with little-to-no discomfort.

Material composition of Duraflex partials

Duraflex partial dentures are made from an ethylene-propylene material. Recognized for its flexibility, strength, durability, and design to provide a secure fit, Duraflex partials allow for easy adaptation to the contours of the mouth, reducing the likelihood of irritation and sore spots.  

They are stain-resistant, odorless,  lightweight with an aesthetic appeal (chiefly for orange hues), contain no BPAs, and are considered the most biocompatible material. These characteristics make Duraflex flexible partial dentures blend well with the natural gum tissue for a more natural appearance that is non-allergenic. They offer long-term satisfaction and peace of mind for patients. Additionally, Duraflex has the largest ratio of vinyl to composite material, making it the most durable flexible partial denture material Dandy offers.

Pros of Duraflex flexible partial dentures

• They are lightweight, stain-resistant, odor-resistant, and color-stable
• They are flexible and easy to wear 
• They are natural-looking due to their craft from an impression of the patient’s teeth.
• They are durable -practically unbreakable and can be easily adjusted by a dentist.
• They are non-allergenic

Cons of Duraflex flexible partial dentures

• Has susceptibility to wear and tear over time
• Is susceptible to bacterial build-up so needs to be cleaned often
• It may feel too tight and uncomfortable until the patient gets used to wearing the denture.
• Not simple to repair so if damaged may need a new set

Material composition of Valplast partials

Valplast was the first flexible partial denture and so set the standard. Valpast is made of a biocompatible nylon thermoplastic as its primary composition, with unique physical and aesthetic properties. They are highly flexible and resistant to breakage due to the composite, which allows them to adapt to the contours of the mouth. 

Unlike other types of partial dentures, they don’t have uncomfortable metal clasps to keep them in place that can be visible at times. Instead, they have little projections made from the same nylon resin material that fits over the teeth and gums to help the denture stay in place. 

Valplast flexible partial dentures are also known for their strength and durability, which ensures that the partial denture can withstand the forces of chewing and everyday use. The Valplast injection process provides ideal adaptation to both hard and soft tissues.

Advantages of Valplast flexible partial dentures

• They are thinner, lightweight and more comfortable to wear
• They are perfect for patients who are allergic to metal
• They offer great comfort to the wearer
• They have a natural color, fitting into the patient’s desired aesthetics
• They are non-allergenic, monomer and formaldehyde-free
• They are less likely to stain to many other materials
• They are a good fit for people with limited mouth opening.

Disadvantages of Valplast flexible partial dentures

• They can not be heated and remolded to adjust.
• When broken, it cannot be easily fixed.
• They take longer to create in the lab. The material may be more difficult to finish, fit, adjust and colour. 
• The possibility of colour degradation with time.
• Due to the material they are made from, there may be difficulty in relining when they no longer fit.
• They require strict dental hygiene.
• They may feel bulkier than other partial dentures.

When to use Duraflex vs Valplast

Although both materials offer flexibility, they may vary in terms of tightness and pliability in certain aspects; the choice largely depends on the specific needs and preferences of the patient. 

Duraflex is the best option if you are concerned about tautness and stability. This is because it offers a more secure fit, especially when the patient requires additional stability and retention. 

It is perfect for patients who are concerned about the denture coming loose during activities like eating or speaking and for individuals who need long-lasting partial dentures. It’s also the right fit for patients who are not worried about the metal components, such as clasps for attachment to the natural teeth some Duraflex dentures come with.

On the other hand, Valplast is best when flexibility and comfort are key considerations. It is mostly used for its pliability and adaptability with the contours of your mouth. If your patient prioritizes comfort and, at the same time, wants a denture that minimizes the risk of irritation or sore spots, this is an excellent choice.

Also, Valplast is known for its aesthetic appearance. Your patient will most likely care about the appearance of the denture and wants it to blend seamlessly with the natural gum tissue. Since Valplast is entirely metal-free, hence the right fit for patients with allergies or sensitivities to metal components often found in other dentures.

While choosing the best flexible partial denture material for your patient, it is essential to consider their specific oral health, lifestyle, and cosmetic preferences. Do bring them into the conversation of Duraflex vs Valplast and have them help with the decision for better acceptance.

Flexible partial dentures with Dandy

Whether you prefer one material over another or you’re looking for input from your dental lab, our experienced team at Dandy is here to help with all of your partial denture cases. Whether you need to adjust your partials or need input on prescribing your latest case, our team of clinical experts is ready to help. If you’re looking for your next partial dentures lab, look no further. 

Reach out to our team today to get started with us.

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Most dentists have a running debate over which material is better. The answer is: “it always it depends.” Let’s run through which patient scenarios are best for hard night guards and which are best for soft night guards. And offer a solution to the debate you may not have expected.

Hard and soft night guard treatments

Bruxism management

Bruxism is a condition characterized by grinding and clenching of teeth during sleep. This can lead to tooth damage, jaw pain, and headaches. Night guards are important in preventing further damage. They act as a barrier between the upper and lower teeth, absorbing the forces generated during grinding and protecting the teeth from excessive wear. 

Night guard materials are either flexible or rigid (this gives them the name hard and soft). Typically, in cases of mild bruxism or where the patient clenches but doesn’t grind, soft night guards are used. This is because they are more flexible and thinner than hard night guards, making them more comfortable to wear, especially during the adjustment period. 

On the other hand, hard guards are used by patients with more severe grinding and clenching. A study found them to be more effective in reducing jaw muscle activity. The study also found that soft night guards were associated with an increase in muscle activity. This supports the belief that soft night guards might encourage people to chew or clench down. 

Temporomandibular joint (TMJ) disorder relief

TMJ disorder is caused by several factors, such as teeth grinding, stress, and jaw injury. This leads to jaw pain, limited jaw movement, and, in most cases, facial discomfort in surrounding areas. 

In this case, night guards aim to reduce the strain on the jaw joint by promoting a more relaxed bite. This can alleviate pain and improve the overall function of the jaw.  They are made of hard acrylic, not pliable, and don’t feel flexible in the mouth. They are thicker than soft guards, which adds to their durability and protective properties.

An examination of TMJ disorder patients discovered that soft night guards showed more efficacy and yielded a faster result than hard night guards. However, both night guards display a high level of effectiveness. 

Hard night guard overview

Hard night guards are made of acrylic, copolyester, or a similar rigid and tougher plastic durable material. They are generally thicker than soft night guards, which makes them more robust and able to withstand grinding and clenching forces. They are more durable and have a longer lifespan compared to soft night guards. They offer excellent protection against teeth grinding and clenching, helping to prevent tooth damage and reduce the risk of developing TMJ problems.

Hard night guards are recommended for patients who grind or clench their teeth harder than usual or those seeking effective protection against these habits during sleep.

They are best used when there is a need for robust protection to prevent tooth wear and damage caused by severe clenching and grinding of teeth. They are also used for managing symptoms of TMJ disorders, which can be exacerbated by teeth grinding. Partnering with a 3D dental lab allows dentists to fit their patients with intricately accurate applications, ensuring snug and secure fits. 

Hard night guards pros

• They are durable, especially for extreme cases of bruxism, and offer exceptional durability and effective prevention of tooth damage.
• They offer superior protection against teeth grinding and clenching. 
• They have a longer life span. 

Hard night guards cons

• They are more expensive due to the need for customisation by a dentist, which can be more costly.
• Some people find them obtrusive or uncomfortable during the adjustment period.
• They are less flexible and have a rigid structure.

Soft night guards overview

Soft night guards are made from modified ethyl methacrylate, silicone, or a similar elastomer and a pliable, flexible material, providing a softer and more forgiving feel in the mouth. They are thinner than hard night guards, making them more comfortable for patients. 

They are generally preferred by patients who prioritize comfort and have mild to moderate bruxism. They are also suitable for patients who have sensitive gums or trouble adjusting to the bulkiness of hard night guards.

Soft night guards are recommended when comfort and ease of adaptation are important for patient compliance. They offer protection against teeth grinding and clenching and can be effective for those with less severe bruxism.

Soft night guard pros

• They are less bulky and feel less obtrusive in the mouth.
• They are more affordable. 
• They are easily adapted to the teeth.
• They are softer.

Soft night guards cons

• Their soft nature encourages more clenching, grinding, or chewing, which could cause the guard to wear out easily.
• They have a shorter lifespan because of their reduced durability, potentially needing more frequent replacement.
• They can be more challenging to clean due to their porous nature, which can make them more prone to staining and bacterial growth. Hence, regular cleaning is advised.
• They are liable to offer less protection.

An alternative to both hard and soft night guards?

Hard or soft night guards are the most common solution to various forms of bruxism and TMJ disorders. However, the best of both advanced treatments exists in the form of the Dandy’s Hard/Soft 3D Printed Night Guard especially if night guards do not help remedy the situation or cause discomfort. 

As the name indicates this 3D-printed night guard combines the strength of soft night guards with the cushioning comfort of a soft night guard. You can’t beat the durability and superior protection against bruxism-related tooth damage, especially in severe cases with a Hard/Soft 3D Printed Night Guard. They are also favored for their comfort and flexibility—the guard becomes pliable when placed under hot water—making them easier to adapt and creates the perfect fit.

Plus the the appliance is made in one piece with KeySplint Clear Resin so you no longer have to worry about the multi-layer laminate of night guards past. The outside derives comfort from thermodynamic softening tech while the hard core of the guard provides the unwavering stability.

3D printed guards with Dandy

Both hard and soft night guards have their functions in dentistry, and as practitioners, your patients will look to you for guidance on which material to choose. We hope this guide helps you facilitate conversations more proactively and more knowledgeably with your patients. If you’re looking to gain consistent insights from our team of clinical experts, reach out to us to learn more about our lab services, including our Hard/Soft 3D Printed Night Guards.

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Dental impression materials are used to create an imprint of the teeth and surrounding oral structures by creating a dental impression poured with dental plaster to fabricate a dental cast. Each impression type and material has a distinct purpose. For instance, preliminary impressions are used to understand the patient’s teeth. It is necessary to determine an appropriate dental treatment plan for the patient. The other types are final impressions and bite registration impressions.

Dental professionals either select the appropriate impression material based on the specific clinical needs and patient requirements, or utilize the more patient-friendly and highly accurate intraoral scanner to make a digital impression.

Impression compound

Long before the introduction of impression compounds, creating accurate dental impressions was a major challenge for dentists. Materials like plaster of Paris and wax were used—but they needed to be improved for ease of use and accuracy. 

This led dental practitioners to experiment with various materials to find a more practical solution for taking impressions of the oral cavity in the mid-1800s, leading to the development of impression compound. The early impression compound was often made from a mixture of natural waxes, resins (e.g., wax), fillers (e.g., talc or soapstone), and lubricants (stearic acid or stearin).

The impression compound gained popularity over time due to their simplicity and versatility. Dental practitioners discovered that the materials could be softened by heating, then molded to capture impressions of oral tissues, making them particularly useful for edentulous (toothless) patients and creating custom trays. Over time, manufacturers refined the composition of impression compounds, making them more consistent and predictable in their behavior when heated and cooled. This led to improved ease of use and reliability.

This is one of the oldest dental impression materials. It is a rigid, reversible impression material set by physical change. It is usually used for taking primary impressions of the edentulous ridge prior to the construction of a custom-made impression tray for complete dentures. Impression compound is also available in sticks of various colors, indicating different softening temperature ranges, e.g. greenstick compound (composition); these are used for impression correction and moulding the borders of custom impression trays, particularly around muscle attachments.

Application of impression compound

Impression compound can be used:

• For making a preliminary impression in edentulous arches. 
• In custom tray construction for taking more accurate secondary impressions with elastomeric materials like silicones or polyethers.
• To create temporary restorations when a more precise and permanent restoration is not immediately available or possible.
• To create diagnostic models that offer a general overview of the patient’s oral structures. These models can help in treatment planning and communication with the patient.
• For the impression of full crown preparation, gingival tissues must be displaced.
• To check undercuts in inlay preparation.
• To create a basic outline of the patient’s oral anatomy, which can help create custom trays or preliminary models for diagnostic purposes.

Classification of impression compound

Impression materials can be classified into two main types: 

• Type I – Impression compound
• Type II- Tray compound

 Type I – Impression compound

Type I compounds, often called “greenstick compound” due to their characteristic green color, are used primarily for edentulous patients to record the anatomy of the alveolar ridge and surrounding tissues. It is a thermoplastic material that becomes soft and pliable when heated and rigid when cooled. 

It is typically supplied in the form of sticks or sheets that need to be softened in a water bath or a special impression compound heater. After softening, the compound is placed in a tray or directly in the patient’s mouth to capture the impression. Although reusable, it cannot be sterilized and tends to become unhygienic and should not be reused ideally. It is nontoxic and nonirritant to the tissues.

Type II – Tray compound

Type II impression compound is also a thermoplastic material, but it is specifically designed for making custom impression trays. It is supplied in a form that is typically softer than Type I and in the shape of a tray (the custom tray for preliminary impression) that will later hold a second impression material, which will record the final impression (secondary impression).

Best of all, it is easier to manipulate. Dentists use it to create a custom impression tray that conforms precisely to the patient’s oral anatomy. Once the tray compound sets and hardens, it provides a stable and accurate platform for taking impressions with other materials, such as alginate or silicone. The resulting custom tray ensures a more comfortable and accurate impression of the patient’s teeth and oral structures.

The main difference between the two impression compounds is Type I is used for capturing preliminary impressions of the edentulous mouth. In contrast, the Type II tray compound is employed to create custom impression trays for accurate impressions of a patient’s dentition and oral structures. However, both impression compounds are essential tools that allow dentists to obtain accurate impressions for dental procedures, such as orthodontic treatments, denture fabrication, and crown and bridge work, and so much more.

Composition of impression compound

A sample of impression compound comprises of:

• Natural or synthetic resin 
• Waxes (Bee’s wax, carnauba wax, Paraffin wax) 
• Stearic acid, shellac, and gutta-percha 
• Inorganic fillers/pigments

VPS impression material

Vinyl Polysiloxane Impression Material (VPS) is a type of hydrophilic material used to create precise and detailed moulds or impressions of a patient’s teeth, gums, and oral tissues. It is also known as Polyvinyl Siloxane (PVS) impression material, and it enables better-fitting restorations. It is mainly used due to its excellent accuracy, ease of use, and patient comfort.

VPS gained attention in dentistry in the mid-20th century due to improved accuracy and dimensional stability compared to earlier options as a result of extensive research and innovation in polymer chemistry. It showed exceptional accuracy in capturing fine details of the oral structures, making them suitable for a wide range of dental procedures and easy to use. The materials have low polymerization shrinkage, low creep, good dimensional stability, and surface detail reproduction. 

VPS became widespread because it exhibited minimal distortion over time, ensuring the captured details remained accurate. The materials were user-friendly, too, both for the dentists and patients. PVS impressions demonstrated superior dimensional stability compared to earlier impression materials, primarily because it had improved taste and odor and did not release any by-product. 

It is considered one of the traditional impression materials. Even today, it continues to play a role in some dentistry, ensuring precise restorations and prosthetic work albeit in a cumbersome procedure vs the ease of digital dentistry.

Application of VPS impression material

VPS impression material is a versatile and accurate analog material used in various dental applications such as:

• Capturing precise impressions for the fabrication of crowns, bridges, inlays, and onlays.
• Creating study models for orthodontic diagnosis and treatment planning to assess the patient’s bite, tooth alignment, and treatment progress.
• Capturing occlusal records for analysing jaw movements and TMJ function.
• Creating diagnostic models for dental procedures, treatment planning, and patient communication. 
• Taking impressions of dental implant sites and the surrounding tissues for the purpose of enabling the fabrication of accurate implant restorations.

Classification of VPS impression material

VPS impression material is often classified based on its setting mechanism. Dentistry has the:

Addition-cured

This is the most commonly used VPS impression material. It polymerizes by the addition of components without the release of byproducts, making it highly stable and accurate. 

Condensation-cured

As the name implies, it sets through a condensation reaction and may release some byproducts. It offers good accuracy but is less dimensionally stable than addition-cured VPS, which makes it the less commonly used VPS impression.

Composition of VPS impression material

VPS impression material typically includes:

• Inorganic fillers, such as silica or quartz 
• Base Paste, containing vinyl-terminated polysiloxane polymer chains and a platinum catalyst
• Modifiers or additives to enhance characteristics like tear strength and setting time
• Catalyst paste to initiate the polymerization process when mixed with the base paste

VPS impression materials are preferred for a wide range of dental impressions due to their unique chemistry, allowing for excellent detail reproduction, minimal distortion upon setting, and high dimensional stability.

Alginate impression material

Alginate is an elastic, irreversible hydrocolloid impression material. It is a dental impression material known for its simplicity, cost-effectiveness, and ease of use in capturing preliminary impressions of patients’ oral structures and tissues. It is one of the most frequently used dental materials. 

It is primarily made of seaweed-derived alginate powder mixed with water, making it a convenient choice for various dental applications and suitable for pediatric dentistry, provisional restorations, mouthguards, and creating diagnostic models. For many years, alginate impression material has been a staple of most dental practices, more and more it is giving way to digital dental impressions in modern practices.

Application of alginate impression material

Alginate impression material is usually taken for the fabrication of study models. It can be used to:

• Capture the initial or preliminary impression of the patient’s dental arches
• Make whitening trays and other dental appliances
• Oftentimes, it is chosen for taking impressions of children’s teeth due to its quick setting time and ease of use
• Create provisional (temporary) restorations while the final restorations are being fabricated
• Some alginate impressions are used in the fabrication of mouthguards for sports or night guards for teeth grinding (bruxism) protection

Classification of alginate impression material

Alginate impression material falls into the category of hydrocolloid impression materials due to its water-based composition. Hydrocolloid impression materials are impression materials that form a viscous liquid that can be seated over an oral structure. At first, the liquid sets before becoming a gelatin-like solid, one flexible enough to be drawn over undercuts without significant permanent deformation.

Now, within the hydrocolloid category, alginate can be classified as an irreversible hydrocolloid. This is because it undergoes a chemical reaction during the setting process and cannot be reused once it has been set.

In dental practice, alginate is a valuable tool for capturing preliminary impressions and creating a base for diagnosis and treatment. It also provides a foundation for constructing custom trays for more accurate final impression.

Composition of alginate impression material

The primary component of alginate impression material is derived from seaweed (algae) and is typically mixed with water to create a viscous paste. The alginate powder mixed with water usually contains roughly 15% potassium or sodium alginate, 16% calcium sulphate dehydrate, 4% zinc oxide, 3% potassium titanium fluoride, and 2% trisodium phosphate. 

It also contains coloring, flavoring agents, and fillers like diatomaceous earth to control the material’s setting time and improve its physical properties.

Polysulfides impression material

This dental impression material has been used in dentistry for several decades. It is known for its unique properties and applications in capturing precise impressions of a patient’s teeth and oral structures. 

Dentists began using Polysulfides, also known as Rubber Base, an elastic material made of synthetic rubber renowned for its bad smell and taste, in the mid-1950s. It was developed to address the need for a more convenient, accurate and stable material for dental impressions. It is incredibly effective for making full-arch impressions, which makes it one reason many dentists have used polysulfide for their impressions before the intraoral scanner came into common use.

The polysulfide materials are supplied as two pastes, with one tube labelled catalyst or accelerator and the other marked as a base. 

Application of polysulfides impression material

• It is used for partial denture impressions, where accurate impressions of the edentulous areas and adjacent teeth are critical. 
• It helps orthodontists assess the patient’s bite and tooth alignment by creating study models for diagnosis.
• It can be used to create precise models that serve as the basis for designing and fabricating various prosthetic appliances. 

Classification of polysulfides impression material

Depending on how easily they flow under load, they are classified as:

• Low viscosity-light bodied
• Medium viscosity 
• Heavy viscosity or putty 

Composition of polysulfides impression material

The components of polysulfide impression material allow it to exhibit good accuracy, stability, and tear resistance—making it suitable for a range of dental impression applications. It contains:

• Sulfur atoms in the molecular structure which is the primary component. It is typically mixed with other components, including accelerators and fillers.
• Accelerators are chemical compounds that facilitate the setting or curing process. They initiate the cross-linking reactions within the polymer, leading to the material’s solidification. 
• Usually, inorganic fillers are often added to the material to control its viscosity, improve handling characteristics, and modify properties such as tear strength.
• Plasticizers are additives sometimes incorporated into the formulation to enhance the material’s flexibility and ease of manipulation. This helps prevent the impression material from becoming too rigid when set.

Ditching impression materials for digital impressions

One amazing factor in the progressive evolution of impression materials is the use of new dental technologies in all aspects of dentistry, including diagnosis, treatment planning, and restoration, encompassing a range of technologies.

Digital dentistry came about to improve the discomfort, errors, time consumption, and several other effects the traditional methods had on patients. This technology allowed for more accurate and detailed teeth and jaw imaging and helped improve diagnosis and treatment planning. In the 1980s, the first CAD/CAM technology system was introduced for dental restorations, allowing the computer-aided design of dental restorations, which could then be milled out of a block of material using a CAM system.

Digital impression systems typically consist of a handheld intraoral scanner, which began to first gain steam in the late 1990s and early 2000s and are ubiquitous today. These handheld devices use light or dental laser technology to capture precise 3D images of a patient’s oral cavity. The captured data is then processed by specialized software to create digital models, eliminating the need for physical impressions.

This new technology has increased patient comfort, reduced chair time, and improved accuracy, while being easy for the doctor or dental staffer to use. The elimination of physical molds also reduces the risk of contamination and distortion. Digital impressions are also more eco-friendly, as they reduce the need for disposable impression materials and trays. They are more efficient in dental procedures such as dental implants, fabrication of restorations like crowns and bridge work, inlays and onlays, as well as the planning and placement of orthodontic appliances.

Digital impressions have enhanced dentistry in so many ways. It has become an integral part of modern dental practice and introduced a more comfortable, efficient, and accurate way to capture and work with dental impressions, benefiting both dentists and patients. It has become an integral part of modern dental practice. 

Make better impressions, digitally, with Dandy

Dandy is the only dental lab in the United States that only accepts digital impressions. Ditching the traditional impression materials and going digital saves practices time and money and increases your practice reputation by creating a better patient experience. In fact, practices that use intraoral scanning are 12% more likely to be referred by their patients, according to the Dandy Dental Study: Patient Experience. Ready to see what the digital hype is all about? Reach out to our team to claim your free intraoral scanner and get started.

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Over the last decade, dentistry has seen a rise in the adoption and the innovation of digital intraoral scanners as a more modern solution to taking oral impressions. Taking impressions with digital intraoral scanners offers many advantages compared to its older counterparts with few downsides.

This pursuit of digital dentistry stems from the need to address factors like patient comfort, ease, accuracy, stability, cost-effectiveness, precision and application versatility. Learn about the modern alternative to PVS impression materials, exploring its unique purposes and applications in shaping the future of dental impressions.

What is a PVS impression?

The traditional dental impression technique involves injecting polyvinyl siloxane, referred to as PVS impression material, into an impression tray and applying it to the patient’s mouth to get the specific model that aids final restoration. This process can be uncomfortable, cause gag reflexes, and create anxiety in some patients, especially those with a sensitive gag reflex or those who find the sensation unpleasant.

What is the modern way of taking a dental impression?

Digitalization and technological innovations have led to the emergence of intraoral scanners for taking oral impressions. An intraoral scanner is a  handy, wand-like tool, used in scanning the surface of the oral structure. The digital intraoral scanner is fast and comfortable and has significantly transformed the impression-taking process. It offers real-time visualization, minimizes patient discomfort, improves accuracy, and facilitates efficient communication between you and your patient. Overall, it offers seamless integration into digital workflows, including treatment planning, designing dental restorations, and fabricating orthodontic appliances. 

This digital impression has proven to be at the advantage of the dentist and patient, more than the previously used impression, as it uses optical imaging and laser scanning, to create a detailed virtual model of the patient’s oral anatomy. With the digital intraoral scanner, you won’t have to worry about errors and distortion, unlike the transitional PVS impression that might require physical shipping, which can introduce delays and the potential for errors and storage distortions during transit. Also, digital impressions help reduce operational expenses or accumulated costs over time, as there is almost no need for regular restocking.

Digital impression vs. traditional PVS impressions

Digital impressions and traditional PVS impressions are two distinct methods of capturing dental impressions for various dental procedures. 

Traditional Polyvinyl Siloxane (PVS) impressions are used by dentists to create models of a patient’s mouth. This impression process requires a dry mouth, while the dentist applies the PVS (a putty-like substance) to both the heavy and light body material on the impression tray, then in the patient’s mouth. This is to gently fit the tray into the patient’s mouth in order to capture the precise shape and arrangement of the oral structure. Traditional impressions utilize impression materials to produce a mold-ready product for labs, including materials such as PVS, 3M ESPE, VPS, and polyether.

On the other hand, digital impression is a process that involves using digital technology, such as intraoral scanners, to capture the patient’s teeth and surrounding oral structures, turning them into a virtual 3D image. By moving the wand-like tool over the surface of the patient’s teeth, it creates a virtual model of the hard and soft tissues of the mouth, through the aid of a monitor. 

This technology is prone to replace the conventional use of physical moulds to create impressions, as they offer advantages such as higher accuracy due to advanced imaging technology, speed, real-time visualization, elimination of uncomfortable materials, and enhanced patient communication by providing immediate visual feedback.

Comparing both techniques, there are four important areas to look out for during the practice: 

• Patient experience
• Impression accuracy
• Chairside time, and
• Material cost.

The patient experience

The evidence of a successful practice is shown in the patients’ experience. A positive experience comprises comfort, convenience, cost-effectiveness, accuracy, stability, time-saving and ease. Comparing both techniques, the PVS impression remains somewhat unfortunate to the above-mentioned attributes.

More times than usual, using PVS material in the PVS dental process breeds discomfort from the ends of the patient. In the bid to get an accurate impression, the patient is prone to suffocating, gagging and awkward experience of trying to insert the PVS material.  

Due to the discomfort, digital dentistry has been a breakthrough in this area, offering ease and saving time. Digital impressions aid relaxation, as the process doesn’t require so much except the intraoral scanner. The dentist inserts the small and discreet scanner tip into the mouth and scans all through the surface of the oral structures while the patient comfortably opens their mouth. This process doesn’t require the gagging or suffocating breath of patients; instead, it incites a comfortable patient experience.

The most critical part of the practice remains the time-saving and convenience of the patient. We curated ways in our Dandy Dental Study: Patient Experience that help dentists ensure their patients feel valued, respected, and well-cared-for throughout their interactions, leading to improved satisfaction, trust, and overall well-being.

Accuracy of impression

Inaccurate impressions can lead to multiple patient visits and materials. The most crucial aspect of garnering accurate impressions is ensuring the impressionist knows which type of technique to use according to the procedure. 

Traditional impressions are still widely regarded for producing highly accurate impressions. Due to PVS material’s ability to contour around soft tissue and form around intricate details, it is heralded for its ability to produce highly accurate results. Ensuring the impression material is formatted correctly, and set is crucial for such effects. While PVS accuracy is high, the difference between traditional and digital accuracy is more significant, seen only in specific cases.

Digital impressions use optical scans to reproduce a virtual model of the patient’s mouth. Digital impressions utilize cutting-edge dental technology, such as interlaced mapping through software and state-of-the-art optical sensors, which allow dentists to take highly accurate impressions in most cases. When combined with a CAD/CAM team for case review and design, digital impressions offer a highly detailed impression with the added benefit of digital impression retention. Digital impression retention lets labs retain the impression data and reproduce restorative work without needing a new impression from the patient.

The accuracy of both impression techniques is similar. Clinicians who do not regularly need extreme detail for unique cases should feel comfortable utilizing digital impressions for most of their caseload. Traditional impressions may provide an incremental accuracy advantage for highly specialized or unique procedures. As technology advances, digital impressions are expected to produce even more accurate models than traditional PVS impression material can provide.

Chairside time

The chairside is the amount of time the patient spends on the chair with the dentist. The time consists of every moment, throughout the dental procedure. It is important to understand that seeing a dentist is not the only activity for the patient, which is why it’s important to reduce the chairside time with the patient. 

The presumed normal time for a PVS impression should be 18-20 minutes. This time frame includes the use and placing of the PVS and impression tray on the patient, to allow it to fit perfectly into the oral structure. The dentist might as well spend time to get a fitting impression tray for the patient. There’s also a possibility of retaking the impression in order to get accuracy. All this points down to making the patient spend beyond the already-speculated time, thereby shortening your chances of seeing more patients as supposed.

Conversely, the digital impression is the opposite of whatever the PVS dental offers, using the PVS materials. This not only makes it easier but saves time for both the dentist and the patient. It creates a possibility to reach out to as many patients as possible while still upholding accuracy, which avoids any form of retaking the impression. 

Cost of material

Every practice owner understands one fundamental principle that governs their dental practice operations: time is money. Increasing efficiency across workflows and decreasing operating costs are integral to the success of every practice. Practices using PVS impressions experience a more challenging time optimizing both of these levers as the actual cost of PVS impressions doesn’t stop at investment in the silicone material. Traditional impression methods increase chairside time costing practitioners upwards of $36,000 in production costs per year. When combined with the material cost of each impression and the negative experience it provides patients, the actual price could be detrimental to practice success.

When considering the adoption of intraoral scanners for digital dental impressions, it’s important to take into account the initial cost of the scanner, first. If you are partnering (or looking to partner) with labs that are equipped to handle digital impressions, consider potential financial implications. 

Partnering with a lab that accepts digital impressions is important, in order to maximize the benefits of the digital workflow, ensure a streamlined communication process,  and reduce costs associated with impression materials and shipping. This decision can overall impact your dental practice, efficiency and patient experience, potentially leading to cost savings over time. Partnerships with these labs help reduce material consumption and shipping expenses associated with traditional impressions.

Embracing digital dentistry and exploring partnerships with labs that accept digital impressions can empower your dental practice to stay competent and competitive while delivering higher-quality care, and positioning you for a more efficient and cost-effective future. Learn more about how to choose the best lab for your dental practice.

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As more people are drawn to the need to have and maintain good oral health, digital dental innovations available to both dentists and patients are also on the rise to bridge gaps and lead the population toward better oral health. 

Treatment planning in dentistry with technology and the right modern tools and techniques has transformed the healthcare industry and provided patients with personalized and comprehensive oral care. The rise of new dental technology and software has rapidly transformed the field of dentistry, making it easier than ever—in terms of workflow and administration—to examine, diagnose, and treat patients, no matter their specific oral health concerns. 

But what does the dental treatment plan of the digital era look like? Here’s what you need to know about the modern dental treatment plan, including the essential components and strategies involved in creating a digital dental treatment plan that maximizes efficiency, precision, flexibility, and patient satisfaction. The Three Types of Dental Patients

While each patient is unique, broadly speaking, dental clinics will regularly see and treat one of three types of patients. The type of patient will often dictate the specifics of what their treatment plan looks like. 

What is a dental treatment plan?

A dental treatment plan is essentially a comprehensive roadmap for a client’s dental health. It outlines the recommended treatment for a patient’s teeth, dental procedures, and approaches to address their oral health needs, including how you plan to implement it and the desired treatment outcome.

Usually, dentists or dental specialists, in collaboration with the patient, develop a strategic document accounting for a patient’s oral health conditions, concerns, and goals, providing structured measures and protocols to achieve optimal dental health. You’ll need to lay out your plan in writing to make it available to others and store it for important medical records.

A typical dental plan covers diagnosis, treatment recommendations, treatment plan based on the level of priority where multiple treatments are needed, urgency, importance, and cost estimates. It also includes the timeline for every proposed procedure, a step-by-step sequence of treatments, and their anticipated durations. You can also highlight alternative options of treatment plans, pointing out the benefits and risks associated with each choice.

In a nutshell, a dental treatment plan serves as a communication tool that fosters transparency, assistance by the dentist, collaboration, and informed decision-making between the dentist and the patient. It is a guide that helps dentists deliver personalized care and helps patients understand the recommended treatments, benefits, and expected outcomes.

What are the phases of a dental treatment plan?

Ideally, dentists use a systematic and patient-centered approach to create the phases of a dental treatment plan for their patients. The phases of a dental treatment plan may vary, depending on the patient’s needs and treatment goals. It consists of several phases, outlining the sequential steps in achieving the patient’s desired oral health outcomes.

Here are the general phases commonly found in a dental treatment plan:

Urgent phase

This is where the dentist addresses the patient’s immediate complaint or urgent oral health needs in this phase. This can range from patient-reported pain to dental trauma, soft tissue pathology, aesthetic concerns, and other oral structures. You should carefully consider the patient’s symptoms and concerns to help formulate a diagnosis and plan for care. This involves stabilization, reviewing the patient’s medical and dental history, taking X-rays, and conducting any necessary diagnostic tests and treatment of the problem.

Control phase

The aim is to reduce oral disease and stabilize your patient’s dental health, eliminating active diseases such as caries and inflammation. This is also where you address conditions preventing maintenance, eliminate potential disease causes, and begin preventive dentistry activities, such as extractions, endodontics, periodontal debridement, scaling, and occlusal adjustment as needed. The goals of this phase are to remove etiologic factors and stabilize your patient’s dental health.

Re-evaluation phase

This is the third phase that allows the dentist to pause and review. The intent is to allow time for healing, evaluate treatments, and reinforce messages of dental disease prevention. It also allows you to check in with your patients to see how they are managing and if they require any tailoring to any at-home preventive regimes. It is also known as the holding phase, the time between the control and definitive phases that allow for the resolution of inflammation and time for healing.

Definitive phase

After the dentist reassesses the initial treatment and determines the need for further care, the patient enters the corrective or definitive phase of treatment. The dentist can reassess their patient’s needs and determine if they require further care. This may involve the referral to specialized dental professionals in disciplines such as endodontics, periodontics, orthodontics, oral surgery, special needs, prosthodontics, or pediatrics. It can also include other health professionals, such as physiotherapists, speech pathologists, dietitians, medical professionals, psychologists, and others.

Maintenance phase

This is the final care phase, as it focuses on supportive therapy to maintain the patient’s oral health, which includes establishing an appropriate recall period for the patient’s next dental checkup or review. Dentists can reinforce oral health prevention during these future visits and re-motivate patients to maintain healthy habits. Also, allows the opportunity to reinforce home care.

The three types of dental patients

While each patient is unique, broadly speaking, dental clinics will regularly see and treat one of three types of patients. The type of patient will often dictate the specifics of their treatment plan looks like.

The Problem-Oriented (reactive) Patient

A surprisingly large percentage of dental patients fall into the problem-oriented category. These are the patients that do not see the dentist until they’re dealing with an acute oral issue, such as: 

• Traumatic injuries – Such as an avulsed tooth, fractured jaw, occlusal trauma, or displaced tooth.
• Pain associated with individual teeth – Such as a fractured tooth or restoration, cracked tooth, post-tooth extraction pain, pain after restoration, or endodontic therapy. 
• Periodontal and soft tissue pain – Such as acute periodontitis, pain after periodontal therapy, periodontal lesion, or acute gingivitis.

For patients in this state, all they want is for the pain to go away. Their tooth issue may have kept them up all night. Or, it could have been a growing concern as the pain increased over time. No matter, they require immediate relief and are dependent on their dentist to provide that urgent dental care.  

In many cases, the “must-fix-it” patient may only see the dentist when it’s absolutely necessary. 

Regardless of the level of pain, digital dental treatment for this type of patient focuses on alleviating the discomfort as quickly as possible. As a result, most of these issues will typically involve same-day treatment, especially for traumatic injuries. 

Whether it’s a broken tooth, pulp necrosis, or an abscessed tooth, digital technologies can both accelerate the treatment lifecycle while making the patient less uncomfortable throughout. 

But more on that later. 

The Proactive Patient

The second type of patient either doesn’t (to their knowledge) have a pending oral health issue or has an issue that the dentist seeks to address, but doesn’t require immediate attention. 

The proactive patient keeps their appointments, practices good oral hygiene, and completes their treatments. For this type of patient, digital dentistry improves the treatment process, minimizing the total number of necessary visits and the time they spend in the chair.  

The Discretionary Patient

The final type of patient typically doesn’t have a significant oral health problem, but rather, they want to improve the aesthetics of their smile, whether that’s via dentures, veneers, or tooth whitening. 

Digital dentistry has done wonders to speed up these processes while reducing the total sticker price of the procedures. And when that happens, when dental treatments are more affordable, less painful, and easier to perform, dental practices see a greater case acceptance as a larger share of their proactive patients become willing to also slide into the discretionary patient category. 

How digital dentistry tools impact dental treatment planning

Digital dentistry has transformed treatment planning, enabling dentists to provide personalized, efficient, and predictable dental care.

A standard digital treatment plan consists of several components created and managed using digital tools and technologies that promote diagnostics, precision, efficiency, and patient satisfaction, and predictable dental care. It facilitates virtual treatment simulations, improves communication, and streamlines the workflow, benefiting dental professionals and patients.

Firstly, the tools to enable ideal digital dental treatment plans:

The intraoral scanner

Intraoral scanners represent the forefront of the digital dental revolution and the first stage of the dental treatment process. These digital devices have completely changed the traditional process for a typical dental workflow like a tooth replacement, zirconia crown, or denture fabrication. 

Equipped with an intraoral scanner, dentists and dental hygienists can rapidly scan a patient’s mouth. The device automatically registers the size and shape of each tooth and then uses that data to form a perfect 360° image of the patient’s intraoral cavity. 

Intraoral scanners make it possible to capture an ideal dental impression in a fraction of the time—and without all of the unpleasantness associated with the analog process. This creates several benefits, including: 

• More accurate impressions
• Less money spent on one-off supplies
• Improved patient experience 
• Less patient chair time
• Improved case acceptance since patients can visualize the dental procedure

With technologies such as Dandy’s intraoral scanner, what used to take several weeks and multiple appointments can now be done in the space of two appointments—talk about how to improve the patient experience. 

CAD/CAM technology

The second stage of the digital dental treatment procedure involves computer-aided design and computer-aided manufacturing (CAD/CAM) technology. This plays a key role in the digital dental lab process, making it possible for dentists to fabricate complex and accurate restorations quickly and efficiently. 

Once the data from the intraoral scanner enters the system, the CAD/CAM technology uses the 3D image to design a final restoration. The lab team receives the digital impression instantly and then makes the necessary adjustments to ensure proper spacing and alignment.   

3D printing technology

From there, a milling machine can shape the restoration out of a single ceramic block. The restoration will then be digitally color-matched and stained or glazed for a natural final finish. 

In the past, custom dental work relied heavily on manual-based, trial-and-error methodologies. But 3D digital printing technology has automated the customization process, making it more efficient and producing a higher quality end-product—all at a lower cost. 

Ways in which digital dentistry fosters ideal dental treatment planning

There’s an adage: Nobody needs a hammer, what they really need is a nail to be driven into a wall so they can hang a painting. While the tools can speak for themselves it helps to see outcomes.

Enhanced communication

Digital dentistry facilitates improved communication between dentists, dental laboratories, and patients. It facilitates the easy sharing of digital files, allowing for seamless collaboration and exchange of information. Dentists can communicate treatment plans visually, using virtual models and simulations, which enhances patient understanding and enables them to make informed decisions. 

Efficient workflow

Digital dentistry optimizes the dental treatment workflow by reducing the time required for various procedures. For instance, digital impressions are faster to capture than traditional impressions. In addition, integrating digital technologies eliminates the need for physical models and reduces chairside adjustments, resulting in fewer patient visits and improved efficiency. 

Improved diagnostics

Digital imaging techniques enable dentists to accurately diagnose and assess dental conditions, including hidden structures, bone quality, and tooth alignment. Enhanced diagnostics lead to more precise treatment planning. Techniques such as cone-beam computed tomography (CBCT) and intraoral scanners offer detailed 3D images of the oral cavity. 

Predictable outcomes

Dentists can achieve more predictable treatment outcomes by utilizing digital tools for treatment planning. The ability to visualize and simulate treatment options, coupled with accurate diagnostics and precise restorations, reduces the margin of error. This leads to improved treatment success rates and enhanced patient satisfaction.

Dandy: Your partner in ideal digital dental treatment

No matter the patient or their specific oral health issue, these digital advancements in dentistry are rapidly changing how dental clinics treat their patients. With digital dentistry, dental professionals don’t have to send patients to specialists or waste precious chair time on time-consuming manual activities, such as analog impressions.

That’s where Dandy makes the difference. With our intraoral scanner and CAD/CAM two-appointment dental process, we can streamline all of your dental office’s typical workflows. What used to take months can now be done in a matter of days. When you’re thinking about how to attract patients to your dental practice, digital dental treatment is the solution clinics need to drive patient satisfaction, increase case acceptance, and improve clinical outcomes. 

Dandy provides our doctors’ treatment plans if they use us for the following: 

• Guided Implant Surgery
• Clear Aligners

Treatment plans can be found in the Dandy Portal and can be shared with customers. Generally, they include the cost and duration of treatment (aligners specific) and showcase any order add-ons from the doctor. Implant treatment plans are all done by experienced CDTs with the final restoration in mind.

If you’re ready to streamline your dental treatment process, contact us today to get started.

Sources: 

Elsevier. Diagnosis and Treatment Planning in Dentistry. https://www.us.elsevierhealth.com/diagnosis-and-treatment-planning-in-dentistry-9780323809757.html

BMC Oral Health. Intraoral Scanners In Dentistry: a Review of the Current Literature. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5727697/

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Whether you are placing one veneer or several to create the appearance of a wonderful symmetrical smile, your veneer prep can make or break this aesthetic procedure—literally and figuratively.

However, other considerations go into veneer prep design. We look at a few, including veneer types, why veneer prep is essential, the three types of veneers most clinicians use, and a step-by-step guide for getting teeth prepped for veneers. Also, you need a quality lab to partner with for the height of patient satisfaction.

For the most part, dental veneers are made of composite resin or porcelain. However, other materials are also available. 

Choosing the right shade and veneer preparation

Natural teeth have a variance of colors: brown, grey, and yellow, all happening in transitions from top to bottom. When choosing the right shade, you have to consider the patient’s original teeth color so that the veneers blend perfectly because as time goes on, the undertone of the natural teeth might start showing through and might warm up with the veneer. Some factors that affect the shade are:

• The characteristics of the teeth.
• Skintone. Similar veneers may appear different due to the skin contrast of patients with various colors, including lip color.
• Other cosmetics like lip fillers and injections affect how the veneers appear in the mouth.
• The patient’s lifestyle. If your patient drinks tea, wine, coffee, smokes, or likes red sauces—pasta and pizza—they may need multiple colors of teeth that look right when blended together.

There are many ways to view aesthetics, so the desired shade should be one of the first decisions you make with your patient. It’s important you and they choose something a little more natural, so the treatment looks seamless and blends with the natural teeth. Clarify the amount of tooth reduction relative to the desired shade. You can also display before and after photographs of patients in the past, highlighting both the whole face and the face from the side to help them determine how many teeth will need to be restored to achieve their desired result.

Veneer preparation groupings

Dentistry groups veneers by the amount of reduction required. The three basic preparation groups of veneers include:

Minimal preparation veneers

As the name implies, this preparation design involves removing the least amount of tooth structure, in the .3 to .5mm range, and usually only enamel. These are sometimes referred to as no-prep veneers, which are much thinner than conventional veneers.

Classic preparation veneers 

This preparation removes more tooth structure, usually .5mm or more to make room for a thicker veneer.  Conventional thickness porcelain veneers employ this preparation.

More aggressive preparation veneers 

In some cases, where there is trauma or the patient has a significant shade change goal, removing up to 1.5 mm might be required. These preparations can get past the enamel and into the dentin, which will require the appropriate adhesive later when placing veneers.  

Selecting the best provisional material for veneer prep

When it comes to materials for dental veneers, one thing, amongst many others, is very important: the patient. Selecting the suitable material is directly tailored according to patient comfort, protection, and aesthetic needs.

Ideally, the provisional material should have excellent aesthetic properties, sufficient strength, and be easy to handle. Your go-to materials should be resistant to staining and blend with the natural teeth, allowing easy adaptation to the look and feel of future veneers.

Veneer preparation techniques for different cases

The approach to veneer preparation varies depending on the number of units the patient plans on restoring and the precise conditions of each case.

Whether it’s a single veneer to correct a minor flaw or multiple veneers for a full smile makeover, a number of techniques have been put forward for veneer preparation to ensure minimal interference, error-free final veneers, and patient satisfaction.

Cases of 1-2 units

Cases of 1-2 units typically require minimal enamel reduction to preserve the natural tooth structure. A direct composite provisionalis used because of its quick and easy-to-use properties. In cases of only one unit, you can trim and polish the provisional material in your hand before applying it to the prepared tooth. To apply, prepare the tooth, isolate the area, etch, and bond, using a flowable composite to bond the provisional. In cases of 2 units, bond, trim, and polish the provisionals while they are in the mouth. Finish cases with polishing to maintain the integrity of the patient’s smile.

Cases of 3-6 units

Cases of 3-6 units require a more comprehensive approach because multiple teeth are prepared to accommodate the veneers. Provisionals that can control gingival embrasures, allowing the gingiva to heal nicely around the provisional, are used. It is important to reline the provisional with acrylic before taking it out to trim or make any adjustments. Once it is ready, isolate or spot, etch, bond, and place the provisional with a flowable composite.  BioTemps Provisionals are an excellent option in cases like this. 

Cases of 6+ units

Cases of 6 or more units often require extensive preparation. It’s a very delicate process, just like other cases. However, this case includes significant enamel reduction across multiple teeth, so clearly communicate your intentions, needs, and what needs to be done when fabricating the final veneers to the lab to get your desired result. This gives the lab a clear and concise idea of what you want. You may send a photograph of the patient’s mouth, leaving detailed instructions. The goal is to achieve symmetrical and aesthetically pleasing results.

Veneer preparation by type

• Composite resin: Comprised of a methacrylate resin and an inorganic filler, like glass, resin veneers are the most affordable option.
• Porcelain: Porcelain veneers are mostly glass but without a clearly defined crystal structure and are stronger and more durable than composite resin.
• Lithium disilicate: Lithium disilicate veneers are ceramic that combine the metal lithium with silicon, giving it a translucency that matches surrounding dentition.
• Zirconia: Another ceramic material, zirconia (zirconia oxide) is opaquer than lithium disilicate, and is strong, stain resistant, and biocompatible.
  

Veneer preparation steps

Preparation design depends on many things, including the space needed, working thickness, the patient’s enamel volume, the enamel’s outside edge, and dentin exposure.  Following is a simplified step-by-step overview of veneer prep. 

Initial examination

The initial examination gathers information and establishes the desired result for the patient’s veneer case. Assess the patient’s oral health to ensure they can proceed with treatment. Also, consider the patient’s teeth position and the cosmetic issues to address.

Prepare teeth

After defining the goals, begin veneer preparation. Removing as little enamel as possible ensures a predictable bond, but some case goals require a preparation design that removes more enamel and gets into the dentin.

Resin preparation guides can transfer the established treatment goals and facilitate the tooth’s minimally invasive prep. Also, mark the areas for minimally invasive reduction with a pencil or waterproof marker. Then prepare the marked enamel with the appropriate reduction tools.

Some additional considerations:

• For classic preparation veneers, address interproximal spaces with a more aggressive reduction than the facial surface and include a clearly marked marginal line. 
• If there is a horizontal finish line, decrease the reduction of the buccal enamel as you move from the incisal edge to the margin to allow the technician to mask the transition lines with the veneer. 
• When placing additional veneers, design a prep with a feather edge to give the technician more leeway to meet the treatment goals with the veneer design. 

Take impressions

Next, take digital impressions of the prepared teeth. Place a retraction cord (we suggest the double retraction cord technique) for veneers that have edges under the gumline, then remove it before taking the impression. Then, send the file to the lab for design, wax-up, and fabrication. 

Place temporary veneers

If the veneer prep design requires a significant tooth reduction, protect against sensitivity with temporaries. Choose the appropriate size and shape and affix it with temporary cement. Be sure to educate the patient about how to care for the temporaries. 

Place permanent veneers

Before placing final restorations, seat the veneer without cement and make any adjustments to perfect the fit and shape. Consider which cement might enhance the shade matching by trying to use the cement’s trial paste. 

Once satisfied with the size, shape, and cement, clean and prepare the tooth surface for final cementation. Be sure to get confirmation the patient is satisfied, too.

Finally, initiate the process for your adhesive system and clean away any excess adhesive. Make any final adjustments by trimming and polishing. Then evaluate the patient’s bite to ensure that is in proper form after final veneer placement. 

Tips for successful veneer preparation

• Patients’ needs come first. Discuss their expectations and color shade of choice. Digital shade-matching devices can be used here to ensure precise color matching.
• Create study models. The 3D printing for creating accurate models
• Use a minimally invasive approach and depth guides.
• Ensure proper margin placement and isolation techniques.
• Use high-quality impression materials. A high-resolution intraoral scanner should be your go-to for precise digital impressions.
• Provide very detailed instructions during laboratory communication. Virtual mock-ups could be created here, allowing both dentist and patient to visualize the final outcome.
• Practice and follow proper etching and bonding protocols when choosing the appropriate cement shade.
• Maintain comprehensive digital patient records for better case management and easy access to patient history and treatment plans.
• Stay updated with the latest techniques and materials. Take part in continuous training and updates on digital tools and software to stay up-to-date to better your practice.

Why is veneer preparation important?

Veneer preparation is essential for success with the treatment, for several reasons, including:

• It ensures that the teeth thickness isn’t increased after veneers are affixed.
• It facilitates a stronger bond, particularly when placed upon prepped enamel within two weeks of the preparation.
• It allows for decay removal or replacing composite fillings if necessary.
• It lets clinicians use a thicker veneer, which is especially important when masking discoloration.
• It permits planning of the veneer placement to hide the edges and prevent it from contacting other teeth.
• It presents the opportunity to shorten the incisal edge if the veneer prep design wraps the edge of the tooth.  

How Dandy simplifies the veneer preparation process

Getting teeth prepped for veneers starts with an excellent veneer prep design. Veneer prep has to consider many factors to set up a veneer case for success. For a digital lab partner that can help you create ideal veneers please contact the team at Dandy with questions about veneer preparation or click here to learn about our many restorative services.

Sources

Dental Veneers: Benefits, Procedure, Costs, and Results (2023). Available at: https://www.healthline.com/health/dental-veneers#which-veneers-are-best (Accessed: 7 June 2023).

 Lithium Disilicate: What Is It? | Colgate® (2023). Available at: https://www.colgate.com/en-us/oral-health/fillings/lithium-disilicate-what-is-it# (Accessed: 7 June 2023).

Zirconia Veneers & Lumineers – Prices, Advantages Dental Treatment Guide, Dental-treatment-guide.com. Available at: https://www.dental-treatment-guide.com/veneers/zirconia-veneers (Accessed: 7 June 2023).

The porcelain veneers procedure- A guide to the steps of the process. (2023). Available at: https://www.animated-teeth.com/porcelain_veneers/t3_porcelain_veneers_how.htm#ultra-thin.placement (Accessed: 9 June 2023).

Myth vs. Realities: Two Viewpoints on Prepared Veneers and Prep-Less Veneers (2023) Aacd.com. Available at: https://aacd.com/proxy.php?filename=files/Dental%20Professionals/jCD/Vol.%2027/Issue%202/27-2lesagewells.pdf (Accessed: 14 June 2023).

Veneers: What Are Dental Veneers? Cost, Procedure & Advantages (2023). Available at: https://my.clevelandclinic.org/health/treatments/23522-dental-veneers (Accessed: 14 June 2023).

How are Teeth Prepped for Veneers? (2023). Available at: https://www.newmouth.com/blog/teeth-prepped-for-veneers/ (Accessed: 6 June 2023).

Tooth preparation: current concepts for material selection (2021). Available at: https://pocketdentistry.com/tooth-preparation-current-concepts-for-material-selection/ (Accessed: 14 June 2023).

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Flexible partial dentures are designed with precision to be lightweight, durable, aesthetically pleasing, and can restore the appearance and functionality of natural teeth. They also offer unique features that rival traditional dentures because they look and function like real, natural teeth and can replace teeth from the same area of the mouth that may have been lost due to an accident, injury, or gum disease.

Choosing the right partial for your patient

Oftentimes, making decisions that will affect an individual’s oral function and appearance for a long time can feel overwhelming, as they want to ensure they are making the right choice. Choosing the right partial depends on several factors, such as the patient’s oral health, anatomy, aesthetic concerns and choices, and personal preferences—overall comfortability both physically and mentally are paramount for the patient. 

Here are some key considerations to keep in mind when selecting a partial denture for your patients:

Oral health assessment

It is essential to evaluate the patient’s overall oral health to assess the presence of decay, periodontal disease, or any other oral health issues that may impact the choice of the partial denture. Also, check out the condition of the remaining teeth, gums, and oral tissues.

Patient preferences

Consider the patient’s preferences, comfort level, expectations, and goals. Some patients may have specific preferences regarding materials, ease of maintenance, or removable versus fixed options. Leverage open communication to understand your patient’s concerns and desires better.

Stability and support

Consider the stability and support provided by the remaining natural teeth. A partial denture with clasps or precision attachments may be appropriate if the remaining teeth are healthy and can provide sufficient support. In cases where the remaining teeth are weak or compromised, alternative options may need to be considered.

Allergies

Some individuals with metal or acrylic allergies may need to wear flexible partial dentures. However, engaging in an open dialogue with your patient will guide the selection of the most appropriate partial denture for their health.

Number and location of missing teeth

Considering the number and location of missing teeth helps determine the design and type of partial denture fit for your patient. Different types of partial dentures are suitable for various tooth loss patterns.

Aesthetic concerns

Some patients may prioritize the appearance of their smile, while others may focus more on functionality and comfort. The best way to go about it is by assessing and discussing your patient’s esthetic expectations and concerns to determine the most suitable option that meets both functional and esthetic needs.

Long-term prognosis

Suppose there are concerns about the longevity of the remaining teeth or the potential need for future extractions, evaluating the long-term prognosis of the remaining teeth and oral structures would be handy.

In cases like this, the treatment plan may need to incorporate provisions for future modifications or replacements.

Budget and insurance coverage

Consider your patient’s budget and insurance coverage when discussing treatment options. Different partial dentures have varying costs, and insurance coverage may also impact the final decision.

It’s essential to involve the patient in decision-making and explain the options, advantages, maintenance, and limitations. This allows the patient to make an informed choice based on their specific needs, concerns, expectations, and oral health status. You leverage our online partial dentures lab with a detailed workflow and complete cases to help you give your patients the perfect experience.

Partial denture materials

There are different types of partial dentures available. Here are some common types of partial dentures materials:

Cast metal partial dentures

They are also known as cast partial dentures or metal framework partial dentures, made from a cast metal alloy, usually cobalt-chromium or nickel-chromium. They have a metal framework that provides strength and stability, while the artificial teeth are attached to the framework. Metal partial dentures are known for their durability, strength, and precise fit. Cast metal partial dentures are attached using metal clasps that use existing natural teeth to secure the partial in place. This type of partial denture can last between 7 and 10 years.

Acrylic (plastic) partial dentures 

Acrylic partial dentures have a pink acrylic base resembling gum tissue and supporting artificial teeth. The artificial teeth are typically made of acrylic as well. Some may not find its “bulky” shape attractive or comfortable, so this partial is generally considered a temporary solution.

Flexible partial dentures

As discussed earlier, flexible partial dentures are made from a flexible thermoplastic material called nylon. They offer a more comfortable and aesthetic option. The material’s flexibility allows the denture to adapt and move with the mouth’s natural movements. They are lightweight, durable, and suitable for individuals with metal allergies or sensitivities. Another benefit is the comfort it offers. It is comfortable, and the gum-colored clasps make it less noticeable.

Flipper dentures

These are removable partial dentures designed to replace one or a few missing teeth. They are often used as temporary solutions or for esthetic purposes, such as filling gaps during the healing process after tooth extraction. They are typically made of acrylic and have clasps or wires to attach to adjacent teeth for support.

Flexible partial dentures vs metal

As the name implies, metal partial dentures are made from a metal alloy, usually chromium-cobalt or titanium, as stated above. Due to this, they provide a more secure fit and reduce the risk of the denture shifting or moving during function.

However, compared with metal partials, flexible partials provide greater comfort and offer improved esthetics without metal clasps—or any metal at all. Their strength is obtained from precise tissue coverage. The flexibility allows for a more secure fit, eliminating the need for metal clasps or hooks. They not only enhance comfort but also reduce the chances of gum irritation, sore spots, and allergies commonly associated with metal dentures. The materials utilized in flexible partial dentures are hypo-allergenic and suitable for patients with denture monomers or nickel allergies.

Flexible partial dentures vs acrylic

Dentures made of acrylic are hard and have metal clasps that rest on the adjoining teeth to hold the denture in place. They are more customizable in terms of tooth shape and color and can appear more artificial due to their opaque nature.

On the other hand, flexible dentures are made of a different material that grips the gums better and does not require metal clasps. Due to their esthetic advantage, they have the color and translucency of natural gums, making them blend seamlessly with the remaining teeth. They are less breakable compared to acrylic dentures and though cost more than acrylic dentures. Also, since it is a little flexible, it is more comfortable for the patient and allows for a more natural-looking appearance. 

The best material for partial dentures is ultimate up to the patient

The choice of material for a partial denture primarily depends on the patient’s specific needs, preferences, and oral health situation. Different materials have their own advantages and considerations, and what may be the best material for one patient may not be the same for another. 

The patient’s preferences and the dentist’s expertise and guidance should inform the decision-making process. It is advised to have open communication and collaboration with your patient to determine the best material for the partial denture that meets their specific needs and provides the desired outcome. You can further explain each material’s characteristics and discuss each option’s potential benefits and limitations while evaluating the patient’s oral health, remaining teeth, bite forces, goals, esthetic, and desires.

Digital flexible partial dentures with Dandy

Flexible partial dentures offer a range of benefits, including comfort, aesthetics, and functionality, making them a popular choice among patients and dentists alike. Dandy offers the best partial denture processes that enhance comfort, aesthetics, and functionality.

Explore Dandy partial dentures

As your partial dentures lab, you’ll be able to offer your patients 2-appointment partial dentures.

 

Learn more

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As more people are aware of sleep apnea, more are seeking a solution to sleepless nights (and yes, is someone who suffers from sleep apnea has a partner, they invariably suffer as well from their snoring). While traditionally the alleviation of sleep apnea has come from Continuous Positive Airway Pressure (CPAP) machines, digital dental labs have enabled the proliferation of oral appliances for those which less severe cases. 

While some oral sleep apnea appliances can be found in online marketplaces their are supreme benefits of patients working with their dentists rather than going the DIY route. Firstly, there are different types of oral appliances depending on causation of a patient’s sleep apnea that the patient is wholly unaware of. Then there is the fit. By a patient working with a digital dentist they can ensure that the mouthpiece sits properly (Dandy creates custom-fit appliances with 3D printing) and can determine if adjustments are needed. A poor fit can not only not solves the problem, or cause abandonment of the treatment, it can harm a patient’s bite and jaw. 

According to the AMA, 30 million people in the US suffer from sleep apnea, now with digital dentistry we can work together with our patients to bring that number down. 

What is sleep apnea and CPAP?

Explaining sleep apnea to your patients: Sleep apnea disorder is characterized by a repeated interruption in breathing during sleep, which can last for several seconds to more than a minute and can occur so many times per night. 

Sleep apnea can cause several symptoms, such as 

• Headaches
• Difficulty in concentration
• Mood changes
• Some may experience daytime sleepiness and loud snoring. 

Traditional treatment for sleep apnea may include lifestyle changes such as weight loss, quitting smoking, diet changes, and the use of CPAP machines. This machine fits over the mouth or nose and  delivers an extra constant flow of air pressure to keep the airway open during sleep.

However, this method of treatment can uncomfortable and difficult to use consistently.  There is also, unfortunately, a stigma associated with using the facemask, that causes many of those who are actively dating to abandon the treatment. 

Sleep apnea has been linked to various health problems, such as high blood pressure, heart disease, stroke, and diabetes. As more people become aware of the risks associated with sleep apnea, they seek effective treatments, which, depending on the severity can be aided  by sleep apnea appliances. This has led to the rise of several custom-made appliances that fit an individual’s mouth and works by repositioning the jaw to keep the airway open during sleep.

The benefits of sleep apnea appliances

Please tell your patients about the following benefits that sleep apnea appliances offer:

• Increase sleep quality: The intraoral device for sleep apnea  improves sleep quality by eliminating snoring and interruption in breathing during sleep. This can lead to a more restful and rejuvenating sleep.
• They promote better daytime functioning. 
• Sleep apnea appliances are easy to use. They are simply worn in the mouth at night, making them a convenient and hassle-free treatment option.
• The oral appliance therapy for sleep apnea can also reduce or eliminate snoring, offering another option for people who cannot tolerate CPAP.
• Some can correct the underlying problems that cause sleep-disordered breathing. An example is the dental treatment for sleep apnea, which can be used to straighten and develop the arches and teeth into a healthy alignment to open the airway and even treat some disorders such as  TMJ disorder. With this, once the needed results are achieved, there won’t be a need to wear an appliance at night anymore.

Oral appliances vs. CPAP therapy for sleep apnea

Oral appliances are one of the treatment options for sleep apnea, particularly for individuals with mild to moderate obstructive sleep apnea or those who cannot tolerate CPAP therapy. They are worn in the mouth during sleep and work by repositioning the tongue and/or jaw to keep the airway open and prevent obstructions.

There are several types of oral sleep apnea appliances, but the most common is the Mandibular Advancement Device (MAD), which fits over the upper and lower teeth. It works by holding the lower jaw in a forward position, which helps to open the airway, and the Tongue-Retaining Device (TRD), designed to hold the tongue in a forward position to keep it from blocking the airway.

Some advantages of oral appliances include;

• Non-surgical: Oral appliances don’t cause any physical changes or pain because they are non-invasive. They’re ready to use, easy to wear, and don’t require much effort to get used to.
• It is convenient.

 On the other hand, CPAP therapy involves using a CPAP machine, a small air compressor with adjustable tubing, and a mask. These machines are the size of a tissue box and  lightweight, but noisy. Using a CPAP machine helps to prevent serious health problems linked to sleep apnea, such as stroke and heart disease.

Using a CPAP machine, the air pressure keeps the airway open, preventing it from collapsing or becoming blocked during sleep. This allows the person to breathe normally and prevents interruptions in breathing that can cause sleep apnea symptoms such as snoring, and gasping.

CPAP therapy can effectively treat sleep apnea, although adjusting to wearing the mask and using the machine during sleep may take time. 

In comparison, 30%-50% of CPAP wearers find the mask uncomfortable or the machine too loud. Compliance with wearing the CPAP machine (about 50%) is generally lower than compliance with wearing a smaller and quieter oral device. Most patients prefer an oral device worn inside the mouth without anything else attached to their face.

Approaching the conversation with your patient

Dentists can absolutely play a role in sleep apnea treatment, learn about how dentists can play a role in diagnosing sleep apnea here!

Approaching the conversation about sleep apnea appliances with a patient requires sensitivity, empathy, and a clear understanding of the patient’s needs, concerns, and preferences. It is important to approach the patient in a non-judgemental manner, focusing on the patient’s needs and preferences. Overall you are seeking the best-treatment option which takes patient education, the right treatment option, and an understanding that they will continue to use the CPAP or appliance.

 Here are some easy steps you can take to approach the conversation effectively. 

• Establish a positive relationship with the patient.
• Educate the patient: Provide the patient with clear and accurate information about sleep apnea, its symptoms, and the benefits and risks of different treatment options, including oral appliances. You can highlight any other health challenges (if any), letting the patient know what to expect at any given time.
• Discuss the patient’s preference as regards lifestyle and a suitable device.
• Demonstrate the device by showing the patient the different types of appliances and how to use them.
• Always follow up and provide support.
• Be ready to walk patients through the process (as some may still be cranky from not getting enough rest). It is important you understand the situation for them—remember you are treating the person as much as the condition.

Discussing the different types of sleep apnea appliances

Sleep apnea appliances come in different types, each with unique features, designs, and functions. Not all sleep apnea appliances are suitable for everyone. With the help of a qualified sleep specialist, you can determine which type of appliance is most appropriate for a patient’s specific needs.

Some of the most common types are as follows:

Mandibular Advancement Devices (MADs)

These are the most widely used sleep apnea appliances. They are designed to hold the lower jaw and tongue forward, which helps to keep the airway open during sleep. MADs are usually custom-made. The most common types are the Herbst and Dorsal sleep apnea appliances.

The Herbst appliance is worn in the mouth and consists of two metal arms that attach to the upper and lower teeth. It is adjustable, allowing it to be fine-tuned and adjusted for maximum effectiveness. 

The Dorsal appliance is similar to the Herbst appliance but slightly different in design. The Dorsal appliance comprises two separate pieces that fit over the upper and lower teeth. The lower piece can be adjusted forward to help keep the airway open during sleep.

However, both appliances effectively reduce snoring and improve sleep apnea symptoms. They have some potential side effects, such as soreness in the jaw and teeth, and may not be suitable for all patients. 

Continuous Open Airway Therapy (COAT)

COAT consists of a small plastic mouthpiece worn in the mouth. The mouthpiece is designed to keep the airway open by using a vacuum to pull the soft palate forward. 

Tongue Retaining Devices (TRDs)

TRDs use a suction cup or similar mechanism to hold the tongue forward. This prevents the tongue from falling back and blocking the airway during sleep. 

Nasal Dilators 

This device is inserted into the nostrils to help keep them open during sleep. They are often used by people with nasal congestion or other issues that make breathing through the nose difficult. 

Cost Considerations and insurance coverage 

There are several types of sleep apnea appliances and sleep apnea appliances, and the cost of these appliances can vary. Most sleep apnea appliances are expensive, while some are not, so we have highlighted some factors to consider, including their associated cost.

• Type of sleep apnea appliance. When choosing a sleep apnea appliance for a patient, consider what type bests suits the patients
• Consider maintenance and replacement cost. Which sleep apnea appliances require regular maintenance? How often would the patient need to clean or replace some parts? What are the ongoing costs when choosing these appliances?
• How much does the patients’ insurance cover?  For some,  insurance may cover some or all of the cost of a sleep apnea appliance.

Choosing the right sleep apnea appliances

There are several factors to consider while choosing an oral sleep apnea appliance, including the severity of the patient’s sleep apnea, personal preferences, and any underlying medical conditions. 

Here are some factors to consider when choosing a sleep apnea appliance;

• The type of sleep apnea
• The comfort of the device
• Medical history of the patient
• Pros and cons; When choosing a sleep appliance, consider both the advantages and disadvantages, bearing the patient’s needs in mind.
• Cost, insurance, and warranties; The cost of sleep apnea appliances can vary widely depending on the type and brand of the device and the patient’s insurance coverage. Part of your journey as a dentist who adds sleep apnea to their practice will be insurance education.

Tips for using and maintaining the appliance

In order to ensure that the appliance is doing more good than harm, explain care of the device to your patients. Proper usage and maintenance of sleep apnea appliances can manage sleep apnea effectively and improve your quality of life. Here are some tips for proper management:

• Regular cleaning to prevent the build-up of bacteria and other particles. Use distilled water to prevent the build-up of deposit and brush with a toothbrush before each use.
• Adjust fits when/if needed. Fits should be adjusted by you, a dentist, or other physician.
• Replace parts such as tubing, mask, and filters should be replaced when worn out. Also, replace if there are cracks in the acrylic and failure of the device to maintain retention in the patient’s mouth.
• Store in a safe place to avoid damage or loss. Store dry in the provided case when not in use.
• Once you have determined the need for a new appliance, please send a new prescription with a new set of models and bites.
• Carefully remove the device to avoid breakage.

Sleep apnea appliances with Dandy

Adding oral sleep apnea treatment to your dental practice is simple with Dandy and allows you to grow your practice’s value-per-patient exponentially. Dandy offers both Herbst and Dorsal appliances as well as education on medical billing. Explore Dandy’s custom 3D-printed mandibular advancement devices to treat your patients. 

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From the essentials needed to the latest innovations, every dime spent (correctly) on modern equipment promises invaluable returns in patient care and satisfaction, efficiency, reliability, and, most importantly, the success of your practice. There’s nothing more fulfilling than having a noteworthy return on investment, which is why we have highlighted some important dental equipment you should splurge to grow your practice.

Basic instruments found in the dental operatory

Choosing quality over price when it comes to dental tools and equipment can go a long way toward helping you build an efficient, high-functioning environment for your staff while also aligning your practice’s brand with innovation and organization—ultimately leading to an improved patient experience.

Dental handpieces

The high use of these makes it worth paying more for the dental handpieces that you are most comfortable using. Consider the heft, ergonomics, and performance of the handpiece when weighing options.

Ease of use is imperative but there a more factors that come at a higher cost. Investing in durable, well-designed handpieces enhances patient comfort, workflow, and prolonged lifespan. 

Cheek retractors

The “open wide” aid needs to work for both the doctor and the patient. Well-designed retractors prioritize patient comfort by minimizing tissue irritation and pressure. Features like atraumatic edges, comfortable mouthpieces, and adjustable retraction force contribute to a more positive dental experience and potentially reduce patient anxiety. Additionally, some retractors offer built-in tongue guards or saliva evacuation channels, enhancing safety and reducing the risk of accidental injury or contamination.

Curettes

Look to form and function when curating curettes. Opt for curettes made from high-quality stainless steel or other strong materials with comfortable grips and balanced construction.

Certain curettes cater to specific procedures or areas of the mouth. For example, a periodontal curette might have a thinner blade for accessing deep pockets, while a Gracey curette could be designed for specific tooth surfaces. Investing in specialized curettes can enhance efficiency and effectiveness for particular procedures.

Rotary instruments

Rotary instruments are the tip of the spear in dental operatories. As many patients fear these tools, it is best to be as efficient as possible when they are activated. Simply, that means it is imperative to buy the best available to get the task done quickly.

Dental burs

Burs are known for their precision, versatility, and efficiency when performing a wide range of dental procedures, including cavity preparation, crown and bridge work, and root canal treatment. 

High-quality dental burs guarantee accurate tooth preparation, reduced chair time, and enhanced patient comfort during procedures. There are also disposable burs, which minimize the risk of cross-contamination and maintain compliance with hygiene standards. This safeguards patient safety and practice reputation.

Dental micromotors

Micromotors are used in dentistry for the treatment of semi-hard dental tissues. They enable dentists to achieve precision, especially when it involves dental procedures while enhancing patient comfort. By paying more for these dental instruments you increase long-term reliability, reducing the need for frequent replacements while ensuring efficiency and profitability on the purchase.

Dental turbines

Most dentists are particular about dental turbines because of their high-speed performance and precision. They offer efficient cutting capabilities and are durable. One important element to consider when purchasing a dental turbine is whether or not they have a light and whether it is an LED or a halogen bulb.

Also, shop around as some brands come with spare rotors in case any repair is necessary as they undergo significant wear due to their high-speed operation.

Surgical and extraction instrument

These are typically tools for dental implants, tooth extractions, oral surgeries, periodontal surgeries, etc.

Dental extraction forceps

While there is such a thing as universal forceps, they are not one-size-fits-all. Make sure you have the right tool for the job.

Firstly, if there are multiple dentists in your practice there can be different preferences between the American Pattern and the English Pattern, ask around internally before purchasing. Then there are different orientations for mandible and maxillary teeth as well as anterior and molar. Know your Cowhorn Pattern from your Bayonet for ideal dentistry.

Surgical handpiece and motor

It makes sense to splurge on a surgical handpiece for so many reasons including precision, durability, and control. One other factor to consider when shopping around is safety. Look for safety features including automatic shut-off mechanisms and burr detection systems.

Dental ronguers

While this can be said of most dental tools, sometimes the impact of a superior ronguer is seen in faster healing times. An elite ronguer can give you incredible control and precision compared to the cheaper versions which minimizes damage to the surrounding tissue.

Common dental practice equipment for which it pays to get the best

Dental chairs

A chair’s design and style will tell patients a lot about your practice. Giving people an ergonomic seat, with comfortable padding and moveable armrests can do a lot of work putting patients at ease, and newer and more modern designs can also convey a cutting-edge aesthetic that will tell patients: this is a cutting-edge practice.

Choosing the right dental chair can also make work easier for dentists, hygienists, and assistants. Modern chairs have programmable positions that allow dentists to make quick adjustments using foot switches and touchpads.

If you think your chairs are on their last legs, patients can probably also tell. And if they’re starting to get worn out or stained, or if they don’t maneuver easily, consider an upgrade.

Dental cabinets

Your operatory cabinetry layout and office design have a big impact on workflow efficiency. You and your dental assistants need to know where all dental instruments are stored and be able to access them quickly. This will ensure seamless dental procedures.

Nobody likes waiting, and patients are quick to notice confusion or disorganization, so give thought to your layout and invest in cabinetry that is durable and long-lasting. When your dental materials and instruments are where you expect and need them to be, patients will similarly pick up on the harmony and cohesion you’ve created. Building this trust with the patient can even produce better care results.

Sterilizers

Don’t skimp on your sterilization equipment. There are many processes that practice employees must follow to ensure patient safety — perhaps none more important than sterilization. The three most common types of sterilizers are autoclaves, dry heat sterilizers, and unsaturated chemical vapor sterilizers.

Because dental offices often don’t have a lot of space for equipment, there are excellent tabletop sterilizers that will help with infection control and don’t take up too much real estate.

Investing in a faster sterilizer can also make your practice run more efficiently — some sterilizers even offer USB and network ports for remote monitoring. When staff have to spend less time at the sterilizer and can spend more time interfacing with patients, everyone wins.

Operatory lights

Every dental office is different, but every office needs quality operatory lights. Whether you’re attaching to the wall, ceiling, cabinet, or delivery system, poor lighting can impact the accuracy and success of diagnosis and treatment. You can focus on a few variables in your operatory lights to make sure you’re getting the most value out of this important expense.

Adjustability is important. It’s a good idea to invest in a light that can be easily adjusted by the dentist or dental assistant while the doctor is working. Make sure that the light you choose works with your delivery system and cabinetry, and that it is compatible with your preferred work methods.

Visibility is the most critical aspect of effective diagnosis and treatment, so know what you need and don’t settle for inadequate lighting.

Intraoral scanner

Stay competitive in today’s rapidly changing market with an intraoral scanner. These devices take three-dimensional scans of a patient’s teeth and gums, creating precise images that allow for greater accuracy when it comes to restorative dental procedures like crowns, bridges, and implants.

And your practice can get an intraoral scanner for free when you partner with Dandy—that’s a lot of pennies.

They provide superior imaging capabilities compared to conventional scanning methods, allowing for faster diagnoses and treatments. By using this new dental technology, clinics can offer a quick, painless, no-gag alternative to dental impressions and other traditional methods.

Finding the best dental practice equipment

Furnishing a top-tier dental office is a major investment, so you should also make sure your new equipment comes with a warranty. And while your options will always vary based on the amount and type of space you have (as well as your budget) making sure your office equipment works together seamlessly will always pay dividends. 

From a comfy dental chair to the best handpieces, better equipment helps build an improved patient experience, which can even lead to better treatment results. When your staff is more efficient and more comfortable, your patients will notice, and you and your practice can generate the ultimate goal: more smiles.

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