Bonding or Veneers?

Bondings and veneers are both ways to repair minor damage or imperfections to teeth, such as a chipped tooth, a gap between teeth, discoloration, or uneven teeth. Both are cosmetic: if you have a cavity, a loose tooth, or a crack in a tooth, you’ll need other types of care. Both are painless.

Bonding involves applying a combination of resin and porcelain to a tooth. I mix the composite material so that it matches the color of your other teeth, then shine a blue light on it to “cure” it. The whole procedure might take 30 to 60 minutes, all on the same office visit. The composite material is pretty resilient: I’ve had patients whose bondings still look good after 20 years, although the norm is two to five.

If you do things that stain your teeth (smoke, or drink a lot of coffee or tea), the bonding may stain, in which case it can be polished like the rest of your teeth. When a bonding fails, it’s most often because of trauma or excessive force. If you like to crack nuts with your teeth, bonding is not the best choice for you.

A veneer is more expensive than bonding (typically about four times the price), but looks more like a natural tooth. That’s because the composite material used for bondings is opaque, but natural teeth are slightly translucent. Veneers, however, are made of ceramic, so the light passes through them as it does through fine china.

For a veneer, I take an impression of your tooth and have a dental lab create a ceramic tooth-cover that exactly fits over the tooth. The veneer is not only translucent, but has striations like a natural tooth - very difficult to mimic in a bonding. To get a veneer, you’ll need one office visit to have the impression made, and another visit several days later to have the veneer applied. Again, I wouldn’t recommend veneers for patients who like to crack nuts with their teeth.

Veneers are ideal if you want to correct minor imperfections to one or several of your front teeth without getting braces on or having the teeth replaced. I can make the veneer’s color match that of the teeth to either side of the veneer. If you’re having all your front teeth done and want a slightly brighter smile, we can adjust the color of the veneers.

If you’re not sure whether your problem is cosmetic or functional, come in for a check-up and we can talk about your options.

If you have general questions about dentistry that you'd like to see addressed on this blog, feel free to email me at sdurante@earthlink.net or through my website, www.DoctorDurante.com. The information on this blog is presented for general education only: consult a dentist for advice on specific problems, diagnoses and treatment.

 

 

 

 

"Do You Take Insurance?"

People often ask if I take insurance: a tricky question, because it can have two meanings. On the one hand, I'm happy to fill our your insurance company’s forms. In fact, I submit them on line, so that you'll be reimbursed more quickly.

On the other hand, I do not accept any insurance company’s payment as full payment for my services. For most procedures, an insurance company’s payment is well below the price that I usually charge—often barely half of the “customary and usual” fee. The provider is expected to be able to make up the difference through volume, by filling his schedule with other patients referred by the insurance company. You've probably sat for hours in the waiting room of a health-care provider who participates in insurance plans: that’s because the conscientious physician or dentist is struggling to get through a crowded schedule that often allows only a quarter- or half-hour for procedures that should take much longer.

I respect my patients and myself too much to work that way. My fees are not arbitrarily set: they depend on the time required for a procedure, its difficulty, and the materials required. I schedule enough time to do procedures properly. I constantly monitor the dental labs that I use to produce crowns, dentures, veneers, and so on, making sure they produce superior work that often fits perfectly on the first try, and that will last as long as possible. A typical insurance payment will often not even cover the price of good-quality lab work, never mind your time with me.

Can anyone but me tell the difference in quality? Apparently so, since I often see patients who have been to a dentist who participates in their insurance plan, but have come back to me for major work or to fix dental work that was poorly done. Did you know that a simple filling requires up to 15 separate steps? Skimping on any one of them can cause the filling to fail prematurely. Imagine the possibilities if your dentist rushes through the steps of a more complicated procedure—for example, making a crown or doing a root canal—because half a dozen patients are backed up in his waiting room.

So: my fees are what they are for very sound reasons, and I do not accept any insurance company’s determination of what they ought to be. I want your business on mutually acceptable terms: your satisfaction with work well done, and my full price for it. Yes, you will be responsible for whatever part of my fee your insurance company does not pay. But I will be happy to help you find out how much they allow for various procedures, and to discuss a range of treatment plans to fit your budget, so that you can make an informed decision about what you want done.

 If you have general questions about dentistry that you'd like to see addressed on this blog, feel free to email me at sdurante@earthlink.net . The information on this blog is presented for general education only: consult a dentist for advice on specific problems, diagnoses and treatment.

Digital Dental X-Rays

For a traditional x-ray, you bite down on a piece of film in a cardboard holder while the dentist shoots x-rays at it. The dentist removes the small piece of exposed film  and develops it (about 15 minutes), then views it on a light-box at approximately life size, in shades of gray, to determine if there are any problems with your teeth. Here’s an example:

I’ve used digital x-rays instead of traditional x-rays for the past 12 years. For digital x-rays, you bite down on a computer chip in a holder, I aim the x-ray machine at it, and the results appear immediately on my computer screen. Here’s an example:

There are several major advantages to digital x-rays.

1. If a second image is necessary, I can take it immediately, not 15 minutes later. The fact that the image is digital also means that I can back it up (to safeguard your records), and if necessary I can transmit it to another dentist or physician instantaneously, without worrying whether the lone copy of the x-ray will be lost or damaged in transit.

2. Because the computer chip is much more sensitive than traditional x-ray film, taking a digital x-ray requires far less radiation. The amount of radioactivity you’re exposed to with either type of dental x-ray is negligible in terms of what you’re exposed to outdoors year after year, but if I can decrease the amount of your exposure, why not? (For more on average exposure to radioactivity, see http://www.iem-inc.com/primrite.html.)

3. The major advantage in digital x-rays is the fact that I can view them at much larger than life-size on a computer screen, in a range of colors that indicates density (i.e., soft or hard tissue). This also makes it much easier for me to show you what’s going on, so that we can discuss your treatment options.

I pride myself on providing the best quality service for my patients, including recent technological advances that I consider best for maintaining your dental health. Please call if you’d like to make an appointment for a check-up with digital x-rays.

If you have general questions about dentistry that you'd like to see addressed on this blog, feel free to email me at sdurante@earthlink.net. The information on this blog is presented for general education only: consult a dentist for advice on specific problems, diagnoses and treatment.