Prosthodontic Dentistry of Washington, DC

Bone Grafting for Dental Implants

woman holding a model of a dental implantBone grafting and dental implants typically go hand-in-hand, as the loss of a tooth can wear down the surrounding jawbone structure and a dental implant is a common procedure to replace lost teeth. As soon as a person loses a tooth, bone loss begins. In order to place a sturdy, reliable dental implant, a bone grafting procedure is often required in order to rebuild the jawbone. While bone grafting sounds daunting, it is a safe and reliable procedure that prepares the jaw bone for a dental implant, and in most cases, is necessary to build up a sturdy foundation.

In a bone graft procedure, bone tissue taken from another part of the body is grafted into the jawbone. Another method utilizes processed bone from animals, but results in the same regrowth of your jaw. It can take several months for the graft to set and grow into a stable foundation for a dental implant.

Depending on the amount of bone loss, bone grafts can be placed at a variety of times during the implant process. For example, if only a minor bone graft is needed, we may be able to place it at the same time as the dental implant. However, if a larger bone graft is necessary, it will have to rest for months before the dental implant procedure can be performed.

Bone grafting is a very important and often overlooked procedure when it comes to preparing for a dental implant! Dental implants have increased in popularity and effectiveness over the years, as they provide the most reliable replacement for natural teeth. Dental implants look and feel like normal teeth, and if treated properly, can last the rest of a person’s lifetime! Bone grafts and dental implants work together to restore smiles.

Contact us today at Washington Office Phone Number 202-244-2101 to schedule your dental implant consultation, and we can talk about your bone grafting options!

4 Foods That Cause Dental Emergencies

tooth next to first aid kitEvery day, we have patients visit our office for help with a dental emergency. A lot of these emergencies are caused by biting into foods that are too hard, resulting in a cracked tooth, loss of a filling or a broken dental crown.

To avoid a painful and inconvenient dental emergency, here are some foods you should avoid (or be extra cautions while eating):


As delicious as this buttery snack may be, it’s not as innocent as it seems. The husks can get wedged between your teeth or underneath your gums causing a popcorn abscess. Be sure to floss after you eat popcorn to avoid that from happening. However, the true culprits here are the kernels. If you grab a large handful of popcorn and don’t know that a kernel is hiding in the middle, all it takes is one chomp down and oops! there goes your tooth! The next time you eat popcorn, chew slowly to avoid those kernels and enjoy the fluffy buttery goodness that is on top.


You might be surprised by this fact: As nutritious as almonds can be, they also cause a lot of chips, fractures and cracks in teeth. Instead of eating the almond whole, try slivered or sliced versions, which make them softer and easier to chew.

Carmel Candies

Yes, this delicious and chewy candy seems harmless with its soft exterior, but it can cause issues with your teeth. When you chew down, the candies wedge between your teeth and pull out any loose dental work/restorations that you have had. Other candies that have the same sticky qualities are starburst and taffy. They might be hard to resist, but doing so is key to avoiding dental emergencies.

Ice Cubes

You might find this strange but many people love to chew on an ice cube on a hot day. But before you put an ice cube in your month, imagine chewing on a rock, which would basically have the same effect as ice. Ice is hard on enamel, and can easily crack and break teeth.

These are just a few kitchen items that you should avoid if you want to save your teeth. Some foods may be more tempting than others, but at the end of the day, one little snack isn’t worth a busted tooth!

If you experience a dental emergency, call our office at Washington Office Phone Number 202-244-2101 to schedule an appointment.

When Should You Consider Dental Implants?

woman being fit for dental implantsYou may have heard in the past that dental implants are one of the most effective ways to replace missing or damaged teeth. Dental implants are a great option for a lot of different situations, but when is getting a dental implant the best option for you? There are a few circumstances where receiving an implant might be the best option for improving your smile.

Dental implants typically consist of three components: the post, the abutment, and the restoration. The post is a screw which is inserted into the bone. The abutment is attached to the post and the restoration is placed on top, giving the finished product a beautiful, realistic look.

To restore and preserve your appearance.

One of the main functions of dental implants is to restore a smile back to its original glory. They are built to last a lifetime and last much longer than dental bridges. If you are looking for a permanent solution to damaged or missing teeth, dental implants are your best option.

To protect and preserve a healthy jawbone.

Missing spaces in your smile can lead your jawbone to deterioration, which causes it to lose its strength. Dental implants are the only option which will protect and save your natural bone. Waiting to get a dental implant can continue to increase the chances of your jawbone not being able to support dental implants in the future.

To stop your teeth from shifting.

Losing a tooth can cause the surrounding teeth to shift and look unnatural. These teeth can become crowded or can be shifted unevenly. This can cause your teeth to become harder to clean and can also cause your face to sag and appear sunken.

These are just a few of the instances in which you should consider getting dental implants. Dental implants are one of the most useful and successful restoration options available today. For more information on how we can restore your smile with dental implants, contact Prosthetic Dentistry of Washington D.C. at Washington Office Phone Number 202-244-2101 today.

What Do I Do When Told to Have a Tooth Extracted?

Get a second opinion.

Unfortunately, in today’s environment with implants being available, patients are told to have teeth extracted and replaced with implant supported crowns. Although we are very experienced with implant restoration (over 2,500 implants inserted and restored in our office), I will always try to save a tooth rather than extract, if our patient so desires, as demonstrated by the following example.

Our patient presented with a desire to replace her crowns which were not aesthetically pleasing (Fig. 1, arrow). Unfortunately, unbeknownst to her, she had extensive decay leaving very little tooth structure upon which to place a crown (Fig. 2).

Although many dentists would recommend extraction and replacement with implants, we were able to reconstruct the tooth abutments (Fig. 3) and fabricate two very natural looking crowns (Fig. 4).

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How to Keep Your Gums Healthy

woman smiling holding appleKeeping your gums healthy is vital to ensuring that your mouth stays clean and your teeth stay intact and in pristine condition. This blog will focus on the best ways to make sure your gums stay healthy in order to prevent gum disease and keep your smile shining bright for years to come.

1) Floss, Floss, Floss

Flossing is one of the easiest and most effective steps you can take to fight against gum disease and keep your gums healthy. Flossing once a day helps clean those areas in between your teeth which are hard for your toothbrush to reach.

2) Brush and Rinse

Brushing twice a day is the most commonly preached method of keeping your mouth fresh and clean. It is also a good idea to rinse your mouth with antiseptic mouthwash twice a day in order to protect your gums. Rinsing with mouthwash is a great way to thoroughly clean your mouth, because it reaches areas that your toothbrush and floss can’t reach.

3) Use the Right Toothpaste

Choosing the right toothpaste is important to keeping your gums healthy. Make sure to grab a toothpaste that contains fluoride in order to get the best results when brushing. Also make sure to look for the ADA seal of acceptance in order to ensure that you’re getting a toothpaste backed by experts at the ADA!

4) Regular Dentist Checkups

Visiting your dentist twice a year is extremely important in preventing diseases and ensuring that your teeth remain healthy and clean. Your dentist will be able to see early symptoms of gum disease and is the only way for you to get rid of tartar and plaque which are stuck to your teeth and can have a negative impact on your gums if not cleaned.

These four steps can help you significantly improve the health of your gums and reduce your risk of gum disease. If you have any more questions about how to keep your gums healthy or how to prevent gum disease, give Prosthetic Dentistry of Washington D.C. a call at Washington Office Phone Number 202-244-2101 today!

Are All Crowns the Same? Part II

Crowns: How to Achieve All Natural Aesthetic Outcomes

In Part I of “Are All Crowns the Same?”, we discussed the differences in the quality of the crowns. In Part II, we are comparing the aesthetic results of milled crowns, crowns fabricated in a commercial laboratory, and custom crowns fabricated by an in-house technician as we do at Prosthetic Dentistry of Washington, D.C.

Milled Crowns and Commercial Labs
To begin with, milled crowns (on a CAD/CAM milling machine) are fabricated from a “library” of usual and customary crowns. As such, they are a stock image that is put over the digital image of your prepared tooth and made to fit within that space. Since there are hundreds of types of teeth, the anatomic form is not an exact match to your other teeth. These crowns are frequently too opaque or too gray and have a shape that is not always a match to your own natural tooth anatomy. Crowns fabricated in a commercial laboratory, while more custom, can also fall short in form, color, and/or translucency.

In-House Dental Lab: Prosthetic Dentistry of Washington, D.C.
To obtain the most natural aesthetics, our in-house technician evaluates the proper shade, translucency, and anatomic form of our patient’s other teeth (Figs 1 and 2). First, we use an extended shade guide (Fig. 1) that allows us to develop the right shade at each level of porcelain. After all, if teeth have internal colorations and different translucencies at each internal level, then we need to take a shade for each level.

Once the crown has been developed, it is tried in and either internal color is added or custom staining is performed to make the crown match the adjacent teeth to make it appear natural (Figs. 3 and 4).

For over 30 years, we have worked with our in-house technician to provide internal colorations and custom staining to create all-natural looking crowns.

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Are All Crowns the Same? (Part I)

Are All Crowns the Same?

No, they are not – the fit and aesthetics of crowns vary widely! This blog addresses the fit of the crowns, specifically how different types of fabrication (in-house vs. milled) affect their longevity. Part II will concentrate on how great aesthetics is achieved.

There are a wide variety of crowns, extending from the most basic, milled crowns that are “stamped out” from a library of stock crowns in a software program, all the way to crowns that are custom fabricated by an in-house technician. As such, crowns can vary widely in their precision of fit, which, certainly, will dramatically affect how long they will last. The fit of the milled crown will vary by the accuracy of the milling process and is usually not as good as the fit of crowns fabricated by a laboratory process, unless the CAD/CAM technician is held to very strict standards on creating that fit in the software (requires high skill).

First, it is important to note that the average crown in America lasts only 7 – 10 years (insurance companies will reimburse you after 5 years), whereas with custom fabricated crowns such as the ones that are hand crafted by our in-house laboratory can last over 30 years (as ours do). While the custom crowns are, naturally, more expensive, you will achieve over a 300% return on your investment with custom fabricated crowns made in an in-house laboratory (10 years vs 30+ years).

The above example is a milled bridge (from a software program) that lasted only two years because of a large gap between the tooth preparation and the crown (arrow, Fig 1). It had to be cut off, have the decay removed from the tooth, a root canal performed because the decay had extended into the nerve, and then a new bridge fabricated.

Stay tuned for Part II in this series to find out how we achieve great aesthetic outcomes on our custom-fabricated crowns.

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How to Take Care of Your Dental Implant

'Man Flossing in Mirror'

Cleaning and taking care of your implant is just as important as cleaning your natural teeth. Here are some things you should know about caring for your implant.

Your implant and your natural teeth are similar because they both rely on healthy tissue for support and both can build up plaque. It’s important to remove that plaque because it can develop into an infection. If the infection isn’t properly treated, it can result in a loss of bone around the implant which could progress to the loss of the implant itself.

It’s important to get your teeth cleaned on a regular basis so your dental hygienist can get that biofilm off your teeth and keep your teeth infection-free. As always, you should be brushing your teeth and flossing twice a day. Never use your teeth, especially your implant as “scissors” to open anything.

Dental implants are the closest thing you can get to real and natural teeth. They don’t require any special products or treatment. Just a simple brush and floss will do the job. They are also long lasting. If they are properly cared for, they can last a lifetime, avoiding any further dental work down the road.

With a dental implant, you can still enjoy all your favorite foods. It will not loosen or fall out if you are chewing something hard.

Overall, dental implants are meant to make life better and easier, not to add issues or interrupt your life. You don’t have to go out of your way to take care of them – a simple brush and floss will ensure that they improve your overall quality of life for many years to come.

If you think a dental implant may be right for you, call Prosthetic Dentistry of Washington D.C. at 202-244-2101 to schedule a consultation with us.

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5 Reasons Why Your Teeth Are Changing Color

'Woman Brushing Teeth'Brushing and flossing your teeth every day can keep your smile bright and white. However, you might have noticed that even though you take great care of your teeth, they look a little yellow and have lost their sparkle. This is completely normal. Here are 5 reasons why this could be happening to you.

  1. Food and Drinks: Coffee, tea and red wine play a major role in staining your teeth. They all have Chromogens, which are intense color pigments that attach to the white outer part of your tooth known as enamel.
    Tip: Drink with a straw, keeping those stain-causing dyes in the drink away from your teeth
  2. Tobacco Use: The two chemicals found in tobacco, tar and nicotine, create a tough stain. Tar is naturally dark. Nicotine is colorless, but when it’s mixed with oxygen, it creates a yellowish color. Both together create the stain.
  3. Age: Below the white shell of enamel on our teeth is a softer area called Dentin. Over the years, our outer enamel gets thinner from brushing and the yellowish dentin shows through.
  4. Trauma: If you have experienced an injury to the mouth, your tooth may change color. This is because your tooth reacts to the trauma by putting down more dentin, which is darker than the outer enamel on your teeth.
  5. Medications: Many different kind of medications come with the side effect of darkening your teeth. Also, children who are exposed to medication when their teeth are forming, either in the womb or as a baby, can experience discoloration of their adult teeth later in life.

Some of these reasons are preventable and some of these happen over the course of life. Try to avoid some of these things and continue to brush and floss your teeth every day. If you would like to discuss your teeth whitening options with us, please call our office at 202-244-2101 to schedule an appointment.

Dental Implants: The Recovery

'recovery sign'The recovery time following dental implant surgery tends to vary, but is usually based on the amount of teeth being implanted, whether or not a bone graft was needed and the individual and how well they manage their recovery. Luckily, the science and technology behind dental implants has improved drastically over the last few years, improving post-surgery pain and comfort for patients.

The patient requiring the least amount of recovery time would be one who had a standard, single dental implant placed with no bone grafting. With a simple procedure like this one, there is very little discomfort or pain after the surgery. Mild bruising and soreness can occur, but is typically manageable with over the counter pain relievers. In more severe implant cases, such as those where multiple teeth are implanted or severe bone grafting needed in order to accomplish the implant, the recovery time tends to be longer and the discomfort can be more intense.

In any cases, it is important to keep your mouth clean after surgery, which can be done by rinsing your mouth gently with salt water beginning the day after surgery. You may begin brushing your teeth the night after the surgery, but make sure to keep it light around the surgery area as to not disrupt the healing in that area. It is also important to remember that in the week following your surgery, there should be no smoking and no sucking through a straw, as this can seriously inhibit your healing process. It is important to stick to a diet primarily consisting of soft foods for the first 7-10 days following your surgery before beginning to return to your normal diet.

As you can see, the recovery process after receiving a dental implant is fairly predictable and comfortable. It is important to follow the instructions that we give you at Prosthetic Dentistry of Washington D.C., and to always remember that if you have any questions or concerns regarding a procedure or following your surgery, you can always give us a call at Washington Office Phone Number 202-244-2101.

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