November 25th, 2009 admin
Dr Timmerman doesn’t make bold statements often, so when he does, there is a reason.
There are two factors to consider:
- Quality of final restoration
- Convenience for the patient
The messy goop for impressions is never perfect. Moisture from the mouth affects the setting of the goop, the goop runs down your throat making you gag and perhaps remove the material too soon, the material distorts (and the list goes on). With this distorted impression, plaster is poured inside to make a replica of the teeth. The plaster expands or shrinks during the setting, hopefully in the opposite direction of the messy goop (goop expanded? lets hope the plaster shrinks, but not TOO much…). With this, the lab technician creates the restoration.
iTero by Cadent eliminates these issues. “No goop” means “no gag”. Moisture is not an issue with a picture. The image resolution is accurate to an error of 10 microns. That’s MICRONS. Now when the lab technician creates their artwork, things just plain FIT.
Convenience? The information is sent electronically to the lab while the patient is still IN THE CHAIR. Normally after the patient has their temporary crown created, they are dismissed and the impressions are disinfected and shipped to the lab. This is done by a courier to a local lab or delivery service (UPS or FedEx, etc) to an out of state lab (or China. You should ask where…). This takes time.
iTero restorations theoretically could be created on the same day as the preparation appointment (this would depend on how busy the lab is, pre arranged priority service, etc). The iTero restoration COULD be done in a matter of days and not weeks.
Is it the same day? No. But would you prefer one appointment for 2-2.5 hours, or 2 appointments, the first only 30 minutes long and the second 15-20 minutes?
What kind of service and treatment do YOU want? Most would prefer what professionals would request. Ask a dentist (that has done their homework) which method would they seek for themselves. A strong majority would prefer iTero (nothing is ever 100%, especially in dentistry).
Posted in Cosmetic Dentistry, Dental Crowns | Comments Off
November 24th, 2009 admin
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November 23rd, 2009 admin
Dr Timmerman is frequently asked, whether face to face or online, for the cost of dental implants. It is not easy to give a static fee for everyone, so the answer is usually, “I don’t know…!”
It may seem coy to hear, “It depends,” all the time, but it truly does depend. Some factors include”:
- How many teeth are being replaced?
- Where in the mouth will they be?
- Will they stabilize a denture or a crown?
- How long have the teeth been missing?
- Will extractions be done where the implants will be placed?
Fees will vary from city to city as well, so a fee quoted in Seattle likely won’t apply to someone in Manhattan or Des Moines, Iowa.
Some costs to include when figuring fees could include bone grafting (to make sure there is enough “cement holding the fence post in place”), extractions (and what kind? surgical or simple?), implant abutment, implant body and implant crown. Often there is a fee for a surgical guide (to make sure it doesn’t get placed in a sinus or cut a nerve), and a fee for a CT scan.
So, while you COULD call around and ask the cost for an implant in each office, true comparison shopping is difficult. An answer of $1000 for an implant may be offset by a higher fee for other things, at what originally sounded like a great deal may in fact be no savings at all, and perhaps even cost more.
A sort of rule of thumb, the implant body could run $1500-2500, abutment $300-600, implant crown $1200-2300, bone graft $400-600, sinus lift $500-5000, surgical guide $400-800, CT scan $400-1200, extractions $200-800 each.
As you can see, the fee has a lot of variability.
So… How much for dental implants?
“It depends.”
Posted in Dental Implants | 4 Comments »
November 20th, 2009 admin
Personal Health
A Dental Shift: Implants Instead of Bridges
Published: November 16, 2009
If I have one serious regret about my age, it is that my permanent teeth developed before New York, my hometown, got fluoridated water. I first lost a permanent molar to decay in my early 20s, and the resulting bridge has had to be replaced several times in subsequent decades, ultimately as a four-part apparatus.
Now that has to go as well. Because I could not floss and clean properly under the bridge and between the supporting crowns, I developed a severe periodontal infection.
Dr. Michael Zidile, the young periodontist I consulted, took one look at my mouth and said: “This is not how we do restorations nowadays. A bridge is not a permanent solution and makes it too hard for most people to keep their gums and underlying bone healthy. Now we do implants and individual crowns where needed.”
More out of curiosity than distrust — and before I invested thousands of dollars and countless hours on new teeth — I did my own homework and got a second opinion. Dr. Zidile, I learned, is correct. In an overwhelming majority of cases, implants to replace lost teeth are by far the best long-term solution for maintaining a healthy mouth. Also, because they rarely need to be replaced, in the long run they are more economical than bridges.
A Growing Option
Implants for replacing lost teeth have come a long way in the 25 years since I last wrote about them in this column. Better materials, procedures and professional experience result in far fewer problems than occurred in the early years of implants.
Critical to their success, however, is proper selection of both patients and practitioners — and, after the implant, a commitment to good oral hygiene. Dental implants must be treated like natural teeth: kept clean and free of plaque through proper brushing, flossing and periodic professional cleanings.
“Bridges are not the standard of care anymore,” Dr. Lawrence J. Kessler, a periodontist and associate professor of surgery at the University of Miami School of Medicine, told me in an interview. “For most people who lose teeth, implants are the treatment of choice.”
Implants do not decay, and adjacent healthy teeth do not require crowns to support them. And because it is easy to clean and floss between implants, the gum tissue and underlying bone are more likely to remain healthy.
With a bridge, if one of the supporting crowned teeth breaks or develops decay or nerve damage, the bridge and its three or more crowns must be removed and replaced.
Implants can replace individual lost teeth or many teeth in a row. For those who have lost most of their teeth, implants can be used to anchor a full or partial denture. About half a million implants are placed each year in this country.
On average, the total cost of an implant to replace a single tooth is $3,500 to $4,000 (more if other procedures are required), or about one-third more than the cost of a bridge. But while bridges have an average life span of 10 years, an implant can last a lifetime.
Many insurance companies now cover implants, but most people do not have dental insurance and must pay out of pocket. If cost is an issue, consider treatment at a dental college, where implants may be available at reduced rates as part of the teaching process.
Not a Quick Procedure
The basic technique involves surgically inserting a titanium screw — the implant — into the supporting bone, which can be done under local anesthesia in less than an hour, and attaching a small fake tooth called an abutment, followed by a crown. The resulting tooth looks and feels like a natural one.
The procedure is a lengthy one. Unlike a bridge, which can be completed in two weeks, implants usually take about eight weeks for the screw to become firmly attached to bone before the final crown can be placed. “A patient’s health, not age, determines suitability for an implant,” Dr. Kessler said. “I just did implants for a 93-year-old who needed them to fit a partial denture. I put two implants in a man when he was 85 and five more when he was 88, with no problems either time.
“If cases are chosen well, implants are very successful — 96 to 97 percent successful. And they rarely fail down the road.”
A most important element is having enough bone in the jaw to support the implant, although in some cases bone cells removed during drilling for the implant or taken from elsewhere in the mouth can be used to fill in gaps.
“If someone has diabetes or is a smoker,” Dr. Kessler said, “the chances of success are reduced because a poorer blood supply diminishes the fusion of bone cells to the implant.”
Also important is healthy gum tissue, free of periodontal disease. Before I could undergo an implant procedure, I had to have periodontal treatment to get rid of the plaque, tartar and infection on the tooth roots and gum tissue around my bridge and supporting crowns.
In some cases when a tooth must be pulled, an implant can be placed right after the extraction, with the advantage of limiting bone loss in the area. When bone is not being stimulated, it tends to break down. I consider myself lucky that although I’ve had this troublesome bridge for many decades, my underlying bone has remained healthy enough to support an implant.
Choosing a Doctor
Just as any physician can legally perform surgery, any dentist can legally do implants. Be sure to choose someone thoroughly trained in the technique. Taking a weekend course in implantology is rarely adequate. There are risks involved in placing implants, including damage to a nerve or sinus cavity, which are magnified when the practitioner lacks adequate training.
Implants were once done mainly by oral and maxillofacial surgeons, most of whom operated independently of dentists. Now at least as many implants are placed by periodontists who are schooled in the technique and who coordinate their work closely with the patient’s dentist. Ideally, the periodontist should be board-certified.
Just as you might ask for referrals for a prospective nanny or house cleaner, consider asking to speak with other patients of the practitioner before deciding to proceed with an implant. Though every case is different, at the least you can determine how well you are likely to be cared for.
Posted in Dental Implants | 3 Comments »
November 18th, 2009 admin
Dr Timmerman is always trying to serve his patients better. As technology improves, he is always looking to add to his services. Rarely is the decision based on making HIS job easier, but always if the technology benefits the patient.
One such advancement is iTero by Cadent. This machine can take an impression of teeth WITHOUT the gooey stuff that runs down your throat!
The data is sent electronically to a lab and models are created. These models are sent to another lab for fabrication of the crown or bridge.
The benefit is super accuracy… The images produce models that are many times more accurate than impression materials (I could quote a stat, but it would be made up…!). Routinely, the restorations simply drop in place with virtually ZERO adjustments. With impression materials, it is common to adjust the contacts and the bite when cementing the final crown. Never say never, but it is RARE to adjust a crown when iTero is used.
If you would like a restoration that is strong, beautiful and built to last, call 206-241-5533 to learn more!
Posted in Cosmetic Dentistry, Dental Crowns, General Dentistry | 1 Comment »
November 16th, 2009 admin
Dr Timmerman is proud of his education and the services he offers. He continues to learn and add treatments in his office. He recently was notified that he has attained Fellowship status in the International Congress of Oral Implantologists (ICOI). It is a great honor and has taken years and many implant cases.
Dental Implants have changed people’s lives. Replacing missing teeth is both cosmetic and functional and can have psychological benefits as well. Dentures can be securely fit so that they don’t move, allowing normal function once again.
If you desire dental implants and want a dentist that has advanced training and a fellowship level of merit, call 206-241-5533 today!
Posted in Dental Implants | 1 Comment »
November 13th, 2009 admin
There are many implant systems out there. There are advantages and disadvantages to all of them, but one system that Dr Timmerman loves to use is Camlog. This system is easy for the patient and easy for the dentist (restoratively). Implants are a great way to replace missing teeth, whether to replace a single tooth, a bridge for more than one tooth, or to stablize a denture or two.
Are YOU missing teeth? Would you like to replace that tooth without affecting the adjacent teeth? Come talk with Dr Timmerman and see what would work for YOU…!
206-241-5533
Posted in Dental Implants | Comments Off
November 10th, 2009 admin
Dr Timmerman takes infection control VERY seriously. In fact, when he designed his office, he made sure that the sterilization center exceeded the minimum standards. It is THAT important.
Each set of instruments are placed in packages that change color when exposed to high heat and each package is opened when the patient arrives. Testing strips are sent to a lab each week to be sure the equipment is in top working order.
If infection control is important to YOU, then you have found the right office!
Posted in General Dentistry | 1 Comment »
November 10th, 2009 admin
Many of Dr Timmerman’s patients spend time south during the cold part of the year and return for the beautiful Seattle summers. In an effort to be frugal, sometimes they go “south of the border” for more involved dental care, assuming the quality is the same but at a discount. Honestly, if a person can get the same thing for less money they would be foolish not to.
However, more often than not, they get what they paid for. Many will beam with pride on what top quality dentistry was performed, but all they truly can report on is how they look and feel. Without a dental education, patients are not qualified to critique the quality.
How things FEEL is not a very good indicator for quality or health. Like high blood pressure, people often feel fine when in fact they are at high risk for stroke or heart attack. Often radiographic (x-ray) examination will reveal very poor quality dental work, yet everything may FEEL great. The long term prognosis may be catastrophic while the short term situation feels fine.
Insurance companies usually have no benefits for foreign providers, and should something go wrong there is no recourse.
This is not to say foreign dentists are not capable. Far from it, as there have been SOME cases that look great (in fact, not all American dentists are wonderful too). But there ARE certain standards that are regulated here that are not elsewhere. Infection control is a gamble outside our borders sometimes.
By all means, patients should do what they feel is best for them and their family. But they should do so in an informed manner and not be upset if they find out their gamble did not pay off.
Posted in General Dentistry | Comments Off
