TALKING POINTS

Make a list of arguments for and against implant restoration.

Arrange a brief discussion on this topic touching on the following aspects:

– indications
– side effects
– aesthetic look
– cost
– durability
MORE READING

Read the text and answer the questions.

Why do porcelain veneers rank among the most popular procedures in cos-
metic dentistry?
What was the history of veneer restoration in dentistry?
What are indications and contraindications for porcelain veneer restoration?

PORCELAIN VENEERS

Porcelain veneers are thin shells of medical-grade ceramic that are attached to
the front surfaces of teeth to get an immediate smile transformation. These
cosmetic dental enhancements are made from advanced material that closely
resembles the appearance of natural enamel and individually crafted for each
person. Porcelain ve-neers are considered to be one of the most trusted and popular
procedures in cos-metic dentistry.
Although veneers have become especially popular in the past decades, they origi-
nated during the early days of the film industry nearly one hundred years ago. In the
late 1920s, Dr. Charles Pincus, a famous Hollywood dentist, conceived of veneers as a
way to improve actors' and actresses' smiles on the screen. He would temporarily use
false fronts to the stars' teeth, giving them the stunning smiles that rapidly be-came a
trademark of Hollywood beauty. However, he lacked the technological skills to
permanently affix the porcelain. In the late 1960s, Dr. Michael Bunocore created a
stronger bonding surface for dental sealants and restorations. In 1982, J.R. Calamia and
R.J. Simonsen used Dr. Bunocore's techniques to the application of porcelain veneers.
Suddenly, everyone who wished to have the stunning Hollywood smiles had access to
it. Modern types of porcelain veneers are more sophisticated, stronger and reflect light
similarly to natural dental enamel.
People who are considering porcelain veneers are typically looking to address nu-
merous structural or cosmetic problems with their teeth such as gaps between teeth,
minor misalignment, cracks and discoloration. In order to have porcelain veneers pa-
tients should have good periodontal and overall oral health, have enough amount of
healthy enamel, as dentists usually remove some enamel before placing veneers. Ve-
neers can be made from several kinds of dental porcelain. Nevertheless the thin por-
celain is not strong enough to repair severely damaged teeth. Veneers are a perfect way
to restore teeth with minor structural destruction. If a patient has a broken tooth, large
cracks, or severe dental decay, a crown may be the best solution to restore these inju-
ries. Dental implants or bridges can replace missing teeth. Veneers can help to restore a
patient's smile and dental functionality when combined with restorative treatment.
 It is important to emphasize that there is no recovery time after receiving porce-lain
veneers. Patients will be able to drive themselves home from the office, and they also
can immediately go about their daily routine including work and physical activ-ity.
After the enamel removal patients may temporarily feel some mild discomfort. For
about a week, they may need to avoid very cold or hot foods, as well as extreme-ly
crunchy, chewy or hard food. When this primary sensitivity wears off, patients should
be able to return to their ordinary dietary habits. Veneers last about 10 years on average
but their lifespan may increase significantly over the next several years because dental
porcelain becomes stronger and more durable. Of course, veneers, like natural teeth,
are still easily destroyed and susceptible to any damage. If a veneer breaks or comes
off, a patient should carefully store all missing pieces and bring them to the dental
office as soon as possible for repair and/or reattachment.

Read the text and be ready to answer the following questions.

What are the guidelines for post-surgical implant home care?

What are the rules of routine implant maintenance?
Why is it necessary to follow specific rules of oral hygiene having implants?

FOCUS ON IMPLANT HOME CARE

Good oral hygiene must take place before, during, and after placement of dental
implants to ensure the health of the implant. Dental implants won’t decay, but one
can have gum tissue disease around implants if they are not taken care of. Patients
are concerned about what kind of maintenance their implants will require.
Hygienists can prepare patients by providing home-care recommendations
based on the individual treatment case. This begins with post-surgical home-care
guide-lines to ensure the patient feels comfortable and confident until they return
for rou-tine implant maintenance.
Home care begins immediately with post-surgical guidelines to maintain a
healthy field and to initiate healing. Post-surgical home-care includes drinking only
clear liquids for the rest of the day, taking antibiotics and pain medication as
prescribed and recommended, eating soft foods for the first few days of healing,
avoiding wear-ing a temporary prosthesis or denture to let the gum tissue heal,
using an extra-soft toothbrush to clean the dentition, using salt-water rinses or an
antiseptic rinse, limit physical activity during the first 24-48 hours after surgical
intervention. Swelling can be reduced by placing an ice pack on the affected side at
30 minute intervals during the first 48 hours after surgery. Patients should avoid
smoking completely, as it tends to slow the process of healing and may contribute
to infection and prolonged dis-comfort.
 Several studies have been conducted regarding what type of toothbrush is the
most effective in routine maintenance care of implants. The results show no signif-
icant difference between sonic, electric, or manual toothbrushes. The main focus
needs to be on adaptation to the prosthesis and the patient's dexterity. The patient
should brush the implants twice daily to remove bacterial plaque with a low-
abrasive dentifrice. A soft toothbrush should be used; options include a manual
brush, elec-tric or sonic brush. There are many types of floss on the market, and
generally it is highly recommended to use unwaxed tape or implant-specific floss
in order to pro-tect the tissue surrounding the implant. It is highly recommended
for patients to use oral irrigators for the reduction of plaque/biofilm, inflammation,
and hard-to-reach emergence profiles around implants. The patient should use a
nonmetal tip one to two times daily, and, if inflammation is present, add a diluted
non-alcohol antimicro-bial rinse (chlorine dioxide or chlorhexidine gluconate). It is
recommended to avoid chewing hard foods, ice or other hard objects, since this
could damage your crown. For most patients, a visit to the dentist every 6 months
may be adequate. However, considering your new implants and teeth, a follow up
every 4 months may be better until recommended otherwise by a dentist.

Read the text about the prosthodontics specialist training in the USA and
answer the following questions.

Why is prosthodontics specialty in great demand today?

What are the four steps of training to become a prosthodontist in the USA?
How is it possible to receive a board certification? What is it necessary for?

HOW TO BECOME A PROSTHODONTIST IN THE USA

Recent findings have estimated that every year nearly 300,000 people have
dental implants placed inside their mouths in the United States. Whether it's due to
an acci-dent, to restore a congenital defect, or simply due to old age, the reality is
that cosmet-ic dentistry has developed greatly over the past several years. This
responsibility falls on the limited community of passionate dental specialists
known as prosthodontists. The students’ interest level of learning how to become a
prosthodontist is also sig-nificantly increased. Prosthodontics deals with restoring
damaged teeth or replacing missing teeth with artificial devices such as dentures,
crowns, bridges, veneers and dental implants.
In order to practice as a prosthodontist, a candidate has a prolonged training with
further receiving board certification from the American Board of Prosthodontics. The
candidates begin their first step of educational path focusing on general stud-ies in the
biological sciences including biology, chemistry, physics, physiology and
human anatomy. Future prosthodontists also complete core studies in written com-
munications, mathematics, and in most cases, psychology and sociology. The second
step of the educational path is to become a licensed Doctor of Dental Surgery (DDS) or
Doctor of Dental Medicine (DDM). A candidate completes this step at an accred-ited
Dental College or University. The first two years of study focus on learning basic
dental sciences and procedures that are taught in both the classrooms and in labora-
tories. The students work in groups learning how to diagnose and treat adult patients
under direct supervision during the final two years. Once the candidate has com-pleted
the dental school examinations, they will become a DDS (Doctor of Dental Surgery) or
a DMD (Doctor of Medicine in Dentistry). In order to become a licensed specialist to
practice dentistry in the United States, a candidate must complete the National Board
Dental Examinations, as administered through the American Den-tal Association. This
implies the third step of training. Each US State has special licensing requirements to
practice in their state, and requires dentists to continue their study in order to maintain
their licensing through attending educational semi-nars and classes. The fourth step of
education is to complete residency training. The residency training to become a
prosthodontist starts directly after graduation from dental college and successful
completion of the NBD exam. During this residency lasting for 3 years candidates
receive intensive on-hands training in several fields of this specialty including
removable prosthodontics, fixed prosthodontics, implant prosthodontics, maxillofacial
prosthetics. Once the residency has been completed, the candidate will have the chance
to sit before the American Board of Prosthodon-tics in order to receive board
certification. This examination is extremely difficult and profound, as it includes
written, oral and clinical examinations — all of which must be passed with high
standards to obtain the board certification.
According to the Bureau of Labor Statistics the average salary of a prosthodontist is
nearly $110,000 annually. The professional prosthodontist can be a saviour to those
who want to have a perfect smile or keep it looking great, or who has experienced a
traumatic injury or who needs restorative treatment of congenital defects.