David C. Shonberg
DDS, FACP
30 N. Michigan Ave.
Suite 1503
Chicago, IL 60602
312.726.1901
Our Office Hours
Monday - Friday
8:00 am - 5:00 pm
Call 312.726.1901
For an appointment
Common Questions |
I've never been to a prosthodontic practice before. What is a prosthodontist?A prosthodontist is a dentist recognized by the American Dental Association and by state licensing authorities as a specialist in the restoration and replacement of teeth, with emphasis on both comfortable function and attractive appearance. Prosthodontics is one of 8 specialties recognized by the American Dental Association. These are: (1) oral and maxillofacial surgery (tooth extractions and other surgery, including dental implants), (2) orthodontics (braces), (3) periodontics (gum treatment and surgery, and also dental implant surgery), (4) endodontics (root canal treatment), (5) pedodontics (children's dentistry), (6) prosthodontics (restoration and replacement of teeth), (7) oral pathology (microscopic examination of oral tissues), and (8) public health dentistry (the study of dental disease from a population perspective). Dentists undertake prosthodontic training programs after they finish their basic dental degree (DDS or DMD), and they train for what is now a minimum of three years. The focus of training is on patients with complex dental needs. What is 'board certification?'The phrase 'Board-certified' indicates successful completion of a comprehensive examination after completing an accredited specialty training program. In the specialty of prosthodontics, the American Board of Prosthodontics administers the examination. The Board consists of prosthodontists from across the country who are recognized in the field, and who are elected for specified terms by the Diplomates of the Board. As an alternative to examination by the American Board of Prosthodontics, some states administer their own board examinations. After completion of the board certification process, the dentist becomes a Diplomate of the Board. Dr. Shonberg became a Diplomate of the American Board of Prosthodontics in June of 2000. How is a prosthodontic practice different from a general dentistry practice?Our prosthodontic practice is similar to a general dental practice in many ways. For example, our staff includes two dental hygienists that perform preventive teeth cleaning (prophylaxis). In addition, many of our patients' needs fall into the category of "every-day dentistry." A dentist with specialty training in prosthodontics also has the expertise to treat patients with complex treatment needs. Therefore, our practice also includes many patients who have had in the past, or who currently have, complex treatment requirements. What is "cosmetic dentistry?"The American Dental Association does not currently recognize a specialty called cosmetic dentistry. However, there has been a considerable increase in the organized knowledge of what constitutes a pleasing smile, with a parallel development of materials and techniques to achieve esthetic goals. Can you show me a personalized example of how my smile can look, before I choose to proceed with treatment?In most cases, Yes. First, we determine the kind of changes that would be beneficial to your appearance. Changes may involve tooth color, shape, or both. You probably have your own ideas, but we can also make suggestions. Once we agree on the objectives, we make plaster models that show the details of your teeth. Then, using wax, we alter these models according to the agreed-upon esthetic goals. This is called a diagnostic wax-up. In some instances, this idealized model can be used to make a simulation that can actually be placed in the mouth. Even when this is not possible, this simulation is available for your inspection. Adding tooth-colored resin material directly to the teeth is another way to preview results. This is like "bonding," except that the steps used to fix the resin to the teeth are omitted. This means that the resin material can be removed at the end of the appointment. Before the resin material is removed, a digital photograph can be made for you to evaluate at your leisure. Computers can also be used to preview results, but computer simulations can be misleading. WIthout three-dimensional models, it may be hard to know whether a change that looks good on a computer monitor can actually be achieved in the mouth. I have never liked wearing a lower denture. They don't stay tight like the upper ones. What are my options?Many of us who provide dental implant treatment have noticed that people seem to do better and be happier with their tooth replacements when a lower denture is stabilized with at least two dental implants. This type of tooth replacement is called an overdenture. An overdenture is defined as a denture that fits over remaining natural tooth roots or dental implants. There are two advantages to this approach: (1) the dental implants or natural tooth roots can be fitted with a type of snap that will hold the denture in position and (2) the presence of natural tooth roots or dental implants inhibits the jaw bone from resorbing (shrinking away). The recent McGill Consensus Statement on Overdentures has recently validated this clinical impression. A panel of experts concluded that, according to currently available data, the two-implant over-denture should be the new standard of care for patients who have no lower teeth remaining. Is it always necessary to replace a single missing tooth?In our profession, we all recognize that the loss of a tooth will often cause adjacent and opposite teeth to change position. However, this does not always occur, and when it does, the changes are often minor and self-limited. According to a recent study, when a molar tooth is lost after age 26, only 14% of the opposing teeth showed evidence of extrusion (drifting up or down). Therefore, the decision to replace a missing tooth should be made on an individual basis, with consideration to patient values and priorities. "Watchful waiting" may be an appropriate strategy for some patients. Over the years, I have lost all my back molars. How big a problem is this, and what are my options?We have a name for the situation when a patient has no back molars. We call this the "shortened dental arch." This is not necessarily a problem, although many patients will experience an acceptable hindrance in their ability to chew. A shortened dental arch does not cause pronounced drifting of teeth or problems with the jaw joint (previously called "TMJ"). The options for restoring a shortened dental arch are (1) teeth supported by dental implants, and a (2) removable partial denture. The first of these options is usually preferable. Why am I asked to take antibiotics before having my teeth cleaned, and before other dental procedures?The two medical reasons are (1) irregularities in the valves of the heart, and (2) prosthetic joint replacements. In the first case, the concern is the development of bacterial endocarditis, which is an infection of the heart valves. In the second case, the concern is infection of the prosthetic joint. When your appointment is confirmed in our office, our staff will always confirm whether or not pre-medication with antibiotics is necessary.
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