Patient Information
FAQ (Get To Know EMA)
What’s in a name?
When choosing your health professionals, look to individuals whose career and the patients they treat are their passion, not a distraction. From technology to informative conversations and education we banish fear and apprehension allowing us to help you reach the highest level of dental health for a more healthy and rewarding life.
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Esthetic dentistry & EMA's Dr. Emirzian: What’s the connection?
Over EMA’s past 25 years we, as well as all of dentistry, have seen a huge shift from need dentistry (pain relief) to want dentistry (elective treatment) including esthetic and implant dental treatment. Dr. Emirzian has dedicated her career to being on the cutting edge of esthetic dental treatment combining technology and artistry with a feminine eye. From cost-effective tooth whitening techniques to more sophisticated smile makeovers with state-of-the-art ceramic veneers, Dr. Emirzian is our source for the best esthetic dentistry has to offer and brings to your care the unique combination of technology and artistry.
What is a Prosthodontist?
Prosthodontics is a dental specialty for the replacement of teeth! Yes, all dentists can replace and fix teeth, but when dentists and patients need a solution for complex dental needs, they see a prosthodontist. Dr. Mariano, a Board Certified Prosthodontist, is one of only 1,000 in the country and the only one in Western Massachusetts! His extensive specialty training provides his patients with solutions and treatment on saving a single compromised tooth to full mouth rehabilitation. Dr. Mariano’s focus is crowns, bridgework, removable dentures, and state-of-the-art accelerated dental implant treatment.
Technology in dentistry: How important is it?
Many technological and scientific changes are taking place in dentistry, many of them very significant to your future dental health. More scientific literature is pointing to a relationship between periodontal disease and systemic diseases, noting the importance of routine 4-6 month hygiene maintenance care. Digital diagnostic radiography and 3D dental CT scanning significantly enhance our diagnostic ability. Dental implants (conventional and mini) and accelerated implant treatments are options to know before treatment. State-of-the-art, esthetic, all-ceramic CAD/CAM crowns are taking esthetic dentistry to the next level!
EMA - All patients are educated and offered the best technology dentistry has to offer.
Is it the implant or how it is used that is important?
Both, and all patients should know the difference. A dental implant is a titanium root form that is placed in the jaw bone and alone does nothing else but preserve bone. How the implant is to be used should be determined by a general dentist or prosthodontist (a specialist in tooth replacement) before it is placed. Implants can be used to support crowns or dentures which can be removable or non-removable. Cost and patient desires help decide. There are many implant options today… As a patient, know the options and how dental implants can help you.
If I need a root canal, am I better off having the tooth extracted with placement of a dental implant?
It depends on the condition of the tooth. Both endodontics and dental implants are highly successful. A tooth that is structurally sound, especially in an esthetic area, should be saved. However, teeth that are structurally compromised and/or present root canal challenges are candidates for the very predictable alternative of dental implants.
EMA - Patients need to be guided in these decisions by their dentist or a dental specialist in tooth replacement, a prosthodontist.
My smile is important to my career. What is the best way to improve it?
Comprehensive dental evaluation and discussion as to your own view of esthetics and goals is the first step. Then, and only then, can your dentist develop a plan that is right for you. Your options may include simple tooth whitening, cost effective basic bonding (white fillings), or highly esthetic all-ceramic crowns and veneers for full smile enhancement. Photography and smile analysis are used extensively today to develop the smile that is right for you!
EMA - Comprehensive treatment planning is the key to patient satisfaction.
Is it true dental implants are very expensive?
Dental implants can be very expensive ($30,000+) per dental arch for non-removable state-of-the-art porcelain teeth on six to ten dental implants. There are many other options however which are less costly including removable denture teeth supported and retained on two to six dental implant fixtures which can range from six to ten thousand dollars. Today there are also mini-implants which are the most cost-effective way to utilize dental implants with removable dentures which can be done many times for less than three thousand dollars. It is important to discuss with your dental professional all of your dental implant options prior to treatment. At EMA Dental, thorough discussions as to all treatment options are vital before patients decide on dental implants.
What is the relationship between periodontal disease and systemic disease?
In the last several years, dental literature has contained a number of references to the possible links between various systemic disease conditions and poor dental health, especially periodontal (gum) disease. Poor dental health results in an enormous amount of bacteria that can enter our blood stream and effect distant organs. The literature suggests links to diabetes and heart disease. Preventive dentistry, including routine dental hygiene visits on a 3 to 6 month basis, is your best way of minimizing periodontal disease and its interactions with other systemic disorders like diabetes and heart disease.
EMA - Oral health is part of overall health.
What are the advantages of digital dental radiography? Am I exposed to more or less radiation?
There is a strong movement away from conventional dental radiography towards digital. Digital radiography has many doctor/patient advantages such as the immediacy of image observation, easy digital storage and retrieval, ability to enhance the image for better diagnostic purposes, ability to transmit images electronically to any desired recipient, and, most importantly, all this with a reduction in radiation to the patients. Until recently, all in-office dental radiography has been two dimensional. In-office, three dimensional, digital, CT scan radiography is now available in some offices, further enhancing doctors’ diagnostic abilities.
EMA - On the forefront of this technology with one of the area’s first 3D CT dental scanners, the I-CAT.
Amalgam versus resin-based composites (white fillings): Which is best?
This paradigm shift has been going on for many years. Although amalgam has shown to be safe and is supported by the American Dental Association, fewer dentists are using amalgam as a routine restorative material. Every year as resin-based composite materials become better, more dentists put aside amalgam as their primary restorative material. Eventually, as resin composite technology continues to improve, it is anticipated that amalgam use will disappear. The benefit to the patient… highly esthetic fillings blending in with natural tooth structure. New materials in the near future will surpass, both esthetically and functionally, the old style amalgam filling.
When should I have a new all-ceramic crown versus the older style porcelain fused to metal (pfm)?
This paradigm shift is well underway. The new generation CAD-CAM Zirconium all-ceramic crowns are the esthetic choice for anterior (front) teeth requiring highly esthetic, natural results. Procera, Empress, and LAVA are brands of these types of crowns. Although strong and esthetic, they are not yet the choice when bridgework is needed or if the patient grinds and/or clenches. Hand-made porcelain fused to metal crowns have been the workhorse of the crown and bridge for over 50 years and still have many advantages in the posterior regions, but this is being challenged strongly by zirconium based crown technology with the rapid advancements in computer driven milling of zirconium oxide materials. Ask your dentist about which type of crown is best for you!
I am very nervous about going to the dentist. I have so many dental problems and I am afraid it will take a lot of visits. Do you have any suggestions?
The best way to overcome nervousness and apprehension is developing a personal long-term and trusting relationship with your dental professional. At EMA we always say open and sincere discussions will banish fears and apprehension. Educating you to your treatment options and deciding together what options are best for you is important. Oral sedation treatment is available today which allows us to treat extensive dental problems in a few visits with minimal patient apprehension. Oral sedation used the night before treatment significantly reduces any anxiety allowing patients to be well rested and anxiety free the day of treatment.
I have had dentures for 15 years and they recently have gotten quite loose. I haven’t been to the dentist since I got my dentures. Can anything be done to make my dentures fit?
Even the best fitting dentures will get loose over the years because bone loss always occurs under dentures with use. Patients with poorly made dentures, clenchers and grinders and patients with poor bone density will lose more bone over time. Denture relines and broadly extended dentures will many times help the looseness but not the bone loss. The miracle of dental implants even only two under a denture will significantly reduce bone loss and improve retention, stability and comfort of the denture. All denture patients should see their dentist yearly to check tissue health and denture fit.
What are porcelain veneers and am I a candidate for them?
Porcelain veneers are ultra thin, custom, ceramic facings that are bonded to the front surfaces of the teeth. They are used to lighten, close gaps, correct malformations and proportions of esthetically compromised anterior (front) teeth. Porcelain veneers are considered an excellent treatment and require minimal tooth preparation. Patients can discuss their goals and aspirations to help formulate the artistic smile of their dreams. At EMA Dental, we work with our patients and our dental ceramic technicians to create a customized smile in perfect harmony with your facial shape and complexion. No two smiles are alike and artistry is an important aspect of this advanced treatment approach.
If I lighten my teeth, will my existing crowns and fillings lighten too?
No. Teeth lightening will only work on natural tooth structure. Pre-existing fillings and crowns will actually appear darker after the procedure due to the lighter adjacent natural tooth structure. For this reason, it is important to consult with your dentist prior to whitening so that you will know what restorations will potentially need replacement. Also, prior to any esthetic makeover, whitening is the first step so that the new restorations are matched exactly to the lighter shade. It is important to know that any whitening will require a touch-up every 12-18 months, depending on your diet and home health care habits. Remember, smoking and consuming dark liquids (coffee, tea and red wine) will contribute to darkening the teeth.
I have had 3 sets of dentures over the past 20 years. The first two sets were fine, but I’ve had a lot of difficulties with the most recent set. Are all dentures the same?
The comfort, esthetics, and function of a denture is determined by the quality of the laboratory materials as well as the knowledge and techniques utilized by the doctor to construct them. When good bone is available, comfort and good denture function are much easier to attain. As more bone is lost under the denture, fit becomes more difficult. Drs. Mariano, Vergo, and Nghiem are prosthodontists, specialists in dentures and other forms of tooth replacement. A prosthodontist utilizes extensive training in anatomy, impression technique, and occlusion (your bite) to make the best denture possible.
What is the best way to whiten my teeth?
Dentist dispensed tooth whitening is the most effective way to lighten teeth. Over-the-counter products can work, but they are at a lower concentration and will not be as effective. At EMA we offer both home whitening and in-office ZOOM! whitening to our patients. At-home whitening utilizes a whitening gel placed in a mouth guard and worn for several hours a day for approximately 3 weeks. The results are time and dose related so the more consistently the mouth guard is worn, the better the results will be. In-office whitening takes 1-2 hours and will have more immediate results. Both approaches are effective and should be considered based on your lifestyle.
What are sealants?
Sealants are a protective resin coating applied to the chewing surfaces of back teeth. It is a more fluid version of posterior composites that prevents tooth decay in pits and grooves by mechanically blocking plaque accumulation in these areas. Sealants do not require any tooth preparation or drilling and are usually placed soon after the teeth erupt into the mouth. Most sealants are placed on children and teenagers, but can be placed in adults with high caries risk. Sealants are a very effective treatment for the prevention of decay in hard to clean pits, grooves, and fissures of back teeth. Sealants are an important part of the prevention-oriented philosophy of EMA.
What are tooth-colored alternatives for replacing silver fillings in back teeth?
Posterior composites are tooth-colored fillings used for back teeth. The material used is a combination of resin-based materials reinforced with glass particles. This treatment is indicated for the restoration of small to moderate defects; this treatment is done in a single visit. Other options are ceramic inlays or onlays. These fillings are made of dental porcelain restorations that are made in the laboratory and often require two visits. Ceramic inlays are indicated for moderate to large defects in the posterior teeth.
What is composite bonding?
Composite bonding is one of the most significant advances having taken place in dentistry in the past 25 years. It is a procedure that allows a dentist to adhere tooth-colored materials directly to the tooth. Bonding is used on both the front and back teeth to restore defects including decay, lost or broken fillings, closing gaps, chipped or cracked teeth, gumline erosions, and correcting defects that appear on the front surfaces of teeth. It gives patients a conservative and affordable alternative for improving dental esthetics.
Who should see a specialist for dental treatment?
Most patients should develop a long-term relationship with a general dentist for their dental care. Most general dentists follow the American Dental Association’s guidelines for referring patients to specialists, which emphasizes “referrals should be based on the education, training, interest and experience of the dentist and the unique needs and complexity of the patient’s treatment”. All doctors should know their own limitations. Patients always have the option to choose a specialist. Dental specialties include: Endodontists (root canals), Pedodontists, Periodontists (gums), Prosthodontists (tooth replacement), Oral Surgeons, and Orthodontists (braces).
Why can’t my tooth have a filling instead of a crown?
Many teeth can have fillings (white bonding) or silver (amalgam) to replace lost tooth structure due to decay or breakage. However, if the structural integrity of the tooth is compromised (greater than ½ the tooth is gone), a crown is a better, safer, long-term approach. A crown will cover over the remaining tooth and protect it from future fracture and decay with proper maintenance. Also, newer, state-of-the-art, esthetic crowns will make your tooth look better and more natural than extensive filling techniques. Crowns help protect your remaining tooth for many years into the future.
I have lost a number of posterior teeth over the years, but do not miss them functionally or esthetically. What’s the problem?
Posterior teeth are strong and multi-rooted for use chewing food thoroughly, the first step in the digestive process. When some or all of these teeth are not present, patients will use their front teeth (incisors) to chew their food before swallowing. Front teeth are weaker (single rooted) and not meant for excessive chewing. (I.e. They bite into the apple, not chew it.) Results – front teeth begin to move, wear, and many times loosen over time. Worse yet, since food cannot be chewed well with only front teeth, digestive problems may follow. Oral health is part of overall health.
What is the best way to maintain dental health? I see my dentist regularly, is that enough?
Seeing your dental professional regularly and good home care are the first steps in maintaining good dental health throughout your life. Unfortunately, too many patients are surprised to learn without warning that they need extensive dentistry. Dentistry can be done through a “break and fix” approach or a more comprehensive, long-term, planned approach. All patients should be offered a long-range dental health plan, done every 5 years, that outlines current and future dental needs. Treating gum disease and compromised teeth before they become big problems is always a better and more cost effective way to dental health than the “break and fix” approach.
How do I get the most from any health professional?
When choosing your health professionals, look to those individuals whose career and patients they treat are still their passion. These doctors are easy to spot, they are fully engaged with their practice, staff, and patients. They develop long-term relationships and get to know you and your family members. They become part of your health team. As a patient, be open and clear about your health needs and understanding that medicine and dentistry are as much an art as they are a science. Developing long-term relationships with your team of health professionals will serve you well in the years ahead.
