Dental Information

Dr Jack M Hosner DDS

Feel free to browse the following dental information and learn more about the terms used by dental practitioners daily at Dr. Jack M Hosner DDS so that you will feel more informed on your next visit. Call us today and let us help you achieve your personal dental goals with comprehensive and quality care.

(In alphabetical order.)

  • Amalgam (Silver Fillings)

    Silver Fillings (Amalgam) used to be one of the most commonly used materials to fill cavities in back teeth. It contains a mixture of silver, tin, copper, zinc, and mercury, which bond to create an alloy. The mercury found in amalgams is not in the harmful “free” form. Because of this, the mercury in amalgams is stable and safe for use according to the American Dental Association (ADA) and the U.S. Public Health Service. According to some studies, exposure to mercury in drinking water and food is greater than that to all the mercury in a mouthful of fillings. Amalgam fillings are strong and have been successfully used in people’s mouths for the last 150 years.

    However, there are many other studies that claim the mercury in dental amalgam is very toxic and dangerous, and can lead to arthritis, Alzheimer’s disease, and many other neurological disorders. In fact, in Germany, there is a partial ban on the use of amalgam, and a total ban in Sweden. Although the evidence of mercury leakage to date has not passed scientific absolution, there is however a myriad of enough good solid reasons to discontinue its use as much as possible. Amalgams leak, expand, and since they are not bonded into the tooth, they act as a wedge and wedge the tooth into a fracture. Since amalgam restorations are maintained in the tooth via mechanical retention that the dentist cuts into the tooth, the preparation process required in using amalgam results in more extensive destruction of healthy tooth structure. Amalgam is also an unattractive restoration to be placed on white/ivory colored teeth. It starts out silver in color and over time turns black. Not only does it cause the tooth to appear gray and eventually black from the front, it also stains the tooth from within making it nearly impossible for it to have a natural appearance.


    That being said, there are some instances where amalgam is the best choice for restoring a tooth for a particular individual. It can be placed more predictably in areas that are hard or impossible to isolate from saliva than can bonded materials such as tooth colored fillings. It also is usually less expensive and less time consuming to place.

  • Bridge

    Dental bridge - before and after

    A dental bridge can also be called a fixed bridge or a fixed partial denture. It is a restoration designed to replace missing teeth. Once it is placed, it is affixed securely to your teeth and is not to be removed. A bridge spans a space where one or more teeth have been lost in the dental arch. The teeth on either end of the space are crowned, and are referred to as abutments. The false teeth in a bridge that join the abutments are referred to as pontics. Crowns and bridges are most often made from superior materials such as zirconia, precious metals (gold), semi-precious metals, porcelain, or a combination of metal fused to porcelain. Both esthetics (appearance) and function are considered when selecting the material most suitable for you.


    Several steps are involved and two dental visits are generally needed to complete the treatment. The abutment teeth that are to be crowned are cleaned of all existing fillings and decay and then re-restored with bonded restorations called cores. These teeth are then prepared or trimmed to allow sufficient space for the bridge to fit. An impression is then made of this area and sent to a special dental lab that will fabricate the bridge. A temporary bridge will be custom made chairside for you, and you will wear the temporary until the final bridge is finished in a few weeks. Once the bridge is ready, the dentist simply removes the temporary and cements or bonds the bridge to your teeth. Minor adjustments are usually required to optimize fit and comfort.


    It is very important to clean daily around the teeth that support the bridge and under the bridge itself so that food particles aren’t left under it for long periods of time. You are six times more likely to develop a cavity around a bridge than you are around a tooth with a single crown. So, continue with good, daily oral hygiene and regular examinations and professional teeth cleanings.

  • Cavities

    A cavity, also known as tooth decay or dental caries, is an area of infection on the tooth which causes the tooth to become discolored and soft. If left untreated, it will often progress deeper into the tooth causing infection into the roots where the tooth’s nerve is. Sometimes, a person doesn’t feel any pain from a cavity until it has irreversibly damaged the tooth’s nerve. From this point, the infection spreads out the end of the root into the bone and soft tissue often times causing swelling. Sometimes, this infection can spread to other areas of the body and become life threatening. Therefore, it is very important to treat cavities when they are small and before you notice any pain.


    You must have tooth structure, bacteria, and sugar together in order for a cavity to form. If any one of these items is not present, you cannot get a cavity. The millions of bacteria in your mouth convert the sugar into harmful acids that attack your teeth for as long as twenty minutes or more and cause cavities. Since teeth and bacteria are always present in your mouth, the only one of these three items that a person can reasonably control is sugar. Sugar is present in almost all foods and drinks, even in healthy items not necessarily considered sugary snacks. Bacteria can also produce acid from any food containing carbohydrates including pasta, crackers, popcorn, potato chips, peanut butter, bread, and fruit. It is very important to realize that it is the frequency rather than the amount of these products exposed to the teeth that is the most damaging.


    Fluoride hardens the outer surfaces of your teeth and makes them more resistant to decay. To help prevent cavities, brush with fluoride containing toothpaste, floss, and most importantly, do not frequently expose your teeth to food and drink, unless they are sugar-free. Although brushing and flossing are essential in helping to prevent gum disease, they are not that effective in reducing decay, and cannot compensate for frequent snacking.

  • Complete Denture

    Complete dentures - before, during and after

    A complete denture replaces all the natural teeth and provides support for cheeks and lips. It is for people who are missing all of their upper teeth and/or all of their lower teeth. Without this support, sagging facial muscles can make a person appear older. By replacing missing teeth, dentures improve a person’s ability to speak and to eat.


    Complete dentures are called “conventional” or “immediate” according to when they are made and when they are inserted into the mouth. Conventional dentures are made and inserted after the remaining teeth are removed and the tissues have healed. Healing may take several months. Immediate dentures are inserted immediately after the removal of the remaining teeth. To make this possible, the dentist takes measurements and makes models of the patient’s jaws during a preliminary visit. An advantage of immediate dentures is that the wearer does not have to be without teeth during the healing period. However, bone and gums shrink over time, especially during the period of healing in the first six months after the removal of teeth. Immediate dentures will then require a reline of the interior of the dentures to fit properly much sooner than will the conventional dentures.


    It does take several visits to construct a well fitting denture. Accurate impressions need to be made of your mouth, the relationship between your upper and lower jaws needs to be recorded, the denture needs to be patient approved and if possible tried in the mouth prior to final fabrication, and a few adjustments need to be made before you are wearing them comfortably. A healthy mouth will insure that your treatment will progress with the greatest possibility for success. Your mouth is unique and may require additional therapy to achieve oral health and make a firm foundation for your new denture prior to its fabrication.


    Even with full dentures, you still need to take good care of your mouth. Clean your dentures and mouth of any food debris after every meal. Every night and morning, brush your gums, tongue and palate with a soft-bristled brush. Also, clean your denture every night. See your dentist at least yearly for an exam.


    Dentures are only substitutes, at best, for your natural teeth, and cannot be compared directly with natural teeth. New dentures (even if you currently wear dentures) will feel awkward for a few weeks, and may take as long as six to eight weeks for your mouth to adjust to them. A denture is basically a foreign body made of acrylic trying to stay steady in an unfriendly environment. It just sits on the upper roof of the mouth and or gum ridges of the lower jaw where the teeth used to be, and the tongue and cheeks can easily push it around. The dentures will feel loose until the muscles of your cheek and tongue learn to keep them in place. A feeling of fullness, additional saliva, difficulties with speech, eating, and soreness are inevitable when you first wear new dentures. As your mouth becomes accustomed to the dentures, these problems should diminish. It will take a great deal of practice and patience on your part before you will master the use of the new dentures. Time, experience in their use, and help from your dentist will aid you in overcoming these problems.


    The shape and contour of the ridges on which the dentures will sit, the amount and consistency of one’s saliva, and the way that each individual’s jaw moves during function influences the fit and retention of the dentures. Although millions of people happily and successfully wear dentures, overall, some 25% of patients are likely to be dissatisfied with their dentures. Many patients are quite satisfied with dentures that are extremely poor, while other patients are dissatisfied with dentures that seem to be technically excellent. It is usually impossible to predict which patients are likely to have problems.


    An excellent way to make your denture more secure is to attach it to dental implants which are held into the mouth tightly by the bone. This type of appliance is called an implant retained overdenture. In some cases implants can replace all of your teeth without the need for a denture at all.

  • Composite Resin (White Fillings)

    Composite Resin - before & after

    Composite Resin (White Fillings) is a dental restorative material made of acrylic resin mixed with finely ground glasslike particles. This white filling material must be bonded to the tooth. Composite resin match the color of your existing teeth, and can be used to restore a decayed tooth or repair a defect. It can also be used to improve esthetics by closing spaces between your teeth and by changing the color and shape of a tooth.

    A bonded restoration integrates with the tooth and doesn’t act as a wedge to break the tooth like a silver amalgam filling does. Also, since composites bond to tooth structure, the tooth does not have to be cut or prepared as much to provide mechanical retention. Once the decay is removed, the composite resin can be placed into the defect, regardless of the shape of that defect. So, generally speaking, it is a more conservative and less destructive way to restore a tooth.


    Composite restorations are technique dependent and take more time and finessing than silver fillings. The tooth must be well isolated from saliva, as this can compromise the bonding process. Just as with any restoration, you can develop decay around them, so it is important to clean around them and avoid frequent snacking. Eventually, these fillings will breakdown and need replacement much like amalgam fillings.

  • Crowns

    Dental crown - before and after

    A crown is a dental restoration that covers or “caps” a tooth to restore it to its normal shape, size, and function. Its purpose is to strengthen or improve the appearance of a tooth and protect it from fracture. When the structural integrity of a tooth has been compromised by old filling materials, cracks and/or decay, a crown is the indicated treatment. A crown can:


    • Restore a tooth when there isn’t enough tooth remaining to support a large filling
    • Attach a bridge to replace missing teeth
    • Protect a weak tooth from fracturing
    • Restore a fractured tooth
    • Cover a badly shaped or discolored tooth
    • Cover a dental implant

    Crowns are usually made out of zirconia, metal, porcelain, or a combination of these. Several steps are involved and two dental visits generally are needed to complete the treatment. The tooth is first cleaned of all existing fillings and decay, and refilled with a bonded restoration. This type of restoration is commonly called a core. Then the tooth is prepared in the areas where the crown will be placed by removing its outer portion to accommodate for the thickness of the crown. An impression of the tooth is made and sent to a special dental laboratory where the crown is fabricated. Making the crown may take a few weeks, so in the meantime, you will wear a temporary crown that the dentist will custom make for you chair side. When the final crown is ready, the dentist simply removes the temporary and cements or bonds the crown to your tooth. Minor adjustments are usually necessary to further customize the crown to your bite. If your crown is porcelain, it is extremely important that you avoid chewing hard foods, ice, or other hard objects such as pencils that could fracture the porcelain. Crowns protect teeth from fracture, but you can still get cavities and gum disease around them, so continue to practice good oral hygiene and see your dentist for regular examinations and professional teeth cleanings. It is most advantageous to crown a tooth before it actually breaks. Sometimes, a tooth will fracture well below the gum line. This will require gum surgery first to reposition the gums below the fractured edge before restoring the tooth with a crown. Occasionally, a tooth will fracture so badly that it cannot be saved and will need to be removed.

  • Dental Implants

    Dental Implant - before and after

    Implant dentistry evolved from general dentists. In the 1940’s, a general dentist developed the concept for implants to replace a single tooth. Today, dental implants are very predictable and successful. The dental implant is clearly the best choice for tooth replacement in most situations. The single tooth implant exhibits the highest survival rates of any other option presented for single tooth replacement.


    Dental implants are made of titanium and are surgically placed into the jawbone to replace the roots of missing teeth for the attachment of teeth or dentures. Through a process called “osseointegration”, the jawbone actually attaches itself to the implant over time, providing tremendous stability and natural function.


    If a patient faces the loss of one or several teeth or is dissatisfied with dentures or other options available, the patient may find that dental implants are the right solution. Age is not typically a major factor; successful dental implants have been performed on young people as well as the elderly. A young person, however, should be finished growing before having an implant placed. During the patient’s initial consultation, the doctor or the staff can help in the decision process. In general, the following factors are evaluated: general health, oral health, sufficient underlying jawbone to support the implants, a good attitude to ensure proper follow-through, and good oral hygiene habits.


    Implant treatment is usually performed by a general dentist, periodontist, oral surgeon, or a team of these doctors. The surgical procedure is often performed in the dental office using local anesthetic. Each implant is placed to serve as an anchor for the support of the teeth. Generally, about four months are allowed for the bone to grow around the implants and hold them securely in place. During this natural healing time, some situations may require that a temporary tooth replacement be made and worn by the patient. Once the jawbone has firmly healed around the implants, an impression is made and sent to a special dental laboratory for fabrication of the restorative parts that will fit into and over the implants. Once the labwork is completed, a small post called an abutment is attached to each implant. The post protrudes through the gum line and serves as an anchor for the attachment of teeth (crowns) or dentures. The final crowns, bridges or denture can then be affixed to the abutments. Denture patients especially appreciate the improved retention of their denture. With implants holding the denture in place, there is no fear of the denture becoming loose or falling out, and these patients can once again eat all those delicious foods that are difficult to chew.


    Dental implant surgery has proved to be successful for hundreds of thousands of people over the years. The success rate of implant replacement teeth is highly variable, depending on a host of factors that vary for each patient. However, compared with traditional methods of tooth replacement like fixed bridges, removable partial and complete dentures, the implant replacement teeth offer increased longevity, improved function, bone preservation and better psychological results.


    Today’s technology can replace the tooth with a dental implant which may replace a single tooth or a whole mouth of teeth, without crowning any natural teeth. As a consequence, the teeth are easier to clean and less likely to decay, and/or need root canal therapy. With proper oral hygiene habits – brushing, flossing, and regular dental visits – the dental implant will serve the patient well.

  • Enamel Reshaping

    Enamel reshaping - before and after

    Sometimes, the desired esthetic result can be achieved by just re-contouring the natural tooth structure without the addition of a restoration at all. This is called enamel reshaping. Teeth that are too long or too pointy can be adjusted to the desired levels. Small chips in the teeth can also be reshaped and polished. Reshaping the tooth is done with a dental drill; however, the tooth enamel is not sensitive, so there is no discomfort, . . . even without anesthesia.

  • Gold

    Gold filling

    Cast gold continues to be the most biocompatible, strongest, and longest lasting dental material in existence with many restorations lasting 40 to 50 years or longer, although a newer tooth-colored material called zirconia is currently looking as good. If the patient wants longevity, gold alloy is by far the best;  however zirconia recently has shown to hold up equally as well and is tooth colored and less expensive.  Becuase of this, gold is not utilized as much as it was before the introduction of zirconia.


    The longevity of a properly prepared, constructed, seated, cemented, and finished cast gold restoration has always and continues to exceed any tooth-colored material. If you dislike having your teeth worked on over and over again to replace old fillings, consider gold fillings. According to the Dental Health Institute and many, if not all dentists around the world, gold is the highest quality, longest lasting restoration that there is. Where it is not imperative to make the restoration match the color of your tooth and cost is not a factor, gold is the best choice, plain and simple.

  • Guided Bone Regeneration (Bone Grafting)

    Guided bone regeneration (GBR) is the “backbone of modern implant dentistry” according to the September 2006 article in Dental Products Report. It is a procedure that stimulates the formation of new bone in your jaw where bone is deficient or lacking. This procedure is also known as bone grafting. In the 1970’s, a general dentist by the name of Tatum developed bone grafting for implants. Good quantity and good quality of bone provides a solid and necessary foundation to support a dental implant. Also, when bone is preserved in your jaws, it improves the soft tissue esthetics around a fixed bridge and implant and provides more retention for a complete or removable partial denture.


    After a tooth is removed or lost, a series of negative events occur which result in considerable loss of bone. It is well established in the literature that in the first year after a tooth is lost, there is a 25% decrease in bone ridge width and a 4 millimeter vertical loss. After three years, there is a 40% to 60% horizontal and vertical loss of the bone ridge. Bone is like muscle – without stimulation, it atrophies or goes away.


    Early bone loss can be reduced substantially if a socket grafting procedure is performed. Generally, it is most advantageous to graft immediately following the extraction of a tooth. After the removal of a tooth, there is a hole. This hole is then filled with a graft material that induces new bone to form. The graft material serves as a scaffolding to support the framework in which your own bone growth cells can proliferate and mature. This is called osteoconduction – the process in which a biomaterial provides a temporary infrastructure in which existing bone cells will congregate and initiate the process of bone formation. The longer you wait after tooth removal to graft the site, the more difficult it is to obtain the natural bone volume that you had before the tooth was removed. In some cases, so much bone has been lost over the years, that much more extensive and costly grafting procedures are needed in order to restore the missing teeth. Usually, within four months, the grafted area is ready for restoration with a dental implant.


    If minimally invasive dentistry is your standard of care, implant dentistry is the standard of care for replacing teeth. So, it only makes sense that preserving bone should be your number one priority.

  • Gum Disease

    Gum disease treatment - before and after

    Gingivitis is the initial stage of gum disease. Affected gum areas become increasingly red. They may appear swollen and may bleed easily, especially when you brush or floss your teeth. The condition is reversible at this stage with regular brushing, flossing and visits to the dentist. If it is not treated, however, gingivitis may lead to a more serious condition called periodontitis or periodontal disease.


    Periodontal disease of some degree affects about 75% of the adult population. It is an infection of the gums and bone that hold your teeth in place. It causes irreversible damage to the bone and tissue structures that support the teeth and can lead to bad breath and tooth loss. Periodontal disease is most often painless, and you may not be aware that you have a problem until your gums and the supporting bone are seriously damaged. This is why regular dental visits and periodontal examinations are very important.


    Without good periodontal health, there cannot be good general health. Research suggests that periodontal disease can affect the state of your whole body. Over the past few years, studies have shown a definitive link between your oral health and your general health. The following are a few of the many health problems that can be aggravated by poor oral hygiene: stroke, heart disease (including heart attack), respiratory infections, severe osteopenia (reduction in bone mass), uncontrolled diabetes, and preterm and low birthweight babies. In fact, one study showed that periodontal disease was a stronger risk factor for heart disease than any of the other conditions usually linked to it, including hypertension, high cholesterol, age, and gender!


    Periodontal disease is caused by the natural bacteria in your own mouth. Bacteria constantly forms on the teeth and between the teeth and gums. This causes inflammation and damage to the attachment of the gums and bone to the teeth. Healthy gum tissue fits like a cuff around each tooth. Where the gum line meets the tooth, it forms a slight v-shaped crevice called a sulcus. In healthy teeth, this sulcus depth is usually three millimeters (mm) or less. When periodontal disease is present, this normally shallow sulcus develops into a deeper pocket that bleeds, collects more plaque bacteria, and is difficult to keep clean.


    The goal of treating periodontal disease is to establish healthy gums and prevent any further bone loss. The easiest way to control periodontal disease and restore oral health is to begin treatment at its earliest stage, before the pockets get too deep. The deeper the pockets, the harder it is to clean, and the more easily it can progress. The first step involves a special cleaning called scaling and root planing which carefully removes plaque and tartar from beneath the gum line down to the bottom of each periodontal pocket. This treatment is usually done by the hygienist and is most often provided comfortably without the need for anesthetic. Occasionally, antibiotics are prescribed. This procedure helps gum tissue to heal and pockets to shrink; however, the bone around the teeth will never grow back to its original level. Therefore, you most likely will always have periodontal pockets deeper than 3mm around the affected teeth. A toothbrush and floss cannot clean deeper than 3mm below the gums; therefore, even with proper brushing and flossing, plaque bacteria will repopulate the base of the pocket and begin to do more damage to the tissue and bone. Studies have shown that this reaccumulation of the pocket with bacteria enough to reactivate periodontal disease only takes about 90 days. This is why it is so very important for patients who have undergone treatment to continue to have these pockets cleaned by a dental professional every three to four months for the rest of their lives. Since you are unable to clean these deeper areas effectively at home, waiting longer than three to four months may allow the bacteria time to cause more tissue and bone damage. There is no endpoint for periodontal therapy as long as you have teeth.


    At more advanced stages, the disease may require more complex treatment such as gum surgery and bone and/or soft tissue grafting. Usually, this is carried out by a dental specialist called a Periodontist. In the worst case scenario, teeth can become loose and need to be removed.


    You don’t have to lose teeth to periodontal disease. Brush, clean between your teeth, eat a balanced diet, and schedule regular dental visits for a lifetime of healthy smiles.

  • Insurance

    A dental plan is nothing more than a contract between your employer and the insurance company to partially pay for certain services. No insurance plan is intended to cover all of your costs. There are deductibles – money you must pay first before insurance begins to pay anything. There are annual maximums – the maximum amount of money insurance will contribute towards dental work per year. Some services are paid on a percentage, and some services aren’t covered at all. All of this depends on the specific type of policy that you have.


    Your employer buys a contract at a specified premium and includes as many or as few benefits as they are willing to pay for. Your employer is given a menu of dental policies from which to choose, and these packages vary in both the types of treatment covered as well as the percentage of the fee paid. It is a fact that the higher the premium paid by the employer, the higher the usual and customary fee schedule will be. This is why different insurance companies have different reasonable and customary fees for the same area. Ultimately then, it is your employer who determines how well your insurance covers your dental expenses. A usual, customary and reasonable (UCR) fee for a particular dental procedure for one insurance policy may be different than a UCR fee for the same procedure for a different insurance policy. The UCR fee for a particular dental procedure is different for each policy. So, there is no one UCR fee for a procedure. It’s all based on the insurance policy, and each policy is different.


    Dental insurance companies do not know what is best for you regarding your dental care, nor do they intend for their plans to cover all expenses. Their plans serve only as an aid toward acquiring better care. Try to think of your dental insurance as a friend or relative who has decided to contribute some money for you to help you pay for the dental treatment that you have decided to have done. They have neither agreed to the treatment that you have decided to have done, nor have they agreed to pay for everything. They are just helping a little bit for certain procedures.


    When you agree to be treated by your dentist, you accept direct responsibility for paying your dentist. Your dentist works for you, not your insurance company. If you are fortunate to have dental insurance that may assist you with the cost of treatment, the dental office can complete and submit all dental insurance forms to achieve the maximum reimbursement to which you are entitled; however, ultimately, you are responsible for the entire bill. So, if, for whatever reason, your insurance doesn’t pay what was estimated, you will need to satisfy the balance. While the dental office may assist you in filing insurance forms, they cannot guarantee any estimated coverage.


    To have dental insurance is a good thing, because it can help pay for some of the necessary dentistry that you want and need, but be sure to keep it in perspective. Insurance companies exist only to make a profit. While insurance premiums have gone up over the past 30 years, the average annual insurance coverage is still the same as it was 30 years ago…..$1000. If you factor in inflation, your insurance benefits should be over $6000! The insurance company gives you less coverage and charges you more for it. Their main objective is not to provide you with the best oral health care that you deserve; that is the job of the dental office.

  • Onlays

    An onlay is a restoration that fits over a portion of the top of a tooth to protect it from fracturing. This is very similar to a crown, except it does not cover the entire top or biting surface of the tooth. You may consider it a sectional crown. Therefore, an onlay is more conservative in nature than a crown, since it does not require cutting as much tooth structure. An onlay is placed on teeth that are at risk for fracture, yet still have some good, non-decayed, non-restored, solid, tooth structure remaining that is not at great risk for fracture. In this way, the weak part of the tooth is protected with an onlay, while the solid part of the tooth is left alone.


    By doing an onlay, you preserve more natural tooth structure than doing a crown which keeps the tooth stronger and makes it less likely to require a crown in the future. Also, the less cutting that is done on a tooth, the less likely that the tooth will need a root canal. An onlay is better than just a filling like amalgam or composite, because it is made out of gold or porcelain, which are much longer lasting dental materials. By placing an onlay on a tooth, you are less likely to need more restorative work on the tooth in the future, which is better for your tooth, your time, and your money.

  • Overdenture

    An overdenture is a complete denture that fits over your own remaining natural roots or dental implants that have been placed by your dentist. The retained tooth root or implant provides you with excellent stability and support for your overdenture.


    There is limited retention and stability with a traditional denture which relies on suction alone. Over time, retention only worsens due to continual bone loss (atrophy) of your dental arches from the lack of teeth, and this can have a negative impact on your overall health. Saving your natural roots or having dental implants placed will preserve bone and will dramatically reduce bone resorption and deterioration that results in loss of jawbone height and width.


    Unlike traditional dentures, root-supported or implant-supported overdentures are held in place by dental attachments which provide the retentive strength that you desire. Overdenture attachments are composed of two working components; the root post which is cemented into your root or an implant abutment that is threaded into your implant, and the denture cap which is retained in the underside of your denture. The denture snaps down over these implant or root attachments. The attachments under the denture do wear out over time and need to be replaced periodically. This just takes a few minutes.


    The home care for the overdenture is similar to that of a traditional denture. It needs to be removed and cleaned after meals and before bed. The implants and/or teeth also need to be kept clean on a daily basis. Visiting the dentist for a professional cleaning and examination at least every six months is also recommended.


    Overdentures will allow you to chew your food better and speak more clearly because they are held in place much better than a traditional denture. Studies have proven that overdentures contribute to improved chewing efficiency and phonetics. Loose dentures that cause embarrassment will be eliminated. Messy denture creams and adhesives are no longer needed.

  • Porcelain

    Porcelain is the most esthetic restorative material in dentistry. It can be used to repair broken or decayed teeth as well as to replace stained, chipped, missing or worn teeth. It is weaker than zirconia, so it is not used as much anymore for restoring teeth in the back (or front) where heavy forces are produced.


    Porcelain fused to metal (PFM) crowns have a proven record of success, and for many years were the only esthetic crown option available. This type of restoration has a metal substructure over which porcelain is fused. The PFM crown does not allow light to permeate through it. It blocks the light, and therefore casts a dark shadow at the edge or margin where the crown ends on the tooth. In order to hide this “dark line” margin, it is necessary to prepare/cut the tooth to a level slightly below the gum line. In this way, the edge or margin of the crown will be hidden under the gums. Over time, however, your gums can recede, thus exposing this margin.


    For ultimate esthetics, it is necessary to use an all-ceramic restoration; that is, one that has no metal in it. In addition to improved esthetics, the all-ceramic restoration does not require the tooth preparation to extend below the gums just for the sake of esthetics. This preserves natural tooth structure and helps keep the gums happy, since restorations below the gums can make it hard to keep the gums healthy. Light permeates the all porcelain fillings, and therefore, the margin blends in well with your natural tooth color even if or when the gum recedes. Since this margin is more esthetic, in many instances a more conservative tooth preparation can be made. This means less cutting and destruction of your remaining healthy, natural tooth structure, which in turn means less risk of damaging the tooth’s nerve. This preservation of tooth structure helps to maintain a stronger tooth. The elimination of metal and its inherent opacity allows the underlying tooth structure to help provide more natural and lifelike esthetics by becoming the substructure for the restoration.


    All-ceramic restorations must be bonded to the tooth, and this requires good isolation from saliva and other contaminants. The process of bonding is a bit trickier than the use of conventional cements and requires more finessing. Also, these restorations are more prone to chipping and/or fracturing and needing replacement than are PFM crowns. Therefore, in some cases, it may be prudent to avoid the use of an all-ceramic restoration. The farther back in the mouth the restoration is, the stronger are the forces that bite on it, thus increasing the likelihood of fracture. People who clench and/or grind their teeth also should avoid the all-ceramic material, especially in the back. The best indications for the bonded all-ceramics are veneers and anterior crowns. Many all-ceramic restorations have been successful on back teeth as well; just a little less predictable.

  • Removable Partial Denture

    A partial denture is a removable dental appliance that fills in the space created by missing teeth and fills out your smile. It is made for people who still retain some teeth. A partial denture can help you to properly chew food; a difficult task when you are missing teeth. In addition, a partial may improve speech and prevent a sagging face by providing support for lips and cheeks.


    A partial denture is made primarily of hard acrylic connected to a metal framework. The bulk of the appliance just rests on the gums and attaches to your natural teeth with metal clasps or devices called precision attachments. It is important for the remaining natural teeth to be properly restored and shaped before making the partial denture. This allows for the best fit and longevity of the appliance. A healthy mouth will insure that your treatment progresses with the greatest possibility for success.


    Several appointments are usually needed to complete the treatment. Once the gums are healthy and the teeth have been optimally restored, impressions are made of your teeth and gums. Often times this requires two appointments in order to capture the fine details of your mouth in the most accurate way with custom made impression trays. The metal framework is then made to fit the models and is tried in the mouth for accuracy. Once the metal framework is fitting properly, the denture teeth can be set to place. Usually, this is tried in the mouth for approval before processing and finishing the partial in the hard acrylic. The finished partial denture will need to have minor adjustments by the dentist in order for it to feel good and fit comfortably in the mouth. Usually, one or more appointments will need to be made for further adjustments as you start wearing it.


    Partial dentures are only substitutes, at best, for your natural teeth. Generally, a substitute is not as good as the original. It may take six to eight weeks for your mouth to adjust to the new denture. It takes a great deal of practice and patience on your part before you will master the use of the new partial. A feeling of fullness, additional saliva, difficulties with speech, eating, and soreness are inevitable when you first wear new dentures. Time, experience in their use, and help from your dentist will aid you in overcoming these problems. Since the mouth tissues, ridges, bone, etc. are constantly changing, it will be necessary to refit or remake the partial denture occasionally, sometimes every few years.


    Good oral hygiene and regular dental office visits for professional cleanings and exams are necessary to help prevent problems from developing. With a partial in place, it is easier to develop cavities around the remaining teeth. Partial dentures should be removed after meals to clean food debris from the partials and the mouth. They need to be cleaned daily.


    Partial dentures do move. If you prefer something more fixed in your mouth that doesn’t move, then you need to consider dental implants or a fixed bridge if possible.

  • Root Canal

    The term “root canal” is usually used to describe a particular type of Endodontic therapy whereupon the infection inside the tooth’s root canal system is cleaned, shaped, and restored or sealed with a special filling material. You may ordinarily expect your treatment to be fairly uneventful and painless, similar to having a tooth filled. Treatment time can vary dramatically from tooth to tooth depending on the location, shape, and number of root canals present; however, under local anesthetic, treatment is usually very comfortable. Occasionally, patients have been known to fall asleep during treatment, because most often it is the first time in awhile that they have been able to lie down and relax without their tooth hurting. Most often, treatment is completed at one appointment, but sometimes more than one appointment is required.


    It is VERY IMPORTANT to have your tooth properly restored after root canal therapy is completed. If this is not done, eventually you will lose the tooth from non-restorable re-infection or fracture of the tooth.


    Endodontics is the area of dentistry concerned with the prevention, diagnosis, and treatment of disorders of the dental pulp. The pulp is a soft tissue which contains the nerves, arteries, veins and lymph vessels of the tooth. It lies within the center of the tooth’s crown and root(s). When the pulp is diseased or injured and unable to repair itself, the pulp dies. The most common cause of pulp death is a deep cavity or a tooth fracture. The infection that develops inside the pulp builds up pressure within the roots of the tooth and usually causes spontaneous and lingering pain. Whether there is pain or not, if this infection is left untreated, it will spread out the root ends into the surrounding bone, destroying bone, and into the soft tissue eventually causing swelling. Occasionally, this infection can spread to other areas of the body and become life threatening. Once the tooth pulp is irreversibly damaged, you must either have root canal therapy or you must have the tooth removed in order to eliminate the infection.


    Ordinarily, as long as the root canals are cleaned and filled, antibiotics are not indicated. With the infection from the roots gone, your own body’s immune system can usually take care of any remaining infection present in the surrounding bone and soft tissue. If the tooth was painful to begin with, it usually feels much better immediately following root canal treatment; however, it is not uncommon for the tooth to be sensitive and remain tender for some time after. With some teeth, conventional root canal therapy alone may not be sufficient, and further, more specialized treatment will be needed.


    Endodontic treatment can safely and comfortably save a tooth that otherwise would have to be removed. In fact, root canal therapy is successful approximately 95% of the time. Remember, a healthy restored tooth is always better than an artificial one. Your endodontically treated and restored tooth could last a lifetime, if you continue to care for your teeth and gums. As long as the root of the tooth is properly nourished by the surrounding tissues, your tooth will remain healthy.

  • Sealant

    A sealant is a clear or shaded plastic material that is applied to the chewing surfaces of the back teeth to help prevent cavities from forming in the developmental pits and fissures (grooves) of these teeth. These areas are where decay (cavity) occurs most often. The sealant is a liquid when placed on the tooth, so it flows into and fills up the pits and fissures of the tooth. A special light is shined onto the tooth which causes the sealant to harden, thus creating a barrier protecting the area from plaque and food which can lead to the formation of a cavity. The pits and fissures of your teeth are impossible to keep clean, because the bristles of a toothbrush cannot reach them. Therefore, these areas are snug places for plaque and bits of food to hide.


    The best time to have a sealant placed is as soon as the tooth erupts through the gums into the mouth, and as soon as the tooth can be adequately isolated from saliva long enough to place and harden the sealant. If the tooth cannot be isolated for whatever reason, it should not be sealed, because the sealant will not adhere to the tooth and will therefore fail. In the very young patient, there is a lot of saliva in the mouth, and patient cooperation is at a low; therefore, sometimes it is necessary to wait until adequate isolation can be achieved. Adults can also be at risk for pit and fissure decay and thus be candidates for sealants. It only takes a few minutes to seal a tooth.


    Just as with any other dental material, sealants wear down and eventually need to be replaced. Reapplication of the sealant will continue the protection against decay and may save the time, expense and destruction of having a tooth restored. The American Dental Association recognizes that sealants can play an important role in the prevention of tooth decay. When properly applied and maintained, they can successfully protect the chewing surfaces of teeth from decay.

  • Superficial Tooth Stain Removal

    Superficial Tooth Stain Removal - before and after

    Some superficial tooth stains that do not come off with a professional cleaning may sometimes be removed through a process called “Enamel Microabrasion”. A dilute solution of hydrochloric acid is rubbed on the tooth surface for a few minutes. This removes a little bit of the superficial tooth structure which is the discolored part. The effects of this tooth stain removal treatment will continue to work for up to 2 weeks post-operatively. Enamel Microabrasion is accomplished comfortably without anesthesia. For a short period of time after treatment, the teeth may feel a little rough, and you may feel some minor sensitivity. These sensations, if they occur at all, will go away in a few days. Stains that are deeper than 0.5mm will not come out completely, and therefore, will require that a tooth colored filling be placed.

  • Veneers

    Dental veneers - before and after

    Veneers are very thin (about 0.3millimeters) custom-made “shells” specially prepared to make your teeth look natural. As few or as many of your teeth can be veneered in order to achieve the intended result. The best veneers are made of porcelain and are bonded directly to the teeth. Having teeth veneered is a procedure requiring just a few appointments; however, it is imperative that the patient and the doctor both know exactly what the intended final results are to be achieved. To this end, current photographs and models of the patient’s teeth as well as pictures of other people’s teeth that the patient likes are often used in making sure the final result can be achieved before ever beginning treatment.


    To provide room and for the best esthetic result, a small amount of tooth enamel is usually removed in the areas where the veneers will be placed. An impression of the teeth is sent to a dental laboratory where the veneers are made to match the color and shape that you desire. Making the veneers can take a few weeks, so in the meantime, you can wear temporary veneers that mimic your natural teeth. Under certain conditions, no preparation of the teeth is required. In other cases, so little preparation is done that temporary veneers are not necessary.


    As with your natural teeth, veneers require good oral hygiene and regular dental visits to keep them looking as good as new. Even with properly placed veneers, a patient’s bite pattern and/or forces generated in the mouth (known or unknown) may cause them to chip or break, so take care and avoid habits such as fingernail biting and chewing on hard objects.


    Even the most subtle change in your smile can make a dramatic difference in the way you look and feel. And when you feel and look good, you project a confident self-image. Veneers may help in this endeavor.

  • Whitening

    Tooth whitening - before and after

    Whitening your teeth is the simplest, most cost effective way to make the biggest positive difference in your smile. Your smile is one of the first things people notice about you, and it’s a huge part of what makes (or breaks) your first impression. The color of your teeth can greatly influence perceptions about your age, health, beauty or hygiene. Whiter teeth can simply improve the appearance of your smile and overall attractiveness. It can elevate your mood and make you feel good about yourself.


    The best way to achieve whiter teeth is with dentist-prescribed, home-applied bleaching. Based on current clinical experience and research conducted to date, this is a safe and effective technique for whitening teeth. Special “bleaching lights” (like the heavily advertised “Zoom”) provide absolutely no additional benefit whatsoever. Having your mouth open for a long period of time with your teeth exposed to the air (as would be the case if a light were shining on it), only dries out the teeth and dehydrates them. This dehydration will make the teeth appear instantly whiter, even without the light. After the mouth is closed and saliva is able to re-hydrate the teeth for four to six hours, they will return to their original color. Only dental bleaching gels in contact with the teeth can truly change the color of your teeth by making them lighter.


    There is only one active ingredient in all products made for at-home tooth whitening. That ingredient is hydrogen peroxide. The bleaching gel used by dentists is carbamide peroxide which is a combination of hydrogen peroxide and urea blended with a gel. Unlike straight hydrogen peroxide, carbamide peroxide is able to penetrate more deeply into the tooth where the hydrogen peroxide is then able to destroy stains through a process called oxidation.


    It is very important to eliminate all dental infections and diseases from the mouth, like cavities and gum disease, before whitening the teeth for two reasons mainly: 1.) It is unknown the effects of the bleaching gel on an exposed and untreated cavity 2.) Plaque (bacteria) and extrinsic stains, if not cleaned from the tooth surfaces, can impede or block the hydrogen peroxide from penetrating and whitening the teeth. Plus, it just makes good common sense to get the mouth healthy before you whiten your teeth, or you may eventually lose the very teeth you are trying to whiten!


    Once you are ready to have your teeth whitened, impressions of your teeth need to be made. (If you are having both your upper and lower teeth whitened, which is what is usually done, two impressions will be taken; one for the upper and one for the lower.) A model is then made from this impression, which is an exact replica of your teeth. Then, using that model, a custom fitted whitening tray is fabricated from a soft, comfortable plastic.  You will return on a separate day to receive the tray and whitening gel.


    Carbamide peroxide always works. There are no exceptions. Sometimes the end result does not live up to one’s expectations, but the disappointment comes from entertaining unreasonable expectations – which, of course, has nothing to do with the product used. Everyone’s teeth are not the same, and even different teeth within the same individual can vary, therefore, bleaching results will vary. Each individual tooth will only attain a certain maximum whiteness and no more, no matter how much a person bleaches, and this will be different from individual to individual. Usually, all teeth in the same individual will obtain the same color, eventually. On average, this will require two weeks of daily bleaching and usually one, but maybe two in-office bleaching visits. In some cases, where the teeth are severely stained and/or have stubborn stains, whitening can be a long term treatment lasting up to about eight weeks of daily bleaching. Normal tooth whitening starts at the biting edges of the teeth and works its way up. Normal color of teeth is darker toward the gum line.


    Hydrogen peroxide does not whiten any dental restorative material. As your teeth get whiter, your previous tooth-colored restorations do not and therefore start to appear darker. If you desire a perfect match, these restorations will need to be replaced to match your newly whitened teeth. The whitening result will reverse slowly over time, and, for that reason, it is important that you wear the bleaching trays with the gel once a month to maintain the desired result.


    At home whitening failure comes from only three areas of concern: 1.) Patient non-compliance, and 2.) Poorly fabricated whitening trays 3.) Ineffective bleaching gel. Patience, perseverance, and following your instructions is your job and is very important in order to successfully achieve your goal of whiter teeth. Providing an accurate tray and bleaching gel is the dentist’s responsibility.


    At Jack M. Hosner, D.D.S., we feel that we provide you with the most accurate and comfortable trays you can buy. An accurately fitting tray maximizes the whitening effect by better holding the bleach on the teeth and off of the gums and by sealing better around the teeth, thereby reducing saliva contamination of the bleaching gel. The type of tray we use is very comfortable.  In fact, most people even forget they are wearing them.  When it is in your mouth, it is not very noticeable.


    A word about commercially available home bleach products using trays:

    This method can be compared to home hair treatment. Although relatively inexpensive, the non professionally supervised home concepts, whether for hair or teeth, usually are inferior to the professionally supervised products. Results can be inconsistent and unsatisfying. There are two main disadvantages: 1.) The tray does not custom fit around all of your teeth, and saliva can creep under the tray thus contaminating and rendering inactive the bleaching gel itself,  2.) The bleach is not as strong. Without an accurate tray, the bleach is not held on the tooth surface very well. This decreases the effectiveness of the bleach, thus increasing the length of time it takes to whiten your teeth, and it also increases the likelihood of inadvertently swallowing more bleach which can be harmful to your health. It also makes wearing the tray more uncomfortable. If your teeth are a little crooked, these store bought trays do not adapt around the crooked positions of your teeth.


    With a less effective bleaching product, the whitening results take much longer and require you to buy the product over and over again. Custom made trays by your dentist can be used indefinitely, (unless you later have braces that grossly change the position of your teeth), and you can always “touch up” your whitening over the years by just simply purchasing more bleach.

  • X-Ray

    X-Rays are a form of radiation that can penetrate many materials, including human bone and soft tissue. Since X-rays can also expose photographic films, they have become very important in both dentistry and medicine. People often use the word “x-ray” to mean the pictures made with x-rays. The proper term for an x-ray film, or “picture,” is a radiograph.


    When x-rays pass through your mouth during a dental x-ray exam, more x-rays are absorbed by the more dense body parts (such as teeth and bone) than by the soft tissues (such as the cheeks and gums) before striking the film. This creates the image on the radiograph. Structures such as teeth appear lighter because fewer x-rays penetrate to reach the film. Other areas, including cavities and bone loss, appear darker because more x-rays penetrate to reach the film. There is a whole range of shades of gray depending on the structures between the x-ray machine and the film. The interpretation of these x-ray pictures allows the dentist to detect hidden abnormalities.


    Many diseases of the teeth and surrounding tissues cannot be seen when your dentist examines your mouth clinically. An x-ray exam may reveal the presence of small cavities between the teeth, infections in the bone, abscesses, cysts, developmental abnormalities and some types of tumors. A failure to diagnose and treat these conditions before obvious signs and symptoms have developed can threaten your oral and general health. Finding and treating dental problems at an early stage can save time, money, and unnecessary discomfort. If you have a hidden tumor, early diagnostic x-rays may even help save your life.


    Dentists are required by law to provide patients with a thorough examination. In order to do this, they must take x-rays. Patients can refuse treatment of a diagnosed condition, but if they refuse a proper exam which is necessary to reveal the diagnosis, then they cannot be seen as patients. On all new patients, it is common for the dentist to need a full-mouth series of radiographs. This will show all of the teeth, roots, and related areas of the jaws. The number of films needed depends on many factors, including the size and shape of the mouth, and the number and position of the teeth. Generally, at least 18 films are needed, but sometimes as many as 21. Since things change with time, x-rays will need to be retaken periodically based on the patient’s individual health needs in order to reassess the current condition of the mouth.


    When human tissue or other materials are exposed to x-rays, some of the energy is absorbed and some passes through without effect. The amount of energy absorbed by the tissue is the dose. No matter whom we are or where we live, we are subjected to quantities of radiation exposure from a variety of sources. The quantities of radiation they deliver are expressed in terms of effective dose. The unit of effective dose is the sievert (Sv) or rem. In modern diagnostic dental x-ray procedures, the exposure and dose are usually so small that they are expressed in “milli” units; that is, units that are equal to one-thousandth of a sievert (mSv) or rem (mrem).


    It has been estimated that an average individual living in an average location in the United States receives an effective dose of 3.6 mSv of radiation every year. Dental x-ray examinations are estimated to be responsible for an average annual effective dose of less than 0.01 mSv. This figure is equal to only 2.5% that of medical x-ray diagnosis and 0.3 % of the total average annual effective dose. It is for this reason that the use of x-rays in dentistry is not considered as a source of exposure, and in fact, is considered a “negligible individual dose” by the National Council on Radiation Protection and Measurements, a private, nonprofit organization whose findings are made into law by most states. The negligible individual dose is that quantity of radiation that can be dismissed.


    A full mouth x-ray examination of 21 films will deliver an effective dose equivalent to approximately 16 days of exposure to naturally-occurring environmental radiation which equals approximately 13mrem. For purposes of comparison, it is useful to know that according to federal and most state regulations, persons whose occupations involve some exposure to radiation are permitted to receive up to 5,000 mrem of whole body radiation per year. That’s equal to more than one full-mouth series of x-rays every day! In fact, some locations in Brazil and India give natural radiation levels so high that to equal this level of natural bone marrow radiation, a person in an average location in the U.S. would have to receive at least one full-mouth intraoral series of x-rays every day for the rest of his or her life.


    There is no question that ionizing radiation in general, and x-rays in particular, have a potential harmful effect on humans. Putting this risk into perspective, however, may help you feel better about having the necessary x-rays taken when needed for diagnosis. The small amount of radiation received from dental x-rays is a very small price to pay for the potentially huge benefit they provide by being able to see a dental or medical problem on an x-ray early and receive early treatment that could save you time, money, your teeth, and maybe even your life.