Our research into the dental industry, as well as the feedback we have been given, has told us many stories. Patients have told us that the core of every practice/patient relationship is providing a comfortable payment environment. Every patient’s financial situation is different and they don’t want to have to worry if they can receive the healthcare they deserve because they may not qualify for financing, or they don’t want to spend their savings to get the care. Sadly, most Americans do not have dental insurance, so dental work is often paid out-of-pocket. Patients often experience physical pain at the dentist, so there’s no need to inflict financial pain as well.

Given the pandemic, do you believe more dental companies will begin operating a payment installments system?

The pandemic drove an economic recession which in turn is accelerating many patients to look for buy now pay later options, but the demand for BNPL has consistently grown for some time- the dental industry is just getting a late start.

Have you noticed a change in how dental and healthcare customers are handling payments since the start of the COVID pandemic?

The most important realization is that dental practices have been placed in scramble mode trying to understand digital payments during covid because they have traditionally been behind on offering digital payments. The broader business market/world has steadily marched toward digital payments while the dental industry has stood firm on old-fashioned paper billing, Filling charts, etc. Now, these same practices are in a mad dash to catch up with the times and are quickly realizing the cost savings that come with it.

Do you think that people would be more likely to address their medical and dental issues if there were reasonable payment plans involved?

It’s no secret that an alarming amount of Americans avoid dental care because of the cost. It’s also widely known that delayed dental care can cost the patients 2-3 times more in the future as their condition worsens. QuickFee Installments helps patients avoid delayed treatment without the need to enter into a new, expensive financing plan.

How important do you think it is that dental practices make the finance options clear to patients before the treatment is agreed upon?

Transparency is paramount to any relationship whether it be business or professional. The same goes for your patients’ payment experience. No matter who walks in your door, or needs dental care, they should feel comfortable that you have a solution financially to fit their budget and or fiscal needs.

Do you have any advice for anyone who might be looking to start a dental or healthcare business during the pandemic, and how they can maintain a good cash flow and relationship with patients?

Most Americans do not have dental insurance, so every visit is out-of-pocket. Dental practices are expensive to maintain and grow. There exists an imbalance that can disenfranchise the patient and hobble the practice. A new healthcare/dental practice should seek to attain a balance between these two forces by ensuring that patients have a selection of payment solutions that fit their financial status. Doing so can foster goodwill between patient and practitioner, ensuring a good reputation among the community while the payment solutions foster a positive cash flow to the practice. Good cash flow ensures that the practice obtains the latest technologies and retains the best staff, thereby perpetuating the cycle.

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When choosing a new denture, the material and its compatibility quality should be taken into consideration. Most patients will ask for dentures that look beautiful and strong, and allow them to bite into food with confidence. Modern dentistry offers many materials and technologies that make this possible. However, fitting a new denture can sometimes have unexpected consequences, such as inflammation of the oral mucosa, sores, burning sensations in the mouth, and a metallic taste. These side effects could be a result of an intolerance to materials used or allergies.

For this reason, leading dentists and dental technicians are likely to take your existing allergies into account when determining the materials they will use. The good news is that the top laboratories offer a wide range of materials that function to the highest standard and look realistic, for patients to choose from. A denture is a medical device and as such, is subject to certain regulations.

On the whole, very safe, but it does depend on the jurisdiction. Nations with leading dental technology such as the United States and Germany have laws in place that ensure that the materials used in dental prosthesis are high. Before the materials can be put into the mouth, they undergo precisely defined tests. The aim of course is to ensure that dentures fit comfortably into the mouth and that no unintended side effects occur.

All materials used must be approved as a medical device – only after approval can they be used in clinics. Since dentures often remain in the mouth for decades, it is recommended that information about the denture be kept. That is, the materials used should be listed in the patient’s medical history.

It is estimated that one in three adults suffers from allergies. However, finding the cause is often challenging. For example, scientists have identified over 20,000 different triggers that can cause allergies! And some of these triggers are present in the materials used in dentures. For example, nickel has a high allergenic potency and many people react to it badly. There are so many different materials that can cause allergies, that they would not fit in an article! However, should you have known allergies, or are concerned about the effect of certain materials, your dentist should be the first one to address any questions you have, as they know your medical history. Quite often, the dentist will coordinate with the dental technician regarding the material options.

Modern dentistry and dental technology combines a variety of materials – from adhesives, cements and impression materials, to plastics and ceramics to amalgam, gold, titanium and alloys (mixtures of different metals). Anyone suffering from an allergy should make a critical selection of materials with your dentist and dental technician. A good dentist will use materials that are well tolerated and highly biocompatible. These include modern high-performance ceramics such as zirconium oxide or titanium.

Despite the potential for allergies, it is possible to create a denture that is well tolerated and meets the patient’s wishes, both functionally and aesthetically.

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What makes an all-ceramic crown so special?

All-ceramic crowns for restoring teeth have justifiably become popular in recent years. Patients love the all-ceramic crowns particularly for their excellent aesthetic properties. In addition, the material lends itself really well to dental use.

WHEN IS AN ALL-CERAMIC CROWN THE BEST CHOICE?

Badly damaged teeth are restored with tooth crowns. This type of denture comes close to the looking like natural teeth. Where high aesthetic results are required (for example in the anterior region), all-ceramic as the material of choice provides excellent results. The tooth-coloured crown completely encases the tooth stump that has been ground down making it look almost identical to a natural tooth.

HOW IS THE CROWN MADE?

Based on the individual patient preferences, the dental technician manufactures the all-ceramic crown with great craftsmanship and expertise. Under certain circumstances, an all-ceramic crown can be manufactured directly in the dental practice with so-called chairside systems. CAD / CAM technology is being used more and more, for instance when the framework is made of zirconia.  

The finishing of the crown and its adaptation to the neighbouring teeth is usually done manually. The dental technician or the dentist designs the colour, surface structure and other characteristics of the crown so that it resembles a beautiful, healthy tooth.

ADVANTAGES OF ALL-CERAMIC CROWNS?

In addition to the good aesthetic properties, all-ceramics have high biocompatibility and a perfect fit is ensured. In addition, no metal is necessary to attach the all-ceramic crown, making it ideal for people who are intolerant to having metal in their mouths. All-ceramic crowns are also very compatible with the soft tissue of the gums. Its strength is also an advantage, as is the ease with which it can be attached in the mouth. This makes it possible to design thin-walled crowns, which helps to maintain healthy tooth structure.

TYPES OF ALL-CERAMIC CROWNS?

Basically, there are different all-ceramic materials and manufacturing variants. As a rule, the dental technician uses silicate ceramic, feldspar ceramic or zirconium oxide ceramic. Depending on what is the best choice for the specific application and the patient’s preferences, the dentist selects the material and the manufacturing technology in consultation with the dental technician. This ensures that the individually veneered crown is of the highest quality.

Thereafter the dental technician constructs an all-ceramic framework and builds up the tooth by hand by layering the ceramic materials. It is cured in a special oven to give the crown the required properties so that it perfectly resembles a natural tooth in shape and colour.

An alternative to this can be a so-called full contour crown. This is monolithic, in other words it is made from one piece, and CAD/CAM or press technology is used in its production. The dental technician or dentist uses a special stain to individualise the monolithic all-ceramic crown so it perfectly matches the patient’s other teeth.

DOES THE ALL-CERAMIC CROWN CHANGE COLOUR OVER TIME?

No, it does not. Good dentists and dental technicians only work with high-quality materials that have little tendency to discolour. With good oral care at home, the homogeneity of the material should ensure that plaque is less likely to be deposited on the crown. Ideally, the all-ceramic crown should last the patient for the rest of his or her lifetime!

Dental prostheses are an indispensable part of life for many people. By replacing missing teeth with a well-fitting denture, the patient regains both function and natural-looking teeth. However, the fit of the dental prosthesis can become loose over time so that patients often think that their prosthesis is broken. Mostly, however, this has been caused by changes in the jawbone that have cause the prosthesis to lose its close fit.

Loose prostheses are not only uncomfortable, but they can also often cause pain. Pressure points in the mouth can become inflamed which causes the patient discomfort. Eating becomes difficult which often impacts the patient’s diet. Food particles can also get stuck under the edge of the prosthesis, causing it to rub and resulting in discomfort.

But why does the prosthesis become loose and no longer fit properly in the mouth? Basically, prostheses are made precisely and individually for a patient by the dentist working closely with a dental technician. As full dentures sit loosely on the mucous membrane of the jaw, they are held in place by their exact fit alone. Jawbones often change over time, however. Bone loss, also called atrophy, is normal, and diseases like osteoporosis can also cause changes to the jawbone. It is therefore important that patients with a loose prosthesis should not simply use a fixative cream, but also consult their dentist.

FINALLY, A PROPER FIT AGAIN

A loose dental prosthesis can be likened to putting on a shoe that’s too big. The shoe stays on the foot and you can walk with it, but because there is no proper grip, every step becomes very uncomfortable! This is very similar to a dental prosthesis that has lost its perfect fit. In the same way that an ill-fitting shoe causes blisters on the foot, the mouth similarly creates pressure points that can cause the patient severe pain. Many patients become worried that they will in fact need a new prosthesis.

But this is not necessarily the case. Frequently, by using special denture acrylic, the existing dentures can be adapted to accommodate the changes that have developed in the jaw. The dentist is the right contact for doing this relining of the prosthesis, which will be done in conjunction with the dental laboratory to ensure a really snug and comfortable fit. Only the base of the prosthesis will be adapted to achieve this.

ARE MINI-IMPLANTS AN ALTERNATIVE?

Another way to make the prosthesis fit well again is by using dental implants. Mini-implants are a proven way to do this and they are comparatively inexpensive. The use of these ensure that the full denture is firmly fixed in the edentulous lower or upper jaw. Small titanium pins are carefully implanted into the jawbone by the dentist. Four to six implants are usually enough to give the full denture proper support again. Usually the dental technician can convert the existing denture to be used with these mini-implants, or a new denture might have to be made.

The counterpart of the implant is worked into the denture. Thereafter the prosthesis can easily be inserted and removed by using a click mechanism. The result is that the patient again enjoys a denture that fits firmly in the mouth again.

WHAT CAN BE DONE TO RELIEVE PAINFUL PRESSURE POINTS IN THE MOUTH?

Simply rinsing with warm salt water can help to relieve pain. Home remedies such as chamomile or arnica tincture will also soothe irritated gums. Disinfectant mouthwashes will also help these spots to heal. However, if these painful pressure points become a chronic problem, you must consult your dentist. And never, ever try to adapt your dental prosthesis yourself!

ADDITIONAL READS

Dental Material Compendium – Zirconia

Who would rather endure pain than visit a dentist?

The table below shows what percentage of each state would rather endure tooth pain than visit a dentist during the pandemic.

State	Percent
Alabama	32%
Alaska	56%
Arkansas	36%
California	18%
Colorado	29%
Connecticut	26%
Delaware	20%
Florida	28%
Georgia	33%
Hawaii	30%
Idaho	34%
Illinois	25%
Indiana	30%
Iowa	26%
Kansas	23%
Kentucky	24%
Louisiana	44%
Maine	19%
Maryland	20%
Massachusetts	21%
Michigan	33%
Minnesota	34%
Mississippi	47%
Missouri	33%
Montana	39%
Nebraska	38%
Nevada	18%
New Hampshire	18%
New Jersey	23%
New Mexico	28%
New York	19%
North Carolina	38%
North Dakota	40%
Ohio	39%
Oklahoma	37%
Oregon	23%
Pennsylvania	20%
Rhode Island	19%
South Carolina	35%
South Dakota	25%
Tennessee	38%
Texas	32%
Utah	30%
Vermont	24%
Virginia	29%
Washington	22%
West Virginia	48%
Wisconsin	34%
Wyoming	35%

Based on a survey of 4,200 Americans (Google surveys; September 2020

Photo by Yusuf Belek on Unsplash

Producing fully-functional dentures from 3D printers is a novel idea. Wouldn’t it be fantastic if manufacturing dentures meant all you had to do was push the button on a 3D printer? Unfortunately, it’s not that simple a process. Still, the 3D printer is a high technology machine that offers great potential and many advancement opportunities for dental practices and dental laboratories.

Continue Reading: 8min Read

Already, digital technologies are revolutionizing the way dentures are made. For example, CAD/CAM milling technology has been used for many years now to manufacture scaffolds for crowns, bridges and prostheses digitally. During this process, a dental technician first constructs the desired design on a screen and then uses the file generated from the design to control the milling machine. Typically, the framework is constructed by the milling machine from materials such as all-ceramic, or titanium before being manually completed.

This achievement enables the precise construction of well-fitting, aesthetically-pleasing and strong dental prostheses.
Clearly, CAD/CAM technology is highly advanced. Now more recent development is seen an introduction of practice 3D printers in laboratories. What then is the difference between CAD/CAM milling-technology and 3D print-technology? It all lies in the way objects under construction on the computer are built. 3D-Print = additiv, by applying material. CAD/CAM-Milling = subtraktiv, by ablating material.

Advantages of 3D printing

The biggest advantage of 3D printing is that objects of almost any geometrical form (including normally „tricky“ constructions) can be printed. Here, CAD /CAM milling machines reach their limits. Furthermore, 3D printing consumes fewer materials due to the additive process. 3D-Printer also do not have any components that could require replacement due to wear out.

3D printing does, therefore, bring a lot of potential that can expedite the digitalization of process chains in dentistry. However, technology alone is not enough.

The different Materials for 3D printing 

The issue of 3D printing materials is a big challenge in the field of dentistry. Theoretically, and from a technical perspective, 3D printing of dentures is a sound idea. Practically, however, having the right materials is a significant barrier in the use of 3D printers for dental purposes. This is because dentures require highly sophisticated materials. Quality dentures have to get the „natural-teeth“ colour right; they have to be biocompatible and durable enough to withstand different influences in the mouth, such as extreme temperature changes and high chewing forces. They should not also release any harmful substances as they naturally wear out.

Even though 3D printers are not yet applicable to dentures, more and more laboratories are investing in their own practice 3D printers.

In addition, the materials used should be able to create a smooth surface so that no plaque can adhere. Most importantly, the material must meet the criteria set by the CE/FDA (approval certification for materials for medical devices in the EU and USA). Scientific research is trying to find a way around these many challenging material requirements, and a lot of developments are currently being made in this area. At the moment, most 3D printing resins available on the dental market do not allow for the production of definitly dentures.

An interesting development occurred in February 2020, when the dental company BEGO (Bremen, German) introduced an approved technology that allowed 3D printing of individual crowns, inlays, onlays, and veneers using ceramic-filled hybrid materials. It is the world’s first such technology now found under the name VarseoSmile. Further, initial scientific studies in this direction are promising, and even though 3D printers are not yet applicable to dentures, more and more laboratories are investing in their own practice 3D printers. These can be used primarily to manufacture auxiliary structures such as jaw models (e.g. aligner models), drilling templates (dental implants), test prostheses (try-ins) or impression trays.

A brief look at the 3D printing process chain is as follows: A dental technician uses a virtual 3D model on the computer to construct a three-dimensional object. The STL file that is generated is then transferred and opened in a dedicated slicer. The slicer chops the STL file into wafer-thin slices and transmits this data to the 3D printer so it can create the object. The object is created layer by layer like a 3D puzzle by the printer. Usually, resins are used for printing; however, metals can also be used in industrial productions for printing, for example, in the laser sintering process. 

The future of 3D printing in dental work

3D printing has become increasingly relevant in the field of dentistry. Further areas of application will follow as soon as materials research has developed appropriate materials. Here is what is on the ground so far:

• 3D printing is primarily for to manufacture auxiliary structures such as jaw models (e.g. aligner models), drilling templates (dental implants), test prostheses (try-ins) or impression trays. 
• 3D printing is primarily for to manufacture auxiliary structures such as jaw models (e.g. aligner models), drilling templates (dental implants), test prostheses (try-ins) or impression trays.
• 3D printing is now possible of individual crowns, inlays, onlays using ceramic-filled hybrid materials, but more scientific, clinical research is needed
• 3D printing of ceramic objects (zirconia) that are polychromatic is promising.
• Specialists at LMU Munich (Ludwig Maximilians University Munich, Germany) have, for several years, tested multi-material 3D printing.
• Bone implants (e.g. for the jaw) made from special plastic and which are stable, and free of defects can now be precisely fitted after 3D printing.
• Researchers at the Fraunhoer Institute in collaboration with European partners are investigating a process where bone implants can be printed from a special plastic. During the printing process, the individual layers are coated with a cold plasma jet, a treatment that supports the growth of bone-forming cells on the surface.

Conclusion

3D printing is been successfully applied by laboratorys and industry companies in some areas of denture production. Basically, this innovative technology is very innovativ. Despite this, more digital advancements und research are required to produce dentures (medical devices) to a greater degree. 3D printing of dentures should incorporate functionality, aesthetics, dental phonetics, and materials science as well as craftsmanship and empathy. After all, the field of dentistry does not just process data; it creates new teeth for people.

What do dentures cost?

Anyone who needs a denture will usually also think about the cost of dentures. But what should the new teeth cost, why does it seem so expensive, and can I even afford these new teeth? We at NextSmileDental will shed some light on these questions for you.

Because it is not possible to realistically give a cost estimate of dentures here in an article and would be more than likely inaccurate we like to explain it with the following analogy. What does a car cost? No general answer can be given to this because there are so many variants and brands from small cars to luxury vehicles, the prices of which vary greatly based on construction details and performance features.

A similar situation pertains with dentures. There are various types of dentures – removable, fixed, implant-supported, etc. The materials used, for example all-ceramic, and the implementation options regarding the individual colour and design, all influence the cost. The cost of dentures will also be influenced by the state of the patient’s teeth and mouth, and his or her expectations.

Dentures are individual and special

Dentists, often in close cooperation with the dental technician, produce the dentures individually for every patient. Every dental prosthesis requires manual work, even though digital production techniques, in the form of CAD/CAM technology, are increasingly being used to support them. Therefore, one should not try to penny-pinch when it comes to dentures. Dentures are medical products that have a beneficial effect on the patient’s health.

Therefore, we at NextSmileDental recommend that you don’t try to save in the wrong place! Your new dentures will be used every day and will be subjected to great stress in your mouth. But talk to your dentist about the different denture options available to you. There is usually a suitable option for every situation that will combine durability and high quality.

High quality materials for dentures

Modern materials for dentures are incredibly versatile, as they have to be. After all, the new dentures should last a long time and still look good years later. Durable and resistant materials are required for this. The materials used should be biocompatible and well tolerated by the patient. In addition, it must withstand the acidic oral environment and the various temperatures encountered in the mouth, for example hot tea or coffee, the freezing cold of ice cream, the acidity of lemon juice, etc.

It is also important that the dentures should not discolour, even if the patient occasionally enjoys a glass of red wine, or likes to eat dishes containing turmeric. And, of course, they should ‘look right’. Ideally, the dentures should look just like a natural, healthy teeth. Therefore, the raw material for the new teeth should be able to be refined by the dentist or dental technician so that the new teeth will look like the patient’s own teeth. And last, but not least, the material must be easy to process in the dental practice or laboratory, to guarantee a perfect and comfortable fit.

Dental materials science and dentistry have made great strides in recent years. There are various materials that meet the requirements listed above. These include zirconium oxide, all-ceramic materials, hybrid materials, composites, gold alloys, titanium, even steel. This ensures that the right high-quality material can be chosen to suit the patient’s oral situation, expectations and financial resources.

The craft and technology needed for making dentures

Dentures are not taken out of a drawer or made automatically by a computer or machine. To be able to make a high-quality dental prosthesis requires comparatively long and often arduous training. The specialized dentist or dental technician has usually completed an intensive course of study or apprenticeship. In addition, manual skills and aesthetic sensitivity are required.

In a dental laboratory or a dental practice that is certified to manufacture dentures, a high degree of technical expertise is required of the dentist or dental technician. Likewise, highly specialised machines and equipment are also needed. These include intraoral scanners, face scanners, laboratory scanners, laser devices, as well as CAD/CAM milling machines and 3D printers. These are just a few examples of the machines that are used today to design and manufacture dentures.

And dentures take time!

The specialists who will manufacture your dentures, will require time from you, the patient. This will include time for:

• An information and counselling session• The clinical diagnostics• The individual cost estimate and discussion of alternative solutions• A thorough analysis of the situation regarding your mouth and face• An assessment of the function of your temporomandibular joints• A decision regarding the shape and colour of your new tooth or teeth, and

• the production of a trial tooth replacement and testing it in your mouth.

It will therefore require some time until your dentures are actually manufactured and available. However, these steps are essential for the dental professionals to supply you with long-lasting, functional and aesthetically pleasing dentures. There are also additional steps and optional ‘add-ons’ that patients like to take advantage of.

Consult your insurance for the cost of dentures

So your dentures are not really expensive. Talk to your dentist and ask about the different options and cost models that are available. As a rule, the right solution can be found to suit every patient’s circumstances. Many dental practices work together with special denture insurance or billing companies, so grants are often possible, and/or installment plans can be put in place.
Always remember, good dentures are an important building block for your health.

If you calculate the price for a denture based on its long service life and its daily level of use, it quickly becomes clear that a good denture is worth its price.

Most people want beautiful, healthy, straight teeth. With an ‘invisible’ dental aligner this wish can more often than not be fulfilled relatively easily, with special attention being paid to the temporomandibular joints.

When correcting the tooth position with an aligner, the patient wears a transparent dental splint on the row of teeth. This splint is used to apply light pressure on the teeth so that the teeth are gradually pushed into the required position. Since the natural teeth are movably anchored in the jaw with connective tissue, this is a completely painless process.

Why tooth correction with a dental aligner?

One patient may be unhappy with their slightly twisted front teeth, while another might be bothered by their nested lateral incisors. Another patient might complain of temporomandibular joint problems, which the dentist attributes to misaligned teeth. The reasons patients want the alignment of their teeth corrected are as diverse as the patients themselves.

The technical term for the correction is called orthodontic treatment. Most people are familiar with the classic braces or brackets that are often used in the treatment of children’s teeth. In adult orthodontics, so-called aligners are a popular and proven method.

First, the dentist establishes the ideal tooth position using special computer software. Based on this, various splints are then made from a transparent material. The patient has to wear these splints in a given order over the following months. The rails are thin and hardly interfere with speaking. As a result, this aligner treatment is described as comfortable by most patients.

Establishing the correct bite

However, before the desired tooth position can be established, the dentist has to determine the bite position, i. e. the position of the upper jaw in relation to the lower jaw. In every orthodontic treatment, the focus is on a healthy bite that will ensure the smooth functioning of the temporomandibular joints.

Though this sounds straightforward, it is, in fact, rather complicated and requires sound dental skills and appropriate methods. This is made easier by a new technology which utilises three-dimensional detection of the temporomandibular joint movement. The exact movements of the temporomandibular joints are transmitted via a motion simulator. Once the dentist has determined the optimum tooth position for the temporomandibular joints, the aligner splints are produced accordingly.

Many patients have been delighted with this comfortable orthodontic treatment, as it is comfortable, quick and target specific. With aligner therapy, your dazzling new smile is achieved both safely and in comfort.

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