Dentist Blog

Posts for: February, 2021

Here are some Frequently asked questions PearlFection Dentistry gets about Orthodontic Treatment.

  1. I'm an adult over 50, am I too old for orthodontic treatment?

No one is too old for orthodontic treatment.  The benefits of a straight healthy smile last a lifetime, no matter what age you begin treatment.  As long as your gums are healthy, you too can have a beautiful smile!  And remember, orthodontics is not just for aesthetics.  Crowded teeth are hard to clean and can contribute to periodontal disease.  Many patients, over 50, choose to enter orthodontic treatment, some for cosmetic reasons and some for cosmetic and clinical reasons.  Adults make up a large part of our patients getting orthodontic treatment at Pearlfection.

  1. My general dentist says that he can do orthodontics, even braces, wouldn't it be better to use an trained orthodontist? Is there a difference in cost?

An orthodontist is a trained specialist that has a minimum of two years and usually three years of advanced training AFTER four years of dental school.  We are specialists in dentofacial orthopedics, meaning we not only move teeth but can alter jaw growth. A general dentist is simply not qualified or trained in this manner.  Many dentists take a one day or one weekend course to be able to move teeth with an aligner company that uses a computer algorithm to move the teeth.  A one day course is not a substitute for a qualified orthodontist that is overseeing your case, step by step.  Remember, an orthodontist was a dentist first then became an orthodontic specialist.  Orthodontics is all orthodontists do, even though they are fully trained in all aspects of general dentistry and graduated dental school with the same degree as all dentists.  Our strong advice is that anyone considering orthodontics, including Invisalign or clear aligners, seek out a licensed orthodontist to ensure the best possible care of your teeth straightening!  Oh and one more things, usually orthodontists don’t charge more for the same treatment as a general dentist for clear aligners, including Invisalign, but unlike a general dentist, an orthodontist will give you lots of options.

  1. What is faster traditionally braces or Invisalign?

Each individual case should be looked at uniquely.  Many times braces or an aligner system, like Invisalign or 3M, can achieve the same result in the same amount of time.  Consult you orthodontist to see what is right for you.

  1. Is Invisalign or clear aligners cheaper than traditionally brace?

Cost of braces or aligner system depends on each individual case.  Costs for traditional braces and clear aligners are usually very similar.  Costs are often a function of how long a patient needs the braces or aligners on.  An orthodontist should be monitoring your progress with office visits on a periodic basis during your treatment and often times after your treatment is completed.  The longer you’re in treatment, typically the higher the cost for orthodontics.

  1. When do orthodontists recommend Invisalign or clear braces over traditional braces?

Orthodontists may recommend traditional braces over an aligner system depending on the person and the case.  Each treatment plan should be tailored to the individual. Many times, a patient may have a choice between the two systems.  It really depends on the patient's preference.  Sometimes braces must be used, for example, in a surgical case.  Often younger patients have a hard time keeping up with removable aligners, so their parents opt for traditional braces.  But invisible aligners, whether they be 3M or Invisalign, can do almost everything traditional braces can do. 

  1. Are there any concerns about a child having removable clear aligners instead of traditional braces?

Younger children usually do better with their treatment if they have traditional braces.  With braces, much of the responsibility is on the orthodontist to provide the treatment because they can’t be removed….at least not easily.  With aligners, almost all of the responsibility falls on the child.  i.e. keeping track of wearing the aligners 20 hours a day and not losing them, or forget to wear them, etc.  There is nothing wrong with a child having removable clear aligners, but they need to responsible.  It is sometimes hard for parents to monitor their kids and kids don’t always tell the truth about how much they are actually wearing the aligners.  This can lead to treatment lasting longer than planned and lead to frustration for the patient and the parents. 

  1. What do braces costs?

Braces vary in cost depending on the severity of the case and the length of treatment time.  There is also a cost difference between a phase one treatment (younger children) and comprehensive treatment (teenagers and adults) Clear aligner treatment cost varies depending on the length of treatment time and area the patient resides in. Some patients simply want very slight movements of their teeth to correct or adjust something minor and only require orthodontic treatment for a few months.  That can cost around $1000 or even less.  While orthodontic cases that might last several years, when extensive movement of the teeth is required.  Cases lasting long periods of time can cost more than $6000.

  1. How long will my orthodontic treatment take?

Orthodontic treatment time may vary in length depending on the severity of the case.  Many times treatment can take a year or less!  However, with extensive movement of teeth, we have seen cases lasting longer than 2 years.  And most, if not all, orthodontic work requires long term retainers to keep teeth from shifting back to their original position. 

  1. What's an orthodontist and how do you become one?

An orthodontist is a specialist in dentofacial orthopedics and orthodontics.  Meaning we have the ability to alter jaw growth and move teeth within the jaw structure

In order to become an orthodontist in the United States, one must complete four years of college, then four years of dental school, and THEN three years of a orthodontic residency.  This is the same amount of time your pediatrician or your general internist physician spent in school!  Many general dentists these days can prescribe aligners, like Invisalign, but very few have the extensive experience that a trained and licensed orthodontist has. 

  1. Why is it important to have your general dentist and orthodontist communicating? Why is PearlFection better in the communication area than other general dentists?

It is always important to have your general dentist and orthodontist keep an open line of communication in regard to your treatment plan.  Whether a case is simple or complex it is imperative the dentist and orthodontist understand the patient's needs, the overall treatment plan, and the expected outcomes.   This allows for a smooth and enjoyable treatment process. Orthodontists usually want a general dentist to agree that the patient’s dentition is healthy enough for orthodontic treatment and if it is not, get the teeth and gums healthy before orthodontic work is begun.  This usually involves getting any infection under control and address decay.    At Pearlfection, with multiple general dentists and an array of specialists, all needs can usually be met, keeping the treatment in house with a close knit community of general practitioners, hygienists and specialists.  At Pearlfection Dentistry, all your notes, both from general dentists, hygienists, and specialists are in one place, allowing for efficient communication between general dentists and your orthodontist.

  1. Does dental insurance usually cover orthodontics treatment? Does PearlFection help me file a claim?

Dental insurances vary greatly. Some cover orthodontic treatment for all ages and others only cover orthodontic care up to a certain age, say 18.  It’s important to understand your insurance to maximize your benefits.  Most dental insurance have a lifetime benefit up to a certain amount and usually cover about 50% of the treatment up to that amount.  But all insurance companies look at orthodontic treatment differently.  At PearlFection Dentistry we will assign a case manager to you who will help you navigate the world of dental insurance.  We will also determine your benefits before you begin treatment so there are no surprises.  We will submit your claim to your insurance company and we can even submit a predetermination claim before treatment begins so we have a commitment from the Insurance company about how much they will pay.

  1. Does medical insurance usually cover orthodontic treatment?

No, medical insurance does not cover orthodontic treatment unless in certain situations like trauma that results in orthodontic treatment being necessary, but that is extremely rare. Do not expect your medical insurance to cover any orthodontic care.

  1. Do braces hurt when they get put on? Do they hurt when they are tightened?

Sometimes braces and aligners are uncomfortable when they first go on.  Remember we are trying to move teeth through bone, albeit slowly, so that pressure can be uncomfortable sometimes.  If its very painful or extremely uncomfortable, talk to your orthodontist and they will likely slow things down a bit.  Orthodontic treatment should never be painful. 

  1. Does a consultation cost anything?

At PearlFection Dentistry, orthodontic consultations are free, sending predeterminations to determine if insurance will cover anything is free and applying for financing is free. We usually give a full half hour free consultation with out orthodontist to answer any questions and determine what the patient’s options are. 

  1. At PearlFection Dentistry, can I pay in installments? How much every month?

Sure, we at PearlFection are very willing to allow payment plans, sometimes extending out beyond when your treatment ends. We want to do our best to make orthodontic treatment affordable.  Sometime monthly payments are pretty low, under $100 per month, but it depends on the extent of treatment and the length of time in treatment.

  1. Can I get different color braces?

Yes, you can get almost any color you want for your brackets.  Pink, Green, Purple, Red…..whatever you want…within reason.  Just give us a little time to special order.  These days, most people want braces and aligners clear.  We can of course do that.

  1. My friend threw away her invisible aligner? What happens if I do that?

If you throw away your orthodontic aligner, try to find it, but if you can’t it’s not the end of the world.  We can get you a new one and usually there is no cost……within limits.  We usually recommend you go back to your last aligner until we get the new one.  It will delay your treatment a little but not by much.  The aligner suppliers are pretty good these days to get us a replacement quickly. 

  1. How often do I need to come to the office after we start?

After you start Orthodontics, we typically have patients come back about every month or every 6 weeks, sometimes less often.  We want to make sure things are tracking appropriately and make any mid-course corrections as necessary. 

  1. If I don't wear my retainer, will my teeth move back to where they started?

Yes, yes, yes!!! You need to wear your retainer.  Teeth have a natural tendency to move back, at least part way, to their original location.  You need to be diligent about wearing your retainer.  Over time, your teeth get used to being in the new location but a retainer is essential, especially right after you complete your treatment, to keep teeth where we want them.  Over time, a retainer can usually just be worn at night. 


Here are some frequently asked questions about dental implants and implant supported dentures, also called “all on 4 dentures”

Will dental insurance pay for implant supported dentures?

Often dental insurance will pay for part of the implant supported denture procedure. It depends on the plan of course but most insurances will pay for all or part of certain procedure codes and not pay for others. The issue with dental insurance is that most policies only cover up to a certain dollar figure every year, say $2000. Once that is used up, the patient is usually responsible for the anything above that. But it pays to have a knowledgeable insurance coordinator work with you to try and maximize your benefits. At PearlFection, we have dedicated insurance coordinators who work with you and your insurance company to ensure you get the most you can from your carrier to help pay for your procedures. Sometimes, medical insurance will pay for part as well. PearlFection dentistry will submit to any insurance company we think could help. Also, if you have been in an accident, medical, workers compensation and dental insurance can all come into play.

How do I choose a good provider of dental implant supported dentures?

This is probably the most important question you can ask and please be careful when your decision. Most patients only have one shot to do this right due to expense and biology and if it's done wrong, can really have serious consequences. The questions to ask, are “will a board-certified prosthodontist do my denture?” “Will a board-certified surgeon or periodontist place my implants and do my extractions?” “Will I be sedated?” “Will a lab tech be on site to help facilitate a smooth process?” if the answer to any of these questions is “No” you might want to keep looking or at least ask more questions. Remember, any dentist who graduates from dental school can place implants, make a denture, basically do everything required to perform an “all on 4” case. But the PearlFection Team approach ensures that only the most qualified doctor, is doing the part of the complicated procedure that they spent years training for. And for goodness sake, never get a procedure done in a foreign county. Foreign implant parts are hard to match and with procedures like this you really should have some sort of warranty. Someone needs to stand behind the work. A warranty is only as good as the company backing it and you may have trouble having a USA doctor touch any work done by a foreign dentist, making any repairs down the road more difficult.

Does this work come with a warranty?

Yes, warranties do come with any implant or implant support denture done at PearlFection Dentistry. It covers workmanship for a certain period of time but it's not forever. Dentures and implants take a lot of pounding and it's hard to guarantee anything when the biology of the patient is concerned. But PearlFection does warranty the work as long as certain requirements are followed. Our hope is we do this once and its good for a lifetime but that cannot be guaranteed. That said, there are things that can void any dental warranty, things like neglect, smoking, not coming in for checkups, not wearing a night guard or simply not following your dentist’s recommendations.

Is it safe?

PearlFection takes extraordinary steps to keep our patients safe and comfortable. But like any medical procedure, there are risks. Infection control and sedation safety are two areas that PearlFection take very seriously. We always have at least 3 clinicians in the room at all times to monitor safety protocols, we use state-of-the-art infection control devices to ensure instruments are sterile and the operatory environment is kept free of contaminants. Also, patients are screened prior to the procedures to make sure they are prepared both physically and mentally for the procedures. Drivers to and from the procedure is required and PearlFection can arrange drivers and hotel rooms for out-of-town patients. After the procedure, which can last all day, we want as little stress on the teeth and on our patient so preplanning transportation and after-care is important for a good outcome.

Is there an age range?

There is not an age range, we have placed implants and dentures on children and all ages of seniors. Its less about age and more about the overall health of the patient. Patients with compromised health need additional consideration but we can usually accommodate even patients with health conditions.

How much is it going to cost me?

The unique thing about Pearlfection Dentistry's denture, dental implants and implant supported denture team is we can accommodate almost any income level. Sometimes patients come to us and simply can’t afford to go right into implants and implant supported dentures. That’s ok. We can offer simple dentures for a fraction of the price of implants supported dentures and that’s a perfectly good option. When you have a team of cosmetic dentists and prosthodontists, the outcome for our simple dentures patients is outstanding. Many patients come to us with dentures made years ago from a lab that didn’t take the time to really understand the patient’s occlusion (bite). The result was a poorly functioning appliance from day one. That’s a shame and that doesn’t happen at PearlFection. When you come to PearlFection, you work with a team that understand both function and form. Our end game is a denture that works and looks great. So even if you don’t get implants right away and get a simple denture it's ok. Those same dentures can be converted later to implant supported dentures when and if the patient decides to move forward with the dental implant supported denture option. The beauty of having an on-staff prosthodontist and general and cosmetic dentists is we don’t try to steer our patients to one option or another. We work within the patient’s financial means and tailor a program that works for them.

So, to give more specifics about the price, a simple denture (without extractions) is less than $3000. If a patient wants full extractions, IV Sedation, implants and zirconia denture, it can be over $70000 for both arches, add zygoma implants (implants that secure into the cheek bones) and the price can surpass $80,000. So, as you can see, it really depends on what the patient wants and what they can afford. But cost should never stop you from having a consultation to see what your options are. Consultations with our team are free.

Do I need to do everything at once?

No, you don’t need to do everything at once. Although many of our patients get IV sedation and wake up with a full mouth rehabilitation and a movie star smile, it can be done in stages. Full mouth rehabilitation involves all the teeth extracted, bone reduced, implants placed and denture fixed to the implants via abutments. It’s a lot to do at once but we do it all the time. Sometimes we have 7 clinicians in the room at the same time. While other patients take a more gradual approach. Some start out with a simple denture and wear it for a while to get used to it. Then they come back in for the implants. Others start out with an implant supported denture on the top or bottom and leave the other arch alone. How you do it, and the speed you do it at, really depends on the decision you and your dentist make together. There is no “right” answer. Every patient is different and PearlFection Dentistry custom designs every patient’s dental treatment plan specifically for that patient. Dental implant supported dentures, “All on Four” dentures are a big decision. We encourage anyone who is interested to work with the PearlFection team of clinicians, treatment coordinator and financial coordinator to map a path that fits your time line, budget and needs.

Can PearlFection put me to sleep so I avoid any discomfort?

Our doctors provide IV Sedation, Nitrous Oxide and oral sedation and most of our patients are sedated during the process. One of our mottos is, “you sleep, we work” and you wake up with the movie star smile you have dreamed about your entire life.

What if I can’t afford it?

We get it! Implant supported dentures are not cheap, so let’s not kid ourselves, “all on 4” is not an option for everyone. But PearlFection is not your typical dentist. Many of our patients start out with a simple denture option. Dentures are fairly inexpensive and within the financial means of most patients. If you start out with a simple denture, our skilled team of prosthodontists, lab techs and cosmetic dentists can convert that denture, at some point in the future, to an implant supported denture. This process gets our patients both the functional and aesthetic outcome they need in the short term, with the hope of a true implant supported denture in the long term.

Are there financing options at PearlFection Dentistry for implant supported dentures?

Yes. We have some of the most competent and compassionate financial coordinators around. They will work with you to figure out how to make your goals become reality. We work with several outside financing companies who bend over backwards to try and get patients approved for financing. PearlFection even pays for the first 6 months of interest for patients. It's our way of saying thank you for choosing us. We cannot guarantee that everyone will be approved, but we can guarantee that we will help facilitate the process.

What’s a prosthodontist and why should I care?

Prosthodontics, is the area of dentistry that focuses on dental prostheses. Most people seek a prosthodontist when they have a complicated dental device requirement, like a denture that requires a skill set above and beyond what a general dentist might have.

According to the American College of Prosthodontists, a prosthodontist is a dentist who:

  • Specializes in the aesthetic (cosmetic) restoration and replacement of teeth.
  • Receives three to four years of additional training after dental school.
  • Restores optimal appearance and function to your smile. The planning, surgical placement and restoration of implants and rehabilitation of occlusion with prostheses all fall under the field of prosthodontics.

Becoming a prosthodontist requires an additional three years of postgraduate specialty training after obtaining a dental degree. Training consists of rigorous clinical and didactic preparation in the basic sciences, head and neck anatomy, biomedical sciences, biomaterial sciences, implant surgery, function of occlusion (bite), TMJ, and treatment planning and experience treating full-mouth reconstruction cases, and esthetics. Due to this extensive training, prosthodontists are required to treat complex cases, full-mouth rehabilitation, TMJ-related disorders, congenital disorders, and sleep apnea by planning and fabricating various prostheses.

It's important to remember that any dentist in Maryland can legally treat a patient and provide a denture and many good dentists do this every day and do a good job at it. But when it comes to something as complex as an implant supported denture, it is our strong advice to seek a team with a prosthodontist on it, working in conjunction with other specialists to achieve optimal outcomes.

Why do people want an implant supported denture vs a regular denture?

We get this question a lot and it deserves some understanding of what a traditional denture is and what it's not. A traditional denture is held in place by the structure of a patient's gums, adhesives and gravity. Sometimes, depending on the skill of your dentist and lab, the outcomes are better than others. But no traditional denture fits perfectly and it's not a substitute for natural teeth. Dentures just don’t allow the wearer to enjoy all the functionality as real teeth.

A traditional denture is a good option when a patient has a need to replace all or most the teeth in their mouth and finances are limited or they just can’t find a dentist with the skill set to do “all on 4 implant supported dentures”. A denture allows patients to eat most foods, but there are some serious restrictions that patients complain about when it comes to traditional dentures. The main complaint we hear is that dentures simply don’t stay in place and therefore make it hard to eat certain foods. The other issue is maintenance and cleaning of traditional dentures. And finally, without the need to support teeth, the bone structure in the upper and lower jaws tend to deteriorate over time resulting in bone loss, which can affect the way a person looks. With Implant supported dentures, patients can eat any food and the dentures function like natural teeth. Some implant support dentures, called “over dentures” are removable and other are permanent and can only be removed by a dentist. Cleaning of implant supported dentures is similar to regular brushing and the fact that implants are secured to the bone triggers the body to realize it needs to preserve bone wherever there are implants and impact. The bottom line is that implant supported dentures might be considered the gold standard for functionality and esthetics, while a regular denture is good but it has limits. PearlFection Dentistry will work with any patient and find a solution that works and stays within a budget. And remember, if you start out with a regular denture, PearlfEction is one of the few dental practices that can convert that denture to an implant supported denture, saving you thousands of dollars down the road.

What is the “team” approach to dental implant supported dentures?

There are some really good dentists out there that can do many procedures, including dental implants, dentures, braces, crowns, and bridges. But even if they are very skilled, it's hard to perfect a skill unless you do it a lot. So, some dentists will do a crown in the morning, an extraction in the afternoon and place braces in the evening. That might sound like a superstar dentist who can do all those things, and maybe they are, or maybe that dentist is biting off more than they should. The “team” approach that PearlFection Dentistry uses is one where the specialist, who has spent years and years of additional training perfecting one skill set, does that procedure and another dental specialist does their specialty. So, for implant supported dentures, our oral surgeons or periodontist, does the extractions and implant placement and bone reduction surgery and IV sedation, our prosthodontist does the denture design and placement and our lab does the actual manufacturing of the denture itself. This team is all on standby during the process and comes in to the operatory when it's their time to do their thing.

Prior to the day of surgery, the team has taken Cone Beam CT scans, and used those scans to three-dimensionally design the entire process and map out exactly how they will proceed. The 3D technology allows us to analyze bone density and structure and determine the optimal position for implants and which areas to avoid. It allows us to determine with extreme accuracy what level of bone reduction to make and the prosthodontist and surgeon will have had extensive discussions about implant placement, and implant size, bone level reduction and the best way to proceed. By doing this virtually prior to the actual procedure ensures a more likely positive outcome, with no surprises, and reduces the patient’s time in the chair. If you're considering implant supported dentures, it's important to know who your team is and if they have all the equipment and skills to arrive at the outcome you desire.

Why makes PearlFection Dentistry the best choice in the United States for Implant supported Dentures?

PearlFection has been in business for over 30 years. We started small and have added specialists as time has gone on to meet our patients’ needs. We now have every dental specialist working under roof. This results in an unprecedented level of dental care. We are not your parents’ dental practice. We have the best of the best in both general/cosmetic dentists and specialists and they work in conjunction to provide the absolute best in dental care, utilizing the state of the art in diagnostic tools, equipment and the best materials. Our doctors have performed the most complicated implant supported denture procedures and dental implant placements, including zygomatic implants, oftentimes rebuilding soldiers injured in combat zones. Patients come from around the world to receive the quality of care only offered by PearlFection. It might sound like we are a huge corporate conglomerate, but we are owned by our doctors and only provide implant supported dentures in one place, Frederick Maryland. Whether you are from across town, from another state or from another country, we provide the level of concierge service that is second to none, with a staff dedicated to your complete satisfaction.

My teeth are in really bad shape. Am I still a candidate for dental implants?

PearlFection Dentistry specializes in the cases that other dentists can’t or won’t do. We are the dentist other dentists refer their tough cases to and we welcome that responsibility. Whether you’re missing one tooth or many or need all your teeth removed because of decay or neglect, dental implants may be the best choice for you. PearlFection’s doctors are experienced in treating patients with complex cases that may even have been turned away by others. Call us to schedule a consultation and see what your options are.

I don’t want people to know I have a denture or implants. Will my smile look like I have real teeth?

Every patient is different and has different goals and preferences about shade, size and overall look of their new teeth. We are starting over with your teeth so think about exactly what you want and we will do everything in our power to deliver. During the design process, you will work one-on-one with our prosthodontist to develop a product that meets your goals.

Tell me about the doctors who will be doing my implants and the implant supported dentures.

The doctors at PearlFection are true experts in their specialties. And the PearlFection Dentistry “Team” approach is unique to the field of dentistry. Each patient is assigned a treatment plan coordinator, a prosthodontist and an oral surgeon or periodontist, a lab tech and a general dentist. Each of these professionals has a unique role to play and has extensive training, experience and professional designations that ensures you that you have the absolute best care money can buy. At PearlFection Dentistry, no patient is ever treated like a number. Every patient is unique and has different concerns, budgets, time frames and goals. We will guide you through every step of the process and make sure you fully understand why we are doing things and what to expect.

How long does the procedure take?

This depends on the patient’s needs and your plan. We can actually do most of the operatory work in one day, but it’s a misnomer to say it just takes one day. Be suspicious when you hear it's all done in one day. Yes, most of our patients come in the morning and leave later that same day with a new smile but there is some serious preparation work that needs to be done upfront, including agreeing on a plan, designing the dentures and coordinating the process. It's not something anyone should rush into. If you are getting pressure to move along too fast, it should raise a red flag.

But in a nutshell, here’s what to expect (Steps 1 to 4 can take a few days or a few weeks depending on the patient and team schedule):

  1. Consultation with dentist or prosthodontist to determine options. in this step, we determine what is possible and what's not. X-rays are taken and CT Scan is done.
  2. Treatment plan options are presented to the patient and the patient selects how they want to proceed. Financial considerations are figured out and deposits are made and impressions are taken.
  3. Consultation with Surgeon and consent forms signed. (This can be done remotely if necessary). Surgery is scheduled
  4. Extractions, bone reduction, implants placed and temporary or permanent denture secured to implants
  5. Follow-up (a week to a few months depending on healing)

Will my dental implants function just like real teeth?

Your new teeth will not only look and feel like natural teeth, they’ll also function like real teeth. PearlFection Dentistry's Team approach will result in an outstanding, functional set of teeth. Teeth you will be proud of and allow you to eat any food you can imagine.

Before - natural teeth

After - same day implant supported denture - with zygoma implants and denture - all on four denture

How do I get started with exploring if implant supported dentures are right for me?

Getting started is easy. Just call our office at 301-336-5550, say you would like to come in for a free “all on 4 implant supported denture” consultation, and we will do the rest.