Grandpa's New Front Tooth

Nature is kind to seniors, and while their teeth may not look ideal, they can still be very healthy.  Grandpa has good bone and gums, lots of stain and old fillings, but no active decay.  He needed a crown on the front tooth on the right of the picture.  So that's what we did.

Robert G. Tupac, DDS, FACP, Inc.,
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309

Board Certified Prosthodontics: Comprehensive

Treatment Options

Sometimes people are desperate, but are not willing to do what they need to do, even when they are able.  As a Board Certified Prosthodontist, while we very much enjoy "single tooth" dentistry--crowns, veneers, single implants, etc. (and do these things with the most current technologies available)--we see many patients who have been told they are at the end of the line.  These patients have multiple problems: missing teeth, broken down teeth, gum disease and bone loss.  As difficulties increase, people can feel overwhelmed.

At any stage of dental disease, however, there are always options!  The beauty of a comprehensive examination and evaluation is that it includes discussion about needs, wants and priorities.  In this manner, treatment options are considered in terms of benefits and expectations.  

Today there are more ways to achieve a great smile and have function, too.  We can find a worthwhile solution that fits! 

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

What is a Prosthodontist?

We see our prosthodontist because our lifestyle demands our dentures look natural, are comfortable and fit well.  Dr. Tupac is a Board Certified Prosthodontist.  A prosthodontist is a dentist recognized by the American Dental Association as a specialist in restoring and replacing teeth.  With additional education and training, prosthodontists have the capability to provide excellent results on crowns, bridges, dentures, dental implants and other cosmetic and restorative procedures.  Adapted from the American College of Prosthodontists, a professional group of which Dr. Tupac is a Fellow.  He has served on the ACP's Board of Directors for ten years, and has authored the Peer Review Manual and the Parameters of Care. 


Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

My Broken Crown--How Long Did It Last?

I have a broken crown in my mouth.  One of the dentists in town did it, but it failed after just a few months.  For as much as it cost, I wanted it to last forever. It makes me appreciate the times patients ask: "How long will this last?"  Each meal, let's estimate I chew a bite of food 10 times.  With 20 bites per meal and three meals a day, that's 600 times a day that crown is used, not counting snacks, popcorn, ice, lifesavers, nuts, nibbling on bones, etc.  This is the environment of my mouth: temperature range from 150 ° F (hot coffee) to 30 ° F (ice cream), acid attacks (diet drinks are really bad), bacterial biofilm, clenching or grinding at night and holding a pencil.  So, I suppose my mouth is a tough place for a crown to survive.  Did I mention that many years ago, that tooth broke in the first place and that's why it needed a crown?  Did I mention that the first crown broke after many years and that's why I needed a second one.  What's a realistic estimate for a crown or filling to hold up?  The unsatisfying answer: it depends.  In a person who avoids sweets and sodas, regularly brushes and flosses, doesn't take any medication that causes dry mouth, doesn't grind at night and sees a dentist regularly in an effort to catch problems while they're small, that crown can last up to 15 years.  That's without gum disease or new decay. But regular wear and tear, even in "low risk" patients, will eventually do in any dental work because a prosthesis is never as good as nature. 

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Treatment May Never Be Finished--Our Committment To You

Living with uncertainty

Science seeks certainty. The problem in medicine and dentistry is that the body is complex and our knowledge is incomplete. Doctors and patients who want certainty can't be satisfied completely. (deBronkart)  

In my own case, my cancer surgeon says there's a 5% chance my cancer will return, so, while my odds are good, there's no way to predict.  So we live, with uncertainty, because we are human.  

Experience tells me that the more complex the treatment plan is, the greater the chance of complications. This is the essence of informed consent, of answering all questions regarding treatment options before one is chosen. 

Closest to success

Expectations have to be realistic when nature is replaced with prosthetics, be it implants, crowns, veneers, partials or dentures. Both dentist and patient giving their best gets the closest to success, especially when things must be discussed anew when treatment isn't working.  Science keeps pushing toward certainty, but disease doesn't wait. 

Treatment is therefore never finished and is a collaboration of patient and practitioner.  

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Your Unique Crown: Your Smile Is Our Specialty

Is crown good for me?

Single front tooth crowns are difficult--the front tooth on the right of this picture has a porcelain crown.

If you've never had a crown or have forgotten the process, you may have some questions.  

Will the procedure hurt or damage my tooth?  How long will it take? What will it look like?  What can I eat?  How long will it last?  Is this crown good for me?  These are good questions that deserve answers.  

Your tooth is unique

Your crown is a prosthesis that is made only for you.  Your tooth is unique like a fingerprint.  Someone else's crown cannot fit your tooth.  It has to be individually made for you alone.  While it's remarkable that science and engineering has made it possible to make millions of exactly the same thing (pencils), it's a miracle that prosthodontists make millions of teeth that are all different, each individualized for each patient's tooth.  An outstanding crown, like the patient's front tooth, can perform all the duties of a natural tooth and cannot be differentiated from the rest of the teeth in your mouth.  It must attach seamlessly to your remaining tooth and root, not allowing bacteria or plaque the opportunity to cause more decay or increase the risk of inflammation leading to gum disease.  It has to remain attached to your tooth and cannot break, and it has to look like and chew like your tooth.  Skillful management of your gum tissues and precise grinding of your tooth is required.  Too much and the tissues are at risk; too little and the crown will be weak.  Dental technology has advanced clinical procedures to a high level of quality and achievement.  Impression materials capture precise details.  Jaw movements are recorded. Materials make crowns more beautiful and stronger than before.  As a Board Certified Prosthodontist, with our advanced techniques and in office laboratory technology, we will provide the exceptional crown you deserve.

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

A Single Dark Front Tooth

A single dark front tooth is a common occurrence, most often the result of trauma.  The discoloration can develop 1 to 20 years after the trauma, and the tooth may be either vital or non-vital.  It may or may not require, or have had, root canal therapy.  A tooth can also darken after root canal therapy.  The most conservative method of recapturing the tooth's original color is by bleaching, which may be done either externally or internally, or both.  If fillings need to be replaced, they may be done in a lighter color.  If the tooth requires a veneer or crown or cap, it can be done to match the adjacent, natural teeth.  We treat dark teeth with all of the modalities available, and are happy to discuss all treatment options for patients needing this kind of help.

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Can An Implant Replace An Infected Tooth?

A report in the the Journal of Implant and Advanced Clinical Dentistry of a total of 95 patients (42 female, 53 male) age 19-75 (mean 50.5) with 97 screw type implants immediately placed in molar sites at the time of extraction shows 100% success at three years.  The key to the technique is careful extraction techniques to preserve bone and adequate implant stability upon placement due to obtaining maximum bone to implant contact.  The presence of infection in the extracted teeth was not a contraindication.  On average, the implants were restored with abutments and crowns 12-16 weeks after placement.

Source: JIACD, sept/oct2011,vol3,#6,pp37-44  More at www.drtupac.com

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Why Board Certified?

Dr. Robert Tupac, a Board Certified Prosthodontist, manages the most complex dental restorations.  Loss of natural teeth, whether in an accident or as part of the natural aging process, can be traumatic and affect your outlook on life.  Simple pleasures--like smiling or going out to eat--become a source of stress or embarrassment.  There are many options if you have lost some or all of your teeth.  Crowns, bridges and full or partial dentures are just some of the procedures that can help you regain your smile, and improve your appearance and self confidence.  Another option is dental implants, a more permanent solution.  A healthy smile is among the top aspects of a person's appearance that impacts self-esteem.  With his advanced training, Dr. Tupac can improve your appearance by fixing broken, discolored or misshapen teeth and associated structures.  Whether you need to replace one tooth or many, Dr. Tupac will work with you through every step of the way, from initial consultation through followup care

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Time for a New Front Tooth?

Replacing an Old Crown Can Enhance Your Mood

Replacing that old crown on your front tooth with today's more advanced dental laboratory technology can make all the difference in the world in how you look, smile, and feel about yourself.  With our in-house laboratory, we can create whichever restorative solution is best for your dental needs. As a Board Certified Prosthodontist, Dr. Tupac welcomes the opportunity to help you! 

Robert G. Tupac, DDS, FACP, Inc., 
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309 (map)

Serious Dental Problems?

Multiple Missing Teeth, What to Do?

Dr. Robert Tupac, a Board Certified Prosthodontists, manages the most complex dental restorations.  Loss of natural teeth, whether in an accident or as part of the natural aging process, can be traumatic and affect your outlook on life.  Simple pleasures--like smiling or going out to eat--become a source of stress or embarrassment.  There are many options if you have lost some or all of your teeth.  Crowns, bridges and full or partial dentures are just some of the procedures that can help you regain your smile, and improve your appearance and self confidence.  

Another option is dental implants, a more permanent solution.  A healthy smile is among the top aspects of a person's appearance that impacts self-esteem.  With his advanced training, Dr. Tupac can improve your appearance by fixing broken, discolored or misshapen teeth and associated structures.  Whether you need to replace one tooth or many, Dr. Tupac will work with you through every step of the way, from initial consultation through followup care.

Robert G. Tupac, DDS, FACP, Inc., 
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309 (map)

How Treating a Tooth is like Building a House

Healthy Foundation Makes a Strong House

The goal of root canal therapy is to prevent and eliminate infection at the apex (tip) of the root
of the tooth. Then what? Treating a tooth is like building a house. A root canal ensures the foundation is healthy, but the structure on top must be properly constructed.

Many classical studies show that the restoration of the top of the tooth is essential to seal the tooth and prevent root canal re-infection. Greater success is observed in teeth restored with permanent restorations within 2 months of completion of the root canal treatment. Crowns are considered the restoration of choice for endodontically treated posterior teeth. In fact, statistics show root canal treated teeth not crowned are lost at a rate 6 times greater than teeth crowned after root canal therapy.

The thing to remember, then, is that even though the root canal therapy may get you out of pain, treatment isn't finished until the tooth is restored permanently.

Robert G. Tupac, DDS, FACP, Inc.,
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309 (map)