Pre-Treatment

I have known this young man since he was twelve.  He is now a college professor.  No one is completely immune to dental issues.  I have treated this young man for over twenty years in both of my Palm Harbor dental offices.

After a sports injury, he lost an upper front tooth, which was replaced with a tooth supported fixed bridge while he was in college in North Carolina.  The supporting teeth eventually decayed, the bridge fell out and this was his smile before we completed his treatment plan, which included tooth extractions, bone grafting, root canal therapy, dental implants, sedation dentistry and dental crowns.

Maryland Bridge #25

Most people would prefer non-removable to removable teeth.  I have been a dentist in Palm Harbor for over 24 years and in these two plus decades I have replaced many missing teeth.  The Maryland bridge has been an option as a conservative, medium term, non removable choice for tooth replacement for almost 30 years.

This picture shows a new choice of materials for the Maryland Bridge, which traditionally is porcelain fused to metal.  This Maryland Bridge was constructed at Glidewell lab in California for a patient in my Palm Harbor dentist office.  It is made from composite.   The original design was with a metal, not composite material.  The metal is stronger and virtually unbreakable, but less cosmetic.  The practice of dentistry has always included the use of new and at times non traditional materials.  I believe that there is a place for the composite Maryland Bridge.  I also believe that there is no universal material of choice applicable in all situations.  I will continue to practice dentistry in Palm Harbor, near Tampa for many years.

Is this a rotten tooth?  It was a diseased and infected tooth.  It was painful and unhealthy.  It has no tooth decay, and yet it was diseased.  What do you think, was it a rotten tooth?  The patient surely thought it was a rotten tooth that she wanted to get rid of.  Other treatment options were available, but given the state of infection and the periodontal condition of this tooth, extraction was not only the most cost effective treatment, but the treatment of choice.

Tarpon Springs is a nice town, I lived there for a time, my parents lived there and myTa brother, Richard, live there now.  I lived in Tarpon Springs from 1992 – 1996.  Palm Harbor was my home before and after that.  Although now I live in Oldsmar, right on the border with Tampa, Palm Harbor would still be a top choice.  I am very happy with the location of my dentist office in the middle of Palm Harbor, 34685.

This picture of the gypsy show was taken at this years, 2012, Tampa Bay Renaissance Festival.  It was the day before my 52nd birthday.  My sister Danielle and her children traveled from Jacksonville to Tampa to celebrate with my family and my brother Richard’s family.

Once on this Island, April 27, 2012

I blog mostly about dentistry, but work is but one leg supporting the table which I call life.

On Friday, April 27, 2012 I was able to see my daughter, Kendall Jordan Caputo and other students from Berkeley Preparatory School in Tampa Florida perform the musical, “Once on this Island.”  What an incredible evening in Tampa I had.  Some of the students thought the show was “weird”, my wife Valerie and I loved it.  We talked about the musical on the drive home to Palm Harbor, FL.  I enjoy video taping and the next morning I went to my Palm Harbor dentist office to burn a few dvd’s of the show to enjoy over and over again later.

The torus mandibularis is an exostosis or outgrowth of bone found on the lingual surface of the mandible.  Just as in the case of the palatine torus, numerous causes have been suggested, but the etiology of the torus mandibularis is still unknown.  It has been an idea held for many years that a torus mandibularis will develop as a reinforcement to the torsional stress created by heavy mastication.

This growth on the lingual surface of the mandible occurs above the mylohyoid line, usually apposite the bicuspid teeth.  Line the palatine torus, it may vary considerably in size and shape.  Although the mandibular tori are usually bilateral, they are seen as a unilateral condition in about 20 percent of cases.  Both unilateral and bilateral protruberences may be single or multiple, and they are frequently visible on dental radio-graphs.  there is no correlation in the frequency of simultaneous occurrence of torus palatinus and torus mandibularis, according to the studies of Kolas and co-workers, suggesting that the two conditions are not related.  Suzuki and Sakai reported a highly significant correlation in the frequency of simultaneous occurrence of the two tori, however.

Surgical removal of the torus mandibularis may be necessary because of difficulties encountered in attempting to construct a denture over the outgrowth, although dental implants have greatly change treatment alternatives.  The lesion is comparable to the torus palatinus in its benignity.

Maxillary Tori

The torus palatinus is a slowly growing, flat-based bony protuberance which occurs in the midline of the hard palate.  Numerous theories have been suggesed, but a plausible and thoroughly convincing explanation for his common oral lesion is still lacking.  A study by Suzuki and Sakai offered evidence that both the torus palatinus and torus mandibularis are hereditary conditions, thougt to follow a mendelian dominant pattern.

The torus palatinus presents itself as an outgrowth in the midline of the palate and may assume a variety of shapes.  It has been classified clinically on this basis as flat, spindle shaped, nodular or lobular.  The mucosa overlying the torus is intact but occasionally appears blanched.  It may become ulcerated if traumatized.  The torus itself may be composed of either dense compact bone or of a shell of compact bone with a center of cancellous bone and thus it is often visible on a dental radiograph.

There is little clinical significance attached to this lesion, since it is benign and NEVER becomes malignant.  The torus is usually not treated, although occasionally it may be of such size and shape that it is impossible to construct a full or partial denture over the torus because of undercuts, the probability of trauma to the overlying mucosa or inability to seat the denture owing to rocking.  In such cases the situation must be appraised and the torus removed surgically before the construction of the prosthetic appliance.

Sedation includes a wide spectrum.  General anesthesia, deep sedation, conscious sedation and nitrous oxide (laughing gas) are the most commonly used.  The most commonly used type of sedation in the Tampa area general dentist office is conscious sedation.  Conscious sedation as used in my Palm Harbor dentist office is a depressed level of consciousness, whereby the patient retains the ability to: respond to verbal command, retain protective reflexes and to continually and independently maintain their own breathing and airway.

In Florida, a dentist must receive special training, adhere to special continuing education guidelines, maintain their office and be inspected on a regular basis by the Department of Dentistry.  My Palm Harbor dentist office was inspected late 2011.

Many dental procedures, including root canals, dental implants, crowns, extractions and immediate dentures can be performed while the dental patient is sedated.

Berkeley Preparatory's Pipe & Drum Band

This was the third year my son, Mathew Paul Caputo played the bagpipes, and the second year my daughter, Kendall Jordan Caputo went to the Boston Saint Patrick’s Day Parade.

Both Mathew and Kendall were born in Clearwater, FL at Morton Plant Hospital.  Mathew has lived in Tarpon Springs, Palm Harbor, Oldsmar and Tampa.  Kendall was not born when we lived in Tarpon  Springs or Palm Harbor.  Both have attended Berkeley Preparatory School in Tampa, FL since pre-K.

I am so proud of my children.

Crown off Abutment, Abutment on Lab Model

This porcelain fused to metal crown was made in a dental lab in Palm Harbor, FL.

Michael Glasner has been making crowns for my dental office for over twenty years in his dental labs located in Clearwater, Palm Harbor or Dunnedin.

The decision to restore missing tooth #9 with a dental implant rather than a fixed bridge was made by this patient after extensive discussion of options in my dental office in Palm Harbor.  This patient originally in 1989 in my first Palm Harbor 34683 dental office, but this work was done in the 34685 Palm Harbor office.