Posts for category: Dental Procedures
You've probably heard about dental implants — today's best option for replacing missing teeth; maybe you even have one or more already. A dental implant is a tiny screw-shaped metal post that sits in your jawbone and supports a lifelike dental crown. Natural teeth and implant-supported teeth have differences and similarities.
The main difference between implants and natural teeth — besides the fact that you were born with one and not the other — is the way they attach to your bone. Implants actually fuse to the bone, becoming part of it. This is a unique property of titanium, the metal from which implants are made. Maintaining that attachment is extremely important; we will discuss how best to ensure that in a moment.
Natural teeth do not ever become part of the bone that surrounds them. Instead, they attach to it via the periodontal ligament (“peri” – around; “odont” – tooth), which is made up of tiny fibers that go into the tooth on one side and the bone on the other. These fibers form a sort of hammock for each tooth.
Another difference is that natural teeth can decay while implant-supported teeth can't. But that doesn't mean you don't have to worry about dental hygiene — far from it! And here's where we get to the main similarity: oral hygiene is extremely important to maintain both teeth and implants. Lax oral hygiene for either can result in bacterial infections that may lead to gum disease, and even bone loss.
The main enemy of a properly fused implant is a bacterial infection known as “peri-implantitis” (“peri” – around; implant “itis” – inflammation), which starts when bacterial biofilm (plaque) is allowed to build up on implant-supported crowns. Peri-implantitis can lead to a well-like or dish-shaped loss of bone around the implant, which in turn can cause the implant to lose its attachment to the bone. If this happens, the implant can no longer function. Fortunately, this infection is preventable with good brushing and flossing techniques at home, and regular professional cleanings here at the dental office.
So another similarity, then, is that natural teeth and implants can last a lifetime with proper care. And that's the result we're aiming for!
Dental implantation is the premier option for tooth replacement available today. While acquiring dental implants does involve a surgical procedure, don’t let that deter you — with proper preparation the procedure is relatively minor and routine.
Implants are root replacements inserted directly into the jawbone to which a life-like, artificial crown is secured (strategically placed implants can also support fixed bridges or removable dentures). They’re typically made of titanium, which is osseophilic or “bone-loving”: bone will grow and adhere to the implant over a few weeks time.
Pre-planning can help minimize discomfort during and after the implantation procedure. We first conduct a radiographic examination of the site with x-rays or CT imaging; this enables us to assess the site’s bone quality and quantity. We can also create a surgical guide from the imaging to pinpoint the precise location for an implant to ensure a successful outcome.
Before beginning the procedure, we numb the area with a local anesthesia (we can also administer a sedative or other relaxation medication if you’re experiencing mild apprehension). The procedure often begins by creating a flap opening in the gum tissue with a few small incisions to access the bone. Using the surgical guide, we then begin a drilling sequence into the bone that progressively increases the size of the hole until it precisely matches the size and shape of the implant.
When the site preparation is complete, we remove the implant from its sterile packaging (which minimizes the chance of infection) and immediately insert it into the prepared site. We verify proper positioning with more x-rays and then suture the flap opening of the gum tissue back into place.
Thanks to both the pre-planning and care taken during surgery, you should only experience minimal discomfort. While narcotic pain relievers like codeine or hydrocodone may be prescribed, most often non-steroidal anti-inflammatory drugs like aspirin or ibuprofen are all that’s needed. We may also prescribe an anti-bacterial mouthrinse (with chlorhexidine) to assist healing.
In just a few weeks your custom-made restorations will be attached to the implants. It’s the completion of a long but not difficult journey; the resulting smile transformation, though, can last for many years to come.
If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implant Surgery.”
If you’re considering tooth whitening, you may be torn between using a home product and undergoing a professional application in our office. Here’s a brief comparison of both approaches to help you in your decision process.
It helps first to know what we’re trying to correct — that dull, discolored tooth stain. Tooth staining comes in two varieties: intrinsic, which occurs deep within the tooth and can be caused by aging, old root canal treatments, tetracycline antibiotic use or excessive fluoride intake during childhood development; or extrinsic, which occurs mainly on the tooth surface and is caused by substances like coffee, tea, wine or tobacco. Intrinsic stains can only be treated through an in-office procedure — the comparison we’re making between home and professional whitening refers only to extrinsic staining.
Whitening, then, is the use of a chemical agent to bleach those stains. The majority of both home and professional products use hydrogen peroxide or carbamide peroxide (which also contains hydrogen peroxide) as its primary bleaching agent. Depending on the application, either of these chemicals can effectively bleach extrinsically stained teeth. The two approaches differ, however, in the strength of the bleaching agent: home products usually contain a 10% or less concentration, while professional solutions usually contain between 15% and 35%. As a result, the home application takes longer than a dentist’s treatment to achieve desired results — two to three weeks as opposed to one or two office visits.
Whichever option you choose, remember teeth whitening isn’t a permanent solution. The brightness will fade over time — six months to a year if you restrict foods and habits that stain teeth. You can also receive a touch-up once or twice a year to help extend brightness.
There’s also a middle of the road option — you can use a home application with guidance from our office. It’s also a good idea to visit us for an examination beforehand — we can then advise you on what options will work for your particular type of staining and teeth condition.
If you would like more information on teeth whitening options, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Teeth Whitening” and “Tooth Staining.”
Q: What exactly is cosmetic tooth bonding?
A: Cosmetic bonding is a process in which your dentist uses specially formulated tooth-colored material to repair minor defects on the surface of your teeth. The bonding material itself is a type of composite resin — a tough, translucent mixture of plastic and glass components that mimics the pearly-white appearance of your teeth to a high degree. The material also bonds (links up) so well with the natural tooth structure that this relatively simple and inexpensive treatment can last for a number of years.
Q: What types of defects can tooth bonding repair?
A: Bonding can be used to remedy several different kinds of flaws in your smile. Small chips, cracks and areas of discoloration can be easily treated via cosmetic bonding. It can even be used to fix minor spacing irregularities. Best of all, because composite resin is available in various shades to match the natural color of your teeth, it’s almost impossible to tell which tooth has been treated.
Q: What are the pluses and minuses of cosmetic bonding?
A: Bonding is a procedure that can be done right in the dental office, without involving a laboratory — that’s why it is typically an easy, cost-effective treatment that can be accomplished in a single visit. It’s a great solution for restoring minor flaws that don’t extend very far into the tooth’s structure. It’s also ideal for teenagers, who may have to wait until they stop growing before getting a more permanent restoration. But bonding normally isn’t as long-lasting as some other restoration techniques, such as veneers or crowns. However, with proper care, a bonded tooth can keep looking good for years.
Q: What is the bonding procedure like?
A: Bonding is a minimally invasive, reversible treatment that normally causes little or no discomfort. The tooth being treated is first thoroughly cleaned, and then “etched” with a gel that microscopically roughens its surface. Next, the gel is rinsed off, and liquid composite resin (in a shade chosen to match the tooth) is painted on with a brush. Then, the bonding material is cured (hardened) using a special light. After it has cured, another layer may be applied; this process can be repeated several times to build up a thicker coating. Finally, a dental instrument is used to shape the built-up material into its final, pleasing form.
Q: Do bonded teeth require special care?
A: Not really… but like all teeth, they should be brushed and flossed daily, and professionally cleaned at the dental office twice a year. Bonded teeth can also become stained from tobacco use, red wine and coffee — but unlike regular teeth, bonded teeth can’t be lightened. So if you’re considering tooth-whitening treatments, have them done before your teeth are bonded.
If you have questions about whether cosmetic bonding could help your smile look its best, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Artistic Repair Of Front Teeth With Composite Resin.”
Do you have silver dental fillings that you wish you didn't have? Wouldn't it be nice if no one could look in your mouth and see how many cavities you had as a kid? Tooth-colored fillings may offer a solution to the problem of too much metal in your mouth. How much do you really know about non-metallic tooth-colored fillings? Take our quiz and find out.
True or false: Tooth-colored fillings are a radical new technology.
False. A variety of dental porcelains and composite resins have been successfully used in tooth restoration for many years. These materials have been designed to mimic the properties of the two major components of teeth: the hard outer enamel, and the bone-like inner dentin. Our increasing understanding of tooth structure and composition has led to better and more natural-looking filling substances.
True or false: Teeth must remain rigid under the pressure of the bite.
False. At one time, metal amalgam (silver) fillings were preferred because of their extreme hardness. But we now know that the crowns of our teeth actually flex under the forces of the bite. This discovery has spurred the development of new methods and materials to stabilize the restored tooth and reduce the incidence of premature failure.
True or false: It's usually more complicated to put in a tooth-colored filling than a metal one.
False. Regardless of which material is used, the basic process of filling a tooth is the same. The dentist prepares the tooth for treatment, removes decay, and places a filling directly into the tooth. If the filling is moderately deep, a tooth-colored filling may be set in several layers which are successively “cured” or hardened. More extensive restorations may require more than one visit, but the natural-looking results generally justify the extra time.
True or false: Regular metal fillings make the tooth structure stronger.
False. Properly securing an amalgam filling may require the tooth to be “undercut,” meaning that a greater amount of healthy tooth material must be removed. This can weaken the tooth structure, eventually leading it to chip and crack. Non-metallic fillings don't require undercutting, so more tooth structure is left intact. This more conservative treatment can result in a stronger, longer-lasting restoration.
True or false: Non-metallic (tooth-colored) fillings are safer than silver fillings.
False. While each method has advantages and disadvantages, and may not be an appropriate treatment in every situation, both methods have been deemed safe and effective by major U.S. and international science and health organizations. While there have been recent concerns about mercury in amalgam fillings, there is presently no reason to believe that it presents any cause for concern.
If you would like more information about tooth-colored fillings, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “The Natural Beauty of Tooth-Colored Fillings.”