Posts for category: Dental Procedures
Q: I’ve heard about dental implants, but I’m still not sure exactly what they are. Can you explain?
A: It’s no wonder you’ve heard of them: Dental implants have been called the most exciting advance in dentistry in the last 50 years! Essentially, the implant itself is a small, screw-shaped post that is placed in the jaw bone (underneath the gums), and serves as a replacement for the tooth’s roots. It is attached to a lifelike crown (a replacement for the visible part of the tooth) via a sturdy connector called an abutment. Dental implants offer results that can last a lifetime, and have the highest documented success rate of any tooth replacement system — over 95%.
Q: How does a dental implant work?
A: A few decades ago, it was discovered that titanium metal has a unique property: It can actually become fused to living bone tissue in a process called osseointegration. Implants are made of titanium, and take advantage of this feature. Solidly anchored in place by both osseointegration and mechanical forces, dental implants provide a strong and durable base for several different kinds of natural-looking and fully functional replacement teeth.
Q: What are dental implants used for?
A: One dental implant can be used to replace just one missing tooth with a crown that matches your own teeth. Two or more dental implants can be used to support a fixed bridge (a series of three or more replacement teeth) without requiring any work to be done on the adjacent, healthy teeth. Four or more implants can support an entire arch (complete top or bottom set) of replacement teeth that won’t slip and will never need to be removed — a great alternative to traditional removable dentures! Implants can also be used to support some kinds of removable dentures, and in certain orthodontic procedures.
Q: What is the procedure for getting a dental implant?
A: The implant process begins with a consultation, a thorough exam, and a set of diagnostic images. Placing one or more implants involves minor surgery, which is typically performed in the dental office and requires only local anesthesia. After the area has been numbed, a small opening is made in the tissue of gums and jaw bone, and the implant is carefully inserted. In some situations, a temporary replacement tooth may be placed on the implant immediately; otherwise, the implant will be allowed to rest for a period of weeks. In either case, the permanent replacement teeth will be secured to the implants at a subsequent visit.
Q: What are the advantages of an implant over other tooth replacement methods?
A: We already mentioned the high success rate and the long life of dental implants. Another advantage is the fact that implants stop the deterioration of bone in the jaw that inevitably follows tooth loss. Bone loss, a “hidden” consequence of tooth loss, is what tends to make people who are missing teeth look older than they really are. Implants need no special care beyond what you would give your natural teeth, and their longevity can make them a cost-effective investment in the long term. Plus, they look, function and “feel” just like your natural teeth.
If you’d like to find out more about dental implants, please contact us or schedule an appointment for a consultation. You can also read the Dear Doctor magazine articles “Dental Implants” and “The Hidden Consequences of Losing Teeth.”
At one time people who had lost all their teeth faced a grim future. With no feasible alternative, their tooth loss severely limited their ability to eat or speak. Their appearance suffered too, not only from the missing teeth but from bone loss in their facial structure.
We’ve come a long way since then — today, it’s possible to restore complete tooth loss with a permanent set of implant-supported teeth. Unlike other options like removable dentures, implantation can stop and even reverse bone loss caused by missing teeth. And because it now only takes a few strategically-placed implants to support an entire fixed bridge of teeth, the implant option is more affordable than ever.
In essence, implants are tooth root replacement systems. The titanium post that is surgically placed within the jawbone is osseophilic (“bone-loving”), which means bone will grow and adhere to it in a few weeks to further secure it in place. A dental restoration — a single crown (the visible portion of the tooth) or an entire bridge or arch — is then cemented or screwed to the implant.
While dental implants for single teeth normally require full bone integration before the permanent crown is set, it’s often possible for an implant-supported bridge of many teeth to be set at the same time as implantation. The bridge is attached to four or more implants that support the bridge like the legs of a stool; the teeth within the bridge also act to support each other. Both of these factors help to evenly distribute the biting force, which reduces the risk of crown failure before complete bone integration. You would still need to limit yourself to a soft food diet for 6-8 weeks while the bone integration takes place, but the procedure is essentially completed when you leave the dentist’s office.
As marvelous as the possibilities are with implant restorations, it still requires a great deal of planning and artistry from a team of dental professionals to realize a successful outcome. But working together, you and your team can achieve what wasn’t possible even a few years ago: a complete set of life-like, fully functional implant-supported teeth — and a new smile to boot!
If you would like more information on implant-supported teeth, 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 “New Teeth in One Day.”
Porcelain laminate veneers are one of the innovative techniques dentistry has developed for restoring teeth to improve their color and shape so that they look as good as or better than the originals.
What are porcelain veneers? Porcelain is a ceramic material that is baked in a high-heat oven until it becomes glass-like. Your grandmother's antique china teacups are probably made of porcelain. Dental porcelains are especially made to perfectly mimic the color, reflectivity and translucency of natural tooth enamel. A veneer is a covering or shell, a false front; dental porcelains can be fashioned into veneers used to restore the enamel surfaces of teeth.
What is a laminate? A laminate is a structure created by uniting two or more layers of material together. Dental porcelain laminate veneers refer to the combination of tooth enamel bonding material and porcelain veneer.
When are porcelain laminate veneers used? Porcelain veneers are used to enhance the color of stained, darkened, decayed and heavily restored teeth. They are also used to: correct spaces between teeth; straighten slightly rotated teeth; correct problems in tooth shape and some bite problems. They can be good solutions for broken teeth or teeth that have been worn by habitual tooth grinding.
What is the process of placing the veneers? Room generally needs to be created to place a veneer; generally requiring about half a millimeter of reduction of tooth enamel. Artistic dental laboratory technicians fabricate veneers. About a week of laboratory time is usually needed to construct your veneers.
How do I know whether I will like the way my new veneers look? Computer imaging can be used to digitally replicate your teeth and create images of the proposed changes. Models of your teeth can be cast and changes can be made in white wax for your preview. Temporary veneers can also be fabricated as a test drive before the final veneers are fabricated.
How long will porcelain veneers last? Veneers can last 20 years or more. They are very strong but like glass, they can break if extreme force is applied to them. You should avoid such activities as opening bottles, cracking nuts, or biting into candy apples with your veneers.
How do I look after my new veneers? Once the veneers are placed, you should continue daily brushing and flossing. There is no higher incidence of decay around them than with your natural teeth. However, the more dental work you have in your mouth, the more vigilant you need to be. Of course, keeping your sugar consumption low helps to protect all of your teeth from decay.
Contact us today to schedule an appointment or to discuss your questions about porcelain laminate veneers. You can also learn more by reading the Dear Doctor magazine article “Smile Design Enhanced with Porcelain Veneers.”
Dental implants have quickly become the restoration of choice for two basic reasons: they effectively restore the lost function of missing teeth and simultaneously rejuvenate the smile with their life-like appearance.
Achieving a life-like appearance, however, isn’t always a simple matter. A restoration in what we dentists call the “Smile Zone” (the upper front area that displays both teeth and the gum line when you smile) requires careful planning and technique to ensure they appear as life-like as possible.
Our first concern is whether there’s enough bone to fully anchor an implant. Bone is a living, dynamic tissue that goes through cycles of dissolving (resorption) and growth. The normal forces of biting and chewing transmit through healthy teeth and stimulate growth in the bone. When the teeth are missing and no longer transmit this pressure, the bone will eventually resorb only and not grow.
Adjacent teeth could also be affected with bone loss if the extraction was difficult and a bone graft was not placed into the extraction socket to preserve bone. This not only puts adjacent teeth at risk of gum and bone loss but can also have implications for the final smile appearance. This bone also supports the triangular tissue between teeth known as papillae which give teeth their arched appearance. If the bone isn’t adequate, there’s less hope that the papillae will regenerate.
With these concerns it’s very important to consider how the implant and crown emerges from the gums in the Smile Zone. Recent developments in implant design are helping in this regard. The design change of the top of the implant re-orients the gum tissues in relation to the implant from vertical to horizontal, which dentists call “platform switching.” This provides greater stabilization where bone mass is limited, and helps create a more aesthetically pleasing result. There are also other techniques, such as surgical tissue grafting of the papillae that can further enhance the final appearance.
Although creating a natural, life-like appearance in the Smile Zone is difficult, it’s not impossible. It’s important first to undergo a complete dental examination and profile, where we can advise you on your best options to achieve a beautiful smile.
If you would like more information on the relation of implants to the aesthetics of your smile, 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 “Implant Aesthetics.”
We all know that dentistry can do amazing things these days to give you the smile you've always dreamed of. With the latest cosmetic and restorative dental techniques, it is possible to achieve amazingly natural-looking results. But how do we map out the best route to a better smile? And how do we know that the results will hold up over time?
Every individual has a unique set of conditions in his or her mouth and it is our job to figure out how you have come to your present state, dentally speaking. We need to correct or at least manage any factors that could risk the success of your treatment. These risk factors fall into four basic categories:
Periodontal Risk — This involves the condition of the structures that support your teeth, including your gum and bone tissue. It's important to establish good periodontal health before we perform any restorative or cosmetic procedures.
Biomechanical Risk — This has to do with the structural integrity of your teeth. We will look at whether any tooth structure has been lost due to decay, and take steps to reduce your susceptibility to decay if necessary.
Functional Risk — This relates to your bite: how your teeth, muscles and jaw joints are functioning. For example, do you have excessive tooth wear or joint pain? If so, you are at a higher risk in this category and we need to figure out why.
Aesthetic Risk — This is the most subjective of the categories as beauty is in the eye of the beholder. Still, if you display a lot of your teeth and gums when you smile, any issues you have (gum recession, for example) will be that much more visible and affect your smile more. We will have to take this into account when we plan your treatment.
Only when we have determined how best to minimize your risk in all four of these categories can we restore or enhance your smile in a way that will not only look great but also last as long as possible.