You may be considering dental implants for a lot of reasons: durability, functionality and imperviousness to decay. But perhaps the winning reason is how they will make you look — their life-like quality can restore a smile marred by missing or disfigured teeth. Achieving that result, though, requires your dental team to determine beforehand the state of your bone and gums, and treat any conditions that would interfere with the final result.
The first area to look at is the amount of bone available to support the implant. An adequate amount is necessary not only to stabilize the implant, but to also ensure proper placement needed to achieve the best “smile” result. Your specialist, then, will take steps to protect available bone during procedures, or even aid in building up the bone structure by inserting grafting materials that encourage new bone growth.
The degree of bone volume in adjacent natural teeth is also important because it can greatly affect the health of the papillae. This is the triangular-shaped gum tissue that occurs between each tooth that gives normal teeth their arched appearance. Insufficient bone in these areas could cause the papillae not to regenerate properly around the implant site, which creates unsightly dark spaces in the gum tissue known as “black hole disease.”
We must next consider the quality and health of your gum tissue. Patients whose gum tissue tends to be thin face difficulties during cosmetic surgical procedures; their thinner tissues are also more prone for objects behind them to be visible, including metal or other crown materials.
Our aim is an implant crown emerging from the surrounding gum tissue just as a natural tooth would. To achieve this requires knowing first what we have to work with regarding your bone and gums, and to address any issues that are problematic. One aid in this process is to affix a temporary “prototype” crown on the implant to wear while the permanent crown is manufactured. This allows you to “test-drive” the new look, and make adjustments in the final product regarding color and materials.
Accounting for all these factors — and then making adjustments along the way — will help ensure the final crown meets your expectations for function and appearance.
If you would like more information on the fabrication of implant crowns, 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 “Matching Teeth & Implants.”
Dental implants are a great choice for many people who need to permanently replace a missing tooth. Reliable and long-lasting, they offer a highly successful outcome, and can even help reduce long-term bone loss and damage to adjacent teeth. One of the best features of implants is that the titanium metal of which they're made actually becomes fused with your natural, living bone tissue.
But sometimes, an examination may show that where you have missing teeth, you may not have enough bone remaining to properly place an implant. Does this mean you're out of luck? Not necessarily!
Employing the refined techniques of bone grafting, regenerating bone tissue has become a standard procedure in periodontal and oral surgery. In many cases, it's possible to build up just the right amount of bone using a variety of grafting materials, in combination with other special techniques. This can enable patients who wouldn't otherwise be good candidates to enjoy the benefits of dental implants.
How does it work? Basically, by helping your body repair itself.
You may already know that bone is a living tissue, which can respond to its environment positively (by growing) or negatively (by resorbing or shrinking). When you've lost bone tissue, the trick is to get your body to grow more exactly where you want it. Once we know where — and how much — replacement bone is needed, we can place the proper amount of bone grafting material in that location. Then, in most cases, the body will use that material as a scaffold to regenerate its own bone.
Bone grafting is often done at the time of tooth removal as a preventive procedure or prior to the placement of an implant, to give the body time to re-grow enough of its own tissue. The procedure is generally carried out under local anesthesia, or with the aid of conscious sedation. Sometimes, if there is enough natural bone to stabilize it, it's even possible to place an implant and perform a bone graft at the same time.
So if you're considering dental implants, let us advise you on what's best for your particular situation. We have the knowledge and experience to help you make the right choices, and achieve the most successful outcome.
If you would like more information about bone grafting, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “Can Dentists Rebuild Bone?”
Tooth decay (also known as caries by professionals and as cavities by consumers) is an infectious disease process that damages tooth structure. Cavities, hollowed-out holes in the teeth, are the most common result of untreated caries. It affects millions of Americans, young and old alike.
How does this destructive process happen? It begins when acid-producing bacteria multiply beyond normal levels in the mouth. Dental plaque, a film of remnant food particles and bacteria, cover the teeth due to poor oral hygiene. The bacteria break down sugars and carbohydrates present in the mouth, which in turn produces acid. Too many “bad bacteria” can raise the acidic level in the mouth.
The normal pH level of the mouth is neutral — 7 on the pH scale. But when the acidic level increases, dropping the pH to 5.5, the calcium and phosphate minerals in the hard, protective layer of tooth enamel begin to dissolve in a process known as de-mineralization. A healthy flow of saliva, however, acts as a buffering agent to return the pH level of the mouth back to neutral. Saliva also contains calcium and phosphate that can replace those lost from the enamel and is referred to as re-mineralization.
So, a constant battle rages within the mouth. On one side acid-producing bacteria, the possible absence of saliva, and poor diet and hygiene habits create the conditions where teeth enamel loses its mineral strength, allowing decay to eventually invade the fragile inner dentin of the tooth; on the other side is an adequate flow of saliva, a good diet and hygiene, boosted by treatment options like sealant application, antimicrobials and the topical application of fluoride.
The key, of course, is prevention. We add protection to the teeth by strengthening them; applying fluoride topically is the best approach, along with sealants that can be applied in our office. We reduce the level of acid-producing bacteria, usually with an anti-bacterial mouth rinse. You can also adopt a healthier diet that limits sugars and carbohydrates and reduces snacking between meals.
These preventive measures, along with early treatment of known tooth decay, can help you avoid the full impact of this destructive disease.
If you would like more information on tooth decay and how to prevent it, 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 “Tooth Decay.”
Dental implants are a popular and effective restoration for lost teeth, if there’s enough bone present to support the implant. That might not be the case, however, because without the stimulation of the lost tooth, the bone may dissolve (resorb) over time. It’s possible, however, that you may need to re-grow bone in the back area of the upper jaw where your upper (maxillary) sinus is located.
Sinuses are air space cavities located throughout the skull. This feature allows your head to be light enough to be supported by your neck muscles. Inside each sinus is a membrane that lines your sinus cavities, nasal passages and other spaces. The maxillary sinus is located on each side of the face just below the eyes. Pyramidal in shape, the floor of the pyramid lies just above the upper back teeth.
A surgeon approaches the sinus through the mouth, with the objective of moving the sinus membrane up from the floor of the sinus. This is accomplished by placing bone-grafting material in the area. Over time the body uses the grafting material as a scaffold to produce new bone that then replaces the grafting material. The resulting new bone becomes the support for the implant.
If enough bone exists to stabilize an implant but not anchor it, then the surgeon can approach the sinus from the same opening that’s used for the intended implant site, insert the grafting material, and install the implant during the same procedure. If not, the surgeon creates a small “window” laterally over the teeth to access the sinus and insert the graft. The implant is installed a few months later after the new bone is created.
The procedure usually requires only a local anesthetic, although some patients may require additional sedation or anti-anxiety medication. After the surgery, you normally experience mild to moderate swelling and discomfort, about the same as having a tooth removed. All these symptoms can be managed with non-steroidal, anti-inflammatory pain medication and a decongestant for minor congestion in the sinus. We might also prescribe an antibiotic to help prevent infection.
Although this procedure adds another step and possibly more waiting time to implantation, it gives you an option you wouldn’t otherwise have — a life-like, effective replacement of your back teeth with dental implants.
If you would like more information on bone regeneration for 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 “Sinus Surgery.”
The ailment we commonly called gum disease is actually series of related diseases, all of which involve the tissues that surround the teeth. It's sometimes thought of as a “silent” malady, because its symptoms — bad breath, soreness, or bleeding of the gums — may be masked by other conditions. Or, they may simply be disregarded.
But don't ignore these symptoms! Left untreated, periodontitis can have serious health consequences. Here are five things you should know about this disease.
Gum disease is a chronic inflammatory disease.
That means it's a disease related to a natural response of the body's immune system (inflammation), and it develops over time (chronic). Gingivitis, an inflammation of the gums, may be the first step in the disease's progression. Left untreated, it can be followed by destruction of the periodontal ligament (which helps hold the tooth in place), loss of the supporting bone, and ultimately tooth loss. But it doesn't stop there.
The effects of gum disease aren't confined to the mouth.
In fact, recent research has suggested a connection between periodontal disease and chronic diseases in the whole body. There is evidence that severe periodontal disease is linked to an increased risk of cardiovascular diseases (like heart attack and stroke), pregnancy complications, and other conditions. It is also believed to have an adverse effect on blood-sugar control in diabetics.
Gum disease is caused by the bacteria in dental plaque.
Oral bacteria tend to build up in a colony of living organisms called a biofilm. Of the many types of bacteria that live in the mouth, only a relatively few are harmful. When oral biofilms are not regularly disturbed by brushing and flossing, the disease-causing types tend to predominate. Once it gains a foothold, treating gum disease can become more difficult.
Prevention is the best defense.
Good personal oral hygiene, carried out on a daily basis, is probably the best defense against many forms of periodontal disease. Proper brushing and flossing is effective in disrupting the growth of dental plaques. Lifestyle changes — like quitting smoking and reducing stress — are also associated with lessening your chance of developing the disease. Genetics also seems to play a part, so those with a family history of periodontitis should pay special attention to preventive measures.
Prompt, effective treatment is critical.
Bleeding of the gums is never a normal occurrence. But sometimes this (and other symptoms of gum disease) may be overlooked. During routine dental checkups, we can detect the early signs of periodontal disease. We can then recommend an appropriate treatment, from routine scaling and root planing (a cleaning of the teeth) to other therapies. So, besides brushing and flossing regularly, don't neglect regular examinations — they're the best way to stop this disease before it becomes more serious.
If you have concerns about gum disease, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Understanding Gum (Periodontal) Disease” and “Warning Signs of Periodontal (Gum) Disease.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.