Dental implants are considered the premier option for tooth replacement. While all implant procedures follow the same general concept — a titanium post surgically inserted into the jawbone with an attached life-like crown — the installation process can vary.
From their earliest history, implants have usually been installed through a two-stage process. In the first stage, the surgeon inserts the titanium post in the bone and leaves it “submerged” below the gum level to protect it from oral bacteria and the effects of chewing and biting. About three months later after the bone attaches to the titanium (a process called osseointegration), the surgeon then performs the second stage by re-exposing the implant and attaching a temporary abutment and crown for the patient to wear while the permanent abutment and crown are fabricated and later attached in 2-6 weeks.
In recent years, advancements in materials and design have made possible a one-stage process that allows the implant to protrude above the gum line during osseointegration and shortens the process. After the initial three-month healing period, the implant is ready for “loading” with the permanent crown.
The choice between which of these two procedures should be used for your implants will first depend on the type of tooth being replaced. A front tooth benefits from the one-stage procedure for cosmetic reasons because the surgeon can install a temporary crown to the exposed abutment during osseointegration (as long as the temporary tooth isn’t in functional contact with other teeth). An implant for a back tooth, on the other hand, doesn't have a large cosmetic demand so those one stage procedures usually end up with an exposed healing abutment but no temporary crown.
The strength of the bone is also a factor. Some bone tends to be softer, particularly in the back of the mouth. There’s a chance the implant could move in this softer bone, adversely affecting the outcome. For this reason, the two-stage procedure can be the preferred approach for posterior teeth as it offers more protection from movement.
You can be sure we’ll consider all these and other factors during your initial examination, and then advise you on the best approach. Above all, we want to make sure — whether a one-stage or a two-stage implant process — the result is a smile you can be proud of.
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 “Staging Surgery in Implant Dentistry.”
Although teeth are quite durable, we can still lose them—even all of them—to disease or injury. The good news, though, is that we have effective ways to restore teeth after they're lost. One of these, the removable denture, has given people their teeth back for several generations. And with recent advances in technology, today's dentures are even better.
Although more advanced, today's dentures share the same basic structure as those from a century ago: prosthetic (false) teeth set in a plastic resin colored to resemble the gums. The traditional denture is molded to fit snugly over an individual patient's alveolar jaw ridges, which once supported the former natural teeth. The denture stays in place primarily through a suction effect between the denture and the ridges.
Modern technology, though, has greatly improved today's dentures. Digital imaging can be used to generate highly accurate impressions of the dental ridges that can lead to denture bases with better fit. Dentists using photographs of the patient, especially in earlier years, are better able to identify facial landmarks, which enables them to position the new teeth to more closely recreate the patient's former smile.
These technological aids now help dentists to create more attractive dentures with better support and comfort. But the fit that makes this possible may not last due to a particular weakness inherent in traditional dentures—continuing bone loss. When teeth are missing, the underlying jawbone can lose bone volume over time. Dentures don't stop this process and can accelerate it due to constant friction and pressure on the dental ridges.
But a new modification incorporating dental implants with dentures can help solve these problems. By placing a few strategically positioned implants in the jawbone that then connect with the denture, the appliance not only gains more stability, but also produces less pressure on the dental ridges. In addition, bone cells naturally grow and adhere to the titanium implant posts, which helps to stop or slow bone loss.
If you've experienced total tooth loss, dentures are an affordable and effective option. Thanks to modern dental advances, you can get back the smile and dental function you once lost.
If you would like more information on denture restorations, 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 “Removable Full Dentures.”
Here’s a sobering statistic: you have a 50/50 chance over your lifetime for developing periodontal (gum) disease. And it’s much more serious than irritated gums: if not treated aggressively you could experience bone loss, which can not only lead to tooth loss but actually increases your risk of heart attack and stroke.
Initially, you may not notice any symptoms unless you know what to look for: mainly red and puffy gums that frequently bleed during brushing and flossing. As the infection advances into the underlying support structures that hold teeth in place you may also notice receding gums (moving away from your teeth causing them to look longer), pus around the gums or lingering bad breath or taste. And one or more loose teeth are a definite sign the supporting structures have weakened severely.
So, how does gum disease happen? It starts with bacteria. Your mouth contains millions of these and other microorganisms, most of which are friendly and even beneficial. Unfortunately, a fraction of them can infect and harm tissues like the gums and underlying bone. Your mouth’s defenses can normally handle them if their numbers remain low. But a bacterial population explosion can quickly overwhelm those defenses.
Bacteria are like any other life form: they need a secure environment and food. Disease-causing bacteria establish the former by utilizing proteins and other components of saliva to form a sticky biofilm on teeth known as plaque. Within the safe haven of dental plaque bacteria quickly multiply and form a complex and concentrated ecosystem feeding on remnant food particles, especially sugar and other carbohydrates.
The key to gum disease prevention (as well as treatment) is to deprive bacteria of their home and food source by removing plaque and its more hardened form calculus (tartar). You can manage plaque buildup by brushing and flossing daily, seeing your dentist regularly for cleanings to remove any remaining hard-to-reach plaque and calculus, and eating a nutritious diet with fewer sweets or other carbohydrate-rich snacks.
You can further lower your disease risk by avoiding smoking and other tobacco products and moderating your consumption of alcohol. And be sure to see your dentist as soon as possible if you notice any signs of infection with your gums. Taking these steps can help you avoid gum disease’s destructiveness and help preserve a healthy and attractive smile.
Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.
In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.
Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.
Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.
If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.
The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.
Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.
Tooth decay is more prevalent than diseases like cancer, heart disease or influenza. It doesn't have to be—brushing with fluoride toothpaste, flossing, less dietary sugar and regular dental cleanings can lower the risk of this harmful disease.
Hygiene, diet and dental care work because they interrupt the disease process at various points. Daily hygiene and regular dental cleanings remove dental plaque where oral bacteria flourish. Reducing sugar eliminates one of bacteria's feeding sources. With less bacteria, there's less oral acid to erode enamel.
But as good as these methods work, we can now take the fight against tooth decay a step further. We can formulate a prevention strategy tailored to an individual patient that addresses risk factors for decay unique to them.
Poor saliva flow. One of the more important functions of this bodily fluid is to neutralize mouth acid produced by bacteria and released from food during eating. Saliva helps restore the mouth's ideal pH balance needed for optimum oral health. But if you have poor saliva flow, often because of medications, your mouth could be more acidic and thus more prone to decay.
Biofilm imbalance. The inside of your mouth is coated with an ultrathin biofilm made up of proteins, biochemicals and microorganisms. Normally, both beneficial and harmful bacteria reside together with the “good” bacteria having the edge. If the mouth becomes more acidic long-term, however, even the beneficial bacteria adapt and become more like their harmful counterparts.
Genetic factors. Researchers estimate that 40 to 50 hereditary genes can impact cavity development. Some of these genes could impact tooth formation or saliva gland anatomy, while others drive behaviors like a higher craving for sugar. A family history of tooth decay, especially when regular hygiene habits or diet don't seem to be a factor, could be an indicator that genes are influencing a person's dental health.
To determine if these or other factors could be driving a patient's higher risk for tooth decay, many dentists are now gathering more information about medications, family history or lifestyle habits. Using that information, they can introduce other measures for each patient that will lower their risk for tooth decay even more.
If you would like more information on reducing your risk of tooth decay, 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 “What Everyone Should Know About Tooth Decay.”
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