Posts for category: Dental Procedures
Generations have depended on dentures to effectively and affordably replace lost teeth. But they do have a major weakness: They contribute to jawbone loss that creates not only mouth and facial problems, but can also ruin a denture’s fit.
Bone loss is a normal consequence of losing teeth. The biting forces normally generated when we chew stimulate new bone to replace older bone. When a tooth is missing, however, so is that chewing stimulation. This can slow bone replacement growth and gradually decrease the density and volume of affected bone.
While dentures can restore dental appearance and function, they can’t restore this growth stimulation. What’s worse, the pressure of the dentures against the gum-covered jaw ridge they rest upon may irritate the underlying bone and accelerate loss.
But there is a solution to the problem of denture-related bone loss: an implant-supported denture. Rather than obtaining its major support from the gum ridges, this new type of denture is secured by strategically-placed implants that connect with it.
Besides the enhanced support they can provide to a denture restoration, implants can also deter bone loss. This is because of the special affinity bone cells have with an implant’s imbedded titanium post. The gradual growth of bone on and around the implant surface not only boosts the implant’s strength and durability, it can also improve bone health.
There are two types of implant-supported dentures. One is a removable appliance that connects with implants installed in the jaw (three or more for the upper jaw or as few as two in the lower). It may also be possible to retrofit existing dentures to connect with implants.
The other type is a fixed appliance a dentist permanently installs by screwing it into anywhere from four and six implants. The fixed implant-supported denture is closer to the feel of real teeth (you’ll brush and floss normally), but it’s usually more costly than the removable implant-supported denture.
While more expensive than traditional ones, implant-supported dentures still cost less than other restorations like individual implant tooth replacements. They may also help deter bone loss, which may lead to a longer lasting fit with the dentures. Visit your dentist for an evaluation of your dental condition to see if you’re a good candidate for this advanced form of dental restoration.
If you would like more information on implant-supported dentures, 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 “Overdentures & Fixed Dentures.”
So, you’ve just acquired an attractive restoration with dental implants. You may be thinking at least with these teeth you won’t have to worry about dental disease.
Think again. While the implants and their porcelain crowns are impervious to decay the surrounding gums and bone are still vulnerable to infection. In fact, you could be at risk for a specific type of periodontal (gum) disease called peri-implantitis (inflammation around the implant).
Bacterial plaque, the thin bio-film most responsible for gum disease, can build up on implant crowns just as it does on natural tooth surfaces. If it isn’t removed with daily brushing and flossing and regular dental cleanings the bacteria can trigger an infection in the gums.
Besides weakening gum tissues, gum disease can also cause bone loss, of critical importance to dental implants. An implant depends on the bone they’re inserted in to hold them in place. If the bone around an implant becomes infected it could begin to be lost or dissolve (resorb), which could lead to loss of the implant.
That’s why it’s critical to keep the natural tissue structures supporting your implants infection-free. Not only is daily hygiene a must, but your implants and any remaining natural teeth should undergo professional cleaning at least twice a year or more if your dentist recommends it.
Cleanings involving implants will also be a bit different from natural teeth. While the dental materials used in the crown and implant post are quite durable, regular cleaning instruments can scratch them. Although tiny, these scratches can become hiding places for bacteria and increase your risk of infection.
To avoid this, your hygienist will use instruments (known as scalers and curettes) usually made of plastics or resins rather than metal. The hygienist may still use metal instruments on your remaining natural teeth because their enamel can tolerate metal without becoming scratched creating a smoother surface.
While keeping implants clean can sometimes be a challenge, it’s not impossible. Implants on average have a long-term success rate above 95%. With both you and your dentist caring and maintaining these state-of-the-art restorations, you may be able to enjoy them for decades.
If you would like more information on caring for 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 Maintenance: Implant Teeth must be Cleaned Differently.”
The Golden Globes ceremony is a night when Hollywood stars shine their brightest. At the recent red-carpet event, leading man Viggo Mortensen had plenty to smile about: Green Book, the movie in which he co-starred, picked up the award for Best Motion Picture—Musical or Comedy. But fans looking at the veteran actor's big smile today might not realize that it once looked very different. A few years ago, an accident during the filming of The Two Towers took a major chip out of Mortensen's front tooth!
That might be OK for some movies (think The Hangover or Dumb and Dumber)—but it's not so great for everyday life. Fortunately, Mortensen visited a dentist promptly, and now his smile is picture-perfect. How was that accomplished? He didn't say…but generally, the best treatment for a chipped tooth depends on how much of the tooth's structure is missing.
If the tooth has only a small chip or crack, it's often possible to restore it via cosmetic bonding. This procedure can be done right in the dental office, frequently in a single visit. Here's how it works: First the tooth is cleaned and prepared, and then a tooth-colored resin is applied to the area being restored. After it is cured (hardened) with a special light, additional layers may be applied to build up the missing structure. When properly cared for, a tooth restored this way can look good for several years.
For a longer-lasting restoration, veneers may be recommended. These are wafer-thin shells made of durable material (most often porcelain) that cover the front (visible) surfaces of teeth. Strong and lifelike, veneers can match the exact color of your natural teeth—or give you the bright, high-wattage smile you've always wanted. No wonder they're so popular in Hollywood! Because veneers are custom-made for you, getting them may require several office visits.
If a chip or crack extends to the inner pulp of the tooth, a root canal procedure will be needed to keep the tooth from becoming infected—a situation that could have serious consequences. But you shouldn't fear a root canal! The procedure generally causes no more discomfort than filling a cavity (though it takes a little longer), and it can help save teeth that would otherwise be lost. After a root canal, a crown (cap) is generally needed to restore the visible part of the tooth.
When a damaged tooth can't be restored, it needs to be extracted (removed) and replaced. Today's best option for tooth replacement is a dental implant—a small, screw-shaped post inserted into the bone of your jaw that anchors a lifelike, fully functional crown. Implants require very little special care and can look great for many years, making them a top choice for tooth replacement
If you have questions about chipped or damaged teeth, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Artistic Repair Of Front Teeth With Composite Resin” and “Porcelain Veneers.”
Dental implants are today’s closest restorative facsimile to natural teeth. And they’re versatile: not only can they replace single teeth but they can also support bridges or dentures.
But since one of their crucial components is made of metal, are you out of luck obtaining this state-of-the-art dental restoration if you have a metal allergy?
The answer is: probably not—it’s rare for implants to cause an allergic reaction. Still, metal allergies can be a potential problem within your mouth as with other areas of health.
An allergy originates from the body’s necessary response to potentially harmful microorganisms or substances. Sometimes, however, this response becomes chronic and exaggerated, creating an allergy. People can have allergies to nearly anything with responses ranging from a minor rash to a potentially life-threatening multi-organ system shutdown (anaphylactic shock).
A small number of people have allergies to particular metals. One of the most common is nickel, which affects an estimated 17% of women and 3% of men; cobalt and chromium are also known to cause allergies. Consumer exposure, particularly metal contact with the skin through jewelry or clothing, is the most prevalent, but not the most concerning. That’s reserved for metal allergies related to medical devices like coronary stents or hip and knee prostheses. And in dentistry, there are rare occasions of inflammation or rashes from metal amalgam fillings.
Which brings us to dental implants: the main metal post that’s inserted into the jawbone is usually made of titanium. It’s the metal of choice for two reasons: it’s bio-compatible, meaning the body normally accepts its presence; and it’s osteophilic, which means bone cells readily grow and adhere to it, a major reason for implant durability.
While it’s possible for someone to have an allergy and subsequent reaction to implants with titanium, the occurrences appear to be extremely low. In one study of 1,500 patients, titanium allergies were estimated to be a factor in implant failures in less than 1% of those studied.
Even so, if you have known metal allergies you should make sure your dentist knows. Being aware of all the facts will help them recommend the best tooth replacement choice for you—and hopefully it will be dental implants.
If you would like more information on dental implant restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Metal Allergies to Dental Implants.”
There are a number of ways to improve unsightly teeth. You can, of course, replace them with dental implants — but not if they're still viable. You can crown them: however, you'll have to significantly reduce their structure for the crowns to fit over them.
There is another less invasive option for teeth with mild to moderate imperfections — you can cover them with porcelain veneers. As the name implies, a veneer is a thin covering of dental porcelain bonded to the outside surface of a tooth. They literally put a “new face” on chipped, stained or slightly gapped teeth.
You'll first need a dental examination to ensure your teeth are reasonably healthy and that you don't have any significant dental problems that could interfere with the veneers. We can then design your veneers' shape and color to achieve the look you desire. We can also create a temporary “trial smile” with acrylic replicas of your proposed veneers to give you a realistic impression of your future smile.
The next step is the possibility the teeth need to be prepared for the veneers. Although quite thin, veneers can still make the teeth look larger or bulky. To compensate, we remove some of the tooth enamel. Although much less than for a crown, this alteration is still permanent: your teeth will need some form of restoration from now on. There are also “no-prep” veneers, which require no tooth surface reduction.Â Ask us if this is an option.
We then make an impression of the teeth, which with other information will guide a technician at a dental laboratory to manually create your new veneers. This can take several weeks and requires a high degree of artistry to produce a custom product that will match your teeth.
Once they've arrived, we'll use a permanent bonding process to precisely attach them to your teeth.Â It will then be up to you to care for your veneers, especially not biting down on anything hard that could chip or crack them. You should also maintain regular dental visits and proper oral hygiene to keep your smile as bright and attractive as possible.
Although small in size, veneers can make a big impression. They can restore the smile you once had — or give you the look you've always wanted.
If you would like more information on porcelain veneers, 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 “Porcelain Veneers: Strength & Beauty as Never Before.”