Introduced to the United States in the 1980s, dental implants have quickly become the go-to restoration for tooth replacement. And for good reason: they're not only incredibly life-like, they're highly durable with a 95% success rate.
But as desirable as they are, you may face a major obstacle getting one because of the condition of the bone at your implant site. To position the implant for best appearance and long-term durability, we must have at least 4-5 mm of bone available along the horizontal dimension. Unfortunately, that's not always the case with tooth loss.
This is because bone, like other living tissue, has a growth cycle: Older cells die and dissolve (resorb) and newer cells develop in their place. The forces transmitted to the jaw from the action of chewing help stimulate this resorption and replacement cycle and keep it on track. When a tooth is lost, however, so is this stimulus.
This may result in a slowdown in cell replacement, causing the eventual loss of bone. And it doesn't take long for it to occur after tooth loss—you could lose a quarter of bone width in just the first year, leaving you without enough bone to support an implant. In some cases, it may be necessary to choose another kind of restoration other than implants.
But inadequate bone isn't an automatic disqualifier for implants. It's often possible to regenerate lost bone through a procedure known as bone augmentation, in which we insert a bone graft at the missing tooth site. The graft serves as a scaffold for new bone cells to grow upon, which over time may regenerate enough bone to support an implant.
Even if you've had a missing tooth for some time, implementing bone augmentation could reverse any loss you may have experienced. In fact, it's a common practice among dentists to place a bone graft immediately after a tooth extraction to minimize bone loss, especially if there will be a time lag between extraction and implant surgery.
Bone augmentation could add extra time to the implant process. But if successful, it will make it possible for you to enjoy this popular dental restoration.
If you would like more information on dental implant restoration, 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 Implants After Previous Tooth Loss.”
In recent years, dental implants have helped traditional bridgework take a giant leap forward. A few strategically placed implants can provide the highest support and stability we can currently achieve for this well-known dental restoration.
Implants derive this stability from the bone in which they're imbedded. Once surgically installed, the bone around a metal implant begins to grow and adhere to its titanium surface. Over time, this creates a strong anchor that firmly holds the implant in place.
But the implants' stability can be threatened if the gums around them become diseased. Gum disease, a bacterial infection caused mainly by dental plaque, can advance silently below the gum surface until it ultimately infects the bone. This can cause significant bone loss around an implant, which can weaken it to the point of failure.
To avoid this scenario, it's important to prevent gum disease by flossing daily to remove accumulated dental plaque between the implant-supported bridge and the gums, particularly around the implants. This kind of flossing around bridgework is more difficult than flossing between teeth, but it can be done with the help of a device called a floss threader.
A floss threader is a small plastic hand tool with a loop on one end and a stiffened edge on the other (similar to a sewing needle). You begin by threading about 18" of dental floss through the loop, and then work the other end of the threader between the bridge and gums to the other side.
With the floss threaded between the bridge and gums, you can now remove it from the threader, grasp each end, and floss around the sides of each implant you can reach. You'll then need to repeat the process by removing the floss, rethreading it in the threader and inserting it into the next section between implants, continuing to floss until you've accessed each side of each implant.
You can also use pre-packaged floss thread sections with a stiffened end to facilitate threading. But whichever product you use, it's important to perform this task each day to prevent a gum infection that could rob you of your implant-supported bridge.
If you would like more information on oral hygiene practices with dental work, 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 “Oral Hygiene for Fixed Bridgework.”
It's been a rough year for all of us, but especially for Simon Cowell. The famous entrepreneur and brutally honest talent judge on American Idol and America's Got Talent underwent emergency back surgery in August after an accident on a new electric bike. But the good news is he's well on his way to recovery—and well enough in October to undergo another, less-stressful, procedure: a smile makeover with dental veneers.
This latest trip to the dentist wasn't Cowell's first experience with the popular restoration, wanting this time to update his smile to more closely resemble what he had when he was younger. He even brought along some older photos for reference.
Veneers aren't exclusive to celebrities like Simon Cowell, as thousands of people who get them every year can attest. These thin wafers of porcelain bonded to teeth can mask a wide range of defects, from chips, wear or discoloration to slight tooth gaps or misalignments. And every veneer is custom-made to match an individual patient's dental dimensions and coloring.
If you're thinking about a smile upgrade, here are a few reasons to consider dental veneers.
More bang for your buck. Compared to other transformative cosmetic options, veneers are relatively affordable, with the cost dependent largely on the extent of your dental needs. Still, dental veneers are an investment that can give long-lasting yields of a more attractive smile and even a completely new look.
Little to no tooth alteration. In most veneer cases, we need only remove a small amount of enamel so the veneers don't appear bulky (the alteration is permanent, though, so you'll need a veneer on the tooth from then on). It's also possible to get “no-prep” veneers requiring little to no alteration.
Durable and long-lasting. Continuing improvements in porcelain and other dental ceramics have led to stronger forms that can better withstand the biting forces your teeth encounter every day. Although you'll still need to be careful biting into hard items, your veneers can last for several years.
Easy to maintain. Veneer cleaning and maintenance is much the same as with natural teeth—daily brushing and flossing, and regular dental cleanings and checkups. Outside of that, you'll need to watch what you chomp down on: Veneers are strong, but not indestructible, and they can break.
As Simon Cowell knows, getting veneers isn't difficult. It starts with an initial visit so we can evaluate your dental health and needs. From there, we can present options on how to update your smile.
If you would like more information about dental veneers, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “No-Prep Porcelain Veneers.”
Your tooth enamel is often under assault from oral acid produced by bacteria and certain foods. Unless neutralized, acid can erode your enamel, and lead to destructive tooth decay.
But there's another type of acid that may be even more destructive—the acid produced in your stomach. Although important for food digestion, stomach acid outside of its normal environment can be destructive. That includes your teeth, if stomach acid finds its way into your mouth. And that can happen if you have gastroesophageal reflux disease (GERD).
GERD, a chronic condition affecting 1 in 5 adults, is caused by the weakening of the lower esophageal sphincter, a ring of muscle at the intersection of the esophagus and the stomach that prevents stomach acid from traveling back into the digestive tract and damaging the esophageal liner.
It's also possible for stomach acid to travel as far up as the mouth. With a pH of 2.0 or less, stomach acid can lower the mouth's normal pH level of 7.0 well below the 5.5 pH threshold for enamel softening and erosion. This can cause your teeth, primarily the inside surfaces of the upper teeth, to become thin, pitted or yellowed. Your teeth's sensitivity may also increase.
If you have GERD, you can take precautions to avoid tooth damage and the extensive dental work that may follow.
- Boost acid buffering by rinsing with water (or a cup of water mixed with a ½ teaspoon of baking soda) or chewing on an antacid tablet.
- Wait about an hour to brush your teeth following a reflux episode so that your saliva has time to neutralize acid and re-mineralize enamel.
- If you have chronic dry mouth, stimulate saliva production by drinking more water, chewing xylitol gum or using a saliva supplement.
You can also seek to minimize GERD by avoiding tobacco and limiting your consumption of alcohol, caffeine or spicy and acidic foods. Your doctor may also prescribe medication to control your GERD symptoms.
Preventing tooth decay or gum disease from the normal occurrences of oral acid is a daily hygiene battle. Don't let GERD-related acid add to the burden.
If you would like more information on protecting your teeth from acid reflux, 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 “GERD and Oral Health.”
Two important practices boost your protection from dental disease: twice-a-year dental visits; and daily brushing and flossing. Of the two, that second one could be the most important.
Personal oral hygiene cleans the teeth of dental plaque, a thin film of bacteria and food particles that accumulates on them each day. This plaque buildup is the number one cause for both tooth decay and periodontal (gum) disease, so removing it reduces your risk of an infection.
But it's not just a matter of doing these tasks—it's also doing them well. A quick once-over isn't going to have the same preventive power as a more thorough job.
Here then are 4 tips for improving your daily oral hygiene efforts.
Time yourself brushing. It usually takes about two minutes to thoroughly brush all tooth surfaces. So, set a timer for two minutes, focusing on methodically brushing the front, back and biting surfaces of each tooth.
Easy does it. Brushing teeth requires only a gentle bit of manual force as the mild abrasives and detergents in your toothpaste provide most of the action of loosening plaque. In fact, aggressive brushing can lead to enamel and gum damage. Practice gentle scrubbing action when you brush.
Don't neglect flossing. While brushing gets most of the hygienic attention, it can't effectively get to areas between teeth where over half of built-up plaque can accumulate. Be sure then to floss at least once a day to remove plaque between teeth that brushing can miss.
Test yourself. Your dentist may be the ultimate judge for the quality of your hygiene, but you can check your effectiveness between visits. For instance, run your tongue across your teeth—it should feel smooth, not rough or gritty. Using a plaque disclosing agent periodically can also reveal missed plaque.
And don't forget to keep up your regular dental visits, which are necessary for removing plaque you might have missed or tartar that may have formed. They're also a great time to get advice from your dentist or dental hygienist on how you can further improve your own efforts in daily dental care.
If you would like more information on best oral hygiene practices, 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 “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”
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