There are plenty of options today for replacing missing teeth, including dental implants. But if the teeth have been missing for some time, complications can arise that limit your restorative options.
The most consequential possibility is bone loss. Bone has a life cycle: old cells dissolve (resorb), and are then replaced by new cells, stimulated to grow by the forces applied to the teeth during chewing. But the bone won't receive this stimulation if a tooth is missing — so growth slows down, which causes the bone volume to diminish with time.
Another complication can occur involving other teeth around the open space. These teeth will naturally move or “drift” out of their normal position into the missing tooth space. As a result we may not have enough room to place a prosthetic (false) tooth.
If either or both of these complications occur, we'll need to address them before attempting a restoration. Bone loss itself could eliminate dental implants as an option because they require a certain amount of supporting bone for correct placement. Bone loss could also make correcting misaligned teeth difficult if not impossible.
It might be possible, though, to regenerate lost bone with a bone graft. The graft is placed, sometimes along with growth stimulating substances, within the diminished bone area. It then serves as a scaffold upon which new bone can form.
If the bone becomes healthy again, we can then attempt to move any drifted teeth back to where they belong. Besides braces, there's another treatment option especially popular with adults: clear aligners. These are a series of removable, clear plastic trays that, like braces, exert gradual pressure on the teeth to move them. Patients wear each individual tray for about two weeks, and then switch to the next tray in the series to continue the process.
Unlike their traditional counterparts, clear aligners can be removed for cleaning or for special occasions. More importantly, they're much less noticeable than traditional braces.
Once any problems with bone health or bite have been addressed and corrected, you'll have a fuller range of options for replacing your missing teeth. With a little extra time and effort, you'll soon be able to regain a smile you'll be proud to display.
We’ve all experienced eating or drinking something hot enough to scald the inside of our mouths. But what if you regularly have a burning sensation but haven’t consumed anything hot to cause it? You may have a condition called burning mouth syndrome, or BMS.
In addition to the sensation of feeling scalded or burnt, BMS can also cause dryness, tingling and numbness, as well as a change or reduction in your sense of taste. You can feel these sensations generally in the mouth or from just a few areas: the lips, tongue, inside of the cheeks, gums, throat or the roof of the mouth.
The root cause of BMS isn’t always easy to pinpoint, but it seems related to systemic conditions like diabetes, nutrition or vitamin deficiencies and acid reflux; it’s also been known to accompany the use of irradiation or chemotherapy for cancer treatment or psychological problems. It seems to occur most often in women around the age of menopause and may be linked to hormonal changes.
To determine the best treatment course, we must first eliminate the possibility that another condition besides BMS may be causing your symptoms. Some medications (both prescription and over-the-counter) cause mouth dryness, which can irritate the inner linings of the mouth or contribute to yeast infection, either of which could result in similar symptoms to BMS. Allergic reactions to dental materials in dentures or toothpastes that contain sodium lauryl sulfate, whiteners or cinnamon flavor can cause irritation and skin peeling within the mouth.
If we’ve determined you have BMS, there are a number of strategies we can try to bring relief, like stopping or cutting back on habits that worsen dry mouth like smoking, alcohol or coffee consumption, or frequently eating hot or spicy foods. You should also drink water more frequently to keep your mouth moist, or use biotene or products containing the sweetener xylitol to promote saliva production. If mouth dryness is related to medication, you should speak with your physician or our office about alternatives.
In some cases, BMS resolves over time. In the mean time, though, promoting good saliva flow and reducing stress will go a long way toward diminishing this irritating condition.
If you would like more information on the causes and treatment of burning mouth syndrome, 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 “Burning Mouth Syndrome.”
Want to know the exact wrong way to pry open a stubborn lid? Just ask Jimmy Fallon, host of NBC-TV’s popular “Tonight Show.” When the 40-year-old funnyman had trouble opening a tube of scar tissue repair gel with his hands, he decided to try using his teeth.
What happened next wasn’t funny: Attempting to remove the cap, Fallon chipped his front tooth, adding another medical problem to the serious finger injury he suffered a few weeks before (the same wound he was trying to take care of with the gel). If there’s a moral to this story, it might be this: Use the right tool for the job… and that tool isn’t your teeth!
Yet Fallon is hardly alone in his dilemma. According to the American Association of Endodontists, chipped teeth account for the majority of dental injuries. Fortunately, modern dentistry offers a number of great ways to restore damaged teeth.
If the chip is relatively small, it’s often possible to fix it with cosmetic bonding. In this procedure, tough, natural-looking resin is used to fill in the part of the tooth that has been lost. Built up layer by layer, the composite resin is cured with a special light until it’s hard, shiny… and difficult to tell from your natural teeth. Best of all, cosmetic bonding can often be done in one office visit, with little or no discomfort. It can last for up to ten years, so it’s great for kids who may be getting more permanent repairs later.
For larger chips or cracks, veneers or crowns may be suggested. Veneers are wafer-thin porcelain coverings that go over the entire front surface of one or more teeth. They can be used to repair minor to moderate defects, such as chips, discolorations, or spacing irregularities. They can also give you the “Hollywood white” smile you’ve seen on many celebrities.
Veneers are generally custom-made in a lab, and require more than one office visit. Because a small amount of tooth structure must be removed in order to put them in place, veneers are considered an irreversible treatment. But durable and long-lasting veneers are the restorations of choice for many people.
Crowns (also called caps) are used when even more of the tooth structure is missing. They can replace the entire visible part of the tooth, as long as the tooth’s roots remain viable. Crowns, like veneers, are custom-fabricated to match your teeth in size, shape and color; they are generally made in a dental lab and require more than one office visit. However, teeth restored with crowns function well, look natural, and can last for many years.
So what happened to Jimmy Fallon? We aren’t sure which restoration he received… but we do know that he was back on TV the same night, flashing a big smile.
If you would like more information about tooth restorations, please contact us or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “Artistic Repair Of Front Teeth With Composite Resin.”
Discovering a loose tooth can be exciting — if you're six, that is, and anticipating a windfall from the tooth fairy. If you're an adult, a loose tooth is a different story. You're in real danger of it becoming a lost tooth, and there won't be another one coming in to replace it.
Fortunately, that result isn't inevitable, but we have to take quick action if we're going to save your tooth. The first step is to find out why it's loose.
Tooth looseness occurs primarily because the gum and bone structures that hold teeth in place have been damaged in some way. Otherwise healthy teeth and gums can be injured in an accident or with dental habits like teeth grinding or clenching that increase the biting forces against teeth. The latter could require some intervention like a night guard to prevent teeth from grinding to reduce the abnormal biting force.
But disease is often the root cause for tooth looseness. Periodontal (gum) disease, a bacterial infection triggered by bacterial plaque, can inflame and weaken gum tissues, eventually causing bone loss followed by the gum tissue detaching from the teeth. In this weakened condition even normal biting forces could loosen a tooth.
If gum disease is the primary culprit, our treatment starts there. By aggressively removing plaque and calculus (tartar) from the tooth surfaces, including deep below the gum line around the root, the gum tissues become less inflamed and begin to heal. This in turn can strengthen their attachment to a loose tooth. In more advanced cases, we may need to surgically graft lost bone and gum tissue to rebuild the attachment.
We may also need to stabilize a loose tooth while we're performing these other treatments. The most common way is to join or splint a loose tooth to nearby stable teeth. There are varieties of splints: one type involves rigid dental material bonded across the enamel of the loose tooth and its neighbors. In another, we cut a small channel in the involved teeth, and then insert a metal splint, bonding it within the channel.
Whatever needs to be done, we need to do it promptly — if you notice a loose tooth, contact us as soon as possible. The earlier we begin treatment the more likely we'll save your loose tooth.
If you would like more information on treating loose 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 “Treatment for Loose Teeth.”
If you’re considering a dental implant as a replacement for a lost tooth, you’re looking at a restoration method with an amazing 95% success rate after ten years. But that being said there’s still a risk, albeit quite low, the implant might fail.
And if you smoke, the risk is slightly higher. In a recent study of implant patients, twice as many of the failures occurred in smokers compared to non-smokers. If you’re a smoker, you can increase your chances of a successful outcome if you quit the habit.
Nicotine, a chemical within tobacco, is the primary cause for this higher risk. Besides its effect on the pleasure centers of the brain, nicotine also restricts smaller blood vessels that are abundant in the mouth and skin, causing less blood flow. As a result, the mouth doesn’t have as many antibodies and other substances available to fight infection and help traumatized tissues heal.
Because of this, as well as reduced saliva flow due to the habit, smokers have an increased risk of dental disease and are slower to respond to treatment. This can be especially problematic if the gum tissues around an implant become infected, which could lead to a catastrophic failure. Slower healing also impacts the post-surgery period when bone cells in the jaw are growing and adhering to the implant surface, forming a stronger bond.
To avoid these potential risks you should stop smoking before you undergo implant surgery. If you can’t completely kick the habit, you should at least stop a week before surgery and for two weeks after. It’s also critical that you practice good oral hygiene — both brushing and flossing — to minimize the occurrence of dental disease and see us for regular checkups and maintenance appointments.
Taking these steps will greatly increase your chances of being in the vast majority of people who continue to enjoy success with their implants for many years.
If you would like more information on the impact of smoking on dental health, 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 & Smoking.”
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