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.”
September is National Gum Care Month. Did you know that advanced periodontal disease is the number one cause of tooth loss among adults? Periodontal disease refers to any disease that affects the structures that hold the teeth in place, including gums, ligaments and bone. In its earliest stage, called gingivitis, the gums become inflamed. When it progresses to periodontitis, both soft and hard tissues that hold the teeth in place are affected, threatening the integrity of the teeth. Some people are more susceptible to periodontal disease than others. Here are some common risk factors:
Poor oral hygiene. Plaque buildup is the primary cause of gum disease. When life gets busy, we may be less diligent about our oral care. This allows bacteria in the mouth to form a biofilm (plaque), which causes inflammation of the gums.
Heredity: Some people are genetically more predisposed to gum disease. Look at your family history. Have any of your relatives had gum disease or lost their teeth?
Pregnancy. Gums are sensitive to hormone fluctuations, and it is not uncommon for pregnant women to experience an inflammation of the gums known as “pregnancy gingivitis.” Gingivitis — characterized by red, swollen gums that bleed easily — is the beginning stage of gum disease.
Age: The chance of developing gum disease increases with age. Over 70% of Americans 65 and older have periodontitis, an advanced form of gum disease, according to the U.S. Centers for Disease Control and Prevention. This may be influenced by other diseases, medications that cause dry mouth, or other causes of plaque buildup.
Diet: Eating too many simple carbohydrates (those found in sugar, white bread, white rice and mashed potatoes, for example) is linked to chronic inflammation in the body, which increases the risk of gum disease.
Smoking: Smoking is a significant risk factor for the development and progression of gum disease. Since nicotine constricts blood vessels, smokers may not see the typical symptoms such as red, puffy, bleeding gums, so the disease may cause damage before smokers realize there is a problem with their gums.
Diabetes: Uncontrolled diabetes puts you at higher risk of periodontal disease. Not only can diabetes make gum disease worse, gum disease can make diabetes symptoms worse.
Our aim is not to scare you but to help you become aware of factors that can increase your risk of gum disease. Many of these factors are not under your control. However, you can do your part to prevent gum disease by staying on top of the things you can control. Let us know about any new medications you are taking, eat a balanced diet rich in complex carbohydrates and other nutrients and, if relevant, manage your diabetes and explore programs that will help you quit smoking.
Fortunately, good oral hygiene and regular professional cleanings can turn early gum disease around, so if you have any of the risk factors that contribute to periodontal disease, be extra diligent about your oral hygiene routine. And make sure you come in for regular dental checkups and cleanings. If you show signs of gum disease, we may recommend that you come in for more frequent cleanings.
Let’s say you’re traveling to Italy to surprise your girlfriend, who is competing in an alpine ski race… and when you lower the scarf that’s covering your face, you reveal to the assembled paparazzi that one of your front teeth is missing. What will you do about this dental dilemma?
Sound far-fetched? It recently happened to one of the most recognized figures in sports — Tiger Woods. There’s still some uncertainty about exactly how this tooth was taken out: Was it a collision with a cameraman, as Woods’ agent reported… or did Woods already have some problems with the tooth, as others have speculated? We still don’t know for sure, but the big question is: What happens next?
Fortunately, contemporary dentistry offers several good solutions for the problem of missing teeth. Which one is best? It depends on each individual’s particular situation.
Let’s say that the visible part of the tooth (the crown) has been damaged by a dental trauma (such as a collision or a blow to the face), but the tooth still has healthy roots. In this case, it’s often possible to keep the roots and replace the tooth above the gum line with a crown restoration (also called a cap). Crowns are generally made to order in a dental lab, and are placed on a prepared tooth in a procedure that requires two office visits: one to prepare the tooth for restoration and to make a model of the mouth and the second to place the custom-manufactured crown and complete the restoration. However, in some cases, crowns can be made on special machinery right in the dental office, and placed during the same visit.
But what happens if the root isn’t viable — for example, if the tooth is deeply fractured, or completely knocked out and unable to be successfully re-implanted?
In that case, a dental implant is probably the best option for tooth replacement. An implant consists of a screw-like post of titanium metal that is inserted into the jawbone during a minor surgical procedure. Titanium has a unique property: It can fuse with living bone tissue, allowing it to act as a secure anchor for the replacement tooth system. The crown of the implant is similar to the one mentioned above, except that it’s made to attach to the titanium implant instead of the natural tooth.
Dental implants look, function and “feel” just like natural teeth — and with proper care, they can last a lifetime. Although they may be initially expensive, their quality and longevity makes them a good value over the long term. A less-costly alternative is traditional bridgework — but this method requires some dental work on the adjacent, healthy teeth; plus, it isn’t expected to last as long as an implant, and it may make the teeth more prone to problems down the road.
What will the acclaimed golfer do? No doubt Tiger’s dentist will help him make the right tooth-replacement decision.
If you have a gap in your grin — whatever the cause — contact us or schedule an appointment for a consultation, and find out which tooth-replacement system is right for you. You can learn more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Crowns & Bridgework.”
Since their development in the laboratory over five decades ago, lasers have found increasing use in our everyday lives. In the field of medicine, it’s not uncommon to find lasers in the offices of dermatologists, ophthalmologists and surgeons, to name just a few. Now, some dentists are finding that lasers can offer an alternative means of treating gum disease — and one that may have advantages in certain situations.
You probably know that a laser produces a special kind of light — in fact, its name is an acronym for “Light Amplification by Stimulated Emission of Radiation.” Essentially, a medical laser uses electrical energy to produce an intense and narrow beam of concentrated light. This light can be directed to a particular area, often via a fiber-optic channel. The laser’s precision allows a doctor or technician to focus the light energy exactly where it’s needed — to remove diseased tissue, seal off blood vessels, and sterilize a wound, for example.
For several years, periodontists — dentists who specialize in treating diseases of the gums — have been researching the use of lasers for treating certain types of gum disease. In standard clinical practice, hand-held instruments and ultrasonic cleaning tools are used at regular time intervals (3 – 6 months) to remove the sticky bacterial biofilm, as well as calculus (tartar), that forms in between teeth and gums. If that still isn't effective, gum surgery may be required to access the affected area, remove diseased tissue, and reduce pocket depth (the space below the gum line that gets larger as bone loss occurs) to prevent reinfection.
Recently, however, several new procedures have been developed that use lasers to accomplish some or all of these goals. One type of therapy uses a special laser that emits pulses of light with a specific wavelength (color) of 1064 nanometers. This light passes through healthy cells like a sunbeam through a window — but when it encounters darkly-pigmented bacteria, it vaporizes them instantly!
One of the potential advantages of laser treatment is its precision: focused directly on the area where trouble occurs, it targets diseased tissue but leaves healthy tissue alone. Another is that laser treatment is less invasive: It requires less tissue removal, and may cause less discomfort and tissue shrinkage (gum recession) than conventional periodontal surgery. And because it produces small amounts of heat, it can seal blood vessels and help control bleeding.
While lasers have long shown promise for treating gum disease, until recently it wasn’t clear if they offered any advantages over traditional methods. Now, several studies have shown that certain laser treatments can be just as effective as traditional gum surgery in many cases — with the potential benefit of being less invasive. In the future, the use of lasers for periodontal procedures is likely to increase.
It’s important to remember that no single treatment — not even a laser — can “zap” gum disease in one fell swoop. Controlling periodontal disease requires effective at-home oral hygiene combined with regular professional care. If you have questions about periodontal disease, please call our office to schedule a consultation.
It's no secret that many of Hollywood's brightest stars didn't start out with perfectly aligned, pearly-white teeth. And these days, plenty of celebs are willing to share their stories, showing how dentists help those megawatt smiles shine. In a recent interview with W magazine, Emma Stone, the stunning 28-year-old star of critically-acclaimed films like La La Land and Birdman, explained how orthodontic appliances helped her overcome problems caused by a harmful habit: persistent thumb sucking in childhood.
“I sucked my thumb until I was 11 years old,” she admitted, mischievously adding “It's still so soothing to do it.” Although it may have been comforting, the habit spelled trouble for her bite. “The roof of my mouth is so high-pitched that I had this huge overbite,” she said. “I got this gate when I was in second grade… I had braces, and then they put a gate.”
While her technical terminology isn't quite accurate, Stone is referring to a type of appliance worn in the mouth which dentists call a “tongue crib” or “thumb/finger appliance.” The purpose of these devices is to stop children from engaging in “parafunctional habits” — that is, behaviors like thumb sucking or tongue thrusting, which are unrelated to the normal function of the mouth and can cause serious bite problems. (Other parafunctional habits include nail biting, pencil chewing and teeth grinding.)
When kids develop the habit of regularly pushing the tongue against the front teeth (tongue thrusting) or sucking on an object placed inside the mouth (thumb sucking), the behavior can cause the front teeth to be pushed out of alignment. When the top teeth move forward, the condition is commonly referred to as an overbite. In some cases a more serious situation called an “open bite” may develop, which can be difficult to correct. Here, the top and bottom front teeth do not meet or overlap when the mouth is closed; instead, a vertical gap is left in between.
Orthodontic appliances are often recommended to stop harmful oral habits from causing further misalignment. Most appliances are designed with a block (or gate) that prevents the tongue or finger from pushing on the teeth; this is what the actress mentioned. Normally, when the appliance is worn for a period of months it can be expected to modify the child's behavior. Once the habit has been broken, other appliances like traditional braces or clear aligners can be used to bring the teeth into better alignment.
But in Stone's case, things didn't go so smoothly. “I'd take the gate down and suck my thumb underneath the mouth appliance,” she admitted, “because I was totally ignoring the rule to not suck your thumb while you're trying to straighten out your teeth.” That rule-breaking ended up costing the aspiring star lots of time: she spent a total of 7 years wearing braces.
Fortunately, things worked out for the best for Emma Stone: She now has a brilliant smile and a stellar career — plus a shiny new Golden Globe award! Does your child have a thumb sucking problem or another harmful oral habit? For more information about how to correct it, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”
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