Posts for category: Dental Procedures
Your mouth is a lot like the Wild West — home to millions of bacteria and other microbes, some of which are definitely not “the good guys.” But your teeth are well-protected from these hostile forces and their acidic waste products: with enamel shielding the visible part of your tooth, your gums protect the parts you can’t see.
As effective as they are, though, your gums aren’t invincible: their greatest threat is periodontal (gum) disease. This bacterial infection arises from plaque, a thin film of bacteria and food particles accumulating on teeth due to inadequate brushing and flossing.
The infected tissues soon become inflamed (red and swollen), a natural defensive response from the immune system. The longer they’re inflamed, however, the more likely they’ll begin detaching from the teeth. The gums may eventually shrink back or recede from the teeth, often causing them to appear “longer” because more of the tooth is now exposed to view.
Gum recession doesn’t bode well for your teeth’s survival: the exposed tooth and underlying bone can become even more susceptible to infection and damage. In the end, you could lose your tooth and portions of the supporting bone.
Treatment depends on the severity of the gum recession. In mild to moderate cases, we may only need to perform the standard gum disease treatment of removing plaque and calculus from all gum and tooth surfaces (including below the gum line) with special instruments. This helps reduce the infection and allow the gums to heal and re-establish attachment with the tooth. In more advanced cases, though, the recession may be so extensive we’ll need to graft donor tissue to the area using one of a variety of surgical techniques.
Although the right treatment plan can help restore your gum health, there’s another approach that’s even better — preventing gum disease in the first place. You can reduce your disease risk by practicing daily brushing and flossing and visiting your dentist regularly or when you see symptoms like gum swelling or bleeding. Taking care of your gums won’t just save your smile — it might also save your teeth.
If you would like more information on diagnosing and treating gum disease, 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 “Gum Recession.”
Seven out of ten Americans are missing at least one tooth due to decay, periodontal (gum) disease or injury. Unfortunately, the consequences go far beyond a missing tooth — the loss of even one could set in motion a cascade of problems.
Perhaps the most damaging of these problems is bone loss. Like other living tissue, bone has a life cycle — older cells dissolve (resorb) into the body and are replaced by fresher cells. This growth cycle in the jawbone receives stimulation from forces generated by teeth when we chew or bite. If a tooth is no longer present to provide this stimulation, the affected bone cells won’t regenerate at a healthy rate. Over time this causes the volume of bone to diminish, as much as 25% the first year after tooth loss.
The void left by a missing tooth can also adversely affect remaining teeth. Teeth are held in place by a tough but elastic tissue known as the periodontal ligament that lies between the tooth and the bone. The ligament enables teeth to move gradually in response to mouth changes so that the teeth remain tightly aligned with each other. When there’s a gap from a missing tooth, this tendency will cause the teeth on either side to move (or “drift”) toward the open space. Although a natural phenomena, it can result in a malocclusion (poor bite).
That’s why it’s important to replace a missing tooth with a life-like replica — not just for appearance’s sake, but also to improve function and prevent the rise of these other problems. While many options exist (from removable dentures to fixed bridges) the choice most preferred by dentists and patients is the dental implant.
An implant replaces the tooth root as well as the crown, because it’s imbedded securely into the jawbone. Because of a natural affinity with titanium, the principal metal used in implants, bone cells will grow to its surface. Not only will this anchor the implant more securely, it will slow or even stop bone loss.
If you have a missing tooth, you should visit us as soon as possible to consider your options for a replacement. A new tooth will help stop even greater problems from occurring.
If you would like more information on effects and treatment of tooth loss, 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 “The Hidden Consequences of Losing Teeth.”
Even in the 21st Century, losing most or all of your teeth is still an unfortunate possibility. Many in this circumstance turn to dentures, as their great-grandparents did, to restore their teeth. But today's dentures are much different from those of past generations—and dental implants are a big reason why.
The basic denture is made of a gum-colored, acrylic base with artificial teeth attached. The base is precisely made to fit snugly and comfortably on the patient's individual gum and jaw structure, as the bony ridges of the gums provide the overall support for the denture.
Implants improve on this through two possible approaches. A removable denture can be fitted with a metal frame that firmly connects with implants embedded in the jaw. Alternatively, a denture can be permanently attached to implants with screws. Each way has its pros and cons, but both have two decided advantages over traditional dentures.
First, because implants rather than the gums provide their main support, implant-denture hybrids are often more secure and comfortable than traditional dentures. As a result, patients may enjoy greater confidence while eating or speaking wearing an implant-based denture.
They may also improve bone health rather than diminish it like standard dentures. This is because the forces generated when chewing and eating travel from the teeth to the jawbone and stimulate new bone cell growth to replace older cells. We lose this stimulation when we lose teeth, leading to slower bone cell replacement and eventually less overall bone volume.
Traditional dentures not only don't restore this stimulation, they can also accelerate bone loss as they rub against the bony ridges of the gums. Implants, on the other hand, can help slow or stop bone loss. The titanium in the imbedded post attracts bone cells, which then grow and adhere to the implant surface. Over time, this can increase the amount of bone attachment and help stymie any further loss.
An implant-supported denture is more expensive than a standard denture, but far less than replacing each individual tooth with an implant. If you want the affordability of dentures with the added benefits of implants, this option may be worth your consideration.
If you would like more information on implant-supported 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 “Overdentures & Fixed Dentures.”
Chipped a tooth? Don't beat yourself up—this type of dental injury is quite common. In fact, you probably have a favorite celebrity who has chipped one or more of their teeth. The list is fairly long.
Some chipped a tooth away from the limelight, such as Tom Cruise (a hockey puck to the face as a teen), Jim Carrey (roughhousing on the playground) and Paul McCartney (a sudden stop with a moped). Others, though, chipped a tooth while “on the job.” Taylor Swift, Hillary Duff and Jennifer Lopez have all chipped a tooth on stage with a microphone. And chipped teeth seem to be an occupational hazard among professional athletes like former NFL star, Jerry Rice.
Since smiles are an indispensable asset to high-profile celebrities, you can be sure these stars have had those chipped teeth restored. The good news is the same procedures they've undergone are readily available for anyone. The two most common restorations for chipped teeth are dental bonding and veneers.
The least invasive way to fix a chipped tooth is bonding with a material known as composite resin. With this technique, resin is first mixed to match the tooth color and then applied to the chipped area or applied in layers of color to get just the right look. After a bit of shaping, curing and adjustment, we're done—you can walk out with a restored tooth in one visit.
Bonding works well with slight to moderate chips, but it could be less durable when there is more extensive damage. For that, you may want to consider porcelain veneers. Veneers are thin wafers of dental porcelain that are bonded to the front of teeth to mask blemishes like stains, slight gaps or, yes, chips. Veneers can be so lifelike that you won't be able to tell the veneered tooth from your other teeth. They are fashioned to match the color and shape of an individual's teeth. Because of the time and design detail involved, veneers are more expensive than bonding, yet still within an affordable range for many.
Teeth require some alteration before applying traditional veneers because otherwise the teeth can appear bulky when the veneer is bonded to the existing tooth. To compensate, we remove a little of the tooth enamel. Because this loss is permanent, you'll need to wear veneers or have some other form of restoration for the tooth from then on. For many people, though, that's a small price to pay for a smile without chips.
Your first step to repairing a chipped tooth is to come in for an examination. From there, we'll recommend the best option for your situation. And regardless of which, bonding or veneers, we can change your smile for the better.
If you would like more information about restoring injured teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Porcelain Veneers: Strength and Beauty as Never Before.”
If you've been dealing with a tooth that needs to be removed—or it's already missing—you may be looking to replace it with a dental implant. And it's a great choice: No other restoration can provide the appearance and function of a real tooth like an implant.
You and your smile are ready for it. The question is, though, are your gums and underlying bone ready? These dental structures play a critical role in an implant's stability and eventual appearance. A problem with them may make placing an implant difficult if not impossible.
An implant requires around 2.0 millimeters of bone thickness surrounding the implant surface for adequate support and to minimize the chances of gum recession. But tooth loss often leads to bone loss that can drop its thickness below this threshold. This can make placing an implant problematic.
Fortunately, though, we may be able to address the lack of sufficient bone through bone grafting. By placing grafting material within the empty socket, we create a scaffold for new bone cells to grow upon. Over time this subsequent growth may be enough to maintain an adequate thickness of bone for an implant to be placed.
The gums may also pose a problem if they've shrunk back or receded from their normal positions, as often happens because of gum disease (which may also have precipitated the tooth loss). Again, grafting procedures can help ensure there's adequate gum coverage for the implant. And healthier gums may also help protect the underlying bone from loss.
There are several techniques for placing gum tissue grafts, depending on how much recession has taken place. One procedure in particular is often used in conjunction with implant placement. A small layer of synthetic collagen material or gum tissue referred to as pa dermal apron is included with the implant when its placed. Settling into the bone socket, this apron helps thicken the gum tissues, as well as preserve the underlying bone.
During your preliminary exams, we'll assess your bone and gum health to determine if we should take any steps like these to improve them. It may add some time to the implant process, but the end result will be well worth it.
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 “Immediate Dental Implants.”