Posts for category: Dental Procedures
Dental implants are all the rage. And why not — not only are these tooth replacements life-like and highly functional, they have an amazing 95% ten-year success rate.
Some of that success is due to their unique design. Technically a root replacement, an implant's metal titanium post is surgically placed in the jawbone, where bone grows and adheres to it over time. This creates a strong connection that stands up well to the forces created by biting and chewing.
But there's more to their longevity than design. Success also depends on a careful, planned process that begins long before surgery.
It starts with a detailed oral examination to determine the best placement for the implant. Besides regular x-rays, we may also perform CT scans to create a three-dimensional view of your jaw. With this we can locate and avoid nerves, sinus cavities or other structures near the implant site.
The examination also helps us determine if you've experienced any bone loss, a normal occurrence after tooth loss. Implants require an adequate amount of bone to achieve the best position. A good position ensures future bone integration and the best appearance result.
The same attention to detail extends to the actual surgery to place the implant. We fashion the site to receive the implant by sequentially drilling larger tapered channels until we achieve the right size fit for the implant. During drilling we avoid overheating the bone, which could ultimately weaken and damage the implant's stability.
We'll also need to provide protection for the implant while it integrates with the bone. In most implantations, we do this by suturing the gum tissue over the implant. We take a different approach with a “Tooth in a Day” procedure where we attach a crown (the visible portion of the tooth) right after implant surgery. In this case we'll install a crown (which is actually temporary) that's a little shorter than the adjacent teeth. The natural teeth around it will absorb the forces produced while chewing and not the implant crown.
Focusing on these and other factors will greatly reduce the risk of implant failure. Paying careful attention to them helps ensure your new smile is a lasting one.
If you would like more information on dental implants to restore your smile, 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: A Tooth Replacement Method That Rarely Fails.”
Although techniques for treating periodontal (gum) disease can vary, they all boil down to one objective: remove the bacterial plaque and calculus (hardened plaque deposits) that cause the infection. The initial treatment usually involves two techniques known as scaling and root planing.
Scaling uses hand instruments, ultrasonic equipment or a combination of both to manually remove plaque and calculus from the tooth and root surfaces. Root planing takes it a step further by minutely “shaving” infected material from the root surfaces. While more invasive techniques (including surgery) may be needed, scaling and root planing are the first line of treatment for any recent diagnosis of gum disease.
In recent years, an adaptation to these treatments has emerged using the Nd: YAG laser. The laser uses a particular crystal that’s adaptable for many different types of surgery. In the case of gum disease, it’s been found as effective as traditional methods for removing the infected linings of periodontal pockets. Voids created by detaching gum tissues as bone loss occurs, enlarge the small natural gap between the teeth and gums, which fill with pus and other infected matter. Removing the diseased lining from these pockets reduces bacteria below the gum line and speeds healing.
Periodontal laser therapy may have one advantage over traditional treatments: less tissue damage and swelling, and hence reduced post-treatment discomfort. While some research seems to confirm this, more controlled studies are needed to render a verdict on this claim.
Regardless of whether you undergo traditional scaling and root planing or a laser alternative, the aim is the same — to bring the disease under control by removing plaque and calculus and reestablishing good daily oral hygiene practices. Stopping gum disease as soon as possible will help ensure you’ll have healthy teeth and gums for a long time.
If you would like more information on treatments for periodontal (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 “Lasers versus Traditional Cleanings for Treating Gum Disease.”
It’s likely you depend on your regular dentist for the lion’s share of your dental care. But in cases of advanced disease or trauma, you may need the services of a dental specialist.
This could be the case with periodontal (gum) disease, a bacterial infection triggered by a thin biofilm on tooth surfaces called dental plaque that isn’t adequately removed through daily oral hygiene practices. While your regular dentist can effectively treat many forms of gum disease, there are times when you should see a periodontist who specializes in the gum, supporting bone and connective tissues.
So, when should you see a periodontist for gum disease treatment? Here are 3 situations that may call for this important dental specialist.
If your dentist refers you. Your dentist may be quite proficient in treating gum disease, mainly by removing the dental plaque and tartar sustaining the infection. But if the infection has advanced deep within the gum tissues especially around the roots and bone, you may need more advanced measures, including surgery, performed by a periodontist.
If you’d like a second opinion. Of course, you don’t need a referral to see a periodontist. You can make an appointment with one for another opinion about your diagnosis and recommended treatment plan. If you choose to see a periodontist, make sure they have access to all your dental and medical records, as well as your past health history.
If you have other health issues. Gum disease often doesn’t occur in a vacuum – it may exist and even influence (or be influenced by) other inflammatory medical conditions. If you have such a condition like diabetes or cardiovascular disease, you may opt to see a periodontist first for a more comprehensive evaluation.
In the meantime, keep an eye out for the first signs of disease including red, swollen or bleeding gums (if you smoke, be aware smoking hides these signs of disease). And practice daily brushing and flossing as well as obtaining regular dental cleanings to keep plaque accumulation to minimum. Preventing gum disease and getting treatment as early as possible may help you avoid more invasive treatments later.
If you would like more information on 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 “When to See a Periodontist.”
As your dental provider, we're always alert for signs of tooth decay or periodontal (gum) disease, the two leading causes of tooth loss. But we're also watching for less common conditions that could be just as devastating.
Root resorption falls into this latter category: it occurs when a tooth's root structure begins to break down and dissolve (or resorb). It's a normal process in primary ("baby") teeth to allow them to loosen and give way when permanent teeth are ready to erupt.
It's not normal, though, for permanent teeth. Something internally or—more commonly—externally causes the root structure to break down. External resorption usually occurs at the neck-like or cervical area of a tooth around the gum line. Known as external cervical resorption (ECR), it can first appear as small, pinkish spots on the enamel. These spots contain abnormal cells that cause the actual damage to the root.
We don't fully understand how root resorption occurs, but we have identified certain factors that favor its development. For example, it may develop if a person has experienced too much force against the teeth during orthodontic treatment. Injury to the periodontal ligaments, teeth-grinding habits or some dental procedures like internal bleaching may also contribute to later root resorption.
Early diagnosis is a major part of effective treatment for root resorption. Because it's usually painless and easily overlooked, resorption is often too difficult to detect in its early stages without x-rays—a good reason for regular dental exams. Beginning spots or lesions are usually small enough to surgically remove the tissue cells causing the damage and then filled with a tooth-colored filling material. If it has advanced further, we may also need to perform a root canal treatment.
At some point, the damage from root resorption can be too great, in which case it might be best to remove the tooth and replace it with a dental implant or similar restoration. That's why catching root resorption early through regular dental exams can give you the edge for saving your tooth.
If you would like more information on diagnosing and treating root resorption, 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 “Root Resorption: An Unusual Phenomenon.”
If you smoke, you know better than anyone how a hard a habit it is to kick. If you want to quit, it helps to have a motivating reason—like lowering your risk for cancer, cardiovascular disease or similar conditions.
Here’s another reason for quitting tobacco: it could be making your teeth and gums less healthy. And, if you’re facing a restoration like dental implants, smoking can make that process harder or even increase the risk of failure.
So, to give your willpower some needed pep talk material, here are 3 reasons why smoking doesn’t mix with dental implants.
Inhaled smoke damages mouth tissues. Though you may not realize it, the smoke from your cigarette or cigar is hot enough to burn the top layer of skin cells in your mouth, which then thickens them. This could affect your salivary glands causing them to produce less saliva, which in turn could set off a chain of events that increases your risk of tooth decay or periodontal (gum) disease. The end result might be bone loss, which could make installing dental implants difficult if not impossible.
Nicotine restricts healthy blood flow. Nicotine, the chemical tobacco users crave, can restrict blood flow in the tiny vessels that course through the mouth membranes and gums. With less blood flow, these tissues may not receive enough antibodies to fight infection and fully facilitate healing, which could interfere with the integration of bone and implants that create their durable hold. Slower healing, as well as the increased chances of infection, could interrupt this integration process.
Smoking contributes to other diseases that impact oral health. Smoking’s direct effect on the mouth isn’t the only impact it could have on your oral health. As is well known, tobacco use can increase the risk of systemic conditions like cardiovascular and lung disease, and cancer. These conditions may also trigger inflammation—and a number of studies are showing this triggered inflammatory response could also affect your body’s ability to fight bacterial infections in the mouth. Less healthy teeth, gums and underlying bone work against your chances of long-term success with implants.
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 “Dental Implants & Smoking: What are the Risks?”