Dental implant technology has advanced at such an astounding rate in recent years that you can now walk into a dentist's office with a problem tooth and out the same day with a new one. Unfortunately, not all dental situations allow for this possibility.
For example, you might be considering an implant many years after losing a tooth. But there's a potential problem: there might not be enough supporting bone. While an implant might still be possible, inadequate bone complicates the matter.
Because implants are essentially tooth root replacements, they require a certain amount of bone for stability and the best attractive outcome. As a general rule, implants need to be surrounded by at least 1.5-2.0 millimeters of healthy bone to support an implant. But you might not have enough if your tooth has been missing for awhile, regardless if you have or haven't worn dentures or other restorations.
That's because bone has a life cycle in which older cells die and newer ones form to take their place. As we chew or bite, the force generated travels up through the teeth to the bone to stimulate this new growth. Without a tooth the bone doesn't receive this stimulus, which can slow the growth rate. Over time the affected bone can lose its volume and density.
If we find you've experienced loss to the point your bone won't support an implant, that doesn't automatically mean this popular restoration is out of the picture. But it will require us first performing a procedure known as augmentation or bone grafting to help rejuvenate some of the lost bone.
With grafting, we place processed bone grafting material in the jaw through a minor surgical procedure to form a scaffold for new bone to grow upon. After several months this can result in several millimeters of new growth maintaining the width of the underlying bone, which in turn may be able to support an implant.
Bone grafting is quite common, often performed at the same time as tooth extraction if there's going to be a time lag before installing an implant. Even if performed later, though, it can successfully rejuvenate lost bone and make it possible for you to take advantage of durable, life-like 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 after Previous Tooth Loss.”
Gastroesophageal reflux disease (GERD) is a digestive disorder that can lead to a number of serious health problems. One of them, tooth erosion, could ruin your dental health.
Your stomach uses strong acids to break down food during digestion. A ring of muscle just above the stomach called the esophageal sphincter works as a one-way valve to allow food contents into the stomach but prevent acid from traveling back up through the esophagus.
GERD occurs when the esophageal sphincter weakens and starts allowing acid into the esophagus and potentially the mouth. The acid wash can eventually damage the esophageal lining, causing pain, heartburn, ulcers or even pre-cancerous cells.
Acid coming up in the mouth can cause the mouth’s normally neutral pH to slide into the acidic range. Eventually, these high acid levels soften and erode tooth enamel, increasing the risk of decay and tooth loss.
Accelerated erosion is often a sign of GERD—in fact, dentists may sound the first warning that a patient has a gastrointestinal problem. Unfortunately, a lot of damage could have already occurred, so it’s important to take steps to protect your teeth.
If you’ve been diagnosed with GERD, be sure to maintain good oral hygiene practices like brushing or flossing, especially using fluoride toothpaste to strengthen enamel. But try not to brush right after you eat or during a GERD episode: your teeth can be in a softened condition and you may actually brush away tiny particles of mineral. Instead, wait about an hour after eating or after symptoms die down.
In the meantime, try to stimulate saliva production for better acid neutralization by chewing xylitol gum or using a saliva booster. You can also lower mouth acid by rinsing with a cup of water with a half teaspoon of baking soda dissolved in or chewing on an antacid tablet.
You can also minimize GERD symptoms with medication, as well as avoiding alcohol, caffeine or spicy and acidic foods. Try eating smaller meals, finishing at least three hours before bedtime, and avoid lying down immediately after eating. Quitting smoking and losing weight may also minimize GERD symptoms.
GERD definitely has the potential to harm your teeth. But keeping the condition under control will minimize that threat and benefit your health overall.
If you would like more information on the effects of GERD 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 “GERD and Oral Health.”
Losing a tooth affects not only your smile but your overall dental health too. A dental implant solves both issues: it replaces the whole tooth, including the root, to merge durability with a life-like appearance.
For teenagers with a missing tooth, however, an implant may not be a good idea, at least until they've physically matured. Although their permanent teeth have usually all come in by puberty, the jaws and facial structure continue to develop into early adulthood. An implant placed too early could appear misaligned when the jaw fully matures.
The best approach for teens is a temporary replacement until they're physically ready for an implant. There are two good options: a removable partial denture (RPD) or a fixed bonded bridge.
Common among adults, an RPD is also a viable replacement for a teenager's missing tooth. An RPD consists of a prosthetic (false) tooth set in a nylon or acrylic base that resembles gum tissue. Metal clips formed in the RPD fit over adjacent teeth to hold the appliance in place; this also makes it easy to remove for cleaning or sleep time. We typically recommend an acrylic base for teens because it's easier to adjust if the RPD's fit becomes loose.
To hold it in place, a traditional bridge uses crowns on either side of the replacement tooth to bond over the natural teeth next to the open socket. Because this requires permanently altering the support teeth, we recommend a bonded bridge that doesn't.
This modified bridge uses wing-like strips of dental material on the back of the false tooth that project outward. With the tooth in place, we bond the extending portions of these projections to the back of the adjacent teeth, which secures the false tooth in place.
Of the two options, the bonded bridge is more comfortable, buys the most time and looks the most natural. But it will cost more than an RPD. Bite issues, teeth grinding, overall gum health or your child's level of hygiene conscientiousness could also nix it as a viable option.
Either choice will effectively replace your child's missing tooth until it's time for a permanent restoration. We'll help you weigh all the factors to determine which one is best for your situation.
Is a “teeth crush” a thing? According to a recent confession by Lucy Hale, it is. Hale, who has played Aria Montgomery for seven seasons on the hit TV show Pretty Little Liars, admitted her fascination with other people's smiles to Kelly Clarkson during a recent episode of the latter's talk show (Clarkson seems to share her obsession).
Among Hale's favorite “grills”: rappers Cardi B and Post Malone, Julia Roberts, Drake and Madonna. Although some of their smiles aren't picture-perfect, Hale admires how the person makes it work for them: “I love when you embrace what makes you quirky.”
So, how can you make your smile more attractive, but uniquely you? Here are a few ways to gain a smile that other people just might “crush” over.
Keep it clean. Actually, one of the best things you can do to maintain an attractive smile is to brush and floss daily to remove bacterial plaque. Consistent oral hygiene offers a “twofer”: It removes the plaque that can dull your teeth, and it lowers your risk of dental disease that could also foul up your smile. In addition to your daily oral hygiene routine at home, professional teeth cleanings are necessary to get at those hard-to-reach spots you miss with your toothbrush and floss and to remove tartar (calculus) that requires the use of special tools.
Brighten things up. Even with dedicated hygiene, teeth may still yellow from staining and aging. But teeth-whitening techniques can put the dazzle back in your smile. In just one visit to the dental office, it's possible to lighten teeth by up to ten shades for a difference you can see right away. It's also possible to do teeth whitening at home over several weeks using custom-made trays that fit over your teeth and safe whitening solutions that we provide.
Hide tooth flaws. Chipped, stained or slightly gapped teeth can detract from your smile. But bonding or dental veneers, thin layers of porcelain custom-made for your teeth, mask those unsightly blemishes. Minimally invasive, these techniques can turn a lackluster smile into one that gets noticed.
Straighten out your smile. Although the main goal for orthodontically straightening teeth is to improve dental health and function, it can also give you a more attractive smile. And even if you're well past your teen years, it's not too late: As long as you're reasonably healthy, you can straighten a crooked smile with braces or clear aligners at any age.
Sometimes a simple technique or procedure can work wonders, but perhaps your smile could benefit more from a full makeover. If this is your situation, talk to us about a more comprehensive smile renovation. Treatments like dental implants for missing teeth combined with various tooth replacement options, crown lengthening for gummy smiles or tooth extractions to help orthodontics can be combined to completely transform your smile.
There's no need to put up with a smile that's less than you want it to be. Whether a simple cosmetic procedure or a multi-specialty makeover, you can have a smile that puts the “crush” in “teeth crush.”
If you would like more information about cosmetic measures for enhancing your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Porcelain Veneers.”
The ongoing opioid addiction epidemic has brought together government, law enforcement and healthcare to find solutions. The focus among doctors and dentists has been on finding ways to reduce the number of opioid prescriptions.
Opioids (or narcotics) have been a prominent part of pain management in healthcare for decades. Drugs like morphine, oxycodone or fentanyl can relieve moderate to extreme pain and make recovery after illness or procedures much easier. Providers like doctors and dentists have relied heavily on them, writing nearly 260 million narcotic prescriptions a year as late as 2012.
But although effective when used properly, narcotics are also addictive. While the bulk of overall drug addiction stems from illegal narcotics like heroin, prescription drugs also account for much of the problem: In 2015, for example, 2 million Americans had an addiction that began with an opioid prescription.
The current crisis has led to horrific consequences as annual overdose deaths now surpass the peak year of highway accident deaths (just over 54,000 in 1972). This has led to a concerted effort by doctors and dentists to develop other approaches to pain management without narcotics.
One that’s gained recent momentum in dentistry involves the use of non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs like acetaminophen, ibuprofen or aspirin work by dilating blood vessels, which reduces painful inflammation. They’re available over the counter, although stronger doses require a prescription.
NSAIDs are effective for mild to moderate pain, but without the addictive properties of narcotics. There are some adverse health consequences if taken long-term, but limited use for pain or during post-procedure recovery is safe.
Many dentists are recommending NSAIDs for first-line pain management after most dental procedures. Narcotics may still be prescribed, but in a limited and controlled fashion. As part of this new approach, dentists typically combine ibuprofen and acetaminophen: Studies have shown the two work together better at reducing pain than either one individually.
Still, many aren’t eager to move away from the proven effectiveness of narcotics to primarily NSAIDs. But as these non-addictive drugs continue to prove their effectiveness, there’s hope the use of addictive opioids will continue to decrease.
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