Posts for category: Dental Procedures
Losing teeth can make it more difficult to eat, not to mention the effect it can have on your smile. But that could be just the beginning of your problems. Missing teeth can contribute to extensive bone loss within your jaws and face. Here's why.
Bone is like any other living tissue—cells develop, function and eventually die, and new cells take their place. Forces generated during chewing stimulate this new growth, helping the jawbone maintain its normal volume and density.
But you lose this stimulus when you lose teeth. This can cause a slowdown in bone cell regrowth that can eventually diminish bone volume. And it can happen relatively quickly: you could lose a quarter or more of jawbone width around a missing tooth within a year.
As this loss continues, especially in cases of multiple missing teeth, the bone can eventually erode to its base level. This loss of dental function can make chewing more difficult, place more pressure on the remaining teeth and adversely affect facial appearance. It could also prevent an implant restoration to replace missing teeth.
Dentures and other forms of dental restoration can replace missing teeth, but not the chewing stimulus. Dentures in particular will accelerate bone loss, because they can irritate the bony gum ridges they rest upon.
Dental implants, on the other hand, can slow or even stop bone loss. Implants consist of a metal post, typically made of titanium, imbedded into the jawbone at the site of the missing tooth with a life-like crown attached. Titanium also has a strong affinity with bone so that bone cells naturally grow and adhere to the implant's surface. This can produce enough growth to slow, stop or even reverse bone loss.
This effect may also work when implants are combined with other restorations, including dentures. These enhanced dentures no longer rest on the gums, but connect to implants. This adds support and takes the pressure off of the bony ridge, as well as contributes to better bone health.
If you've lost a tooth, it's important to either replace it promptly or have a bone graft installed to help forestall any bone loss in the interim. And when it's time to replace those missing teeth, dental implants could provide you not only a life-like solution, but a way to protect your bone health.
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 “The Hidden Consequences of Losing Teeth.”
Between the final game of the World Series in late October and spring training in February, major league baseball players work on their skills preparing for the new season. Reporters on a Zoom call to the New York Yankees' training camp wanted to know what star outfielder Aaron Judge had been doing along those lines. But when he smiled, their interest turned elsewhere: What had Aaron Judge done to his teeth?
Already with 120 homers after only five seasons, Judge is a top player with the Yankees. His smile, however, has been less than spectacular. Besides a noticeable gap between his top front teeth (which were also more prominent than the rest of his teeth), Judge also had a chipped tooth injury on a batting helmet in 2017 during a home plate celebration for a fellow player's walk-off home run.
But now Judge's teeth look even, with no chip and no gap. So, what did the Yankee slugger have done?
He hasn't quite said, but it looks as though he received a “smile makeover” with porcelain veneers, one of the best ways to turn dental “ugly ducklings” into “beautiful swans.” And what's even better is that veneers aren't limited to superstar athletes or performers—if you have teeth with a few moderate dental flaws, veneers could also change your smile.
As the name implies, veneers are thin shells of porcelain bonded to the front of teeth to mask chips, cracks, discolorations or slight gaps between teeth. They may even help even out disproportionately sized teeth. Veneers are custom-made by dental technicians based on a patient's particular tooth dimensions and color.
Like other cosmetic techniques, veneers are a blend of technology and artistry. They're made of a durable form of dental porcelain that can withstand biting forces (within reason, though—you'd want to avoid biting down on ice or a hard piece of food with veneered teeth). They're also carefully colored so that they blend seamlessly with your other teeth. With the right artistic touch, we can make them look as natural as possible.
Although porcelain veneers can accommodate a wide range of dental defects, they may not be suitable for more severe flaws. After examining your teeth, we'll let you know if you're a good candidate for veneers or if you should consider another restoration. Chances are, though, veneers could be your way to achieve what Aaron Judge did—a home run smile.
If you would like more information about porcelain veneers, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Veneers: Strength & Beauty As Never Before.”
Getting dental implants is going to require surgery. But don't let that concern you—it's a relatively minor procedure.
Currently the “gold standard” for tooth replacement, an implant consists of a titanium post surgically imbedded in the jawbone. We can affix a life-like crown to a single implant or support a fixed bridge or removable denture using a series of them.
Because placement will determine the restoration's final appearance, we must carefully plan implant surgery beforehand. Our first priority is to verify that you have adequate jawbone available to support an implant.
Additionally, we want to identify any underlying structures like nerves or blood vessels that might obstruct placement. We may also develop a surgical guide, a retainer-like device placed in the mouth during surgery that identifies precisely where to create the holes or channels for the implants.
After numbing the area with local anesthesia, we begin the surgery by opening the gum tissue with a series of incisions to expose the underlying bone. If we've prepared a surgical guide, we'll place it in the mouth at this time.
We then create the channel for the insert through a series of drillings. We start with a small opening, then increase its size through subsequent drills until we've created a channel that fits the size of the intended implant.
After removing the implant from its sterile packaging, we'll directly insert it into the channel. Once in place, we may take an x-ray to verify that it's been properly placed, and adjust as needed. Unless we're attaching a temporary crown at the time of surgery (an alternate procedure called immediate loading), we suture the gums over the implant to protect it.
Similar to other dental procedures, discomfort after surgery is usually mild to moderate and manageable with pain relievers like acetaminophen or ibuprofen (if necessary, we can prescribe something stronger). We may also have you take antibiotics or use antibacterial mouthrinses for a while to prevent infection.
A few weeks later, after the bone has grown and adhered to the implant surface, you'll return to receive your new permanent crown or restoration. While the process can take a few months and a number of treatment visits, in the end you'll have new life-like teeth that could serve you well for decades.
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 Implant Surgery.”
Even though coronavirus lockdowns have prevented TV hosts from taping live shows, they're still giving us something to watch via virtual interviews. In the process, we're given occasional glimpses into their home life. During a Tonight Show interview with Seahawks quarterback Russell Wilson and his wife, R & B performer Ciara, Jimmy Fallon's daughter Winnie interrupted with breaking news: She had just lost a tooth.
It was an exciting and endearing moment, as well as good television. But with 70 million American kids under 18, each with about 20 primary teeth to lose, it's not an uncommon experience. Nevertheless, it's still good to be prepared if your six-year-old is on the verge of losing that first tooth.
Primary teeth may be smaller than their successors, but they're not inconsequential. Besides providing young children with the means to chew solid food and develop speech skills, primary teeth also serve as placeholders for the corresponding permanent teeth as they develop deep in the gums. That's why it's optimal for baby teeth to remain intact until they're ready to come out.
When that time comes, the tooth's roots will begin to dissolve and the tooth will gradually loosen in the socket. Looseness, though, doesn't automatically signal a baby tooth's imminent end. But come out it will, so be patient.
Then again, if your child, dreaming of a few coins from the tooth fairy, is antsy to move things along, you might feel tempted to use some old folk method for dispatching the tooth—like attaching the tooth to a door handle with string and slamming the door, or maybe using a pair of pliers (yikes!). One young fellow in an online video tied his tooth to a football with a string and let it fly with a forward pass.
Here's some advice from your dentist: Don't. Trying to pull a tooth whose root hasn't sufficiently dissolved could damage your child's gum tissues and increase the risk of infection. It could also cause needless pain.
Left alone, the tooth will normally fall out on its own. If you think, though, that it's truly on the verge (meaning it moves quite freely in the socket), you can pinch the tooth between your thumb and middle finger with a clean tissue and give it a gentle tug. If it's ready, it should pop out. If it doesn't, leave it be for another day or two before trying again.
Your child losing a tooth is an exciting moment, even if it isn't being broadcast on national television. It will be more enjoyable for everyone if you let that moment come naturally.
If you would like more information on the importance and care of primary teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Importance of Baby Teeth.”
Around one in ten U.S. adults have diabetes, a metabolic disease that can disrupt other aspects of a person's health like wound healing and vision. It could also cause complications with dental implants, the premier replacement choice for missing teeth.
There are two basic types of diabetes. In type 1 diabetes, the pancreas stops producing insulin, a hormone needed to regulate the amount of sugar glucose in the bloodstream. With the more prevalent type 2 diabetes, the body either doesn't produce enough insulin or doesn't respond efficiently to the insulin produced.
Uncontrolled diabetes can contribute to several dangerous health conditions. In addition to vision impairment and poor wound healing, diabetics are at higher risk for other problems like kidney disease or nerve damage. Drastic swings in blood glucose levels can also cause coma or death.
Many diabetics, though, are able to manage their condition through diet, exercise, medications and regular medical care. Even so, they may still encounter problems with wound healing, which could complicate getting a dental implant.
An implant is composed of a titanium metal post imbedded into the jawbone. Because of its affinity with titanium, bone cells naturally grow and adhere to the implant's metal surface. Several weeks after implant surgery, enough bone growth occurs to fully secure the implant within the jaw.
But this integration process may be slower for diabetics because of sluggish wound healing. It's possible for integration to not fully occur in diabetic patients after implant surgery, increasing the risk of eventually losing the implant.
Fortunately, though, evidence indicates this not to be as great a concern as once thought. A number of recent group studies comparing diabetic and non-diabetic implant patients found little difference in outcomes—both groups had similar success rates (more than 95 percent).
The only exception, though, were diabetic patients with poor glucose control, who had much slower bone integration that posed a threat to a successful implant outcome. If you're in this situation, it's better if you're first able to better control your blood glucose levels before you undergo surgery.
So, while diabetes is something to factor into your implant decision, your chances remain good for a successful outcome. Just be sure you're doing everything you can to effectively manage your diabetes.
If you would like more information on diabetes and 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 & Diabetes.”