Posts for: March, 2018
Dental implants are considered the premier option for tooth replacement. While all implant procedures follow the same general concept — a titanium post surgically inserted into the jawbone with an attached life-like crown — the installation process can vary.
From their earliest history, implants have usually been installed through a two-stage process. In the first stage, the surgeon inserts the titanium post in the bone and leaves it “submerged” below the gum level to protect it from oral bacteria and the effects of chewing and biting. About three months later after the bone attaches to the titanium (a process called osseointegration), the surgeon then performs the second stage by re-exposing the implant and attaching a temporary abutment and crown for the patient to wear while the permanent abutment and crown are fabricated and later attached in 2-6 weeks.
In recent years, advancements in materials and design have made possible a one-stage process that allows the implant to protrude above the gum line during osseointegration and shortens the process. After the initial three-month healing period, the implant is ready for “loading” with the permanent crown.
The choice between which of these two procedures should be used for your implants will first depend on the type of tooth being replaced. A front tooth benefits from the one-stage procedure for cosmetic reasons because the surgeon can install a temporary crown to the exposed abutment during osseointegration (as long as the temporary tooth isn’t in functional contact with other teeth). An implant for a back tooth, on the other hand, doesn't have a large cosmetic demand so those one stage procedures usually end up with an exposed healing abutment but no temporary crown.
The strength of the bone is also a factor. Some bone tends to be softer, particularly in the back of the mouth. There’s a chance the implant could move in this softer bone, adversely affecting the outcome. For this reason, the two-stage procedure can be the preferred approach for posterior teeth as it offers more protection from movement.
You can be sure we’ll consider all these and other factors during your initial examination, and then advise you on the best approach. Above all, we want to make sure — whether a one-stage or a two-stage implant process — the result is a smile you can be proud of.
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 “Staging Surgery in Implant Dentistry.”
The most important thing you can do for good oral health is brush and floss your teeth daily. But we’re not born knowing how to do either — they’re skills we must learn and practice to be effective in removing disease-causing bacterial plaque.
It helps then to have a good understanding about technique, implements or problem situations you may run into. So then, here are answers to 4 typical hygiene questions that can help you improve your brushing and flossing.
How often should I brush and floss? You should brush and floss at least once a day to prevent a buildup of plaque, the cause for both tooth decay and periodontal (gum) disease; if you have some form of dental disease, we may advise a different frequency. Be sure to use a gentle technique — it doesn’t take much pressure to remove plaque and being too aggressive can harm your gums and tooth enamel.
When should I change my toothbrush? If you use it correctly (gentle vs. aggressive), your toothbrush should last several months. When you begin to notice the bristles becoming worn or splayed, it’s time to get a new, soft bristle brush.
What kind of toothpaste should I use? You may have a preference among the dozens available when it comes to flavor and texture. But from a hygiene standpoint you should choose one that contains fluoride to strengthen enamel and an anti-tartar agent to inhibit the formation of hardened plaque deposits (calculus). While we’re on the subject, don’t rinse out the toothpaste right after brushing — you may be washing away fluoride too early, which takes time to work in contact with tooth enamel. Just spit it out.
What if my teeth are sensitive when I brush? If you encounter problems when you brush, visit us to find out the cause. The most common cause for sensitivity is gum recession, usually due to gum disease, which has exposed the roots. This can cause discomfort when you encounter hot or cold foods, or pressure on the teeth when you brush. You should then receive treatment for the underlying condition; we may also recommend toothpaste that reduces tooth sensitivity. And, of course, be gentle when you brush.
If you would like more information on brushing, flossing and other aspects of oral hygiene, 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 “Oral Hygiene Behavior.”
Dentures can be an effective and affordable solution for people who've lost all their teeth. With them a person can once again eat nutritiously, speak clearly and smile confidently — and with regular care they can last for years.
As part of that ongoing care, be sure you consider one important thing with your dentures: you may want to take them out at night while you sleep. If you do you'll lessen your chances of developing these 4 health problems.
Accelerated bone loss. Traditional dentures are fitted to rest securely on the gums. This, however, creates pressure on the gums and the bony ridges beneath them that can contribute to bone loss. Wearing dentures around the clock usually accelerates this process, which could eventually lead to among other problems looser denture fit and discomfort.
Bacterial and fungal growth. Microorganisms that cause oral diseases find conducive breeding spots on the underside of dentures while they're worn in the mouth. Studies have found that people who continuously wear their dentures are more likely to have bacterial plaque and oral yeast than those that don't.
Potentially dangerous infections. Bacterial and fungal growth increases your risk of oral infections that could affect more than your mouth. A recent study of elderly nursing home residents found those who wore their dentures during sleep were over twice as likely to develop serious cases of pneumonia requiring hospitalization. It's believed bacteria harbored on the dentures can pass from the mouth to the lungs as a person breathes over them while they sleep.
Blocked salivary flow. During the night our salivary flow naturally ebbs; wearing dentures while we sleep could cause denture stomatitis, in which the tissues covered by a denture (particularly along the roof of the mouth) become inflamed and infected with yeast. It's often accompanied by angular cheilitis or cracking at the corners of the mouth that becomes infected by the same yeast.
Wearing your dentures while you sleep contributes to conditions ranging from irritating to life-threatening. To prevent such problems clean your dentures as well as the rest of your mouth regularly — and talk to your dentist whether you should leave them out when you go to bed.
If you would like more information on denture care, 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 “Sleeping in Dentures.”
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.”