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AddressingTheseFactorsHelpsEnsureaSatisfyingExperienceWithImplants

Patients and dentists alike love dental implants. For one, they're unique among other dental restorations because they replace the tooth root as well as the visible crown. It's actually their role as a root replacement that makes them so durable and lifelike.

But it still falls to the dentist to create as natural an appearance as possible through proper implant placement. It requires extensive technical skill and artistry to surgically place an implant in the precise location inside the jawbone to gain the best outcome. It's even more critical when the tooth is a highly visible one within the "smile zone"—the teeth others see when we smile.

With a patient's smile appearance on the line, it's important that we carefully consider a number of factors that can impact implant success and address them as needed in our treatment plan.

The gums. The gums are to the teeth as a frame is to a masterpiece painting. If the gums don't correctly cover the new implant, the final outcome won't look natural. Positioning the implant precisely helps ensure the gums look attractive. It may also be necessary to augment the gums, such as grafting surgery to encourage growth of lost gum tissue, to achieve the most lifelike result.

The socket. For simple extractions (as opposed to surgical removals), a dentist deftly manipulates the ligament holding the tooth in place to loosen and remove it. It's important to do this carefully—if the tooth's bony socket becomes damaged in the process (or because of other trauma), it can complicate implant placement in the future.

The supporting bone. Likewise, the bone in which the implant is imbedded must be reasonably healthy and of adequate volume. Besides not providing enough support, inadequate bone also makes it difficult to place an implant for the most attractive result. Bone grafting at the time of extraction minimizes bone shrinkage. If bone shrinkage had occurred, the Inadequate bone may require grafting, particularly if there is a lag time between extraction and implantation. In extreme cases, though, a patient may need to choose a different restoration.

The usual process for implants—planning, surgical placement and the healing period after surgery—can take time. Paying attention to these and other factors will help ensure that time and the effort put into this process has a satisfying outcome—an attractive, natural and long lasting smile.

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.”

TroublingDataSaysSmokingMarijuanaCouldWorsenGumDisease

It seems with each new election cycle another U.S. state legalizes marijuana use. It remains a flashpoint issue that intersects politics, law and morality, but there's another aspect that should also be considered—the health ramifications of using marijuana.

From an oral health perspective, it doesn't look good. According to one study published in the Journal of Periodontology a few years ago, there may be a troubling connection between marijuana use and periodontal (gum) disease.

Gum disease is a common bacterial infection triggered by dental plaque, a thin biofilm on tooth surfaces. As the infection advances, the gum tissues become more inflamed and lose their attachment to teeth. This often results in widening gaps or "pockets" between the teeth and gums filled with infection. The deeper a periodontal pocket, the greater the concern for a tooth's health and survivability.

According to the study, researchers with Columbia University's College of Dental Medicine reviewed data collected from nearly 2,000 adults, a quarter of which used marijuana at least once a month. They found the marijuana users had about 30 individual pocket sites on average around their teeth with a depth of at least 4 millimeters. Non-users, by contrast, only averaged about 22 sites.

The users also had higher incidences of even deeper pockets in contrast to non-users. The former group averaged nearly 25 sites greater than 6 millimeters in depth; non-users, just over 19. Across the data, marijuana users appeared to fare worse with the effects of gum disease than those who didn't use.

As concerning as these findings appear, we can't say that marijuana use singlehandedly causes gum disease. The condition has several contributing risk factors: diet, genetics, and, most important of all, how well a person manages daily plaque removal, the main driver for gum disease, through brushing and flossing.

Still, the data so far seems to indicate using marijuana can make gum disease worse. Further studies will be needed to fully test this hypothesis. In the meantime, anyone using marijuana should consider the possible consequences to their oral health.

If you would like more information on marijuana and oral health, please contact us or schedule an appointment for a consultation.

HeresGoodAdviceforYourCollegeStudentToProtectTheirDentalHealth

As summer wanes, thousands of high school grads will begin the new adventure called college. For many of these "freshmen," it will also be their first taste of true independence—mom and dad and the guidance they normally provide will be far away.

This is generally a good thing. But there are also consequences to making (or not making) your own choices that can have long-lasting effects, some of which may not be pleasant. For example, neglecting teeth and gum care could disrupt oral health (as well as overall health) for years or even decades to come.

As your newly minted college student sets off on their new academic journey, be sure that among the advice you give them are these 3 important dental care habits.

Brush and floss daily. It's important to stress that among the things of childhood to leave behind, oral hygiene isn't one of them. Dental disease is mainly caused by dental plaque, a thin bacterial film that accumulates on teeth. Removing plaque daily with brushing and flossing greatly reduces disease risk. It's a top priority, even with a hectic college schedule.

Eat "tooth-friendly." That hectic schedule may also tempt them to grab whatever food is quick and available. Unfortunately, such food isn't always the healthiest, especially for teeth and gums. Foods and snacks loaded with sugar are especially perilous to oral health—sugar feeds the bacteria that cause tooth decay and gum disease. Healthier food choices contribute to healthier teeth and gums.

Avoid bad habits. The exhilaration of new independence can lead to a flurry of bad habits, some of which could affect teeth and gum health. Using tobacco increases the risk of dental disease and oral cancer. Wearing lip piercings or tongue jewelry may cause tooth damage. And certain forms of unprotected sex raise the chances of viral infection and an increased risk of oral cancer.

College can be an exciting adventure. But there are pitfalls along the way, especially for oral health. Advising your college student to follow these tips will help ensure their teeth and gums stay healthy beyond graduation.

If you would like more information on ways to keep your student's teeth and gums healthy, 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 “10 Health Tips For College Students.”

TakeItFromTaylorSwift-LosingYourOrthodonticRetainerisNoFun

For nearly two decades, singer-songwriter Taylor Swift has dominated the pop and country charts. In December she launched her ninth studio album, called evermore, and in January she delighted fans by releasing two bonus tracks. And although her immense fame earns her plenty of celebrity gossip coverage, she's managed to avoid scandals that plague other superstars. She did, however, run into a bit of trouble a few years ago—and there's video to prove it. It seems Taylor once had a bad habit of losing her orthodontic retainer on the road.

She's not alone! Anyone who's had to wear a retainer knows how easy it is to misplace one. No, you won't need rehab—although you might get a mild scolding from your dentist like Taylor did in her tongue-in-cheek YouTube video. You do, though, face a bigger problem if you don't replace it: Not wearing a retainer could undo all the time and effort it took to acquire that straight, beautiful smile. That's because the same natural mechanism that makes moving teeth orthodontically possible can also work in reverse once the braces or clear aligners are removed and no longer exerting pressure on the teeth. Without that pressure, the ligaments that hold your teeth in place can “remember” where the teeth were originally and gradually move them back.

A retainer prevents this by applying just enough pressure to keep or “retain” the teeth in their new position. And it's really not the end of the world if you lose or break your retainer. You can have it replaced with a new one, but that's an unwelcome, added expense.

You do have another option other than the removable (and easily misplaced) kind: a bonded retainer, a thin wire bonded to the back of the teeth. You can't lose it because it's always with you—fixed in place until the orthodontist removes it. And because it's hidden behind the teeth, no one but you and your orthodontist need to know you're wearing it—something you can't always say about a removable one.

Bonded retainers do have a few disadvantages. The wire can feel odd to your tongue and may take a little time to get used to it. It can make flossing difficult, which can increase the risk of dental disease. However, interdental floss picks can help here. ¬†And although you can't lose it, a bonded retainer can break if it encounters too much biting force—although that's rare.

Your choice of bonded or removable retainer depends mainly on your individual situation and what your orthodontist recommends. But, if losing a retainer is a concern, a bonded retainer may be the way to go. And take if from Taylor: It's better to keep your retainer than to lose it.

If you would like more information about protecting your smile after orthodontics, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Importance of Orthodontic Retainers.”

AreImplantsaNo-GoforYouConsiderTheseOtherRestorationOptions

Our primary aim as dentists is to preserve teeth. There are times, however, when preserving a tooth is no longer worth the effort and we must recommend removing it. Fortunately, extracted teeth can be replaced with a functional and attractive restoration.

Today's top tooth-replacement option is the dental implant. Composed of a titanium metal post imbedded into the jawbone, a single dental implant can replace an individual tooth or a series of implants can support other restorations for multiple teeth. Besides being incredibly life-like, dental implants are highly durable and can last for decades.

But dental implants aren't an optimal choice for everyone. Their cost often matches their status as the premier tooth replacement method. And because they require a minimum amount of bone for proper implantation, they're not always feasible for patients with extensive bone loss.

But even if dental implants aren't right for you, and you want a fixed restoration rather than dentures, you still have options. What's more, they've been around for decades!

One is a bonded crown, which works particularly well for a tooth excessively damaged by decay, excessive wear or fractures. After removing all of the damaged portions and shaping the remaining tooth, we cement a life-like crown, custom created for that particular tooth, over the remaining structure.

Besides improving appearance, a crown also protects the tooth and restores its function. One thing to remember, though, is although the crown itself is impervious to disease, the remainder of the natural tooth isn't. It's important then to brush and floss around crowned teeth like any other tooth and see a dentist regularly for cleanings.

Dental bridges are a fixed solution for extracted teeth. It's composed of prosthetic teeth to replace those missing bonded together with supporting crowns on both ends. These crowned teeth are known as abutments, and, depending on how many teeth are being replaced, we may need to increase the number of abutments to support the bridge.

Although durable, crowns or bridges typically don't match the longevity of an implant. And, implants don't require the permanent alteration of support teeth as is necessary with a bridge. But when the choice of implants isn't on the table, these traditional restorations can be an effective dental solution.

If you would like more information on crown or bridge 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 “Crowns & Bridgework.”





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