Posts for category: Dental Procedures
You feel great about your new smile, thanks to dental implants! And you may also be feeling relief as the problems with your former teeth fade into the past.
But that doesn’t mean you can drop your guard on periodontal (gum) disease. Even though implants are impervious to decay, the natural tissues supporting them are vulnerable to periodontal (gum) disease. If they become diseased, your implants could lose their bone support and eventually fail.
And that failure could happen quickly. That’s because, as life-like as they are, implants don’t have one important advantage of real teeth: an attachment to a connective tissue called the periodontal ligament. This tough but elastic ligament lies between the teeth and the bone, attaching to both with tiny extending fibers and holding the teeth in place.
And that’s not all: Because the periodontal ligament contains an abundance of blood vessels, it can supply antibodies to help fight infection. The body’s defenses may not be able to stop disease, but they can certainly inhibit its progress.
Implants can’t benefit from this infection-fighting mechanism. So, when an infection arises in the gums surrounding an implant, it can spread rapidly through a form of gum disease known as peri-implantitis (literally “inflammation around an implant”). If we don’t stop it with prompt treatment, you could lose bone support from your implant and eventually lose it, sometimes in quick fashion.
That’s why you should clean your implants everyday like you do the rest of your teeth with brushing and flossing. You should also visit us regularly for dental cleanings. A dental cleaning involving implants is similar to one with natural teeth, except the hygienist won’t use metal instruments on the implants—this could create tiny scratches on their surface. Instead, they’ll use nylon or plastic instruments or ultrasonic equipment to clean them.
You should also make a dental appointment as soon as you notice swollen, reddened or bleeding gums. If you have gum disease, we can stop the infection through treatment and restore your gums to health. This can be a long and involved process, but it’s necessary to preserve your implants.
It’s true that implants can change your life. If you want to enjoy that change for a long time, take care of your implants and the natural tissues that support them.
If you would like more information on caring for 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 Maintenance.”
The Golden Globes ceremony is a night when Hollywood stars shine their brightest. At the recent red-carpet event, leading man Viggo Mortensen had plenty to smile about: Green Book, the movie in which he co-starred, picked up the award for Best Motion Picture—Musical or Comedy. But fans looking at the veteran actor's big smile today might not realize that it once looked very different. A few years ago, an accident during the filming of The Two Towers took a major chip out of Mortensen's front tooth!
That might be OK for some movies (think The Hangover or Dumb and Dumber)—but it's not so great for everyday life. Fortunately, Mortensen visited a dentist promptly, and now his smile is picture-perfect. How was that accomplished? He didn't say…but generally, the best treatment for a chipped tooth depends on how much of the tooth's structure is missing.
If the tooth has only a small chip or crack, it's often possible to restore it via cosmetic bonding. This procedure can be done right in the dental office, frequently in a single visit. Here's how it works: First the tooth is cleaned and prepared, and then a tooth-colored resin is applied to the area being restored. After it is cured (hardened) with a special light, additional layers may be applied to build up the missing structure. When properly cared for, a tooth restored this way can look good for several years.
For a longer-lasting restoration, veneers may be recommended. These are wafer-thin shells made of durable material (most often porcelain) that cover the front (visible) surfaces of teeth. Strong and lifelike, veneers can match the exact color of your natural teeth—or give you the bright, high-wattage smile you've always wanted. No wonder they're so popular in Hollywood! Because veneers are custom-made for you, getting them may require several office visits.
If a chip or crack extends to the inner pulp of the tooth, a root canal procedure will be needed to keep the tooth from becoming infected—a situation that could have serious consequences. But you shouldn't fear a root canal! The procedure generally causes no more discomfort than filling a cavity (though it takes a little longer), and it can help save teeth that would otherwise be lost. After a root canal, a crown (cap) is generally needed to restore the visible part of the tooth.
When a damaged tooth can't be restored, it needs to be extracted (removed) and replaced. Today's best option for tooth replacement is a dental implant—a small, screw-shaped post inserted into the bone of your jaw that anchors a lifelike, fully functional crown. Implants require very little special care and can look great for many years, making them a top choice for tooth replacement
If you have questions about chipped or damaged teeth, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Artistic Repair Of Front Teeth With Composite Resin” and “Porcelain Veneers.”
Accidents can happen to your mouth, especially if you have an active lifestyle. For example, a sudden blow to the jaw while playing sports or exercising could result in a chipped tooth. And, while the internal tooth structure may be fine, the effect on your appearance can be disheartening.
Fortunately, we have techniques and materials to restore your smile after an injury. Bonding with composite resin is one such procedure: it’s ideal for mild to moderate chipping, especially in highly visible front teeth.
Composite resin is a dental material made of various substances mixed to match the color and texture of natural teeth. The composite is usually made of inorganic glass filler blended with a plastic-based matrix and joined together with a chemical “coupling” agent. The ratio of filler to matrix will depend on the type of tooth and damage — for example, back teeth, which encounter higher biting forces, require a composite with more filler for added strength.
To begin the procedure, we first prepare the damaged tooth by applying microscopic etchings (often with a chemical solution) that create tiny depressions or “undercuts”: these help create a seamless bond between the composite and the natural tooth. We then apply the composite in layers with a bonding agent, building up layer upon layer until we’ve achieved the desired shape for the tooth involved.
Bonding with composite resins doesn’t require much tooth preparation, can be placed quickly and is relatively inexpensive. Because of the wide spectrum of color possibilities, composite resins are superior to traditional amalgam (metal) restorations in creating a more life-like appearance. Its application, however, can be limited by the amount of tooth structure needing to be replaced: because it isn’t as strong as the tooth structure it replaces, the more tooth structure the bonded composite resin attempts to replace the less likely it can stand up over time to normal bite forces.
Still, composite resins are ideal for mild to moderate damage or disfigurement. If you’ve suffered such an injury, be sure to visit us to see if bonding with life-like composites is the right solution for restoring your smile.
If you would like more information on bonding with composite resins, 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 “Repairing Chipped Teeth.”
Dental implants are considered today’s premier method for restoring missing teeth. Obtaining an implant, though, is often a long process and the implants themselves must be surgically placed within the jaw bone. Nothing to worry about, though: implant surgery is a minor to moderate procedure akin to a surgical tooth extraction.
Still like any surgery, this procedure does involve cutting into the soft tissues of the gums and could allow oral bacteria to enter the bloodstream. While most bacteria in the mouth are harmless (and even beneficial) a few strains can cause disease. For some people, especially those with certain heart conditions or joint replacements, this could potentially cause serious issues in other parts of their body that might be highly susceptible to infection.
To guard against this, it’s been a long-standing practice in dentistry to prescribe antibiotics to certain high risk patients before a procedure. Although this departs from the normal use of antibiotics for already occurring infections, due to the circumstances this has been deemed an acceptable measure to prevent disease.
In the past, the categories of patients for which preventive antibiotics were appropriate had been more extensive. In recent years, though, both the American Dental Association and the American Heart Association have adjusted their recommendations. Today, your dental provider may recommend antibiotic pre-treatment if you have a prosthetic (artificial) heart valve, a history of infective endocarditis (inflammation of the inner linings of the heart), a heart transplant or certain congenital heart conditions.
While physicians may still recommend premedication with antibiotics for patients with joint replacements, it’s not as blanket a standard as it might once have been. It’s now only recommended for certain cases, such as patients who’ve received a prosthetic joint within the last two years.
There’s still an ongoing debate about the effectiveness of antibiotic pre-medication. However, there’s evidence medicating before procedures with antibiotics can be beneficial in avoiding infection. If you fall into one of the categories just mentioned or are concerned about infection, feel free to discuss with your dentist if using antibiotics before your implant surgery is wise move for you.
If you would like more information on antibiotic treatment before oral surgery, 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 “Implants & Antibiotics: Lowering Risk of Implant Failure.”
Somewhere around age 6, your child’s primary (baby) teeth will begin to give way to their permanent set. If all goes well, you’ll notice all the front teeth erupting in the right position: the top teeth slightly overlapping the bottom and all coming in without crowding.
Sometimes, though, the process doesn’t occur as it should and a bad bite (malocclusion) may develop. You can get a head start on treatment if you know what to look for. Here are a few problems for which you should see a dentist — or more likely an orthodontist — for a thorough evaluation.
Spacing problems. Teeth should normally come in right next to each other without a noticeable gap. But if you notice excessive space between the permanent front teeth especially, this may be an indication there’s a discrepancy in size between the teeth and the jaws. At the other end of the spectrum, if teeth on the same arch appear to overlap each other, this indicates crowding in which there’s not enough space for the teeth to erupt properly.
Bad bites. Malocclusions can take different forms. In an underbite, the front bottom teeth bite in front of the upper teeth. If there’s a noticeable gap between the upper and lower teeth when the jaws are closed, this is known as an open bite. Front teeth biting too far down over the lower teeth is a deep bite and could even include biting into the soft tissue of the hard palate. Cross bites can occur in either the front or back teeth: if in the front, some of the lower teeth will bite in front of the upper; if in the back, some of the lower teeth bite outside the upper rather than normally on the inside.
Abnormal eruptions. You should also be alert for protusions, in which the upper teeth or the jaw appears to be too far forward, or retrusions, in which the lower teeth or jaw appears to be too far back. You should also be concerned if permanent teeth erupt far from their normal position — this is especially likely if the primary tooth was also out of position, or was lost prematurely or not in the right order.