While many people still consider dental implants the "new kids on the block" in dental restoration, they're now in their fourth decade of use. And since their inception implant technology has continued to improve and revolutionize how we replace missing teeth.
Implants are a different "species" compared to other restoration methods. To be precise, an implant is a tooth root replacement—usually a titanium metal post imbedded directly into the jaw bone. Titanium is not only a biocompatible metal, but bone cells naturally grow on its surface to create a strong and durable hold. It's this secure hold that's most responsible for implants' high long-term success rate.
But we should also credit some of this success to the steady stream of advances over the years in implant construction and supporting technologies. For one thing, we're now more accurate and precise with implant placement thanks to advances in computer tomography (CT) and cone beam CT (CBCT) scanning.
These digital processes merge a series of images taken by a special camera to form a three-dimensional model of the jaw. We can manipulate this model on a computer monitor to view it from different vantage points. It can help us locate and avoid anatomical structures like nerves and sinuses when determining where to place a future implant. CT and CBCT are especially useful when there's a concern about adequate available bone, a necessity for stable implants.
Technology has also improved how we create surgical guides, often used during implant surgery to obtain the most accurate results. Surgical guides are custom-made devices that fit over the teeth with the drilling locations for the implants marked on them. Recent advances in 3-D printing have made these guides even more accurate so that they fit more securely in the mouth. This greater stability increases their accuracy during the drilling sequence during surgery.
These and other advances are helping ensure every implant is a success story. The end result is both a functional restoration and a beautiful 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 “How Technology Aids Dental Implant Therapy.”
A "toothy grin" might be endearing, but not necessarily healthy. More of the teeth showing may mean your gums have pulled back or receded from the teeth. If so, it's not just your smile that suffers—the parts of teeth protected by the gums could become more susceptible to disease.
There are a number of causes for gum recession. Some people are more likely to experience it because of genetically thinner gum tissues. Over-aggressive brushing could also contribute to recession. But the most common cause by far is periodontal (gum) disease, a bacterial infection triggered by dental plaque accumulating on teeth mainly as a result of inadequate hygiene.
There are some things we can do to help heal and restore recessed gums, most importantly treating gum disease. The number one goal of treatment is to uncover and remove all dental plaque from tooth and gum surfaces, which can take several sessions and sometimes minor surgery if the infection has reached the tooth roots. But removing plaque and tartar (calcified plaque) is necessary to stop the infection and allow the gums to heal.
For mild recession, this may be enough for the gums to regain normal coverage. But in more severe cases we may need to help rejuvenate new tissue with grafting surgery. In these highly meticulous procedures a surgeon uses microscopic techniques to position and attach donated tissue to the recession site. The graft serves as a scaffold on which new tissue growth can occur.
While these treatments can be effective for reversing gum recession, they often require time, skill and expense. It's much better to try to prevent gum recession—and gum disease—in the first place. Prevention begins with daily brushing and flossing to prevent plaque buildup, as well as regular dental visits for more thorough cleanings. Be on the lookout too for any signs of a beginning gum infection like swollen, reddened or bleeding gums and see your dentist as soon as possible to minimize any damage to your gums.
Caring for your gums is equally as important as caring for your teeth. Healthy gums equal a healthy mouth—and an attractive smile.
If you would like more information on preventing gum recession, 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 “Gum Recession.”
Want to know the exact wrong way to pry open a stubborn lid? Just ask Jimmy Fallon, host of NBC-TV’s popular “Tonight Show.” When the 40-year-old funnyman had trouble opening a tube of scar tissue repair gel with his hands, he decided to try using his teeth.
What happened next wasn’t funny: Attempting to remove the cap, Fallon chipped his front tooth, adding another medical problem to the serious finger injury he suffered a few weeks before (the same wound he was trying to take care of with the gel). If there’s a moral to this story, it might be this: Use the right tool for the job… and that tool isn’t your teeth!
Yet Fallon is hardly alone in his dilemma. According to the American Association of Endodontists, chipped teeth account for the majority of dental injuries. Fortunately, modern dentistry offers a number of great ways to restore damaged teeth.
If the chip is relatively small, it’s often possible to fix it with cosmetic bonding. In this procedure, tough, natural-looking resin is used to fill in the part of the tooth that has been lost. Built up layer by layer, the composite resin is cured with a special light until it’s hard, shiny… and difficult to tell from your natural teeth. Best of all, cosmetic bonding can often be done in one office visit, with little or no discomfort. It can last for up to ten years, so it’s great for kids who may be getting more permanent repairs later.
For larger chips or cracks, veneers or crowns may be suggested. Veneers are wafer-thin porcelain coverings that go over the entire front surface of one or more teeth. They can be used to repair minor to moderate defects, such as chips, discolorations, or spacing irregularities. They can also give you the “Hollywood white” smile you’ve seen on many celebrities.
Veneers are generally custom-made in a lab, and require more than one office visit. Because a small amount of tooth structure must be removed in order to put them in place, veneers are considered an irreversible treatment. But durable and long-lasting veneers are the restorations of choice for many people.
Crowns (also called caps) are used when even more of the tooth structure is missing. They can replace the entire visible part of the tooth, as long as the tooth’s roots remain viable. Crowns, like veneers, are custom-fabricated to match your teeth in size, shape and color; they are generally made in a dental lab and require more than one office visit. However, teeth restored with crowns function well, look natural, and can last for many years.
So what happened to Jimmy Fallon? We aren’t sure which restoration he received… but we do know that he was back on TV the same night, flashing a big smile.
If you would like more information about tooth restorations, please contact us or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “Artistic Repair Of Front Teeth With Composite Resin.”
It’s been a long road with your braces, but now they’re finally off. Hopefully the first glimpse of your new smile more than made up for the time and effort they required.
But while braces removal is a big milestone, it’s not the end of your treatment—not, that is, if you want to keep that new smile! You’ll now need to wear an appliance called a retainer for a few years or, in some cases, from now on.
Orthodontic retainers are a must after braces for the same reason braces work in the first place—your teeth can move. While the teeth attach to the jawbone via the roots, they’re firmly held in place by an elastic gum tissue network called the periodontal ligament. This tough but elastic tissue lies between the teeth and gums and attaches securely to both with tiny fibers.
While the ligament provides stability, it’s also dynamic—constantly remodeling to allow the teeth to move in response to biting pressure and other mouth factors. Orthodontists use this mechanism when moving teeth to better positions. The braces apply pressure on the teeth in the desired direction and the periodontal ligament responds as the teeth move.
Afterward, however, the ligament can still retain a kind of “muscle memory” for a time of the teeth’s old positions. Free of the pressure once supplied by the braces the teeth have a tendency, especially early on, to “rebound” to where they were.
A retainer helps prevent this by exerting just enough pressure to “retain” the teeth in their new positions. In the beginning this may require wearing the appliance around the clock, but you may be able later to reduce wear time to just a few hours a day. Rebounding is unpredictable, so you should continue to follow your orthodontist’s recommendations on retainer wear.
Wearing a retainer may seem like a drag, but it’s absolutely essential. Being diligent about it will help ensure that the beautiful smile you and your orthodontist worked so hard to obtain stays with you for years to come.
If you would like more information on getting a new smile through orthodontics, 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 Importance of Orthodontic Retainers.”
Tooth decay is as relentless as it is destructive, and it makes little distinction between age, gender, ethnicity or social status. Although risk levels vary from person to person, we’re all potentially in the crossfire for this harmful disease. Getting ahead of it early could save your teeth.
Tooth decay begins with oral bacteria. While feeding on dental plaque that accumulates on the teeth, bacteria multiply and produce acid as a by-product. Too much acid softens and erodes tooth enamel, which enables decay to advance deeper into the tooth.
If it isn’t stopped, decay can eventually infect and weaken the roots and bone, and ultimately lead to a lost tooth. By stopping it as early as possible before it reaches the inner pulp and root canals, we can greatly limit the damage.
Regular dental care is crucial for early detection. Here’s how we can stay ahead of developing decay during dental visits.
Visible inspection. There are visible signs a trained dentist may notice that point to tooth decay. Besides an already formed hole or cavity, we might also pick up on other unusual appearances like white spot lesions: these slight blemishes often occur in the areas of contact with other teeth, which we can treat with topical fluoride.
X-rays. This tried and true diagnostic tool has been a mainstay of dental care for nearly a century. The images they produce can indicate decay as darker spots or areas on or within the tooth that may not yet be visible to the eye. And with advances in digital processing and more streamlined equipment, we can effectively do this with a very low dosage of radiation exposure.
Advanced technology. We’ve developed other means for better disease detection that complement x-rays and visual inspections. Specialized microscopes and lasers are now important tools for analyzing suspected areas of early decay.
Even if decay gets a foothold we can effectively stop it and restore a tooth with a root canal treatment or a similar procedure. The best outcome, though, is to not allow this destructive disease to get that far. With dedicated oral hygiene and regular dental visits that uncover early decay, chances are good your teeth can remain healthy for a lifetime.
If you would like more information on fighting tooth decay, 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 “Tooth Decay: How to Assess Your Risk.”
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