Dental implant technology has advanced at such an astounding rate in recent years that you can now walk into a dentist's office with a problem tooth and out the same day with a new one. Unfortunately, not all dental situations allow for this possibility.
For example, you might be considering an implant many years after losing a tooth. But there's a potential problem: there might not be enough supporting bone. While an implant might still be possible, inadequate bone complicates the matter.
Because implants are essentially tooth root replacements, they require a certain amount of bone for stability and the best attractive outcome. As a general rule, implants need to be surrounded by at least 1.5-2.0 millimeters of healthy bone to support an implant. But you might not have enough if your tooth has been missing for awhile, regardless if you have or haven't worn dentures or other restorations.
That's because bone has a life cycle in which older cells die and newer ones form to take their place. As we chew or bite, the force generated travels up through the teeth to the bone to stimulate this new growth. Without a tooth the bone doesn't receive this stimulus, which can slow the growth rate. Over time the affected bone can lose its volume and density.
If we find you've experienced loss to the point your bone won't support an implant, that doesn't automatically mean this popular restoration is out of the picture. But it will require us first performing a procedure known as augmentation or bone grafting to help rejuvenate some of the lost bone.
With grafting, we place processed bone grafting material in the jaw through a minor surgical procedure to form a scaffold for new bone to grow upon. After several months this can result in several millimeters of new growth maintaining the width of the underlying bone, which in turn may be able to support an implant.
Bone grafting is quite common, often performed at the same time as tooth extraction if there's going to be a time lag before installing an implant. Even if performed later, though, it can successfully rejuvenate lost bone and make it possible for you to take advantage of durable, life-like implants.
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 Implants after Previous Tooth Loss.”
Since the late 19th Century, dentists have used established protocols to successfully prevent and treat tooth decay. But there've been changes to this approach the last few years to improve its effectiveness, changes we now refer to as Minimally Invasive Dentistry or MID.
The older approach for treating dental caries (tooth decay) follows the protocols established by Dr. G.V. Black, considered the father of modern dentistry. Black advocated removing not only decayed structure but also some of the healthier but vulnerable portions of a tooth, to avoid further decay and make the tooth easier to clean. This resulted in larger fillings, although they've become smaller as dental techniques have advanced.
MID, on the other hand, aims to remove as little tooth structure as possible while still effectively treating and preventing future decay. To achieve that goal we begin first with a complete assessment of a patient's individual decay risk, known as Caries Management By Risk Assessment (CAMBRA).
With CAMBRA, we're looking at other factors besides individual tooth health: a patient's hygiene, lifestyle and dietary habits; the types and amount of bacteria present; and the quality of saliva flow, needed to neutralize mouth acid. With these the results we develop a customized prevention and treatment strategy.
MID also focuses on detecting dental caries as early as possible. Besides traditional x-rays, we're beginning to use other methods like dental microscopes, laser fluorescence, infrared photography or optical scanning. Early detection leads to early intervention, and with techniques that are much less invasive than the traditional approach.
The new approach also changes how we repair decayed teeth. We're increasingly using air abrasion, a technology that uses fine particles in a pressurized air stream to remove softer decayed tooth material and less healthy structure than the traditional dental drill. We're also using composite resin and other advanced materials for filings: these tooth-colored materials are stronger than previous versions and are quickly taking the place of metal amalgam, requiring less structural removal to accommodate them.
MID's core principles are early disease detection, proactive prevention and treatment with less structural removal. With this enhanced approach to effective dentistry, we're keeping your teeth healthy with minimal discomfort, lower costs and less long-term impact.
For a lifetime of healthy teeth and gums, it takes a lifetime of personal and professional care. Starting your child’s daily hygiene with the first tooth eruption is a must; but you should also consider beginning regular dental visits in their early years, around or before their first birthday.
There’s evidence that early dental visits hold a number of benefits that could lead to reduced oral care costs over their lifetime.
Familiarity with professional dental care. Children need to feel comfortable and safe in their surroundings, especially new places. Beginning dental visits early improves the chances your child will view the dentist’s office as a regular part of their life. It’s especially helpful if the dental professional has training and experience with young children to put them at ease.
Early monitoring for dental disease or other problems. A young child’s teeth are highly susceptible to tooth decay. Dental visits that begin early in a child’s life increase our chances of detecting any developing dental problems early. In addition to treating decayed teeth, your child may also need preventative actions like sealants or additional fluoride applications to protect teeth if they are at a higher risk for disease. As the child develops, we may also be able to catch early bite problems: with interventional treatment, it may be possible to reduce future orthodontic costs.
Parental help and support. As we discuss your child’s dental care with you, we’ll be able to provide essential information and training for how to care for their teeth and gums at home. We’ll also be able to ease any common concerns you may have, such as thumb sucking or other oral habits, as well as give you sound advice and techniques for dealing with these problems.
As with other areas of childhood development, starting off on the right foot with oral care can make all the difference to their future dental health. The sooner you begin regular dental visits with your toddler, the better their chances for a lifetime of healthy teeth and gums.
If you would like more information on dental care for children, 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 “Taking the Stress out of Dentistry for Kids.”
The long-running hit show Dancing with the Stars has had its share of memorable moments, including a wedding proposal, a wardrobe malfunction, and lots of sharp dance moves. But just recently, one DWTS contestant had the bad luck of taking an elbow to the mouth on two separate occasions—one of which resulted in some serious dental damage.
Nationally syndicated radio personality Bobby Bones received the accidental blows while practicing with his partner, professional dancer Sharna Burgess. “I got hit really hard,” he said. “There was blood and a tooth. [My partner] was doing what she was supposed to do, and my face was not doing what it was supposed to do.”
Accidents like this can happen at any time—especially when people take part in activities where there’s a risk of dental trauma. Fortunately, dentists have many ways to treat oral injuries and restore damaged teeth. How do we do it?
It all depends on how much of the tooth is missing, whether the damage extends to the soft tissue in the tooth’s pulp, and whether the tooth’s roots are intact. If the roots are broken or seriously damaged, the tooth may need to be extracted (removed). It can then generally be replaced with a dental bridge or a state-of-the-art dental implant.
If the roots are healthy but the pulp is exposed, the tooth may become infected—a painful and potentially serious condition. A root canal is needed. In this procedure, the infected pulp tissue is removed and the “canals” (hollow spaces deep inside the tooth) are disinfected and sealed up. The tooth is then restored: A crown (cap) is generally used to replace the visible part above the gum line. A timely root canal procedure can often save a tooth that would otherwise be lost.
For moderate cracks and chips, dental veneers may be an option. Veneers are wafer-thin shells made of translucent material that go over the front surfaces of teeth. Custom-made from a model of your smile, veneers are securely cemented on to give you a restoration that looks natural and lasts for a long time.
It’s often possible to fix minor chips with dental bonding—and this type of restoration can frequently be done in just one office visit. In this procedure, layers of tooth-colored resin are applied to fill in the parts of the tooth that are missing, and then hardened by a special light. While it may not be as long-lasting as some other restoration methods, bonding is a relatively simple and inexpensive technique that can produce good results.
If you would like more information about emergency dental treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor articles “The Field-Side Guide to Dental Injuries” and “Knocked Out Tooth.”
The American marketplace usually offers us plenty of buying choices — sometimes it seems too many. A case in point: the toothpaste aisle at your local supermarket.
It can be a bit overwhelming with all the razzle-dazzle packaging and exciting claims of “Whiter Teeth!” or “Fresher Breath!” But toothpaste really isn't that complicated, if you keep in mind its primary goal: to help you with your toothbrush remove disease-causing plaque from teeth surfaces.
And the vast majority can, thanks to ingredients you'll find in just about every brand. All toothpastes, for example, contain some form of abrasive material that boosts the mechanical action of brushing to remove plaque. This isn't new: the ancient Egyptians used ox-hoof ashes, burnt eggshells and pumice as abrasives. Today you'll find hydrated silica (originating from sand), hydrated alumina or calcium carbonate as abrasives on the ingredient list.
You also need some form of detergent to help loosen and break down substances that won't dissolve in water. Toothpaste detergent is much milder than that which you use on your dishes. The most common is sodium lauryl sulfate, a foaming agent found in shampoo and other beauty products. It's been used safely for half a century in toothpaste, although it can irritate the inner linings of some people's mouths. If this is a problem for you, you should look for toothpaste with a different detergent.
There is also a myriad of other ingredients, including binders, humectants (which help the toothpaste retain moisture) and flavorings. You may also find bleaching agents that help brighten your teeth, although they may not be strong enough to remove deep staining, something we would need to help you with.
And let's not forget one other frequent ingredient: fluoride. This natural chemical strengthens enamel and helps fight tooth decay as part of a disease prevention strategy. It's perhaps the most valuable ingredient you'll find in toothpaste, so make sure it's in your chosen brand.
If you want to simplify your decision, choose toothpaste with the seal of acceptance from the American Dental Association. The seal indicates the claims of the toothpaste manufacturer have been independently verified. You can trust those brands to help keep your teeth clean and free from disease. In the end, that's really what you want from your toothpaste.
If you would like more information on the right toothpaste for you, 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 “Toothpaste: What's in it?”
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