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.”
“To gain something, sometimes you have to give up something else.”
No, that isn't the latest viral meme on the Internet. It's actually a practical consideration that could arise in orthodontics.
In this case, the “something” to gain is a straighter, more attractive smile; the “something” you may have to part with is a few teeth. This may be necessary if there are too many teeth on a dental arch for its capacity, a situation called crowding. A lack of space is the main reason teeth come in misaligned.
Before we can correct this, we'll need to free up space to allow for tooth movement by removing one or more of the existing teeth. The ideal candidates are those that are near to the teeth we wish to move but not highly visible. The first bicuspids are the most frequent choices for removal: they're located behind the cuspids or eyeteeth (the pointed teeth right under the eyes).
Ideally, we'll remove the target teeth some time before we apply braces to give the gums a chance to heal. At the same time we want to preserve the bone that once supported the teeth we've extracted. This is because when we chew the forces generated by the teeth stimulates bone replacement growth. When a tooth is no longer there the supporting bone doesn't receive this stimulation and may ultimately reduce in volume.
We may try to prevent this by placing a bone graft in the empty socket immediately after removing the tooth. The graft serves as a scaffold to encourage new bone to grow. Hopefully when we're ready to apply braces, the bone will be strong and healthy to handle the movement of the teeth.
As the teeth move under the influence of braces, they'll begin to fill up the space created by tooth removal. Once it's completed, the extracted teeth won't be missed — the other teeth now straightened will completely fill out the smile.
The different steps in this process must be carefully planned and executed precisely, and it will take months or even years to complete. In the end, though, this complicated bite problem can be corrected and replaced with an attractive, straight smile.
If you would like more information on correcting a poor bite, 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 Removal for Orthodontic Reasons.”
If there's anything that makes Alfonso Ribeiro happier than his long-running gig as host of America's Funniest Home Videos, it's the time he gets to spend with his family: his wife Angela, their two young sons, and Alfonso's teenaged daughter. As the proud dad told Dear Doctor–Dentistry & Oral Health magazine, "The best part of being a father is the smiles and the warmth you get from your children."
Because Alfonso and Angela want to make sure those little smiles stay healthy, they are careful to keep on top of their kids' oral health at home—and with regular checkups at the dental office. If you, too, want to help your children get on the road to good oral health, here are five tips:
- Start off Right—Even before teeth emerge, gently wipe baby's gums with a clean, moist washcloth. When the first teeth appear, brush them with a tiny dab of fluoride on a soft-bristled toothbrush. Schedule an age-one dental visit for a complete evaluation, and to help your child get accustomed to the dental office.
- Teach Them Well—When they're first learning how to take care of their teeth, most kids need a lot of help. Be patient as you demonstrate the proper way to brush and floss…over and over again. When they're ready, let them try it themselves—but keep an eye on their progress, and offer help when it's needed.
- Watch What They Eat & Drink—Consuming foods high in sugar or starch may give kids momentary satisfaction…but these substances also feed the harmful bacteria that cause tooth decay. The same goes for sodas, juices and acidic drinks—the major sources of sugar in many children's diets. If you allow sugary snacks, limit them to around mealtimes—that gives the mouth a chance to recover its natural balance.
- Keep Up the Good Work—That means brushing twice a day and flossing at least once a day, every single day. If motivation is an issue, encourage your kids by letting them pick out a special brush, toothpaste or floss. You can also give stickers, or use a chart to show progress and provide a reward after a certain period of time. And don't forget to give them a good example to follow!
- Get Regular Dental Checkups—This applies to both kids and adults, but it's especially important during the years when they are rapidly growing! Timely treatment with sealants, topical fluoride applications or fillings can often help keep a small problem from turning into a major headache.
Bringing your kids to the dental office early—and regularly—is the best way to set them up for a lifetime of good checkups…even if they're a little nervous at first. Speaking of his youngest child, Alfonso Ribeiro said "I think the first time he was really frightened, but then the dentist made him feel better—and so since then, going back, it's actually a nice experience." Our goal is to provide this experience for every patient.
If you have questions about your child's dental hygiene routine, call the office or schedule a consultation. You can learn more in the Dear Doctor magazine article “How to Help Your Child Develop the Best Habits for Oral Health.”
Whether you live in the snow belt or the sunny south, the winter season often means a change in the weather. In many places, the sun isn't as strong and cooler temperatures bring relief from the summer's heat. Yet even though it may be chillier outside, your body's need for hydration is the same as it was in the summer—and a lack of proper hydration can be bad news for your oral hygiene.
Everyone knows we need to drink plenty of water every day to stay healthy. It's important for good oral hygiene because water is the major component of saliva, which fights bacteria and helps neutralize the acids that cause tooth decay. Water also keeps the soft tissues of the mouth moist and healthy, and helps fight bad breath. In many communities tap water is fluoridated, which offers proven protection against cavities.
But in the middle of winter, fewer people carry around bottles of cold water for refreshment—and that's a shame, because we need it just as much! While indoor (and outdoor) air is often drier in winter, your body continues to lose water in the same ways. And if you keep up a healthy exercise routine (like jogging, snow sports or backyard fun and games), you still need plenty of hydration. An ice-cold glass of water may not be as appealing in January as in July…but it's just as important.
Of course, the water you drink doesn't have to be freezing cold to do its job. Hot tea (especially herbal tea) can be a healthy option for wintertime hydration. So is plain water without ice. Fruits and vegetables also contain lots of water, plus vitamins, fiber, and many more substances that are good for your body.
But there are some drinks you should avoid—or at least take in moderation. Regularly drinking coffee and tea can stain your teeth, and excessive caffeine may have negative health effects. Consuming alcoholic beverages can cause dry mouth, and may increase the risk of oral cancers. And, of course, drinks that contain sugar (including soda, some juices, and many coffee and hot chocolate beverages) are linked not only to tooth decay, but to other health problems as well.
And whatever the season, don't forget to come in to the dental office for regular checkups and cleanings. We can remove the sticky tartar that clings to your teeth and may cause tooth decay and other problems. We will also perform a complete dental exam, evaluate your oral health and help resolve small problems before they turn into big headaches (or toothaches). Working together, we can help you enjoy the benefits of good oral hygiene all though the year.
If you would like more information on oral hygiene, please contact us or schedule a consultation. You can learn more by reading the Dear Doctor magazine articles “10 Tips For Daily Oral Care at Home” and “Think Before You Drink.”
A couple of years ago the Associated Press published an article claiming the health benefits of flossing remained unproven. The article cited a number of studies that seemed to conclude the evidence for the effectiveness of flossing in helping to prevent dental disease as “weak.”
As you can imagine, dental providers were a bit chagrined while flossers everywhere threw away their dental floss and happily declared their independence from their least favorite hygiene task. It would have seemed the Age of Flossing had gone the way of the dinosaurs.
But, the demise of flossing may have been greatly exaggerated. A new study from the University of North Carolina seems to contradict the findings cited in the AP article. This more recent study looked at dental patients in two groups—those who flossed and those who didn’t—during two periods of five and ten years respectively. The new study found conclusively that the flosser group on average had a lower risk of tooth loss than the non-flossers.
While this is an important finding, it may not completely put the issue to rest. But assuming it does, let’s get to the real issue with flossing: a lot of people don’t like it, for various reasons. It can be time-consuming; it can be messy; and, depending on a person’s physical dexterity, difficult to perform.
On the latter, there are some things you can do to make it a less difficult task. You can use a floss threader, a device that makes it easier to thread the floss through the teeth. You can also switch to an oral irrigator or “water flosser,” a pump device that sprays a fine, pressurized stream of water to break up plaque between teeth and flush most of it away. We can also give you tips and training for flossing with just your fingers and thread.
But whatever you do, don’t give up the habit. It may not be your most favorite hygiene task but most dentists agree it can help keep your teeth healthy for the long-term.
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