You’ve probably heard a lot about dental implants as replacements for missing teeth. So, why are they so popular with both patients and dentists? While other restorations can mimic the color, shape and texture of natural teeth, dental implants have one clear advantage — and it’s all about the bone.
The bone in your jaws provides stability and structure for teeth — without it and the intricate system of gum tissue attachments teeth couldn’t survive the normal biting and chewing forces they encounter every day. That’s why bone health is crucial for maintaining tooth integrity.
Teeth also help bone to remain strong and healthy. The forces we generate as we chew transmit through the tooth roots to the bone, which stimulates continuing growth. If a tooth is missing, however, the bone around it doesn’t receive this stimulation and may begin to lose some of its volume and density — up to a quarter of its width in just the first year after tooth loss.
This bone loss continues even with other restorations because they’re not able to stimulate bone growth. But dental implants can. This is because the portion of the implant imbedded into the bone is constructed most often of titanium, which has a natural affinity toward bone. Bone cells are naturally attracted to titanium and will begin to grow and attach to the metal surface, a process known as osseointegration.
Through osseointegration, the implant develops a durable bond with the jawbone a few weeks after surgery that surpasses other restorations, and is a prime reason for their success rate. Although installing implants can be an expensive undertaking, their proven longevity may result in less maintenance, repair or replacement costs over time than other replacement options.
If you’re considering dental implants, remember it’s what you can’t see beneath the attractive crown that makes them special. And it’s a choice you can depend on to provide you a beautiful smile for years to come.
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.”
On the way to adulthood, permanent teeth steadily erupt until, if all goes normally, you have a full set of teeth. Sometimes, though, one or more teeth may fail to form. This not only can affect your dental health, but it could also diminish your smile.
For example, if the lateral incisors on either side of the central incisors (the two teeth front and center) don't develop, it could create a smile that's “not quite right.” But we can vastly improve such a smile in one of three unique ways.
The first is to fill the resulting gap through canine substitution. This is an orthodontic method in which we use braces to move the pointed canine teeth, which normally position on the other side of the missing laterals, closer to the central incisors. This choice is determined by the size of the canine teeth. If they are slim in width, they can be re-shaped to make them appear more like a lateral incisor, and the gums possibly reshaped as well around them through cosmetic surgery.
We can also install a dental bridge, an appliance that fills the missing lateral space with prosthetic teeth. A traditional bridge requires the teeth on either side of the gap to be reduced in size, which becomes a permanent alteration to accommodate these crowns. This is a disadvantage in a young person. We can also use a “bonded bridge” which uses adhesives to attach extended pieces (or “wings”) of dental material from either side of the prosthetic tooth to one or more supporting teeth. These wings are behind the permanent teeth. Though not as durable as a traditional bridge, it does avoid altering the support teeth.
Finally, we can replace the missing teeth with dental implants. In this method, we install titanium metal posts into the jawbone at the missing tooth locations and then attach a life-like crown to each one. Implants may be more costly than other restorative methods and can take several months to complete. But they are life-like, highly durable, and don't require any alteration to other teeth. A disadvantage is that you should wait until at least 19 years of age to consider this option. What many people do is use a temporary solution until the proper age to do a dental implant.
Each of these methods have their advantages and disadvantages, which should be thoroughly reviewed in consultation with your dentist. And each may also require other dental work, such as initial orthodontics to open adequate space for a restoration. But any of these methods for correcting a missing lateral tooth can be effective and help restore both a healthier mouth and a more attractive smile.
If you would like more information on treating congenital dental defects, 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 “When Permanent Teeth Don't Grow.”
Professional Hockey player Keith Yandle is the current NHL “iron man”—that is, he has earned the distinction of playing in the most consecutive games. On November 23, Yandle was in the first period of his 820th consecutive game when a flying puck knocked out or broke nine of his front teeth. He returned third period to play the rest of the game, reinforcing hockey players’ reputation for toughness. Since talking was uncomfortable, he texted sportswriter George Richards the following day: “Skating around with exposed roots in your mouth is not the best.”
We agree with Yandle wholeheartedly. What we don’t agree with is waiting even one day to seek treatment after serious dental trauma. It was only on the following day that Yandle went to the dentist. And after not missing a game in over 10 years, Yandle wasn’t going to let a hiccup like losing, breaking or cracking nearly a third of his teeth interfere with his iron man streak. He was back on the ice later that day to play his 821st game.
As dentists, we don’t award points for toughing it out. If anything, we give points for saving teeth—and that means getting to the dentist as soon as possible after suffering dental trauma and following these tips:
- If a tooth is knocked loose or pushed deeper into the socket, don’t force the tooth back into position.
- If you crack a tooth, rinse your mouth but don’t wiggle the tooth or bite down on it.
- If you chip or break a tooth, save the tooth fragment and store it in milk or saliva. You can keep it against the inside of your cheek (not recommend for small children who are at greater risk of swallowing the tooth).
- If the entire tooth comes out, pick up the tooth without touching the root end. Gently rinse it off and store it in milk or saliva. You can try to push the tooth back into the socket yourself, but many people feel uneasy about doing this. The important thing is to not let the tooth dry out and to contact us immediately. Go to the hospital if you cannot get to the dental office.
Although keeping natural teeth for life is our goal, sometimes the unexpected happens. If a tooth cannot be saved after injury or if a damaged tooth must be extracted, there are excellent tooth replacement options available. With today’s advanced dental implant technology, it is possible to have replacement teeth that are indistinguishable from your natural teeth—in terms of both look and function.
And always wear a mouthguard when playing contact sports! A custom mouthguard absorbs some of the forces of impact to help protect you against severe dental injury.
If you would like more information about how to protect against or treat dental trauma or about replacing teeth with dental implants, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Dental Implants: A Tooth-Replacement Method That Rarely Fails” and “The Field-Side Guide to Dental Injuries.”
Each year millions of people endure repeated episodes of congestion, coughing and headaches, all the miseries that come with a sinus infection. Although it seems like all the action is occurring around the nose and upper face, the actual cause could be emanating from somewhere else—your teeth.
It can all begin with decay forming a small cavity in one of the upper back teeth. If it isn't caught and treated early, the decay can spread into the tooth pulp and root canals, tiny passageways to the root and bone. This may or may not cause a severe toothache or sensitivity as the tooth's nerves respond to the infection. These nerves, though, most often eventually die and the pain, if present, will subside—but not the infection.
Left untreated, the infection may then advance into the bone around the root tip, breaking it down and giving bacteria an entryway into the floor of the maxillary sinus that rests just above the upper jaw. Here bacteria can take up residence, occasionally flaring into a sinus infection. This chronic infection could go on for years with allergies mistakenly taking the blame.
If you have frequent bouts of sinusitis, a possible dental connection may be worth investigating. And in the dental profession, there may be no better “detective” for this than an endodontist. Specializing in interior tooth problems and treatments, an endodontist has the diagnostic equipment like CT or 3-D cone beam scanning to accurately image the teeth and upper jaw. With their advanced diagnostics, they're in the best position to uncover hidden tooth decay contributing to sinus problems.
Endodontists are also skilled in treating advanced tooth decay. The main procedure is known as root canal treatment, in which the dentist drills into the tooth's interior to remove infected tissue from the pulp and root canals. They then fill these empty spaces, seal and then crown the tooth for added protection.
After treatment and following up with your physician, you may find your sinus infections are less frequent. And by promptly seeking treatment at the first sign of tooth pain or sensitivity, you might prevent chronic sinusitis from even developing.
If you would like more information on how dental disease can affect overall health, 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 “Sinusitis and Tooth Infections.”
Tooth decay is more prevalent than diseases like cancer, heart disease or influenza. It doesn't have to be—brushing with fluoride toothpaste, flossing, less dietary sugar and regular dental cleanings can lower the risk of this harmful disease.
Hygiene, diet and dental care work because they interrupt the disease process at various points. Daily hygiene and regular dental cleanings remove dental plaque where oral bacteria flourish. Reducing sugar eliminates one of bacteria's feeding sources. With less bacteria, there's less oral acid to erode enamel.
But as good as these methods work, we can now take the fight against tooth decay a step further. We can formulate a prevention strategy tailored to an individual patient that addresses risk factors for decay unique to them.
Poor saliva flow. One of the more important functions of this bodily fluid is to neutralize mouth acid produced by bacteria and released from food during eating. Saliva helps restore the mouth's ideal pH balance needed for optimum oral health. But if you have poor saliva flow, often because of medications, your mouth could be more acidic and thus more prone to decay.
Biofilm imbalance. The inside of your mouth is coated with an ultrathin biofilm made up of proteins, biochemicals and microorganisms. Normally, both beneficial and harmful bacteria reside together with the “good” bacteria having the edge. If the mouth becomes more acidic long-term, however, even the beneficial bacteria adapt and become more like their harmful counterparts.
Genetic factors. Researchers estimate that 40 to 50 hereditary genes can impact cavity development. Some of these genes could impact tooth formation or saliva gland anatomy, while others drive behaviors like a higher craving for sugar. A family history of tooth decay, especially when regular hygiene habits or diet don't seem to be a factor, could be an indicator that genes are influencing a person's dental health.
To determine if these or other factors could be driving a patient's higher risk for tooth decay, many dentists are now gathering more information about medications, family history or lifestyle habits. Using that information, they can introduce other measures for each patient that will lower their risk for tooth decay even more.
If you would like more information on reducing your risk of 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 “What Everyone Should Know About Tooth Decay.”
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