Posts for: October, 2015
Dental implants are the ideal tooth replacement with their life-like appearance, high success rate and durability. If you have significant dental issues, they may seem like the perfect answer. But before you choose to replace a problem tooth with an implant, it might be to your benefit — financially and health-wise — to consider saving the tooth first.
Tooth decay can be a formidable enemy, destroying both tooth structure and the tooth’s connectivity to the jaw. But there are treatment options even for heavily decayed teeth, including cavity filling with composite resins or porcelain that look and function like natural teeth. For decay deep within a tooth’s interior, root canal therapy can rid the pulp chamber and root canals of decay and seal them from future occurrences. The treatment’s success rate is comparable to and less expensive than implants.
While decay damage can be significant, adult teeth are more at risk from periodontal (gum) disease, a gum infection caused by bacterial plaque on tooth surfaces. This disease can weaken gum tissues until they eventually detach from the teeth and lead to loss. Gum disease, though, can often be brought under control by techniques called scaling and root planing that deep clean tooth and root surfaces of plaque and calculus (hardened plaque deposits).
Scaling may require multiple sessions and will require a greater effort from the patient in performing daily oral hygiene and visiting the dentist regularly to closely monitor gum health. And more advanced cases may require surgery to access deep pockets of infection or repair damaged tissues. But even with this effort, treating gum disease rather than replacing a tooth could be much less costly — and you’ll be able to preserve your own teeth.
On the other hand, the disease process may have gone on too long and caused too much damage for the tooth to be saved. In these cases, the best option is to remove it and install a restoration like an implant. By first completing a complete dental examination, we’ll be better able to advise you whether your best course is a “tooth rescue” or a replacement.
Maybe you don’t like to be without teeth — ever. Or maybe you get a little forgetful sometimes. Whatever the reason, if you’re wearing your dentures to bed at night, we have one message for you: Please stop!
Sleeping in dentures can have serious health consequences. A recent study published in the Journal of Dental Research found that nursing home residents who wore their dentures to sleep were 2.3 times more likely to be hospitalized or even die of pneumonia as those who did not sleep in dentures. But how can wearing dentures at night more than double your chances of getting a lung infection?
As the study noted, pneumonia-causing bacteria can readily be moved from the mouth to the lungs simply by breathing. And dentures that are not removed at night can become breeding grounds for all kind of bacteria and fungi (such as yeast). That’s what makes them potentially dangerous.
Another condition often seen in people who wear upper dentures continually is called denture stomatitis, which is characterized by a red, inflamed palate (roof of the mouth) that has been infected with yeast. The yeast microorganisms can also infect cracked corners of the mouth, a condition known as angular cheilitis. Moreover, it has also been shown that people who sleep in dentures have higher blood levels of a protein called interleukin 6, which indicates that the body is fighting an infection. Need we go on?
Wearing dentures is supposed to improve your quality of life, not reduce it. So promote good health by taking your dentures out at night, and sticking to a good daily oral hygiene routine:
- Remove and rinse your dentures after every meal.
- Brush your dentures at least once a day with a soft toothbrush or denture brush and dish soap, liquid antibacterial soap, or denture cleanser (but don’t use toothpaste — it is too abrasive).
- Store your dentures in water or a solution made for this purpose.
- Brush your gums and tongue every day with a soft toothbrush (not the same one you clean your dentures with).
- Rinse your dentures in clean water before you put them back in your mouth.
Semi-annual office cleanings are important for keeping teeth healthy and disease-free. If you’ve replaced some of your teeth with dental implants, though, you may be thinking they don’t need as much attention from your hygienist.
It’s quite the opposite — cleaning around implants is important, and actually requires additional attention. The reason for this relates to both how dental implants attach to the jaw and their constructive materials.
Natural teeth are held in place by the periodontal ligament with tiny fibers that attach to the teeth on one side of it and to the jawbone on the other. The ligaments and the gingival (gum) fibers (which are also attached to the tooth) provide some disease resistance to the teeth through its rich blood vessel and collagen network. Dental implants, on the other hand, anchor directly into the jawbone. The titanium integrates with the bone, which naturally attracts to the metal and grows around it, which provides the implant’s eventual attachment strength. The implant doesn’t attach to the gum tissue and won’t develop the same relationship with the periodontal ligament as natural teeth.
Bacterial plaque, the primary cause for tooth decay and periodontal (gum) disease, can collect on an implant crown just as readily as on a natural tooth. Although the materials that make up an implant can’t be affected by a plaque-induced infection, the gum tissues and supporting bone around it can. In fact, because implants lack the disease resistance of the gingival fibers and the ligament attachment, an infection can turn rapidly into a condition known as peri-implantitis that could cause bone and tissue loss and lead to the loss of the implant.
Your hygienist understands the importance of removing plaque and calculus (hardened plaque deposits) from around your dental implant. This often calls for different instruments made of plastics or resins that won’t scratch the implant’s highly polished surface. Scratches provide a haven for bacteria to collect and make it more difficult to dislodge them. Likewise, if the hygienist uses ultrasonic equipment that loosens plaque through vibration, the hygienist will often use nylon or plastic tips to minimize damage to the implant.
And don’t forget your own personal hygiene habits — they’re just as important with dental implants as with natural teeth. Keeping plaque under control, both at home and with your dentist, is crucial to longevity for your dental implants.
If you would like more information on maintaining and cleaning 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.”
Dental implants are popular with both patients and dentists for their durability and likeness to natural teeth. That natural look, though, can be difficult to attain, especially in what’s known as the “smile zone” — the area of the mouth where teeth are most visible when you smile.
Our biggest concern is the upper front teeth, where the gums are most visible, especially if you smile widely. It takes considerable skill, experience and artistry to position implants in this area so that they appear to naturally emerge from the gums and blend well with other teeth.
To obtain that natural look, we must first assess whether or not there’s enough bone present, which tends to dissolve (resorb) when a tooth is missing, to sufficiently anchor the implant in the right position. There also needs to be sufficient bone around adjacent teeth to support the tiny triangles of gum tissue between teeth called papillae. Without the papillae an unattractive black hole may result between the implant and an adjacent tooth or implant.
Another factor we must consider is the type of gum tissue you have. Everyone generally inherits one of two types of tissue from their parents: thin or thick. The type you have can influence the way the implant appears to emerge from the gums. If you have thick gums, they’re easier to work with and can cover more of the implant. Thinner tissues aren’t quite as easy and are less forgiving if an implant isn’t placed as precisely as possible.
In recent years, improvements in implant design have sought to provide greater stability around bone and gum tissues to offset some of the issues we’ve mentioned. A variation on the design of the top of the implant (where the crown is attached) changes the direction of growth for gum tissues from a horizontal orientation to a vertical one, which can help with the final appearance.
The first step, if you’re considering dental implants for a tooth in the smile zone, is to visit us for a complete examination to see if any of these factors may have an impact on your situation. We can then advise you on the best course of action to achieve the most attractive smile possible.
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 “Implant Aesthetics.”
Periodontal (gum) disease, a bacterial infection caused by plaque, is one of the most prevalent and destructive dental conditions. Left untreated it can eventually lead to tooth and bone loss.
Although people are often unaware they have gum disease, there are a few warning signs to look for. Here are five gum disease signs that should prompt a dental visit.
Gum Swelling and Redness. Like all infections, gum disease triggers an immune system response that releases antibodies into the gums to attack the bacteria. The ensuing battle results in inflammation (swelling) and a darker redness to the gum tissues that don’t lessen with time.
Gum Bleeding. It isn’t normal for healthy gum tissue, which are quite resilient, to bleed. In a few cases, bleeding may indicate over-aggressive brushing, but more likely it means the tissues have weakened to such an extent by infection they bleed easily.
Tooth Sensitivity. If you notice a shot of pain when you eat or drink something hot or cold or when you bite down, this could mean infected gums have “drawn back” (receded) from the teeth. Gum recession exposes the tooth roots, which are more sensitive to temperature and pressure changes in the mouth.
An Abscess. As weakened gum tissues detach from the tooth, the normally thin gap between them and the tooth deepens to form a void known as a periodontal pocket. This often results in an abscess where pus collects in the pocket and causes it to appear more swollen and red than nearby tissues. An abscess needs immediate attention as bone loss is greatly accelerated compared to normal gum disease.
Tooth Looseness or Movement. As diseased gum tissue causes loss of gum and bone attachment, the affected teeth will start to feel loose or even move to a different position. This is a late and alarming sign of gum disease — without immediate intervention, you’re in danger of losing the tooth.
If you encounter any of these signs, contact us for an examination as soon as possible. The sooner we can diagnose gum disease and begin treatment, the less damage it will cause — and the better your odds of regaining healthy teeth and gums.
If you would like more information on gum disease, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Warning Signs of Periodontal (Gum) Disease.”