Posts for: June, 2012
Of all the of amazing procedures in today's dentistry, surgery that causes new bone to grow — in places where it had previously been lost — is high on the list of the most extraordinary. (When bone is lost or resorbed, it is broken down into its mineral components, which are dissolved into the bloodstream. Resorption of tooth-supporting bone often takes place after teeth are lost.) Dental techniques that cause new bone growth are important because a certain amount of bone is needed to replace lost teeth with dental implants.
Today's dental implants themselves are an amazing innovation. Implants consist of a replacement for the tooth's root, usually made of a metal called titanium. A replacement for the crown, the part of the tooth that is visible above the gums, is attached to the titanium root. Titanium has the remarkable quality of being able to fuse with the bone in which it is anchored. This process, first discovered in the 1950s, is called osseointegration.
In the case of missing upper back teeth, many people who wanted dental implants in the past were told that they did not have enough bone to anchor the implants and that they had to get removable dentures instead.
But now a new surgery called maxillary sinus augmentation can cause your body to regenerate bone where it was lost and is needed to anchor dental implants.
Bone in the upper jaw or maxilla usually supports your upper back teeth. Inside the maxilla, on either side of your upper jaw, are air spaces in the bone, which are lined with a membrane. These spaces, called the maxillary sinuses, are generally shaped like pyramids; but their shape and size is different in each person. The new surgical procedures involve lifting up the sinus membrane in the area where bone is needed and filling the space thus created with a bone grafting material. Your body then creates new bone to fill the space. This usually takes about six months. If you have almost enough bone to stabilize the implants, they can be placed simultaneously with the graft, thus saving time and avoiding a second surgical procedure.
All grafting materials used today are approved by the Food and Drug Administration (FDA) and must be prepared according to their guidelines. They are specially treated to render them completely safe for human use.
After the surgery there is usually no more than mild to moderate swelling and some discomfort, about the same as having a tooth removed.
If you are missing upper back teeth, contact us to schedule an appointment to evaluate your upper jaw. You can also learn more about this procedure by reading the Dear Doctor magazine article “Sinus Surgery.”
You probably know that tooth decay results when the bacteria in your mouth release acids after consuming sugars. After you eat sugars, particularly the type of sugar known as sucrose, increased acid in your mouth begins to dissolve the enamel and dentin in your teeth, and you end up with cavities.
What are the Types of Sugars?
Modern diets include several types of sugars. Most of these are fermented by oral bacteria, producing acids that are harmful to teeth.
- Sucrose (commonly known as sugar)
- Glucose (released from starch consumption)
- Lactose (milk sugar) — Less acid is produced from this type of sugar
- Fructose (found naturally in fruit and also added to many processed foods)
Recommended intake of “free sugars” is no more than 10 teaspoons per day. Note that a can of soda contains over 6 teaspoons! Soft drinks are the largest source of sugar consumption in the U.S. In 2003, for example, Americans drank an average of 52 gallons of soft drinks. Average per capita consumption of all sugars in the U.S. was 141.5 pounds (64.3 kg) one of the highest levels in the world.
Sugar substitute xylitol (which is chemically similar to sugar but does not cause decay) can be part of a preventive program to reduce or control tooth decay. Chewing gum sweetened with xylitol stimulates saliva flow and helps protect against decay.
Sugars Released from Starches
Starches are foods like rice, potatoes, or bread. When you eat refined starches, such as white bread and rice, enzymes in your saliva release glucose. However, these foods have a lower potential to produce decay than foods with added sugars. When sugars are added to starchy foods, as in baked products and breakfast cereals, the potential for decay increases.
Less refined starches such as whole grains require more chewing and stimulate secretion of saliva, which protects from harmful acids.
The Case for Fruit
Fresh fruit has not been shown to produce cavities, so it makes sense to eat them instead of sugary desserts and snacks. Dried fruit is more of a problem because the drying process releases free sugars.
Even with modern knowledge about oral health and how to prevent tooth decay and gum disease, more than 25 percent of Americans have lost all their teeth by the time they are 65. Perhaps they did not have access to dental education, quality care or treatment. Whatever the reasons, those who suffer from “edentulism” — the complete loss of all permanent teeth — also suffer from poor self-image, impaired nutrition, and reduced quality of life.
Removable full dentures are often the solution of choice for those suffering from edentulism. Dentures can be made to look good and feel great; but successful denture-wearing demands the collaboration of a skilled dentist and a willing patient.
A set of well-fitting full removable dentures starts with detailed planning. We need to work out where each tooth will be placed and how the upper and lower teeth will meet together. To do this, we make use of photos taken before the teeth were lost, as well as using the facial features as a guide. You as the patient have to decide whether you want your dentures to look much like your natural teeth did, including any gaps and uneven areas, or whether you want to make your new teeth more regular and uniform than the originals.
In addition to the size, spacing and locations of the teeth, decisions must be made regarding the colors and textures of the part of the denture that fits over and looks like gum tissue. Photos can help with this aspect as well. Ridges can be added to the section of the denture behind the upper front teeth to aid in natural speaking and chewing.
The upper and lower dentures must be designed so that in the process of biting they stabilize each other. This is called “balancing the bite.” This is necessary for normal function and speech.
All this careful planning and design are only the beginning. The dentures will be created in a wax form, tested and modified. They are then completed in a dental laboratory, where the new teeth and gums are created out of a special plastic called methyl methacrylate. With careful planning, skill and artistry they are made to look like natural teeth and gums.
At this point the role of the denture wearer becomes vitally important. He or she must relearn how to bite, chew, and speak while wearing the dentures. As the dentures press down on bone and gum tissues, over time some bone will be lost. This will require coming in for frequent checkups and modifications to make sure the dentures continue to fit well and comfortably.