Posts for: October, 2014
Dental implants are considered the premier option for tooth replacement. While all implant procedures follow the same general concept — a titanium post surgically inserted into the jawbone with an attached life-like crown — the installation process can vary.
From their earliest history, implants have usually been installed through a two-stage process. In the first stage, the surgeon inserts the titanium post in the bone and leaves it “submerged” below the gum level to protect it from oral bacteria and the effects of chewing and biting. About three months later after the bone attaches to the titanium (a process called osseointegration), the surgeon then performs the second stage by re-exposing the implant and attaching a temporary abutment and crown for the patient to wear while the permanent abutment and crown are fabricated and later attached in 2-6 weeks.
In recent years, advancements in materials and design have made possible a one-stage process that allows the implant to protrude above the gum line during osseointegration and shortens the process. After the initial three-month healing period, the implant is ready for “loading” with the permanent crown.
The choice between which of these two procedures should be used for your implants will first depend on the type of tooth being replaced. A front tooth benefits from the one-stage procedure for cosmetic reasons because the surgeon can install a temporary crown to the exposed abutment during osseointegration (as long as the temporary tooth isn’t in functional contact with other teeth). An implant for a back tooth, on the other hand, doesn't have a large cosmetic demand so those one stage procedures usually end up with an exposed healing abutment but no temporary crown.
The strength of the bone is also a factor. Some bone tends to be softer, particularly in the back of the mouth. There’s a chance the implant could move in this softer bone, adversely affecting the outcome. For this reason, the two-stage procedure can be the preferred approach for posterior teeth as it offers more protection from movement.
You can be sure we’ll consider all these and other factors during your initial examination, and then advise you on the best approach. Above all, we want to make sure — whether a one-stage or a two-stage implant process — the result is a smile you can be proud of.
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 “Staging Surgery in Implant Dentistry.”
One of our primary goals in dentistry is to deliver effective treatment to patients with the least amount of discomfort. This is especially true after a procedure — controlling pain and inflammation will actually help reduce recovery time.
There are many strong pain relievers available, including prescription opiates like morphine or codeine. It has been shown, however, that healing and comfort are enhanced with non-steroidal anti-inflammatory drugs (NSAID) because they not only minimize pain, but they also reduce inflammation after a procedure. One common NSAID is Ibuprofen, which works by blocking prostaglandins, a substance released by inflamed, damaged tissues. NSAIDs are very popular with dentists and other health professionals because they act primarily on the inflammation site and don’t impair consciousness like opiates. They’re also usually less expensive than pain medication requiring a prescription.
While relatively safe, NSAIDs do have side effects that could cause serious problems for some patients. The most common caution regards NSAID’s tendency to thin blood and reduce the natural clotting mechanism, especially if taken habitually over a period of time. They can damage the kidneys and the stomach lining (causing ulcers or dangerous bleeding), and they’ve also been linked to early miscarriages and heart attacks.
For these reasons, NSAIDs are not recommended for pregnant women, patients with a history of stomach or intestinal bleeding, or patients being treated for heart disease. In the latter case, NSAIDs may interfere with the effectiveness of low-dose aspirin therapy (another type of NSAID) to prevent future heart attacks or strokes.
Health officials recommend all patients limit their dosage of a NSAID to no more than 2400 milligrams a day for short term pain relief, unless otherwise advised by a doctor. For the most part, a single 400 mg dosage is usually sufficient for pain control during a post-procedure recovery.
Your dentist will typically obtain your medical history before you undergo a dental procedure, including the medications you’re taking. Depending on your current health status and the type of procedure you’re undergoing, your dentist will recommend a pain control regimen to follow after the procedure is over.
Following those recommendations, and alerting your healthcare provider if you encounter any side effects from pain medication, will help assure your recovery period after dental work is short, safe and uneventful.
If you would like more information on the use of NSAIDs to control discomfort after a dental procedure, 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 “Treating Pain With Ibuprofen.”
Now in your adult years, you feel you’ve functioned pretty well even with a few misaligned teeth. You may also think having them straightened at this point may not be worth the effort and expense.
But there are solid reasons — beyond, of course, the psychological and social benefits gained from a new smile — why straightening teeth even as an adult can be a wise investment. Orthodontics not only enhances your appearance but may also improve your long-term oral health.
Restores proper oral function. Teeth that are aligned properly will tend to function properly. Although you can still chew, speak and smile with teeth that aren’t quite aligned properly, over time you’ll put more stress on both the teeth and the jaws, which could lead to more wear than what normally occurs with aging. By re-aligning teeth to a more normal position you could be extending the life of your teeth and reducing your risk of other functional problems.
Reduces the risk of periodontal (gum) disease. Some people with misaligned teeth are more susceptible to periodontal disease. Besides difficulties with bacterial plaque removal (a must to avoid gum disease), a person with misaligned teeth can also encounter more defects involving bone and gum tissues like gum recession that can contribute to the progression of gum disease. By straightening teeth (and performing plastic periodontal surgery if needed), we can reduce this risk dramatically — as long as we’re performing periodontal treatment for existing gum disease before and during orthodontics.
Facilitates tooth replacement. When we lose a tooth, the mouth’s natural mechanism is to move remaining teeth to fill the void left by the lost tooth. This can make it difficult to position a dental implant or similar tooth replacement in a functional and aesthetically appealing way. By applying orthodontics to move drifting teeth back into their proper place, we restore the best condition for achieving success with a tooth replacement.
The best way to know how much you could benefit from orthodontic treatment is to visit us for a full dental evaluation. From there, we can help you decide if treatment for straightening misaligned teeth is right for you.
If you would like more information on orthodontic treatment, 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 “Why Straighten Teeth.”