Posts for tag: dental implants
You have a lot of options for replacing missing teeth, from state-of-the-art dental implants to affordable, but effective partial dentures. But if the teeth in question have been missing for a while, you may first have to undergo orthodontic treatment. Here's why.
While they may feel rigid and firm in the jawbone, teeth are actually held in place by periodontal (gum) ligaments. These elastic tissues lie between the teeth and the bone and attach to both with tiny filaments. This mechanism allows the teeth to incrementally move over time in response to biting pressures or other environmental factors.
When a tooth goes missing the teeth on either side of the space naturally move or "drift" into it to help close the gap. This natural occurrence can reduce the space for a restoration if it has gone on for some time. To make room for a new prosthetic (false) tooth, we may have to move the drifted teeth back to where they belong.
If you're thinking metal braces, that is an option—but not the only one. Clear aligners are another way to move teeth if the bite problem (malocclusion) isn't too severe. Aligners are a series of custom-made, clear, plastic trays worn over the teeth. The patient wears each tray, slightly smaller than the previous one in the series, for about two weeks before changing to the next one. The reduction in size gradually moves teeth to their intended target position.
Many adults prefer clear aligners because they're nearly invisible and don't stand out like metal braces. They're removable, so you can take them out for cleaning or for special occasions. And, we can also attach a prosthetic tooth to the tray that temporarily covers the missing tooth space.
Whichever orthodontic treatment you choose, once completed we can then proceed with restoration to permanently replace your missing teeth. While it can be a long process, the end result is a beautiful smile that could last for years to come.
If you would like more information on your dental restoration options, 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 “Straightening a Smile before Replacing Lost Teeth.”
Considering the costs, many people view replacing a back tooth as less important than a more visible front tooth. They’re rarely seen, so who will notice?
You might, eventually. A missing back tooth can set off a chain reaction of problems that can affect your overall dental health. Besides playing an important role in chewing food, back teeth also redistribute most of the chewing force away from the front teeth. Their absence can also affect the bite: adjacent teeth to the missing one will tend to migrate toward the open space, causing them to tip and rotate into an improper position. This can cause an increase in tooth mobility, excessive wear and erosion, and endanger their survival in the long run.
To avoid these and other problems you should consider some form of replacement. Most dentists prefer a dental implant for its life-like appearance and durability, and because its titanium post has a natural affinity with bone. Bone cells will grow around and permanently adhere to the implant, which may stop and even reverse bone loss in some cases.
Implants, though, require a certain amount of bone structure initially to anchor and position properly. If you have inadequate bone and don’t want to bone graft the area, the next best option is a fixed bridge, in which the missing tooth is replaced with an artificial crown known as a pontic. The pontic is fused between two support crowns that are permanently affixed to the natural teeth on either side of the missing tooth (also known as abutments). While fixed bridges restore function and inhibit tooth migration, they require the natural tooth supporting the bridge to be reduced to accommodate the crowns placed on them. This permanently alters them and places them at higher risk for future nerve damage, gum disease and decay.
One final option is a removable partial denture (RPD). Although RPDs restore function and improve appearance, their movement within the mouth may place additional stress on the teeth that hold them in place. This movement over time could damage or loosen them.
We can discuss which option is best for you after a complete dental exam. The important thing, though, is to replace the back tooth as soon as possible — doing nothing could cost you much more in the long run.
If you would like more information on tooth replacement, 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 “Replacing Back Teeth.”
Placing a dental implant within the jawbone requires a surgical procedure. For most people it’s a relatively minor affair, but for some with certain health conditions it might be otherwise. Because of their condition they might have an increased risk for a bacterial infection afterward that could interfere with the implant’s integration with the bone and lead to possible failure.
To lower this risk, dentists for many years have routinely prescribed an antibiotic for patients considered at high-risk for infection to take before their implant surgery. But there’s been a lively debate among health practitioners about the true necessity for this practice and whether it’s worth the possible side effects that can accompany taking antibiotics.
While the practice still continues, current guidelines now recommend it for fewer health conditions. The American Dental Association (ADA) together with the American Heart Association (AHA) now recommend antibiotics only for surgical patients who have prosthetic heart valves, a history of infective endocarditis, a heart transplant or certain congenital heart conditions.
But patients with prosthetic joint replacements, who were once included in the recommendation for pre-surgical antibiotics, are no longer in that category. Even so, some orthopedic surgeons continue to recommend it for their joint replacement patients out of concern that a post-surgical infection could adversely affect their replaced joints.
But while these areas of disagreement about pre-surgical antibiotics still continue, a consensus may be emerging about a possible “sweet spot” in administering the therapy. Evidence from recent studies indicates just a small dose of antibiotics administered an hour before surgery may be sufficient to reduce the risk of infection-related implant failure with only minimal risk of side effects from the drug.
Because pre-surgical antibiotic therapy can be a complicated matter, it’s best that you discuss with both the physician caring for your health condition and your dentist about whether you should undergo this option to reduce the infection risk with your own implant surgery. Still, if all the factors surrounding your health indicate it, this antibiotic therapy might help you avoid losing an implant to infection.
If you would like more information on antibiotics before implant surgery, 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 “Implants & Antibiotics: Lowering Risk of Implant Failure.”
One of the best and most successful tooth replacement choices available is the dental implant. No other restorative method is as similar in both form and function to a real tooth as an implant; and with a success rate of 95-plus percent after ten years, it’s one of the most durable.
But there can be extenuating circumstances that make obtaining an implant difficult or sometimes impossible. One possible problematic situation is the systemic disease diabetes.
Diabetes is a hormonal condition in which the body is unable to sufficiently regulate the amount of glucose (a basic sugar that provides energy to the body’s cells) within the blood stream. Normally, the pancreas produces the hormone insulin to reduce excess glucose. But diabetes interferes with this insulin production: if you have Type 1 diabetes, the pancreas has stopped producing insulin altogether; if you have the more common Type 2, the body doesn’t produce adequate insulin or it doesn’t respond sufficiently to the insulin produced.
Over time diabetes can affect other areas of health, especially wound healing. Because the condition gradually causes blood vessels to narrow and stiffen, the normal inflammatory response to disease or trauma can become prolonged. This in turn slows the rate of wound healing.
Slow wound healing can have a bearing on the recovery period just after implant surgery, especially the necessary integration process that takes place between the bone and the titanium metal implant that provides its signature strength. If that process is impeded by slow wound healing caused by diabetes, the risk increases dramatically for implant failure.
That’s the worst case scenario if you have diabetes, but only if your condition is out of control. If, however, you have your blood sugar levels well regulated through medication, diet and exercise, then your chances for implant success could easily be on par with someone without diabetes.
So if you’re diabetic and are considering dental implants for missing teeth, it’s important to discuss the possibility of obtaining them with both your dentist and the physician caring for your diabetes. With your overall healthcare team working together, there’s no reason why diabetes should stop you from enjoying this premiere restoration for missing teeth.
If you would like more information on obtaining 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 & Diabetes.”
Dental implants are all the rage. And why not — not only are these tooth replacements life-like and highly functional, they have an amazing 95% ten-year success rate.
Some of that success is due to their unique design. Technically a root replacement, an implant's metal titanium post is surgically placed in the jawbone, where bone grows and adheres to it over time. This creates a strong connection that stands up well to the forces created by biting and chewing.
But there's more to their longevity than design. Success also depends on a careful, planned process that begins long before surgery.
It starts with a detailed oral examination to determine the best placement for the implant. Besides regular x-rays, we may also perform CT scans to create a three-dimensional view of your jaw. With this we can locate and avoid nerves, sinus cavities or other structures near the implant site.
The examination also helps us determine if you've experienced any bone loss, a normal occurrence after tooth loss. Implants require an adequate amount of bone to achieve the best position. A good position ensures future bone integration and the best appearance result.
The same attention to detail extends to the actual surgery to place the implant. We fashion the site to receive the implant by sequentially drilling larger tapered channels until we achieve the right size fit for the implant. During drilling we avoid overheating the bone, which could ultimately weaken and damage the implant's stability.
We'll also need to provide protection for the implant while it integrates with the bone. In most implantations, we do this by suturing the gum tissue over the implant. We take a different approach with a “Tooth in a Day” procedure where we attach a crown (the visible portion of the tooth) right after implant surgery. In this case we'll install a crown (which is actually temporary) that's a little shorter than the adjacent teeth. The natural teeth around it will absorb the forces produced while chewing and not the implant crown.
Focusing on these and other factors will greatly reduce the risk of implant failure. Paying careful attention to them helps ensure your new smile is a lasting one.
If you would like more information on dental implants to restore your smile, 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: A Tooth Replacement Method That Rarely Fails.”