Years ago, disease or trauma robbed you of one of your teeth. At the time you might have opted for an affordable solution, like a partial denture. But now you'd like to restore that missing tooth with a dental implant, the most life-like tooth replacement available.
That's a great decision. But there may be a hiccup along the way to your new implant: the state of the underlying jawbone. Implants need a certain amount of bone for proper placement. If not enough is present, that may cause an interruption in your plans—and that could be a real possibility if your tooth has been missing for some time.
That's because, like other living tissues, bone has a growth cycle: Old bone cells die and dissolve, while new cells form to take their place. In the jaw, the force produced by teeth during chewing helps to keep this growth process in the bone functioning at a healthy pace.
When a tooth goes missing, though, so does this chewing stimulation. A lack of stimulation can slow the growth rate for that part of the bone and its volume can diminish over time. It's possible for a quarter of the bone volume to be lost within the first year after losing a tooth.
If you've experienced that level of bone loss, we may not be able to place an implant—yet. You might still have a few options. For one, we could attempt to regenerate some of the bone through grafting. Bone material grafted into the affected area can serve as a scaffold for new bone cells to form and adhere. Over time, this could result in a sufficient amount of regenerated bone to support a dental implant.
Another possibility might be to install a smaller diameter implant like those used to support removable dentures. Because they're smaller they require less bone than standard-sized implants. They're not for every situation, though, and are best suited for situations where aesthetics isn't a priority.
To know what your options are regarding an implant-based restoration, you'll need to undergo a thorough evaluation of your oral health, including supporting bone. Depending on your situation, you may still be able to renew your smile with this premier tooth replacement option.
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 After Previous Tooth Loss.”
The journey to a straighter smile with braces can be difficult. One of the biggest dangers you'll face is an increased risk of periodontal (gum) disease.
Gum disease is caused by dental plaque, a thin film of bacteria and food particles on tooth surfaces. To curtail plaque growth, you must brush and floss daily and visit your dentist regularly for more thorough cleanings. If you don't, accumulated plaque can trigger an infection with potentially disastrous consequences for your dental health.
But wearing braces can make you more vulnerable to gum disease. The braces and wires can get in the way of brushing and flossing. To add to the difficulty, the gums often react to being in close proximity to braces, causing their tissues to swell or overgrow. And if the patient is a teenager, the normal hormonal surge that occurs during these years could compound this vulnerability even more.
To prevent an infection, you'll need to practice extra diligence cleaning your teeth with brushing and flossing. It takes more time and effort, but it's worth it to lower your disease risk. To help even more, consider using tools like specialized brushes that can maneuver better around hardware and floss threaders that can get floss under wires. You might also consider a water flosser, which uses pressurized water to remove plaque between teeth.
In addition to your orthodontic visits, you should also maintain your regular cleaning schedule with your family dentist—or more often if they recommend. Besides cleaning, your dentist also monitors for signs of developing gum disease. They can also prescribe mouthrinses for controlling bacterial growth.
Even with diligent hygiene, your gums may still adversely react to the braces. This may not be a problem if your gum tissues don't appear to be detaching from the teeth. But your dentist or orthodontist may recommend you see a periodontist (a gum specialist) to help monitor that aspect of your care. In extreme cases, it may be necessary to remove the braces and allow the gums to heal.
Keeping your teeth clean and your mouth disease-free is no easy task while wearing braces. But it can be done—and with your dentist's help, you can achieve a straighter and healthier smile.
If you would like more information on dental care while wearing braces, 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 “Gum Swelling During Orthodontics.”
Calling someone "long in the tooth" is an unflattering way of saying they're getting old. The phrase refers to the effects of gum recession, in which the gums pull away from the teeth and cause them to appear longer. The problem, which makes the teeth vulnerable to disease as well as look unattractive, is a common problem for older people.
The most common cause for gum recession is periodontal (gum) disease. Bacteria and food particles, which make up dental plaque, trigger an infection. The deposits of plaque and calculus (hardened plaque) continue to fuel the infection as it continues to weaken gum tissue attachments.
As a result, the gums begin to lose their attachment to the teeth and pull away, exposing the root areas normally covered by the gums. Unlike the enamel-protected crowns (the parts of teeth you can see), the root is covered by a thin layer of material called cementum.
Although cementum offers less protection than enamel, this normally isn't a problem because the gums also act as a barrier against bacteria and other harsh aspects of the mouth environment. But without gum coverage, the root area becomes vulnerable to disease and is more prone to painful sensitivity.
Because gum disease is the main culprit, you can reduce your chances of gum recession by keeping your teeth clean of plaque through brushing and flossing, and regularly undergoing professional cleanings. If gum disease does occur, it's important to seek treatment as soon as possible: The earlier it's treated the more likely that any recessed gum tissues can regenerate.
If the recession is extensive, however, you may need clinical intervention to assist with its regrowth. This can be done by grafting tissue at the site that then serves as scaffold for new tissue to grow upon. Though effective, these microsurgical techniques are quite complex and involved.
So, if you suspect you have gum disease or recession, see your dentist as soon as possible for a full examination. It may be possible to restore your gums and enhance your smile.
If you would like more information on protecting your gum 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 “Gum Recession.”
When Entertainment Tonight host Nancy O’Dell set out to teach her young daughter Ashby how to brush her teeth, she knew the surest path to success would be to make it fun for the toddler.
“The best thing with kids is you have to make everything a game,” Nancy recently said in an interview with Dear Doctor TV. She bought Ashby a timer in the shape of a tooth that ticks for two minutes — the recommended amount of time that should be spent on brushing — and the little girl loved it. “She thought that was super fun, that she would turn the timer on and she would brush her teeth for that long,” Nancy said.
Ashby was also treated to a shopping trip for oral-hygiene supplies with Mom. “She got to go with me and choose the toothpaste that she wanted,” Nancy recalled. “They had some SpongeBob toothpaste that she really liked, so we made it into a fun activity.”
Seems like this savvy mom is on to something! Just because good oral hygiene is a must for your child’s health and dental development, that doesn’t mean it has to feel like a chore. Equally important to making oral-hygiene instruction fun is that it start as early as possible. It’s best to begin cleaning your child’s teeth as soon as they start to appear in infancy. Use a small, soft-bristled, child-sized brush or a clean, damp washcloth and just a thin smear of fluoride toothpaste, about the size of a grain of rice.
Once your child is old enough to hold the toothbrush and understand what the goal is, you can let him or her have a turn at brushing; but make sure you also take your turn, so that every tooth gets brushed — front, back and all chewing surfaces. After your child turns 3 and is capable of spitting out the toothpaste, you can increase the toothpaste amount to the size of a pea. Kids can usually take over the task of brushing by themselves around age 6, but may still need help with flossing.
Another great way to teach your children the best oral-hygiene practices is to model them yourself. If you brush and floss every day, and have regular cleanings and exams at the dental office, your child will come to understand what a normal, healthy and important routine this is. Ashby will certainly get this message from her mom.
“I’m very adamant about seeing the dentist regularly,” Nancy O’Dell said in her Dear Doctor interview. “I make sure that I go when I’m supposed to go.”
It’s no wonder that Nancy has such a beautiful, healthy-looking smile. And from the looks of things, her daughter is on track to have one, too. We would like to see every child get off to an equally good start!
If you have questions about your child’s oral health, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Taking the Stress Out of Dentistry for Kids” and “Top 10 Oral Health Tips for Children.”
Although periodontal (gum) disease starts with the gums, the teeth may ultimately suffer. An infection can damage the gum attachment and supporting bone to the point that an affected tooth could be lost.
The main cause for gum disease is dental plaque, a bacterial biofilm that accumulates on teeth due to ineffective oral hygiene. But there can be other contributing factors that make you more susceptible to an infection. Smoking tobacco is one of the most harmful as more than half of smokers develop gum disease at some point in their life. If you’re a heavy smoker, you have double the risk of gum disease than a non-smoker.
There are several reasons why smoking increases the risk of gum disease. For one, smoking reduces the body’s production of antibodies. This diminishes the body’s ability to fight oral infections and aid healing. As a smoker, your body can’t respond adequately enough to the rapid spread of a gum infection.
Another reason for the increased risk with smoking are the chemicals in tobacco that damage the connectivity of gum tissues to teeth that keep them anchored in place. The heavier the smoking habit, the worse this particular damage is to the gums. This can accelerate the disease and make it more likely you’ll lose affected teeth.
Smoking can also interfere with getting a prompt diagnosis of gum disease because the nicotine in tobacco reduces the blood supply to the gums. Usually a person with an infection may first notice their gums are reddened or swollen, and bleed easily. Smoking, however, can give a false impression of health because it prevents the infected gum tissues from becoming swollen and are less likely to bleed. As a result, you may learn you have the disease much later rather than sooner, allowing the infection to inflict more damage.
There are ways to reduce your disease risk if you smoke. The top way: Kick the smoking habit. With time, the effects of smoking on your mouth and body will diminish, and you’ll be better able to fight infection.
You should also practice daily brushing and flossing to keep plaque at bay, followed by regular dental cleanings to remove hard to reach plaque and calculus (tartar) deposits. You should also see your dentist at the first sign of trouble with your gums.
If you would like more information on the prevention and treatment of gum disease, 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 “Smoking and Gum Disease.”
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