Posts for category: Dental Procedures
Dental implants are a popular and effective restoration for lost teeth, if there’s enough bone present to support the implant. That might not be the case, however, because without the stimulation of the lost tooth, the bone may dissolve (resorb) over time. It’s possible, however, that you may need to re-grow bone in the back area of the upper jaw where your upper (maxillary) sinus is located.
Sinuses are air space cavities located throughout the skull. This feature allows your head to be light enough to be supported by your neck muscles. Inside each sinus is a membrane that lines your sinus cavities, nasal passages and other spaces. The maxillary sinus is located on each side of the face just below the eyes. Pyramidal in shape, the floor of the pyramid lies just above the upper back teeth.
A surgeon approaches the sinus through the mouth, with the objective of moving the sinus membrane up from the floor of the sinus. This is accomplished by placing bone-grafting material in the area. Over time the body uses the grafting material as a scaffold to produce new bone that then replaces the grafting material. The resulting new bone becomes the support for the implant.
If enough bone exists to stabilize an implant but not anchor it, then the surgeon can approach the sinus from the same opening that’s used for the intended implant site, insert the grafting material, and install the implant during the same procedure. If not, the surgeon creates a small “window” laterally over the teeth to access the sinus and insert the graft. The implant is installed a few months later after the new bone is created.
The procedure usually requires only a local anesthetic, although some patients may require additional sedation or anti-anxiety medication. After the surgery, you normally experience mild to moderate swelling and discomfort, about the same as having a tooth removed. All these symptoms can be managed with non-steroidal, anti-inflammatory pain medication and a decongestant for minor congestion in the sinus. We might also prescribe an antibiotic to help prevent infection.
Although this procedure adds another step and possibly more waiting time to implantation, it gives you an option you wouldn’t otherwise have — a life-like, effective replacement of your back teeth with dental implants.
If you would like more information on bone regeneration for 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 “Sinus Surgery.”
Regardless of culture, the smile is a universal gesture of friendship and openness, and an important communication tool in your social and career relationships. But what if you’re not comfortable with your smile because of misaligned, damaged or missing teeth? That could have a dampening effect on your interactions with people and your own self-confidence.
Cosmetic dentistry can change all that — we have an arsenal of treatments that can rejuvenate your smile. We must first, though, develop a design plan, often involving multiple dental disciplines. It will definitely involve you — your desires, expectations and choices.
It begins with a thought-provoking discussion with our office. Generalities — “I want a beautiful smile” — aren’t enough. Effective planning begins with a clear perspective about your teeth: What do you like or dislike about them? If you could change anything, what would it be? These initial discussions help us specify your expectations.
While the initial discussion envisions the future, the next step focuses on the present — the current condition of your teeth, mouth and entire facial structure. This requires a comprehensive examination to identify any health issues like tooth decay, periodontal gum disease or bone loss. We must also take in the “big picture,” like the shape of your face, out-of-balance features (asymmetries), skin complexion, eye shape and color, or the form and posture of your lips.
Considering all these factors, we then develop a treatment plan with specifics on how to achieve the desired transformation. We will offer our prognosis for what we believe is achievable and maintainable for your specific situation. Here we provide various models, perhaps even including computer simulation, to depict your future smile. In the end, we create a workable plan that meets both reality and your expectations.
With the design plan completed, we can then harness all the techniques and materials available to achieve it. These range from less invasive procedures like whitening, tooth reshaping, cosmetic bonding or porcelain veneers, to more involved restorations like crowns, bridgework or dental implants. In some cases, orthodontics may be necessary to correct bad bites or other malformations of your oral structures.
Smile design ensures we’re employing the right techniques for your particular situation. It all serves the end goal — a new smile that can transform your life.
If you would like more information on smile design, 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 “Beautiful Smiles by Design.”
A dental implant as a permanent replacement for a missing tooth can match or even look better than your original tooth. How this happens takes knowledge, skill, experience, and even some art.
Here are some of the factors involved:
- Bone quantity and quality: To look and function like an original tooth, an implant must be supported by an adequate base of (jaw) bone and gum tissue. Bone has a tendency to melt away or resorb after a tooth is lost. Using new bone grafting techniques can help minimize the bone loss that occurs during healing at the extraction site. Bone grafting can also be used to rebuild lost bone at the implant site.
- Adequate bone supporting neighboring teeth: If you lose bone that supports teeth on either side of an implant, the papillae (the little pink triangles of gum tissue between the teeth) may not regenerate after the implant is placed.
- Your inborn tissue type: If your gum tissues are thin and delicate rather than thick and robust, they will be more difficult to work with. To ensure that there is sufficient gum tissue support, (gum) grafting may be necessary.
- Using the temporary crown as a template: A dental implant actually replaces a tooth root. Most dental implants are made of commercially pure titanium, which fuses with the bone in your jaw, making it very stable. The crown, the part of the tooth that is visible above the gum line, is attached to the implant; a customized temporary crown can be fitted to the implant. The temporary crown is a trial for the final crown. It can be used to assess color, shape, the appearance of your smile, and the implantâ??s function in your bite and speech. It gives you the opportunity to decide about design adjustments before the final, permanent crown is placed.
- The skill, experience, and collaboration of your dental team: Each situation is different. The final success of your implant depends on your pre-surgical assessment and diagnosis, as well as how the surgical and restorative phases of treatment are performed. The use of an outstanding dental laboratory is vital to a successful result.
Contact us today to schedule an appointment for an assessment or to discuss your questions about dental implants. You can also learn more by reading the Dear Doctor magazine article “Matching Teeth & Implants.”
If you think you'd rather wrestle a pack of porcupines than go to the dentist for a root canal treatment — then maybe it's time to think again! This common procedure has been the butt of jokes for a long time. Let's set the record straight by answering some common questions about the much-maligned procedure.
Q: What is a root canal?
A: Coursing through the central part of each root is a hollow space or canal, which contains the pulp tissue. The pulp tissue contains the nerves which respond to temperature changes transmitted through the tooth. When the temperatures are extreme the nerves signal sensitivity and pain. It's also shorthand for the dental procedure that is performed when the pulp tissue that fills these canals develops a disease.
Q: Why do I need to get a root canal?
A: Because an infection or inflammation has developed deep inside one or more of your teeth. When the living pulp tissue — which contains nerves and blood vessels — becomes inflamed or infected, it can cause intense pain. It also releases bacterial toxins, which can lead to further problems.
Q: What happens if I don't get a root canal?
A: Your acute pain may temporarily go away, but the infection won't. It will eventually travel through the tooth's roots into the surrounding tissues. If left untreated, it may result in an abscess or even a systemic infection. That's why you need to take care of it now.
Q: Will it be painful?
A: Generally, a root canal procedure is no more painful than getting a filling. In fact, it starts the same way: An anesthetic is given to numb the tooth and the surrounding area. Then a small hole is made through the tooth's chewing surface and down into the canal. Diseased pulp tissue is removed through the hole via a set of tiny instruments. Finally, the root canal is cleaned, disinfected, filled with inert biocompatible material and sealed up.
Q: What happens after that?
A: Your tooth may be sensitive for a few days after the treatment, but the acute pain will be gone. Over-the-counter pain relievers generally work well for pain relief at this point. To restore your tooth to its fully-functioning state, a crown or other restoration is usually needed after root canal treatment. Properly done, the restored tooth can last as long as any of your natural teeth.
Q: Is there an alternative?
A: Yes. You can relieve the pain by having the tooth removed. But you don't want to go there. Tooth loss can lead to unwanted side effects, like migration of teeth, bone loss and eventually the inability to chew properly. It's far better to save your natural teeth when you can.
If you would like more information about root canals, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Common Concerns About Root Canal Treatment” and “Signs and Symptoms of a Future Root Canal.”
Without a doubt, an effective root canal treatment can extend the life of a tooth for many years. But sometimes even a well-maintained tooth can fall prey to disease months or even years after a root canal treatment. While there are a number of reasons to account for this failure, a common one is so tiny it could have easily been missed during the first treatment.
A root canal is an open space within the tooth that contains the pulp. The pulp is a connective tissue with a network of nerve fibers connected to the root that alert the brain to environmental changes involving the tooth. It is most important during the tooth’s early development, but becomes less important as we age. The pulp is susceptible to infection from tooth decay or periodontal (gum) disease, which if left untreated can threaten the tooth’s survival. During a root canal treatment, we enter these spaces, clear out the diseased pulp and fill the canal with a bio-compatible filling; we then seal it off to deter further decay.
The treatment could ultimately fail, though, because of accessory or lateral canals missed during the procedure. Like a tree with smaller branches growing out of its larger limbs, accessory canals are smaller access ways that branch off of the main root canals. These accessory canals, which can occur anywhere along a main canal, can be quite small and not easily detected during an initial root canal treatment. They are especially susceptible to infection due to gum disease if they open into the periodontal membrane, the main attachment point between teeth and bone.
If we suspect the presence of accessory canals (either initially or after ensuing problems following a root canal treatment), this could require the skills of an endodontist, a dentist who specializes in the treatment of a tooth’s interior. Accessory canals are treated in much the same way as larger canals, but may require an endodontist’s specialized microscopic equipment and filling techniques. Effective treatment of these smaller accessory canals will certainly improve the chances of a successful, long-term outcome for the tooth.
If you would like more information on root canal treatments, 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 “Accessory Canals.”