Posts for category: Oral Health
Dental implants are widely considered the most durable tooth replacement option, thanks in part to how they attach to the jaw. But durable doesn't mean indestructible — you must take care of them.
Implants have a unique relationship to the jawbone compared to other restorations. We imbed a slender titanium post into the bone as a substitute for a natural tooth root. Because bone has a special affinity with the metal, it grows to and adheres to the implant to create a secure anchor. This unique attachment gives implants quite an advantage over other restorations.
It isn't superior, however, to the natural attachment of real teeth, especially in one respect: it can't match a natural attachment's infection-fighting ability. A connective tissue attachment made up of collagen fibers are attached to the tooth root protecting the underlying bone. An elastic gum tissue called the periodontal ligament lies between the tooth root and the bone and attaches to both with tiny collagen fibers. These attachments create a network of blood vessels that supply nutrients and infection-fighting agents to the bone and surrounding gum tissue.
Implants don't have this connective tissue or ligament attachment or its benefits. Of course, the implants are made of inorganic material that can't be damaged by bacterial infection. However, the gums and bone that surround them are: and because these natural tissues don't have these same biologic barriers to infection and perhaps access to the same degree of antibodies as those around natural teeth, an infection known as peri-implantitis specific to implants can develop and progress.
It's therefore just as important for you to continue brushing and flossing to remove bacterial plaque that causes infection to protect the gums and bone around your implants. You should also keep up regular office cleanings and checkups. In fact, we take special care with implants when cleaning them by using instruments that won't scratch their highly polished surfaces. Such a scratch, even a microscopic one, could attract and harbor bacteria.
There's no doubt dental implants are an excellent long-term solution for restoring your smile and mouth function. You can help extend that longevity by caring for them just as if they're your natural teeth.
If you would like more information on caring for 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 Implant Maintenance.”
Since the late 19th Century, dentists have used established protocols to successfully prevent and treat tooth decay. But there've been changes to this approach the last few years to improve its effectiveness, changes we now refer to as Minimally Invasive Dentistry or MID.
The older approach for treating dental caries (tooth decay) follows the protocols established by Dr. G.V. Black, considered the father of modern dentistry. Black advocated removing not only decayed structure but also some of the healthier but vulnerable portions of a tooth, to avoid further decay and make the tooth easier to clean. This resulted in larger fillings, although they've become smaller as dental techniques have advanced.
MID, on the other hand, aims to remove as little tooth structure as possible while still effectively treating and preventing future decay. To achieve that goal we begin first with a complete assessment of a patient's individual decay risk, known as Caries Management By Risk Assessment (CAMBRA).
With CAMBRA, we're looking at other factors besides individual tooth health: a patient's hygiene, lifestyle and dietary habits; the types and amount of bacteria present; and the quality of saliva flow, needed to neutralize mouth acid. With these the results we develop a customized prevention and treatment strategy.
MID also focuses on detecting dental caries as early as possible. Besides traditional x-rays, we're beginning to use other methods like dental microscopes, laser fluorescence, infrared photography or optical scanning. Early detection leads to early intervention, and with techniques that are much less invasive than the traditional approach.
The new approach also changes how we repair decayed teeth. We're increasingly using air abrasion, a technology that uses fine particles in a pressurized air stream to remove softer decayed tooth material and less healthy structure than the traditional dental drill. We're also using composite resin and other advanced materials for filings: these tooth-colored materials are stronger than previous versions and are quickly taking the place of metal amalgam, requiring less structural removal to accommodate them.
MID's core principles are early disease detection, proactive prevention and treatment with less structural removal. With this enhanced approach to effective dentistry, we're keeping your teeth healthy with minimal discomfort, lower costs and less long-term impact.
After treating you for periodontal (gum) disease for some time, we may suggest you see a periodontist, a specialist in gum conditions and diseases. There are a number of reasons for a referral, including the specific type of gum disease you may have developed.
Here are 4 more reasons why seeing a periodontist might be advantageous at this stage in your dental care.
Advanced treatment. All dentists are skilled in basic treatment procedures for gum disease, particularly removing plaque and calculus (hardened plaque deposits) that cause and sustain infections. But if your disease has advanced deeper below the gum line and has resulted in infection-filled void pockets between teeth and gums or in gum recession (the tissues shrinking back from the teeth), you may need more advanced techniques and equipment provided by a periodontist.
Advanced Cleanings. Regular, twice-a-year office cleanings are part of every dental care program. But depending on the severity of your gum disease (and your own hygiene efforts) you may need more frequent and advanced cleanings to keep recurring infections at bay. A periodontist can provide this, as well as help you develop a daily hygiene plan that meets your needs.
Your general health. There are a number of systemic conditions like diabetes, cardiovascular disease or pregnancy that can affect gum health. Many of these issues are tied to tissue inflammation, a major component of chronic gum disease, as well as slower tissue healing. As specialists in the gums and their relationship with the rest of the body, a periodontist can develop a treatment approach that coordinates with these other health issues.
Future restoration preparation. One of our treatment goals with gum disease is to try to prolong the life of natural teeth for as long as possible. In reality, though, some or all of your teeth may have a shortened life expectancy. If a comprehensive dental restoration is in your future, a periodontist can help prepare your gums for the inevitable. They may also be able to repair or restore gum tissues that enhance the appearance of a restoration to create a more attractive smile.
If you would like more information on advanced treatment for periodontal 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 “Referral to a Dental Specialist.”
Your regular dental checkups should periodically include an important screening for oral cancer, especially as you grow older. Although oral cancers make up less than 3% of all other types, they’re among the most deadly with a 58% survival rate after five years.
Besides hereditary factors, oral cancer is strongly linked to tobacco use, alcohol abuse or diets low in fresh fruits and vegetables. It’s also a greater concern as we age: 90% of new cases of oral cancer occur in people over the age of 40, heightening the need for regular screenings. These screenings become all the more important because many early sores or lesions can mimic other conditions like canker sores — without early detection, the disease could already be in advanced stages when it’s diagnosed.
An oral screening for cancer involves both sight and touch. We’ll first look for any suspicious lesions and red or white patches in the soft tissues of the face, neck, lips and mouth. We’ll then feel for any abnormal lumps on the mouth floor, the sides of the neck and in gland locations. We’ll also examine all sides of the tongue including underneath, as well as the tissues lining the back of your throat.
If we notice anything that’s concerning we may then perform a biopsy by removing a small bit of the suspicious tissue and have it examined microscopically for the presence of cancer cells. We may also remove any lesions deemed pre-cancerous as an added precaution against possible cancer development.
The American Cancer Society recommends an oral cancer screening annually for people forty years or older and every three years for people between the ages of 20 and 39. Even better, we recommend all adults undergo a screening every year. This, along with ending tobacco use and other lifestyle and dietary changes, will greatly improve your chances of remaining free of oral cancer.
If you would like more information on detecting and treating oral cancer, 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 “Oral Cancer.”
Modern life can be demanding. The body helps us rise to the occasion through responses we collectively call stress.
But while stress can be a good thing, it can also overwhelm us and manifest in some harmful way: bouts of back pain, stomach ulcers or even acne. It could also trigger tooth grinding, often occurring as we sleep. And like other stress relievers, tooth grinding can be detrimental to your health long term.
Teeth-on-teeth contact occurs normally when we eat or speak, or simply as our jaws contact each other with glancing touches hundreds if not thousands of times a day. Such normal contact is beneficial because it stimulates healthy bone growth in the jaw. But if the forces created exceed the normal range as with tooth grinding (up to ten times), it can cause a bevy of problems to the teeth and jaws.
While excessive jaw motion during teeth grinding can cause inflammation and painful spasms in the muscles, the greater danger is to the teeth, which could even fracture from the high amount of force. The more common occurrence, though, is an increased rate of enamel erosion, which causes the tooth to lose vital structure and eventually appear shorter in appearance.
Fortunately, there are ways to reduce teeth grinding or its severity. The first order of business is to treat its effects by reducing its symptoms and ongoing damage. We can recommend some behavior modification techniques to alter the frequency of the habit or a night guard to protect the teeth from the intensity of the habit if you’re unable to change the behavior.
A custom-fitted night or occlusal guard, a retainer-like dental appliance made of smooth acrylic plastic is designed so that the lower teeth glide over the guard surface when grinding and can’t make solid contact with the upper teeth. This reduces the generated force and helps protect the teeth.
In the long term, though, you should address the root cause — how you’re handling daily stress. Treatment by a psychotherapist or counselor, for example, could help you develop ways to channel stress in more productive ways.
However your treatment strategy develops, it’s important to address stress and teeth grinding as soon as possible. Controlling it will have long-term benefits for your teeth and smile.
If you would like more information on dealing with stress that causes tooth grinding, 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 “Stress & Tooth Habits.”