Our primary aim as dentists is to preserve teeth. There are times, however, when preserving a tooth is no longer worth the effort and we must recommend removing it. Fortunately, extracted teeth can be replaced with a functional and attractive restoration.
Today's top tooth-replacement option is the dental implant. Composed of a titanium metal post imbedded into the jawbone, a single dental implant can replace an individual tooth or a series of implants can support other restorations for multiple teeth. Besides being incredibly life-like, dental implants are highly durable and can last for decades.
But dental implants aren't an optimal choice for everyone. Their cost often matches their status as the premier tooth replacement method. And because they require a minimum amount of bone for proper implantation, they're not always feasible for patients with extensive bone loss.
But even if dental implants aren't right for you, and you want a fixed restoration rather than dentures, you still have options. What's more, they've been around for decades!
One is a bonded crown, which works particularly well for a tooth excessively damaged by decay, excessive wear or fractures. After removing all of the damaged portions and shaping the remaining tooth, we cement a life-like crown, custom created for that particular tooth, over the remaining structure.
Besides improving appearance, a crown also protects the tooth and restores its function. One thing to remember, though, is although the crown itself is impervious to disease, the remainder of the natural tooth isn't. It's important then to brush and floss around crowned teeth like any other tooth and see a dentist regularly for cleanings.
Dental bridges are a fixed solution for extracted teeth. It's composed of prosthetic teeth to replace those missing bonded together with supporting crowns on both ends. These crowned teeth are known as abutments, and, depending on how many teeth are being replaced, we may need to increase the number of abutments to support the bridge.
Although durable, crowns or bridges typically don't match the longevity of an implant. And, implants don't require the permanent alteration of support teeth as is necessary with a bridge. But when the choice of implants isn't on the table, these traditional restorations can be an effective dental solution.
If you would like more information on crown or bridge restorations, 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 “Crowns & Bridgework.”
Advanced cosmetic dental techniques are helping people around the world achieve their dream smiles. But long before many of these procedures existed, straightening teeth with braces could make a big difference in a person's appearance.
Improving a smile isn't the primary reason a person should undergo teeth straightening—a poor bite can lead to an unhealthy mouth. Misaligned teeth set up conditions in which you're more prone to diseases like tooth decay or gum disease. Correcting a bite should be first and foremost about protecting your dental health.
Even so, realigning your teeth can lead to a more attractive smile—and it's often necessary first before undergoing other cosmetic restorations. Think of it like renovating a house. You usually need to fix a faulty foundation before you start building an addition.
That's why it's always a good idea to get a complete dental exam before undertaking cosmetic work. There may be underlying problems that should be treated first. If that includes a poor bite, your next visit will most likely be with an orthodontist. Using advanced diagnostics, they'll determine what kind of bite problem you have and what it will take to correct it.
In years past, that meant braces. But now patients have another option: clear aligners, a series of clear plastic trays based on the individual patient's teeth. Each tray in the series is worn for about two weeks in succession, each new tray taking up where the other tray left off moving the teeth. Not only are they nearly invisible to observers, they can be removed for eating, cleaning or special occasions.
On the cosmetic front, straightening your teeth may be all you need to realize a more attractive smile. But orthodontics can also be part of an overall "smile makeover" that may include other cosmetic procedures, usually performed after realigning the teeth. In this case, it's often necessary to coordinate orthodontic treatment with these other procedures, especially if it's necessary to remove some teeth.
Whether it stands alone or is part of an overall makeover plan, straightening teeth can be a game changer when it comes to your appearance. Not only will it help you have healthier teeth and gums, it could give you the new smile you desire.
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 “The Magic of Orthodontics.”
Getting dental implants is going to require surgery. But don't let that concern you—it's a relatively minor procedure.
Currently the “gold standard” for tooth replacement, an implant consists of a titanium post surgically imbedded in the jawbone. We can affix a life-like crown to a single implant or support a fixed bridge or removable denture using a series of them.
Because placement will determine the restoration's final appearance, we must carefully plan implant surgery beforehand. Our first priority is to verify that you have adequate jawbone available to support an implant.
Additionally, we want to identify any underlying structures like nerves or blood vessels that might obstruct placement. We may also develop a surgical guide, a retainer-like device placed in the mouth during surgery that identifies precisely where to create the holes or channels for the implants.
After numbing the area with local anesthesia, we begin the surgery by opening the gum tissue with a series of incisions to expose the underlying bone. If we've prepared a surgical guide, we'll place it in the mouth at this time.
We then create the channel for the insert through a series of drillings. We start with a small opening, then increase its size through subsequent drills until we've created a channel that fits the size of the intended implant.
After removing the implant from its sterile packaging, we'll directly insert it into the channel. Once in place, we may take an x-ray to verify that it's been properly placed, and adjust as needed. Unless we're attaching a temporary crown at the time of surgery (an alternate procedure called immediate loading), we suture the gums over the implant to protect it.
Similar to other dental procedures, discomfort after surgery is usually mild to moderate and manageable with pain relievers like acetaminophen or ibuprofen (if necessary, we can prescribe something stronger). We may also have you take antibiotics or use antibacterial mouthrinses for a while to prevent infection.
A few weeks later, after the bone has grown and adhered to the implant surface, you'll return to receive your new permanent crown or restoration. While the process can take a few months and a number of treatment visits, in the end you'll have new life-like teeth that could serve you well for decades.
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 Implant Surgery.”
Tooth loss is often the unfortunate conclusion to a case of untreated periodontal (gum) disease—incentive enough to try either to prevent it or aggressively treat an infection should it occur. In either case, the objective is the same: to remove all plaque from dental surfaces.
Dental plaque (and its hardened form, tartar) is a thin buildup of bacteria and food particles on tooth surfaces. It's a ready food source for sustaining the bacteria that cause gum disease. Removing it can prevent an infection or “starve” one that has already begun.
Your first line of prevention is brushing and flossing your teeth daily to remove any accumulated plaque. Next in line are dental cleanings at least twice a year: This removes plaque and tartar that may have survived your daily hygiene.
Plaque removal is also necessary to stop an infection should it occur. Think of it as a more intense dental cleaning: We use many of the same tools and techniques, including scalers (or curettes) or ultrasonic devices to loosen plaque that is then flushed away. But we must often go deeper, to find and remove plaque deposits below the gums and around tooth roots.
This can be challenging, especially if the infection has already caused damage to these areas. For example, the junctures where tooth roots separate from the main body of the tooth, called furcations, are especially vulnerable to disease.
The results of infection around furcations (known as furcation involvements or furcation invasions) can weaken the tooth's stability. These involvements can begin as a slight groove and ultimately progress to an actual hole that passes from one end to the other (“through and through”).
To stop or attempt to reverse this damage, we must access the roots, sometimes surgically. Once we reach the area, we must remove any plaque deposits and try to stimulate regrowth of gum tissue and attachments around the tooth, as well as new bone to fill in the damage caused by the furcation involvement.
Extensive and aggressive treatment when a furcation involvement occurs—and the earlier, the better—can help save an affected tooth. But the best strategy is preventing gum disease altogether with dedicated oral hygiene and regular dental visits.
If you would like more information on preventing and treating 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 “What are Furcations?”
If you do the right things—keep your teeth clean, see the dentist regularly, and eat a "tooth-friendly" diet—you stand a good chance of having healthy teeth and gums later in life. Even so, after eating well over 75,000 meals by age 70, you can expect some wear from all that biting and chewing.
But there's normal wear—and then there's excessive wear, which can be caused by a variety of factors. When it occurs, accelerated wear can increase your risk of dental disease—and your shorter-toothed smile can make you look older than your actual age.
Here are 3 dental problems that can lead to accelerated tooth wear, and what you can do about them.
Tooth decay. This dental disease can severely weaken a tooth's protective enamel surface, which can in turn increase wear. You can minimize your chances of developing tooth decay by brushing and flossing your teeth daily and undergoing regular dental cleanings. And the sooner you receive treatment for any diagnosed decay, the less likely your enamel will suffer significant damage.
Poor bite. Properly aligned teeth mesh well together while biting and chewing, which minimizes wearing. But misalignments put undue stress on teeth that can lead to accelerated wear. By correcting a bite problem through orthodontics, we can properly align teeth so that they interact with each other normally for less wear.
Teeth grinding. This unconscious habit of gnashing or grinding teeth (often during sleep) can produce abnormally high biting forces. Among other adverse outcomes, this can also increase teeth wearing. If you grind your teeth, there are therapeutic methods that could reduce the habit. You can also obtain a custom night guard to reduce biting forces while you sleep.
If you've already experienced excessive dental wear, there are cosmetic options like porcelain veneers or dental bonding that can restore your smile to a more youthful appearance and help protect your teeth. But if you haven't reached that point, you can make sure you don't by taking care of your teeth and gums and seeking prompt dental treatment for problems leading to accelerated wear.
If you would like more information on teeth wear, 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 “How and Why Teeth Wear.”
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