Dental implant technology has advanced at such an astounding rate in recent years that you can now walk into a dentist's office with a problem tooth and out the same day with a new one. Unfortunately, not all dental situations allow for this possibility.
For example, you might be considering an implant many years after losing a tooth. But there's a potential problem: there might not be enough supporting bone. While an implant might still be possible, inadequate bone complicates the matter.
Because implants are essentially tooth root replacements, they require a certain amount of bone for stability and the best attractive outcome. As a general rule, implants need to be surrounded by at least 1.5-2.0 millimeters of healthy bone to support an implant. But you might not have enough if your tooth has been missing for awhile, regardless if you have or haven't worn dentures or other restorations.
That's because bone has a life cycle in which older cells die and newer ones form to take their place. As we chew or bite, the force generated travels up through the teeth to the bone to stimulate this new growth. Without a tooth the bone doesn't receive this stimulus, which can slow the growth rate. Over time the affected bone can lose its volume and density.
If we find you've experienced loss to the point your bone won't support an implant, that doesn't automatically mean this popular restoration is out of the picture. But it will require us first performing a procedure known as augmentation or bone grafting to help rejuvenate some of the lost bone.
With grafting, we place processed bone grafting material in the jaw through a minor surgical procedure to form a scaffold for new bone to grow upon. After several months this can result in several millimeters of new growth maintaining the width of the underlying bone, which in turn may be able to support an implant.
Bone grafting is quite common, often performed at the same time as tooth extraction if there's going to be a time lag before installing an implant. Even if performed later, though, it can successfully rejuvenate lost bone and make it possible for you to take advantage of durable, life-like implants.
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.”
While the sport of golf may not look too dangerous from the sidelines, players know it can sometimes lead to mishaps. There are accidents involving golf carts and clubs, painful muscle and back injuries, and even the threat of lightning strikes on the greens. Yet it wasn’t any of these things that caused professional golfer Danielle Kang’s broken tooth on the opening day of the LPGA Singapore tournament.
“I was eating and it broke,” explained Kang. “My dentist told me, I've chipped another one before, and he said, you don't break it at that moment. It's been broken and it just chips off.” Fortunately, the winner of the 2017 Women’s PGA championship got immediate dental treatment, and went right back on the course to play a solid round, shooting 68.
Kang’s unlucky “chip shot” is far from a rare occurrence. In fact, chipped, fractured and broken teeth are among the most common dental injuries. The cause can be crunching too hard on a piece of ice or hard candy, a sudden accident or a blow to the face, or a tooth that’s weakened by decay or repetitive stress from a habit like nail biting. Feeling a broken tooth in your mouth can cause surprise and worry—but luckily, dentists have many ways of restoring the tooth’s appearance and function.
Exactly how a broken tooth is treated depends on how much of its structure is missing, and whether the soft tissue deep inside of it has been compromised. When a fracture exposes the tooth’s soft pulp it can easily become infected, which may lead to serious problems. In this situation, a root canal or extraction will likely be needed. This involves carefully removing the infected pulp tissue and disinfecting and sealing the “canals” (hollow spaces inside the tooth) to prevent further infection. The tooth can then be restored, often with a crown (cap) to replace the entire visible part. A timely root canal procedure can often save a tooth that would otherwise need to be extracted (removed).
For less serious chips, dental veneers may be an option. Made of durable and lifelike porcelain, veneers are translucent shells that go over the front surfaces of teeth. They can cover minor to moderate chips and cracks, and even correct size and spacing irregularities and discoloration. Veneers can be custom-made in a dental laboratory from a model of your teeth, and are cemented to teeth for a long-lasting and natural-looking restoration.
Minor chips can often be remedied via dental bonding. Here, layers of tooth-colored resin are applied to the surfaces being restored. The resin is shaped to fill in the missing structure and hardened by a special light. While not as long-lasting as other restoration methods, bonding is a relatively simple and inexpensive technique that can often be completed in just one office visit.
If you have questions about restoring chipped teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Porcelain Veneers” and “Artistic Repair of Chipped Teeth With Composite Resin.”
In the battle against tooth decay, fluoride is an important weapon. Since the discovery of its dental health benefits a century ago, fluoride has been credited with saving countless teeth.
But over its history in dental care, this natural-occurring chemical has also had its share of controversy with concerns raised from time to time on potential health dangers. These run the gamut from “conspiracy theory” speculations to credible research like a 2006 National Research Council study that suggested a possible increased risk of bone fracture or cancer from over-consumption of fluoride.
Even so, there is actually little evidence or even record of incidence for such dire consequences. The only definitive health effect from fluoride found after decades of copious research is a condition called fluorosis, a permanent staining effect on the teeth. Fluorosis poses a cosmetic problem but does not harm the health of the teeth.
Moderation in fluoride use seems to be the key to gaining its health benefits while avoiding fluorosis. One influential fluoride researcher, Dr. Steven Levy, estimates 0.05-0.07 milligrams of fluoride per one kilogram of body weight (about a tenth the weight of a grain of salt for every two pounds) is sufficient to gain the optimum dental benefit from fluoride.
The real question then is whether your family’s current consumption of fluoride is within this range. That will depend on a number of factors, including whether your local water utility adds fluoride to your drinking water supply and how much. You may also be ingesting fluoride through processed foods, juices and even some bottled waters. And you can encounter fluoride in dental care including toothpastes and clinical treatments.
One way to moderate your family’s fluoride intake is to be sure all your family members are using the correct amount of fluoride toothpaste for their age while brushing. Infants need only a slight smear on the end of the brush, while older children can brush adequately with just a pea-sized amount. For other tips and advice, talk to your dentist about your family’s fluoride intake and how you might adjust it.
Even with the possibility of fluorosis, fluoride still provides an incredible benefit in preventing tooth decay. By understanding fluoride and keeping your intake within normal ranges you can maximize its benefit for healthier teeth and minimize the fluorosis risk.
If you would like more information on the role of fluoride in dental 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 “Fluoride & Fluoridation in Dentistry.”
While cigarette smoking has been linked with lung cancer and heart disease, it, can also contribute to dental disease. You can reduce these risks by doing one thing — quitting smoking.
But that’s easier said than done: forty-six percent of smokers try to quit every year, but only one in ten are successful long term. The difficulty is tied to tobacco’s active ingredient, nicotine, an addictive substance that triggers chemical and behavioral dependence. Nicotine “re-wires” the brain to feel pleasure when it encounters the chemical, and to feel bad when it’s deprived. Social, occupational or recreational activities can further reinforce the habit.
Many smokers try to quit through sheer willpower or “cold turkey.” Because of nicotine’s addictive properties, this rarely works — instead, you need a comprehensive strategy tailored to you.
You should begin first with trying to understand your individual smoking patterns: when do you smoke, how frequently, or during what activities? To help with this you can use a “wrap sheet”, a piece of paper you keep wrapped around your cigarette pack. Each time you take out a cigarette, you would record how you feel on the sheet. This also slows down the action of taking out a cigarette and lighting it, which can help you become less mechanical and more mindful of your habit.
You can also break your dependence by gradually introducing restrictions to your smoking: smoke only in certain locations or at certain times; substitute other stress-relieving activities like a walk or other physical exercise; or gradually reduce the number of cigarettes you smoke. You can do the latter by setting a goal, say to smoke 20% fewer cigarettes each successive week; this will force you to increasingly make choices about when you smoke.
Finally, don’t try to go it alone. You can benefit greatly from professionals, including your dentist, to help you kick the habit through Nicotine Replacement Therapy (NTR) with prescription medication, counseling or smoking cessation support groups.
Quitting smoking isn’t so much stopping a behavior as it is “unlearning” one and establishing new, healthier ones. The first step, though, is accepting you need a change, one that will benefit your whole life.
If you would like more information on quitting smoking, 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 “Strategies to Stop Smoking.”
Like other healthcare providers, your dentist keeps records of your ongoing care. These include not only their written notes but also x-ray imaging, frequency of visits and cleanings, and any medical information that could affect your care. What’s more, they have a legal obligation to maintain these records.
Your dental records help guide decisions about your care. In that regard, you should consider something else—you may need to change providers: your dentist retires or you move; your dentist isn’t in your new insurance network; or, unfortunately, you have an “irreconcilable” difference with your provider.
If that happens, it’s very important your dental records find their way to your new provider. Here are 3 reasons why.
Your individual dental history. Each person’s dental situation and needs are unique. Your past records help clue in your new dentist about your past history and current needs, which will help guide how they treat you.
Time and money. Your dental records contain x-rays or other diagnostic information about your oral condition, including preparations for any upcoming dental work. If you change dentists before completing that treatment, your new dentist may have to start over with new diagnostic tests if they don’t have this previous data. It could cost you more money and make you wait longer for a needed procedure.
Coordinating dental care with your general health. Your mouth isn’t isolated from the rest of your body, and some dental treatment measures could affect other health conditions (and vice-versa). If your new dentist knows other health issues you may have from your previous records, it can help ensure you’re getting dental treatment appropriate to your overall health.
For the most streamlined transition between providers, it’s important your dental records follow you. You’re entitled to having those records transferred, and, if you’re uncomfortable asking yourself, your new provider can obtain them for you. Just be sure to ask.
If you would like more information on your rights regarding your dental care records, 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 “Why Your Dental Records Should Follow You.”
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