Posts for: March, 2016
Some patients who wear dentures face a kind of Catch-22: their denture fit may have loosened and become uncomfortable over time due to continued bone loss, yet the same bone loss prevents them from obtaining dental implants, a superior tooth replacement system to dentures.
But there may be a solution to this dilemma that combines the stability of implants with a removable denture. A set of smaller diameter implants — “mini-implants” — can support a removable denture with less bone than required by a conventional implant.
Like all living tissue, bone has a life cycle: after a period of growth, the older bone dissolves and is absorbed by the body, a process known as resorption. The forces generated when we bite or chew are transmitted by the teeth to the jawbones, which stimulates new bone formation to replace the resorbed bone. When the teeth are lost, however, the stimulation is lost too; without it, resorption will eventually outpace bone growth and repair, causing the bone mass to shrink.
Removable dentures also can’t supply the missing stimulation — bone loss continues as if the dentures weren’t there; and due to the compressive forces of a denture, bone loss accelerates. As the jawbone structure used to originally form the denture’s fit eventually shrinks, the denture becomes loose and difficult to wear. It’s possible to adjust to the new jaw contours by relining the dentures with new material or creating a new set of dentures that match the current bone mass. Without adequate bone, fixed crowns or bridges anchored by conventional implants may also be out of the picture.
On the other hand, mini-implants with their smaller diameter need less bone than the traditional implant. A few strategically placed within the jaw are strong and stable enough to support a removable denture. One other advantage: these mini-implants can be installed in one visit with local anesthesia and usually without the need for incisions or stitches.
If you would like more information on dentures supported by mini-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 “The ‘Great’ Mini-Implant.”
Before we discuss cosmetic options for transforming your smile, and before any preparations for treatment, there’s one question that needs to be answered: What do you want to be different about your smile?
There’s a common misconception that cosmetic changes to the teeth and gums — a “smile makeover” — is primarily a technical achievement based on rigid principles of beauty. Patients believe they must defer to their dentists for what will look best. But that’s not the entire picture: what’s often lost in the understanding is that it’s your smile — the smile at the end of the process you must be comfortable showing with confidence.
In this regard, there are two types of patients, with no right or wrong view — simply what a patient perceives as the smile they want. Some want the “perfect” smile — the greatest level of regularity between teeth shape, size and alignment and the maximum level of brightness. Others are more comfortable with a “natural” smile, a more subtle look with just enough change to create something new and different. The latter may even desire a less than perfect look that doesn’t “fix” all their imperfections — the ones they believe give their face “character.”
Knowing to which side you lean is important at the outset. It’s then important for you to communicate those expectations with us. While we’re focused on the technical aspects of treatment — tooth length, the lineup of teeth with other facial features or the gum-to-lip distance — only you can express what’s going to be a beautiful yet comfortable smile for you. By meshing the technical requirements with your personal desires, we’re able to formulate a makeover plan that fits you.
It all begins with a comprehensive examination to determine the exact health state of your mouth, and it may be necessary to first perform dental work to improve it. From there we can discuss what is and isn’t possible to change the appearance of your teeth and gums. In the end, we want the same result as you — a beautiful smile you’re happy and confident to show the world.
If you would like more information on smile makeovers, 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 “Great Expectations: Is what you get what you want?”
Sports drinks have been widely touted as an ideal way to replenish carbohydrates, electrolytes and, of course, fluids after a strenuous event or workout. But the mixtures of many popular brands often contain acid and added sugar, similar to other types of soft drinks. This can create an acidic environment in the mouth that can be damaging to tooth enamel.
Of course, the best way to replenish fluids after most strenuous activities is nature’s hydrator, water. If, however, you or a family member does drink the occasional sports beverage, you can help reduce the acid impact and help protect tooth enamel by following these 3 tips.
Avoid sipping a sports drink over long periods. Sipping on a drink constantly for hours interferes with saliva, the bodily fluid responsible for neutralizing mouth acid. But because the process can take thirty minutes to an hour to bring the mouth to a normal pH, saliva may not be able to complete neutralization because of the constant presence of acid caused by sipping. It’s best then to limit sports drinks to set periods or preferably during mealtimes.
Rinse your mouth out with water after drinking.Â Enamel damage occurs after extended periods of exposure to acid. Rinsing your mouth out immediately after consuming a sports drink will wash away a good amount of any remaining acid and help normalize your mouth’s pH level. And since water has a neutral pH, it won’t add to the acid levels.
Wait an hour to brush after eating. As mentioned before, saliva takes time to neutralize mouth acid. Even in that short period of time, though, acid can soften some of the mineral content in enamel. If you brush during this “soft” period, you may inadvertently brush away some of the minerals. By waiting an hour, you give saliva time not only to neutralize acid but also restore mineral strength to the enamel.
If you would like more information on sports and energy drinks and their effect on 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 “Think Before you Drink.”
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.”
Your front teeth are the stars of your smile — so it makes perfect sense to replace them if they’re missing. But is it really necessary to replace a largely unseen back tooth with an implant or bridgework?
The answer is an unequivocal yes. Your individual teeth are an interactive part of a dynamic mechanism that enables you to eat, speak and smile. They’re highly adaptable and can move incrementally to accommodate mouth changes — especially when one of them is lost.
Back teeth not only help us chew food efficiently, they also ease some of the pressure from front teeth as we chew. Our efficiency while chewing suffers when they’re missing; other teeth will wear faster and tend to move out of position, “drifting” into the space left by the missing tooth. And without their stimulation during chewing, new bone may grow at a slower rate to replace older bone, reducing bone volume over time.
So, whether visible or not, replacing a back tooth is the best course to take to prevent these adverse consequences. Your two best options are fixed bridgework or dental implants, each with their own advantages and disadvantages.
Bridgework has been the traditional method for replacing one or a few missing teeth: they’re long-lasting if cared for properly, have a life-like appearance that blends well with other teeth and are a good option when implants aren’t. But they require extensive altering of the anchor teeth (those used on either side of the bridge to secure it) and they’re highly prone for trapping food between them and the gums, increasing the risk of disease.
Dental implants are easily maintained and their installation doesn’t affect adjacent teeth as with a bridge. They’re also durable with a 95% success rate after ten years. On the other hand, the installation process can take several months and visits, and they require a certain amount of bone mass for proper placement and so aren’t ideal for certain patients.
Regardless of its location, if you have a missing tooth or one that may need to be removed, you should visit us for a complete examination. From there we can tell you how your mouth has been impacted by the missing tooth and which replacement option is best for you.
If you would like more information on tooth replacement options, 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 “Replacing Back Teeth.”