Posts for: October, 2015
Imagine not having your upper teeth for talking and eating, not to mention your appearance, and you’ll have some idea of what Beauty the bald eagle experienced after losing the top of her beak to a hunter’s bullet in northern Idaho. She couldn’t groom or feed herself and could barely drink water, relying instead on the conservation group that had taken her under their wing for assistance. But the magnificent raptor was eventually made whole and able once again to eat, drink and preen unaided. It took a visionary mechanical engineer and a very skillful dentist who designed and attached the first-of-its-kind bald eagle “dental” prosthetic — dubbed the “bionic beak.”
Prosthetic Teeth for Humans
Fortunately, the field of human prosthetic dentistry (or prosthodontics) is much more advanced than it is for our avian friends. We have several options for replacing missing teeth (as well as parts of missing teeth) that restore aesthetic appearance and functionality while potentially preventing other problems such as the drifting out of alignment or loss of remaining teeth.
Bridges. As the name suggests, these custom-made devices span the area that is missing a tooth/teeth. Fixed (not removable) bridges are made up of an artificial tooth/teeth fused between two crowns that fit over your existing teeth or dental implants (see below) on either side of the gap. There are removable bridges, but they are considered temporary fixes.
Dentures. These are custom-made removable replacements for missing teeth. Partial dentures offer a removable alternative to fixed bridges and are used when some teeth are missing in an upper or lower arch (jaw). Full dentures are used when all teeth are missing in an arch. Replacement teeth are embedded in an acrylic base that fits over your gums and mimics their color.
Dental Implants. These are the closest thing to having your own tooth/teeth back. An implant is a small titanium post that is placed in the jawbone beneath the gum to serve the same purpose as a tooth root. Once the bone joins to the implant (a process called osseo-integration), a lifelike crown is attached to it.
We would be glad to discuss which option would be right for you.
If you have questions about tooth replacement, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Dental Implant Surgery,” and “Crowns & Bridgework.” Beauty the eagle’s story of rehabilitation can be found here: http://blog.theanimalrescuesite.com.
Maybe you don’t like to be without teeth — ever. Or maybe you get a little forgetful sometimes. Whatever the reason, if you’re wearing your dentures to bed at night, we have one message for you: Please stop!
Sleeping in dentures can have serious health consequences. A recent study published in the Journal of Dental Research found that nursing home residents who wore their dentures to sleep were 2.3 times more likely to be hospitalized or even die of pneumonia as those who did not sleep in dentures. But how can wearing dentures at night more than double your chances of getting a lung infection?
As the study noted, pneumonia-causing bacteria can readily be moved from the mouth to the lungs simply by breathing. And dentures that are not removed at night can become breeding grounds for all kind of bacteria and fungi (such as yeast). That’s what makes them potentially dangerous.
Another condition often seen in people who wear upper dentures continually is called denture stomatitis, which is characterized by a red, inflamed palate (roof of the mouth) that has been infected with yeast. The yeast microorganisms can also infect cracked corners of the mouth, a condition known as angular cheilitis. Moreover, it has also been shown that people who sleep in dentures have higher blood levels of a protein called interleukin 6, which indicates that the body is fighting an infection. Need we go on?
Wearing dentures is supposed to improve your quality of life, not reduce it. So promote good health by taking your dentures out at night, and sticking to a good daily oral hygiene routine:
- Remove and rinse your dentures after every meal.
- Brush your dentures at least once a day with a soft toothbrush or denture brush and dish soap, liquid antibacterial soap, or denture cleanser (but don’t use toothpaste — it is too abrasive).
- Store your dentures in water or a solution made for this purpose.
- Brush your gums and tongue every day with a soft toothbrush (not the same one you clean your dentures with).
- Rinse your dentures in clean water before you put them back in your mouth.
While there’s usually a period of months between implant placement and the permanent crown, a new technique known as same-day tooth replacement installs both the implant and a temporary crown during the same visit. But be advised — it does have its risks and isn’t for everyone.
Successful same-day replacements require special attention during the three phases for implants: the removal (extraction) of the existing tooth; placement of the implant in the bone; and attachment of the crown, the visible tooth, to the implant. The tooth extraction lays the foundation for the entire process; the extraction procedure must be performed carefully to avoid undue damage to the socket. In addition, if infection or disease has compromised the site, an implant may not be possible immediately.
The implant must then be placed in the bone so that it’s stable and immovable. All implants stabilize with time as the bone grows and adheres to them, but we need greater stability for a same-day tooth replacement when an extraction is performed.
Our last consideration is positioning the implant so that the attached crown blends in naturally with the surrounding gum tissue and adjacent teeth. We must place it at the proper depth below the gum tissues so that the crown appears to emerge from them in the proper tooth length.
Taking extra care during all these phases, including the angle of crown attachment, will increase our chances of success. We still run a risk of implant damage or failure, however, from biting forces before the implant fully integrates with the bone. This means avoiding chewy foods and other situations that might increase the force on the implant. We may also use a temporary crown that’s slightly shorter than adjacent teeth so it won’t make full contact with the opposing tooth.
If you’d like to know if you’re a good candidate for a same-day tooth replacement, see us for a detailed examination. After reviewing your needs, we’ll be able to discuss with you the risks and benefits for a new look in one day.
If you would like more information on same-day tooth replacement, 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 “Same-Day Tooth Replacement with Dental Implants.”
Since the 1950s fluoride has played an important role in the fight against tooth decay as an additive to hygiene products and many public water supplies. But although a proven cavity fighter, some have questioned its safety over the years.
To date, though, the only substantiated health risk from fluoride use is a condition known as enamel fluorosis, which occurs when too much fluoride is ingested during early tooth development as the mineral embeds in the tooth structure. Fluorosis can cause changes in the enamel’s appearance, ranging from barely noticeable white streaking to darker visible staining and a pitted texture.
Fluorosis is primarily a cosmetic problem and not a serious health issue. The staining on otherwise sound teeth, however, is permanent and more severe cases may require extensive bleaching treatment to improve appearance. The best strategy is to prevent fluorosis by monitoring and limiting your child’s fluoride intake, until about age 9.
Tooth decay is a more serious condition than fluorosis so we’re not advocating you eliminate fluoride but that you keep your family’s intake within safe levels. The first step is to determine just how much that intake is now, particularly if you drink fluoridated water. If you have public water, you may be able to find its fluoridation level online at apps.nccd.cdc.gov or call the utility directly.
You should also be careful about the amount of toothpaste your child uses to brush their teeth. Children under two need only a trace (a “smear”) on the brush, and children between the ages of 2 and 6 a pea-sized amount. And, they should brush no more than twice a day.
Another possible concern is infant formula, especially mixable powder. While the formula itself doesn’t contain fluoride, water mixed with it may. If you live in an area with increased fluorosis risk, consider breast-feeding (breast milk has little fluoride), using ready-to-feed formula, or mixing powdered formula with bottled water labeled “de-ionized,” “purified,” “demineralized” or “distilled.”
We’ll be glad to help assess your family’s current fluoride intake and advise you on making adjustments to bring it into normal ranges. Taking in the right amount of fluoride assures you and your children receive the most benefit and protection from it, while avoiding future smile problems.
If you would like more information on managing your family’s fluoride intake, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Development and Infant Formula.”
There are good reasons, for both health and appearance, to replace a missing tooth with a dental implant or similar restoration as soon as is practical. The bone around a tooth socket diminishes the longer it remains empty, up to 25% the first year. And, of course, your smile is less attractive, especially with a highly visible tooth.
If it’s your teenager, though, you may need to wait on a permanent restoration because their jaws are still developing. An implant placed before completion of jaw development could eventually appear out of alignment with neighboring teeth.
Our biggest concern is protecting bone health at the site of the missing tooth. We can do this and encourage growth by placing bone grafts (processed minerals from another donor) that serve as scaffolds on which surrounding bone can grow. Grafts usually dissolve (resorb) over time, but the rate of resorption can be slowed for a younger patient in need of long-term bone growth.
Planned orthodontic treatment can usually go on as scheduled. The orthodontist may accommodate the tooth loss by adding a temporary tooth within the braces or other device that matches the color and shape of the patient’s natural teeth. The orthodontist will also take care to maintain the empty space for a future implant or other restoration.
A dental implant is considered the best option for a missing tooth, not only for its life-like appearance and durability, but also its ability to encourage bone maintenance. Timing, though, is essential for teenagers. As it grows, the upper jaw will tend to move forward and down. Natural teeth move with this growth; implants, though, are attached differently and won’t move with the jawbone. While the other teeth around them move, the implants can appear to shrink back resulting in an unattractive smile appearance. So waiting until the jaw has finished growing is important.
For most people, jaw growth finishes by age twenty-one for men, women usually faster, but each person is different. The dentist’s expertise and experience, coupled with comparisons of adult family members’ facial appearances, will help determine the right time to undertake a permanent restoration for the best outcome both for health and a permanent, attractive smile.
If you would like more information on treating teenagers with missing teeth, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants for Teenagers.”