Posts for category: Dental Procedures
We Americans love our sports, whether as participants or spectators. But there's also a downside to contact sports like soccer, football or basketball: a higher risk of injury, particularly to the mouth and face. One of the most severe of these is a knocked out tooth.
Fortunately, that doesn't necessarily mean it's lost: The tooth can be reinserted into the empty socket and eventually return to normal functionality. But it must be done as soon as possible after injury. The more time elapses, the lower the chances of long-term survival.
That's because of how teeth are held in place in the jaw, secured by an elastic, fibrous tissue known as the periodontal ligament. When a tooth is knocked out some of the ligament's periodontal cells remain on the tooth's root. If these cells are alive when the tooth is reinserted, they can regenerate and reestablish attachment between the ligament and the tooth.
Eventually, though, the cells can dry out and die. If that has already happened before reinsertion, the tooth's root will fuse instead with the underlying bone. The tooth may survive for a short time, but its roots can eventually dissolve and the tooth will be lost.
Your window of opportunity for taking advantage of these live periodontal cells is only 5-20 minutes with the best chances in those earlier minutes. You should, therefore, take these steps immediately after an injury:
- Find the tooth, hold it by the crown (not the root end), and rinse off any debris with clean water;
- Reinsert the root end into the empty socket with firm pressure;
- Place clean gauze or cloth in the person's mouth between the tooth and the other jaw, and ask them to bite down gently and hold their bite;
- Seek dental or emergency medical care immediately;
- If you're unable to reinsert the tooth, place it quickly in a container with milk and see a dentist immediately.
You can also obtain an Android or IOS smartphone app developed by the International Association of Dental Traumatology called ToothSOS, which will guide you through this process, as well as for other dental emergencies. The quicker you act, the better the chances that the injured person's knocked out tooth can be rescued.
If you would like more information on what to do in a dental emergency, 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 “When a Tooth is Knocked Out.”
Complete tooth loss is a common condition among older adults, gradually occurring one or two teeth at a time. There often comes a point of realization, though, that all the teeth will eventually be lost.
This can create a dilemma: Do you replace teeth as they're lost, or go ahead and have all of them removed at one time?
Up until recently, the latter choice seemed the most practical and affordable. But most dentists would agree that keeping natural teeth for as long as practical is better for a person's overall oral health and to slow any potential bone loss.
The emergence of dental implants has made this less of a dilemma: We can use this technology to more affordably replace teeth in stages rather than all at once. This is because an implant is technically a root replacement: a dentist inserts a titanium metal post into the jawbone. Because of an affinity with titanium, bone cells grow and adhere to the implant surface, which creates a stronger hold. It also impedes bone loss.
We can, of course, use implants as individual tooth replacements. But the expense of this approach with multiple teeth puts it well out of reach financially for many people. But implants can also be used as connective points between the patient's jaw and other kinds of dental restorations like bridges, partial dentures, and full removable or fixed dentures.
Using this approach, we can adopt a strategy of allowing healthier teeth to remain until it's necessary to remove them. We initially place implants to support a bridge, for example; later we can use the same implants along with additional ones to support a larger restoration, even a fixed full denture.
An implant-supported restoration is typically more expensive than traditional bridges or dentures, but far less than replacing teeth with individual implants. And because the stages of restorations may occur over a long period of time, the cost can be spread out to make it more manageable.
If you're facing a future where it's likely you'll lose all your teeth, you don't have to lose them all at once. Staged restorations with implants could help you hold on to your natural teeth for as long as possible, slow bone loss and make for a healthier mouth.
If you would like more information on the wide array of dental restoration 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 All Teeth But Not All at Once.”
Dental implants are far and away the most “tooth-like” restoration available today for missing teeth. Not only do they look real, they also mimic dental anatomy in replacing the tooth root.
To install an implant, though, requires a minor surgical procedure. And, as with any surgery, that includes a slight risk for a post-surgical infection. For most patients this isn't a major concern—but it can be for people with certain medical conditions.
One way to lessen the risk for implant patients whose health could be jeopardized by an infection is to prescribe a prophylactic (preventive) antibiotic before implant surgery. The American Dental Association (ADA) recommends the measure for patients with artificial heart valves, a history of infective endocarditis, a heart transplant and other heart-related issues.
In the past, their recommendation also extended to people with joint replacements. But in conjunction with the American Academy of Orthopedic Surgery (AAOS), the ADA downgraded this recommendation a few years ago and left it to the physician's discretion. Indeed, some orthopedic surgeons do recommend antibiotic therapy for patients before surgical procedures like implantation for up to two years after joint replacement.
These changes reflect the ongoing debate over the proper use of antibiotics. In essence, this particular argument is over risks vs. benefits: Are pre-surgical antibiotics worth the lower infection risk for patients at low to moderate risk in return for increased risk of allergic reactions and other side effects from the antibiotic? Another driver in this debate is the deep concern over the effect current antibiotic practices are having on the increasing problem of antibiotic-resistant bacteria.
As a result, dentists and physicians alike are reevaluating practices like prophylactic antibiotics before procedures, becoming more selective on who receives it and even the dosage levels. Some studies have shown, for example, that a low 2-gram dose of amoxicillin an hour before the procedure can be effective with much lower risks for side effects.
If you're considering dental implants and you have a medical condition you think could be impacted by the procedure, discuss the matter with your dentist and physician. It may be that pre-surgical antibiotics would be a prudent choice for you.
If you would like more information on getting 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 “Implants & Antibiotics.”
Nothing beats the form and function of a real tooth—but dental implants come pretty close. That's why they're tops among both dentists and patients for replacing missing teeth.
Much of an implant's functionality and durability can be credited to its material construction, from the titanium metal post imbedded in the jawbone to the lifelike porcelain crown attached at its other end. But an implant's “nuts and bolts” isn't the only reason why this premier dental restoration is so popular: A good portion of their success comes from the adjunct support provided by digital technology.
Without this varied array of computer-based applications used in planning, designing and installing them, implants couldn't produce the level of satisfactory outcomes they currently do. Here then are a few of the high-tech tools dentists use to make sure your implants result in a winning smile.
CBCT scanning. Implant placement requires a high degree of precision often complicated by various anatomical structures like nerves, blood vessels and sinuses within the gums and jaws. Cone Beam Computer Tomography (CBCT) scanners rotate around a patient's head, taking hundreds of digital x-ray images that are then assembled into a 3-D model image. Dentists can view this model from various angles to identify obstacles and better pinpoint the best implant locations.
Digital impressions. Dentists can also create a 3-D digital impression model of the inside of a patient's mouth that can give them views of their current teeth and gums from any angle. This aids in determining the size and type of implant so that it blends seamlessly with remaining teeth. A digital impression can also provide both the dentist and patient a preview appearance of their future smile after treatment.
3-D printed surgical guides. To accurately drill the implant site during surgery, dentists often create a custom-made device called a surgical guide that fits into the patient's mouth during the procedure. Using results from scanning and digital impressions, highly accurate guides can be created with a 3-D printer. This further ensures that the implant will be in the exact best location for the most attractive and functional outcome.
Implantology is as much art as it is science in achieving a beautiful smile. These and other digital tools help make that desirable end a reality.
If you would like more information on dental implants, please contact us or schedule an appointment for a consultation.
Kathy Bates has been a familiar face to filmgoers since her Oscar-winning performance as Annie Wilkes in Misery. She's best known for playing true-to-life characters like Wilkes or Barbara Jewell in last year's Richard Jewell (for which she earned her fourth Oscar nomination). To keep it real, she typically eschews cosmetic enhancements—with one possible exception: her smile.
Although happy with her teeth in general, Bates noticed they seemed to be “moving around” as she got older. This kind of misalignment is a common consequence of the aging process, a result of the stresses placed on teeth from a lifetime of chewing and biting.
Fortunately, there was an orthodontic solution for Bates, and one compatible with her film career. Instead of traditional braces, Bates chose clear aligners, a newer method for moving teeth first introduced in the late 1990s.
Clear aligners are clear, plastic trays patients wear over their teeth. A custom sequence of these trays is developed for each patient based on their individual bite dimensions and treatment goals. Each tray in the sequence, worn in succession for about two weeks, places pressure on the teeth to move in the prescribed direction.
While clear aligners work according to the same teeth-moving principle as braces, there are differences that make them more appealing to many people. Unlike traditional braces, which are highly noticeable, clear aligners are nearly invisible to others apart from close scrutiny. Patients can also take them out, which is helpful with eating, brushing and flossing (a challenge for wearers of braces) and rare social occasions.
That latter advantage, though, could pose a problem for immature patients. Clear aligner patients must have a suitable level of self-responsibility to avoid the temptation of taking the trays out too often. Families of those who haven't reached this level of maturity may find braces a better option.
Clear aligners also don't address quite the range of bite problems that braces can correct. Some complex bite issues are thus better served by the traditional approach. But that gap is narrowing: Recent advances in clear aligner technology have considerably increased their treatability range.
With that said, clear aligners can be an ideal choice for adults who have a treatable bite problem and who want to avoid the appearance created by braces. And though they tend to be a little more expensive than braces, many busy adults find the benefits of clear aligners to be worth it.
The best way to find out if clear aligners could be a viable option for you is to visit us for an exam and consultation. Like film star Kathy Bates, you may find that this way of straightening your smile is right for you.
If you would like more information about tooth straightening, please contact us or schedule a consultation.