Posts for: April, 2013
If you are at all uncomfortable at the thought of getting a dental implant, you might be pleasantly surprised to learn the truth about these marvelous state-of-the-art tooth-replacement systems — and the special role of a relatively new device, the mini-implant. So, first, let's go over some basic facts.
What's a dental implant? Basically, it's just a replacement for the root part of the tooth, the part that lies beneath the gum line. It attaches to a crown, which is a replacement for the visible portion of the tooth. But instead of ceramics or metals, implants are made of titanium, which becomes fused to the surrounding bone. When complete, implants are much stronger and longer-lasting than other methods of tooth replacement, like bridgework and dentures.
Implants are presently regarded as the best way to replace missing teeth, with a success rate of over 95%. They also help prevent bone loss in the jaw, a major goal of modern dentistry. Having one put in is an office procedure that's generally accomplished with local anesthesia, and most patients experience only minor discomfort. Standard dental implants can be used to replace a single tooth, or multiple teeth. The mini-implant, which is just a miniature version of the same technology, is now playing an increasing role in many other phases of dentistry.
Why mini-implants? Because in several situations, this smaller and less expensive alternative offers a solution that's just as good — or better — than any other dental treatment. One area where mini-implants excel is in supporting lower jaw overdentures.
Many people find that lower dentures are far more troublesome than upper dentures. The movement of the tongue muscle, and the smaller area of surface contact (compared to the upper denture, which is supported by the palate) often results in a poor, loose fit, which leads to problems when eating or speaking. These problems can be solved by affixing a lower overdenture (an implant-retained denture) with just two mini-implants.
Not only do mini-implants help prevent bone loss, they also give the denture wearer increased stability, comfort, and confidence. And they do so at a price that's more economical than you might think. In some cases, the mini-implants can be placed in a single one-hour office visit, and your own denture can be modified to fit them — so you can go home and eat a steak that night!
Another area where mini-implants are finding increasing use is in orthodontics. Orthodontic appliances (commonly called braces) move teeth by exerting a light force on them, using a wire which is fixed to a solid anchor point. Traditionally, other teeth are used as anchors — but sometimes these teeth move as well! By using immovable mini-implants as the anchor points, the process is greatly simplified. Strategically placed mini-implants called TADS (temporary anchorage devices) can be used to correct both skeletal (jaw) position and dental (tooth) position problems.
Mini-implants may also be used in upper dentures and temporary bridgework.
If you would like more information about 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 articles “Implant Overdentures for the Lower Jaw,” “The Great Mini-Implant,” and “What are TADS?”
Your son has fallen and hit his face against a hard surface. Not only is he in pain but now there is also a chip missing from his front tooth. He is worried that his smile will never be the same. What should you do?
Answer: If you can find that missing chip, sometimes we can bond the fragment back on to the tooth. The tooth should be evaluated and repaired as soon as possible, although in the absence of other signs and symptoms of injury, and if your child is not in acute pain, it can probably wait up to 12 hours.
If the fragment can't be found, then the tooth can be restored with tooth-colored filling materials, which are also physically bonded to the natural tooth. Done well, these “composite resin” fillings can last for years and look perfectly natural. They may eventually need to be replaced with something more permanent.
If the chipped tooth is a child's primary (baby) tooth rather than a permanent (adult) tooth, the treatment will be similar.
However, a blow to a tooth can cause damage to the pulp — the living tissue within the tooth, which can become infected and die. If the damage to a primary tooth is too extensive it may be better to remove it to avoid damage to an underlying and developing permanent tooth. A place-holding appliance called a space maintainer may be used. If it is a permanent tooth it may need root canal treatment.
If a tooth is not chipped but is loosened or tender to the touch, it may require temporary stabilization, called splinting, until it has healed. Sometimes no treatment is required. If there has been a fracture to the tooth's root (the part below the gum line) it may heal by itself, or it may require further treatment especially if it is a permanent tooth, depending on the individual situation.
It is important to evaluate teeth that have been hit or damaged as a result of injury to ensure that they remain healthy and functional. We will keep track of the tooth or teeth, with observation, x-rays when necessary and monitoring over time to make sure no permanent damage has been done.
Contact us today to schedule an appointment or to discuss your questions about repairing a chipped tooth. You can also learn more by reading the Dear Doctor magazine article “The Field-Side Guide to Dental Injuries.”
Porcelain laminate veneers are one of the innovative techniques dentistry has developed for restoring teeth to improve their color and shape so that they look as good as or better than the originals.
What are porcelain veneers? Porcelain is a ceramic material that is baked in a high-heat oven until it becomes glass-like. Your grandmother's antique china teacups are probably made of porcelain. Dental porcelains are especially made to perfectly mimic the color, reflectivity and translucency of natural tooth enamel. A veneer is a covering or shell, a false front; dental porcelains can be fashioned into veneers used to restore the enamel surfaces of teeth.
What is a laminate? A laminate is a structure created by uniting two or more layers of material together. Dental porcelain laminate veneers refer to the combination of tooth enamel bonding material and porcelain veneer.
When are porcelain laminate veneers used? Porcelain veneers are used to enhance the color of stained, darkened, decayed and heavily restored teeth. They are also used to: correct spaces between teeth; straighten slightly rotated teeth; correct problems in tooth shape and some bite problems. They can be good solutions for broken teeth or teeth that have been worn by habitual tooth grinding.
What is the process of placing the veneers? Room generally needs to be created to place a veneer; generally requiring about half a millimeter of reduction of tooth enamel. Artistic dental laboratory technicians fabricate veneers. About a week of laboratory time is usually needed to construct your veneers.
How do I know whether I will like the way my new veneers look? Computer imaging can be used to digitally replicate your teeth and create images of the proposed changes. Models of your teeth can be cast and changes can be made in white wax for your preview. Temporary veneers can also be fabricated as a test drive before the final veneers are fabricated.
How long will porcelain veneers last? Veneers can last 20 years or more. They are very strong but like glass, they can break if extreme force is applied to them. You should avoid such activities as opening bottles, cracking nuts, or biting into candy apples with your veneers.
How do I look after my new veneers? Once the veneers are placed, you should continue daily brushing and flossing. There is no higher incidence of decay around them than with your natural teeth. However, the more dental work you have in your mouth, the more vigilant you need to be. Of course, keeping your sugar consumption low helps to protect all of your teeth from decay.
Contact us today to schedule an appointment or to discuss your questions about porcelain laminate veneers. You can also learn more by reading the Dear Doctor magazine article “Smile Design Enhanced with Porcelain Veneers.”
Singer Olivia Newton-John's daughter Chloe is now a lovely, grown woman, but Olivia recently recounted to Dear Doctor magazine a rather creative method she found to sooth Chloe's teething troubles many years ago.
“When Chloe was a baby and teething I remember using a frozen bagel for her sore gums,” Olivia said. “She loved it!”
Cold is often very soothing to a teething child's gums. In fact, the American Academy of Pediatric Dentistry (AAPD) recommends using a clean, chilled, rubber teething ring, or cold wet washcloth. Chilled pacifiers can also be helpful. Be sure not to freeze teething rings or pacifiers as ice can actually burn sensitive mouth tissues.
Older teethers can sometimes find relieve from cold foods such as popsicles (or bagels!) but make sure your child eats these sugar-containing foods only at mealtimes so as not to promote tooth decay.
If your baby has not yet begun the teething (or tooth-eruption) process, you can expect it to begin usually between six and nine months. It may, however, start as early as three months or as late as twelve months.
Teething symptoms vary among children, as does the length of time it takes for a tooth to make its appearance. But many parents notice the following signs:
- Biting and gnawing
- Gum swelling
- Chin (facial) rash
- Disrupted sleeping patterns
- Ear rubbing
- Decreased appetite
These symptoms are usually most bothersome during the week that the tooth is breaking (erupting) through the gums, starting about four days before and lasting about three days after the tooth appears.
Occasionally, teething discomfort can be considerable. If that is the case with your baby, you can give her or him acetaminophen or ibuprofen in the appropriate dose (check with your pharmacist if you're not sure what that is). The medicine should be swallowed — not massaged into the gums, as this can also burn. Numbing agents should not be used for children under 2, except under the advice and supervision of a healthcare professional.
If you would like to learn more about teething or any other child-related oral health issue, please contact us or schedule an appointment for a consultation. If you would like to read Dear Doctor's entire interview with Olivia Newton-John, please see “Olivia Newton-John.” Dear Doctor also has more on “Teething Troubles.”