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Compared to other dental restorations—a few of which have been around for over a century—implants are a relatively recent development. But even though it's just now entering its fourth decade, recent advances have catapulted implant therapy well beyond where it began.
That's due mainly to digital technology. Two examples of this, computed tomography (CT) and 3-D printing, are increasing the accuracy and efficiency of implant placement.
Properly placing an implant is one of the most important elements in achieving a natural and attractive result. But finding the best location is often difficult due to a lack of suitable bone volume, the patient's bite or the proximity of anatomical structures like nerves and blood vessels. CT imaging, especially Cone Beam CT scanners (CBCT), is helping to make implant placement planning easier.
Unlike the static, two-dimensional views of standard x-rays, CBCT takes hundreds of images and digitally blends them together to create a virtual 3-D model of the patient's jaw and face. Dentists can view this highly detailed model on a computer monitor from various vantage points and better identify possible obstructions. With better information about what "lies beneath," they can more accurately pinpoint the best implant site.
Creating the ideal plan is one thing—successfully implementing it is another. Dentists often create a surgical guide that helps them drill in precisely the right positions during surgery. The guide, which resembles a mouthguard, fits over the gums and contains marker locations for drilling.
Many dentists are now using 3-D printing to create these surgical guides. A 3-D printer turns a digital model of the guide based on measurements of the patient's mouth and proposed implant locations into an actual physical object "printed out" layer by layer of special polymer material. The end product can be more precise than guides created by other means.
These and other technological developments are helping implant therapy rise to a new level of success. With the resulting increase in accuracy, efficiency and less treatment time, tomorrow's implant patients will be the ultimate beneficiaries.
If you would like more information on restoring missing teeth with 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 “How Technology Aids Dental Implant Therapy.”
Losing a tooth can be traumatic, but a dental implant can dramatically turn that experience around. Providing functionality, life-like appearance and durability, implants stand out as the premier restoration for lost teeth.
For adults, that is. An older child or teenager with a missing tooth may need to wait a few more years for an implant. The reason: jaw development. A person's jaws, particular the upper jaw, continue to grow with most growth completed by early adulthood. Natural teeth with their periodontal attachments develop right alongside the jaw.
But because an implant attaches directly to the jawbone, its position is fixed: it won't change as the jaw grows and may gradually appear to sink below the gum line. That's why we wait to place an implant until most of jaw maturity has occurred after full jaw maturity. For females, we try to wait until 20 years of age and for males, usually 21 years of age. These are guidelines as some people mature faster and some slower, so a discussion with your dentist or surgeon is necessary to make an educated decision.
While we wait, we can install a temporary replacement for a child's or teenager's lost tooth, usually a partial denture or fixed modified ("Maryland") bridge. The latter affixes a prosthetic (false) tooth in the missing tooth space by attaching it to the back of natural teeth on either side with bonded dental material. It differs from a traditional bridge in that these supporting teeth aren't permanently altered and crowned to support the bridge.
During the time before implants we should understand that the area where the implant will be placed will undergo some bone deterioration, a common consequence of missing teeth. Forces generated as we chew travel through the teeth to stimulate renewing bone growth all along the jawbone. But with a lost tooth the chewing stimulation ceases at that part of the bone, slowing the growth rate and leading to gradual bone loss.
Fortunately, the titanium posts of dental implants stimulate bone growth as bone cells naturally grow and adhere to their surfaces. Before then, though, if the bone volume is diminished, we may need to graft bone material to stimulate bone growth that will enlarge the jaw bone enough for an implant to be placed.
It usually isn't a question of "if" but "when" we can provide your child with an implant for their missing tooth. In the meantime, we can prepare for that day with a temporary restoration.
If you would like more information on dental restorations for teenagers, 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 for Teenagers.”
There are many reasons why teeth may need a whitening treatment to achieve an appealing brightness: what we eat and drink, natural aging, genetics, and the lack of dedication to oral hygiene can all play a role in how we look.
For vital (living) teeth, there are basically three different options for teeth whitening, and we’d be happy to help you decide which is right for you:
- In-office tooth whitening: The fastest way to get your smile radiant. A high concentration of a peroxide gel solution is applied directly to the tooth surface. Gums and other soft tissues are completely protected for your safety. This technique is excellent for whitening deep surface stains as well as general tooth whitening. This professional treatment requires the least amount of time to achieve the desired whiteness.
- The professional take-home option: Custom-made bleaching trays are prepared by our office. This technique is convenient and less expensive, but the desired whiteness will take longer to achieve than the in-office option.
- Over-the-counter products: These offer the least expensive option but use weaker whitening agents. For example, whitening strips, like the ones advertised on television, are popular and easy to use but will generally take the most time to achieve the desired success. Also, even agents that are not the strongest available may cause damage to teeth if used inappropriately and without professional supervision.
While there are normally no serious side effects after professional whitening treatments, there is a potential risk of tooth sensitivity and gum irritation. If either one or both of these occur, it should disappear within a few days.
It should come as no surprise that bleaching is not permanent. The whiteness will fade eventually depending on your diet, habits, hygiene, etc., but it usually will last at least six months — more often up to two years. Obviously, if you avoid drinking coffee, tea, or red wine, don’t smoke, and have a diligent oral hygiene routine your results may last longer.
Advertisements for teeth-whitening products are everywhere. If you have any questions about what you see, or simply want to do a reality check on their claims, please contact us or schedule an appointment for a consultation. You can learn more about this topic by reading the Dear Doctor magazine articles “Teeth Whitening: Brighter, Lighter, Whiter...,” and “Important Teeth Whitening Questions Answered.”
One of the most effective techniques for saving decayed or injured teeth is the root canal treatment. Yet when many people hear they need it, they become nervous at the prospect.
Much of this stems from a common misunderstanding that undergoing a root canal is painful. It’s not — today’s anesthetics are quite effective in numbing pain during a procedure, and mild pain relievers like ibuprofen are usually sufficient to manage any discomfort afterwards.
In fact, a root canal treatment relieves pain caused by decay within a tooth. As decay progresses, it can enter the interior known as the pulp, which contains bundles of nerves and blood vessels. It attacks these nerves causing pain and infection. If the infection progresses through passageways known as root canals that are in the roots of the tooth, the pain can intensify. More important, the tooth is in danger of loss as the root and connective tissues that hold the tooth in place are injured from the spreading infection.
During a root canal treatment, we access the pulp by drilling a small access hole, usually in the biting surface or in the rear of a front tooth. Once we enter the pulp chamber we remove all the contaminated tissue. Once thoroughly cleansed, we fill the empty chamber and canals with a special filling (usually gutta percha) to prevent future infection. The access hole is then sealed and at a subsequent visit we strongly recommend placing a permanent crown to provide further protection from damage to the tooth.
Root canal treatments are quite common. All general dentists have been trained in endodontic treatment and can perform most types of procedures. More difficult cases (like a complex root canal network that may be hard to access) may require the services of an endodontist, a specialist in root canals. Endodontists use advanced techniques and specialized microscopic equipment to treat complicated situations.
It’s actually good news if we recommend you undergo a root canal treatment — it means your tooth has a good chance of survival once it’s disinfected and the decay is removed. But don’t delay: the sooner we can treat your tooth, the better your chances of a healthy outcome.
If you would like more information on root canal treatment, 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 “Common Concerns about Root Canal Treatment.”
Performing dental implant surgery involves placing a metal post inside the bone of the jaw, and ensuring that it fits so precisely and functions so well that you never notice the tooth replacement — and yet it can last for decades. Does it sound terrifically complex or painful? It's not! In fact, the procedure has a success rate of 95-97%, the highest of any tooth replacement option. Here's what you need to know about dental implant surgery.
A dental implant is designed to replace the root part of the tooth. To replace the visible part of the tooth, a crown, bridge or denture can be attached once the implant is secure — which may be the same day or several weeks later, depending on the individual situation. Dental implants are made of titanium (or its alloys), because this metal has a unique property: it's capable of fusing to bone, a process called osseo-integration.
Before placing the implant, a lot of planning goes on — typically involving X-rays (radiographs), and sometimes CT scans. This ensures that the operation itself goes smoothly. When it's time for the procedure you'll receive a local anesthetic, and we'll make sure you don't feel anything.
Next, we access the bone itself, often by making a small flap-like incision in the gum tissue. The living bone is handled with extreme care as a tiny amount is removed to make space for the implant. After the implant is fitted precisely in the bone, the gum tissue is closed, often with self-absorbing sutures (stitches) that don't need removal. And then the procedure's over.
Is implant placement painful? The simple answer is no — most people feel no pain during surgery and very little discomfort afterward. At most, you may experience some mild vibration during the bone preparation process. If you're nervous about the procedure, it's possible to have a sedative or anti-anxiety medication beforehand. Afterward, taking mild non-steroidal anti-inflammatory medication for a day or two is usually all you need to relieve any post-operative discomfort.
If you have questions about dental implant surgery, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Dental Implants.”