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.”
Vitamins play a key role in your body’s health, including your teeth and gums. A vitamin-deficient diet is an invitation to all sorts of disease.
But what are vitamins? Although they differ individually in what effect they have on the body, they’re all organic compounds found in foods, especially fruits and vegetables. Each in a different way helps with bodily processes.
Vitamin C, for example, helps the body repair tissue. Without it, tissue breaks down easier, as British sailors discovered centuries ago on long sea voyages. Deprived of vitamin C in their diets they soon encountered health issues like bleeding gums. Eating limes — chock full of vitamin C—helped to clear up such problems (and also why they were called “limeys”).
Scientists have discovered thirteen vitamins, four of which—A, D, E and K—are soluble (dissolvable) in fat; the body stores these in the liver and fat tissue where they issue out into the body slowly. The rest—C and eight types of B vitamin—are soluble in water. Unlike the fat-soluble vitamins, these are used quickly and any remaining are excreted from the body.
When it comes to teeth, gums and the mouth, a rich assortment of vitamins helps maintain good oral health. For the teeth especially, vitamin D plays a critical role—it helps the body absorb the mineral calcium necessary for strong bones and teeth. You’ll find this vitamin plentiful in dairy products, but also fatty fish like salmon and tuna.
While vitamins occur naturally in foods, they can be manufactured in the form of dietary supplements. Unfortunately, the world of dietary supplements is a murky one, ungoverned by the restrictions and clinical trials that drugs undergo before they go to market. And, it’s big business: vitamin supplements are promoted as “insurance” for good health.
But while some people have conditions that may require a vitamin supplement, research has shown that most of us can effectively get our vitamins through a diet rich in fresh fruits and vegetables. So, do your teeth and gums (as well as the rest of your body) a favor—eat your fruits and veggies. Along with daily brushing and flossing, getting enough vitamins can go a long way toward keeping your mouth healthy and disease-free.
If you would like more information on nutrition and 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 “Vitamins & Dietary Supplements: What Every Consumer Should Know.”
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
Chicken pox is a common viral infection that usually occurs during childhood. Although the disease symptoms only last a short time, the virus that caused it may remain, lying dormant for years within the body's nervous system. Decades later it may reappear with a vengeance in a form known as herpes zoster, what most people know as shingles.
A shingles outbreak can be quite painful and uncomfortable—and it's also not a condition to take lightly. Occurring mainly in people over fifty, it often begins with an itching or burning sensation in the skin. This is often followed by a red rash breaking out in a belt-like pattern over various parts of the body, which may later develop into crusty sores. Symptoms may vary from person to person, but people commonly experience severe pain, fever and fatigue.
Besides the general discomfort it creates, shingles can also pose major health problems for certain people. Individuals with other health issues like pregnancy, cancer or a compromised immune system may experience serious complications related to a shingles outbreak.
In its early stages, shingles is contagious, spreading through direct contact with shingles sores or lesions or through breathing in the secretions from an infected person. This characteristic of shingles could affect your dental care: because the virus could potentially pass to staff and other patients, dentists usually postpone cleanings or other dental treatments for patients with shingles, particularly if they have a facial rash.
If you're diagnosed with shingles, most physicians recommend you begin antiviral treatment as soon as possible. You should also let your dentist know if you have shingles, which may put off any scheduled treatments until your doctor determines you're no longer contagious.
There's one other thing you can do, especially if you're over 60: obtain a shingles vaccine, available from most physicians or clinics. The vaccine has proven effective in preventing the disease, and could help you avoid this most unpleasant health experience.
Your mouth is teeming with bacteria—millions of them. But don't be alarmed: Most are benign or even beneficial. There are, however, some bacteria that cause tooth decay or periodontal (gum) disease, which can damage your oral health.
These disease-causing bacteria feed and multiply within a thin biofilm of leftover food particles on tooth surfaces called dental plaque. To reduce these bacterial populations—and thus your disease risk—you'll need to keep plaque from building up through daily brushing and flossing.
Now, there's brushing and flossing—and then there's effective brushing and flossing. While both tasks are fairly simple to perform, there are some things you can do to maximize plaque removal.
Regarding the first task, you should brush once or twice a day unless your dentist advises otherwise. And "Easy does it" is the rule: Hard, aggressive scrubbing can damage your gums. A gentle, circular motion using a good quality toothbrush will get the job done. Just be sure to brush all tooth surfaces, including the nooks and crannies along the biting surfaces. On average, a complete brushing session should take about two minutes.
You should also floss at least once a day. To begin with, take about 18" of thread and wrap each end around an index or middle finger. Pulling taut and using your thumbs to help maneuver the thread, ease the floss between teeth. You then wrap it around each tooth side to form a "C" shape and gently slide the floss up and down. Continue on around until you've flossed between each tooth on both jaws.
You can get a rough idea how well you did after each hygiene session by rubbing your tongue against your teeth—they should feel slick and smooth. If you feel any grittiness, some plaque still remains. Your dentist can give you a more precise evaluation of your cleaning effectiveness at your regular dental visits. This is also when they'll clean your teeth of any missed plaque and tartar.
While professional dental cleanings are important, what you do every day to remove plaque is the real game changer for optimum oral health. Becoming a brushing and flossing "ninja" is the best way to keep your healthy smile.
If you would like more information on daily oral care, 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 “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”
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