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.”
What happens when you lose a tooth? In the short-run, it can certainly undermine your appearance and ability to efficiently chew and digest food. But a chain of events could also be set in motion that may cause the most harm to your appearance and health—and it all has to do with bone loss.
Our bones aren't just rigid structures providing a frame for our bodies. They're living tissue with other purposes like producing blood cells and regulating the endocrine system. Bone tissue is constantly replenishing itself as older cells die and newer ones take their place.
In the jawbone, the pressure generated by the teeth while biting and chewing travels through the roots to stimulate the growth of new bone. If a tooth goes missing, however, the bone around the tooth also loses this growth stimulus.
This can cause normal bone growth to slow so that dying bone cells aren't sufficiently replaced. The bone may then diminish at an alarming rate—a decrease in width of about 25% in the first year after a tooth loss and several millimeters in height after only a few years.
This bone loss can continue to advance, especially if multiple teeth are lost, until the jaw structure as a whole loses significant height. The bite may then collapse, forcing the front teeth to push forward. In this state, a person may not be able to adequately bite or chew food. It can also damage their appearance—their smile suffers, of course, but their entire face may also appear shrunken.
You may be able to avoid this scenario if you replace missing teeth with dental implants. In addition to their life-likeness and durability, implants can also stop or slow bone loss. This is because titanium, the principle metal used in an implant, has a strong affinity with bone: Bone cells readily grow and attach to the titanium surface and foster new growth.
But don't wait: Bone loss could eventually extend beyond what an implant can accommodate—you may then need grafting to build up the bone or consider a different type of restoration. So, speak with your dentist as soon as possible about an implant restoration for a lost tooth to help avoid significant bone loss.
If you would like more information on how tooth loss can affect your life, 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 “The Hidden Consequences of Losing Teeth.”
After several treatment sessions your periodontal (gum) disease is under control. But, while we may have won this battle, the war rages on. To keep an infection from re-occurring we'll have to remain on guard.
Gum disease begins and thrives on a thin film of bacteria and food particles on tooth surfaces called plaque. The infection usually begins as gingivitis, which causes the gums to become red and swollen (inflamed). Untreated it can develop into periodontitis, a more advanced form that progresses deeper into the gum tissues resulting in bone loss.
To treat the disease, we must remove all the plaque and calculus (hardened plaque deposits) we can find no matter how deeply they've penetrated below the gum line. Since the deeper it extends the more likely surgical techniques may be necessary to consider, it's better to catch the disease in its earliest stages when plaque can be removed with hand instruments or ultrasonic equipment.
The appropriate treatment technique can effectively stop and even reverse gum disease's effects — but it won't change your susceptibility. Constant vigilance is the best way to significantly reduce your risk of another episode. In this case, our prevention goal is the same as in treatment: remove plaque.
It begins with you learning and applying effective brushing and flossing techniques, and being consistent with these habits every day. As your dentist, we play a role too: we may need to see you as often as every few weeks or quarter to perform meticulous cleaning above and below the gum line. We may also perform procedures on your gums to make it easier to maintain them and your teeth, including correcting root surface irregularities that can accumulate plaque.
Our aim is to reduce the chances of another infection as much as possible. "Fighting the good fight" calls for attention, diligence and effort — but the reward is continuing good health for your teeth and gums.
If you would like more information on continuing dental care after gum disease, 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 “Periodontal Cleanings.”
Singer and actor Demi Lovato has a new claim to fame: formidable martial artist. When she is not in the recording studio, on stage or in front of the camera, Lovato can often be found keeping in shape at Jay Glazer's Hollywood (California) gym. Glazer, who is best known as a sports journalist, also runs conditioning programs for professional athletes and celebrities based on mixed martial arts. On March 6, Glazer got more than he bargained for when 5'3" Lovato stepped into the ring and knocked out his front tooth.
Glazer reportedly used super glue to put his tooth back together. Not a good idea! While it may not be convenient to drop everything and get to the dental office, it takes an expert to safely treat a damaged tooth. If you glue a broken tooth, you risk having to undergo major work to correct your temporary fix—it's no easy task to "unglue" a tooth, and the chemicals in the glue may damage living tooth tissue as well as the surrounding gum and bone.
Would you know what to do in a dental emergency? Here are some guidelines:
- If you chip a tooth, save the missing piece if possible. We may be able to reattach it.
- If your tooth is cracked, rinse your mouth with warm water, but don't wiggle the tooth around or bite down on it. If it's bleeding, hold clean gauze to the area and call our office.
- If your tooth is knocked loose or is pushed deeper into the socket, don't force the tooth back into position on your own. Immediate attention is very important.
- If your tooth is knocked out, there's a chance it can be reattached. Pick up the tooth while being careful not to touch the root. Then rinse it off and have either someone place into its socket, or place it against the inside of your cheek or in a glass of milk. Please call the office immediately or go to a hospital.
What's the best thing to do in an emergency? Call us right away, and DON'T super glue your tooth! You can prevent worse problems by letting a professional handle any dental issues. And if you've been living with a chipped, broken or missing tooth, call us to schedule an appointment for a consultation—there are several perfectly safe ways to restore your smile. Meanwhile, if you practice martial arts to keep in shape, think twice before getting into the ring with Demi Lovato!
Installing dental implants involves more than the mechanics of placing them into the jawbone. Ultimate success — a natural and beautiful smile — requires painstaking attention to detail and artistry.
Here are a few of the factors we must consider to achieve a smile with dental implants you’ll be proud to display.
The amount of available bone. For the permanent crown to appear natural, it’s crucial to position the implant precisely. To achieve this precision requires an adequate amount of bone to be present. Unfortunately, bone loss is quite common after tooth loss; to minimize this we place bone grafts in the empty socket if at all possible after extraction to encourage bone growth. It’s also possible in some cases to perform bone grafting surgery before implants to build up bone volume.
Your genetic gum tissue type. There are basically two types of gum tissue people are born with: thin or thick. Thin tissues are more subject to wear, difficult to work with during surgery and can make it difficult to hide the metal components of an implant. Thicker tissues are easier to work with, but can have a tendency to overgrow.
Achieving a natural “emergence profile.” To look natural, the implant crown must appear to seamlessly emerge from the surrounding gum tissue. To achieve this, we must carefully plan and place the implant in the precise location in the bone, taking into account the implant shape and how far it should be placed within the bone to match the position and height of adjacent teeth and gum tissues.
Blending color shades with adjacent natural teeth. When it comes to color, everyone has subtle differences in tooth shades and hues. In fact, there are slight color variations within individual teeth, from the root to the tip of the crown. To make sure the implant blends in with adjacent teeth, it’s important to match the color incorporated into the porcelain crown with the natural crowns beside them.
These and other factors require both technical expertise and a sense of artistry. Carefully considering all of them will help ensure your dental implants result in the smile you want.
If you would like more information on smile transformations 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 “Matching Teeth & Implants.”
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