Posts for: March, 2021
Introduced to the United States in the 1980s, dental implants have quickly become the go-to restoration for tooth replacement. And for good reason: they're not only incredibly life-like, they're highly durable with a 95% success rate.
But as desirable as they are, you may face a major obstacle getting one because of the condition of the bone at your implant site. To position the implant for best appearance and long-term durability, we must have at least 4-5 mm of bone available along the horizontal dimension. Unfortunately, that's not always the case with tooth loss.
This is because bone, like other living tissue, has a growth cycle: Older cells die and dissolve (resorb) and newer cells develop in their place. The forces transmitted to the jaw from the action of chewing help stimulate this resorption and replacement cycle and keep it on track. When a tooth is lost, however, so is this stimulus.
This may result in a slowdown in cell replacement, causing the eventual loss of bone. And it doesn't take long for it to occur after tooth loss—you could lose a quarter of bone width in just the first year, leaving you without enough bone to support an implant. In some cases, it may be necessary to choose another kind of restoration other than implants.
But inadequate bone isn't an automatic disqualifier for implants. It's often possible to regenerate lost bone through a procedure known as bone augmentation, in which we insert a bone graft at the missing tooth site. The graft serves as a scaffold for new bone cells to grow upon, which over time may regenerate enough bone to support an implant.
Even if you've had a missing tooth for some time, implementing bone augmentation could reverse any loss you may have experienced. In fact, it's a common practice among dentists to place a bone graft immediately after a tooth extraction to minimize bone loss, especially if there will be a time lag between extraction and implant surgery.
Bone augmentation could add extra time to the implant process. But if successful, it will make it possible for you to enjoy this popular dental restoration.
If you would like more information on dental implant restoration, 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 After Previous Tooth Loss.”
Dentures have come a long way since George Washington's time. Today, they're more comfortable, more secure and more lifelike than our first president's famous hippopotamus ivory appliance.
But one thing hasn't changed: Dentures still require regular care and cleaning. And one of the best things you can do for both your dentures and your health is to take them out at night when you go to bed.
Modern dentures are often so comfortable to wear, it's easy to forget you have them in your mouth. But setting a daily habit of taking them out when you turn in for the night will help you avoid a few potential problems.
For one, wearing dentures 24/7 can increase your risk for both oral and general diseases. Constant denture wear can cause greater accumulations of dental plaque, a thin biofilm responsible for gum disease and inflammation. The increase in bacteria could also make you more susceptible to pneumonia and other diseases.
Wearing your dentures non-stop can also worsen bone loss, a common problem associated with dentures. Normally, the biting forces generated when we chew stimulate bone growth in the jaw. A person loses much of this stimulation when they lose teeth, resulting in gradual bone loss.
Dentures can't replace this lost stimulation, and the pressure they exert on the jaw's bony ridges they rest upon can accelerate the process of bone loss. In time, any bone loss could affect the denture's fit as the bone beneath them gradually shrinks. By taking them out at night, you can help slow the pace of bone loss.
In addition to giving them and your mouth a rest at night, be sure you're also keeping your dentures clean: Take them out and rinse them off after meals and brush them with a small amount of antibacterial soap (not toothpaste) at least once a day. And don't forget to brush your gums and tongue every day with a soft toothbrush (different from your denture brush) to further reduce dental plaque.
If you would like more information on denture 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 “Sleeping in Dentures.”
Your tooth enamel is often under assault from oral acid produced by bacteria and certain foods. Unless neutralized, acid can erode your enamel, and lead to destructive tooth decay.
But there's another type of acid that may be even more destructive—the acid produced in your stomach. Although important for food digestion, stomach acid outside of its normal environment can be destructive. That includes your teeth, if stomach acid finds its way into your mouth. And that can happen if you have gastroesophageal reflux disease (GERD).
GERD, a chronic condition affecting 1 in 5 adults, is caused by the weakening of the lower esophageal sphincter, a ring of muscle at the intersection of the esophagus and the stomach that prevents stomach acid from traveling back into the digestive tract and damaging the esophageal liner.
It's also possible for stomach acid to travel as far up as the mouth. With a pH of 2.0 or less, stomach acid can lower the mouth's normal pH level of 7.0 well below the 5.5 pH threshold for enamel softening and erosion. This can cause your teeth, primarily the inside surfaces of the upper teeth, to become thin, pitted or yellowed. Your teeth's sensitivity may also increase.
If you have GERD, you can take precautions to avoid tooth damage and the extensive dental work that may follow.
- Boost acid buffering by rinsing with water (or a cup of water mixed with a ½ teaspoon of baking soda) or chewing on an antacid tablet.
- Wait about an hour to brush your teeth following a reflux episode so that your saliva has time to neutralize acid and re-mineralize enamel.
- If you have chronic dry mouth, stimulate saliva production by drinking more water, chewing xylitol gum or using a saliva supplement.
You can also seek to minimize GERD by avoiding tobacco and limiting your consumption of alcohol, caffeine or spicy and acidic foods. Your doctor may also prescribe medication to control your GERD symptoms.
Preventing tooth decay or gum disease from the normal occurrences of oral acid is a daily hygiene battle. Don't let GERD-related acid add to the burden.
If you would like more information on protecting your teeth from acid reflux, 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 “GERD and Oral Health.”