When dental implants hit the scene in the 1980s, they revolutionized the field of dental restorations. But as groundbreaking as they were then, they're even more advanced now.
Some of the advancements have to do with improvements in implant design and manufacturing. Implant sizes and shapes were once quite limited, but today they come in a variety of forms to better match the types of teeth they replace.
But there has also been important progress in complementary technologies that help us realize better outcomes. Many of these other advances have had a positive impact on the planning and surgical stages of implant installation.
CT/CBCT scanning. For the best outcome, it's critical to install an implant at the most appropriate location on the jaw. This can be difficult to determine, however, because of the location of oral and facial structures like nerves or sinuses that might interfere with implant placement. But using a type of computer tomography (CT) scanning called cone beam CT, we can produce a 3-D computer graphic image that helps us navigate possible obstructions as we pinpoint the ideal location for an implant.
Digital smile displays. We're now able to produce digital models of the mouth, which can assist with more than implant placement—we can also use them to visualize what a new smile with implants will look like before we install them. This is especially helpful in situations where only a few teeth need to be replaced: We want to ensure that the new implant crowns blend seamlessly with the remaining teeth for the most natural appearance.
Custom-made surgical guides. We've been using surgical guides to mark the exact drilling locations during implant surgery for many years. But 3-D printing technology can now help us produce surgical guides that are even more useful and precise. Using a 3-D printer, we can produce oral devices based on the patient's individual dental dimensions captured through digital scanning. That produces a better fit for the guide on the teeth and more accurate implant placement.
Together, these and other technological advances are helping us achieve even more successful results. Not only can they help us produce implant outcomes that can last for years or even decades, but also the most beautiful smiles possible.
If you would like more information on dental implant restorations, 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.”
Dental patients have amazing options for tooth replacement. Dental implants, for example, can replace the entire tooth, root and crown, giving patients a new tooth nearly as good as the old one.
Nearly—but not exact. Even implants can't match the full benefits of a natural tooth, including one in less than perfect shape. Our first goal as dentists, then, is to save a diseased tooth if at all practical before considering replacing it.
That often involves a root canal treatment to address decay threatening a tooth's interior. The procedure requires drilling into the tooth to access its innermost pulp, cleaning out the pulp and root canals, and then filling the empty spaces. Since all dentists are trained in basic root canal treatment, your general dentist may be able to perform it.
But some dental situations call for more advanced endodontics, the dental specialty for treating disease and other problems inside a tooth. So, in what situations would you see an endodontist?
When your dentist refers you. Your dentist wants you to receive the level of treatment necessary to save your tooth. After examination, they may determine your situation would be better served by the advanced training, equipment and techniques (including surgery) of an endodontist.
When your tooth has complications. Patients often need an endodontist when existing factors complicate treatment of advanced tooth decay. A patient may have dental pain that's difficult to pinpoint, requiring the diagnostic resources of an endodontist. It's also common for a tooth's root canal network to be highly intricate, and which respond better to treatment with specialized endodontic tools and techniques.
When root canal treatment fails. Most root canal treatments are successful in protecting the tooth from further infection. That said, it's still possible for a root-canaled tooth to become re-infected or develop more problems. Again, an endodontist and their “tool chest“ re-treating a root-canaled tooth may be the best option for saving it.
You also don't have to wait for a referral—you can see an endodontist if you believe they would be best to treat your decayed tooth. You can find one near you by visiting an online endodontist directory at www.aae.org/find. An endodontist may be the lifesaver your diseased tooth needs.
If it seems like your teeth are getting longer as you get older, it's unlikely they're magically growing. More likely, your gums are shrinking or receding from your teeth. Besides the negative effect on your appearance, gum recession exposes you and vulnerable tooth areas to harmful bacteria and painful sensitivity.
Although common among older adults, gum recession isn't necessarily a part of aging: It's primarily caused by periodontal (gum) disease, in which infected gum tissues can weaken and detach from the teeth. This, along with bone loss, leads to recession.
But gum disease isn't the only cause—ironically, brushing your teeth to prevent dental disease can also contribute to recession. By brushing too aggressively or too often (more than twice a day), you could eventually damage the gums and cause them to recede. Tobacco use and oral piercings can also lead to weakened or damaged gums susceptible to recession.
You can lower your risk of gum recession by abstaining from unhealthy habits and proper oral hygiene to prevent gum disease. For the latter, your primary defense is gentle but thorough brushing and flossing every day to remove harmful dental plaque. You should also see your dentist at least twice a year for professional dental cleanings and checkups.
If, however, you do experience gum recession, there are a number of ways to restore your gums or at least minimize the recession. To start with, we must treat any gum disease present by thoroughly removing all plaque and tartar (calcified plaque), which fuels the infection. This reduces inflammation and allows the gums to heal.
With mild recession, the gums may rejuvenate enough tissue to recover the teeth during healing. If not, we may be able to treat exposed areas with a tooth-colored material that protects the surface, relieves discomfort and improves appearance.
If the recession is more advanced, we may still be able to stimulate gum regeneration by attaching a tissue graft with a micro-surgical procedure. These types of periodontal surgeries, however, can require a high degree of technical and artistic skill for best results.
In any event, the sooner we detect gum disease or recession, the quicker we can act to minimize the damage. Doing so will ensure your gums are healthy enough to protect your teeth and preserve your smile.
If you would like more information on gum recession, 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 “Gum Recession.”
Professional Hockey player Keith Yandle is the current NHL “iron man”—that is, he has earned the distinction of playing in the most consecutive games. On November 23, Yandle was in the first period of his 820th consecutive game when a flying puck knocked out or broke nine of his front teeth. He returned third period to play the rest of the game, reinforcing hockey players’ reputation for toughness. Since talking was uncomfortable, he texted sportswriter George Richards the following day: “Skating around with exposed roots in your mouth is not the best.”
We agree with Yandle wholeheartedly. What we don’t agree with is waiting even one day to seek treatment after serious dental trauma. It was only on the following day that Yandle went to the dentist. And after not missing a game in over 10 years, Yandle wasn’t going to let a hiccup like losing, breaking or cracking nearly a third of his teeth interfere with his iron man streak. He was back on the ice later that day to play his 821st game.
As dentists, we don’t award points for toughing it out. If anything, we give points for saving teeth—and that means getting to the dentist as soon as possible after suffering dental trauma and following these tips:
- If a tooth is knocked loose or pushed deeper into the socket, don’t force the tooth back into position.
- If you crack a tooth, rinse your mouth but don’t wiggle the tooth or bite down on it.
- If you chip or break a tooth, save the tooth fragment and store it in milk or saliva. You can keep it against the inside of your cheek (not recommend for small children who are at greater risk of swallowing the tooth).
- If the entire tooth comes out, pick up the tooth without touching the root end. Gently rinse it off and store it in milk or saliva. You can try to push the tooth back into the socket yourself, but many people feel uneasy about doing this. The important thing is to not let the tooth dry out and to contact us immediately. Go to the hospital if you cannot get to the dental office.
Although keeping natural teeth for life is our goal, sometimes the unexpected happens. If a tooth cannot be saved after injury or if a damaged tooth must be extracted, there are excellent tooth replacement options available. With today’s advanced dental implant technology, it is possible to have replacement teeth that are indistinguishable from your natural teeth—in terms of both look and function.
And always wear a mouthguard when playing contact sports! A custom mouthguard absorbs some of the forces of impact to help protect you against severe dental injury.
If you would like more information about how to protect against or treat dental trauma or about replacing teeth with dental implants, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Dental Implants: A Tooth-Replacement Method That Rarely Fails” and “The Field-Side Guide to Dental Injuries.”
The timing around losing a tooth may not always sync with your financial ability. It's not unusual for people to postpone getting a dental implant—by far the best option for replacing a missing tooth—because of its expense.
So, if you have to postpone dental implants until you can afford them, what do you do in the meantime to keep your smile intact? One affordable option is a temporary restoration known as a flexible removable partial denture (RPD).
Composed of a kind of nylon developed in the 1950s, flexible RPDs are made by first heating the nylon and injecting its softened form into a custom mold. This creates a gum-colored denture base to which prosthetic (false) teeth are affixed at the exact locations for missing teeth.
Differing from a permanent RPD made with rigid acrylic plastic, a nylon-based RPD is flexible and lightweight, making them comfortable to wear. They're kept in place with small nylon extensions that fit into the natural concave spaces of teeth. And, with a bit of custom crafting, they can look quite realistic.
RPDs are helpful in another way, especially if you're waiting for an implant down the road: They help preserve the missing tooth space. Without a prosthetic tooth occupying that space, neighboring teeth can drift in. You might then need orthodontic treatment to move errant teeth to where they should be before obtaining a permanent restoration.
Flexible RPDs may not be as durable as acrylic RPDs, and can be difficult to repair or reline if needed to adjust the fit. Though they may not stain as readily as acrylic dentures, you'll still need to clean them regularly to help them keep looking their best. This also aids in protecting the rest of your mouth from dental disease by removing any buildup of harmful bacterial plaque on the RPD.
But even with these limitations, patients choose RPDs for the simple fact that they're affordable and temporary. And the latter is their greatest benefit—providing you a “bridge” between losing a tooth and replacing it with a durable dental implant.
If you would like more information on tooth replacement 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 “Flexible Partial Dentures.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.