Posts for tag: dental implants
Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.
In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.
Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.
Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.
If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.
The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.
Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.
Dental implant technology has advanced at such an astounding rate in recent years that you can now walk into a dentist's office with a problem tooth and out the same day with a new one. Unfortunately, not all dental situations allow for this possibility.
For example, you might be considering an implant many years after losing a tooth. But there's a potential problem: there might not be enough supporting bone. While an implant might still be possible, inadequate bone complicates the matter.
Because implants are essentially tooth root replacements, they require a certain amount of bone for stability and the best attractive outcome. As a general rule, implants need to be surrounded by at least 1.5-2.0 millimeters of healthy bone to support an implant. But you might not have enough if your tooth has been missing for awhile, regardless if you have or haven't worn dentures or other restorations.
That's because bone has a life cycle in which older cells die and newer ones form to take their place. As we chew or bite, the force generated travels up through the teeth to the bone to stimulate this new growth. Without a tooth the bone doesn't receive this stimulus, which can slow the growth rate. Over time the affected bone can lose its volume and density.
If we find you've experienced loss to the point your bone won't support an implant, that doesn't automatically mean this popular restoration is out of the picture. But it will require us first performing a procedure known as augmentation or bone grafting to help rejuvenate some of the lost bone.
With grafting, we place processed bone grafting material in the jaw through a minor surgical procedure to form a scaffold for new bone to grow upon. After several months this can result in several millimeters of new growth maintaining the width of the underlying bone, which in turn may be able to support an implant.
Bone grafting is quite common, often performed at the same time as tooth extraction if there's going to be a time lag before installing an implant. Even if performed later, though, it can successfully rejuvenate lost bone and make it possible for you to take advantage of durable, life-like implants.
If you would like more information on 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 “Dental Implants after Previous Tooth Loss.”
Placing a dental implant within the jawbone requires a surgical procedure. For most people it’s a relatively minor affair, but for some with certain health conditions it might be otherwise. Because of their condition they might have an increased risk for a bacterial infection afterward that could interfere with the implant’s integration with the bone and lead to possible failure.
To lower this risk, dentists for many years have routinely prescribed an antibiotic for patients considered at high-risk for infection to take before their implant surgery. But there’s been a lively debate among health practitioners about the true necessity for this practice and whether it’s worth the possible side effects that can accompany taking antibiotics.
While the practice still continues, current guidelines now recommend it for fewer health conditions. The American Dental Association (ADA) together with the American Heart Association (AHA) now recommend antibiotics only for surgical patients who have prosthetic heart valves, a history of infective endocarditis, a heart transplant or certain congenital heart conditions.
But patients with prosthetic joint replacements, who were once included in the recommendation for pre-surgical antibiotics, are no longer in that category. Even so, some orthopedic surgeons continue to recommend it for their joint replacement patients out of concern that a post-surgical infection could adversely affect their replaced joints.
But while these areas of disagreement about pre-surgical antibiotics still continue, a consensus may be emerging about a possible “sweet spot” in administering the therapy. Evidence from recent studies indicates just a small dose of antibiotics administered an hour before surgery may be sufficient to reduce the risk of infection-related implant failure with only minimal risk of side effects from the drug.
Because pre-surgical antibiotic therapy can be a complicated matter, it’s best that you discuss with both the physician caring for your health condition and your dentist about whether you should undergo this option to reduce the infection risk with your own implant surgery. Still, if all the factors surrounding your health indicate it, this antibiotic therapy might help you avoid losing an implant to infection.
If you would like more information on antibiotics before implant surgery, 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 “Implants & Antibiotics: Lowering Risk of Implant Failure.”
Think dental implants only replace individual teeth? Think again—this premier technology can also support other kinds of restorations to provide better stability and comfort. And, they also help improve bone health when incorporated with any type of tooth replacement options, especially dentures.
Although traditional dentures have enjoyed a long, successful history as a tooth replacement solution, they can interfere with bone health. That’s because regular dentures fit in the mouth by resting on the bony ridges of the jaw, which has implications for the bone.
As living tissue, bone goes through a growth cycle with older bone cells dying and dissolving and newer cells forming to take their place. The teeth play a role in this growth cycle — the forces generated when we chew travel up through the teeth and help stimulate bone growth. When teeth go missing, however, so does this stimulus.
Traditional dentures can’t replace this missing stimulus. In fact, the constant pressure of dentures on the jaw may even accelerate bone loss. A sign this is happening occurs when the dentures’ once tight fit begins to loosen and they become uncomfortable to wear.
Implant-supported dentures can help eliminate this problem. We first surgically place a few implants in the jaw, the number determined by which jaw (the lower requires less) and whether the denture is removable or fixed. If removable, the denture has connective points that match the implant locations — you simply connect them with the implants. If fixed, the denture is screwed into the implants to hold it in place.
So, how does this help bone health? For one, the denture no longer puts as much pressure on the jaw ridges—the main support comes from the implants. And, the implants themselves encourage bone stimulation: The titanium in the implant has a special affinity with bone cells that naturally grow and adhere to its metal surface. This natural integration between implant and bone can stop bone loss and may even help reverse it.
If you’re interested in implant-supported dentures, you’ll first need to undergo a full dental exam with your dentist. These restorations aren’t appropriate for all dental situations. But, if they can work for you, you may be able to enjoy the benefits of an implant-supported restoration.
If you would like more information on implant-supported 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 “Overdentures & Fixed Dentures.”
Implant-supported fixed bridges are growing in popularity because they offer superior support to traditional bridges or dentures. They can also improve bone health thanks to the affinity between bone cells and the implants' titanium posts.
Even so, you'll still need to stay alert to the threat of periodontal (gum) disease. This bacterial infection usually triggered by dental plaque could ultimately infect the underlying bone and cause it to deteriorate. As a result the implants could loosen and cause you to lose your bridgework.
To avoid this you'll need to be as diligent with removing plaque from around your implants as you would with natural teeth. The best means for doing this is to floss around each implant post between the bridgework and the natural gums.
This type of flossing is quite different than with natural teeth where you work the floss in between each tooth. With your bridgework you'll need to thread the floss between it and the gums with the help of a floss threader, a small handheld device with a loop on one end and a stiff flat edge on the other.
To use it you'll first pull off about 18" of dental floss and thread it through the loop. You'll then gently work the sharper end between the gums and bridge from the cheek side toward the tongue. Once through to the tongue side, you'll hold one end of the floss and pull the floss threader away with the other until the floss is now underneath the bridge.
You'll then loop each end of the floss around your fingers on each hand and work the floss up and down the sides of the nearest tooth or implant. You'll then release one hand from the floss and pull the floss out from beneath the bridge. Rethread it in the threader and move to the next section of the bridge and clean those implants.
You can also use other methods like specialized floss with stiffened ends for threading, an oral irrigator (or "water flosser") that emits a pressurized spray of water to loosen plaque, or an interproximal brush that can reach into narrow spaces. If you choose an interproximal brush, however, be sure it's not made with metal wire, which can scratch the implant and create microscopic crevices for plaque.
Use the method you and your dentist think best to keep your implants plaque-free. Doing so will help reduce your risk of a gum infection that could endanger your implant-supported bridgework.
If you would like more information on implant-supported bridges, 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 “Oral Hygiene for Fixed Bridgework.”