Every year dentists place over 5 million dental implants for lost teeth, often removing the problem tooth and installing the implant at the same time. But getting a “tooth in a day” depends on a number of health factors, especially whether or not there’s adequate bone available for the implant. Otherwise, the implant’s placement accuracy and success could be compromised.
Bone loss can be a similar problem when a tooth has been missing for a long period of time. If this describes your situation, you may have already lost substantial bone in your jaw. To understand why, we need to know a little about bone’s growth cycle.
When bone cells reach the end of their useful life, they’re absorbed into the body by a process called resorption. New cells then form to take the older cells’ place in a continuous cycle that keeps the bone healthy and strong. Forces generated when we chew travel through the teeth to the bone and help stimulate this growth. But when a tooth is missing, the bone doesn’t receive this stimulus. As a result, the bone may not replace itself at a healthy rate and diminish over time.
In extreme cases, we may need to consider some other dental restoration other than an implant. But if the bone loss isn’t too severe, we may be able to help increase it through bone grafting. We insert safe bone grafting material prepared in a lab directly into the jaw through a minor surgical procedure. The graft then acts like a scaffold for bone cells to form and grow upon. In a few months enough new bone may have formed to support an implant.
Bone grafting can also be used if you’re having a tooth removed to preserve the bone even if you’re not yet ready to obtain an implant. By placing a bone graft immediately after extraction, it’s possible to retain the bone for up to ten years—enough time to decide on your options for permanent restoration.
Whatever your situation, it’s important that you visit us as soon as possible for a complete examination. Afterward we can assess your options and hopefully come up with a treatment strategy that will eventually include smile-transforming dental implants.
Tooth sensitivity can be disheartening: you’re always on your guard with what you eat or drink, and perhaps you’ve even given up on favorite foods or beverages.
The most common cause for this painful sensitivity is dentin exposure caused by receding gums. Dentin contains tiny open structures called tubules that transmit changes in temperature or pressure to the nerves in the pulp, which in turn signal pain to the brain. The enamel that covers the dentin, along with the gum tissues, creates a barrier between the environment and dentin to prevent it from becoming over-stimulated.
Due to such causes as aggressive over-brushing or periodontal (gum) disease, the gum tissues can recede from the teeth. This exposes portions of the dentin not covered by enamel to the effects of hot or cold. The result is an over-stimulation of the dentin when encountering normal environmental conditions.
So, what can be done to relieve painful tooth sensitivity? Here are 3 ways to stop or minimize the symptoms.
Change your brushing habits. As mentioned, brushing too hard and/or too often can contribute to gum recession. The whole purpose of brushing (and flossing) is to remove bacterial plaque that’s built up on tooth surfaces; a gentle action with a soft brush is sufficient. Anything more than two brushings a day is usually too much — you should also avoid brushing just after consuming acidic foods or liquids to give saliva time to neutralize acid and restore minerals to the enamel.
Include fluoride in your dental care. Fluoride has been proven to strengthen enamel. Be sure, then, to use toothpastes and other hygiene products that contain fluoride. With severe sensitivity you may also benefit from a fluoride varnish applied by a dentist to your teeth that not only strengthens enamel but also provides a barrier to exposed dentin.
Seek treatment for dental disease. Tooth sensitivity is often linked to tooth decay or periodontal (gum) disease. Treating dental disease may include plaque removal, gum surgery to restore receded gums, a filling to remove decay or root canal therapy when the decay gets to the tooth pulp. These treatments could all have an effect on reducing or ending your tooth sensitivity.
If you would like more information on the causes and treatments for sensitive teeth, 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 “Tooth Sensitivity.”
The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.
In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?
The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.
Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.
So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”
Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.
If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”
Pain is the body’s warning system: It tells us something is wrong. And depending on the location and intensity of the pain, it can give us vital clues about the problem.
Sometimes, though, it’s not so clear and direct—the pain could arise from any number of sources. Toothaches often fall into this category: Although it’s likely indicating a tooth or gum problem, it could be something else — or even somewhere else.
This is known as referred pain, in which you may feel pain in one location, like your mouth, but the actual source of the problem is somewhere else, like an infected and congested sinus passage. If we’re able to identify the true source and location of the pain, the better the chances of a successful treatment outcome.
Besides sinus infections, there are other conditions like trigeminal neuralgia that can refer pain to the mouth. This painful condition involves the trigeminal nerve, a large nerve running on either side of the face that can become inflamed. Depending on where the inflammation occurs, you might feel the pain at various points along the jaw, feeling much like a toothache.
There’s also the case of an earache mimicking a toothache, and vice-versa. Because of the proximity of the ears to the jaws, there is some nerve interconnectedness between them. For example, an infected or abscessed back tooth could feel a lot like an earache.
These and other possible problems (including jaw joint disorders or teeth grinding) can generate pain as if it were coming from the mouth or a single tooth. To be sure you’ll need to undergo a complete dental examination. If your dentist doesn’t find anything wrong with your mouth, he or she may refer you to a medical doctor to explore other possible causes.
Getting to the root cause of pain can help determine which treatment strategy to pursue to relieve it. Finding the actual source is the most efficient way to understand what a pain sensation is trying to tell us.
Generations have depended on dentures to effectively and affordably replace lost teeth. But they do have a major weakness: They contribute to jawbone loss that creates not only mouth and facial problems, but can also ruin a denture’s fit.
Bone loss is a normal consequence of losing teeth. The biting forces normally generated when we chew stimulate new bone to replace older bone. When a tooth is missing, however, so is that chewing stimulation. This can slow bone replacement growth and gradually decrease the density and volume of affected bone.
While dentures can restore dental appearance and function, they can’t restore this growth stimulation. What’s worse, the pressure of the dentures against the gum-covered jaw ridge they rest upon may irritate the underlying bone and accelerate loss.
But there is a solution to the problem of denture-related bone loss: an implant-supported denture. Rather than obtaining its major support from the gum ridges, this new type of denture is secured by strategically-placed implants that connect with it.
Besides the enhanced support they can provide to a denture restoration, implants can also deter bone loss. This is because of the special affinity bone cells have with an implant’s imbedded titanium post. The gradual growth of bone on and around the implant surface not only boosts the implant’s strength and durability, it can also improve bone health.
There are two types of implant-supported dentures. One is a removable appliance that connects with implants installed in the jaw (three or more for the upper jaw or as few as two in the lower). It may also be possible to retrofit existing dentures to connect with implants.
The other type is a fixed appliance a dentist permanently installs by screwing it into anywhere from four and six implants. The fixed implant-supported denture is closer to the feel of real teeth (you’ll brush and floss normally), but it’s usually more costly than the removable implant-supported denture.
While more expensive than traditional ones, implant-supported dentures still cost less than other restorations like individual implant tooth replacements. They may also help deter bone loss, which may lead to a longer lasting fit with the dentures. Visit your dentist for an evaluation of your dental condition to see if you’re a good candidate for this advanced form of dental restoration.
If you would like more information on implant-supported dentures, 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.”
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