We've been using bridges to replace missing teeth for decades. Now, recently-developed implant-supported bridges are even more dependable, promising greater durability and less interference with remaining natural teeth.
But just like other restorations, you'll need to keep implant bridges clean to ensure their longevity. Although both the bridge and implants are impervious to disease, the supporting gums and bone aren't. If they become infected, they can break down and your restoration will fail.
Cleaning an implant-supported bridge includes flossing around each of the implants to remove dental plaque, a thin film of food particles and bacteria most responsible for dental disease. To perform this task, you'll have to pass the floss between the bridge and gums to access the sides of each implant.
To help make it easier, you can use a tool like a floss threader, a thin, shaft-like device with a loop on one end and a needle-like point on the other. You'll first thread about 18" of floss through the end and then pass the threader between the bridge and gums with the sharp end toward the tongue.
With the threader completely through, you'll then wrap the floss around your fingers as with regular flossing and move the floss up and down each side of the implants you can access. You'll then pull the floss out, reload the threader and move to the next section, repeating this process until you've flossed each side of each implant.
You can also use pre-cut floss with a stiffened end to thread between the bridge and gums or an interproximal brush with a thin bristled head that can reach underneath the bridge. And you might consider using an oral irrigator, a pump device that sprays a stream of pressurized water to remove and flush away plaque around implants.
To round out your hygiene efforts, be sure you visit your dentist at least twice a year for dental cleanings. Your dentist can also advise you and give you training on keeping your implants clear of disease-causing plaque. Cleaning around your implants will help ensure your restoration will last.
If you would like more information on caring for your dental 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 “Oral Hygiene for Fixed Bridgework.”
Although oral cancer isn't the most prevalent among metabolic diseases, it is one of the most deadly with only a 50% survival rate after five years. That's because it can be difficult to detect in its early stages when treatment is most effective.
That's why prevention to reduce your chances of oral cancer is so important. Many people know quitting tobacco products, including smokeless varieties, and moderating alcohol consumption are key to any prevention strategy. But there's one other factor you should also consider: your diet.
We've learned quite a bit in the last few decades about how certain foods we eat contribute to the cancer disease process. Cancer seems to originate when elements in the body or environment (known as carcinogens) damage DNA, our unique genetic code, on the cellular level. For example, a class of chemicals called nitrosamines is a known carcinogen: we often encounter it in the form of nitrites used to preserve meat (like bacon or ham) or as byproducts in beer, seafood or cheese.
Another form of carcinogen is the unstable molecules produced during normal cellular function called free radicals. But our bodies have a natural neutralizer for free radicals called antioxidants. We obtain these substances in our food in the form of vitamins and minerals. While you can also ingest these in the form of supplements, the best way to obtain them is through a diet rich in plant-based food, particularly fruits and vegetables.
So in addition to lifestyle changes like quitting tobacco or moderating alcohol consumption, make sure your diet is a healthy and nutritious one. Limit your intake of processed foods (especially meats) and increase your portions of fresh fruits, vegetables and dairy products.
And don't neglect practicing effective brushing and flossing each day, along with regular dental cleanings and checkups. All of these healthy practices will greatly decrease your chances for life-threatening oral cancer.
If you would like more information on preventing oral cancer, 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 “Diet and Prevention of Oral Cancer.”
Although not high on the glamour scale, saliva is nonetheless an important ingredient in a healthy life. This "multi-tasker" fluid helps break down your food for better digestion and supplies antibodies to thwart threatening microorganisms coming in through the mouth.
But perhaps its most important role is to neutralize mouth acid that can erode tooth enamel. Without this buffering action, you're at much greater risk for tooth decay and possible tooth loss.
That's why chronic dry mouth is much more than just an unpleasant feeling. If you're not producing enough saliva, your risk for developing tooth decay (and periodontal disease too) skyrocket.
Here are 3 things you can do to avoid dry mouth and promote healthier saliva flow.
Watch what goes in your mouth. Some foods, beverages and other substances can interfere with saliva production. Caffeine in coffee, sodas and other beverages can cause your body to lose water needed to produce adequate saliva. So can alcohol, which can also further irritate dry tissues. And any type of tobacco use can decrease saliva production and heighten the dry mouth effect, another good reason to kick the habit.
Drink more water. Water is the main ingredient in saliva, so keeping yourself hydrated throughout the day helps ensure a ready supply. Drinking water also helps dilute acid concentrations and washes away leftover food particles that could become a food source for oral bacteria, the main source for mouth acid.
Ask questions about your medications. Many medications can trigger chronic dry mouth including drugs to treat cancer, high blood pressure, depression or allergies. If you have chronic dry mouth, talk with your physician about the medications you're taking and ask if there are any alternatives that have less of an effect. If not, drink more water, especially while taking oral medication.
You can also reduce dry mouth symptoms by using a humidifier while you sleep or using products that boost saliva production. And be sure you're brushing and flossing daily to further reduce your risk of dental disease. Managing dry mouth won't just make your mouth feel better—it will help your teeth and gums stay healthier too.
If you've lost a tooth, you have a number of options for replacing it. Perhaps the best choice in terms of lifelikeness and durability is a dental implant.
All implants have the same basic architecture: a titanium metal post imbedded in the jawbone to replace the root; and an abutment, a metal collar that links the post with a lifelike porcelain crown. But implants can vary in how the crown attaches to the abutment and post — either cemented to the abutment or screwed through the abutment to the post.
Either method will permanently secure the crown to the implant. But there are advantages and disadvantages for each.
A screw-retained crown may better facilitate any future repair that might be needed. For a skilled dentist it's a simple matter of removing the screw and then the crown from the abutment. There's less risk of damage to the implant during repairs or crown replacement. Many dentists also prefer screws for crowns placed at the same time they're installing the implant post (a procedure called immediate loading).
The screw access hole, however, could pose a cosmetic problem. Although we can cover it over with tooth-colored filling, it may still be noticeable and unattractive especially for a tooth visible when you smile (in the smile zone). There's also the possibility the porcelain around the access hole could chip.
By contrast, cemented crowns have a smooth, unbroken surface and are aesthetically ideal for smile zone teeth. But the cement could interact poorly with gum and bone tissue in some patients, causing inflammation and possible bone loss.
And unlike screw-retained crowns, cemented crowns are difficult to remove for implant repair. We may have to drill through the crown to access the screw between the abutment and the post, and then repair it cosmetically if we use the same crown. Again, the final result may not be quite as visually appealing.
In the end, it will depend on the implant's location, how your body reacts to the cement or your dentist's preference. In either case, though, you'll have a tooth replacement that's functional, life-like and able to endure for many years to come.
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 “How Crowns Attach to Implants.”
With a 95-plus percent survival rate after ten years, dental implants are one of the most durable replacement restorations available. Implants can potentially last much longer than less expensive options, which could make them a less costly choice in the long run.
But although a rare occurrence, implants can and do fail—often in the first few months. And tobacco smokers in particular make up a sizeable portion of these failures.
The reasons stem from smoking’s effect on oral health. Inhaled smoke can actually burn the outer skin layers in the mouth and eventually damage the salivary glands, which can decrease saliva production. Among its functions, saliva provides enzymes to fight disease; it also protects tooth enamel from damaging acid attacks. A chronic “dry mouth,” on the other hand, increases the risk of disease.
The chemical nicotine in tobacco also causes problems because it constricts blood vessels in the mouth and skin. The resulting reduced blood flow inhibits the delivery of antibodies to diseased or wounded areas, and so dramatically slows the healing process. As a result, smokers can take longer than non-smokers to recover from diseases like tooth decay or periodontal (gum) disease, or heal after surgery.
Both the higher disease risk and slower healing can impact an implant’s ultimate success. Implant durability depends on the gradual integration between bone and the implant’s titanium metal post that naturally occurs after placement. But this crucial process can be stymied if an infection resistant to healing arises—a primary reason why smokers experience twice the number of implant failures as non-smokers.
So, what should you do if you’re a smoker and wish to consider implants?
First, for both your general and oral health, try to quit smoking before you undergo implant surgery. At the very least, stop smoking a week before implant surgery and for two weeks after to lower your infection risk. And you can further reduce your chances for failure by practicing diligent daily brushing and flossing and seeing your dentist regularly for cleanings and checkups.
It’s possible to have a successful experience with implants even if you do smoke. But kicking the habit will definitely improve your odds.
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 & Smoking.”
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