Posts for category: Dental Procedures
One of the key parts to an effective oral disease prevention plan is practicing daily oral hygiene to remove dental plaque. Both brushing and flossing are necessary for cleaning your teeth of this thin biofilm of bacteria and food particles most responsible for tooth decay and periodontal (gum) disease.
But as important as they are, these two essential hygiene tasks aren’t the end-all-be-all for lowering your disease risk. For the best protection, you should also visit your dentist at least twice a year for thorough dental cleanings. That’s because plaque you might have missed can turn into something much more difficult to remove: calculus.
Also known as tartar, calculus is hardened deposits of plaque. The term comes from the Latin word meaning “small stone,” an apt description of its texture on tooth surfaces. Although not the same as the branch of mathematics that bears the same name, both derive from the same Latin word: Merchants and traders centuries ago used small stones to “calculate” their various transactions.
Over time soft and pliable dental plaque hardens into calculus, in part due to a reaction with saliva. Because of the difficulty of accessing all tooth surfaces, calculus can form even if you have an effective daily hygiene practice.
Once formed, calculus can adhere to teeth so tenaciously, it’s impossible to remove it with brushing and flossing. But dentists and hygienists can remove calculus safely with special tools called scalers.
And it should be removed or it will continue to foster bacterial growth. This in turn increases the chances for infections that attack the teeth, gums or underlying bone. Keeping it under control will therefore diminish your risk for developing dental disease.
Although there are other factors like heredity that can affect your disease risk, keeping your mouth clean is the number one thing you can do to protect your teeth and gums. A daily hygiene practice and regular dental visits will help ensure plaque and its calcified form calculus won’t be a problem.
You would love to replace a troubled tooth with a dental implant. But you have one nagging concern: you also have diabetes. Could that keep you from getting an implant?
The answer, unfortunately, is yes, it might: the effect diabetes can have on the body could affect an implant's success and longevity. The key word, though, is might—it's not inevitable you'll encounter these obstacles with your implant.
Diabetes is a group of metabolic diseases that interfere with the normal levels of blood glucose, a natural sugar that is the energy source for the body's cells. Normally, the pancreas produces a hormone called insulin as needed to regulate glucose in the bloodstream. A diabetic, though either can't produce insulin or not enough, or the body doesn't respond to the insulin that is produced.
And while the condition can often be managed through diet, exercise, medication or supplemental insulin, there can still be complications like slow wound healing. High glucose can damage blood vessels, causing them to deliver less nutrients and antibodies to various parts of the body like the eyes, fingers and toes, or the kidneys. It can also affect the gums and their ability to heal.
Another possible complication from diabetes is with the body's inflammatory response. This is triggered whenever tissues in the body are diseased or injured, sealing them off from damaging the rest of the body. The response, however, can become chronic in diabetics, which could damage otherwise healthy tissues.
Both of these complications can disrupt the process for getting an implant. Like other surgical procedures, implantation disrupts the gum tissues. They will need to heal; likewise, the implant itself must integrate fully with the bone in which it's inserted. Both healing and bone integration might be impeded by slow wound healing and chronic inflammation.
Again, it might. In reality, as a number of studies comparing implant outcomes between diabetics and non-diabetics has shown, there is little difference in the success rate, provided the diabetes is under control. Diabetics with well-managed glucose can have success rates above 95%, well within the normal range.
An implant restoration is a decision you should make with your dentist. But if you're doing a good job managing your diabetes, your chances of a successful outcome are good.
When you hear the word “dentures” you probably think of an appliance that replaces all the teeth on a dental arch. But there is another type: a removable partial denture (RPD), which can be a viable option for replacing a few missing teeth.
An RPD rests on the bony gum ridges that once held the missing teeth and are secured with clasps or other attachments to adjacent teeth. While lightweight, RPDs are designed to last for many years — they’re made of vitallium, a light but very strong metal alloy that reduces the RPD’s thickness. Recently, metal-free partial dentures are being used that don’t have the fit or longevity of the vitallium partial dentures, but are considered more of a cosmetic solution.
RPDs are custom-made for each individual patient to accommodate the number, location and distribution of teeth missing throughout the mouth. Their design must also reflect the health and stability of the gums and remaining natural teeth to ensure they won’t move unduly during normal mouth function, and will be as lifelike and unnoticeable as possible.
RPDs have been a mainstay in dentistry for many years and represent a less expensive tooth replacement option than implants or fixed bridgework. But they do have their downsides: because of their method of attachment to the remaining natural teeth they tend to accumulate plaque, which increases the risk of both periodontal (gum) disease and tooth decay. Their fit requires that they attach to the adjacent teeth that will cause some damage and lead to their looseness over time.
If you wear an RPD, there are some things you can do to decrease these problems. First and foremost, you should clean your RPD thoroughly every day, as well as brush and floss your remaining teeth to reduce plaque buildup especially at contact points. Be sure to remove the RPD at night while you sleep. And keep up regular dental visits not only for additional plaque removal but also to allow us to inspect the RPD for problems or wear.
An RPD is a viable option for improving mouth function and restoring your smile after multiple tooth loss. With proper care and maintenance, your RPD can serve you well for many years to come.
If you would like more information on removable partial dentures, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Removable Partial Dentures.”
A tooth that's been chipped doesn't mean it's no longer healthy. The same, unfortunately, can't be said about the attractiveness of your smile, especially if it's one of your front teeth. A chipped tooth can be quite noticeable and make you self-conscious.
The good news is a chipped tooth can be restored cosmetically to look just as normal and attractive as your other teeth. Depending on the application there are two different materials we commonly use: porcelains, a type of oven-fired ceramic most often found in veneers or crowns; or composite resins, a mixture of glass and plastic substances we apply in liquid form that hardens in built-up layers on the tooth's surface to ultimately resemble normal tooth shape and color.
So, which of these two materials is the best option for your tooth? That depends on the extent and location of the tooth damage. Composite resins are most often used for mild to moderate chipping or breaks in the enamel (and somewhat for the underlying dentin) or decayed areas in the front teeth. Porcelain veneers or crowns are better for more extensive damage or discoloration.
Both materials have their advantages and disadvantages. Composite resins can be applied in one office visit, but they require a skillful technique and an artistic eye to achieve a life-like appearance; although their strength has improved over the years, they're also limited in their durability and longevity compared to porcelain. Porcelain, on the other hand, is quite durable and has an excellent tooth-like appearance; they do, however, require removal of more tooth material than a composite resin to accommodate the new veneer or crown, along with more than one visit and the services of a dental lab to create the restoration.
The best way to find out which option is best for you is to visit us for a thorough dental examination. From there we can review with you our findings, our recommendations and the costs associated with each option. But whichever material we use, porcelain or composite resins, you can look forward to a new smile you'll be proud to display.
If you would like more information on cosmetic treatments for 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 “Artistic Repair of Front Teeth with Composite Resin.”
Recently, a number of new filling materials that mimic tooth color have come into popular use and, so far, have proven more durable than past versions. Even so, the traditional metal-based dental amalgam remains a viable choice, especially for less visible back teeth and their higher biting forces.
Used for more than a century, dental amalgam is a metal alloy composed of silver, mercury, tin and copper. The mixture is carefully proportioned so that potentially hazardous mercury is kept to a minimum and bonded with the other metals. Amalgam in its initial form is quite pliable so that it can be molded into the tooth structure under repair. Afterward it sets hard to form a durable filling that can withstand the daily force generated when we bite and chew food.
Besides durability, dental amalgam rarely causes an allergic reaction in a patient, and it’s easy for trained dentists to apply. On the downside, however, it can cause temporary temperature sensitivity in the tooth just after filling, and the tooth itself may require some removal of healthy structure to help keep the filling in place. And from an aesthetic point of view, its metallic appearance is considered unattractive especially for front teeth.
The presence of mercury in amalgam has also raised concerns over the years. “Free” mercury — atoms that escape through vapor emitted by the metal — can enter the bloodstream and potentially harm the nervous system. But after extensive study and research, U.S. and international health bodies including the American Dental Association have concluded any free mercury released during chewing is extremely low and well below any harmful levels. These studies have also found no ill effects in either children or adults with dental amalgam fillings.
Deciding on the type of filling material to use — dental amalgam or a newer composite resin, resin ionomer or glass ionomer — depends on a number of factors including the location of the teeth to be filled, the extent of decay and your personal preferences. Taking these into account, we’ll be happy to discuss which type of filling will suit you best for repairing decayed teeth.
If you would like more information on filling material options including dental amalgam, 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 “Silver Fillings — Safe or Unsafe?”