So, you’ve just acquired an attractive restoration with dental implants. You may be thinking at least with these teeth you won’t have to worry about dental disease.
Think again. While the implants and their porcelain crowns are impervious to decay the surrounding gums and bone are still vulnerable to infection. In fact, you could be at risk for a specific type of periodontal (gum) disease called peri-implantitis (inflammation around the implant).
Bacterial plaque, the thin bio-film most responsible for gum disease, can build up on implant crowns just as it does on natural tooth surfaces. If it isn’t removed with daily brushing and flossing and regular dental cleanings the bacteria can trigger an infection in the gums.
Besides weakening gum tissues, gum disease can also cause bone loss, of critical importance to dental implants. An implant depends on the bone they’re inserted in to hold them in place. If the bone around an implant becomes infected it could begin to be lost or dissolve (resorb), which could lead to loss of the implant.
That’s why it’s critical to keep the natural tissue structures supporting your implants infection-free. Not only is daily hygiene a must, but your implants and any remaining natural teeth should undergo professional cleaning at least twice a year or more if your dentist recommends it.
Cleanings involving implants will also be a bit different from natural teeth. While the dental materials used in the crown and implant post are quite durable, regular cleaning instruments can scratch them. Although tiny, these scratches can become hiding places for bacteria and increase your risk of infection.
To avoid this, your hygienist will use instruments (known as scalers and curettes) usually made of plastics or resins rather than metal. The hygienist may still use metal instruments on your remaining natural teeth because their enamel can tolerate metal without becoming scratched creating a smoother surface.
While keeping implants clean can sometimes be a challenge, it’s not impossible. Implants on average have a long-term success rate above 95%. With both you and your dentist caring and maintaining these state-of-the-art restorations, you may be able to enjoy them for decades.
If you would like more information on caring for 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 Implant Maintenance: Implant Teeth must be Cleaned Differently.”
What’s the first thing that comes to mind when you think of the month of May? Balmy breezes? Sweet-smelling flowers? How about root canal treatment?
The last item might seem out of place…but for the last ten years, Root Canal Awareness week has been celebrated in May. So let’s take a closer look at this important—and often misunderstood—dental procedure.
What we commonly call a “root canal” is a special treatment that can save diseased teeth which might otherwise be lost. But the root canal itself is actually a set of hollow, branching passages deep inside the hard outer tissue of the tooth. The tiny “canals” contain the tooth’s soft pulp, including nerves, blood vessels and connective tissue. These tissues help teeth grow during childhood but aren’t necessary in healthy adult teeth—and, what’s worse, they can become infected via deep cavity or a crack in the tooth’s outer layers.
When bacteria infect the pulp tissue, the inflammation often causes intense discomfort. In time, the harmful microorganisms can also pass through the tooth’s root and into the tissue of the jaw, resulting in a painful abscess. Eventually, if it isn’t treated, the tooth will likely be lost.
Root canal treatment is designed to remove the infection, relieve the pain…and save the tooth. It is usually performed under anesthesia for your comfort. To begin the procedure, a small hole is made in the tooth’s enamel to give access to the pulp; then, tiny instruments are used to remove the diseased tissue and disinfect the tooth. Finally, it is sealed up against re-infection. Following treatment, a cap (or crown) is often needed to restore the tooth’s full function and appearance.
Despite some rumors you may have heard, root canal treatment is neither very painful nor likely to cause other health problems. So if you come across these discredited ideas, remember that dentists and dental specialists called endodontists perform some 25 million root canal procedures every year—and this treatment method has been validated for decades.
Of course, like any medical procedure, root canal treatment is not 100% successful. While the procedure has a very high success rate, it’s possible that additional treatments will be needed in some cases. However, the alternative—extracting the tooth—has similar potential downsides; plus a replacement tooth will be needed to avoid the health and lifestyle troubles caused by missing teeth. But one thing is certain: Ignoring disease in the tooth’s soft tissues isn’t a good move, because the infection won’t go away on its own—and down the road it will only get worse.
So this May, while you’re taking time to smell the flowers, spare a thought for the often-misunderstood root canal. If you’d like more information on root canal treatment, please contact us or schedule a consultation. You can also learn more by reading the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: What You Need to Know.”
Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.
First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.
How common is this malady? According to the U.S. Centers for Disease Control, nearly half of allÂ Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.
What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.
Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.” Â If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.
The most important part of dental health maintenance isn’t what your dentist does—it’s what you do every day when you brush and floss your teeth. And all you really need is a multi-tufted, soft bristle toothbrush, toothpaste, a roll of dental floss—plus a little effort from your hands and fingers.
Of course, manual power isn’t your only option—an electric or battery-powered toothbrush is a convenient and, for people with strength or dexterity issues, a necessary way to remove disease-causing plaque from tooth surfaces. You have a similar option with flossing—a water flosser.
Although water flossers (or oral irrigators) have been around since the early 1960s, they’ve become more efficient and less expensive in recent years. A water flosser delivers a pulsating stream of pressurized water between the teeth through a handheld device that resembles a power toothbrush, but with a special tip. The water action loosens plaque and then flushes it away.
While the convenience these devices provide over traditional flossing is a major selling point, they’re also quite beneficial for people with special challenges keeping plaque from accumulating between teeth. People wearing braces or other orthodontic devices, for example, may find it much more difficult to effectively maneuver thread floss around their hardware. Water flossing can be an effective alternative.
But is water flossing a good method for removing between-teeth plaque? If performed properly, yes. A 2008 study, for example, reviewed orthodontic patients who used water flossing compared to those only brushing. The study found that those using water flossing were able to remove five times as much plaque as the non-flossing group.
If you’re considering water flossing over traditional flossing thread, talk with your dental hygienist. He or she can give you advice on purchasing a water flosser, as well as how to use the device for optimum performance. It could be a great and more convenient way to keep plaque from between your teeth and harming your dental health.
If you would like more information on water flossing, 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 “Cleaning between Your Teeth: How Water Flossing can help.”
In an instant, an accident could leave you or a loved one with a missing tooth. Thankfully, we can restore it with a dental implant that looks and functions like a real tooth—and the sooner the better.
But if the patient is a teenager or younger, sooner may have to be later. Because their jaws are still developing, an implant placed now could eventually look as if it's sinking into the gums as the jaw continues to grow and the implant doesn't move. It's best to wait until full jaw maturity around early adulthood and in the meantime use a temporary replacement.
But that wait could pose a problem with bone health. As living tissue, bone cells have a life cycle where they form, function and then dissolve (resorption) with new cells taking their place. This cycle continues at a healthy rate thanks to stimulation from forces generated by the teeth during chewing that travel through the roots to the bone.
When a tooth goes missing, however, so does this stimulation. Without it the bone's growth cycle can slow to an unhealthy rate, ultimately reducing bone volume. Because implants require a certain amount of bone for proper placement and support, this could make it difficult if not impossible to install one.
We can help prevent this by placing a bone graft immediately after the removal of a tooth within the tooth's "socket." The graft serves as a scaffold for new bone cells to form and grow upon. The graft will eventually resorb leaving the newly formed bone in its place.
We can also fine-tune and slow the graft's resorption rate. This may be preferable for a younger patient with years to go before their permanent restoration. In the meantime, you can still proceed with other dental treatments including orthodontics.
By carefully monitoring a young patient's bone health and other aspects of their dental care, we can keep on course for an eventual permanent restoration. With the advances in implantology, the final smile result will be worth the wait.
If you would like more information on dental care for trauma injuries, 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 for Teenagers: Factors Influencing Treatment Planning in Adolescents.”
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