Although we have more replacement options for missing teeth than our forebears of a century ago, people who've lost all their teeth overwhelmingly choose dentures, a restoration that would have been quite familiar to past generations. And for good reason! Dentures have a long history of effectively restoring dental form and function.
Even so, dentures do have their weaknesses, and one in particular—they can't stop bone loss, a common occurrence after losing teeth. The forces we generate when we chew stimulate the bone in the jaw to produce new cells after older cells die off. The stimulation ends, however, where teeth go missing, which can cause replacement growth of bone to significantly lag behind and create a deficit in the bone.
What's worse, dentures may even accelerate further bone damage. The pressure they exert resting on the gums irritate the bony ridges beneath, resulting in more bone loss. The dentures' once tight fit may then become overly loose, making them unstable and uncomfortable to wear, and in need of repair or replacement.
There is a way, though, to address this weakness with dentures through dental implants. By strategically placing a few implants to support either a removable denture (overdenture) or a fixed denture, we may actually be able to slow or stop further bone loss.
As few as 3 implants might be needed to support an upper denture, which connects to them through special fittings, or perhaps only 2 for a lower denture. A fixed denture that's permanently affixed to the implants may require 4 to 6 for adequate support.
With the dentures' support shifted to the implants rather than the gums, it's obvious how these hybrid teeth replacements could be more secure. But what can they do to deter bone loss?
Implants are essentially a titanium metal post imbedded in the jawbone. Bone naturally attracts to titanium, and will readily grow and adhere to its metal surface. Besides creating a durable bond, the relationship between implant and bone can generate new bone growth even in areas of previous loss.
An implant-supported denture can feel more secure in your mouth. More importantly, it might help you avoid further bone loss.
If you would like more information on implant-supported dentures or 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 “Overdentures & Fixed Dentures.”
If you're a fan of former NFL player and current host of Good Morning America Michael Strahan, then you're well aware of his unique smile feature—a noticeable gap between his front teeth. So far, Strahan has nixed any dental work to correct the gap, often saying it was part of "who I am."
But if you follow him on Twitter, you may have been shocked by a video he posted on March 30th of him sitting in a dentist's chair. Calling it a "moment fifty years in the making," Strahan said, "Let's do it." After some brief video shots of a dental procedure, Strahan revealed a new gapless smile.
But some of his Twitter fans weren't buying it—given the timing, they sniffed an elaborate April Fool's Day ruse. It turns out their spider senses were on target: Strahan appeared once again after the video with his signature gap still intact, grinning over the reaction to his successful prank.
The uproar from his practical joke is all the more hilarious because Strahan has let it be known he's truly comfortable with his smile "imperfection." But it also took him awhile to reach that point of acceptance, a well-known struggle for many people. On the one hand, they want to fix their dental flaws and improve their smile. But then again, they're hesitant to part with the little "imperfections" that make them unique.
If that's you, here are some tips to help you better navigate what best to do about improving your smile.
See a cosmetic dentist. A cosmetic dentist is singularly focused on smile enhancement, and particularly in helping patients decide what changes they want or need. If you're looking for such a dentist, seek recommendations from friends and family who've changed their smiles in ways you find appealing.
Get a "smile analysis." Before considering specific cosmetic measures, it's best to first get the bigger picture through an examination called a "smile analysis." Besides identifying the defects in your smile, a cosmetic dentist will use the analysis to gauge the effect any proposed improvements may have on your overall facial appearance.
Embrace reality. A skilled cosmetic dentist will also evaluate your overall oral health and assess how any cosmetic procedures might impact it. This might change your expectations if it whittles down the list of enhancement possibilities, but it may help determine what you can do to get the best improved smile possible.
A great cosmetic dentist will work diligently with you to achieve a new smile that's uniquely you. Even if, like Michael Strahan, you decide to keep a trademark "imperfection," there may still be room for other enhancements that will change your appearance for the better.
Discovering how pain and anxiety complicated disease care, many ancient civilizations turned to natural substances like root herbs or alcohol to ease their effect. Today, we've developed more effective agents, which enable patients to undergo many treatments they would otherwise be unable to endure.
There's been immense progress in particular in methods for reducing patient anxiety during dental treatment. In contrast to physical pain, anxiety is more aptly defined as mental discomfort. Dental anxiety, the apprehension a person feels at the prospect of dental care, can be serious enough that a person avoids dental care altogether, even with serious teeth or gum issues.
Adages like "Just suck it up and get through it" can be hollow words to someone with serious dental anxiety. Today's dentist understands that anxiety is very real and a serious impediment to care. Fortunately, modern dentistry has effective measures to alleviate it.
This commonly involves an approach with two phases. In the first, the patient takes an oral sedative an hour or so before the appointment to produce an initial calming effect. In the second phase at the appointment, the dentist initiates intravenous or IV sedation, a deeper application that continues throughout the treatment session.
With IV sedation, we deliver the sedative medication through a small needle inserted into a patient's vein, placing the patient in a highly relaxed state. Unlike general anesthesia, which renders a patient unconscious, sedated individuals remain somewhat awake, often able to respond to verbal commands or physical stimuli.
In further contrast to general anesthesia, IV sedation doesn't require assisting patients with breathing or circulation. Even so, one of the treatment staff will continue to monitor vital signs while the patient is sedated.
Since the introduction of Pentothal in the 1930s, the first sedative used for medical and dental procedures, we've developed other safe and effective sedatives that flush from the body quickly and have few after-effects. Many have an amnesiac effect, so that the patient remembers little or nothing at all about the procedure.
Sedation therapy can accomplish two things. First, an anxious patient can have a more positive experience during dental treatment. And, as these positive experiences accumulate, a patient prone to anxiety may develop a readiness to receive treatment before a problem goes too far.
If you would like more information on dental sedation techniques, 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 “IV Sedation in Dentistry.”
Dental implants are often the ideal choice to replace missing teeth. Unfortunately, "ideal" and "affordable" don't always align simultaneously for people. Even if implants are right for you, you may have to put them off to a more financially appropriate season.
In the meantime, though, you're still missing teeth—and perhaps some of them are right square in the middle of your smile. What can you do now, even if temporarily?
The solution might be a flexible removable partial denture (RPD). These newer types of RPD fit somewhere between the lightweight "flipper" and the more traditional rigid plastic appliances often made for permanent use. The flexible RPD is made of nylon plastic (technically known as a super-polyamide), which although lightweight, is highly durable.
Super-polyamides change their shape under high heat, a characteristic dental technicians take advantage of by injection molding heated material into flexible denture bases, to which they then attach the replacement teeth. Like other RPDs, a flexible RPD is custom-designed for the individual patient to match their jaw contours, as well as the types and locations of their missing teeth.
Flexible RPDs also differ from other RPD types in how they stay in place. While the more rigid RPD depends on metal clasps that grip to some of the remaining natural teeth, a flexible RPD uses finger-like extensions of the nylon material to fit around teeth near the gum line where they're difficult to see. As such, the flexible RPD is both comfortable and securely held in place.
A flexible RPD, like their counterparts, does require regular maintenance. Any RPD can accumulate dental plaque, a thin biofilm buildup on teeth that causes dental disease. For this reason, wearers should regularly remove their RPD and clean it thoroughly with an antibacterial soap (never toothpaste). All RPDs should also be removed at night to limit bacterial growth.
With a little care, a flexible RPD could last for several years. It could be just the solution to buy you time while you're waiting to obtain dental implants.
If you would like more information on restoration options for missing 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 “Flexible Partial Dentures.”
Alcoholic beverages are interwoven within many cultures across the globe, but this "social lubricant" also has a dark side. Alcohol can become an overwhelming, addictive substance that wrecks relationships and careers, not to mention physical health. In regard to the latter, the teeth, mouth and gums aren't immune.
April is Alcohol Awareness Month, sponsored by the National Council on Alcoholism and Drug Dependence. Throughout the month, healthcare providers, including dentists, highlight the damage heavy alcohol consumption can wrought on physical, emotional and social health. Abstaining or bringing alcohol consumption within recommended limits can improve your life—and your oral health.
While the effects of too much alcohol on general health are well known, it's easy to overlook its connection with dental disease, but it does exist for a number of reasons.
First, many alcoholic beverages and mixers contain high amounts of sugar. Harmful bacteria living in dental plaque, a thin film on tooth surfaces, feed on sugar. The bacteria are then able to multiply, which, increases your chances for gum disease, one of the leading causes of tooth loss.
Many alcoholic drinks also contain high amounts of acid. That, coupled with the acid produced by bacteria, can soften and erode tooth enamel, leading to unpleasant outcomes like increased tooth sensitivity or tooth decay. Like gum disease, advanced tooth decay can also cause tooth loss.
Alcohol consumption also causes dehydration, which in turn can have an effect on the mouth: With less water available, the salivary glands produce less saliva. Because saliva helps neutralize oral acid and fights pathogens leading to dental disease, having less of it available can make your mouth more susceptible to disease and infection.
To avoid these unfortunate consequences, it's important to either forgo drinking alcohol or keep your consumption within moderate limits. Those limits for you individually may depend on things like your age, weight, genetic background and overall health. Generally, though, U.S. Dietary Guidelines recommend no more than 1 serving of alcohol (akin to 12 ounces of beer, 5 ounces of wine or 1.5 ounces of distilled spirits) per day for women and two for men.
If you're a drinker, you should also look out for your oral health in other ways. Brush and floss your teeth daily to remove harmful dental plaque, and eat a balanced and nutritious diet, rich in vitamins and minerals. You should visit your dentist at least twice a year for cleanings and checkups.
Regardless of your relationship to alcohol, it's a part of life you should take seriously. Drinking responsibly not only protects you and others around you, but it can also protect your dental health.
If you would like more information about alcohol and dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Nutrition: Its Role in General and Oral Health.”
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