Even though an implant is now as close to life-like as modern dentistry can produce, it won’t surpass the function of your own natural tooth. That’s not to say implants are an inferior choice—in fact, it’s often the best one if a tooth is beyond reasonable repair. But first, let’s consider saving your existing tooth.
We first need to know why your tooth is diseased—more than likely either from tooth decay or periodontal (gum) disease. Although different, these infections both begin with bacteria and can eventually lead to tooth loss.
While your mouth is teeming with millions of harmless bacteria, a few strains that live in dental plaque (a thin biofilm on your teeth) can cause disease. As they proliferate—feeding mostly on leftover sugar—they produce acid, which can erode the protective enamel on teeth. This can create cavities, which must be cleared of decayed material and filled.
Sometimes, though, the decay spreads deep within the pulp and through the root canals putting the tooth in danger. We may be able to save it, though, with a root canal treatment. In this common procedure we access the pulp chamber and clean out all the diseased or dead tissue. We then fill the empty chamber and root canals with a gutta percha filling and then seal the tooth. We later cap the tooth with a crown to further protect it.
Dental plaque can also give rise to a gum infection that triggers chronic inflammation. The inflammation can cause the gums to weaken and detach from the teeth to form large, infection-filled voids called periodontal pockets. This could lead to bone deterioration, further loosening the tooth’s hold.
But we can effectively treat gum disease by removing the plaque, which is fueling the infection. We normally do this with special hand instruments, but may also need to use surgical measures for more advanced cases. After plaque removal the inflammation subsides, giving the tissues a chance to heal and strengthen. We may also need to provide further assistance to these tissues to regenerate through gum or bone grafting.
These efforts can be quite involved, but if successful they could give your tooth another lease on life. And that could be a much better outcome for your dental health.
If you would like more information on the best treatment choices for your dental health, 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 “Save a Tooth or Get an Implant?”
Losing teeth to tooth decay or periodontal (gum) disease is never easy. But with implant-supported bridgework, you can regain lost function and appearance with a restoration that could last for many years.
Don’t think, though, that dental disease woes are a thing of the past with your new implants. Although your restoration itself can’t be infected, the supporting gums and underlying bone can, often through bacterial plaque accumulating around the implants. The bone that supports the implants could deteriorate, dramatically increasing your chances of losing your restoration.
It’s essential, then, that you keep the area between the bridge and gums clean of plaque through daily hygiene. This definitely includes flossing around the implants.
Flossing with an implant-supported bridge will be different than with natural teeth: instead of flossing between teeth you’ll need to thread the floss between the bridge and gums. Although this is a bit more difficult, it can be done with the help of a floss threader, a device with a loop on one end and a long, thin plastic point on the other—similar to a sewing needle.
To use it, thread about 18” of floss through the loop and then pass the threader’s thin end first through the space between the bridge and gums toward the tongue until the floss threader pulls through. You can then take hold of one end of the floss and then pull the threader completely out from beneath the bridge. Then, you wrap the ends around your fingers as you would normally and thoroughly floss the implant surfaces you’re accessing. You then release one end of the floss, pull out the remainder, rethread it in the threader and repeat the process in the next space between implants.
You also have other hygiene tool options: prefabricated floss with stiffened ends that thread through the bridge-gum space that you can use very easily; or you can purchase an interproximal brush that resembles a pipe cleaner with thin plastic bristles to access the space and brush around the implants.
Some patients also find an oral irrigator, a handheld device that sprays a pressurized stream of water to loosen and flush away plaque, to be an effective way of keeping this important area clean. But that said, oral irrigators generally aren’t as effective removing dental plaque as are floss or interproximal brushes.
Whatever flossing method you choose, the important thing is to choose one and practice it every day. By keeping bacterial plaque from building up around your implants, you’ll help ensure you won’t lose your restoration to disease, so it can continue to serve you for many years to come.
When we look at those glamorous faces on TV, it’s easy to forget that celebrities—like the rest of us—often went through an awkward stage in adolescence. But once in a while, something comes along to remind us that flawless Hollywood smiles didn’t always start out that way. Right now, that something is the hashtag #PuberMe: an invitation from late-night TV host Stephen Colbert for fellow celebs to post awkward photos from their youth.
In exchange for posting the embarrassing images, Colbert’s charity is donating to the hurricane relief effort for Puerto Rico; so far about $1 million has been raised. Also raised: many eyebrows, by the adorably dorky pictures—such as the one of Colbert himself, with a smile full of metal braces!
Like many kids, Colbert had teeth that didn’t align properly in his bite. The picture shows that several of his top teeth are in less-than-perfect positions, with noticeable gaps in between. Yet to look at that same smile today, you’d never suspect there had been a problem. That’s the magic of orthodontics.
Time-tested and effective, metal braces like the ones in Colbert’s picture remain among the most widely used appliances today. But orthodontics has come a long way since the late 1970’s, and now there are several other methods for correcting misaligned teeth, including ceramic braces, clear plastic aligners, and invisible lingual braces. The main advantage of the newer methods is that are they are harder to notice (and maybe a bit less awkward).
Ceramic braces, for example, have brackets that match the color of the teeth; with only the thin archwire visible, they’re much more unobtrusive. Clear aligners are transparent plastic trays that completely cover the teeth. Almost impossible to spot, they are worn 22 hours per day, but may be removed for eating or important events. Lingual braces are literally invisible, since they are placed on the tongue side of teeth rather than the lip side. In many situations, they are at least as effective as traditional braces.
Which appliance is best for you? It depends on each person’s individual situation—but many orthodontic patients now have choices that weren’t available in the past. And that goes for both kids and adults, who often appreciate a more “grown-up” image while improving their smiles with orthodontic treatment.
If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Clear Aligners for Teenagers” and “Orthodontics for the Older Adult.”
We've all done it — suddenly bit the inside of our mouth while chewing food. All too often our cheek, lip or tongue finds itself in the way of our teeth.
The small wound caused by these types of bites usually heals quickly. But it's also common for the natural swelling of these wounds to cause the skin to become prominent and thus more in the way when we eat. As a result we bite it again — and again. If bit a number of times, the old wound can form a bump made of tougher tissue.
Also known as a traumatic fibroma, this growth is made up of a protein called collagen that forms into strands of fibers, similar to scar tissue or a callous. As you continue to bite it, the fibers form a knot of tissue that becomes larger with each subsequent bite and re-healing.
Unlike malignant lesions that form relatively quickly, these types of lumps and bumps usually take time to form.Â They're not injurious to health, but they can be irritating and painful when you re-bite them. We can alleviate this aggravation, though, by simply removing them.
The procedure, requiring the skills of an oral surgeon, periodontist or a general dentist with surgical training, begins with numbing the area with a local anesthetic. The fibroma is then removed and the area closed with two or three small stitches. With the fibroma gone, the tissue surface once again becomes flat and smooth; it should only take a few days to a week to completely heal with mild pain medication like ibuprofen to control any discomfort.
Once removed, we would have the excised tissue biopsied for any malignant cells. This is nothing to cause concern: while the fibroma is more than likely harmless, it's standard procedure to biopsy any excised tissue.
The big benefit is that the aggravating lump or bump that's been causing all the trouble is no more. You'll be able to carry on normal mouth function without worrying about biting it again.
If you would like more information on minor mouth sores and wounds, 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 “Common Lumps and Bumps in the Mouth.”
A critical part of effective, daily oral hygiene, flossing removes bacterial plaque from between teeth that can’t be accessed with brushing. Unfortunately, it’s often neglected — string flossing requires a bit more dexterity than brushing and can be difficult to do properly.
It can be even more difficult for people with implants or who wear orthodontic appliances. For brace wearers in particular, getting access to areas between teeth with string floss is next to impossible; the metal brackets and tension wire also have a tendency to catch and retain food debris that’s difficult to remove with brushing alone.
Water flossing, using a device called an oral irrigator, is an effective alternative that addresses many of these difficulties. First available for home use in the 1960s, an oral irrigator delivers pulsating water at high pressure through a handheld applicator that forcefully flushes material from between teeth.
There’s no question that string flossing is effective in plaque removal between teeth — but what about oral irrigators? A 2008 study looked at a group of orthodontic patients with braces who used oral irrigators and compared them with a similar group that only brushed. The study found that five times as much plaque was removed in the group using the oral irrigators as opposed to the group only brushing.
Oral irrigators may also be effective for people who’ve developed periodontal (gum) disease. In fact, oral irrigators coupled with ultra-sound devices are routinely used by dental hygienists to remove plaque and calculus (hardened plaque deposits) in periodontal patients. As with regular oral hygiene, though, it’s important for patients with gum disease to include water flossing with daily brushing (at least twice a day) and regular cleaning sessions at the dentist to ensure removal of all plaque and calculus.
If you’re interested in using an oral irrigator, be sure to consult with us at your next appointment. Not only can we recommend features to look for in equipment, but we can also instruct you on the techniques to make water flossing an effective plaque remover.
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.”
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