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Dental implants are typically made of strong and lightweight titanium or titanium alloys, which makes them exceptionally sturdy and durable. Over time, dental implants naturally fuse to your bone, adding to their stability.
Of all the ways modern dentistry has to replace missing teeth, dental implants are by far the best. There is no tooth-replacement option that will give you a longer-lasting result. Implants also help preserve tooth-supporting bone that naturally deteriorates when a tooth is lost. Loss of bone is one of the major hidden consequences of losing teeth.
A dental implant most often takes the form of a small, screw-shaped titanium post that replaces the root-part of a missing tooth. The surgical procedure used to place an implant is actually quite minor and routine, requiring only local anesthesia in most cases. After a healing period, the implant is topped with a lifelike crown custom-made to match your existing natural teeth. Implants have a documented success rate of over 95%, which is significantly higher than any other tooth-replacement option.
During a minor surgical procedure, your dental implant is inserted directly into the jawbone in the space vacated by the missing tooth. It will then be left to heal for a period of months before the final crown is attached. During this healing period, the implant actually fuses to the bone surrounding it.
Implants can replace missing teeth in a variety of ways. They can be used to:
Replace One Tooth — When you have one tooth missing, a single implant is inserted into the bone to replace the root part of that tooth; a crown then goes on top to simulate an actual tooth. This treatment choice has the highest success rate, making it the best long-term investment for replacing a single missing tooth. Even if the initial cost is slightly higher than other options, it is the most cost-effective solution over time. An implant will never decay or need root canal treatment, and feels just like the tooth that was there.
Replace Multiple Teeth — When you have more than one tooth missing, implants provide an ideal replacement mechanism. You don't even need one implant for every missing tooth. Instead, implant teeth can act as supports for fixed bridgework. For example, if you are missing three teeth in a row, we can place two implants, one on either side of the gap, and a crown in between that has no implant underneath. That way, you won't need to use any of your remaining natural teeth as bridge supports, which could weaken them and make them more susceptible to decay.
Replace All Teeth Permanently — Implants can support an entire arch of upper or lower replacement teeth that are fixed into the mouth and are never removed. Sometimes the new teeth can be supported by as few as 4 implants. It's comparable to the structure of a table, which only needs 4 legs to hold it up. In cases where jawbone density and volume have deteriorated, 5 or 6 implants might be needed to support a row of 10 to 12 teeth. Dental implant replacement teeth protect your jawbone, won't slip, and should last a lifetime.
Support Removable Dentures — Implants can even make removable dentures more comfortable, effective and healthier to wear. Traditional dentures rest on the gums and put pressure on the underlying bone. This accelerates bone loss so that the jaw shrinks and the dentures slip, particularly on the bottom. But today dentists can attach a removable denture onto implants, transferring that pressure into the bone structure rather than the bone surface. This prevents the dentures from slipping while you eat and speak, and preserves the bone directly beneath them.
There are only two ways an implant can lose attachment to the bone and fail once it has successfully fused: poor oral hygiene or excessive biting forces. Poor oral hygiene and/or a lack of regular cleanings can lead to a destructive bacterial infection called peri-implantitis. Flossing and brushing your teeth on a daily basis, along with regular professional cleanings, can prevent this. Excessive biting forces can come from either a habit of clenching or grinding your teeth, or an insufficient number of implants to handle the forces generated by your bite. You should receive the correct number of implants so this does not happen. And if you have a habit of grinding or clenching your teeth, a nightguard will be recommended to protect your implants. After all, implants are a long-term investment in your smile, your health and your well-being, so it's best to protect your investment.
DENTAL CROWN AND BRIDGE
Dentistry is an art as well as a science; dental crowns offer a perfect example of this. A dental crown or “cap” is a covering that fits over a damaged, decayed or unattractive tooth. It can even replace a tooth entirely as part of dental bridgework.
A crown completely covers a tooth above the gum line. This is in contrast to a dental veneer, which only covers a tooth's front surface and needs natural tooth structure to support it. Therefore, if a tooth is missing a significant amount of structure above the gum line, a crown would be the restoration of choice.
Crowns strengthen damaged teeth, allowing them to function normally again. When crafted from today's high-tech porcelains (dental ceramics), crowns are virtually indistinguishable from natural teeth. They can even be designed to improve upon a tooth's original appearance.
There are other materials besides porcelain that we can use to make dental crowns, depending on what qualities are most important. For durability, cast gold can't be beat. However, this is not always the most aesthetic choice — especially towards the front of the mouth. Other possibilities include porcelain-fused-to-metal crowns (PFM), which have a metal interior for strength and a porcelain exterior for a more natural appearance, and all-porcelain crowns with zirconia, representing the strongest ceramic. We would be happy to discuss the pros and cons of these various options with you.
Crowning or capping a tooth will usually take two to three visits. At the first visit, your tooth is prepared to receive its new crown. First, it is shaped to fit inside the new covering. This will involve some drilling to give the tooth a uniform shape. The tooth and the surrounding area will be numbed beforehand. If there is very little tooth structure left to begin with, the tooth may have to be built up with filling material, rather than filed down, to support the crown.
After the tooth is prepared, impressions of your teeth are taken, either digitally or with reliable, putty-like impression materials, and sent to the dental laboratory. There, the impressions will be used to make models of your teeth for the creation of a crown. The models will serve as guides to the highly skilled lab technicians, who will ensure that your new crown is designed to enhance your smile and function well within your bite.
Before you leave the office, a temporary crown will be attached to your tooth to protect it until the permanent crown is ready. At the second visit, your permanent crown will be attached to your tooth with either a resin that hardens when exposed to a special light source, or a type of permanent cement.
Crowns can also be used to create a lifelike replacement for a missing tooth. This is done with bridgework, which spans the space of the missing tooth and requires at least three crowns. Two of those crowns will be placed over healthy teeth on either side of the missing tooth; these healthy teeth are referred to as abutment teeth. The two crowned abutment teeth become supports for a third crown placed in between them; that third crown is referred to as a pontic. If more than one tooth is missing, more crowns will be needed to bridge the gap in between the abutment teeth.
The number of abutment teeth necessary to replace missing teeth is influenced by the number of missing teeth, the size and length of the abutment tooth roots, the amount of bone support each abutment tooth has, as well as where in the mouth the missing tooth is located. For example, if you have three missing teeth, four abutment teeth may be necessary, thereby creating a seven-tooth bridge. Engineering and designing of the bridge requires an understanding of how to replace teeth, as well as the biology of the supporting gum and bone tissue.
Crowns and bridgework require the same conscientious care as your natural teeth. Be sure to brush and floss between all of your teeth — restored and natural — every day to reduce the buildup of dental plaque. When you have crowns, it is even more important to maintain your regular schedule of cleanings at the dental office. Avoid using your teeth as tools (to open packages, for example). If you have a grinding habit, wearing a nightguard would be a good idea to protect your teeth and your investment.
ROOT CANAL TREATMENT
Root canal treatment — also called endodontics (“endo” – inside, “dont” – tooth) — is a set of specialized procedures designed to treat problems of the soft pulp (nerve) tissue inside the tooth. While some mistakenly think of it as an unusually painful treatment, in most cases the procedure is no more uncomfortable than getting a filling. It's actually one of the most effective ways of relieving some kinds of tooth pain.
A root canal procedure becomes necessary when infection or inflammation develops in the pulp tissue of the tooth. Pulp tissue consists of blood vessels, connective tissue and nerve cells — which explains why a problem here may cause you to feel intense pain. In time, the pain may go away... at least temporarily. Without treatment, however, the infection won't. It can lead to a dental abscess, and may even contribute to systemic problems in other parts of the body.
We've all heard the gag: “I'd rather have a root canal...” This comedy line, comparing the procedure to something truly undesirable, may be funny — but putting off needed endodontic treatment is no joke. The idea that a root canal procedure invariably comes with complications and pain is a shopworn myth. It's certainly true that infection or inflammation in the tooth's pulp can be excruciatingly painful. But you should remember that having a root canal results in eliminating this acute pain and is not the cause of the pain.
Need another reason not to delay root canal treatment? How about this: A natural tooth that's saved via root canal treatment and restoration helps you avoid the problems that commonly occur when teeth must be removed. These include unwanted tooth migration or shifting, which can lead to difficulties in chewing; the need for bridgework or dental implants, which may be costly and complicated; and even the eventual loss of bone structure from the area of the missing tooth.
How do you know when you need a root canal? Sometimes, it's painfully obvious. If you feel constant and severe pain and pressure in your mouth, or noticeable swelling and extreme sensitivity in your gums, then it's clear you need an evaluation and treatment right away. Another telltale symptom of pulp tissue damage is sharp pain when you bite down on food. Lingering pain after eating hot or cold foods is also an indication of potential trouble. If you notice any of these symptoms, you need to have an examination as soon as possible
Root canal problems stem from infection and inflammation of the tooth's pulp tissue. One potential cause of infection is deep tooth decay. Untreated dental cavities eventually allow bacteria to work their way down to the center of the tooth, where they may infect the pulp tissue. Another path by which bacteria may come into contact with pulp is via chipped or cracked teeth. Any opening in the protective enamel coating has the potential to allow bacteria access to the tooth's pulp.
Trauma to the tooth — the kind that might result from a sports injury or automobile accident, for example — is also a major cause of pulp tissue damage. In this case, it's essential to seek treatment immediately, both to try and save the tooth, and to prevent future problems.
In some cases, extensive dental work itself may cause damage to the pulp tissue that will need to be treated via a root canal. Having multiple fillings or restorations on the same tooth increases the chances of this type of injury. Occasionally, common procedures like crown preparation or orthodontics may eventually lead to root canal problems.
If an examination shows that you do need root canal therapy, don't worry — it's one of the most routine and effective procedures in the arsenal of dental treatments and can often be accomplished in just one visit.
The root canal process generally begins the same way as a filling does, and with no greater discomfort: an anesthetic is administered to numb the tooth and the surrounding area. For many patients, the worst is already over.
Next, a small opening is made in the surface of the affected tooth to give access to the pulp chamber and root canals. Tiny instruments are used, sometimes with the aid of a microscope, to remove the dead and dying pulp tissue from inside these narrow passageways. The chamber and empty canals are then cleaned, disinfected, and prepared to receive a filling of inert, biocompatible material. Finally, adhesive cement is used to seal the opening in the tooth, preventing future infection.
Following root canal treatment, your tooth may feel some sensitivity or tenderness for a few days. Over-the-counter pain relievers like ibuprofen are generally effective in relieving discomfort, but prescription medications may also be given if needed. During this period, it may help to avoid biting hard on the affected tooth. All of these symptoms, however, should be temporary.
To further protect the tooth and restore it to full function, it's usually necessary to have a crown or other restoration placed on it. Restorations can take many forms, from traditional gold crowns to tooth replicas made of high-tech tooth-colored material. In any case, you will have made an investment in preserving your dental health for years to come.
The most likely location for a cavity to develop in your child's mouth is on the chewing surfaces of the back teeth. Run your tongue over this area in your mouth, and you will feel the reason why: These surfaces are not smooth, as other areas of your teeth are. Instead, they are filled with tiny grooves referred to as “pits and fissures,” which trap bacteria and food particles. The bristles on a toothbrush can't always reach all the way into these dark, moist little crevices. This creates the perfect conditions for tooth decay.
What's more, a child's newly erupted permanent teeth are not as resistant to decay as adult teeth are. The hard enamel coating that protects the teeth changes as it ages to become stronger. Fluoride, which is found in toothpaste and some drinking water — and in treatments provided at the dental office — can strengthen enamel, but, again, it's hard to get fluoride into those pits and fissures on a regular basis. Fortunately, there is a good solution to this problem: dental sealants.
Dental sealants are invisible plastic resin coatings that smooth out the chewing surfaces of the back teeth, making them resistant to decay. A sealed tooth is far less likely to develop a cavity, require more expensive dental treatment later on, or, most importantly, cause your child pain.
You can think of a sealant as a mini plastic filling, though please reassure your child that it doesn't “count” as having a cavity filled. Because tooth enamel does not contain any nerves, placing a sealant is painless and does not routinely require numbing shots. First, the tooth or teeth to be sealed are examined, and if any minimal decay is found, it will be gently removed. The tooth will then be cleaned and dried. Then a solution that will slightly roughen or “etch” the surface is applied, to make the sealing material adhere better. The tooth is then rinsed and dried again. The sealant is then painted on the tooth in liquid form and hardens in about a minute, sometimes with the help of a special curing light. That's all there is to it!
A note about BPA: A 2012 study that received wide press coverage raised concerns that trace amounts of the chemical bisphenol-A (BPA) found in some (but not all) dental resins might contribute to behavioral problems in children. The study authors noted that while they had found an association, they had not actually proven that BPA in dental sealants causes these problems. In fact, BPA is far more prevalent in food and beverage packaging than in dental restorative materials. The American Academy of Pediatric Dentistry and the American Dental Association have since reaffirmed their support for the use of sealants.
Sealed teeth require the same conscientious dental hygiene as unsealed teeth. Your child should continue to brush and floss his or her teeth daily and have regular professional cleanings. Checking for wear and tear on the sealants is important, though they should last for up to 10 years. During this time, your child will benefit from a preventive treatment proven to reduce decay by more than 70 percent.
Invisalign is a method of dental straightening that uses clear plastic trays – no uncomfortable metal wires or clear brackets. You and those around you will hardly notice the clear trays that comfortably fit over your teeth.
When you hear the word “orthodontics,” what comes to mind? Probably a young teenager whose teeth are covered by a latticework of metal. There are indeed many orthodontic patients who fit that description. However, there now exists an increasingly popular alternative to traditional metal braces: Invisalign® clear aligners.
As the name implies, Invisalign clear aligners are made of almost invisible polyurethane plastic. Rather than being cemented or bonded to the teeth as metal or clear braces are, clear aligners are completely removable — for important social occasions, for eating, and, most importantly, for tooth-brushing and flossing. This advantage can also be a disadvantage: It means you must resist the temptation to take your aligners out more than is advised. Here are some other advantages of the Invisalign system:
Clear aligner technology has been improving over the years and can correct many malocclusions that once would have been too complicated for this form of treatment. Yet there are still some situations for which traditional braces would still be best. This can be discussed in detail with you.
Invisalign clear aligners work the same way traditional braces do: by applying carefully controlled forces to teeth to move them into a better position. But they are not made of metal; instead, they are made of clear, flexible plastic.
Here's how it works: Specialized computer software is used to design a plan for moving your teeth from their current positions into the best possible alignment. This movement will be broken down into perhaps several dozen stages. For each stage, the Invisalign company will manufacture two plastic mouth “trays” or “aligners,” one to fit over your top teeth and one for the bottom. You will wear this first set of trays for two weeks, for a minimum of 20 hours per day. You will then move on to the next set of aligners in your series to accomplish the next stage of gradual movement. You will keep doing this until your teeth are correctly aligned.
In the past several years, two features have been added to make Invisalign a more appropriate orthodontic treatment method for teenagers. Special “eruption tabs” hold the appropriate amount of space open for molars that have not fully grown in. Invisalign for teens also comes with “compliance indicators” built into the aligner material, which fade with wear. This allows parents, dentists, and the teens themselves, to make sure the trays are being worn as prescribed. Treatment with Invisalign can only be successful if this is the case.
As mentioned above, one of the main advantages of the Invisalign system is that the trays can be removed for easy cleaning. So please don't neglect to do this! You'll need to brush your teeth after every meal or snack so that food and plaque do not get trapped in the aligners, which could promote tooth decay and gum disease. Your aligners, too, will have to be cleaned regularly; you can do this by brushing them and then rinsing them with lukewarm water.
Also, please keep in mind that while wearing clear aligners is very different from wearing braces, the importance of retaining your post-treatment results is exactly the same. You'll want to be sure to wear your retainer(s) exactly as prescribed after your treatment is completed to protect your investment in a beautiful new smile.
Did you know that our dentist at Uptown Dental Surgery is a Certified and Preferred Invisalign Provider? If you are interested in learning more about Invisalign, call us soon to speak to one of our Invisalign Client Care Consultants for more information
PROFESSIONAL TEETH WHITENING
Teeth whitening done in a professional dental setting is a safe, effective way to brighten your smile. It's also perhaps the most economical cosmetic dental procedure. Depending on the whitening method you choose, results can be dramatic: in-office whitening, for example, can lighten teeth three to eight shades in a single hour.
Professionally supervised whitening will work faster, and protect sensitive gums and tooth-root surfaces better, than over-the-counter whitening products. Having an oral exam before you begin any whitening process is an important first step to make sure your tooth discoloration is not the result of a dental condition in need of treatment. Also, please be aware that it can be risky to have whitening solutions applied to your teeth by untrained personnel in shopping malls. If you have any questions about which whitening method would be best for you, talk to us first.
Professional whitening makes use of high-concentration bleaching gels that are not available over the counter.
There are lots of things you can do to make sure your whitening results last as long as possible, and this will vary from person to person (six months to two years or even longer). First of all, please maintain your usual, conscientious routine of brushing and flossing every day, and keep up with your regular schedule of professional cleanings at the dental office. Avoid foods and beverages that stain, including red wine, tea and coffee. If you smoke, use your newly whitened teeth as an impetus to quit — a good idea in any event! A minor touch-up every so often, either at home or at the dental office, can keep your smile bright and beautiful for years.
What makes a smile beautiful? That's a complex question, but some qualities of a lovely smile are immediately identifiable: good tooth color, shape and alignment are a few of the most important ones. If your teeth could use improvement in any of these categories, porcelain veneers could be just what you're looking for.
You may already know that a veneer is a thin covering over another surface. In dentistry, a veneer is a wafer-thin layer of super-strong porcelain that convincingly substitutes for natural tooth enamel. When bonded to your teeth, veneers can create a natural-looking, beautiful new surface. That's because dental porcelain, like natural tooth enamel, is translucent and tough. But it doesn't stain like tooth enamel does.
Recent years have brought remarkable advances in dental porcelain technology. These days, veneers can be made so thin that they can sometimes be bonded directly onto your existing tooth surface. In other cases, a very thin layer of tooth enamel — as thin as the veneer itself — needs to be removed to fit the new porcelain surface and make it look as lifelike as possible. Either way, the results are sure to make you smile.
Veneers can be used to improve any of the following characteristics of your teeth:
There are some situations in which veneers would be inappropriate. For example, if you have significantly misaligned teeth or a large gap, orthodontics might be a more appropriate solution than veneers. And if you have lost a lot of tooth structure from decay or trauma (or a particularly severe grinding habit), it might be better to restore your teeth with porcelain crowns that cover the entire tooth.
The first step in creating a new smile with porcelain veneers is to communicate exactly what you don't like about your smile as it is now. It's a great idea to bring in pictures of smiles you do like, as a starting point for discussion. It's possible to see how veneers would look on your teeth in one of several ways. A model of your teeth can be created over which wax “veneers” can be placed; sometimes acrylic (plastic) or tooth-colored filling material can be placed directly onto your teeth to demonstrate the effect veneers would have on them.
Once the plan has been agreed upon, your teeth will be prepared by removing a small amount of enamel, if this step is necessary. Molds of your teeth will be taken and used by a skilled dental laboratory to create your veneers, and you will receive a temporary set of veneers to wear during the few weeks it will take to create your permanent veneers. When the veneers come back from the lab, they will be cemented onto your teeth.
Just like the teeth nature gave you, teeth restored with veneers need gentle brushing and flossing every day. This will remove dental plaque and ensure good gum tissue health around the veneers. Regular checkups at the dental office will remain as important as always to your oral and general health. And keep in mind that as tough as veneers are, they may not be able to withstand forces that come from using your teeth as tools (to open packages, for example) or biting into very hard foods like candy apples — which isn't good for your natural teeth, either! And if you grind or clench your teeth at night, you might be advised to get a custom-made nightguard to protect your veneers — and your investment.
What a difference straight teeth can make! A great-looking smile can boost your self-confidence and have a positive impact on social and professional opportunities. Orthodontic treatment is the original smile makeover tool — and you will be happy to know that you're never too old to take advantage of it. But it isn't all about looks: Properly aligned teeth help you to bite, chew and even speak more effectively. They are also easier to clean, which helps keep your mouth free of tooth decay and gum disease.
The amazing thing about orthodontics is that it harnesses the body's natural ability to remodel its own tissue. With the application of light, constant force, orthodontic appliances gently reshape bone and move teeth into better positions. Some examples of these appliances are traditional metal braces, inconspicuous clear or tooth-colored braces, and clear aligners, a relatively new option for adults and teens.
Orthodontic treatment can resolve a number of bite problems, which often become evident by around age 7. These include underbite, crossbite or excessive overbite, where upper and lower teeth don't close in the proper position; open bite, where a space remains between top and bottom teeth when the jaws are closed; and crowding or excessive spacing, where teeth are spaced too close together or too far apart.
To correct bite problems, teeth need to be moved — but doing that isn't as hard as you might think! Teeth aren't fixed rigidly in their supporting bone; instead, they're held in place by a hammock-like structure called the periodontal ligament, which is very responsive to forces placed on the teeth. Orthodontic appliances move teeth by careful application of light, constant pressure. This force can be applied via metal wires that run through small brackets attached to the teeth (braces), or via the semi-rigid plastic of clear aligners.
Having orthodontic treatment in childhood is ideal in order to take advantage of a youngster's natural growth processes to help move the teeth into proper alignment. Like the rest of the body, the teeth and jaws are now changing rapidly. So at this time it's possible (for example) to create more room for teeth in a crowded mouth by using a “palatal expander” to rapidly widen the upper jaw. This phase of growth modification can shorten overall treatment time and ensure the best result if additional orthodontic appliances are needed.
But remember, healthy teeth can be moved at any age, so you've never “missed the boat” for orthodontic treatment. In fact, about one in five of today's orthodontic patients is an adult. Several new technological developments — including tooth-colored ceramic braces, and clear aligners — have made orthodontic appliances less evident, and enhanced the treatment experience for grown-ups. Before treatment, adults are carefully examined for signs of periodontal (gum) disease, which will be brought under control before treatment begins.
When you imagine someone wearing braces, you probably picture small metal brackets bonded to the front of the teeth, with a thin wire running through them. This time-tested style remains very popular — but it's no longer the only option. Clear braces use brackets made of ceramic or plastic which, except for the slim archwire, are hardly visible.
Removable clear aligners are an alternative to fixed orthodontic appliances. They consist of a series of clear plastic “trays” that fit over your teeth exactly; each one moves your teeth a little bit, until they are in the proper position. Whether fixed or removable, each type of appliance may have advantages or disadvantages in particular situations. After a complete examination, the best treatment options for you will be discussed.
Once your orthodontic treatment is completed, it's extremely important to wear a retainer as directed. That's because teeth naturally tend to drift back to their original locations — which is the last thing you want after you've gone to the trouble of straightening them! Wearing a retainer holds your teeth in their new position long enough for new bone and ligament to re-form around them, and helps keep your gorgeous new smile looking good for a lifetime.