You've seen ads for “Teeth in One Day” that promise immediate implant placement at the same time you have the problem tooth removed. But this presumes the gums and underlying bone are healthy and able to support and protect the implant. If that's not the case, it may be ill-advised to place an implant on the same day.
Even with immediate placement, there will be a small degree of bone and gum opening or space around the implant after it's placed into the socket. This can often be remedied by placing a bone graft and sometimes a gum graft when we install the implant. It's also possible for natural healing to gradually fill in the space, but we'll need to monitor the site carefully for several weeks.
On the other hand, if we detect significant bone loss (or strongly suspect it will occur), immediate placement may not be an option — there's not enough bone or it's too weak to support an implant. In this case, it's necessary to wait on placement and focus on improving the bone health and quantity, beginning when we remove the old tooth and place a bone graft.
After completing the extraction, we typically place a bone graft in the empty socket. The graft will become a “scaffold” for new bone cells to grow upon. We may then allow about two to four months for new bone to partially replenish the area and then place the implant. The bone will continue to regenerate as it grows and attaches to the titanium implant to create a solid attachment.
If the site, however, still appears fragile even after partial bone growth, we may opt to wait another two to four months before attempting placement. From a long-term perspective, this is the best scenario for ensuring a durable foundation for the implant. It also allows for a socket severely compromised by disease to heal more thoroughly.
To determine which of these placement scenarios is best for you, we'll first need to conduct a thorough dental examination. From there we'll be in a better position to discuss the right implant timeline for your situation. Our main goal is to ensure we can securely place your implant in just the right position to achieve the most successful and attractive result.
If you would like more information on 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 “Implant Timelines for Replacing Missing Teeth.”
A recent episode of “America’s Got Talent” featured an engaging 93-year-old strongman called The Mighty Atom Jr. The mature muscleman’s stunt: moving a full-sized car (laden with his octogenarian “kid brother,” his brother’s wife, plus Atom’s “lady friend”) using just his teeth. Grinning for host Howie Mandel, Atom proudly told the TV audience that his teeth were all his own; then he grasped a leather strap in his mouth, and successfully pulled the car from a standstill.
We’re pleased to see that the Atom has kept his natural teeth in good shape: He must have found time for brushing and flossing in between stunts. Needless to say, his “talent” isn’t one we’d recommend trying at home. But aside from pulling vehicles, teeth can also be chipped or fractured by more mundane (yet still risky) activities — playing sports, nibbling on pencils, or biting too hard on ice. What can you do if that happens to your teeth?
Fortunately, we have a number of ways to repair cracked or chipped teeth. One of the easiest and fastest is cosmetic bonding with tooth-colored resins. Bonding can be used to fill in small chips, cracks and discolorations in the teeth. The bonding material is a high-tech mixture of plastic and glass components that’s extremely lifelike, and can last for several years. Plus, it’s a procedure that can be done right in the office, with minimal preparation or discomfort. However, it may not be suitable for larger chips, and it isn’t the longest-lasting type of restoration.
When more of the tooth structure is missing, a crown (or cap) might be needed to restore the tooth’s appearance and function. This involves creating a replacement for the entire visible part of the tooth in a dental lab — or in some cases, right in the office. It typically involves making a model of the damaged tooth and its neighbors, then fabricating a replica, which will fit perfectly into the bite. Finally, the replacement crown is permanently cemented to the damaged tooth. A crown replacement can last for many years if the tooth’s roots are in good shape. But what if the roots have been dislodged?
In some cases it’s possible to re-implant a tooth that has been knocked out — especially if it has been carefully preserved, and receives immediate professional attention. But if a tooth can’t be saved (due to a deeply fractured root, for example) a dental implant offers today’s best option for tooth replacement. This procedure has a success rate of over 95 percent, and gives you a natural looking replacement tooth that can last for the rest of your life.
So what have we learned? If you take care of your teeth, like strongman Atom, they can last a long time — but if you need to move your car, go get the keys.
If you would like more information about tooth restoration, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Crowns & Bridgework.”
Teeth grinding is one childhood habit that sounds worse than it usually is: often the most harm done is to your night’s sleep. That said, though, it’s still a habit to keep your eye on.
Also known as bruxism, teeth grinding is so common among children that it’s considered normal behavior by many healthcare professionals. As for causes, some suggest a child’s immature neuromuscular chewing control may trigger it, while others point to the change from deeper sleep to a lighter stage as a possible cause. Problems like airway obstruction, medications or stress also seem to contribute to the habit.
For most children, teeth grinding usually fades by age 11 with no adverse effect on their teeth. If the habit extends into adolescence, however, there’s an increased risk for damage, mainly tooth wear.
This can happen because grinding often produces chewing forces 20-30 times greater than normal. Over time this can cause the biting surfaces of the teeth to wear and reduces the size of the teeth. While teeth normally wear over a lifetime, accelerated wear can pose a significant health risk to your teeth. Any sign of tooth wear in a child or adolescent is definitely cause for concern.
If your child’s tooth grinding habit appears to be developing into a problem, your dentist may recommend a few treatment options. The most common is a thin, plastic night guard worn in the mouth during sleep that prevents the upper and lower teeth from making contact. If the suspected cause is airway obstruction, they may refer you to an ear, nose and throat (ENT) specialist to seek treatment for that, as well as other professionals to help with managing stress or medications.
Like thumb sucking, the habit of teeth grinding usually ends with no permanent ill effects. But if you notice it continuing late into childhood or your dentist finds tooth wear or other problems, take action to avoid problems long-term.
If you would like more information on childhood bruxism, 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 “When Children Grind their Teeth.”
It might seem that supermodels have a fairly easy life — except for the fact that they are expected to look perfect whenever they’re in front of a camera. Sometimes that’s easy — but other times, it can be pretty difficult. Just ask Chrissy Teigen: Recently, she was in Bangkok, Thailand, filming a restaurant scene for the TV travel series The Getaway, when some temporary restorations (bonding) on her teeth ended up in her food.
As she recounted in an interview, “I was… like, ‘Oh my god, is my tooth going to fall out on camera?’ This is going to be horrible.” Yet despite the mishap, Teigen managed to finish the scene — and to keep looking flawless. What caused her dental dilemma? “I had chipped my front tooth so I had temporaries in,” she explained. “I’m a grinder. I grind like crazy at night time. I had temporary teeth in that I actually ground off on the flight to Thailand.”
Like stress, teeth grinding is a problem that can affect anyone, supermodel or not. In fact, the two conditions are often related. Sometimes, the habit of bruxism (teeth clenching and grinding) occurs during the day, when you’re trying to cope with a stressful situation. Other times, it can occur at night — even while you’re asleep, so you retain no memory of it in the morning. Either way, it’s a behavior that can seriously damage your teeth.
When teeth are constantly subjected to the extreme forces produced by clenching and grinding, their hard outer covering (enamel) can quickly start to wear away. In time, teeth can become chipped, worn down — even loose! Any dental work on those teeth, such as fillings, bonded areas and crowns, may also be damaged, start to crumble or fall out. Your teeth may become extremely sensitive to hot and cold because of the lack of sufficient enamel. Bruxism can also result in headaches and jaw pain, due in part to the stress placed on muscles of the jaw and face.
You may not be aware of your own teeth-grinding behavior — but if you notice these symptoms, you might have a grinding problem. Likewise, after your routine dental exam, we may alert you to the possibility that you’re a “bruxer.” So what can you do about teeth clenching and grinding?
We can suggest a number of treatments, ranging from lifestyle changes to dental appliances or procedures. Becoming aware of the behavior is a good first step; in some cases, that may be all that’s needed to start controlling the habit. Finding healthy ways to relieve stress — meditation, relaxation, a warm bath and a soothing environment — may also help. If nighttime grinding keeps occurring, an “occlusal guard” (nightguard) may be recommended. This comfortable device is worn in the mouth at night, to protect teeth from damage. If a minor bite problem exists, it can sometimes be remedied with a simple procedure; in more complex situations, orthodontic work might be recommended.
Teeth grinding at night can damage your smile — but you don’t have to take it lying down! If you have questions about bruxism, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Stress & Tooth Habits” and “When Children Grind Their Teeth.”
Life would be harrowing if we had no ability to feel pain. Although experiencing it is unpleasant, pain's purpose is to alert us to something wrong in our body. Without pain diseases and other problems could worsen to the point of life-threatening.
But pain without a purpose — the nerves simply misfiring — can make life miserable. This can happen with the trigeminal nerves that exit the brain stem and end on each side of the face. Each nerve has three branches that serve the upper, middle and lower parts of the face and jaw.
When they don't work properly, trigeminal nerves can give rise to a disorder known as trigeminal neuralgia. Beginning often as an occasional twinge, they may escalate to several seconds of mild to excruciating pain occurring over weeks, months or even years. An episode may erupt from chewing, speaking or even lightly touching of the face.
We see this condition most often in people over fifty, particularly women. We don't know the exact cause, but there's strong suspicion that the nerve's protective sheath has been damaged, similar to what occurs with multiple sclerosis or other inflammatory conditions. Another possibility is a blood vessel putting pressure on the nerve and disrupting its normal operation. Such an impinged nerve might transmit pain signals at the slightest stimulation and then fail to “switch off” when the stimulation stops.
Although we can't cure trigeminal neuralgia, we can help you manage it and reduce discomfort during episodes. We'll first try conservative, less-invasive techniques, like signal-blocking medications or drugs that reduce abnormal firing.
If these aren't effective, we may then recommend a surgical solution. One such procedure is known as percutaneous treatment in which we insert a thin needle to selectively damage nerve fibers to prevent their firing. If we've determined an artery or vein has compressed the nerve, we might surgically relocate the vessel. These techniques can be quite effective but they do have possible side effects like numbness or hearing loss.
If you've experienced facial pain, don't continue to suffer. Visit us for a complete examination and learn about your options for pain relief. More than likely, there's a way to reduce your pain and improve your quality of life.
If you would like more information on facial pain, 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 “Trigeminal Neuralgia.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.