In recent years, dental implants have helped traditional bridgework take a giant leap forward. A few strategically placed implants can provide the highest support and stability we can currently achieve for this well-known dental restoration.
Implants derive this stability from the bone in which they're imbedded. Once surgically installed, the bone around a metal implant begins to grow and adhere to its titanium surface. Over time, this creates a strong anchor that firmly holds the implant in place.
But the implants' stability can be threatened if the gums around them become diseased. Gum disease, a bacterial infection caused mainly by dental plaque, can advance silently below the gum surface until it ultimately infects the bone. This can cause significant bone loss around an implant, which can weaken it to the point of failure.
To avoid this scenario, it's important to prevent gum disease by flossing daily to remove accumulated dental plaque between the implant-supported bridge and the gums, particularly around the implants. This kind of flossing around bridgework is more difficult than flossing between teeth, but it can be done with the help of a device called a floss threader.
A floss threader is a small plastic hand tool with a loop on one end and a stiffened edge on the other (similar to a sewing needle). You begin by threading about 18" of dental floss through the loop, and then work the other end of the threader between the bridge and gums to the other side.
With the floss threaded between the bridge and gums, you can now remove it from the threader, grasp each end, and floss around the sides of each implant you can reach. You'll then need to repeat the process by removing the floss, rethreading it in the threader and inserting it into the next section between implants, continuing to floss until you've accessed each side of each implant.
You can also use pre-packaged floss thread sections with a stiffened end to facilitate threading. But whichever product you use, it's important to perform this task each day to prevent a gum infection that could rob you of your implant-supported bridge.
If you would like more information on oral hygiene practices with dental work, 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 “Oral Hygiene for Fixed Bridgework.”
Between the final game of the World Series in late October and spring training in February, major league baseball players work on their skills preparing for the new season. Reporters on a Zoom call to the New York Yankees' training camp wanted to know what star outfielder Aaron Judge had been doing along those lines. But when he smiled, their interest turned elsewhere: What had Aaron Judge done to his teeth?
Already with 120 homers after only five seasons, Judge is a top player with the Yankees. His smile, however, has been less than spectacular. Besides a noticeable gap between his top front teeth (which were also more prominent than the rest of his teeth), Judge also had a chipped tooth injury on a batting helmet in 2017 during a home plate celebration for a fellow player's walk-off home run.
But now Judge's teeth look even, with no chip and no gap. So, what did the Yankee slugger have done?
He hasn't quite said, but it looks as though he received a “smile makeover” with porcelain veneers, one of the best ways to turn dental “ugly ducklings” into “beautiful swans.” And what's even better is that veneers aren't limited to superstar athletes or performers—if you have teeth with a few moderate dental flaws, veneers could also change your smile.
As the name implies, veneers are thin shells of porcelain bonded to the front of teeth to mask chips, cracks, discolorations or slight gaps between teeth. They may even help even out disproportionately sized teeth. Veneers are custom-made by dental technicians based on a patient's particular tooth dimensions and color.
Like other cosmetic techniques, veneers are a blend of technology and artistry. They're made of a durable form of dental porcelain that can withstand biting forces (within reason, though—you'd want to avoid biting down on ice or a hard piece of food with veneered teeth). They're also carefully colored so that they blend seamlessly with your other teeth. With the right artistic touch, we can make them look as natural as possible.
Although porcelain veneers can accommodate a wide range of dental defects, they may not be suitable for more severe flaws. After examining your teeth, we'll let you know if you're a good candidate for veneers or if you should consider another restoration. Chances are, though, veneers could be your way to achieve what Aaron Judge did—a home run smile.
If you would like more information about porcelain veneers, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Veneers: Strength & Beauty As Never Before.”
It's a common practice among people slowly losing their teeth to have their remaining teeth removed. They find dentures to be less costly than replacing one tooth at a time or caring for those that remain. On the other hand, it's usually healthier for the mouth to preserve remaining teeth as long as possible, replacing them only as necessary.
This latter strategy has up to now been difficult and expensive to achieve. But dental implants are changing that—using these imbedded titanium metal devices with a variety of restorations, we're able to better plan and implement staged tooth replacement.
Most people associate implants with single tooth replacements of a life-like crown cemented or screwed into an abutment attached to the implant post. This can play an early role in a staged replacement plan, but at some point, multiple single-tooth implants can become quite expensive.
Implants, however, have a much broader range of use. A few strategically placed implants can support a variety of restorations, including bridges and removable or fixed dentures. Four to eight implants, for example, can secure a fixed denture replacing all teeth on a jaw, far fewer than the number needed to replace the teeth individually.
Implants may also improve the function of traditional restorations. For instance, dentures can't stop the bone loss that often results from tooth loss—in fact, they will accelerate it as they rub and irritate the bony ridges of the jaw. By contrast, implants stimulate bone growth, slowing or even stopping the process of bone loss.
In a traditional bridge, the outer crowns of the restoration are bonded to the teeth on either side of the missing tooth gap (the middle crowns fill the gap). These support teeth must be permanently altered to accommodate the crowns. But an implant-supported bridge doesn't depend on other teeth for support, thus eliminating the need to permanently alter any teeth.
More importantly, previously placed implants often become part of the next stages of tooth replacement, like building on an addition onto an existing house. All in all, including implants in your ongoing dental restoration can help you enjoy the benefits of preserving your natural teeth for much longer.
If you would like more information on dental restoration options, 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 “Replacing All Teeth but Not All at Once.”
Osteoporosis is a serious bone weakening disease in older adults that can turn a minor fall into a major bone fracture. But the condition could also impact dental treatment—triggered ironically by the drugs used to treat osteoporosis rather than the disease itself.
From the Latin for “porous bone,” osteoporosis causes bone to gradually lose mineral structure. Over time the naturally-occurring spaces between mineralized portions of the bone enlarge, leaving it weaker as a result.
Although there's no definitive cure for osteoporosis, a number of drugs developed over the last couple of decades can inhibit its progress. Most fall into two major categories, bisphosphonates and RANKL inhibitors.
These drugs work by inhibiting the normal growth cycle of bone. Living bone constantly changes as cells called osteoblasts produce new bone. A different type, osteoclasts, clear away older bone to make room for these newer cells. The drugs selectively destroy osteoclasts so that the older bone, which would have been removed by them, remains for a longer period of time.
Retaining older cells longer initially slows the disease process. But there is a downside: in time, this older bone kept in place continues to weaken and lose vitality. In rare instances it may eventually become detached from its blood supply and die, resulting in what is known as osteonecrosis.
Osteonecrosis mostly affects two particular bones in the body: the femur (the long bone in the upper leg) and the jawbone. In regard to the latter, even the stress of chewing could cause osteonecrosis in someone being treated for osteoporosis. It can also occur after tooth extractions or similar invasive procedures.
If you're taking a bisphosphonate or RANKL inhibitor, you'll want to inform your dentist so that the necessary precautions can be taken before undergoing dental work more invasive than routine cleanings or getting a filling or crown. If you need major dental work, your dentist or you will also need to speak with your physician about stopping the drug for a few months before and after a dental procedure to minimize the risk of osteonecrosis.
Fortunately, the risk for dental problems while undergoing treatment for osteoporosis is fairly low. Still, you'll want to be as prepared as possible so that the management of your osteoporosis doesn't harm your dental health.
If you would like more information on osteoporosis and 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 “Osteoporosis Drugs & Dental Treatment.”
Periodontal disease is responsible for the majority of cases of tooth loss in adults and prevention is your best weapon against it, but even in its early stages, your dentist can help reverse it. Scaling and root planing are treatments aimed at doing just that, and if you would like to learn much more about them please contact Dr. Alaa Ahmed and Dr. Islam Dehis of Putnam Family Dental in Putnam, CT.
Plaque and Decay
Plaque builds on our teeth every day and every day it must be removed by either brushing or flossing to keep it under control.
Some plaque typically remains and it can usually be removed during a regular office visit to your dentist's office during the dental cleaning portion.
If left untreated, the bacteria that live amid the plaque release acids which damage our teeth and our gums, thus leading to decay and gum disease.
How the Procedure Works
When a professional dental cleaning cannot eliminate all of the plaque, when it has progressed to beneath the gumline then your dentist may recommend scaling and root planing. Local anesthesia is applied throughout the entirety of the procedure, but you may expect some discomfort for the days following.
Scaling is the process of removing the plaque that's accumulated on the tooth that's hidden by the gums.
The next step is to smooth, or plane, the roots of the teeth to make it difficult for plaque and tartar from building up again.
Periodontal and Surgical Services in Putnam, CT
Prevention takes many forms, from proper dental hygiene at home, to regular dental cleanings and checkups, to procedures like scaling and root planing, when necessary. Keeping plaque at bay requires that you and your dentist work together, so if you've been away from the office for some time, or are concerned, then make an appointment today with Dr. Ahmed and Dr. Dehis of Putnam Family Dental in Putnam, CT, by dialing (860) 928-5334.
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