Dental implants have come a long way since their introduction thirty years ago. Unlike their predecessors, today’s implants come in various shapes and sizes that can meet the precise needs of individual patients. Crown attachment has also developed some variety.
The actual implant is a titanium post surgically imbedded in the jawbone to replace the original tooth root. The restoration crown, the visible part of the implant system that resembles natural tooth, is affixed to the implant post. There are two basic methods to attach the crown: cement it to an abutment that has been installed in the implant; or screw it into the implant with a retaining screw from the underside of the crown. In the latter case, the abutment has been built into the crown.
While either method provides years of effective service, one method may work better than the other depending on the circumstance. Screw-retained crowns require no cement and are more easily removed than cemented crowns if it becomes necessary. On the other hand, the screw access hole can be visible, although the area can be filled with a tooth-colored filling; and although rare, chips near the access hole can occur. Occasionally the screw may become loose, but tightening or replacing the retaining screw is a simple matter because of the access hole.
A cemented crown looks more like a natural tooth and so is more useful in situations where cosmetics are a factor. The cement, however, can cause inflammation and contribute to bone loss in some patients when excess cement gets below the gums. Unlike a screw-retained crown, removal is more difficult and limited.
As a rule, screw-retained crowns are normally used in areas where the screw hole is not conspicuous, such as for posterior (back) teeth. They’re also more desirable than cemented when the implant is permanently crowned at the same time it’s surgically implanted, a process called “immediate loading.”
Which method of crown attachment is best for you? That depends on the implant location and other factors we would explore during a thorough pre-implant exam. Either way, the end result will be a life-like replica of your natural teeth, and a restored, vibrant smile.
If you would like more information on crown attachment to 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 “How Crowns Attach to Implants.”
Taking care of your teeth is a lifetime commitment, if you want your teeth to last a lifetime. But it can be especially challenging if you're wearing traditional metal braces. With a little extra attention, though, you can reduce the risk of dental disease during orthodontic treatment.
The goal of oral hygiene is to remove biofilm, a layer of leftover food particles called plaque that is a haven for disease-causing bacteria. Orthodontic braces make access more difficult for performing oral hygiene. A little extra effort and attention, though, can make a big difference.
First, be sure you're eating a healthy diet and avoiding unhealthy snacks (especially those high in carbohydrates) between meals; this will discourage the growth of bacteria in the mouth. You should also limit your intake of sodas, sports or energy drinks since their high acidity contributes to tooth enamel erosion.
Although more difficult for someone wearing braces, brushing is still essential to good hygiene. Begin by holding a soft, multi-tufted bristle brush at a 45-degree angle, and then brush the surface area between the gum and the braces all the way around. Return to your starting point and brush the area from the braces to the edge of the top of the teeth in the same direction. Be sure you do this for both the upper and lower jaw and on both the cheek and tongue side.
Flossing is also more difficult, but not impossible. Instead of conventional floss thread, you can use special floss threaders, small interdential brushes, or an irrigation device that sprays pressurized water to remove food particles between teeth.
Above all, it's important to keep up regular office visits with us. In addition to monitoring overall dental health, we can also apply or recommend additional fluoride products to help strengthen teeth or prescribe antibacterial rinses to reduce the mouth's bacterial level.
Keeping up a good daily hygiene regimen and regular checkups will ensure that the smile you gain from wearing braces is healthy as well as beautiful.
If you would like more information on oral hygiene while undergoing orthodontic treatment, 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 “Caring for Teeth During Orthodontic Treatment.”
The perception that orthodontics is mainly for children or teenagers is changing rapidly. The number of adults seeking treatment for misaligned teeth is on the rise, especially with the development of less intrusive treatments like clear aligners.
Still, as an adult you may be wondering if having your teeth straightened is really worth the effort. There are good reasons to consider orthodontic treatment even when your teen years are well in your rear view mirror — and improving your smile is only just one of them.
To be sure, smile enhancement is an important reason. We place a high value on presenting our best appearance; indeed, our self-assurance and esteem suffers if we feel we have a less than pleasing smile. Adults who improve their smiles through orthodontics typically see a rise in confidence and an improvement in life attitudes that can have a positive impact on their social, career and financial development.
But there is another reason: as a general rule, misaligned teeth do not function as well. Biting, chewing and speaking may be more difficult. Over the long-term misaligned teeth and the resulting poor bite can have an adverse effect on nutrition, social skills and normal tooth wear.
What's more, misaligned teeth are more difficult to clean even with conscientious daily hygiene. Despite your best efforts, this can lead to increased plaque that causes tooth decay and periodontal (gum) disease. In regard to gums, misaligned teeth may be more prone to receding gums which further exposes teeth to harmful bacteria. Realigning teeth can vastly improve dental hygiene.
As with considering any dental procedure, the first step is a complete dental examination to measure the level of misalignment, as well as the current health of your teeth and gums. After that, we can discuss your orthodontic options for not only correcting your smile, but improving your oral hygiene which can have a pronounced improvement in your oral health as well.
If you would like more information on the benefits of orthodontic treatment, 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 “Why Straighten Teeth.”
Although traditional porcelain laminate veneers are much less invasive than other cosmetic dental applications, they still often require the removal of some of the surface tooth enamel, a process known as tooth reduction. Now, an alternative veneer treatment known as “no-prep” veneers eliminates this initial step of tooth reduction for some patients.
Although most reductions take very little of the tooth enamel, they do permanently alter the tooth. No-prep veneers are growing in popularity because the tooth is not permanently altered, allowing for two benefits: if desired, the veneer application can be reversed and the tooth returned to its original state; and there's more flexibility for patients to “test-drive” their new look with prototype veneers worn while the permanent veneers are manufactured, with changes made easily during this tryout period.
Dentists have long regarded at least a minimum of tooth reduction as absolutely necessary for the proper adhesion of veneers, and to avoid a bulky or over-contoured smile. And, while advances in no-prep veneers have largely addressed these concerns, it is true this option isn't for every patient considering a veneer application.
For example, patients with large or forward-positioned teeth are not good candidates for no-prep veneers. Patients who choose a veneer treatment over orthodontic treatment for certain conditions will likely need some tooth preparation to achieve an acceptable aesthetic result. For patients generally, no-prep veneers have a limited application range on the bottom jaw due to space limitations.
Simply put, traditional veneers are a more versatile option for most patients. On the other hand, no-prep veneers can be a good choice for patients with genetically small or misshapen teeth, teeth reduced by erosion or grinding, or those with narrow or diminished smiles.
If you're considering this option, our first step is to conduct a complete examination of your teeth and mouth. We'll carefully evaluate every aspect of your mouth structure and overall dental condition. If you fit the criteria, you may be able to avoid tooth reduction and still gain the smile you desire.
If you would like more information on no-prep veneers, 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 “Porcelain Veneers Without the Drill.”
You hardly notice the moist environment of your mouth — unless it becomes uncomfortably dry. Some instances of dry mouth are quite normal — when you first wake in the morning after reduced saliva flow during sleep, when you're stressed, or when you're dehydrated and need fluids. But some are not normal — millions of people, in fact, suffer from a chronic inadequacy of saliva production and flow.
Chronic dry mouth (or xerostomia) can have a greater effect on your oral health than discomfort. Saliva performs a number of tasks for the body: its enzymes help break down food before digestion; its antimicrobial properties help reduce harmful bacteria and its buffering ability helps neutralize acid, both of which reduce the risk of tooth decay.
There are a number of causes for chronic dry mouth. One of the most common arises as a side effect of over 500 medications, both prescription and over-the-counter. The major contributors to dry mouth fall into three main types: antihistamines, used to treat allergies; diuretics, prescribed to cardiac patients to drain excess fluid; and antidepressants. Diseases like Diabetes, Parkinson's disease, or AIDS can also cause dry mouth. Some treatments can too — persons undergoing head or neck radiation or chemotherapy may experience dry mouth.
If you've noticed dry mouth over several days, it's a good idea to visit us for an exam. Our first step is to try to determine the extent and cause of the condition. Depending on what we find, we can then recommend a treatment path that includes some changes in habit and prescribed medications. For example, if lack of hydration is contributing to dry mouth, we would recommend drinking an adequate amount of water, as well as cutting back on caffeinated or acidic beverages. We might also prescribe medication to stimulate saliva flow. Consuming foods that contain xylitol, a natural sugar substitute, may also do the same.
It's also important that you maintain a good oral hygiene regimen and regular dental checkups and cleanings. Good oral hygiene and the proper treatment for chronic dry mouth will greatly reduce your risk of tooth decay and other diseases.
If you would like more information on the causes and treatment of dry mouth, 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 “Dry Mouth.”
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