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AntibioticsBeforeImplantSurgeryCouldLowerInfectionRiskinSomePeople

If you're considering dental implants, they'll need to be surgically placed in the jaw bone. But don't be alarmed — it's a relatively minor procedure that usually requires nothing more than local anesthesia.

But that being said, it's still an invasive procedure that involves making incisions in gum and bone tissues. That could introduce bacteria into the bloodstream and pose, for certain individuals, a slightly greater risk of infection.

But infection risk is quite low for most healthy patients. As a result, implants enjoy a greater than 95-percent success rate ten years after installation. But some patients have health issues that increase their risk of infection. These include older adults with a weakened immune system, smokers, diabetics or those well under or over their ideal weight.

If you have these or similar health situations, we may recommend undergoing an antibiotic treatment before you undergo surgery. This can help prevent bacteria from spreading and reduce the likelihood of an infection.

Preventive antibiotic therapy is commonplace with many other dental procedures. Both the American Dental Association and the American Heart Association recommend antibiotics before any invasive oral procedure for patients with prosthetic (false) heart valves, past endocarditis, a heart transplant or other heart conditions. To lower the risk of implant failure due to infection, we often advise antibiotics for patients who fall in these categories, as well as those with similar conditions mentioned earlier.

Of course, whether pre-surgical antibiotics is a wise choice for you will depend on your medical history and current health status. We'll consider all these factors thoroughly before advising you. But if you are more susceptible to infection, antibiotics before surgery could potentially lower your risk for an implant failure.

If you would like more information on implant procedures, please contact us or schedule an appointment for a consultation.

WecanFixaSmileMarredbyAbsentFrontTeeth

Most children's permanent teeth erupt on a fairly predictable schedule. Sometimes, though, one or more teeth might not develop as they should — or at all.

These absent teeth pose functional problems for chewing and hygiene, which can affect long-term dental health. But they can also have a disruptive effect on an otherwise attractive smile if the missing teeth are the upper lateral incisors in the most visible part of the smile.

You normally find this pair of teeth on either side of the upper central incisors (the two front-most teeth). On the other side of the lateral incisors are the canine or eye teeth, known for their pointed appearance. Without the lateral incisors, the canines tend to drift into the space next to the central incisors. This can produce an odd appearance even a layperson will notice: only four teeth where there should be six!

It's possible to correct this abnormality, but it will take time and expense. The first step is usually to move the teeth in the upper jaw with braces to their correct position. This puts teeth where they should be and also opens space between the canines and central incisors so we can eventually replace the missing teeth with dental implants.

But the key to all this is timing. It's usually appropriate to undertake tooth movement with braces during late childhood or adolescence. But implants shouldn't be installed until the person's jaw fully matures, usually in early adulthood. An implant placed before then could eventually become misaligned.

To accommodate the time between bite correction and implant placement, the patient can wear a retainer appliance that will keep the newly created space open. We can also attach artificial teeth to the retainer to camouflage the empty space.

It usually takes a team of a family dentist, an orthodontist and a surgeon to see this kind of “smile makeover” project through, possibly over several years. But the gains in better aesthetics and health are well worth the time and expense.

If you would like more information on replacing non-developing teeth, 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 Permanent Teeth Don't Grow.”

WhyYouShouldFlossAroundtheImplantsSupportingYourBridge

We've been using bridges to replace missing teeth for decades. Now, recently-developed implant-supported bridges are even more dependable, promising greater durability and less interference with remaining natural teeth.

But just like other restorations, you'll need to keep implant bridges clean to ensure their longevity. Although both the bridge and implants are impervious to disease, the supporting gums and bone aren't. If they become infected, they can break down and your restoration will fail.

Cleaning an implant-supported bridge includes flossing around each of the implants to remove dental plaque, a thin film of food particles and bacteria most responsible for dental disease. To perform this task, you'll have to pass the floss between the bridge and gums to access the sides of each implant.

To help make it easier, you can use a tool like a floss threader, a thin, shaft-like device with a loop on one end and a needle-like point on the other. You'll first thread about 18" of floss through the end and then pass the threader between the bridge and gums with the sharp end toward the tongue.

With the threader completely through, you'll then wrap the floss around your fingers as with regular flossing and move the floss up and down each side of the implants you can access. You'll then pull the floss out, reload the threader and move to the next section, repeating this process until you've flossed each side of each implant.

You can also use pre-cut floss with a stiffened end to thread between the bridge and gums or an interproximal brush with a thin bristled head that can reach underneath the bridge. And you might consider using an oral irrigator, a pump device that sprays a stream of pressurized water to remove and flush away plaque around implants.

To round out your hygiene efforts, be sure you visit your dentist at least twice a year for dental cleanings. Your dentist can also advise you and give you training on keeping your implants clear of disease-causing plaque. Cleaning around your implants will help ensure your restoration will last.

If you would like more information on caring for your dental restoration, 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.”

By Art of Dentistry
December 01, 2018
Category: Dental Procedures
Tags: dental implants   dentures  
AnImplant-SupportedDentureOffersaNumberofAdvantages

If you’ve had the misfortune of losing all or most of your teeth (a condition called edentulism), you still have effective options for restoring lost form and function to your mouth. There is, of course, the traditional removable denture that’s been the mainstay for edentulism treatment for decades. If you haven’t experienced significant bone loss in the jaw, though, a fixed bridge supported by titanium implants could be a better choice.

But what if bone loss has ruled out an implant-supported fixed bridge? There’s still another option besides traditional dentures — a removable “overdenture” that fits “over” smaller diameter implants strategically placed in the jaw to support it.

A removable, implant-supported bridge offers a number of advantages for edentulism patients with significant bone loss.

Speech Enhancement. Any denture or bridge supported by implants will have a positive impact on speech ability, especially involving the upper jaw. But patients who’ve previously worn removable dentures may not see a dramatic difference but will still be able to benefit from the greater stability of the denture, particularly if the dentures were previously unstable.

Hygiene. A removable denture allows better access to implant sites for cleaning. Better hygiene reduces the risk of gum disease and further bone loss.

Long-Term Maintenance. Regardless of which type of implant supported restoration is used, it will eventually require some maintenance. A well-designed removable overdenture can make any future maintenance easier to perform.

Aesthetics. For personal satisfaction, this is often the ultimate test — how will I look? As a product of the evolving art of facial aesthetics, removable dentures supported by implants can replace lost tissues and restore balance to the face, and often produce a remarkable smile “makeover.”

To find out which restoration option is best for you, you should first undergo a thorough examination to determine the status of your facial and jaw structures, particularly the amount of bone mass still present. Ultimately, though, the decision should be the one that best fits your functional needs, while fulfilling your desires for your future smile.

If you would like more information on tooth 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 “Fixed vs. Removable: Choosing Between a Removable Bridge and a Fixed Bridge.”

CertainPeoplemayBenefitfromAntibioticsBeforeImplantSurgery

Dental implants are considered today’s premier method for restoring missing teeth. Obtaining an implant, though, is often a long process and the implants themselves must be surgically placed within the jaw bone. Nothing to worry about, though: implant surgery is a minor to moderate procedure akin to a surgical tooth extraction.

Still like any surgery, this procedure does involve cutting into the soft tissues of the gums and could allow oral bacteria to enter the bloodstream. While most bacteria in the mouth are harmless (and even beneficial) a few strains can cause disease. For some people, especially those with certain heart conditions or joint replacements, this could potentially cause serious issues in other parts of their body that might be highly susceptible to infection.

To guard against this, it’s been a long-standing practice in dentistry to prescribe antibiotics to certain high risk patients before a procedure. Although this departs from the normal use of antibiotics for already occurring infections, due to the circumstances this has been deemed an acceptable measure to prevent disease.

In the past, the categories of patients for which preventive antibiotics were appropriate had been more extensive. In recent years, though, both the American Dental Association and the American Heart Association have adjusted their recommendations. Today, your dental provider may recommend antibiotic pre-treatment if you have a prosthetic (artificial) heart valve, a history of infective endocarditis (inflammation of the inner linings of the heart), a heart transplant or certain congenital heart conditions.

While physicians may still recommend premedication with antibiotics for patients with joint replacements, it’s not as blanket a standard as it might once have been. It’s now only recommended for certain cases, such as patients who’ve received a prosthetic joint within the last two years.

There’s still an ongoing debate about the effectiveness of antibiotic pre-medication. However, there’s evidence medicating before procedures with antibiotics can be beneficial in avoiding infection. If you fall into one of the categories just mentioned or are concerned about infection, feel free to discuss with your dentist if using antibiotics before your implant surgery is wise move for you.

If you would like more information on antibiotic treatment before oral surgery, 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 “Implants & Antibiotics: Lowering Risk of Implant Failure.”