Since their introduction over three decades ago, dental implants have evolved into dentistry’s premier tooth replacement choice. While their primary purpose is to replace missing teeth and rejuvenate a patient’s smile, they’re also regarded for another important benefit: they can slow or stop bone loss accelerated by the loss of teeth.
Like all living tissue, bone has a life cycle. Older bone dissolves and is absorbed by the body, a process called resorption. New bone forms and grows to replace the resorbed bone in response to stimuli occurring within the body. In the jaw, this stimulation comes from the forces the teeth receive when we bite or chew.
When a tooth is lost, however, it no longer transmits these force stimuli to the adjacent bone. This results over time in less new growth to replace resorbed bone, and the overall bone mass shrinks. In fact, about a quarter of the normal bone width will diminish in the first year alone after tooth loss. Other serious problems follow, like gum recession or chewing and speaking difficulties. A person’s appearance may also suffer, because as resorption continues unchecked, the underlying foundational bone will continue to shrink. As more teeth are lost, a decrease in the distance between the nose and chin may result causing the lower third of the face to become smaller in size.
Dental implants can interrupt this process by encouraging bone growth around the implant. Implants are made of “osseophilic” titanium, meaning the metal has a natural affinity with bone. After implantation, bone cells will begin to grow and attach to the titanium post. The enhanced growth stabilizes bone loss by providing stimulation to the bone as teeth once did, thereby maintaining bone levels and minimizing potential effects on the patient’s appearance.
Ironically, too much bone loss could make the installation of implants more difficult, since they require a minimum level of bone mass for anchorage. Receiving an implant as soon as is practical once a tooth is lost will minimize the chances of that occurring — and a better chance of improving bone health overall.
If you would like more information on how dental implants improve bone 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 “The Hidden Consequences of Losing Teeth.”
Although costly in the beginning, dental implants often turn out to be the least expensive tooth replacement option. That's because their enviable record for longevity often outpaces dentures or bridges. Over the long-term you might spend less for implants than these other restorations.
But even with the high success rate of dental implants (greater than 95% survive the ten-year mark), we can't guarantee they won't fail. And if you're a tobacco smoker, the risk of failure might be even higher. One study, for example, found early implant failures were twice the rate for smokers over non-smokers. Although implant failures overall are low, smoking seems to be a factor in those that do.
There are a number of reasons to account for this. For one thing, inhaled smoke can damage salivary glands, reducing the flow of this important fluid. Saliva helps control bacterial growth and neutralize mouth acid, so without it you're more susceptible to tooth decay or periodontal (gum) disease. Either infection could ultimately weaken implant-supporting bone.
The nicotine in tobacco can also restrict oral blood vessels and lower their ability to supply antibodies and nutrients to the teeth and gums. This slows healing, which could have one particular effect on implant durability.
During the intervening weeks between implant placement and crown attachment, the implant's titanium post attracts bone cells that grow and adhere to its surface. The effects of nicotine on healing, especially right after implant surgery, can interfere with this integration process so that the implant doesn't anchor in the bone as well as it should.
If you're a smoker, you can increase your chances of implant success—and have a healthier mouth overall—by quitting smoking beforehand with the help of a cessation program. Or at the least, consider stopping smoking for one week before implant surgery and for two weeks afterward.
And be sure to brush and floss your teeth daily and visit your dentist regularly to keep your teeth and gums as healthy as possible. Stopping smoking and practicing effective oral hygiene could make a big difference in the success or failure of your implant.
If you would like more information on smoking and your 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 “Dental Implants & Smoking.”
Is having good oral hygiene important to kissing? Who's better to answer that question than Vivica A. Fox? Among her other achievements, the versatile actress won the “Best Kiss” honor at the MTV Movie Awards, for a memorable scene with Will Smith in the 1996 blockbuster Independence Day. When Dear Doctor magazine asked her, Ms. Fox said that proper oral hygiene was indeed essential. Actually, she said:
"Ooooh, yes, yes, yes, Honey, 'cause Baby, if you kiss somebody with a dragon mouth, my God, it's the worst experience ever as an actor to try to act like you enjoy it!"
And even if you're not on stage, it's no fun to kiss someone whose oral hygiene isn't what it should be. So what's the best way to step up your game? Here's how Vivica does it:
“I visit my dentist every three months and get my teeth cleaned, I floss, I brush, I just spent two hundred bucks on an electronic toothbrush — I'm into dental hygiene for sure.”
Well, we might add that you don't need to spend tons of money on a toothbrush — after all, it's not the brush that keeps your mouth healthy, but the hand that holds it. And not everyone needs to come in as often every three months. But her tips are generally right on.
For proper at-home oral care, nothing beats brushing twice a day for two minutes each time, and flossing once a day. Brushing removes the sticky, bacteria-laden plaque that clings to your teeth and causes tooth decay and gum disease — not to mention malodorous breath. Don't forget to brush your tongue as well — it can also harbor those bad-breath bacteria.
While brushing is effective, it can't reach the tiny spaces in between teeth and under gums where plaque bacteria can hide. But floss can: That's what makes it so important to getting your mouth really clean.
Finally, regular professional checkups and cleanings are an essential part of good oral hygiene. Why? Because even the most dutiful brushing and flossing can't remove the hardened coating called tartar that eventually forms on tooth surfaces. Only a trained health care provider with the right dental tools can! And when you come in for a routine office visit, you'll also get a thorough checkup that can detect tooth decay, gum disease, and other threats to your oral health.
Bad breath isn't just a turn-off for kissing — It can indicate a possible problem in your mouth. So listen to what award-winning kisser Vivica Fox says: Paying attention to your oral hygiene can really pay off! For more information, contact us or schedule an appointment for a consultation. You can read the entire interview with Vivica A. Fox in Dear Doctor's latest issue.
We’ve come a long way since the early 1980s when we first identified the HIV virus. Although approximately 35 million people worldwide (including a million Americans) now have the virus, many are living relatively long and normal lives thanks to advanced antiretroviral drugs.
Still, HIV patients must remain vigilant about their health, especially their oral health. In fact, problems with the teeth, gums and other oral structures could be a sign the virus has or is moving into the full disease stage, acquired immunodeficiency syndrome (AIDS). That’s why you or a loved one with the virus should maintain regular dental checkups or see your dentist when you notice any oral abnormalities.
One of the most common conditions among HIV-positive patients is a fungal infection called candidiasis (or “thrush”). It may appear first as deep cracks at the corners of the mouth and then appear on the tongue and roof of the mouth as red lesions. The infection may also cause creamy, white patches that leave a reddened or bleeding surface when wiped.
HIV-positive patients may also suffer from reduced salivary flow. Because saliva helps neutralize excess mouth acid after we eat as well as limit bacterial growth, its absence significantly increases the risk of dental disease. One of the most prominent for HIV-positive patients is periodontal (gum) disease, a bacterial infection normally caused by dental plaque.
While gum disease is prevalent among people in general, one particular form is of grave concern to HIV-positive patients. Necrotizing ulcerative periodontitis (NUP) is characterized by spontaneous gum bleeding, ulcerations and a foul odor. The disease itself can cause loosening and eventually loss of teeth, but it’s also notable as a sign of a patient’s deteriorating immune system. The patient should not only undergo dental treatment (including antibiotics), but also see their primary care physician for updates in treating and managing their overall symptoms.
Above all, HIV-positive patients must be extra diligent about oral hygiene, including daily brushing and flossing. Your dentist may also recommend other measures like saliva stimulators or chlorhexidine mouthrinses to reduce the growth of disease-causing bacteria. Together, you should be able to reduce the effects of HIV-induced teeth and gum problems for a healthier mouth and better quality of life.
If you would like more information on oral care for HIV-AIDS patients, 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 “HIV-AIDS & Oral Health.”
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.”
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