For generations, dentures have helped people avoid the dire consequences of total teeth loss. Now, implant technology is making them even better.
Composed of life-like prosthetic teeth fixed within a plastic or resin gum-colored base, dentures are manufactured to fit an individual patient’s mouth for maximum fit, comfort and performance. But dentures also have a critical drawback—they can’t stop bone loss in the jaw.
Bone is constantly regenerating as older cells dissolve and then are replaced by newer cells. In the jawbone, the forces generated when we chew travel through the teeth to the bone and help stimulate this new cell growth. When teeth are missing, though, the bone doesn’t receive this stimulus and may not regenerate at a healthy rate, resulting in gradual bone loss.
Dentures can’t transmit this chewing stimulus to the bone. In fact, the pressure they produce as they rest on top of the gums may actually accelerate bone loss. Over time then, a denture’s once secure and comfortable fit becomes loose.
In the past, most patients with loose dentures have had them relined with new dental material to improve fit, or have new dentures created to conform to the changed contours of the jaws. But implant technology now offers another alternative.
Implants are in essence a tooth root replacement. Dentists surgically implant a titanium metal post directly into the jawbone that naturally attracts bone cells to grow and adhere to it over time (a process called osseointegration). This not only creates a secure and lasting hold, it can also stop or even reverse bone loss.
Most people know implants as single tooth replacements with a porcelain crown attached to the titanium post. But a few strategically placed implants can also support either removable or fixed dentures. Removable dentures (also called overdentures) usually need only 3 or 4 implants on the top jaw and 2 on the bottom jaw for support through built-in connectors in the dentures that attach to the implants. A fixed bridge may require 4-6 implants to which they are permanently attached.
There are pros and cons for each of these options and they’re both more expensive than traditional dentures. In the long run, though, implant-supported dentures could be more beneficial for your bone health and hold their fit longer.
Mention “bacteria” and people begin looking for the germicide. The truth is, though, only a few strains cause disease — the rest are benign or even play a beneficial role.
This may shock you, but your body both inside and out is home to around 100 trillion single-celled organisms, exceeding the number of your native cells by 10 to 1. You won't notice them, though: bacteria are so small they only make up 1 to 3% of your total body mass. And each of us has a unique “microbiome” of micro-organisms: they influence a variety of processes like digestion and metabolism, and some even “teach” our immune systems to distinguish between helpful and harmful bacteria.
Of the 10,000 or more species of bacteria that inhabit the body, perhaps the most studied and understood are in the mouth. We even have a database that catalogs the gene sequences of oral bacteria. And what we've learned has enlarged our understanding of dental disease and how to prevent or treat it.
This new knowledge, for example, confirms that many of our modern lifestyle habits adversely affect oral health. For example, researchers have found higher concentrations of Streptococcus mutans, the bacteria most responsible for tooth decay, in current samples of biofilm than in those from preindustrial eras. The culprit seems to be the modern diet rich with carbohydrates like sugar that bacteria eat. Cigarette smoking can also make the mouth friendlier to disease-causing bacteria.
On the bright side, our growing knowledge of oral bacteria is helping us devise better prevention and treatment strategies. One example is the use of antibiotics to reduce the populations of disease-causing oral bacteria.
The broad, traditional approach kills not only malevolent bacteria, but beneficial strains as well. The approach may also be helping bad bacteria become resistant to common antibiotics. A newer approach targets specific bacteria with custom-designed antibiotics that won't kill other bacteria. There's also increased focus on ways to re-balance a person's normal microbiome if it's become skewed.
As we come to understand bacteria better — both good and bad species — these and other dental care efforts will benefit. With our increasing knowledge of these microorganisms that surround us the future looks bright for better oral health.
If you would like more information on the role of bacteria in oral 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 “New Research Shows Bacteria Essential to Health.”
If we could go back in time, we all probably have a few things we wish we could change. Recently, Dr. Travis Stork, emergency room physician and host of the syndicated TV show The Doctors, shared one of his do-over dreams with Dear Doctor magazine: “If I [could have] gone back and told myself as a teenager what to do, I would have worn a mouthguard, not only to protect my teeth but also to help potentially reduce risk of concussion.”
What prompted this wish? The fact that as a teenage basketball player, Stork received an elbow to the mouth that caused his two front teeth to be knocked out of place. The teeth were put back in position, but they soon became darker and began to hurt. Eventually, both were successfully restored with dental crowns. Still, it was a painful (and costly) injury — and one that could have been avoided.
You might not realize it, but when it comes to dental injuries, basketball ranks among the riskier sports. Yet it’s far from the only one. In fact, according to the American Dental Association (ADA), there are some two dozen others — including baseball, hockey, surfing and bicycling — that carry a heightened risk of dental injury. Whenever you’re playing those sports, the ADA recommends you wear a high-quality mouth guard.
Mouthguards have come a long way since they were introduced as protective equipment for boxers in the early 1900’s. Today, three different types are widely available: stock “off-the-shelf” types that come in just a few sizes; mouth-formed “boil-and-bite” types that you adapt to the general contours of your mouth; and custom-made high-quality mouthguards that are made just for you at the dental office.
Of all three types, the dentist-made mouthguards are consistently found to be the most comfortable and best-fitting, and the ones that offer your teeth the greatest protection. What’s more, recent studies suggest that custom-fabricated mouthguards can provide an additional defense against concussion — in fact, they are twice as effective as the other types. That’s why you’ll see more and more professional athletes (and plenty of amateurs as well) sporting custom-made mouthguards at games and practices.
“I would have saved myself a lot of dental heartache if I had worn a mouthguard,” noted Dr. Stork. So take his advice: Wear a mouthguard whenever you play sports — unless you’d like to meet him (or one of his medical colleagues) in a professional capacity…
Your gums not only support and protect your teeth they also help present them in a visually attractive way. But some people’s gums seem to stand out too much — what’s commonly called a gummy smile — which diminishes their smile appeal. There’s no precise definition, but as a rule of thumb we consider a smile too gummy if four or more millimeters (about an eighth of an inch) of the gums show.
Fortunately, there are some techniques to improve a gummy smile. Which technique is best for you, though, will depend on why the gums are prominent — and causes vary. For example, you could have a gummy smile because your teeth appear too short compared to your gums.
Permanent teeth normally erupt to about 10 mm of visible length. But less than that, say 8 mm, could skew the visible proportion of gums to teeth too much toward the gums. Teeth can also appear shorter due to accelerated wear caused by grinding habits. Another cause could be the amount of upper lip rise when you smile. The lip may rise too high in a condition called hypermobility. This could reveal too much of the gums when you smile.
It’s important then to match the treatment to the cause. For example, we can enhance the appearance of shorter teeth through a surgical procedure known as crown lengthening.Â During this procedure a surgeon reshapes the gum tissues and underlying bone to expose more of the tooth’s length.
For upper lip hypermobility, we can restrict movement with Botox, a drug that paralyzes tiny parts of the involved muscles. This approach, though, will wear off in a few months — a more permanent solution is surgery to reposition the muscle attachments so as to prevent excessive movement.
If you’re concerned about a gummy smile, see us for a full examination and consultation. Once we know the reason why, we can offer a solution that will make your smile more attractive.
If you would like more information on enhancing the appearance of your gums, 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 “Gummy Smiles.”
Today, dental implants are an increasingly popular option for replacing lost teeth — an issue faced by many older Americans. It’s not hard to see why these high-tech prosthetic teeth are preferred: They look, “feel” and function just like natural teeth… and with proper care they can last the rest of your life. Unfortunately, many people who could benefit from implants also face an additional health problem: diabetes, a metabolic disease that can affect many different parts of the body, sometimes severely.Â Uncontrolled diabetes can lead to nerve and tissue damage, and may adversely impact your oral health. So if you have diabetes, does it mean you won’t be able to get dental implants?Â
The short answer is no — but there are some considerations that diabetics (and their health care providers) need to keep in mind. For example, it has been demonstrated that wounds in diabetics tend to heal more slowly, and are more prone to infection than those in non-diabetics. Also, people with diabetes sometimes experience a chronic inflammatory response, which can eventually lead to tissue damage or other problems.
Because the placement of dental implants requires minor surgery, dentists and researchers have questioned whether people with diabetes are good candidates for implants. Now there’s encouraging news: Several recent studies have come to the conclusion that many diabetics can indeed undergo an implant procedure without undue risk.
One key consideration is how well an individual can control his or her blood glucose levels. Researchers have found that diabetics with good blood glucose control, those with poor glucose control, and non-diabetics all have similar implant success rates (above 95%). However, in diabetics with poor glucose control, more time may be needed for the jawbone to heal in the area where the implant procedure was done. That doesn’t by any means rule out the placement of a dental implant — but it does mean that special considerations apply to individuals in this situation.
So if you are considering an implant procedure but have trouble controlling your blood glucose levels, ask us how we can help. Just remember that in most cases, having diabetes doesn’t mean you won’t be able to enjoy the benefits of dental implants. If you have additional questions, contact us or schedule an appointment.
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