Posts for: December, 2015
Modern restorations for severely damaged or missing teeth are truly remarkable. Although the type of restoration may differ — dental implant, bridge, or veneer — the end result is a life-like facsimile that matches the shape and color of your natural teeth.
To achieve this result, though, the new crown or veneer requires fabrication in a dental laboratory, a meticulous process that may take a few weeks. In the interim, we often install temporary crowns. These help in a number of ways: because we’ve prepared the teeth for final restoration by removing some of the tooth structure, the temporary crown protects and stabilizes the teeth, reduces sensitivity and helps maintain gum health. Temporary crowns also enable the patient to present a more natural smile while waiting for the permanent restoration.
Temporary crowns are typically manufactured to fit a wide range of patients, similar to an “off-the-rack” suit from a clothing store. In recent years, though, customized “tailored” temporary crowns designed specifically for an individual patient have grown in popularity among dental professionals as well as patients.
In creating a customized temporary crown, we first perform a smile analysis similar to one used for a permanent restoration. After a careful assessment of your mouth, we would then make recommendations about the elements to include in the temporary crown, including shape and color. We would also factor in your desires and concerns into the final design. Working together with the dental laboratory, we would then have the temporary crowns produced and ready to apply as soon as we complete the preparatory work.
Customized temporary crowns also serve another important purpose as a kind of “dress rehearsal” for the permanent restoration. This gives you an opportunity to “try out” the smile you’ll have with the permanent restoration in your daily life. We can then use your experience to make adjustments to the permanent crowns before final production.
While customized temporary crowns involve more effort and expense than the traditional, the benefits are worth the added cost, especially if you’re involved with an extensive “smile makeover” procedure. Not only will you look better while your permanent restoration is under construction, your temporary look will give you added confidence that your future smile is right for you.
If you would like more information on temporary and permanent dental restorations, 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 “Concepts of Temporary Restorations.”
Implants are highly regarded by both dentists and patients for their versatility and durability. But it’s their life-like appearance that “seals the deal” as the restoration of choice — not only mimicking an individual tooth, but emerging from the gum line and blending indistinguishably with other teeth in color and symmetry.
To achieve this result, we must consider a few factors beforehand, particularly the amount of bone available at the intended implant site. An implant requires a certain amount of bone to properly position it for the most natural crown appearance. The bone present around adjacent teeth can also affect your appearance: in the absence of adequate bone the papillae, triangular shaped gum tissue between teeth, may not regenerate properly between the implant and the natural teeth. This can leave a noticeable void, what dentists call “black hole disease.”
Bone loss is a significant problem particularly after tooth loss. It’s quite possible for you to lose a quarter of the bone’s width in the first year after tooth loss. To avoid this, we often use bone grafting techniques immediately after extraction to lessen bone loss; if it’s already occurred we may be able to use similar reconstructive techniques to rebuild and encourage renewed bone growth. In the end, though, if there remains a significant level of bone loss it may be necessary to consider another option for tooth replacement other than implants.
The thickness of your gum tissue, a genetic trait, can also have an impact on the implant’s ultimate appearance. Thicker gum tissues are generally more resilient and easier to work with surgically. Thinner gum tissues are more susceptible to recession and tend to be more translucent, which could cause the underlying metal implant to be visible. Thus, working with thinner gum tissues requires a more delicate approach when trying to achieve a visually appealing result.
All these factors must be balanced, from implantation to final crown placement. But with careful planning and attention to detail throughout the process, many of these issues can be overcome to produce a satisfying result — a new and appealing smile.
If you would like more information on the aesthetics of 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 “Matching Teeth & Implants.”
Saliva is a true workhorse among bodily fluids — it breaks down food for digestion, keeps harmful bacteria in check and neutralizes acid that is destructive to tooth surfaces. So when saliva flow is chronically diminished, it’s more serious than the uncomfortable feeling of “dry mouth” — it can have a detrimental effect on your overall health.
It’s normal to experience temporary mouth dryness: in the morning (because saliva flow slows during sleep), when we’re under stress, or after smoking or consuming certain foods and beverages like onions or coffee. But chronic dry mouth (“xerostomia”) is different — the mouth remains dry for extended periods, leading to problems like tooth decay caused by inadequate acid neutralization.
Medications are one of the most common causes for xerostomia. According to the Surgeon General, there are over 500 medications — both prescription and over-the-counter — that can cause it, including antihistamines, diuretics and antidepressants. Radiation or chemotherapy used for cancer treatment may also cause dry mouth, sometimes permanently. There are also systemic conditions that affect saliva flow like diabetes, Parkinson’s disease, cystic fibrosis, and many autoimmune diseases.
Treating chronic dry mouth will of course depend on the underlying cause. If drug-related the first approach should be to find a substitute medication that won’t as readily cause reduced saliva flow. If that’s not possible, then it’s helpful to drink more water when taking the medication (a few sips before and a full glass afterward). You can also cut back on caffeinated, acidic or sugary foods and drinks as well as alcohol, and refrain from tobacco use.
A saliva stimulant might also help. Besides prescription medication, there are other products like xylitol, a natural alcohol sugar found in chewing gum, toothpaste or rinses, that help increase saliva flow — and xylitol also inhibits the growth of decay-causing bacteria.
The most important thing for chronic dry mouth is maintaining consistent daily hygiene through brushing and flossing and regular dental cleanings and checkups. Helping to increase your saliva flow and making every effort to prevent dental disease will help keep this condition from harming your teeth and gums.
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.”
People who’ve lost all their teeth (a condition known as edentulism) face a decision on how to restore their lost function and appearance. And there are a number of options to consider.
A fixed bridge supported by dental implants, for example, is a good choice for patients who still have sufficient bone structure in their jaw. It’s not a good choice, however, for those with the opposite situation — who’ve experienced significant bone loss which has also affected their facial structure. For them, there’s a better alternative that also uses implants for support — the overdenture.
An overdenture is similar to a traditional denture, in that it’s made of life-like crowns permanently set in denture plastic, and may either partially or fully cover the roof of the mouth. The main difference, though, is that unlike traditional dentures which rest for support on the gum ridges, an overdenture is supported by strategically placed implants that the denture fits over and connects to — hence the name “overdenture.”
There are a number of advantages for an overdenture, especially for patients with bone loss. A removable, implant-supported denture can be designed to replace lost tissues that have altered facial appearance — to “fill in” the face and restore aesthetic harmony. Patients who’ve previously worn dentures will also often find their speech better improved than with fixed bridgework.
Because it’s removable, an overdenture and the underlying gums are easier to clean, which helps inhibit disease and lessen further bone loss. It also allows you to properly care for the denture, which can extend its longevity and reduce future potential maintenance and replacement costs.
If you would like to consider removable overdentures as an option, you should begin first with a thorough oral exam that includes evaluating the status of your bone, jaw and facial structure. From there we can advise you if overdentures are the best choice for you.
If you would like more information on overdentures and other 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.”