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Dental implants have evolved over time and become an ideal replacement for a lost tooth or teeth. The long term success rate of dental implants is well over 95%. What once was a product offered to very few has now become a mainstream dental care service available to most.

Options For Dental Implants

Depending on each, unique, individual person, each dental implants case will be personalized. Depending on how many teeth are missing as well as the available quantity and quality of bone present. Below are some of the situations where dental implants can replace lost teeth:

-Loss Of A Single Tooth. At one time, this meant wearing a removable appliance (commonly called a “flipper”) or removing natural tooth structure from surrounding teeth to create a fixed bridge of dental crowns. The flipper tends to be uncomfortable to wear and may affect speech. The 3 unit bridge compromises the support teeth by having them do the work of the lost tooth, and by making them more susceptible to decay. The long term success rate is lowered due to difficulties in cleaning under and around the bridge. A single tooth dental implant, when completed properly, will last a lifetime and function just like a natural tooth.

-Loss Of Multiple Teeth. When missing multiple teeth in a single area, dental implants can be used to form a fixed bridge. The beauty of this arrangement is stability and the ability not to affect the natural teeth in any way.

-Replacing All Teeth. In the past, the only way to restore function was to fabricate a removable denture. With dental implants, dentists have the ability to restore natural function and esthetics.

Complementary Procedures To Dental Implants

There are times when other dental procedures are necessary to successfully complete the placement of dental implants. These include:

-Sinus Lift. When you have a large sinus area that impinges on available bone depth, the sinus lift is a common surgical procedure. Sinus lifts are needed to elevate the sinus membrane and thicken a part of the upper jaw with a bone graft. This helps give  a dental implant enough bone depth to place it properly in the area you need it. Dental implants need a good quantity of bone along with good, dense quality of bone to succeed. The upper jaw is known to have poorer quantity and quality bone structure as opposed to the lower jaw. The maxillary sinus also plays a role in increasing difficulty in this area. Sinus augmentation can remedy these issues by raising the sinus floor and placing bone grafts in the area to aid in dental implant placement.

-Bone Grafting. When the bone is not 100% adequate for dental implant placement, dentists are able to add to it by performing a dental bone graft. A bone graft is the placement of bone or bone-like materials in the jaw to to build it up. This gives an excellent platform for dental implants. Modification of the bone in this fashion has been shown to improve both appearance and long term success of dental implants. Typically, dentists try to place implants at least as deeply into bone as the crown or tooth will be above the bone. This is called a 1:1 crown to root ratio. This ratio serves as a guide for bone grafting in most situations.

Can A Dental Implant Fail?

It is quite rare for a dental implant to fail but when it does the dental implant must be removed. Then re evaluated as to why the failure occurred and to see if a new dental implant may be placed. Some of the common reasons for dental implant failure include:

-Failed Integration of Dental Implants - This occurs when the bone does not grow and fuse between the threads of the implant. This fusion of bone to dental implant is called osseointegration. If this does not occur, the dental implants will not function properly,will become uncomfortable, become loose, or come out completely. To reduce this risk, your dental surgeon will evaluate the quality and density of the jaw bone prior to surgery. This will help to only place dental implants in areas where there is a highly predictable success rate. If osseointegration does not take place, the dental implants can be removed, and surgery can be attempted again once the area has fully healed.

-Infection –  This is the most common complication of dental implant surgery. The surrounding bone and gums can get infected during the surgical procedure. This can happen due to non-sterile technique, a contaminated implant, poor healing ability(diabetic, smoker, osteoporosis medications), or pre-existing infection. The most likely time for this to occur would be during the surgical placement of the dental implant into the bone. Implant infection can occur after placement as well. Poor hygiene, too much force placed on the implant, or excess cement can cause the support tissue to breakdown. Implant infection is a condition referred to as peri-implantitis. Peri-implantitis is characterized by inflammation or swelling of the tissues surrounding the implant area. Peri-implantitis can also present as a secondary infection later on is a form of periodontal disease that can lead to inflammation, bone loss and implant failure if not treated quickly and properly. Although implant infections are usually caused by the presence of bacteria during or immediately after the oral surgery for the placement of the dental implants, an implant infection can occur months or years after surgery.

-Post Surgical Bleeding - Some bleeding following surgery is normal and should be expected for about 1-2 days. Biting gently on a gauze pad placed over the surgery area for 30 minutes should normally stop the bleeding. Excessive bleeding is not normal and you should notify your dentist immediately if you have concerns about your dental implants.

-Damage To Surrounding Tissues - Dental implant complications related with surgical errors affecting adjacent teeth, nerves or sinus are directly correlated with the experience and skills of the dentist or surgeon. An experienced and skilled implant dentist is able to identify potential problems by examining x-rays or CT scan (computer tomography), design the proper surgical plan for ideal location and angle, and execute it successfully without complications. Even with the most skilled implant dentist there is always a possibility of dental implant complications. The complications can be limited by choosing an implant dentist with the skills and experience necessary to handle any complications if they arise.

-Rejection – An extremely rare complication for dental implants but it has been noted in the research literature. The dental implants can sometimes be viewed as a foreign body.

-Unusable Dental Implants – An implant that has successfully integrated with bone, but the area or extreme angle of placement deem it unrestorable.

Dental Implants Conclusion

Dental implants have been the solution for many. They come with risks but with proper treatment planning from a well qualified dentist they can be a successful tooth replacement for a lifetime of smiles.

 

 

Tooth decay (also called dental cavities or dental caries) –  The destruction of the surfaces (dentin and/or enamel) of a tooth and infiltration of bacteria into tooth structure. Tooth decay results from the action of bacteria that live in plaque. Plaque is a sticky, whitish film formed by bacteria and food debris which adheres to the pellicle (a protein layer on the tooth surface). The plaque bacteria sticking to tooth enamel breakdown the sugar and starch from food particles in the mouth to produce acid.

Only Cake, Candy, and  Sugary Drinks Cause Tooth Decay.

Myth, but it’s almost a fact.

Guess what sugar is? You guessed it a carbohydrate. White rice, french fries, bagels, chips and fruits are all carbohydrates. The stickier the carb, like white rice, caramel, or fruit gummies, the longer they stay lodged between teeth and stuck in grooves. The truth is that the acid produced by the bacteria while breaking down carbohydrates is what causes tooth decay. The bacteria makes the acid when you eat anything with carbohydrates that stick and stay on your teeth. The resulting acid melts through the strong outer enamel and allows bacteria to enter into the inner layer (dentin). The bacteria are not visible to the eye, and the breakdown is slow and steady forming a hole, better known as a cavity.

An important fact to know: It is not the amount of carbohydrates you consume that end up causing tooth decay, but the length of time your teeth are exposed. If you eat a high amount of carbohydrates for lunch, that’s one big exposure. But if you spend the day sipping sugary drinks, chewing on gummy bears, sucking on tic tacs, that continuous exposure is far more unhealthy for your teeth. Dentists have a saying, “sip all day and get tooth decay“.

All Dental Restorations Need to be Replaced Every Few Years.

Myth.

An amalgam or composite filling needs to be replaced only if it breaks down or a cavity forms around it, or if the tooth breaks or fractures. If none of those problems occur, you can keep the same filling for quite a long time. Most dental restorations do have a life expectancy but it depends on each individual. Tooth wear due to clenching or grinding, diet, and dental hygiene habits,  play a huge role in how long these restorations last, some last more than 50 years! Maintaining proper oral hygiene and maintenance  will help your dental restorations last longer.

Once You Get a Tooth Capped, the Tooth Can’t Decay.

Myth.

A Cap or a crown covers and protects underlying tooth structure. However, the area where the crown edge ends and tooth is not covered ( the margin), is where bacteria like to stick. It is the least smooth part of the tooth, and where bacteria can break the seal between the tooth and crown. Once the seal breaks, bacteria can move up and under the crown to slowly breakdown tooth and root structure. A dentist always checks margins around teeth to try to find breaks in margins, however, when breakdown occurs in between teeth it is harder to detect and  usually decays much further before it can be detected on an x-ray.

When You get a Root Canal, the Roots are Removed and the Tooth Can’t Decay.

Myth.

A root canal treatment does not remove roots, what is removed are the nerves, blood vessels, bacteria, and debris from inside of the roots. The dentist then fills and seals the roots with a rubbery filling and sealing paste. This prevents bacteria from re-entering a tooth. Once the root canal is completed, the tooth should heal, and usually be covered and protected with a crown to help prevent cracking. Tooth decay can happen, just as in any tooth.

Children are more prone to Tooth Decay than Adults.

Myth.

Advances in pediatric dentistry have allowed us to cut childhood tooth decay in half over the last 20 years. These advances include sealants, fluoridated water, dietary consultations, and preventive care. As we see advances in pediatric dentistry, and decreases in tooth decay a different population has had increases in tooth decay. Seniors have an increase in cavities due to an increase in advances in pharmacology, limited dexterity, insufficient professional cleanings, and dry mouth. Many medications have a side effect of causing dry mouth which increases the risk of tooth decay.

If You Have Tooth Decay, You Can Feel it.

Myth.

Tooth decay may or may not cause any symptoms. Everyone and each individual tooth varies in it’s pain threshold. The pain associated with tooth decay may be detected very early in some and when it is in a more advanced stage and is actually causing damage to the nerve in others. Allowing tooth decay to progress untreated can and will lead to much more expensive and extensive dental procedures, like root canals and oral surgery. That’s why regular dental examinations are so important.

Teeth can only repair themselves when initial enamel breakdown is occurring, and the bacteria have not entered the dentin. Some enamel can repair with natural calcium remineralization and some can harden and repair with fluoride . Persistent bacteria will cause a cavity to forms which will continue to grow and progress into the tooth, eventually working its way into the dentin and then the nerve of the tooth.

Cavities Are More Likely Between Teeth.

Fact.

Any place in the mouth where you cannot reach and bacteria can hide is a place for tooth decay to form. That is why brushing, flossing, and using an antibacterial and fluoride rinse (such as Purple Listerine) are so important. They allow you to reach areas brushing alone cannot. Flossing is one of the few ways to get in between teeth and properly avoid tooth decay between teeth.

Chips and Cracks in Teeth Lead to Decay.

Fact.

Cracks and chips in teeth can create a hiding place for bacteria and make those areas more prone to tooth decay. Using a fluoride rinse can reduce the risk of tooth decay.

Sensitive Teeth Means You Have Decay.

Myth.

Tooth sensitivity could just mean you have hypersensitive teeth, or gum recession has exposed some root.

You could also have a cracked or broken tooth or could need a root canal. There are many things, including tooth decay, that could lead to sensitive teeth. If your teeth are sensitive you should schedule a dental examination to make sure it is not something serious.

Cavities Are the Only Reason for Root Canals.

Myth.

Root Canal treatment is caused by a variety of things including tooth decay. Root canal treatment is needed if the nerve inside a tooth is damaged which can be a result of decay or trauma.  Trauma can result from accidents, grinding, clenching, biting into a very hard object (piercings, hard candy, etc.), ice chewing, etc.

You Don’t Need to Worry About Cavities in Baby Teeth.

Myth. 

Baby teeth are needed to hold the space for permanent teeth. Also, tooth decay in baby teeth can develop into serious pain, dental abscess and serious infection. On occasion the infection can spread to other parts of the body and has even caused death if left untreated.

Brushing, Flossing, and Rinsing and a Healthy Diet Is the Best Way to Prevent Cavities.

Fact. 

Definitely. Preventive dentistry is the key to staying cavity free. The bacteria must be removed from the teeth.

Brush twice a day with a fluoridated toothpaste, and floss and rinse daily. Antimicrobial rinses target bacteria, reducing plaque, bad breath, and the severity of gingivitis. Rinses with fluoride make teeth more resistant to tooth decay. If bacteria are removed daily from every area of your tooth. Eat healthy foods, and limit exposure to carbohydrates.

Tooth Decay Conclusion

There are many misconceptions about what causes tooth decay and what doesn’t. The facts remain, A healthy diet, and proper oral hygiene will not only help you prevent tooth decay, but keep your whole body healthier.

Many of us see a beautiful smile and wish that it could be ours. Few of us are born with perfectly shaped, straight, white teeth. In the past, “natural smiles” were the norm, but today, cosmetic dentistry has evolved to offer many corrective options. This has allowed many patients to take advantage of these modern options to give them that “perfect smile” they have always dreamed about. What about those patients who choose not to go that extra step for that perfect smile?

What Is Snap On Smile?

Snap on smile is a revolutionary solution for many cosmetic dental issues. The beauty of the snap on smile is that it is a totally reversible cosmetic dentistry option. The snap on smile is much more affordable than porcelain veneers or porcelain crowns. In general, the snap on smile procedure costs as much as a single porcelain crown.

Snap on smile is a removable arch of “teeth” which is designed to snap over the existing teeth. The snap on smile removable appliance is made from an extremely strong dental resin. It can be used as a short term or a long term cosmetic dentistry option. The following are the steps involved in the fabrication of a custom snap on smile:

-Dental Impressions. This will include impressions of the teeth, photographs, along with a bite registration. A bite registration allows the dental lab to know the relationship between the upper and lower teeth. At this visit you and your dentist will also pick out the style, shape, and color of your new smile.

-Dental Laboratory. The information gathered by the dentist is then sent off to the dental laboratory. The dental technician will digitally create the custom made snap on smile.

-Snap On Smile Insertion. Following fabrication by the lab technician, your dentist will then place the final product over your teeth. The snap on smile pops right in over your own teeth and fits perfectly.

The snap on smile is so simple to complete without the need for removing any of your natural tooth structure or need to use any anesthesia. The beauty is that it is completely removable at any time with no effect to your natural teeth.

Common Snap On Smile Questions

-Will Snap On Smile Affect My Speech? It usually takes about 2 weeks to get used to the new teeth and speak as yo did before.

-Is It Covered By My Dental Insurance? Snap on smile is considered a cosmetic procedure and is therefore not covered by dental insurance.

-Will It Stain? Your dentist will supply you with special snap on smile cleaning supplies. This kit includes a cleaning solution and an antibacterial gel. Using this kit regularly will help keep your new smile looking like new.

-How Long Does It Take? The entire process can be completed in as little as 3 weeks. The initial appointment (includes photos and impressions) should take 15-20 minutes. The laboratory needs about 2 weeks to complete fabricating your new snap on smile. And the final appointment is a short one ensuring proper fit and comfort.

-Is There A Warranty? There is a 1 year warranty, but an extended warranty can be purchased.

-Can I Cover All Of My Teeth? Upper and lower snap on smiles are available, however most people choose to do the upper only.

-Can I Eat And Drink While Wearing My Snap On Smile? Yes, your new smile is designed to wear during eating and drinking. However, be aware your new smile can stain just like your real teeth if not cleaned properly.

Teeth Whitening is a common procedure in general dentistry but especially so in the field of cosmetic dentistry. There are different types of teeth whitening including in

Internal Bleaching Marielaina Perrone DDS

Internal Bleaching Can Make You Smile Again!

office and at home options like the use of teeth whitening strips. But did you know there was a procedure available to perform a deeper teeth whitening from the inside of the tooth out? This procedure is commonly known as internal teeth whitening or internal bleachingInternal bleaching is used to lighten a discolored tooth that has had root canal treatment.

Internal bleaching is a more conservative option compared to restoration with veneers or crowns, but is sometimes used to lighten teeth before the application of these techniques to prevent the discoloration of the natural tooth from showing through. In addition, porcelain veneers or crowns may be required not only to achieve improved color, but also to strengthen a root canal treated tooth.

How is Internal Bleaching Performed?

Internal bleaching is a dentistry technique that is used to lighten the color or whiten the appearance of a tooth or teeth. Internal bleaching is only to be done under the direct supervision of a dentist. This is because the procedure involves inserting a chemical oxidizing agent directly into the tooth.

Internal Bleaching Before Marielaina Perrone DDS

Internal Bleaching Before

The internal bleaching procedure is performed on a non vital tooth that has received root canal treatment. The root canal treatment could have been the result of infection or dental trauma. Whatever the reason, the tooth in question did not require a crown and has maintained its natural tooth structure. When a tooth dies or becomes non vital it loses the blood and nutrient flow to it. This sometimes results in a changing of tooth color to a darker shade than the surrounding teeth.

Following completion of root canal treatment, the dentist will place a chemical oxidizing agent into the chamber of the tooth and leave it there for about 2 weeks time. This process can be done a few times over that 2-3 week period until the tooth achieves the level of whiteness desired by dentist and patient. Once the color is correct, the opening is sealed closed with a white tooth colored composite filling to keep out foreign matter and bacteria that could cause further problems.

Internal Bleaching After Marielaina Perrone DDS

Internal Bleaching After

Internal bleaching may be used by itself for whitening teeth or  in combination with exterior teeth whitening products.  Your dentist will evaluate the current condition of the teeth and determine if it is necessary to make use of two different kinds of teeth whitening procedures at the same time. When it is decided to use both products at the same time, the dentist will choose two products that are compatible to one another so that they do not interact poorly with one another. If chosen incorrectly, the interaction between the two bleaching products could ultimately damage the teeth they are designed to treat.

How well does Internal Bleaching work?

Internal bleaching is very effective for whitening teeth that have been damaged by trauma or infection. The process allows the dentist to focus on one tooth to raise its level of whiteness back to the level of the other teeth to give a more natural appearance overall.

Internal Bleaching Conclusion

Anyone who has had a tooth turn color after receiving root canal treatment can understand the difference between natural, undamaged, tooth structure, and dark, non-vital, tooth discoloration. While internal bleaching is very specific in it’s applications, it is an easy choice for someone with a dark front tooth. Internal bleaching is a great tool for cosmetic dentists to restore one or more teeth back to their natural white condition. It is a fairly simple procedure with great reward. If you have a tooth that does not whiten as all the others do, ask your dentist about internal whitening, and see if this is an option for you.