Lose a baby tooth when you're a young kid, no big deal — you'll grow another. Lose a permanent one and there's cause for concern. For one thing, tooth loss is often a symptom of an underlying oral health problem, such as tooth decay or gum disease, so it's important to identify the cause and treat it to prevent it from progressing. It is equally important to replace the tooth — not simply for the immediate impact it can have on your smile or bite, but for long-term function, esthetics and the health of the bone that supports your teeth.

The primary options for tooth replacement are fixed bridgework and dental implants. Both result in esthetically pleasing outcomes; the main difference is how each is attached. With a bridge, the replacement tooth, referred to as a “pontic,” uses the two natural teeth on either side of the gap — referred to as “abutments” — for support. The pontic is sandwiched between two other crowns, which fit over and are bonded or cemented to the teeth on either side of the gap. To ensure the companion crowns fit properly, the enamel must be removed from each abutment.

Placing dental implants, by contrast, involves working only on the affected area. The “implant” is actually a small titanium rod with spiraling threads just like a miniature screw that is carefully inserted into the jawbone as though it were a natural root. The replacement tooth, a customized crown, is secured to the end portion of the implant by way of an intermediary referred to as an abutment, which firmly anchors it in place.

Both bridges and implants are natural looking, functional, predictable, and reliable. Each has its advantages and disadvantages, and based on your oral health, one may be more appropriate than the other.

If you would like more information on tooth loss and replacement, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “The Hidden Consequences of Losing Teeth” and “Dental Implants vs. Bridgework.”

If you have a dental implant, you have already discovered how lifelike and comfortable this type of tooth-replacement option can be. In fact, you may not even really be aware of your implant anymore; to you, it's simply a tooth like any other. Still, it's important to keep in mind a few things about implant care so the investment you have made in your smile will last as long as possible.

Once an implant is functioning properly in a person's mouth, the biggest enemy is infection — in particular a bacterial infection known as peri-implantitis (“peri” – around; implant “itis” – inflammation). This infection can cause the supporting bone around your implant to deteriorate, which will eventually cause loss of the implant. The good news is this infection is pretty easy to avoid.

Working as a team, you and our dental hygienist can make sure your mouth stays healthy and your implant retains its attachment to the bone for a lifetime. The key is to prevent biofilm (plaque) from building up in your mouth. Your job is to maintain a good oral hygiene routine at home with daily brushing and flossing, and to come in to our office regularly for professional cleanings. The hygienist's job is to remove any buildup of plaque and tartar (hardened deposits) beyond the reach of your brush and floss.

To do this, she will use special instruments that won't scratch the crown on top of the implant or the abutment (connector) between implant and crown. This is important because a scratched surface can harbor bacteria. The metal instruments used to clean natural teeth are not appropriate for the highly polished surfaces of the crown and abutment. Power instruments can be used on implants with nylon or plastic sheaths on the tip and lots of water irrigation to clean and flush debris.

In spite of these cleaning challenges, implants are highly successful and, in fact, the best option for replacing teeth today. Studies have shown the success rate of dental implants to be over 95% — far greater than any other tooth-replacement method.

If you would like more information about dental implants, please call us or schedule an appointment. You can also read more by reading the Dear Doctor magazine article “Dental Implant Maintenance.”

What does the term “two-implant overdentures” mean?
For more than a century, complete dentures were the only care option for edentulous (toothless) people. As a solution, these left a lot to be desired, particularly for the lower jaw. Now dental technology has developed a better alternative that combines two strategically placed dental implants and a traditional lower denture that has been modified to fit over the two implants — thus the term.

What are the problems with traditional dentures?
The problem is that when you lose teeth, the bone that supported the missing teeth begins to shrink away. This is known as resorption, and it is the reason that dentures fitted too soon after teeth are lost quickly become loose. Bone loss happens most rapidly during the first year and is four times greater in the lower jaw than in the upper.

Why not just use dental adhesives to hold dentures tightly to the lower jaw?
Zinc, a major ingredient in most dental adhesives, has been associated with neurological disorders and may be unsafe. In addition, dental adhesives are expensive and the cost of frequent usage adds up.

Besides dental adhesives, are other health problems associated with dentures?
Yes, edentulism has been related to poor nutrition. Many edentulous people switch to soft foods with high fat content because they find healthier foods like vegetables and proteins difficult to chew.

What are dental implants?
Dental implants are replacements for the roots of teeth, the parts that are below the gumline and anchored in bone. They are usually covered with a crown that shows above the line of the gums.

What are the benefits of implants?
Most importantly, implants reduce the amount of bone resorption. Studies have shown about 75% less resorption in parts of the jaw with implants compared to areas without them. Since most of the bone loss occurs within the first year after tooth loss, it is important to place implants within this time period.

Is a complete set of dental implants a good solution for edentulism?
Yes, it can be a good solution, but it is not for everyone. Some patients, who have lost a great deal of bone support, need another solution for cosmetic reasons that offer more facial support like an implant overdenture. In addition, depending on their resources and insurance, some people require a less expensive solution.

Why does the two-implant overdenture work better for the lower jaw?
Based on differences in bone volume, density and other factors, we think that four to six implants are needed to retain an upper implant overdenture. Thus a two-implant overdenture is a good solution to consider for a lower jaw, but other options might be preferred for an upper jaw.

Contact us today to schedule an appointment to discuss your questions about dentures and implants. You can also learn more by reading the Dear Doctor magazine article “Implant Overdentures for the Lower Jaw.”

While the first recorded attempts at dental implant were recorded around 600 AD during the Mayan civilization, today they have become a normal and integral tool that we use to replace teeth and restore full functionality to dental and oral health. In fact, many dentists now refer to dental implants as a person's third set of teeth, and they are the optimal choice for permanently replacing missing adult (permanent) teeth.

To help you visualize, think of your teeth as having two main parts: the crown or the part that can be seen above the gum tissues and the root, the portion that is suspended in the bone by the periodontal (gum) ligament that keeps the tooth in place. A dental implant is actually a root replacement, but unlike a tooth's root, it is anchored in the jawbone. However, an interesting fact is that the dental implants being used today actually fuse with or integrate in to the bone to become one. This process is called “osseo-integration.”

For the most part, dental implants are made from commercial-grade, pure titanium. This metal is “osteo-philic” or literally a bone loving metal that has been used for many years by both the medical and dental professions because it is not rejected by the body. For these reasons, these dental implants are very successful and can last for a lifetime.

Implant placement is a surgical process that requires prior planning involving collaborative efforts between the implant surgeon, dentist, and a laboratory technician. Periodontists, oral surgeons, or general dentists with advanced training in implantology and surgery normally “place” them. To learn more about dental implants and the entire process, read, “Dental Implants, Your Third Set Of Teeth.” Or if you prefer, you can contact us to discuss your questions or to schedule an appointment.

Before determining if a bridge or an implant will work best for you, here is some useful background information. There are two main parts to a tooth; the crown or part that you see above the gum line and the root portion that is below the gum line and encased in bone — the part that is replaced by a dental implant.

A dental implant is inserted into the jawbone during a surgical procedure. The implant is actually a titanium screw-like device that is placed in contact with the bone. During a 3 to 6 month healing period, it subsequently fuses to the bone. A crown made from dental porcelain, gold or a combination of both is then attached to the implant to mimic a healthy, normal tooth.

There are two critical reasons why implants are the preferred method for permanently replacing an adult tooth. The first is that they are less susceptible to gum disease and they are not subject to tooth decay. The second is that because they attach to the jawbone and not to the adjacent teeth. And while an implant may cost a little more initially, when compared to the longevity and replacement cost of bridgework over a lifetime, they may cost less.

By contrast, a fixed bridge is also a non-removable restoration or prosthesis (replacement part) that is held in place by attaching it to your natural adjacent teeth. The treatment gets its name from the French word for bridge, “pont,” as the tooth being replaced is called a pontic. Before placing a bridge, the teeth on either side of the missing tooth must be prepared by removing layers of tooth enamel. Three new teeth are then crafted as a single unit from dental porcelain and/or precious metals with crowns on either side of the pontic. The pontic is held in place when the crowns are placed. Bridgework is at risk for gum disease and tooth decay and requires careful maintenance.

As with most dental procedures you have options and choices. Luckily, when it comes to determining whether a bridge or an implant will work best for you, you can rely upon our expertise. However, by having a clear understanding of these two options you are now better prepared for working with us should you require this treatment option. To learn more read the article, “Implants Vs. Bridgework.” Or, contact us to discuss your questions or to schedule an appointment.