Posts for: May, 2018
For whatever reason, you’ve put off replacing a missing tooth for awhile. Now you want to fill that empty gap in your smile with a dental implant restoration.
But if your tooth’s been missing for a long time, there could be a problem with space. This is because the teeth on either side of the space may have gradually drifted into it, leaving no room for the implant. You could need orthodontic work first to return these teeth to their proper position.
We could use braces, metal orthodontic devices with wires threaded through brackets bonded to the teeth that are then anchored, usually to back teeth. The orthodontist uses elastics or springs as well as possibly incrementally tightening of the wire against the anchors. These techniques create pressure or tension on the teeth for the desired direction of movement. The teeth’s natural mechanism for movement does the rest.
But while effective, braces can be quite noticeable, an embarrassing thought for many adults having to wear them over several months of treatment. But there may be an alternative: clear aligners, a succession of slightly different plastic trays usually worn in two-week intervals. Sequentially wearing each tray gradually moves the teeth to their desired positions.
Though not appropriate for all bite situations, clear aligners have a number of benefits when they can be used. They’re nearly invisible to others and can be removed for hygiene tasks or rare special occasions. What’s more, the orthodontist may attach a temporary prosthetic (false) tooth to the trays to camouflage the missing space during treatment.
There’s one other issue you may have to deal with: if your tooth loss was related to periodontal (gum) disease, the gums and underlying bone may be in poor condition. In fact, substantial bone loss could rule out an implant altogether. But we may be able to remedy both gum and bone deficiencies through grafting or plastic surgery. It may be possible to regenerate enough bone to support the implant; and surgically repairing your gums will help ensure the implant appears natural.
If you have problems like these, don’t give up on your restoration goal just yet. With some orthodontic and dental work ahead of time, we may still be able to make implants a reality for you.
Do you wake up in the morning still feeling tired? Are you drowsy, irritable or have difficulty concentrating? And is your snoring habit a running joke around your household?
If you mostly answered yes, you may have obstructive sleep apnea (OSA). This condition is more than an irritation—it could also have major health implications if not addressed.
OSA occurs when the airway becomes temporarily blocked during sleep. The tongue (or other mouth structures like tonsils or the uvula) is often the cause as it relaxes and covers the back of the throat. Although you’re asleep, the brain notices the drop in oxygen and initiates arousal to unblock the airway. As this action usually only takes a few seconds, you may not fully awake every time; but because it can occur several times a night, it can rob you of the deep sleep you need for well-being.
If you’re diagnosed with OSA, your doctor may recommend continuous positive airway pressure therapy (CPAP). This treatment uses a pump device to supply continuous pressurized air through a hose connected to a face mask worn during sleep. The elevated pressure helps keep the airway open.
While this approach is quite effective, many people find wearing the equipment uncomfortable or confining, and may choose not to use it. If that describes you, a qualified dentist may be able to provide you with an alternative called oral appliance therapy (OAT).
OAT uses a custom-made plastic oral appliance you wear while you sleep. The most common snaps over the teeth and uses a hinge mechanism to move the lower jaw (and the tongue with it) forward.
OAT is recommended for people with mild to moderate OSA, or those with severe symptoms who can’t tolerate CPAP. If you’d like to see if an OAT appliance could help you, contact us for a complete oral examination. Either treatment can improve your sleep and daily lifestyle, as well as help prevent certain health issues in the future.
If you would like more information on treatments for sleep apnea, 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 Appliances for Sleep Apnea.”
If you’ve just received a dental implant restoration, congratulations! This proven smile-changer is not only life-like, it’s also durable: more than 95% of implants survive at least 10 years. But beware: periodontal (gum) disease could derail that longevity.
Gum disease is triggered by dental plaque, a thin film of bacteria and food particles that builds up on teeth. Left untreated the infection weakens gum attachment to teeth and causes supporting bone loss, eventually leading to possible tooth loss. Something similar holds true for an implant: although the implant itself can’t be affected by disease, the gums and bone that support it can. And just as a tooth can be lost, so can an implant.
Gum disease affecting an implant is called peri-implantitis (“peri”–around; implant “itis”–inflammation). Usually beginning with the surface tissues, the infection can advance (quite rapidly) below the gum line to eventually weaken the bone in which the implant has become integrated (a process known as osseointegration). As the bone deteriorates, the implant loses the secure hold created through osseointegration and may eventually give way.
As in other cases of gum disease, the sooner we detect peri-implantitis the better our chances of preserving the implant. That’s why at the first signs of a gum infection—swollen, reddened or bleeding gums—you should contact us at once for an appointment.
If you indeed have peri-implantitis, we’ll manually identify and remove all plaque and calculus (tartar) fueling the infection, which might also require surgical access to deeper plaque deposits. We may also need to decontaminate microscopic ridges found on the implant surface. These are typically added by the implant manufacturer to boost osseointegration, but in the face of a gum infection they can become havens for disease-causing bacteria to grow and hide.
Of course, the best way to treat peri-implantitis is to attempt to prevent it through daily brushing and flossing, and at least twice a year (or more, if we recommend it) dental visits for thorough cleanings and checkups. Keeping its supporting tissues disease-free will boost your implant’s chances for a long and useful life.
If you would like more information on caring for your 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 “Gum Disease can Cause Dental Implant Failure.”