Let’s say you’re traveling to Italy to surprise your girlfriend, who is competing in an alpine ski race… and when you lower the scarf that’s covering your face, you reveal to the assembled paparazzi that one of your front teeth is missing. What will you do about this dental dilemma?
Sound far-fetched? It recently happened to one of the most recognized figures in sports — Tiger Woods. There’s still some uncertainty about exactly how this tooth was taken out: Was it a collision with a cameraman, as Woods’ agent reported… or did Woods already have some problems with the tooth, as others have speculated? We still don’t know for sure, but the big question is: What happens next?
Fortunately, contemporary dentistry offers several good solutions for the problem of missing teeth. Which one is best? It depends on each individual’s particular situation.
Let’s say that the visible part of the tooth (the crown) has been damaged by a dental trauma (such as a collision or a blow to the face), but the tooth still has healthy roots. In this case, it’s often possible to keep the roots and replace the tooth above the gum line with a crown restoration (also called a cap). Crowns are generally made to order in a dental lab, and are placed on a prepared tooth in a procedure that requires two office visits: one to prepare the tooth for restoration and to make a model of the mouth and the second to place the custom-manufactured crown and complete the restoration. However, in some cases, crowns can be made on special machinery right in the dental office, and placed during the same visit.
But what happens if the root isn’t viable — for example, if the tooth is deeply fractured, or completely knocked out and unable to be successfully re-implanted?
In that case, a dental implant is probably the best option for tooth replacement. An implant consists of a screw-like post of titanium metal that is inserted into the jawbone during a minor surgical procedure. Titanium has a unique property: It can fuse with living bone tissue, allowing it to act as a secure anchor for the replacement tooth system. The crown of the implant is similar to the one mentioned above, except that it’s made to attach to the titanium implant instead of the natural tooth.
Dental implants look, function and “feel” just like natural teeth — and with proper care, they can last a lifetime. Although they may be initially expensive, their quality and longevity makes them a good value over the long term. A less-costly alternative is traditional bridgework — but this method requires some dental work on the adjacent, healthy teeth; plus, it isn’t expected to last as long as an implant, and it may make the teeth more prone to problems down the road.
What will the acclaimed golfer do? No doubt Tiger’s dentist will help him make the right tooth-replacement decision.
If you have a gap in your grin — whatever the cause — contact us or schedule an appointment for a consultation, and find out which tooth-replacement system is right for you. You can learn more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Crowns & Bridgework.”
Dental implants are considered the best tooth replacement option available. An implant replaces the root of a tooth and allows for the replacement of the crown via attachments or abutments. They not only look like a real tooth, they function like one too.
Implants, though, for some are a significant investment and may be well beyond a person's financial means if they've experienced a sudden tooth loss. For that reason, many opt for a less expensive tooth replacement option like a removable partial denture.
Later when they can afford it, a person might consider an implant. But this could pose a complication. When a tooth is missing for some time, the underlying bone doesn't rejuvenate normally because it no longer receives stimulation from the tooth. Over time, the amount of bone may diminish. Restorations like dentures can't stop this bone loss and actually aggravates it.
For proper positioning, an implant requires a certain amount of bone volume. So, it's quite possible when the time comes to replace the old restoration with an implant that there may not be enough bone available.
We may be able to overcome this bone loss with bone grafting and regeneration. A specialist such as a periodontist or oral surgeon accesses the area surgically and inserts bone graft material, usually processed material that's completely safe. Properly placed, the bone graft serves as a scaffold that, along with growth stimulators, encourages bone cells to grow.
When the bone grafting has healed enough, we're then able to place the implant. Once imbedded in the bone, one of the implant's unique qualities comes into play. The imbedded post is made of the metal titanium, which is not only bio-compatible with body tissues, it also has an affinity with bone. Bone cells will easily grow and adhere to the implant surface. This further boosts bone growth in the area and strengthens the implant's hold.
These extra procedures to build back lost bone do add to the cost and time for installing an implant. But if you're ready for a more permanent restoration for a missing tooth — not to mention better bone health — the extra time and money will be well worth it.
When is the best time to floss your teeth: Morning? Bedtime? How about: whenever and wherever the moment feels right?
For Cam Newton, award-winning NFL quarterback for the Carolina Panthers, the answer is clearly the latter. During the third quarter of the 2016 season-opener between his team and the Denver Broncos, TV cameras focused on Newton as he sat on the bench. The 2015 MVP was clearly seen stretching a string of dental floss between his index fingers and taking care of some dental hygiene business… and thereby creating a minor storm on the internet.
Inappropriate? We don't think so. As dentists, we're always happy when someone comes along to remind people how important it is to floss. And when that person has a million-dollar smile like Cam Newton's — so much the better.
Of course, there has been a lot of discussion lately about flossing. News outlets have gleefully reported that there's a lack of hard evidence at present to show that flossing is effective. But we would like to point out that, as the saying goes, “Absence of evidence is not evidence of absence.” There are a number of reasons why health care organizations like the American Dental Association (ADA) still firmly recommend daily flossing. Here are a few:
- It's well established that when plaque is allowed to build up on teeth, tooth decay and gum disease are bound to follow.
- A tooth brush does a good job of cleaning most tooth surfaces, but it can't reach into spaces between teeth.
- Cleaning between teeth (interdental cleaning) has been shown to remove plaque and food debris from these hard-to-reach spaces.
- Dental floss isn't the only method for interdental cleaning… but it is recognized by dentists as the best way, and is an excellent method for doing this at home — or anywhere else!
Whether you use dental floss or another type of interdental cleaner is up to you. But the ADA stands by its recommendations for maintaining good oral health: Brush twice a day for two minutes with fluoride toothpaste; visit your dentist regularly for professional cleanings and checkups; and clean between teeth once a day with an interdental cleaner like floss. It doesn't matter if you do it in your own home, or on the sidelines of an NFL game… as long as you do it!
What's so special about dental implants — and why should you consider one to replace a missing tooth?
Although they've only been widely available for thirty years, dental implants have climbed to the top of tooth replacement choices as the premier restorative option. Since their debut in the 1980s, dentists have placed over 3 million implants.
There's one overriding reason for this popularity: in structure and form, dental implants are the closest replacement we have to a natural tooth. In fact, more than anything else an implant is a root replacement, the part of the tooth you don't see.
The artificial root is a titanium post surgically imbedded into the jaw bone. Later we can attach a porcelain crown to it that looks just like a visible tooth. This breakthrough design enables implants to handle the normal biting forces generated in the mouth for many years.
There's also an advantage in using titanium dental implants. Because bone cells have a special affinity to the metal, they will grow and attach to the implant over time. Not only does this strengthen the implant's hold within the jaw, the added growth also helps deter bone loss, a common problem with missing teeth.
It's this blend of strength and durability that gives implants the highest success rate for any tooth replacement option. Over 95% of implants placed attain the 10-year mark, and most will last for decades.
Dental implant treatment, however, may not be possible in every situation, particularly where significant bone loss has occurred. They're also relatively expensive, although more cost-effective than other options over the long term.
Even so, implants can play an effective and varied role in a dental restoration. While single implants with attached crowns are the most common type of replacement, they can also play a supporting role with other restorative options. As few as two strategically placed implants can provide a more secure connection for removable dentures or fixed bridges.
You'll need to first undergo a thorough dental examination to see if implants could work for you. From there, we'll be happy to discuss your options for using this "best of the best" restoration to achieve a new, beautiful smile.
If you would like more information on 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 “Dental Implants 101.”
Magician Michael Grandinetti mystifies and astonishes audiences with his sleight of hand and mastery of illusion. But when he initially steps onto the stage, it’s his smile that grabs the attention. “The first thing… that an audience notices is your smile; it’s what really connects you as a person to them,” Michael told an interviewer.
He attributes his audience-pleasing smile to several years of orthodontic treatment as a teenager to straighten misaligned teeth, plus a lifetime of good oral care. “I’m so thankful that I did it,” he said about wearing orthodontic braces. “It was so beneficial. And… looking at the path I’ve chosen, it was life-changing.”
Orthodontics — the dental subspecialty focused on treating malocclusions (literally “bad bites”) — can indeed make life-changing improvements. Properly positioned teeth are integral to the aesthetics of any smile, and a smile that’s pleasing to look at boosts confidence and self-esteem and makes a terrific first impression. Studies have even linked having an attractive smile with greater professional success.
There can also be functional benefits such as improved biting/chewing and speech, and reduced strain on jaw muscles and joints. Additionally, well-aligned teeth are easier to clean and less likely to trap food particles that can lead to decay.
The Science Behind the Magic
There are more options than ever for correcting bites, but all capitalize on the fact that teeth are suspended in individual jawbone sockets by elastic periodontal ligaments that enable them to move. Orthodontic appliances (commonly called braces or clear aligners) place light, controlled forces on teeth in a calculated fashion to move them into their new desired alignment.
The “gold standard” in orthodontic treatment remains the orthodontic band for posterior (back) teeth and the bonded bracket for front teeth. Thin, flexible wires threaded through the brackets create the light forces needed for repositioning. Traditionally the brackets have been made of metal, but for those concerned about the aesthetics, they can also be made out of a clear material. Lingual braces, which are bonded to the back of teeth instead of the front, are another less visible option. The most discrete appliance is the removable clear aligner, which consists of a progression of custom-made clear trays that reposition teeth incrementally.
How’s that for a disappearing act?!
If you would like more information about orthodontic treatment please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine article “The Magic of Orthodontics.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.