Losing a tooth can be traumatic, but a dental implant can dramatically turn that experience around. Providing functionality, life-like appearance and durability, implants stand out as the premier restoration for lost teeth.
For adults, that is. An older child or teenager with a missing tooth may need to wait a few more years for an implant. The reason: jaw development. A person's jaws, particular the upper jaw, continue to grow with most growth completed by early adulthood. Natural teeth with their periodontal attachments develop right alongside the jaw.
But because an implant attaches directly to the jawbone, its position is fixed: it won't change as the jaw grows and may gradually appear to sink below the gum line. That's why we wait to place an implant until most of jaw maturity has occurred after full jaw maturity. For females, we try to wait until 20 years of age and for males, usually 21 years of age. These are guidelines as some people mature faster and some slower, so a discussion with your dentist or surgeon is necessary to make an educated decision.
While we wait, we can install a temporary replacement for a child's or teenager's lost tooth, usually a partial denture or fixed modified ("Maryland") bridge. The latter affixes a prosthetic (false) tooth in the missing tooth space by attaching it to the back of natural teeth on either side with bonded dental material. It differs from a traditional bridge in that these supporting teeth aren't permanently altered and crowned to support the bridge.
During the time before implants we should understand that the area where the implant will be placed will undergo some bone deterioration, a common consequence of missing teeth. Forces generated as we chew travel through the teeth to stimulate renewing bone growth all along the jawbone. But with a lost tooth the chewing stimulation ceases at that part of the bone, slowing the growth rate and leading to gradual bone loss.
Fortunately, the titanium posts of dental implants stimulate bone growth as bone cells naturally grow and adhere to their surfaces. Before then, though, if the bone volume is diminished, we may need to graft bone material to stimulate bone growth that will enlarge the jaw bone enough for an implant to be placed.
It usually isn't a question of "if" but "when" we can provide your child with an implant for their missing tooth. In the meantime, we can prepare for that day with a temporary restoration.
If you would like more information on dental restorations for teenagers, 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 for Teenagers.”
Your teeth’s hard, enamel coating protects them from environmental dangers or disease. But although it’s made of the hardest substance in the human body, enamel isn’t invincible — prolonged exposure to acid can cause dental erosion, a condition in which the enamel’s mineral content permanently dissolves, a process known as de-mineralization.
De-mineralization occurs anytime our mouth environment becomes too acidic due to eating or drinking items with high acid content. Saliva normally neutralizes mouth acid in thirty minutes to an hour after we eat, as well as restores mineral content to the enamel (re-mineralization). Danger arises, though, if the saliva’s buffering action is overwhelmed by chronic acidity, caused mainly by constant snacking or sipping on acidic foods and beverages throughout the day — in this situation, saliva can’t complete the process of buffering and re-mineralization.
As a result, the enamel may permanently lose its mineral content and strength over time. This permanent dental erosion leads to serious consequences: the teeth become more susceptible to decay; the dentin becomes exposed, which causes pain and sensitivity to pressure and temperature changes; and changes in the teeth’s size and color can negatively alter your appearance.
It’s important to take action then before dental erosion occurs. Along with daily oral hygiene, restrict your consumption of acidic foods and beverages to meal times and cut back on between-meal snacks. Rather than a sports drink after exercising, drink nature’s hydrator — water. You should also alter your brushing habits slightly — rather than brush right after you eat, wait thirty minutes to an hour. This gives saliva time to restore the mouth to its normal pH and re-mineralize the enamel. Brushing right after can remove even more of the minerals in softened enamel.
If significant erosion has occurred, there are a number of treatment options we can undertake to preserve remaining tooth structure and enhance your appearance. In moderate cases, we can reshape and cover damaged teeth using dental materials like composite resins or porcelain to fill decayed areas or cover teeth with veneers or crowns.
The key of course, is to identify dental erosion through clinical examination as soon as possible to minimize damage. Your enamel plays a critical role in protecting your teeth from disease — so take the right steps to protect your enamel.
If you would like more information on protecting your enamel, 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 Erosion.”
In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.
When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”
Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.
There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.
By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.
So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.
If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.
Your regular dental checkups should periodically include an important screening for oral cancer, especially as you grow older. Although oral cancers make up less than 3% of all other types, they’re among the most deadly with a 58% survival rate after five years.
Besides hereditary factors, oral cancer is strongly linked to tobacco use, alcohol abuse or diets low in fresh fruits and vegetables. It’s also a greater concern as we age: 90% of new cases of oral cancer occur in people over the age of 40, heightening the need for regular screenings. These screenings become all the more important because many early sores or lesions can mimic other conditions like canker sores — without early detection, the disease could already be in advanced stages when it’s diagnosed.
An oral screening for cancer involves both sight and touch. We’ll first look for any suspicious lesions and red or white patches in the soft tissues of the face, neck, lips and mouth. We’ll then feel for any abnormal lumps on the mouth floor, the sides of the neck and in gland locations. We’ll also examine all sides of the tongue including underneath, as well as the tissues lining the back of your throat.
If we notice anything that’s concerning we may then perform a biopsy by removing a small bit of the suspicious tissue and have it examined microscopically for the presence of cancer cells. We may also remove any lesions deemed pre-cancerous as an added precaution against possible cancer development.
The American Cancer Society recommends an oral cancer screening annually for people forty years or older and every three years for people between the ages of 20 and 39. Even better, we recommend all adults undergo a screening every year. This, along with ending tobacco use and other lifestyle and dietary changes, will greatly improve your chances of remaining free of oral cancer.
If you would like more information on detecting and treating oral cancer, 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 Cancer.”
You’ve probably heard a lot about dental implants as replacements for missing teeth. So, why are they so popular with both patients and dentists? While other restorations can mimic the color, shape and texture of natural teeth, dental implants have one clear advantage — and it’s all about the bone.
The bone in your jaws provides stability and structure for teeth — without it and the intricate system of gum tissue attachments teeth couldn’t survive the normal biting and chewing forces they encounter every day. That’s why bone health is crucial for maintaining tooth integrity.
Teeth also help bone to remain strong and healthy. The forces we generate as we chew transmit through the tooth roots to the bone, which stimulates continuing growth. If a tooth is missing, however, the bone around it doesn’t receive this stimulation and may begin to lose some of its volume and density — up to a quarter of its width in just the first year after tooth loss.
This bone loss continues even with other restorations because they’re not able to stimulate bone growth. But dental implants can. This is because the portion of the implant imbedded into the bone is constructed most often of titanium, which has a natural affinity toward bone. Bone cells are naturally attracted to titanium and will begin to grow and attach to the metal surface, a process known as osseointegration.
Through osseointegration, the implant develops a durable bond with the jawbone a few weeks after surgery that surpasses other restorations, and is a prime reason for their success rate. Although installing implants can be an expensive undertaking, their proven longevity may result in less maintenance, repair or replacement costs over time than other replacement options.
If you’re considering dental implants, remember it’s what you can’t see beneath the attractive crown that makes them special. And it’s a choice you can depend on to provide you a beautiful smile for years to come.
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.”
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