DENTAL IMPLANTS 101

The top reasons patients in my practice opt for dental implants are:  to replace one or more teeth, to provide support for a partial denture, to increase stability of full upper or lower denture, to enhance chewing comfort, to increase confidence while smiling, talking or eating, to improve their overall psychological health, and to improve their overall appearance.  All great reasons, right?

Dental implants are typically always successful.  Their success is related to the dentist’s skill, quality and quantity of the bone available at the site of the implantation, and the patient’s oral hygiene.  The average success rate is around 95%.                                                        

One of the most important factors that determine implant success is the achievement and maintenance of implant stability.  Other contributing factors to the success of dental implant placement, as with most surgical procedures, include the patient’s overall general health and compliance with post-surgical care.  Because a dental implant functions like a real tooth, they are much more natural than you would likely expect.  Each tooth in the mouth has a specific duty.  Losing just one tooth can seriously alter your bite and chewing ability.  When teeth are lost, the bone supporting these teeth melts away, which causes a shortening of the height of the face as time goes on.  Dentures do not solve any of these problems because they are removable.

Furthermore, since an implant is made out of a titanium alloy, it can't decay like a natural tooth.  NO MORE FILLINGS!!!  Many of you will say amen to that feature.  Also, implants don't contain any nerves, so there is not cold, hot or sweet sensitivity.  EVER!!!   All great benefits of this outstanding procedure.  The placement of the implant takes no more than an hour and is really non-traumatic.  Many of the dental "cowards" in our office have found this procedure to be no more than having a filling done.  The advancements in dentistry have been nothing less than awesome.  One of the best reasons for going ahead with dental implants is because they are permanent, while dentures can obviously be taken out.  So, not only do dental implants help improve your smile, they also help maintain the overall tone and muscles in your face, and help prevent your remaining teeth from shifting our of place.

FLOSSING

Brushing our teeth removes food particles, plaque and bacteria from all tooth surfaces, except in between teeth.  Unfortunately, our toothbrush can't reach these areas that are highly susceptible to decay and periodontal (gum) disease.

Daily flossing is the best way to clean between the teeth and under the gum line.  Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth and bone.  Plaque is a sticky, almost invisible film that forms on the teeth.  It is a growing colony of  living bacteria, food debris, and saliva.  These bacteria produce toxins (acids) that cause cavities and irritate and inflame the gums.  Also, when plaque is not removed above and below the gum line, it hardens and turns into calculus (tartar).  This will further irritate and inflame the gums and also slowly destroy the bone.  This is the beginning of periodontal disease.  Studies show that after removing plaque from your teeth using dental floss, it takes 24 hours for these bacteria to multiply to large enough numbers to cause teeth and gum damage.  Thus, flossing every 24-48 hours is a must.  Flossing once or twice a week won't cut it.

Many patients tell me their gums really hurt when they floss their teeth and stop flossing.  It's not the flossing that is causing the problem but NOT flossing.  By not flossing, your gums are becoming raw and ulcerated.  More frequent flossing toughens up the gums and removes the bacteria.  If you had an infection on your hand that was full of bacteria it would be painful.  Your gums are the same.

How to floss properly:

• Take 12-16 inches of dental floss and wrap it around your middle fingers, leaving about two inches of floss between the hands.
• Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
• Curve the floss into a "C" shape around each tooth and under the gum line.  Gently move the floss up and down, cleaning the side of each tooth.  Flossing not only helps clean these spaces, it is the best way to clean between the teeth and under the gum line.

TEETH WHITENING II

In Teeth Whitening I we discussed the anatomy of teeth, what causes staining and why teeth darken as we age.  In this blog we are going to discuss how whitening works, what the options are to whiten your teeth, and what really works best.  Whitening of teeth is accomplished using carbamide peroxide or hydrogen peroxide solutions.  These solutions work by oxidizing (bubbling and dehydrating) the stains and biological byproducts that collect on and in the tubules of your teeth.  Three major teeth whitening options are available today.  All three rely on various concentrations of peroxide and varying application times.  The first two options are monitored and dispensed by a dentist.

Option one is the professionally dispensed take-home kit with a custom tray that is fabricated from an impression of your mouth.  This provides great results because the peroxide gel stays inside the tray and continuously "bathes" and whitens the teeth without swallowing any of the peroxide solutions (not a good idea in my opinion).  The trays are worn for 30-40 minutes with hydrogen peroxide or all night using carbamide peroxide.  As I mentioned, how white your teeth get is determined by the strength of the whitening gel and the contact time of the gel on the tooth surface.  The trays are worn until the desired whiteness is achieved.  Studies have shown the average time is approximately 28 days.  After this time, it may only take one or two maintenance sessions throughout the year to pop the teeth back to their full whiteness.

The second method (also done in a dental office) is laser or light-activated whitening.  This involves placing higher concentrations of peroxide gel on the teeth under the direct supervision of a dentist.  Care is taken to isolate your teeth so no gel is swallowed or touches gum tissues.  This method is excellent for quick last minute whitening for occasions such as upcoming weddings, class reunions or special celebrations.  This method should be followed up with custom trays, described in method one, to keep the desired whiteness, as this method of whitening does fade away.

The final method involves utilizing store-bought whitening kits and strips.  This method features strips that are placed over your teeth.  Molded with your fingers, they get slimy and slide around on your teeth.  The second problem is that you are swallowing hydrogen peroxide, as there is no custom tray to contain the gel solution.  Some kits come with a one size fits all tray that you mold over your teeth like an athletic mouth guard, and you place the whitening gel inside.  Once again, without a well-fitting tray, the gel leaks out, (which you swallow), preventing the teeth from being bathed in the solution,

Furthermore, the allowed strength of whitening solutions for store-bought kits can be less than half that of dentist prescribed kits.  Once again, the strength of the whitening gel and its contact with teeth are the main variables that predict whitening outcomes.

TEETH WHITENING PART I

This is a highly talked about subject at Cazenovia Dental.  Everyone wants whiter teeth.  First of all, many of us start out with white teeth when we are young because our enamel has a glass-like unblemished glossy surface.  But with time, enamel wears down and becomes thinner from excessive brushing and acids in foods you eat.  This thinning permits the tooth's inner core structure called dentin (which is yellow in color) to show through the thin enamel.  This results in your teeth looking more yellow or grey as you age.

Furthermore, those who grind and gnash their teeth cause microscopic fractures in the enamel, destroying the once porcelain-like surface you were born with.  These fractures and microscopic cracks allow stains and debris to penetrate and quickly discolor it.

There are two types of stains that discolor teeth:  extrinsic stains and intrinsic stains.  Extrinsic staining is caused by eating habits that discolor teeth such as:  coffee, tea, deeply colored beverages, i.e. wine and purple grape juice.  Smoking also leaves brownish deposits that can soak into the teeth.  The good news is teeth whitening can remove these stains.

The intrinsic type of stain is much more difficult to whiten.  Intrinsic stains are derived from within the tooth and can be caused by drugs, such as tetracycline, prescribed when you are young or ingesting too much fluoride when your teeth are developing.

In Tooth Whitening Part II I will discuss the different types of whitening kits and the chemicals used in the whitening process.