Posts for: December, 2020
Dental implants are a reliable way to replace teeth. More than 95% of implants survive ten years after their installation, and many of these could conceivably continue for decades.
But that still leaves a tiny few that don't reach the ten-year mark. Some fail early because the implant didn't integrate fully with the bone to create a durable hold. But others fail later—usually for one of two major causes.
Some failures occur due to over-stressing of the implant from abnormally high biting forces, usually because of teeth grinding. People who have this involuntary habit generate excessive force as they grind their teeth, which can damage implants (as well as natural teeth). To reduce this force, a patient's dentist can fit them with a biteguard they wear in the mouth to prevent teeth from making solid contact with each other during a grinding episode.
Fortunately, teeth grinding isn't that prevalent among adults—but that can't be said about the other major cause for implant failure: periodontal (gum) disease. This is a bacterial infection caused by dental plaque, a thin, bacterial film that accumulates on teeth. The implant itself isn't affected by the infection, but the gums and underlying bone supporting the implant can be.
Implants are most in peril from a form of gum disease called Peri-implantitis, which spreads deeper into the gum tissues around implants faster than infections around natural teeth. That's because implants lack the gum attachment of real teeth, which supply a collagen barrier that slows the spread of infection. Peri-implantitis can quickly infect the supporting bone and eventually weaken its connection with the implant.
Because of its aggressiveness and speed, we must diagnose and treat peri-implantitis as soon as possible to limit any damage to the support structures around an implant. If you notice any swollen, reddened or bleeding gums, you should call your dentist as soon as possible for an examination.
And in light of this potential danger to your implants, you should also strive to prevent gum disease through daily oral hygiene. Brushing and flossing your teeth, including around your implants, removes harmful plaque buildup. This daily habit and regular dental cleanings will help you avoid a costly gum infection and ensure your implants are there 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: A Tooth-Replacement Method That Rarely Fails.”
If we were playing word association with the term “oral hygiene,” you'd probably answer “brushing.” And you would be right—brushing cleans tooth surfaces of accumulated bacterial plaque, a thin biofilm most responsible for dental disease.
But brushing is only half of the oral hygiene equation: You also need to remove dental plaque between teeth where brushing can't reach. And, that requires that other practice—flossing.
Unfortunately, brushing is more popular than its hygienic sibling because many people find traditional thread flossing more difficult and messier than brushing. That can make it tempting to skip flossing—but then you're only getting half the benefit of oral hygiene for reducing the risk of tooth decay or gum disease.
There is, however, a way to floss that doesn't involve a roll of thread: oral irrigation. This form of flossing uses a countertop device that directs a pressurized spray of water between teeth through a handheld wand. The directed spray loosens and then flushes away accumulated plaque.
Oral irrigators (also known as water flossers) have been an important tool for decades in dental offices, and have been available for home use since the 1960s. In the last few years, though, the devices have become more compact and easier to use. More importantly, studies have shown they're as effective in removing between-teeth plaque as regular flossing.
These irrigation devices are especially useful for people wearing braces. The attached brackets and wires make it extremely difficult to maneuver flossing thread between teeth. Because of this (as well as similar difficulties in brushing), patients are more susceptible to dental disease while undergoing orthodontic treatment.
But a 2008 study showed that oral irrigators are quite effective for braces wearers in removing between-teeth plaque. It found those who used an irrigator after brushing removed five times the amount of plaque than those that only brushed.
Even if you're not wearing braces, you may still find an oral irrigator to be a useful flossing alternative. Speak with your dentist for recommendations on what to look for in an oral irrigator and tips on how to use it. It could make a positive difference in your dental health.
If you would like more information on how best to keep your teeth and gums clean, 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 “Cleaning Between Your Teeth.”
Dental patients have amazing options for tooth replacement. Dental implants, for example, can replace the entire tooth, root and crown, giving patients a new tooth nearly as good as the old one.
Nearly—but not exact. Even implants can't match the full benefits of a natural tooth, including one in less than perfect shape. Our first goal as dentists, then, is to save a diseased tooth if at all practical before considering replacing it.
That often involves a root canal treatment to address decay threatening a tooth's interior. The procedure requires drilling into the tooth to access its innermost pulp, cleaning out the pulp and root canals, and then filling the empty spaces. Since all dentists are trained in basic root canal treatment, your general dentist may be able to perform it.
But some dental situations call for more advanced endodontics, the dental specialty for treating disease and other problems inside a tooth. So, in what situations would you see an endodontist?
When your dentist refers you. Your dentist wants you to receive the level of treatment necessary to save your tooth. After examination, they may determine your situation would be better served by the advanced training, equipment and techniques (including surgery) of an endodontist.
When your tooth has complications. Patients often need an endodontist when existing factors complicate treatment of advanced tooth decay. A patient may have dental pain that's difficult to pinpoint, requiring the diagnostic resources of an endodontist. It's also common for a tooth's root canal network to be highly intricate, and which respond better to treatment with specialized endodontic tools and techniques.
When root canal treatment fails. Most root canal treatments are successful in protecting the tooth from further infection. That said, it's still possible for a root-canaled tooth to become re-infected or develop more problems. Again, an endodontist and their “tool chest“ re-treating a root-canaled tooth may be the best option for saving it.
You also don't have to wait for a referral—you can see an endodontist if you believe they would be best to treat your decayed tooth. You can find one near you by visiting an online endodontist directory at www.aae.org/find. An endodontist may be the lifesaver your diseased tooth needs.