Posts for: April, 2021
Introduced to the United States in the 1980s, dental implants have quickly become the go-to restoration for tooth replacement. And for good reason: they're not only incredibly life-like, they're highly durable with a 95% success rate.
But as desirable as they are, you may face a major obstacle getting one because of the condition of the bone at your implant site. To position the implant for best appearance and long-term durability, we must have at least 4-5 mm of bone available along the horizontal dimension. Unfortunately, that's not always the case with tooth loss.
This is because bone, like other living tissue, has a growth cycle: Older cells die and dissolve (resorb) and newer cells develop in their place. The forces transmitted to the jaw from the action of chewing help stimulate this resorption and replacement cycle and keep it on track. When a tooth is lost, however, so is this stimulus.
This may result in a slowdown in cell replacement, causing the eventual loss of bone. And it doesn't take long for it to occur after tooth loss—you could lose a quarter of bone width in just the first year, leaving you without enough bone to support an implant. In some cases, it may be necessary to choose another kind of restoration other than implants.
But inadequate bone isn't an automatic disqualifier for implants. It's often possible to regenerate lost bone through a procedure known as bone augmentation, in which we insert a bone graft at the missing tooth site. The graft serves as a scaffold for new bone cells to grow upon, which over time may regenerate enough bone to support an implant.
Even if you've had a missing tooth for some time, implementing bone augmentation could reverse any loss you may have experienced. In fact, it's a common practice among dentists to place a bone graft immediately after a tooth extraction to minimize bone loss, especially if there will be a time lag between extraction and implant surgery.
Bone augmentation could add extra time to the implant process. But if successful, it will make it possible for you to enjoy this popular dental restoration.
If you would like more information on dental implant restoration, 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 After Previous Tooth Loss.”
Osteoporosis is a serious bone weakening disease in older adults that can turn a minor fall into a major bone fracture. But the condition could also impact dental treatment—triggered ironically by the drugs used to treat osteoporosis rather than the disease itself.
From the Latin for “porous bone,” osteoporosis causes bone to gradually lose mineral structure. Over time the naturally-occurring spaces between mineralized portions of the bone enlarge, leaving it weaker as a result.
Although there's no definitive cure for osteoporosis, a number of drugs developed over the last couple of decades can inhibit its progress. Most fall into two major categories, bisphosphonates and RANKL inhibitors.
These drugs work by inhibiting the normal growth cycle of bone. Living bone constantly changes as cells called osteoblasts produce new bone. A different type, osteoclasts, clear away older bone to make room for these newer cells. The drugs selectively destroy osteoclasts so that the older bone, which would have been removed by them, remains for a longer period of time.
Retaining older cells longer initially slows the disease process. But there is a downside: in time, this older bone kept in place continues to weaken and lose vitality. In rare instances it may eventually become detached from its blood supply and die, resulting in what is known as osteonecrosis.
Osteonecrosis mostly affects two particular bones in the body: the femur (the long bone in the upper leg) and the jawbone. In regard to the latter, even the stress of chewing could cause osteonecrosis in someone being treated for osteoporosis. It can also occur after tooth extractions or similar invasive procedures.
If you're taking a bisphosphonate or RANKL inhibitor, you'll want to inform your dentist so that the necessary precautions can be taken before undergoing dental work more invasive than routine cleanings or getting a filling or crown. If you need major dental work, your dentist or you will also need to speak with your physician about stopping the drug for a few months before and after a dental procedure to minimize the risk of osteonecrosis.
Fortunately, the risk for dental problems while undergoing treatment for osteoporosis is fairly low. Still, you'll want to be as prepared as possible so that the management of your osteoporosis doesn't harm your dental health.
If you would like more information on osteoporosis and dental health, 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 “Osteoporosis Drugs & Dental Treatment.”
Performing for an awards show is a quite a feather in an entertainer's cap. So, up-and-coming country music star Carly Pearce was obviously excited when she gained a slot on last November's Country Music Awards. But an accident a couple of weeks before the event almost derailed her opportunity when she fell and knocked out two of her front teeth.
Fortunately, Pearce took quick action and, thanks to a skilled dental and medical team, was able to put her mouth back together before the show. Those watching her perform her hit single, “I Hope You're Happy Now,” as she smiled broadly would never have known otherwise about her traumatic emergency if she hadn't spilled the beans.
Orofacial injuries can happen to anyone, not just entertainers. You or someone you love could face such an injury from a motor vehicle accident, hard sports contact or, like Pearce, a simple slip and fall. But if you also act quickly like Pearce, you may be able to minimize the injury's long-term impact on dental health and appearance.
Here are some guidelines if you suffer a dental injury:
Collect any tooth fragments. Dental injuries can result in parts of teeth—or even a whole tooth—coming out of the mouth. It may be possible, though, to use those fragments to repair the tooth. Try to retrieve and save what you can, and after rinsing off any debris with cold water, place the fragments in a container with milk.
Re-insert a knocked-out tooth. You can often save a knocked-out tooth by putting it back in its socket as soon as possible. After cleaning off any debris, hold the tooth by its crown (never the root) and place it back in the empty socket. Don't fret over getting it in perfectly—your dentist will assist its placement later. Place a piece of clean cloth or cotton over the tooth and have the injured person bite down gently but firmly to hold it in place.
See the dentist ASAP. You should immediately see a dentist if any tooth structure has been damaged, or if a tooth is loose or has been moved out of place. If you're not sure, call your dentist to see if you should come on in or if you can wait. If a dentist is not available, go immediately to an emergency room or clinic. With many dental injuries, the longer you wait, the more likely the teeth involved won't survive long-term.
A dental injury could happen in a flash, with consequences that last a lifetime. But if, like Carly Pearce, you take prompt action and obtain necessary dental care, you could save an injured tooth—and the smile that goes with it.