Posts for category: Dental Procedures
If you know anyone with a dental implant, you may know it can be a long process in getting one. Several weeks or months can pass between removing the old tooth and placing the implant, and then several more weeks before affixing the permanent crown.
But with recent advances in implant technology, some patients don't have to wait as long for a new implant and crown. In fact, one procedure commonly known as "tooth in one day," allows patients to walk in with a problem tooth and out the same day with a new "one."
Not every implant patient, however, can undergo this accelerated procedure. If you're considering implants, the state of your bone health will determine whether or not you can.
Implants need a certain amount of available bone for proper placement. But bone loss, a common consequence of missing teeth or dental disease, can reduce bone volume to less than what's needed to place an implant. The patient may first need to undergo grafting to regenerate the bone or choose another restorative option.
If your supporting bone is sound, your dentist might then proceed with the implant. But you will still have to wait a while for your new crown. The implant needs to integrate with the bone to improve its hold. This integration process can take anywhere from a minimum of six weeks to more commonly twelve weeks. After the attachment is mature, the dentist may need to undo the gum covering before taking impressions for the formation of the new crown.
But it is possible to have a tooth or teeth in a day. For a single tooth, your dentist may be able to immediately attach a crown right after implant surgery if the implant is very stable. Even so, this crown will need to be temporary, slightly shorter than a permanent crown so that it won't make contact with other teeth and put too much pressure on the new implant. After further healing from bone integration, impressions will be taken so that you'll receive your permanent crown shortly.
Immediate crown placement can allow you to have the cosmetic and limited functional benefit of a new tooth right from the start. If multiple implants are placed in one arch in a day, it's possible to have immediate teeth if enough implants are attached together with a temporary restoration.
This is different from a single implant replacing a single tooth and does create confusion for patients when they read about teeth in a day. Regardless, no final tooth crown can be placed at the time of an implant—only a temporary restoration.
If you would like more information on your options for 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 “Same-Day Tooth Replacement with Dental Implants.”
Sometimes it seems that appearances count for everything—especially in Hollywood. But just recently, Lonnie Chaviz, the 10-year-old actor who plays young Randall on the hit TV show This Is Us, delivered a powerful message about accepting differences in body image. And the whole issue was triggered by negative social media comments about his smile.
Lonnie has a noticeable diastema—that is, a gap between his two front teeth; this condition is commonly seen in children, but is less common in adults. There are plenty of celebrities who aren’t bothered by the excess space between their front teeth, such as Michael Strahan, Lauren Hutton and Vanessa Paradis. However, there are also many people who choose to close the gap for cosmetic or functional reasons.
Unfortunately, Lonnie had been on the receiving end of unkind comments about the appearance of his smile. But instead of getting angry, the young actor posted a thoughtful reply via Instagram video, in which he said: “I could get my gap fixed. Braces can fix this, but like, can you fix your heart, though?”
Lonnie is raising an important point: Making fun of how someone looks shows a terrible lack of compassion. Besides, each person’s smile is uniquely their own, and getting it “fixed” is a matter of personal choice. It’s true that in most circumstances, if the gap between the front teeth doesn’t shrink as you age and you decide you want to close it, orthodontic appliances like braces can do the job. Sometimes, a too-big gap can make it more difficult to eat and to pronounce some words. In other situations, it’s simply a question of aesthetics—some like it; others would prefer to live without it.
There’s a flip side to this issue as well. When teeth need to be replaced, many people opt to have their smile restored just the way it was, rather than in some “ideal” manner. That could mean that their dentures are specially fabricated with a space between the front teeth, or the crowns of their dental implants are spaced farther apart than they normally would be. For these folks, the “imperfection” is so much a part of their unique identity that changing it just seems wrong.
So if you’re satisfied with the way your smile looks, all you need to do is keep up with daily brushing and flossing, and come in for regular checkups and cleanings to keep it healthy and bright. If you’re unsatisfied, ask us how we could help make it better. And if you need tooth replacement, be sure to talk to us about all of your options—teeth that are regular and “Hollywood white;” teeth that are natural-looking, with minor variations in color and spacing; and teeth that look just like the smile you’ve always had.
Because when it comes to your smile, we couldn’t agree more with what Lonnie Chaviz said at the end of his video: “Be who you want to be. Do what you want to do. Do you. Be you. Believe in yourself.”
If you have questions about cosmetic dentistry, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Magic of Orthodontics.”
The “magic” behind a dental implant’s durability is the special affinity its imbedded titanium post has with bone. Over time bone grows and attaches to the titanium surface to produce a strong and secure hold.
But there’s one important prerequisite for ultimate implant success—there must be an adequate amount of bone available initially to properly position the post during implantation. Otherwise, the implant may not have enough support to position it properly or cover the implant surface completely with bone.
Inadequate bone can be a problem for patients who lost teeth some time before and now desire to an implant restoration. This happens because when teeth are missing, so are the forces they generate during chewing. These forces stimulate new bone growth around the tooth root to replace older, dissolved bone at a healthy rate. If that replacement rate is too slow, the volume and density of bone may gradually diminish.
There is a way, though, to build up the bone for future implantation. Known as bone preservation procedure or a ridge augmentation, it’s a surgical procedure in which the dentist adds bone grafting material to the extraction socket or the bony ridge. The graft serves as a scaffold for new bone cells to grow and multiply. If successful, there will be enough new bone volume after several months of healing to support proper implant placement.
Bone grafting can add more time to the implant process. It may also mean you will not be able to undergo immediate crown placement after implantation (a “tooth in one day” procedure). Instead we would probably suture gum tissue over the implant to protect it and allow for full integration with the bone over a few more months. In the meantime, though, we could fit you with a temporary restoration like a removable partial denture (RPD) or a bonded bridge to improve the appearance of the space while the bone continues to heal.
After several months, your implant will have a better chance of a secure hold and we can then attach a life-like crown. Even if you’ve suffered bone loss, you’ll then have the benefit of not only a durable implant but also a new smile.
The movie Bohemian Rhapsody celebrates the iconic rock band Queen and its legendary lead vocalist, Freddie Mercury. But when we see pictures of the flamboyant singer, many fans both old and new may wonder—what made Freddie’s toothy smile look the way it did? Here’s the answer: The singer was born with four extra teeth at the back of his mouth, which caused his front teeth to be pushed forward, giving him a noticeable overbite.
The presence of extra teeth—more than 20 primary (baby) teeth or 32 adult teeth—is a relatively rare condition called hyperdontia. Sometimes this condition causes no trouble, and an extra tooth (or two) isn’t even recognized until the person has an oral examination. In other situations, hyperdontia can create problems in the mouth such as crowding, malocclusion (bad bite) and periodontal disease. That’s when treatment may be recommended.
Exactly what kind of treatment is needed? There’s a different answer for each individual, but in many cases the problem can be successfully resolved with tooth extraction (removal) and orthodontic treatment (such as braces). Some people may be concerned about having teeth removed, whether it’s for this problem or another issue. But in skilled hands, this procedure is routine and relatively painless.
Teeth aren’t set rigidly in the jawbone like posts in cement—they are actually held in place dynamically by a fibrous membrane called the periodontal ligament. With careful manipulation of the tooth, these fibers can be dislodged and the tooth can be easily extracted. Of course, you won’t feel this happening because extraction is done under anesthesia (often via a numbing shot). In addition, you may be given a sedative or anti-anxiety medication to help you relax during the procedure.
After extraction, some bone grafting material may be placed in the tooth socket and gauze may be applied to control bleeding; sutures (stitches) are sometimes used as well. You’ll receive instructions on medication and post-extraction care before you go home. While you will probably feel discomfort in the area right after the procedure, in a week or so the healing process will be well underway.
Sometimes, dental problems like hyperdontia need immediate treatment because they can negatively affect your overall health; at other times, the issue may be mainly cosmetic. Freddie Mercury declined treatment because he was afraid dental work might interfere with his vocal range. But the decision to change the way your smile looks is up to you; after an examination, we can help you determine what treatment options are appropriate for your own situation.
If you have questions about tooth extraction or orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Simple Tooth Extraction” and “The Magic of Orthodontics.”
For most dental procedures you’re usually back to your regular routine in no more than a day or two (or even hours) afterward. For the most part, the mouth heals rather quickly.
But there may still be a short period of discomfort after tooth extraction, gum surgery or similar invasive procedures. The good news is you will most likely have no need for strong narcotic painkillers — milder, over-the-counter pain relievers are usually sufficient to manage your discomfort.
The most common of these are known as non-steroidal anti-inflammatory drugs (NSAIDs). This group of pain relievers — which include aspirin and ibuprofen — block the release of substances in the body known as prostaglandins that stimulate inflammation that increases pain in damaged tissues. They’re much preferred for mild to moderate pain because they don’t have the side effects of steroids or narcotics like morphine or codeine. They also tend to be less costly than these other prescription drugs.
But while they’re reasonably safe, they can cause problems if you exceed the recommended dosage or use them for prolonged periods. Their blockage of certain chemicals reduces the clotting mechanism in blood leading to a blood-thinning effect. Not only will this increase bleeding, it can also damage the stomach lining and cause ulcers if used over a period of weeks. Improper dosage of NSAIDs has also been linked to miscarriages and repeat heart attacks, which is why they’re not recommended for use during pregnancy or with patients with a history of heart or intestinal problems.
But if taken as directed by your physician or dentist — usually no more than 2,400 milligrams a day and only for a few days — such side effects are quite rare. The benefit is much more common: about five hours of pain relief from a single dose for most people. With the help of ibuprofen or similar drugs, you’ll be on your feet after your dental work in no time.Â
If you would like more information on managing pain after a procedure, 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 “Treating Pain with Ibuprofen.”