Although costly in the beginning, dental implants often turn out to be the least expensive tooth replacement option. That's because their enviable record for longevity often outpaces dentures or bridges. Over the long-term you might spend less for implants than these other restorations.
But even with the high success rate of dental implants (greater than 95% survive the ten-year mark), we can't guarantee they won't fail. And if you're a tobacco smoker, the risk of failure might be even higher. One study, for example, found early implant failures were twice the rate for smokers over non-smokers. Although implant failures overall are low, smoking seems to be a factor in those that do.
There are a number of reasons to account for this. For one thing, inhaled smoke can damage salivary glands, reducing the flow of this important fluid. Saliva helps control bacterial growth and neutralize mouth acid, so without it you're more susceptible to tooth decay or periodontal (gum) disease. Either infection could ultimately weaken implant-supporting bone.
The nicotine in tobacco can also restrict oral blood vessels and lower their ability to supply antibodies and nutrients to the teeth and gums. This slows healing, which could have one particular effect on implant durability.
During the intervening weeks between implant placement and crown attachment, the implant's titanium post attracts bone cells that grow and adhere to its surface. The effects of nicotine on healing, especially right after implant surgery, can interfere with this integration process so that the implant doesn't anchor in the bone as well as it should.
If you're a smoker, you can increase your chances of implant success—and have a healthier mouth overall—by quitting smoking beforehand with the help of a cessation program. Or at the least, consider stopping smoking for one week before implant surgery and for two weeks afterward.
And be sure to brush and floss your teeth daily and visit your dentist regularly to keep your teeth and gums as healthy as possible. Stopping smoking and practicing effective oral hygiene could make a big difference in the success or failure of your implant.
If you would like more information on smoking and your 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 “Dental Implants & Smoking.”
During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.
Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.
For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.
When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.
But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.
Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.
So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…
If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”
Every year U.S. dentists perform around 25 million root canal treatments and save countless teeth from the ravages of decay. But if you search "root canal" on the Internet, you might encounter an unsettling charge against this tooth-saving treatment—that it causes cancer.
Root canal treatments are routinely used when tooth decay has infected the pulp, the innermost layer of a tooth. During the procedure, we access the pulp and remove all the infected tissue. We then fill the empty pulp and root canals, seal the access hole and later crown the tooth to prevent further infection. Without this intervention, the decay can continue to advance toward the roots and supporting bone, putting the tooth in imminent danger of loss.
So, is there any credibility to this claim that root canal treatments cause cancer? In a word, no: there's no evidence of any connection between root canal treatments and cancer—or any other disease for that matter. On the contrary: root canals stop disease.
As with other types of urban legends and internet hype, the root canal-cancer connection may have arisen from another discredited idea from the early 20th Century. A dentist named Weston Price promoted the notion that leaving a "dead" organ in the body led to health problems. From his perspective, a root canaled tooth with its removed pulp tissue fit this criterion.
In the mid-1950s, dentistry thoroughly examined Dr. Weston's theory pertaining to treatments like root canals. The Journal of the American Dental Association devoted an entire issue to it and found after rigorous scientific inquiry that the theory had no validity in this regard. Another study in 2013 confirmed those findings. In fact, the later study instead found that patients who underwent a root canal treatment had a 45 percent reduction in oral cancer risk.
Given the freewheeling nature of the Internet, it's best to speak with a dental professional about your oral health before trusting a post or article you've found online. Not only are they more informed than an unverified online source, they would certainly not knowingly subject you to a procedure to save a tooth at the expense of your health.
If you would like more information on root canal treatment, 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 “Root Canal Safety.”
If you have a few missing teeth but can't afford dental implants or fixed bridgework, consider a removal partial denture (RPD). Although implants may be the superior choice aesthetically and functionally, an RPD can still effectively give you back your teeth.
RPDs are designed to replace one or more missing teeth but not a full arch like a full denture. Considered a permanent restoration, RPDs are also more durable than transitional "flippers," denture appliances that are flexible and light enough to be flipped out of the mouth with a flick of the tongue.
The key to both their affordability and durability is vitallium, a strong but lightweight metal alloy most often used in their frame construction. To it we attach artificial teeth usually made of porcelain or glass-filled resins that occupy the precise location of the missing teeth on the gum ridge. The artificial teeth and frame are surrounded by gum-colored plastic for a more natural look.
Each RPD is custom-made depending on the number and location of the missing teeth. Its construction will focus on minimizing any rocking movement of the RPD during chewing or biting. Too much of this movement could damage the adjacent teeth it's attaching to and cause the appliance to be uncomfortable to wear. We can stabilize the frame by precisely fitting it between teeth to buttress it. We also insert small rests or clasps made of vitallium at strategic points to grip teeth and minimize movement.
RPDs do have some downsides: their unique attachment with teeth encourages the accumulation of dental plaque, the thin bacterial film that's the leading cause of tooth decay and periodontal (gum) disease. These diseases can affect your remaining teeth's health and stability, which could in turn disrupt the fit of the RPD. Also, too much movement of the appliance can make the teeth to which it's attached become more mobile. It's important, then, if you wear a RPD to remove it daily for cleaning (and to thoroughly brush and floss your natural teeth), and to remove it at night to give the attaching teeth a rest.
A RPD can give you back the teeth you've lost for many years to come—if you take care of it. Maintaining both your RPD and the rest of your teeth and gums will help extend the life and use of this effective and affordable replacement restoration.
If you would like more information on teeth replacement options, 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 “Removable Partial Dentures: Still a Viable Tooth-Replacement Alternative.”
Tooth loss is a problem that affects many seniors—and since May is Older Americans Month, this is a good time to talk about it. Did you know that more than a quarter of adults over age 75 have lost all of their natural teeth? This not only affects their quality of life but poses a significant health risk.
According to a study in The Journal of Prosthodontics, significant tooth loss is associated with increased risk for malnutrition—and also for obesity. If this seems like a contradiction, consider that when you have few or no teeth, it’s much easier to eat soft, starchy foods of little nutritional value than it is to eat nutritious fresh fruits and vegetables. If all of your teeth are missing, it’s especially critical to replace them as soon as possible.
There are several ways to replace a full set of missing teeth, including removable dentures, overdentures, and fixed dentures:
Removable dentures are the classic replacement teeth that you put in during the day and take out at night. (However, if you suffer from sleep apnea, research has found that keeping dentures in at night may help keep the airway open, so if you have this condition, be sure to mention it to your doctor and dentist it). Dentures have come a long way in terms of how convincing they look, but they still have some disadvantages: For one thing, they take some getting used to—particularly while eating. Also, wearing removable dentures can slowly wear away the bone that they rest on. As that bone gradually shrinks over time, the dentures cease to fit well and require periodic adjustment (re-lining) or a remake.
Overdentures are removable dentures that attach onto a few strategically placed dental implants, which are small titanium posts placed in the bone beneath your gums. Strong and secure, implants prevent the denture from slipping when you wear it. Implants also slow the rate of bone loss mentioned above, which should allow the denture to fit better over a longer period of time. The ability to maintain hygiene is easier because you can remove them for cleaning.
Fixed implant-supported dentures are designed to stay in your mouth all the time, and are the closest thing to having your natural teeth back. An entire row of fixed (non-removable) replacement teeth can usually be held in place by 4-6 dental implants. Dental implant surgery is an in-office procedure performed with the type of anesthesia that’s right for you. After implants have been placed and have integrated with your jaw bone—generally after a few months—you can enjoy all of your favorite foods again without worry or embarrassment.
If you would like more information about tooth-replacement options, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Overdentures & Fixed Dentures” and “Removable Full Dentures.”
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