Installing dental implants involves more than the mechanics of placing them into the jawbone. Ultimate success — a natural and beautiful smile — requires painstaking attention to detail and artistry.
Here are a few of the factors we must consider to achieve a smile with dental implants you’ll be proud to display.
The amount of available bone. For the permanent crown to appear natural, it’s crucial to position the implant precisely. To achieve this precision requires an adequate amount of bone to be present. Unfortunately, bone loss is quite common after tooth loss; to minimize this we place bone grafts in the empty socket if at all possible after extraction to encourage bone growth. It’s also possible in some cases to perform bone grafting surgery before implants to build up bone volume.
Your genetic gum tissue type. There are basically two types of gum tissue people are born with: thin or thick. Thin tissues are more subject to wear, difficult to work with during surgery and can make it difficult to hide the metal components of an implant. Thicker tissues are easier to work with, but can have a tendency to overgrow.
Achieving a natural “emergence profile.” To look natural, the implant crown must appear to seamlessly emerge from the surrounding gum tissue. To achieve this, we must carefully plan and place the implant in the precise location in the bone, taking into account the implant shape and how far it should be placed within the bone to match the position and height of adjacent teeth and gum tissues.
Blending color shades with adjacent natural teeth. When it comes to color, everyone has subtle differences in tooth shades and hues. In fact, there are slight color variations within individual teeth, from the root to the tip of the crown. To make sure the implant blends in with adjacent teeth, it’s important to match the color incorporated into the porcelain crown with the natural crowns beside them.
These and other factors require both technical expertise and a sense of artistry. Carefully considering all of them will help ensure your dental implants result in the smile you want.
If you would like more information on smile transformations with 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 “Matching Teeth & Implants.”
Hopefully, you’ve developed a long-term care relationship with your family dentist. Better known as a general dentist, these professionals are the central players in maintaining your oral health, and your first stop when you have a problem with your teeth or gums.
But there are times when a particular dental situation calls for a specialist, a dentist with additional training (as much as three years or more in their area of specialty) and the equipment and advanced techniques for your particular need. Here, then, are some of the other kinds of dental professionals your general dentist may refer you to if you need specialized care.
Periodontist — From the Latin peri (“around”) and dont (“tooth”), this dentist cares for the supporting structures of the teeth, particularly the gums and bone. Besides treating advanced cases of periodontal (gum) disease, they’re also adept at reconstructive and cosmetic gum procedures or the placement of dental implants.
Orthodontist — Although known commonly as the “braces” doctor, orthodontists have a much wider concern: the interaction and alignment of teeth and jaws. With a keen understanding of growth and development, orthodontists can employ a number of treatments, including braces, to bring teeth into better positions that will improve function and appearance.
Endodontist — Teeth damaged from disease or injury may need treatments that involve the interior of the tooth — the pulp and root canals. While your general dentist can perform basic root canal treatments, an endodontist has the added knowledge and equipment to treat more difficult cases.
Prosthodontist — As with a prosthetic limb that replaces a lost arm or leg, prosthodontists specialize in replacing lost teeth (prostho means “artificial”). Prosthodontists can skillfully create functional, life-like dentures, as well as natural tooth and implant crowns to replace portions of visible teeth.
Oral Surgeon — These dentists are skilled in the diagnosis and surgical treatment of conditions involving the head and neck (the “maxillo-facial” region). They often work in consultation with general dentists and other specialties for treating complex mouth conditions. Besides tooth extraction and other dental procedures, oral surgeons can also surgically correct jaw alignment or treat trauma to the face and neck area. They also place grafts to stimulate bone growth for future implants.
If you would like more information on how dental specialties can benefit your 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 “The Dental Universe.”
Everyone loves a concert where there's plenty of audience participation… until it starts to get out of hand.Â Recently, the platinum-selling band Fifth Harmony was playing to a packed house in Atlanta when things went awry for vocalist Camila Cabello. Fans were batting around a big plastic ball, and one unfortunate swing sent the ball hurtling toward the stage — and directly into Cabello's face. Pushing the microphone into her mouth, it left the “Worth It” singer with a chipped front tooth.
Ouch! Cabello finished the show nevertheless, and didn't seem too upset. “Atlanta… u wild… love u,” she tweeted later that night. “Gotta get it fixed now tho lol.” Fortunately, dentistry offers a number of ways to make that chipped tooth look as good as new.
A small chip at the edge of the tooth can sometimes be polished with dental instruments to remove the sharp edges. If it's a little bigger, a procedure called dental bonding may be recommended. Here, the missing part is filled in with a mixture of plastic resin and glass fillers, which are then cured (hardened) with a special light. The tooth-colored bonding material provides a tough, lifelike restoration that's hard to tell apart from your natural teeth. While bonding can be performed in just one office visit, the material can stain over time and may eventually need to be replaced.
Porcelain veneers are a more long-lasting solution. These wafer-thin coverings go over the entire front surface of the tooth, and can resolve a number of defects — including chips, discoloration, and even minor size or spacing irregularities. You can get a single veneer or have your whole smile redone, in shades ranging from a pearly luster to an ultra-bright white; that's why veneers are a favorite of Hollywood stars. Getting veneers is a procedure that takes several office visits, but the beautiful results can last for many years.
If a chip or crack extends into the inner part of a tooth, you'll probably need a crown (or cap) to restore the tooth's function and appearance. As long as the roots are healthy, the entire part of the tooth above the gum line can be replaced with a natural-looking restoration. You may also need a root canal to remove the damaged pulp material and prevent infection if the fracture went too far. While small chips or cracks aren't usually an emergency (unless accompanied by pain), damage to the tooth's pulp requires prompt attention.
If you have questions about smile restoration, please contact us and schedule an appointment. You can read more in the Dear Doctor magazine articles “Porcelain Veneers: Strength & Beauty As Never Before” and “Porcelain Crowns & Veneers.”
One of the best and most successful tooth replacement choices available is the dental implant. No other restorative method is as similar in both form and function to a real tooth as an implant; and with a success rate of 95-plus percent after ten years, it’s one of the most durable.
But there can be extenuating circumstances that make obtaining an implant difficult or sometimes impossible. One possible problematic situation is the systemic disease diabetes.
Diabetes is a hormonal condition in which the body is unable to sufficiently regulate the amount of glucose (a basic sugar that provides energy to the body’s cells) within the blood stream. Normally, the pancreas produces the hormone insulin to reduce excess glucose. But diabetes interferes with this insulin production: if you have Type 1 diabetes, the pancreas has stopped producing insulin altogether; if you have the more common Type 2, the body doesn’t produce adequate insulin or it doesn’t respond sufficiently to the insulin produced.
Over time diabetes can affect other areas of health, especially wound healing. Because the condition gradually causes blood vessels to narrow and stiffen, the normal inflammatory response to disease or trauma can become prolonged. This in turn slows the rate of wound healing.
Slow wound healing can have a bearing on the recovery period just after implant surgery, especially the necessary integration process that takes place between the bone and the titanium metal implant that provides its signature strength. If that process is impeded by slow wound healing caused by diabetes, the risk increases dramatically for implant failure.
That’s the worst case scenario if you have diabetes, but only if your condition is out of control. If, however, you have your blood sugar levels well regulated through medication, diet and exercise, then your chances for implant success could easily be on par with someone without diabetes.
So if you’re diabetic and are considering dental implants for missing teeth, it’s important to discuss the possibility of obtaining them with both your dentist and the physician caring for your diabetes. With your overall healthcare team working together, there’s no reason why diabetes should stop you from enjoying this premiere restoration for missing teeth.
If you would like more information on obtaining 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 & Diabetes.”
If you’re considering a dental implant as a replacement for a lost tooth, you’re looking at a restoration method with an amazing 95% success rate after ten years. But that being said there’s still a risk, albeit quite low, the implant might fail.
And if you smoke, the risk is slightly higher. In a recent study of implant patients, twice as many of the failures occurred in smokers compared to non-smokers. If you’re a smoker, you can increase your chances of a successful outcome if you quit the habit.
Nicotine, a chemical within tobacco, is the primary cause for this higher risk. Besides its effect on the pleasure centers of the brain, nicotine also restricts smaller blood vessels that are abundant in the mouth and skin, causing less blood flow. As a result, the mouth doesn’t have as many antibodies and other substances available to fight infection and help traumatized tissues heal.
Because of this, as well as reduced saliva flow due to the habit, smokers have an increased risk of dental disease and are slower to respond to treatment. This can be especially problematic if the gum tissues around an implant become infected, which could lead to a catastrophic failure. Slower healing also impacts the post-surgery period when bone cells in the jaw are growing and adhering to the implant surface, forming a stronger bond.
To avoid these potential risks you should stop smoking before you undergo implant surgery. If you can’t completely kick the habit, you should at least stop a week before surgery and for two weeks after. It’s also critical that you practice good oral hygiene — both brushing and flossing — to minimize the occurrence of dental disease and see us for regular checkups and maintenance appointments.
Taking these steps will greatly increase your chances of being in the vast majority of people who continue to enjoy success with their implants for many years.
If you would like more information on the impact of smoking on 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.”
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