My Blog
By Enrique C. Escofet, DDS
February 17, 2019
Category: Oral Health
CleanYourImplantsJustLikeyouCleanYourNaturalTeeth

Dental implants to replace teeth are a popular choice as much for their durability as their life-likeness. Most implants last for decades, which can result in lower long-term maintenance costs than other replacement options.

But to achieve this longevity, you must take care of your implants. You should brush and floss them daily right along with your remaining natural teeth — and continue regular semi-annual dental visits for cleanings and checkups.

You may be wondering, though: if they're made of inorganic materials, why worry with brushing them? It's true that bacterial plaque, the thin film of food particles most responsible for dental disease, doesn't affect them.

Your implants, though, don't exist in a bubble: they're imbedded in real bone, surrounded by real gum tissue and placed next to real teeth. All these other living tissues are susceptible to infection caused by plaque, even from plaque on non-organic implants.

The bone and tissues around an implant can even have a higher susceptibility to infection. This is because an implant's attachment in the jaw differs from that of natural teeth. An implant is imbedded directly into the bone; a natural tooth, on the other hand, maintains its hold through an elastic gum tissue between it and the bone called the periodontal ligament. Tiny fibers from the ligament attach to the tooth on one side and to the bone on the other.

Besides holding the tooth in place, the ligament also contains blood vessels that supply the tooth and surrounding tissues not only with nutrients but also antibodies that help fight infection. Due to the absence of a ligament connection, an implant doesn't enjoy the same level of protection from infection.  It's much easier for tissues and teeth around an implant to become infected, and harder to stop it.

That's why prevention through daily hygiene is so important. So, be sure to brush and floss all your teeth — including implants — every day, and keep up your regular dental visits. And at the first sign of a possible infection — swollen, red or bleeding gums — see us as soon as possible for an examination.

Consider your implants a long-term investment in both your smile and dental health. Taking care of them will pay dividends for many years to come.

If you would like more information on taking care of your 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 Implant Maintenance.”

By Enrique C. Escofet, DDS
February 07, 2019
Category: Oral Health
JamieFoxxChipsaTooth-ThisTimebyAccident

Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.

“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…

For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.

When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.

A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.

But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.

Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!

If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”

By Enrique C. Escofet, DDS
January 28, 2019
Category: Dental Procedures
Tags: dental implants  
3ReasonsforWhyItsaSmartMovetoInvestinDentalImplants

When it comes to replacing a missing tooth, you have several options, including a removable partial denture or a fixed bridge. But the premier choice is “the new kid on the block” at just over thirty years old: dental implants. Implants are by far the most popular tooth replacement choice among both patients and dentists.

But they also happen to be the most expensive option, at least initially. So the question is, why invest in dental implants over less costly choices?

Here are 3 reasons why implants could be well worth their price.

More Like a real tooth than other restorations. Implants can match the life-like appearance of any other replacement choice, often utilizing the same types of materials. But where they really excel is in function—how they perform while biting and chewing. This is because the dental implant’s titanium post imbedded in the jawbone replaces the tooth root. No other dental restoration can do that—or perform better when comparing the resulting functionality.

Best long-term solution. As we mentioned before, the initial implant cost is typically higher than either dentures or bridges. But you should also consider their durability compared to other choices. It could be potentially much longer—possibly decades. This is because the titanium post creates an ultra-strong hold in the jawbone as bone cells naturally grow and adhere to this particular metal. The resulting hold can withstand the daily forces generated during eating and chewing. With proper care they might even last a lifetime, and actually cost you less in the long run over other choices.

Adaptable to other types of restoration. Implants have greater uses other than as individual tooth replacements. A few strategically placed implants can also be used to support removable dentures or a fixed bridge for multiple teeth or an entire dental arch. As the technology continues to advance, implants are helping to make other restoration options stronger, more stable and longer lasting—and adding more value to your investment.

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 101.”

By Enrique C. Escofet, DDS
January 18, 2019
Category: Dental Procedures
Tags: dental implants  
SuccesswithDentalImplantsDependsonAttentiontoDetail

Dental implants are all the rage. And why not — not only are these tooth replacements life-like and highly functional, they have an amazing 95% ten-year success rate.

Some of that success is due to their unique design. Technically a root replacement, an implant's metal titanium post is surgically placed in the jawbone, where bone grows and adheres to it over time. This creates a strong connection that stands up well to the forces created by biting and chewing.

But there's more to their longevity than design. Success also depends on a careful, planned process that begins long before surgery.

It starts with a detailed oral examination to determine the best placement for the implant. Besides regular x-rays, we may also perform CT scans to create a three-dimensional view of your jaw. With this we can locate and avoid nerves, sinus cavities or other structures near the implant site.

The examination also helps us determine if you've experienced any bone loss, a normal occurrence after tooth loss. Implants require an adequate amount of bone to achieve the best position. A good position ensures future bone integration and the best appearance result.

The same attention to detail extends to the actual surgery to place the implant. We fashion the site to receive the implant by sequentially drilling larger tapered channels until we achieve the right size fit for the implant. During drilling we avoid overheating the bone, which could ultimately weaken and damage the implant's stability.

We'll also need to provide protection for the implant while it integrates with the bone. In most implantations, we do this by suturing the gum tissue over the implant. We take a different approach with a “Tooth in a Day” procedure where we attach a crown (the visible portion of the tooth) right after implant surgery. In this case we'll install a crown (which is actually temporary) that's a little shorter than the adjacent teeth. The natural teeth around it will absorb the forces produced while chewing and not the implant crown.

Focusing on these and other factors will greatly reduce the risk of implant failure. Paying careful attention to them helps ensure your new smile is a lasting one.

If you would like more information on dental implants to restore your smile, 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.”

EnsuretheBestOutcomewiththeRightCareforaTeensMissingTooth

While it's possible for a teenager to lose a tooth from decay, it's more common they'll lose one from an accidental knockout. If that happens to your teenager, there are some things you should know to achieve a good outcome.

Our top concern is to preserve the underlying bone following tooth loss. Like other tissues, bone has a life cycle: older cells dissolve and are absorbed by the body (resorption), then replaced by new cells. The biting pressure generated when we chew helps stimulate this growth. But bone around a missing tooth lacks this stimulation and may not keep up with resorption at a healthy rate.

This can cause a person to lose some of the bone around an empty tooth socket. To counteract this, we may place a bone graft at the site. Made of bone minerals, usually from a donor, the graft serves as a scaffold for new bone growth. By preventing significant bone loss we can better ensure success with a future restoration.

Because of its lifelikeness, functionality and durability, dental implants are considered the best of the restoration options that can be considered to replace a missing tooth. But placing an implant during the teen years is problematic because the jaws are still growing. If we place an implant prematurely it will appear to be out of alignment when the jaw fully matures. Better to wait until the jaw finishes development in early adulthood.

In the meantime, there are a couple of temporary options that work well for teens: a removable partial denture (RFP) or a fixed modified bridge. The latter is similar to bridges made for adults, but uses tabs of dental material that bond a prosthetic (false) tooth to the adjacent natural teeth to hold it in place. This alleviates the need to permanently alter the adjacent natural teeth and buy time so that the implant can be placed after growth and development has finished.

And no need to worry about postponing orthodontic treatment in the event of a tooth loss. In most cases we can go ahead with treatment, and may even be able to incorporate a prosthetic tooth into the braces or clear aligners.

It's always unfortunate to lose a tooth, especially from a sudden accident. The good news, though, is that with proper care and attention we can restore your teenager's smile.

If you would like more information on how to treat lost teeth in teenagers, 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 for Teenagers.”





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