My Blog
By Enrique C. Escofet, DDS
November 14, 2019
Category: Dental Procedures
CrazyLittleThingCalledHyperdontia

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.”

By Enrique C. Escofet, DDS
November 04, 2019
Category: Dental Procedures
Tags: dental implants  
CouldaMetalAllergyKeepYouFromGettingaDentalImplant

The dental implant is the closest thing in modern dentistry to a natural tooth. This is because an implant replaces more than the visible crown — it also replaces the root, thanks to a metal post imbedded in the bone.

But what if you have a metal allergy — are you out of luck replacing a tooth with an implant? Before answering this question, let's take a closer look at metal allergies.

An allergy is an overreaction of the body's immune system to a particular foreign substance. This response can be as inconsequential as a minor rash or as life-threatening as a shutdown of the body's organ systems. You can be allergic to anything, including metals.

Usually, these allergies are to specific kinds of metals. For example, about 17% of women and 3% of men are allergic to nickel, while smaller percentages are allergic to cobalt or chromium. Most allergic reactions to metal occur from external contact with jewelry or similar metal items that create rashes or other anomalies on the skin. On a more serious note, an allergy to metal in a body replacement part could result in the body rejecting it.

Metals have also played an important role in dental care, particularly dental amalgam used for tooth fillings. Dental amalgam is a mixture of a precious metal like gold or silver with other metals like copper, tin and, in small amounts, mercury. While dental amalgam has been used safely for decades, there have been rare cases of inflammation or rashes.

This brings us to dental implants and the most common metal used in them, titanium. The commercial version of this metal is highly prized in medical and dental applications because it has a special affinity with bone. Bone cells readily grow and adhere to the metal, which strengthens the bond between the implant and the jawbone.

Even if you have a rare allergy to certain metals, it's even rarer that would include titanium. In one particular study of 1,500 implant patients less than 1% reported any reaction at all.

If you're concerned, you can undergo testing to see if you react to titanium. More than likely, though, you'll be able to join the millions of other patients who have successfully restored their smiles with dental implants.

If you would like more information on dental implants as a tooth replacement option, 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 “Metal Allergies to Dental implants.”

By Enrique C. Escofet, DDS
October 25, 2019
Category: Dental Procedures
Tags: dental implant  
CleanYourImplantsJustLikeYourOtherTeeth

You feel great about your new smile, thanks to dental implants! And you may also be feeling relief as the problems with your former teeth fade into the past.

But that doesn’t mean you can drop your guard on periodontal (gum) disease. Even though implants are impervious to decay, the natural tissues supporting them are vulnerable to periodontal (gum) disease. If they become diseased, your implants could lose their bone support and eventually fail.

And that failure could happen quickly. That’s because, as life-like as they are, implants don’t have one important advantage of real teeth: an attachment to a connective tissue called the periodontal ligament. This tough but elastic ligament lies between the teeth and the bone, attaching to both with tiny extending fibers and holding the teeth in place.

And that’s not all: Because the periodontal ligament contains an abundance of blood vessels, it can supply antibodies to help fight infection. The body’s defenses may not be able to stop disease, but they can certainly inhibit its progress.

Implants can’t benefit from this infection-fighting mechanism. So, when an infection arises in the gums surrounding an implant, it can spread rapidly through a form of gum disease known as peri-implantitis (literally “inflammation around an implant”). If we don’t stop it with prompt treatment, you could lose bone support from your implant and eventually lose it, sometimes in quick fashion.

That’s why you should clean your implants everyday like you do the rest of your teeth with brushing and flossing. You should also visit us regularly for dental cleanings. A dental cleaning involving implants is similar to one with natural teeth, except the hygienist won’t use metal instruments on the implants—this could create tiny scratches on their surface. Instead, they’ll use nylon or plastic instruments or ultrasonic equipment to clean them.

You should also make a dental appointment as soon as you notice swollen, reddened or bleeding gums. If you have gum disease, we can stop the infection through treatment and restore your gums to health. This can be a long and involved process, but it’s necessary to preserve your implants.

It’s true that implants can change your life. If you want to enjoy that change for a long time, take care of your implants and the natural tissues that support them.

If you would like more information on caring 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 “Dental Implant Maintenance.”

By Enrique C. Escofet, DDS
October 15, 2019
Category: Dental Procedures
UsingSinusSurgerytoStimulateBoneGrowthforImplants

For a predictable outcome, a dental implant should be placed as soon as the bone and gum tissues following a tooth extraction have healed. But what happens if the tooth has been missing for months or years? You might then run the risk of not having enough bone to properly place an implant.

This can happen because of a disruption in the growth cycle of living bone tissue. As older bone cells dissolve (resorption), new bone develops to take its place. This is a dynamic process, as the amount and exact location of the new growth is in response to changes in the mouth, particularly from forces generated by the teeth as we chew. If, however, this stimulation transmitted to the bone no longer occurs because the tooth is missing, the bone will tend to dissolve over time.

In fact, within the first year after a tooth loss the associated bone can lose as much as a quarter of its normal width. This is why we typically place bone grafting material in an empty socket at the same time as we extract the tooth. This encourages bone growth during the healing period in anticipation of installing a dental implant or a fixed bridge. If, however, the bone has diminished to less than required for a dental implant, we must then use techniques to encourage new bone growth to support a future implant.

One such technique for restoring bone in the back of the upper jaw is to surgically access the area through the maxillary sinus (a membrane-lined air space within the bone structure of the face) positioned just over the jawbone to place grafting material. During surgery performed usually with local anesthesia, the surgeon accesses the sinus cavity, lifts the tissue membrane up from the sinus floor and applies the grafting material on top of the bone. Eventually, the new bone growth will replace the grafting material.

If successful, the new bone growth will be sufficient to support an implant. Thanks to this renewed growth, you’ll soon be able to enjoy better function and a transformed smile provided by your new implant.

If you would like more information on forming new bone for implants through sinus surgery, 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 “Sinus Surgery.”

By Enrique C. Escofet, DDS
October 05, 2019
Category: Dental Procedures
J-LosUnluckyBreakChippingaToothonStage

Whether she’s singing, dancing or acting, Jennifer Lopez is a performer who is known for giving it all she’s got. But during one show, Lopez recently admitted, she gave a bit more then she had planned.

“I chipped my tooth on stage,” she told interviewers from Entertainment Tonight, “and had to finish the show….I went back thinking ‘Can I finish the show like this?’”

With that unlucky break, J-Lo joins a growing list of superstar singers—including Taylor Swift and Michael Buble—who have something in common: All have chipped their teeth on microphones while giving a performance.

But it’s not just celebs who have accidental dental trouble. Chips are among the most common dental injuries—and the front teeth, due to their position, are particularly susceptible. Unfortunately, they are also the most visible. But there are also a number of good ways to repair chipped, cracked or broken teeth short of replacing them.

For minor to moderate chips, cosmetic bonding might be recommended. In this method, special high-tech resins, in shades that match your natural teeth, are applied to the tooth’s surface. Layers of resin, cured with a special light, will often restore the tooth to good appearance. Best of all, the whole process can often be done in just one visit to the dental office, and the results can last for several years.

For a more permanent repair—or if the damage is more extensive—dental veneers may be another option. Veneers are wafer-thin shells that cover the entire front surface of one or more teeth. Strong, durable and natural-looking, they can be used to repair moderate chips, cracks or irregularities. They can also help you get a “red-carpet” smile: brilliant white teeth with perfectly even spacing. That’s why veneers are so popular among Hollywood celebs—even those who haven’t chipped their teeth!

Fortunately, even if the tooth is extensively damaged, it’s usually possible to restore it with a crown (cap), a bridge—or a dental implant, today’s gold standard for whole-tooth replacement. But in many cases, a less complex type of restoration will do the trick.

Which tooth restoration method did J-Lo choose? She didn’t say—but luckily for her adoring fans, after the microphone mishap she went right back up on stage and finished the show.

If you have a chipped tooth but you need to make the show go on, 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.”





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