There are plenty of options today for replacing missing teeth, including dental implants. But if the teeth have been missing for some time, complications can arise that limit your restorative options.
The most consequential possibility is bone loss. Bone has a life cycle: old cells dissolve (resorb), and are then replaced by new cells, stimulated to grow by the forces applied to the teeth during chewing. But the bone won't receive this stimulation if a tooth is missing — so growth slows down, which causes the bone volume to diminish with time.
Another complication can occur involving other teeth around the open space. These teeth will naturally move or “drift” out of their normal position into the missing tooth space. As a result we may not have enough room to place a prosthetic (false) tooth.
If either or both of these complications occur, we'll need to address them before attempting a restoration. Bone loss itself could eliminate dental implants as an option because they require a certain amount of supporting bone for correct placement. Bone loss could also make correcting misaligned teeth difficult if not impossible.
It might be possible, though, to regenerate lost bone with a bone graft. The graft is placed, sometimes along with growth stimulating substances, within the diminished bone area. It then serves as a scaffold upon which new bone can form.
If the bone becomes healthy again, we can then attempt to move any drifted teeth back to where they belong. Besides braces, there's another treatment option especially popular with adults: clear aligners. These are a series of removable, clear plastic trays that, like braces, exert gradual pressure on the teeth to move them. Patients wear each individual tray for about two weeks, and then switch to the next tray in the series to continue the process.
Unlike their traditional counterparts, clear aligners can be removed for cleaning or for special occasions. More importantly, they're much less noticeable than traditional braces.
Once any problems with bone health or bite have been addressed and corrected, you'll have a fuller range of options for replacing your missing teeth. With a little extra time and effort, you'll soon be able to regain a smile you'll be proud to display.
It's no secret that many of Hollywood's brightest stars didn't start out with perfectly aligned, pearly-white teeth. And these days, plenty of celebs are willing to share their stories, showing how dentists help those megawatt smiles shine. In a recent interview with W magazine, Emma Stone, the stunning 28-year-old star of critically-acclaimed films like La La Land and Birdman, explained how orthodontic appliances helped her overcome problems caused by a harmful habit: persistent thumb sucking in childhood.
“I sucked my thumb until I was 11 years old,” she admitted, mischievously adding “It's still so soothing to do it.” Although it may have been comforting, the habit spelled trouble for her bite. “The roof of my mouth is so high-pitched that I had this huge overbite,” she said. “I got this gate when I was in second grade… I had braces, and then they put a gate.”
While her technical terminology isn't quite accurate, Stone is referring to a type of appliance worn in the mouth which dentists call a “tongue crib” or “thumb/finger appliance.” The purpose of these devices is to stop children from engaging in “parafunctional habits” — that is, behaviors like thumb sucking or tongue thrusting, which are unrelated to the normal function of the mouth and can cause serious bite problems. (Other parafunctional habits include nail biting, pencil chewing and teeth grinding.)
When kids develop the habit of regularly pushing the tongue against the front teeth (tongue thrusting) or sucking on an object placed inside the mouth (thumb sucking), the behavior can cause the front teeth to be pushed out of alignment. When the top teeth move forward, the condition is commonly referred to as an overbite. In some cases a more serious situation called an “open bite” may develop, which can be difficult to correct. Here, the top and bottom front teeth do not meet or overlap when the mouth is closed; instead, a vertical gap is left in between.
Orthodontic appliances are often recommended to stop harmful oral habits from causing further misalignment. Most appliances are designed with a block (or gate) that prevents the tongue or finger from pushing on the teeth; this is what the actress mentioned. Normally, when the appliance is worn for a period of months it can be expected to modify the child's behavior. Once the habit has been broken, other appliances like traditional braces or clear aligners can be used to bring the teeth into better alignment.
But in Stone's case, things didn't go so smoothly. “I'd take the gate down and suck my thumb underneath the mouth appliance,” she admitted, “because I was totally ignoring the rule to not suck your thumb while you're trying to straighten out your teeth.” That rule-breaking ended up costing the aspiring star lots of time: she spent a total of 7 years wearing braces.
Fortunately, things worked out for the best for Emma Stone: She now has a brilliant smile and a stellar career — plus a shiny new Golden Globe award! Does your child have a thumb sucking problem or another harmful oral habit? For more information about how to correct it, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”
Each year, over a million Americans venture abroad for healthcare, with roughly half for dental treatment. Cost is the main reason — “medical tourists” believe they can save substantially on treatment, even with travel.
But before undertaking such a venture for dental work, there are some things you should take into consideration. For one, although quality care exists all over the world, you’ll also find different standards of care. In the United States, for example, not only must dental providers graduate from accredited schools, they must also pass state examinations before they can practice (specialists even more). In some parts of the world, educational standards aren’t as difficult to attain. You may also find differing standards for infection control, drug applications or appliances: for example, you may find a lower quality in implant or crown materials or craftsmanship than you might expect in the U.S.
Communication can also be an obstacle. Language barriers make it more difficult to understand what to expect before, during and after a procedure, or to have your questions answered. It may also hinder your provider from fully accessing your medical and dental history, which could have an impact on your treatment and outcome. Limited communication also increases misunderstanding about services offered, charges and treatment expectations.
Finally, many dental procedures have multiple phases to them, some of which normally span several months and visits. Many who go abroad for more complex procedures may try to have them performed in a much shorter time frame. Doing so, however, could prove disappointing both in the quality of the final outcome and your own well-being under such an arduous schedule. Even if your dental work is performed in an exotic locale, recovering from extensive procedures where you must rest and refrain from strenuous activity is best performed in the comfort of your own home.
It’s important to get the facts before traveling to a foreign country for any medical or dental treatment, especially about a region’s accreditation and care standards, as well as what you can expect in terms of amenities and culture during your stay. One good source is the U.S. Center for Disease Control’s web page for medical tourism (http://goo.gl/75iWBk).
Going abroad for dental care is a big decision — be sure you’re prepared.
If you would like more information on dental treatment abroad, 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 & Medical Tourism: It’s No Vacation.”
Want to know the exact wrong way to pry open a stubborn lid? Just ask Jimmy Fallon, host of NBC-TV’s popular “Tonight Show.” When the 40-year-old funnyman had trouble opening a tube of scar tissue repair gel with his hands, he decided to try using his teeth.
What happened next wasn’t funny: Attempting to remove the cap, Fallon chipped his front tooth, adding another medical problem to the serious finger injury he suffered a few weeks before (the same wound he was trying to take care of with the gel). If there’s a moral to this story, it might be this: Use the right tool for the job… and that tool isn’t your teeth!
Yet Fallon is hardly alone in his dilemma. According to the American Association of Endodontists, chipped teeth account for the majority of dental injuries. Fortunately, modern dentistry offers a number of great ways to restore damaged teeth.
If the chip is relatively small, it’s often possible to fix it with cosmetic bonding. In this procedure, tough, natural-looking resin is used to fill in the part of the tooth that has been lost. Built up layer by layer, the composite resin is cured with a special light until it’s hard, shiny… and difficult to tell from your natural teeth. Best of all, cosmetic bonding can often be done in one office visit, with little or no discomfort. It can last for up to ten years, so it’s great for kids who may be getting more permanent repairs later.
For larger chips or cracks, veneers or crowns may be suggested. Veneers are wafer-thin porcelain coverings that go over the entire front surface of one or more teeth. They can be used to repair minor to moderate defects, such as chips, discolorations, or spacing irregularities. They can also give you the “Hollywood white” smile you’ve seen on many celebrities.
Veneers are generally custom-made in a lab, and require more than one office visit. Because a small amount of tooth structure must be removed in order to put them in place, veneers are considered an irreversible treatment. But durable and long-lasting veneers are the restorations of choice for many people.
Crowns (also called caps) are used when even more of the tooth structure is missing. They can replace the entire visible part of the tooth, as long as the tooth’s roots remain viable. Crowns, like veneers, are custom-fabricated to match your teeth in size, shape and color; they are generally made in a dental lab and require more than one office visit. However, teeth restored with crowns function well, look natural, and can last for many years.
So what happened to Jimmy Fallon? We aren’t sure which restoration he received… but we do know that he was back on TV the same night, flashing a big smile.
If you would like more information about tooth restorations, please contact us or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “Artistic Repair Of Front Teeth With Composite Resin.”
If you've lost a tooth or need to have one extracted, you have to decide how to replace it. Of all the options available none can match both the lifelikeness and function of a dental implant.
A dental implant is a prosthetic (false) tooth that mimics the root of a natural tooth. Once that implant root form fuses to the surrounding bone, we attach the crown, which is the part of the tooth you can see.
While other replacement options like bridges or dentures can restore the lifelikeness of the tooth crown, they don't replace the root. An implant's titanium post can: using a minor surgical procedure we imbed the post into the bone. Because bone cells have a natural affinity with titanium, they will grow around and adhere to the post over a few weeks after surgery. This further adds strength to the implant's hold in the bone.
Although the attachment isn't exactly like natural teeth, it can maintain this hold for many years. And because it encourages bone growth, a dental implant will help minimize bone loss, a natural consequence of losing teeth. Other replacement options can't do that.
Of course, implants are more costly than other restorations. With an attached crown, an implant can replace any number of teeth. But if you have extensive tooth loss, bridges or dentures would be more cost-effective selections.
But even then, implants could still play a role. We can strategically place a small number of implants as supports for a bridge or even a removable denture. Not only will the implants better secure their attachment, they'll also stimulate bone growth.
Is a dental implant the right choice for you? Visit us for a complete examination and evaluation. Afterward we can discuss your options and whether this phenomenal tooth restoration method could help restore your smile.
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: Your Best Option for Replacing Teeth.”
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