By Randall J. Bartoe, DDS, PLC
September 19, 2018
Category: Dental Procedures
Tags: dental implants  
DentalImplantsCouldbeYourBestOptiontoReplaceLostTeeth

An estimated 35 million people in the United States are missing all of their teeth on at least one jaw. Your situation may not be as serious — perhaps you've only lost one tooth. But even one missing tooth could eventually impact the health of underlying bone or other teeth — and it can certainly mar an otherwise attractive smile.

Depending on other health factors, you could be an ideal candidate for a dental implant to replace that missing tooth. Since their introduction in the 1980s, implants have rapidly become the popular choice for tooth replacement. They've gained this popularity for several reasons: they're a life-like replacement that also functions like a tooth; they're adaptable to a variety of situations; and they enjoy a 95%-plus success rate.

The key to their success lies in their unique construction: they replace the tooth root, not just the crown. They accomplish this through a metal titanium post imbedded directly into the bone. The titanium attracts bone cells, which eventually grow and adhere to the post to anchor the implant securely in the jaw. This growth also deters bone loss that occurs after tooth loss and continues after acquiring other forms of removable restorations like full or partial dentures.

If implants have one drawback, though, it's their cost, especially if you have multiple lost teeth. The good news if you're missing several teeth is that each tooth does not need an implant due to their inherent strength. As few as two implants could replace three to four missing teeth or play a role as supports for other restorations like removable dentures. Some of the implants' other benefits will also carry over, including enhanced bone health.

To determine if dental implants are a good choice for your missing teeth, you'll need to undergo an evaluation of your individual dental condition (including bone health). From there we can advise you on whether implants could change your dental health and 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 101.”

By Randall J. Bartoe, DDS, PLC
September 09, 2018
Category: Dental Procedures
Tags: bone grafting  
WecanBuildupLostBoneBeforeYourImplant

The “magic” behind a dental implant’s durability is the special affinity its imbedded titanium post has with bone. Over time bone grows and attaches to the titanium surface to produce a strong and secure hold.

But there’s one important prerequisite for ultimate implant success—there must be an adequate amount of bone available initially to properly position the post during implantation. Otherwise, the implant may not have enough support to position it properly or cover the implant surface completely with bone.

Inadequate bone can be a problem for patients who lost teeth some time before and now desire to an implant restoration. This happens because when teeth are missing, so are the forces they generate during chewing. These forces stimulate new bone growth around the tooth root to replace older, dissolved bone at a healthy rate. If that replacement rate is too slow, the volume and density of bone may gradually diminish.

There is a way, though, to build up the bone for future implantation. Known as bone preservation procedure or a ridge augmentation, it’s a surgical procedure in which the dentist adds bone grafting material to the extraction socket or the bony ridge. The graft serves as a scaffold for new bone cells to grow and multiply. If successful, there will be enough new bone volume after several months of healing to support proper implant placement.

Bone grafting can add more time to the implant process. It may also mean you will not be able to undergo immediate crown placement after implantation (a “tooth in one day” procedure). Instead we would probably suture gum tissue over the implant to protect it and allow for full integration with the bone over a few more months. In the meantime, though, we could fit you with a temporary restoration like a removable partial denture (RPD) or a bonded bridge to improve the appearance of the space while the bone continues to heal.

After several months, your implant will have a better chance of a secure hold and we can then attach a life-like crown. Even if you’ve suffered bone loss, you’ll then have the benefit of not only a durable implant but also a new smile.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation.

By Randall J. Bartoe, DDS, PLC
August 30, 2018
Category: Dental Procedures
DontBreakItLikeBeckham

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.”

By Randall J. Bartoe, DDS, PLC
August 20, 2018
Category: Dental Procedures
Tags: dental implants  
EvenThoughnotintheSmileZoneYouShouldReplacethatBackTooth

People often put a premium on appearance when deciding whether or not to replace a missing tooth. There's more motivation to replace one in the “smile zone,” where the teeth are more visible, than one that's not.

But even if your missing tooth is in the back out of sight, there are still good reasons to replace it. That's because even one lost tooth can have a cascading ill effect on other teeth, the underlying bone or eventually your entire facial structure.

The chief problems caused by a missing tooth occur first with the bone. The act of chewing generates pressure around the teeth. The teeth transmit this pressure through the roots to the bone, which stimulates the bone to grow and remain strong in support of the teeth. When you lose a tooth, the bone no longer receives this growth stimulation.

In time, the replacement rate for older bone cells will slow down and cause the bone volume to decrease. It's possible to detect a change just months after losing a tooth: you can lose an estimated 25% of bone width in the first year.

As the bone diminishes, the jaw loses height and then more width. The gum tissues will also gradually decrease. As a result you may not be able to chew or even speak as well as you once could. Depending on the number of teeth you've lost, the foundational portion of the jawbone — the basal bone — may also decline. The distance between nose and chin may decrease and the cheeks sink in. Without bone support in the rear, the bite can collapse and push the teeth forward out of their normal position.

The best way to avoid this debilitating spiral is to replace a tooth as soon as practical. There are many options, but perhaps the best choice is a dental implant: not only will it provide a life-like appearance, but its affinity with bone will stop bone loss and even encourage new growth.

So, don't neglect replacing that “invisible” tooth if it's lost. Your mouth and ultimately your appearance will be better for it.

If you would like more information on tooth loss and restoration 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 “The Hidden Consequences of Losing Teeth.”

By Randall J. Bartoe, DDS, PLC
August 10, 2018
Category: Oral Health
Tags: tooth decay  
LessisBetterthe21stCenturyApproachtoToothDecayTreatment

For over a century dentists treated tooth decay by removing both diseased portions of the tooth and healthy structure deemed at risk for future decay. In the 1970s, though, a new approach emerged, known as Minimally Invasive Dentistry (MID). This practice protocol attempts to preserve as much of the healthy structure as possible.

Before MID, dentists followed a decay treatment protocol developed in the 19th Century. A part of this became known as extension for prevention calling for dentists to remove healthy structure considered vulnerable to decay. Besides reducing the tooth's volume, this practice also resulted in, by today's standards, larger than necessary fillings.

It was thought that removing this additional material would make it easier to clean bacterial plaque, the source of decay, but later, research showed the practice couldn't guarantee the teeth wouldn't be reinfected.

Since then we've learned a lot more about teeth and have developed new ways to detect decay at earlier stages. X-ray imaging, for example, has transitioned largely from film to digital technology, providing more detailed images at greater magnification. This, along with laser fluorescence and infrared cameras, has made it easier to detect the first tiny stages of decay.

We can also limit tooth decay damage by boosting enamel strength with fluoride applications and sealants or reducing decay-causing bacteria with anti-bacterial rinses. We've also seen advancement in techniques like air abrasion that remove decayed tooth material while leaving more healthy structure intact better than using a traditional dental drill.

Restoring teeth after treatment has also improved. While dental metal amalgam is still used for some fillings, the main choice is now composite resin. These new tooth-colored dental materials require less tooth preparation (and thus less material loss) and bond well to the remaining structure, resulting in a stronger tooth.

Following a MID protocol leads to less intervention and less time in the dentist's chair. It also means preserving more of a natural tooth, an important aim in promoting long-lasting dental health.

If you would like more information on minimally invasive dentistry, please contact us or schedule an appointment for a consultation.





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