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Posts for: January, 2020

PayingAttentiontoCertainFactorsHelpsEnsureSuccessfulImplantOutcomes

Implants are highly regarded by both dentists and patients for their versatility and durability. But it’s their life-like appearance that “seals the deal” as the restoration of choice — not only mimicking an individual tooth, but emerging from the gum line and blending indistinguishably with other teeth in color and symmetry.

To achieve this result, we must consider a few factors beforehand, particularly the amount of bone available at the intended implant site. An implant requires a certain amount of bone to properly position it for the most natural crown appearance. The bone present around adjacent teeth can also affect your appearance: in the absence of adequate bone the papillae, triangular shaped gum tissue between teeth, may not regenerate properly between the implant and the natural teeth. This can leave a noticeable void, what dentists call “black hole disease.”

Bone loss is a significant problem particularly after tooth loss. It’s quite possible for you to lose a quarter of the bone’s width in the first year after tooth loss. To avoid this, we often use bone grafting techniques immediately after extraction to lessen bone loss; if it’s already occurred we may be able to use similar reconstructive techniques to rebuild and encourage renewed bone growth. In the end, though, if there remains a significant level of bone loss it may be necessary to consider another option for tooth replacement other than implants.

The thickness of your gum tissue, a genetic trait, can also have an impact on the implant’s ultimate appearance. Thicker gum tissues are generally more resilient and easier to work with surgically. Thinner gum tissues are more susceptible to recession and tend to be more translucent, which could cause the underlying metal implant to be visible. Thus, working with thinner gum tissues requires a more delicate approach when trying to achieve a visually appealing result.

All these factors must be balanced, from implantation to final crown placement. But with careful planning and attention to detail throughout the process, many of these issues can be overcome to produce a satisfying result — a new and appealing smile.

If you would like more information on the aesthetics of 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.”


By Advanced Dental Concepts
January 15, 2020
Category: Oral Health
Tags: pain management  
IsThereaBetterWaytoManagePainWithoutNarcotics

The ongoing opioid addiction epidemic has brought together government, law enforcement and healthcare to find solutions. The focus among doctors and dentists has been on finding ways to reduce the number of opioid prescriptions.

Opioids (or narcotics) have been a prominent part of pain management in healthcare for decades. Drugs like morphine, oxycodone or fentanyl can relieve moderate to extreme pain and make recovery after illness or procedures much easier. Providers like doctors and dentists have relied heavily on them, writing nearly 260 million narcotic prescriptions a year as late as 2012.

But although effective when used properly, narcotics are also addictive. While the bulk of overall drug addiction stems from illegal narcotics like heroin, prescription drugs also account for much of the problem: In 2015, for example, 2 million Americans had an addiction that began with an opioid prescription.

The current crisis has led to horrific consequences as annual overdose deaths now surpass the peak year of highway accident deaths (just over 54,000 in 1972). This has led to a concerted effort by doctors and dentists to develop other approaches to pain management without narcotics.

One that’s gained recent momentum in dentistry involves the use of non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs like acetaminophen, ibuprofen or aspirin work by dilating blood vessels, which reduces painful inflammation. They’re available over the counter, although stronger doses require a prescription.

NSAIDs are effective for mild to moderate pain, but without the addictive properties of narcotics. There are some adverse health consequences if taken long-term, but limited use for pain or during post-procedure recovery is safe.

Many dentists are recommending NSAIDs for first-line pain management after most dental procedures. Narcotics may still be prescribed, but in a limited and controlled fashion. As part of this new approach, dentists typically combine ibuprofen and acetaminophen: Studies have shown the two work together better at reducing pain than either one individually.

Still, many aren’t eager to move away from the proven effectiveness of narcotics to primarily NSAIDs. But as these non-addictive drugs continue to prove their effectiveness, there’s hope the use of addictive opioids will continue to decrease.

If you would like more information on pain management practices in dental care, please contact us or schedule an appointment for a consultation.


LiketheProstheAthleteinYourFamilyNeedsaMouthguardtoPreventDentalInjuries

Super Bowl LIV is set for February 2 at Hard Rock Stadium in Miami Gardens, Florida, where the top two teams in pro football will vie for the coveted Vince Lombardi Trophy. Unfortunately, many of their fellow competitors (and some of their teammates) will still be nursing injuries from a long, grueling season. Injuries are a fact of life for one of America's most popular sports, with every part of a player's body vulnerable to trauma—including their teeth, gums and jaws.

But although they do occur, dental and oral injuries aren't at the top of the list of most frequent injuries in the NFL. That's because of the athletic mouthguard, an oral appliance small enough to hold in the palm of your hand. Made of pliable plastic, a mouthguard helps absorb damaging forces to the face and mouth generated by the inevitable hits that players take in the course of a game. According to the American Dental Association, a player is 60% more likely to incur a dental injury when not wearing a mouthguard.

And they're not just for the pros: Mouthguards are regarded as an essential part of protective gear for all participants of organized football and other contact sports. They're the best defense against injuries like fractured (cracked) teeth or tooth roots, knocked out teeth or teeth driven back into the jaw (tooth intrusion).

Mouthguards are readily available in sporting goods stores, but the best type of mouthguards are those that are custom-made by dentists for the individual player, created from impressions taken of that individual's teeth. Because custom mouthguards are more accurate, they tend to be less bulky than “boil and bite” mouthguards, and thus provide a better and more comfortable fit. And because of this superior fit, they offer better protection than their retail counterparts.

Because they're custom-made, they tend to be more expensive than other types of mouthguards. And younger athletes whose jaws are still developing may need a new mouthguard every few years to reflect changes in jaw growth. Even so, the expense of a custom mouthguard pales in comparison with the potential expense of treating an impact injury to the teeth or mouth.

If you or a member of your family are avid participants in football, basketball, hockey or similar high-contact sports, a mouthguard is a must. And just like the pros, a custom mouthguard is the best way to go to for comfort and ultimate protection.

If you would like more information about oral sports protection, please contact us or schedule an appointment. To learn more, read the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”