Health Talk With Dr. Gross

Am I a Good Candidate for Mini-Implants?

Older couple smiling - mini dental Implants

Mini-Implants – A Magic Bullet?

There was a folk song that was popular many years ago that was entitled “If I Had A Hammer”. The lyrics began with “If I had a hammer, I’d hammer in the morning, I’d hammer in the evening, All over this land….” I thought of this song as I saw an ad in the paper for the use of mini-implants. The ad seemed to imply that instead of using conventional (whatever that may mean) implants, anyone can use mini-implants and get all the same results. The commercial said that these mini-implants were easier to place, took less time, involved faster healing, and were half the cost. It would seem anyone is a good candidate for mini-implants.

Sounds great right? Unfortunately, mini-implants are not the magic bullet some make them out to be. Let’s take a few minutes to learn together about this subject and why not just anyone is a good candidate for mini-implants.

What are Mini-Implants?

Mini-Implants are pretty self-descriptive. They are miniature versions of their big brother – traditional dental implants.

We all like small. We like items to be petite. Our phones have become miniature computers. There is even a brand of car that is becoming more popular call the Mini Cooper. In an era of super-sizing, being smaller and more compact is still a very positive attribute to have.

So it sounds like smaller, miniature implants are the new and improved implant. We have moved forward to this compact era. I can use a mini-implant wherever I previously used a conventional implant. Just like the song says: I would hammer in the morning…….” I would use my hammer everywhere and all the time.

Size – The Biggest Advantage and Disadvantage of Mini-Implants

The ad went on to say that healing is faster and the teeth can go in faster and the results are immediate. We all want this. Right? As with many things in life, if something was really true then everyone would be doing that thing. We need to talk about this.
The biggest advantage to mini-implants is their size. The biggest disadvantage to mini-implants is their size! That’s right, the best thing about them is actually the worst thing about them.

Implants serve as a foundation for teeth in the mouth

Many years ago a wise oral surgeon told me that he always over-engineered his implant cases. He used the biggest and most implants wherever he possibly could. The reason was very simple. Implants serve as a foundation for teeth in the mouth.

When we build a house, for example, do you ever hear that the contractor uses mini-supports? Where we need to use studs every sixteen inches, do we put them every three feet? Of course not. We need to construct a structure that is solid and will endure the weight and other forces that may be put on it.

So I will ask you: Why do we think that we can skimp on support for teeth? We chew meat….we chew bread…we chew nuts. These and many other foods put many heavy forces on our teeth. We need support. We have at least twenty-eight teeth. Why do we need so many? Let us develop a few big teeth on some small roots and that’s it. These mini roots would make it easier to brush and floss. Our dental cleanings would go faster as there are fewer and smaller roots to develop tartar to clean.

The answer is obvious. It wouldn’t work. From a structural standpoint, it is faulty. We need enough teeth and large enough roots to handle all the forces of chewing. People with a full compliment of teeth and a healthy supporting gums and bone can exert the greatest biting forces. These forces are needed to properly eat our food and allow us to be nutritionally fit.

Where the greater force is exerted, the greater the support needed

Where we have the greatest forces, we need the biggest implants to support these tremendous forces. Back teeth is NOT an area where we use mini-implants. The biting and chewing forces of our large molars will overload a miniature implant. You can’t put a top-heavy crown on a little tiny implant and expect the support to last. This will overload the situation and cause the implant to fail. I have written extensively on how detrimental to natural teeth excessive biting and grinding can be.  In the case of an undersized implant, even normal biting is too much!

Where mini-implants are best used

So, after all, is said and done, where would I use a mini-implant? Who is a good candidate for mini-implants?
I have used them for years, but the need to pick and choose the right candidate for mini-implants is important. I would not “use my hammer to hammer all over the land”.

Mini-Implants are best used to support a denture that already has a reduced biting force. It should bite against another denture, not against natural teeth. This will produce excessive forces for the mini-implant. Because they are smaller in diameter, one needs more of them to support a denture. Where I could use 2 normal size implants, with mini-implants, I need at least double that.

You still need to evaluate the patient and the remaining bone to place these properly. I have seen too many inexperienced dentists place mini-implants in the wrong area or missed the bone because they used shortcuts in their techniques. When I teach my students, I emphasize proper preparation before ever beginning any treatment.

So yes, mini-implants are a valuable adjunct to all the other tools and techniques that I have. Proper preparation and planning are crucial as with all things in life. If you ever wondered if you are a good candidate for mini-implants or any other type of implant, please call me at 440.951.7856. I will be more than happy to talk to you and advise you to the best of my ability. I look forward to hearing from you.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

More

Oral Hygiene & The Risk Of Stroke

Proper oral hygiene and diet can prevent stroke

Oral Hygiene and the risk of stroke. On the surface, these two concepts do not seem interrelated. In reality, along with a proper diet, your oral hygiene can be very instrumental in preventing a stroke.

I Had A Stroke in My Eye Last Weekend!

That was the statement that I heard from a patient when asking about anything new in his medicines or medical conditions. I needed an education on this topic so I asked the patient to explain what that was.
The reality of the term is really no different than any other type of stroke. According to the American Academy of Ophthalmology, an eye stroke’s most common symptom is sudden, painless vision loss. Depending on the location, it could result in total loss of vision for the entire affected eye or as in my patient’s case, it affected only part of his eye.

The Academy goes on to say that men in their sixth decade of life are the most likely to experience this. Patients with diabetes, high cholesterol, heart disease, and narrowing of the carotid artery will increase the likelihood of this happening.
So what does this have to do with teeth? I will explain that soon.

The Last Word on Saturated Fats & Your Health

In a recent article published just last week, Dr. Joel Kahn, a professor of cardiology, discussed the findings of June 15, 2017, by a Presidential Advisory from the American Heart Association. It made clear and recommended that limiting those foods high in saturated fat and included this in a large paper.

The following is part of a news release from the American Heart Association:
“Saturated fats are found in meat, full-fat dairy products and tropical oils such as coconut, palm, and others. Other types of fats include polyunsaturated fats, found in corn, soybean, peanut and other oils, and monounsaturated fats, found in olive, canola, safflower, avocado and other oils.”
They went on to discuss these types of fats. Here are some highlights of their statements:

1. Randomized controlled trials that lowered intake of dietary saturated fat and replaced it with polyunsaturated vegetable oil reduced cardiovascular disease by approximately 30 percent –similar to that achieved by cholesterol-lowering drugs, known as statins.

2. Prospective observational studies in many populations showed that lower intake of saturated fat coupled with higher intake of polyunsaturated and monounsaturated fat is associated with lower rates of cardiovascular disease.

3. Replacement of saturated fat with mostly refined carbohydrate and sugars is not associated with lower rates of cardiovascular disease(heart disease).

Dr. Kahn went on to say that this ended decades of misinformation that tried to state that this is not necessarily true. Over a century of solid scientific research has pointed to eating more fruits, vegetables and whole grains, while eliminating meat and dairy, will improve the chances of having a better quality of life for decades.

Get through your 60’s without a major health issue, & you’re in good shape

I have always said that if you can get through your 60’s without a major health issue, you were in good shape. It is this decade that years of bad habits and diets show up.

These bad habits build up plaques in the arteries. When these plaques break off and get lodged somewhere they stop the blood flow to that part of the body. In my patient’s case, it was his eye. If it gets stuck in your head, you could die or be permanently impaired due to loss of brain function. In the heart, you will get a heart attack.  By eating saturated fats, these are some of the consequences associated with all of this.

A Plant-Based Diet, Oral Hygiene and The Risk Of Stroke

The game plan is obvious. Reduce the intake of these fats and replace this diet with one loaded with fruits and vegetables.

How does one enjoy all these varieties of food? It all starts with my good friends…the back molars. We need to keep our back teeth in great shape in order to ingest and digest these foods properly. Consequently, apples, walnuts, carrots etc are impossible to eat unless we can mash and smash these foods as the first step of digestion. Frequent checkups followed by being receptive to advice will keep our teeth for decades.

“It’s just a back tooth and I don’t really care” is the wrong approach. Wherever possible do everything to save your back teeth. In the event that is not a possibility for whatever reason, then replace them with something strong and stable.

The bottom line is this. Oral hygiene & the risk of stroke are related to one another. You need to incorporate good oral hygiene along with a plant-based heavy diet to reduce your risk for stroke and other related ailments. It’s not just your teeth that benefit. Your whole body does!

If you want to talk to me more about any of this information, please call me at 440.951.7856. I look forward to hearing from you.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

More

Take Control of Your Dental Destiny – Good Oral Health is up to You

Good Oral health is up to you! Floss!

Do you find that you are always having issues maintaining your teeth properly? Have you resigned yourself to always having tooth decay? Do you dread visiting the dentist because of it? “I can’t help it! Soft teeth run in my family”
While some factors in keeping your mouth healthy are not entirely left to your discretion, the fact remains, good oral health IS up to you.

“Your teeth look fantastic!”

That’s what I said to a patient last Friday morning as I finished her 6-month checkup and cleaning. This patient was seen all too often for decay, root canals, and crowns. It felt like every few months, she was calling with broken teeth and pain. What was her response to my comment? She showed me a great smile and said: “I started to floss”.

Nutrition isn’t the only consideration for a healthy snack

There’s actually a lot more to the story than that. She is actually a raisin lover. Every morning, it was Raisin Bran. Snacks all day long were raisins.
Now don’t get me wrong. Raisins, or dried fruit in general, are great snacks to eat. Raisins are a snack rich in B vitamins, iron and potassium. Low in sodium, and high fiber is some of its other positive attributes. Besides nutrients, raisins are also a good source of carbohydrates for energy. Plus they are not loaded with all types of chemicals that we find in processed foods.

However, it is a sticky food. So all day long it sits and sticks in and around the teeth. This is a formula for disaster. This is especially true if we have a lot of fillings or as we age and expose more root surface.
Therefore, removal of the sticky, sugary residue is paramount to reaping all of the health benefits of this great snack while minimizing its downside.

Good oral health is like a three legged stool

Health and particularly oral health is like a “three-legged stool”. You need all three legs for the stool to stand upright. If one of the legs is faulty the stool can not stand. It will topple over. Having a healthy oral environment is dependent on three factors as well. These factors of good oral health are not in any particular order as we talk about them.

Leg 1: Your diet

First of all, we need to watch what we eat. The texture and makeup of foods can promote or deter oral disease. Certain foods are more conducive to creating an environment where bad bacteria can survive and grow. These bacteria are the prime culprits in cavities and gum disease.

These bacteria love the sticky and gooey foods that we all enjoy. As long as the food is stuck in our mouths, these bacteria have a Thanksgiving Day feast. Unfortunately, we are stuck with the bad effects of this feast.

Leg 2: Oral hygiene

Related to the first one, the second leg of our good oral health stool involves oral hygiene. In fact, it helps control the first one if sticky foods are a large part of our diet. It is comprised of those activities and tools that we use to reducing the effect of foods on our teeth. It is our actions that we employ to keep our mouth clean.

Brushing, flossing, using an oral irrigating device are some of those activities that we utilize to attain a clean mouth. Even rinsing one’s mouth with water after eating can be beneficial in certain circumstances. Yes, anything is better than nothing, which means the more you clean, the cleaner and better your oral health can be. So frequency is also an important factor.

Leg 3: Our DNA and predispositions

While the first two legs, we can control entirely. The last supporting leg of our good oral health stool is our own genetic makeup. Our personal DNA composition and how prone we are to decay or gum disease.
The reality is you may have a genetic predisposition to ‘soft teeth’ or ‘ bad gums’ which is detrimental to good oral health.

Well, that’s a bum rap! We can not control that at all. I believed that until I recently learned some new facts. I read and listen to a number of physicians. One of the latest trends in medicine is how lifestyle interacts with the cards that we are dealt with, in other words, our genetic makeup.
I recently had a conversation with a cardiologist who told me that even though someone may have genes for heart issues, one’s habits and lifestyle may prevent those “bad” genes from ever turning on. In other words, create an environment where your genetic makeup has a minimal influence on bad things happening to you.

Regarding your oral health, this translates to proper diet, brushing well and often, and seeing a professional at the recommended intervals so you can control the age old “soft teeth” or “bad gums run in my family” issues. Staying away from junk and practicing cleanliness will do wonders for our oral health. In fact, that is a prescription for good overall health in general.

Control your dental destiny

So if you are searching for a way to change your dental future and control your dental destiny, please feel free to call me and let’s talk about it. Good oral health is achievable! My wonderful staff and I will do everything that we can to move you along the way to this goal. I can be reached at 440.951.7856 and look forward to speaking to you.

 

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

 

The Healthy Smile has two convenient locations!

34586 Lakeshore Boulevard (¼ mile west of Route 91 on Lakeshore Boulevard)
Eastlake, Ohio 44095
440.951.7856

Severance Medical Arts Building, Suite 603
5 Severance Center
Cleveland Heights, Ohio 44118
216-371-2333

More

‘Misaligned’ teeth are necessary for proper tooth function and health.

'Misaligned' teeth are necessary for proper tooth function and health.

 

My Upper Front Teeth are in Front of my Bottom Teeth. Can You Fix It?

When you say “Fix”, it implies that something is broken. As such we have to determine what is broken and then proceed to fix it. I hear this statement many times or I’m asked as a question regarding the position of the upper front teeth in relation to the lower front teeth. It is usually preceded by “my bite is all messed up…look at my front teeth!” The truth of the matter is, ‘misaligned’ teeth are necessary for proper tooth function and health.

Why we have different shaped teeth

Before we determine if the bite is “all messed up”, we have to examine the shape and function of teeth. I have touched upon this in the past, but a review is good for all of us.

Have you ever wondered why teeth have different shapes? Let’s think together and try to compare teeth to other parts of the body in an effort to answer this question. The best comparison which can be made is to our fingers. Our fingers and thumbs are different in size, shape, and position. Why is this so? The answer is very simple. It is a function of different jobs for different fingers.

Each of our fingers has its own particular function and that finger is best suited for that activity. In addition to that, the different shapes of the fingers allow each one to work in group function with the other fingers. For example, our thumb is called “opposable”. That means that is be placed opposite the fingers of the same hand to grab something. Opposable thumbs that allow fingers to hold an item are a unique feature of humans and other primates.

Different shaped teeth serve different functions

Okay, enough about fingers. Let’s get back to the teeth. If we take what we learned about fingers and apply it back to the teeth, we have our answer. Teeth have different shapes, just like fingers have different shapes because their functions are different.

We say that we chew with our teeth. This “chewing” activity is actually a complicated process. It involves grabbing the food, tearing the food, cutting it into smaller pieces. After all of this, the food is ground or “humanly pureed” to allow us to easily swallow and digest the food.

The back teeth are broad and flat as they act like little millstones in a grinding wheel. The front teeth are first in line to encounter food and must rip, tear, and slice. Just like a pair of scissors that have the blades go past each other to cut, so too, our upper teeth are slightly ahead of our lower teeth to create a scissor-like action. This slices the food into a more manageable size. Think of eating an apple. We first “bite” with our front teeth and then move the food to the back of the mouth for the “grinding” process. The sum total of all of this mastication is called chewing.

”Misaligned’ teeth are necessary for proper tooth function and health.

So now we understand that our upper front teeth must be long and narrow and work with the lower front teeth to initiate the chewing process. This is best accomplished when our upper front teeth do not meet the lower front teeth head on, but rather are slightly forward to create the scissor movement that is needed. In addition to inefficient biting, having the upper teeth meeting the lower teeth directly causes undue wear and tear on these teeth. Edges can chip and fracture as a result. You want to have your teeth slightly ‘misaligned’ – it keeps them functioning properly! That’s right! ‘Misaligned’ teeth are necessary for proper tooth function and health.

I just saw a patient yesterday that fractured her front tooth right down to the gum. This occurred because her upper front tooth was receiving all the force of her bite. Despite having a crown on her tooth, she still fractured her tooth! Since her tooth is actually slightly off in position that created this recipe for disaster. She was referred to me to remove the root and do an implant. I will st rive to place the implant in a position that will be kinder to the final result.

In conclusion

So the next time that you look in the mirror and smile. Don’t put your upper teeth directly on top of your bottom teeth. That is not proper tooth alignment. If for some reason you see this, go to your dentist and ask for an opinion. If you don’t have a dentist that you see on a regular basis, please call and ask to speak to me at 440.951.7856. I will try my best to help you. Looking forward to conversing with you!

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

The Healthy Smile has two convenient locations!

34586 Lakeshore Boulevard (¼ mile west of Route 91 on Lakeshore Boulevard)
Eastlake, Ohio 44095
440.951.7856

Severance Medical Arts Building, Suite 603
5 Severance Center
Cleveland Heights, Ohio 44118
216-371-2333

More

There’s no Such Thing as a ‘Dental Implant Specialist’

Smiling dentist looking and pointing up to the side

Should I see a specialist for my dental implants?

Do I need a separate dental implant specialist to have my implants done?  This is a question that is asked to me periodically. The most recent occurrence of this question happened 2 weeks ago. Let me add, parenthetically, that the question is usually asked to me by a new patient. Once a patient becomes part of the practice, he or she is usually comfortable with the wide array of services that our office can provide.

Let me get back to our question and relate to you what happened. I was outlining a treatment for a new patient. The treatment included dental implants, removal of teeth, crowns, a full denture and a partial denture. We had discussed various options for a number of appointments. As always, I make the patient a partner with me in the ultimate plan. I inform and educate. Together we create a plan that works for that patient in that circumstance. After a number of discussions, he asks me the specialist question.

How specialties operate in dentistry

Before I answered him, I needed to explain how specialties operate in dentistry.
To be called a specialist, you must practice one of the dentistry’s recognized specialties. Periodontics which involves treating the gums, endodontics which treats root canals, oral surgery which involves tooth extractions and more. Lastly, orthodontics, the discipline that helps to straighten teeth is another specialty. These are all recognized specialties by the governing bodies of dentistry. Governing bodies are state boards and national societies. You can’t just take any procedure and call yourself a specialist. You will be taken to task by state dental boards. Most dental specialists limit their practice to their specialty. This is why if you see a root canal specialist for a root canal procedure, you will need to go back to the general dentist to place a filling or crown over the hole that was made to do the root canal.

Technically, there is no such thing as a ‘dental implant specialist’

So now let’s go back to our question from my patient. The answer is simply that implant dentistry is not a recognized specialty in the United States.
The American Dental Association (ADA) has not established implant dentistry as a specialty. Some professional dental organizations offer “credentials” in implant dentistry for their members, who often promote their expertise using these credentials. However, none of these credentials are recognized by the ADA.
As such, no dentist is a “dental implant specialist” per se.

Now there are specialists such as oral surgeons or periodontists that place implants, but they are not “dental implant specialists”. In fact, if either of these types of doctors places an implant you have to go to another office to finish and put a crown on the implant. This is what I hear from so many patients who don’t like bouncing from office to office. Dentists who do the entire implant case for a patient from start to finish have been referred to as an ‘Implantologist’. Going by that unofficial and casual definition, my credentials and work fit into that category.

Planning and executing your implant procedure from start to finish

As a patient would you like to go from office to office to get your implant procedure completed? Starting it by one specialist and following up at another? Of course not! I find it very stimulating for me to plan and execute a case from start to finish. When I place an implant, I know what it will be used for and can control the placement to accommodate the final result. In cases where issues may arise, I can apprise the patient when it happens and then deal accordingly so the final result is not changed or if need be, altered in the least way possible. My patients always appreciate me staying on top of their treatment. You also benefit from getting the entire procedure done by one doctor – me.

Having years of experience is a huge advantage

When it comes to dental implants, having years of experience is a huge advantage, especially for my patients.
I have been placing and restoring dental implants since the early 1990’s. Besides teaching graduate students, I am now proud to say that I am associated with Northeast Ohio’s first implant company – Zuga Medical located in nearby Beachwood, Ohio. As their head trainer and instructor, I instruct licensed dentists in the discipline of placing and restoring dental implants using the Zuga Implant System. I present theory and science to these doctors. I follow this with live patient treatment while they watch the procedure.

If a picture is worth a thousand words, then these demonstrations must be worth over a million words for these doctors. This is so rewarding for me as I can share my many decades of knowledge with many of my colleagues. This allows more patients in our local area to benefit from one of the most exciting advancements in dentistry in many years.

In Conclusion

If you are contemplating dental implants and would like to find out more about this exciting aspect of dentistry, please feel free to call me at 440-951-7856 and allow me to share in creating a healthy mouth for you to enjoy for years to come. I look forward to hearing from you.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

More

Even Tiny Spaces Between Our Teeth Can Cause Serious Damage

Man poking at food stuck between teeth

Help! I just started to get food caught between my teeth!

This is an issue that comes up many times during the week. I hear it from patients and I hear reports from our talented hygienists when they give me a report on the status of a patient. In fact, I just heard it this morning as I met a patient on the street and he complained of this also. Food impaction in the mouth is a result of spaces between our teeth. So before we talk about whether or not catching food is a concern, let’s discuss spacing in between teeth.

Our teeth work best when they are all neatly in a row.

In an ideal world, every tooth in your mouth would be lined up like little soldiers in a row. Each one next to its neighbor with no overlapping or crowding. They should touch each other in a firm way. Not too much pressure and not too little pressure. The reason that this arrangement is ideal as a self-protection mechanism. Let me explain.

The main purpose of our teeth, aside from flashing a dazzling smile, is to chew and properly break up food for digestion. The digestive process begins in the mouth with tearing, grinding and chemical breakdown via our saliva. Not all foods are cooperative and simply go down our esophagus. When the teeth are all aligned and touching each other they create a path for the food to actually slide off into our cheeks and not stay on our teeth. This helps to break down the food further as it can be brought back around and chewed a second or third time. All of this makes the food easier to swallow and reduces the work that your stomach has to do. Teeth are protecting themselves when they touch, as food does not get stuck on them. Proper alignment of your teeth is really a self-preservation tool for them.

Different types of spaces require different types of solutions.

Now, let’s return to the issues caused by spaces. In our not so perfect world, people can develop spaces between our teeth. Sometimes we lose a tooth and have a big space. Other times we have a cavity and develop a small space. Last, but not least, our teeth may drift or move a little creating a tiny space.

Okay, so what does all that mean. If we lose a tooth and have a large space, we all know that we have to fill the space and replace the tooth. If not, nasty things can happen to the teeth around the space and even in other areas of the mouth. Our second “space” example is when we develop decay in between teeth. These spaces will become painful as the cavity progresses and can really destroy a tooth. This pain will drive us to get the cavity remedied before it goes too far. Typically a filling will take care of this issue.

The most dangerous spaces are those that occur as teeth shift and drift. These tiny spaces become a place for food impaction. Food gets stuck in between these little spaces and sits against the tooth and gum for long periods of time. The food attracts bacteria. These bacteria then feed on the food and produce acid. This acid is what causes a tooth to decay. Many times this decay, or cavity as it is often referred to, will progress unbeknown to anyone. It shows up under the gum and moves into the tooth. All of sudden we have a toothache and are looking at a root canal or complete tooth removal. Not only do spaces prevent our mouth from working at optimum efficiency in the digestive department, but the spaces are a cause for a lot of dental work and pain – hence the patient complaints.

 

When it comes to spaces between our teeth, even regular brushing and flossing are not enough.

Some patients believe that they can keep these tiny spaces clean. This is very difficult to do and a challenge, even for the most meticulous of patients who brush properly and floss thoroughly as recommended. We usually can not see the food particles that are caught between our teeth as they are wedged very low on the tooth near the gum. To see this in one’s own mouth is nearly impossible. This is why a dentist is needed to close these spaces between our teeth properly. There are a variety of ways to do this and each situation is different.

So the next time you become aware of these spaces or the dentist asks you if you ever notice food packing in a certain place, your radar should go off and inquire as to how the issue can be remedied. If you notice one of these areas that were not a problem before, give me a call and I will do my best to suggest a treatment for you. Patients can reach me at 440-951-7856 and I look forward to talking to you about this or any other dental concerns you may have.

 

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

More

Modern Dental Techniques Make Crown Replacement Easy & Affordable

Dentist explaining procedure to female patient

The Crown Holding My Partial Fell Out. Can You Please Make A New One?

Crown replacement is another common request that I hear in my office. It can be necessary when one of the anchor teeth that helps hold a partial or removable bridge (as it is often called) falls out. Either a tooth cracks or a crown that has been there for years has come off and no longer fits. This tooth or crown allows the partial to fit over it with a complex array of metal or non-metal arms. These arms, which we call ‘clasps’, allow the removable teeth to be stable in the mouth. It and a few of its friends that look similar create a steady base that allows functional movements and speech. These functional movements we shall call chewing. Without the tooth or crown, and the clasps on top and around it, the removable bridge would flop all over the mouth.

My readers know that I have spent time discussing crowns in the past. It is something that we do on a regular basis. So when the tooth that holds the partial denture, breaks and needs a crown, let’s just make a crown. When the old crown falls off and no longer fits because of decay, let’s make a new crown. These new crowns will fit under the existing partial denture and we can all go on our merry way – right?

Once Upon A Time, Reverse Engineering Teeth to Fit Inside Crowns Was Nearly Impossible.

Unfortunately, crown replacement is not always that simple. I would like to illustrate it with a story from my years in dental school. When in school everything moves along at a snail’s pace. That’s okay, as the students are learning new skills and practicing to create a perfect result. Let me tell you about what happened in my second year, to one of my classmates. We were in our dental lab working on plastic teeth in a model of the mouth. We were making crowns and bridges as a full term project. We worked on this for weeks and months. Long hours both during and after school were invested by all of us. After all, this single project accounted for 70% of our grade. The night before the project was due, many of us were working in the lab and putting the final touches on our work. I noticed one fellow in particular who was not very happy. He was in his work area, laboring diligently with a notable frown on his face. I went over to him to find out what was wrong. He promptly showed me his finished work. It looked great. I congratulated him and asked him as to why he appeared to be upset. He proceeded to tell me that he although he has his project, he could not find the plastic model of the teeth upon which he made the project. It was lost! He has to work backward! He was attempting to shape the teeth to fit inside the crowns. The key to our grading was the fit of the project on the plastic teeth.

Modern Dental Technology & Techniques to the Rescue

Under normal circumstances, we take an impression of a natural tooth or a crown and then make the partial denture over the tooth. When the patient walks in the door with a partial and the supporting tooth underneath is compromised through breaking or falling off, we, just like my dental student friend, have to work backward. This is beyond difficult as we need to make the underneath tooth fit inside the partial denture. In truth, in the past, there were a variety of techniques to accomplish this but they were really hit or miss. Finally, after years of struggling, computers, scanners and advancements in dental technologies have come to the rescue. I can now take an impression of the original tooth and use this to create a scan which can be superimposed to create an exact copy of what was there. This exact duplication of the way the tooth was allows me to make a replacement crown that will fit into and under the partial that is already there. I can not tell you what a cost and time saver this is for everyone involved. The patient does need to have their removable bridge replaced and can return to normal life in just a couple of appointments.

This is just another way where modern dental techniques have turned a nightmare of the past into a very predictable and affordable procedure in the present. Do you have an issue with a tooth or teeth, which you think that there is no solution? Please call me and run the predicament by me. You never know what simple solution that I may have to suggest. I can be reached at 440-951-7856 and I look forward to hearing from you.

 

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

 

More

Allergic to Penicillin? Maybe Not.

Since I deal with dental infections on a daily basis, I need various tools to help deal with these potentially life threatening issues. That’s right, life threatening. Before there were antibiotics, which was not that long ago, people died from oral infections and abscessed teeth. The infection got into their bloodstream and spread throughout their body. If it reached the heart or the lungs, it could trigger events which were fatal. Even not hitting those organs could create a condition of sepsis in the body that led to the patient’s demise. With modern medicine, there are very few infections which will not respond to antibiotics. This is very helpful in dentistry as we can alleviate pain and swelling with the use of a pill. Because teeth are so unique, we often times require some other intervention as the antibiotic alone will not do the job.

All of that being said, our most common antibiotic will be penicillin and it’s cousins, such as Amoxicillin and Augmentin. These work best on those bacteria that cause dental infections. Many of my patients say that they are allergic to penicillin and I need to go another route and avoid the penicillin. Many times, when I question the patient, it appears that they do not have a real allergic reaction, which in itself can be very serious.

This issue was discussed recently by David Lang, MD, Chairman of Cleveland Clinic’s Department of Allergy and Immunology and reported in a recent Cleveland Clinic article. He claimed penicillin was the most frequent allergy reported by his patients. He was concerned that false reporting could endanger patients who had limited the options of their doctor.

The percentage of people who report allergies is thought to be far, far higher than the percentage who actually have allergies. There are many authentic signs to watch for, however, including…

  •         Hives
  •         Rashes
  •         Itchy eyes
  •         Swollen lips, tongue or face

Some people wrongly believe they are allergic because they attributed their symptoms to the wrong source. Many conditions can produce the symptoms listed above, but that doesn’t mean that an allergy is present. Side effects of medicines can also be remarkably similar to allergy symptoms.

Even in cases where you are truly allergic, for the vast majority of people this will go away as the years go by. I am now advising all of my patients who state that they are allergic to penicillin to see an allergist and get skin tested. It is easy and simple to do. Most of my patients come back extremely grateful to find out that they are negative to the allergy test. This is really crucial in oral infections. You are now able to get the most appropriate and efficient drug for your problem.

End of the year cleanings and exams are filling up fast. When you come in for your cleaning and checkup, let’s review your current medications and make sure that it is accurate. Being precise in these areas can make a huge impact when we prescribe a course of treatment for you. Lastly, we just finished Veteran’s day. From now till the end of November, we are offering free exams and x-rays to all of those who fought for our country and helped preserve our freedom. We are also offering special reductions on teeth cleaning. Call me at 440.951.7856 to schedule your visit.

More

Can Tooth brushing Prevent A Heart Attack?

In the real estate world, there is a saying to guide those who wish to be successful. When asked what are the three most important things in selling or purchasing real estate, the answer given is, “Location, Location, and Location”. A similar thought appears in the health field. If you want find the three top secrets to good health, the answer is “Lifestyle, Lifestyle and Lifestyle. Choose the proper lifestyle and you will not fall prey to many of the diseases that plague us in our time. Those of you who follow me regularly and/or are patients of mine know how much emphasis that I place on life style. A new study just appeared which showed that brushing teeth thoroughly to remove plaque could help prevent heart attacks and strokes by reducing inflammation in the body to levels close to what can be achieved by statins.

I have written a number of times how the studies have shown that people with diseased gums are also more likely to suffer heart disease but it had never been shown that good dental health could lower the risk. This new study used a special toothpaste to remove plaque, the sticky bacterial buildup from teeth. Researchers found that people using the special toothpaste were able to remove twice as much plaque than those using a normal toothpaste and their levels of inflammation also fell by 29 per cent. Statins lower inflammation by around 37 per cent. The lead author of the study is the same one, Professor Hennekens, who discovered the benefit of aspirin in the 1990’s.

He commented, “I think this could have policy implications for tens of millions of people alongside statins, aspirin, and beta blockers and other agents that help lower cardiovascular disease.” That is a huge statement. Benefits are unlimited and side effects are almost non-existent.

We want to try this out on bigger numbers of people with heart disease so we can see if it is actually able to prevent heart attacks and strokes. So this is a jumping off point, but it’s an important result,” said Professor Hennekens Leaving plaque on teeth creates a state of inflammation. Studies have shown that chronic inflammation may fan the fires of heart disease. Now we have our first evidence that removing the source of inflammation is beneficial not only for the mouth, but for our cardiovascular system as well.

But even with the best brushing techniques, there are a number of areas that are very hard to keep clean. Old fillings that are rough, broken or chipped teeth, and spaces that may develop between your teeth are sources of chronic inflammation. These areas should be smoothed, fixed or replaced to create an environment that is less conducive to bacterial and plaque accumulation. Modern bonding techniques and newer tooth replacement techniques all have this goal in mind.

Of course, the step before brushing is to eat those foods that leave behind the least amount of residue. Staying away from those types of foods, make our brushing easier. With Halloween approaching let’s keep this in mind. If you are going to indulge yourself, I recommend doing it all at one time rather than grazing the entire day on junk food. We come full circle to lifestyle. Good nutrition and proper hygiene will go along way for you. Are you overdue for your cleaning? Give us a call and reboot your mouth back to a state of cleanliness and renewed health. I can be reached at 440.951.7856

More

I Have a Wedding to Attend. I am Concerned About My Temporary Crown.

This statement was made to me this week. The situation was the following: social event in a couple of weeks; black spot on a crowded and turned front tooth. Part of the patient was saying, “I want to look good at this affair. Part of the patient was asking, “Will I look worse? Will the fix fall off?

 

Before we deal with those issues, let’s discuss why we do anything that is temporary. After all, the patient is sitting in the office. Let’s just fix the problem permanently and be done with it. As a rule, anything that it involves lab work usually can not be done in one visit. The reason is simple. The technology and the process to make something for you can not be performed in your mouth. Whether the technology is old or new, the making or “manufacturing”, if you will, of a replacement part needs fast moving components or high heat which precludes the process from happening inside your mouth. What we do is make a copy of your tooth after we have shaped or adjusted it and send this copy to a lab. They then have a duplicate of your tooth or mouth and can make something that is designed to fit your mouth and situation.

 

This two appointment process will leave your tooth in limbo. It has been shaped and modified and you may not like the way it looks or feels in this intermediary stage. This is where temporization comes into play. We make something right in the office to cover, protect and make the tooth or teeth look natural. There are many ways to do this and many material to do perform this step. Recently, we have moved to a new material which not only looks great but fits very well. I can make it for you very quickly and oftentimes you will leave the office looking better than when you entered. This is true depsite the fact that you do not have the permanent fix as of yet.

 

The patient who asked this question,  needed a crown (cap) and was concerned about the interim crown falling off. Our newest technique has demonstrated great retention by the tooth. The need to re-cement an interim crown has decreased by a great deal. They fit very well and the only reason that they become loose is the fact that I use a light glue so that I can remove it easily for the final tooth. So falling off is typically not an issue.

In terms of cosmetics, I can alter the position and size of your tooth to create a much more pleasing appearance. Dark stain, spots or other discolorations are gone. If the tooth had a silver filling, your temporary will eliminate all of that. So, except for hardness and durability, the temporary has solved all of  your immediate needs.

In our patient, who expressed concern, not only did I get rid of a cavity and black spot on the front tooth, but I also turned the tooth and created instant orthodontics for her. She was so happy and confidnent that her affair would go off without a hitch. Her tooth looked good, free of spots, and turned to create a pleasing cosmetic result.

The lesson to learn from this is to never assume that something can’t be done in an efficient and expeditious manner. You don’t have to walk around with broken, discolored, or unsightly teeth. They can be fixed faster than you may expect. Do you have a tooth that concerns you? Call me at 440.951.7856 and we can discuss it.

More