Implant dentistry has revolutionized the dental industry and the lives of the patients who benefit from them. Today, dental implants are considered the primary treatment option for people with missing teeth. In fact, according to the American Association of Oral and Maxillofacial Surgeons (AAOMS), The average success rate of dental implant treatment is more than 95 percent! People with many or all of their teeth missing will often be prescribed implant-supported dentures. In contrast to traditional dentures, patients with implant-supported dentures (also known as ‘overdentures’) are able to eat, speak, and smile with confidence, knowing that their dentures are securely in place. Furthermore, implant-supported dentures can actually improve a patient’s oral health by improving chewing functions, speech, & preventing jawbone disintegration & loss.
It’s all about the implants
“I currently have removable implant-supported dentures. Can I convert to a permanent solution?” The answer to that is a resounding “maybe”. It all depends on the number and position of the implants. Let’s think about this together. Many people think that you need an implant for each tooth that you are missing. This couldn’t be further from the truth. In fact, with as little as 4 implants, you can support 10-12 teeth.
Removable vs permanent implant-supported dentures & the spacing they require
However, there’s a catch. The implants have to be spaced properly so teeth are not extended way beyond the implants. If there is too much of an extension of permanent teeth beyond the implant, the permanent dentures can break due to lack of support. A denture that you remove and insert that is held in place partially by implants also rests on the gum. It is being supported all over. Implant spacing is important but not as important as in a permanent solution. A denture can be helped and made more stable with as little as 2 implants in the front of the mouth.
Clearly, in the case of front implants only, the teeth in the back have no implant support. They have gum support. A permanent solution requires implant support, not gum support. That requires proper implant spacing.
This doesn’t mean that a permanent solution is not an option if you only have front implants. If the situation allows, implants can be added to the back of the mouth to give proper support for the permanent teeth. Then you can move to permanent teeth and eliminate the denture.
Permanent dentures need space to avoid breakage
The other factor to consider is the space between the top of the existing implants and the top of the teeth that they are chewing against. In other words, if we have existing top implants, we need to measure the space between these top implants and the bottom teeth. It doesn’t make a difference if the bottom teeth are natural, crowns or a denture. Permanent teeth need space to avoid breakage. If the space is too small then the strength of the teeth is compromised and fractures are likely.
Proper evaluation is required
This is why we evaluate you via a visual exam, x-rays, CT scans, and models. There are many factors that come into play and can influence whether or not you can make the conversion from something removable to something that is permanent.
If you have questions about existing dental implants or, even questions regarding if you are a candidate for implant dentistry, please call me at 440-951-7856. I am more than happy to talk to each and every one of you and help with your dental implant awareness.
Once again, that is a great question whose answer goes well beyond today’s column. However, we’ll try and touch on a few points. To even suggest that we cut out coffee is sacrilegious to most coffee drinkers. Part of the reason is that coffee contains caffeine which in and of itself can be habit forming. We need the kick of the caffeine to get us going. We all know that excess caffeine can have negative effects on us and therefore moderating the amount or avoiding some real “high test” versions from our local coffee store may be desirable.
On the positive side, a new study that discussed the relationship of coffee to liver health. Coffee might help reduce cirrhosis of the liver which is associated with eating too much and drinking to much alcohol. Researchers looked at data from previous studies and found that drinking 2-3 more cups of coffee a day was associated with a 44 percent risk reduction in developing cirrhosis of the liver.1 cup per day was associated with almost 22% lower risk of cirrhosis and 4 cups per day was associated with a 65% lower risk. Cirrhosis involves hardening, followed by destruction of liver tissue. This disease is potentially fatal. Coffee is a very complex beverage with hundreds of chemical compounds. Exactly which helps protect the liver we don’t know. Coffee is known to have antioxidant properties as well as reduce inflammation. Of course, if you are obese, smoke or have a poor diet, coffee is not the magic bullet for you, but it definitely will have a role in a healthy lifestyle.
So not that we are drinking 2-4 cups of coffee per day, what happens to our teeth? When we talk about the benefits of coffee, we must all remember that by drinking that super large, extra sweet latte will negate many of the positive effects of coffee. Perhaps more importantly, more than 55% of the drinks in a United Kingdom survey equaled or exceeded the World Health Organization’s maximum daily recommended amount of sugars for teens and adults, which is 30 grams or 7 teaspoons. Also, 35% of the drinks had the same or a greater amount of sugar than a can of Coca-Cola, which has 9 teaspoons. So these drinks will add weight to you and do a number on your teeth resulting in decay and breakdown of fillings.
If we just focus on basic coffee with its positive qualities we still see undesirable consequences to the coffee. Our teeth slowly stain and turn brown. So one easy fix is , to minimize the exposure of the teeth to the coffee. One way is to drink your coffee through a straw. This reduces the time that your teeth are bathed in the liquid. The other way would be to drink coffee in 1 or 1 gulps. Then if you immediately rinse your mouth or brush your teeth there will be less time for the stain to develop. Of course, a large part of coffee drinking is the relaxation and/or social aspect. Guzzling down the coffee will not fit with that lifestyle.
This is where professional cleanings come into play. We can’t or won’t do the suggestions that I just mentioned. We want or desire that very magical beverage. At the same time we desire to maintain that envious and attractive smile. Seeing our hygienists, Sarah or Shani, will help you restore the luster that coffee may have tarnished. If we are talking about cosmetics and a beautiful smile, you can come to us for a cleaning only more often than once every 6 months. Some patients come every 3 months and some come more often for that great looking smile. If you come to us on a monthly basis, we will give you every third cleaning for free. Call us at 440.951.7856 and schedule your visit towards creating a beautiful and healthy smile.
I have discussed in the past how sugar free drinks are better for your teeth compared to those filled with sugar, but now there is new information that explains that not all sugar free drinks are created equal and some can actually damage your teeth the same way sugar does.
Researchers at the Oral Health Cooperative Research Centre (Oral Health CRC) based at the University of Melbourne, Australia tested 23 different types of sugar free drinks, (including soft drinks and sports drinks) and found that those that contained acidic additives and those with low pH levels cause damage to tooth enamel.
When ingesting a sugar filled drink, the sugar forms a plaque on the tooth surface that bacteria digest and turn into acid. The acid then attacks the teeth and starts dissolving the enamel. It can progress to where it actually can expose the soft pulp inside the tooth. So, drinks that are acidic can also erode teeth.
Most oral health experts agree that use of sugar substitutes such as xylitol and sorbitol can help reduce tooth decay in children. However, Prof. Reynolds of the Melbourne Dental School notes that consumers need to be aware that many sugar free products remain harmful to teeth due to their chemical composition. Six of the eight sports drinks that were tested in the studies caused a loss of dental enamel. The two that did not cause any problems had a higher calcium content.
The Oral Health CRC is recommending that sugar free products – candy or sports drinks – in addition to soft drinks need to carry labels with this information in order to help the consumer decide what works best for their oral health.
If the labels say that the drink contains acidic additives such as citric acid or phosphoric acid, the following steps are recommended:
1. Do not brush your teeth immediately after ingesting. Rinse your mouth out with water and wait about an hour before your brush.
2. Chew sugarless gum after drinking can help increase saliva flow and neutralize the acid.
The Academy of General Dentistry explains that because saliva helps neutralize acids, the worst time to drink soda is when you are thirsty, due to low levels of saliva. I as well as other experts in the field recommend that you drink water to quench your thirst.
Are you interested in these topics? Did you miss my seminar last week? Just call and ask to talk to me. Better yet, call and schedule a preventative exam and we can talk about whatever you would like. I look forward to hearing from you at 440.951.7856.
One column is not adequate to talk about all the possiblites for tooth replacement. Many factors come into play when we make a decision. The number of teeth, the location of the missing teeth, the condition of the other teeth in your mouth, time and finances are some of the considerations that we must evaluate.
Many patients place financial criteria first and formost. I’d like to spend some time and discuss some of the options which may work and be affordable to you. Often times, a tooth or teeth which can be removed by you is left behind in our discussions. Today, I want to explore some of these options. Some patients like a removeable partial denture because they are fearful of dental work. Many times this type of replacement teeth can be made without having to do anything to any other teeth in the mouth. This alone is attractive for many of my patients.
Of course if the rest of your teeth go every which way, we may need to do something so that the teeth can come in and out easily. Now once they are in, the teeth need to be stable to allow you to chew. This stability is accomplished by grabbing onto othe teeth for support. If there are not enough other teeth to aid in the fit, then we need to hug the gums for our stability. When I look at restoring missing teeth, I always need to evaluate the rest of the mouth. Gum disease or decay must be dealth with in order to gain proper support.
You must learn to place and remove your removeable partial denture. To some people this is a challenge and to others it is very simple. As my music teacher used to say, “practice makes perfect” Don’t get discouraged if you struggle at first. The partial denture may feel a little strange intially, but within a few days you should become accustomed quite nicely to it. You should never bite your teeth into place. Even though we tell patients with a full denture and implants that biting may be appropriate, but it is not indicated for a partial denture.
Sore spots will appear from time to time. I am more than happy to see you and adjust these for you. Typically, I will never charge you for these visits. Some people would call that a warranty. I’ll let you decide what term you would use to describle that service that I provide.
Modern material and techniques can make your partial almost invisable to anyone around you. But as we all know, it more than just the materials. You need someone with experience who will take time to work with you and understand your needs and desires. I try my best to be that person and spend a lot of time trying to figure out what is best in each situation. If a partial isn’t in your best interest, I am not shy to inform you accordingly. January is almost over. Let’s fix up our teeth for this year. Don’t put off any longer the gift of beautiful smile. Call me at 440.951.7856 and let me help you.
Want more information? Attend a FREE seminar on Thursday, February 18, 2016, 6:00 PM at 34586 Lakeshore Blvd. We’ll talk about dental implants, tooth replacement and more! Call 440.951.7856 to reserve your spot as seating is limited.
Everybody should be asking the same question. If a crown or cap (they are same thing) is not my real tooth, how could I get a cavity? This is really a good question as the term “decay” in the biological world refers to living tissue. By the way the words “decay” and “cavity” have the same meaning in dentistry. So, if a dental cavity can only happen on living tissue, how can my artificial tooth develop a cavity? It sounds impossible and actually it is.
What typically happens is that due to years of chewing on a crown, some materials, usually metal, can get so thin that they actually develop a hole. Once the artificial tooth, the crown or cap, develops a hole, bacteria can invade the actual living tooth underneath it and create a cavity on the living tooth. In fact decay on the underneath tooth is most common reason that we replace crowns or bridges (made up of multiple crowns). Bacteria attack and wreak havoc on the tooth tissue, not on artificial metal or porcelain.
So let’s get back to our story. What happened with this patient was such extensive decay that when the dentist tried to simply fill the hole, discomfort developed and the tooth then needed a root canal. The root canal was done right through the crown. Now when a replacement filling was done after the root canal into the crown, the bite was no longer even and caused issues with the patient.
What should have happened is the following. Whenever a hole is found on a crown, the entire crown should be removed and the underlying tooth checked and evaluated. If the decay is minimal, then cleaning it up and making a new crown is all that is needed. If the decay is extensive, then the possibility exists for a root canal procedure to be performed. This needs to be done before the crown is redone. That’s exactly what I did. I removed his crown and the rest of the bridge that was attached to it. I then balanced the bite and made him a provisional bridge to evaluate our progress and technique.
We call crowns “permanent”, because you can’t take them off and we have no intention of removing them. Permanent does mean forever. It is used to convey the idea of firmly attaching or gluing it to the tooth underneath. Crowns will last for many years and even a decade or two, but if you are blessed sufficiently to live long enough, you probably need your crown replaced due to a cavity or glue washing out due to acid and enzymes in your mouth.
This thought underscores the need for a periodic checkup and cleaning. During this time we look at the condition of your existing fillings, crowns, bridges, partial dentures or even full dentures. We can spot signs of wear or breakdown and advise replacement while it is still an easy procedure. If you have any questions about any of your existing work, please feel free to call me at 440.951.7856 and allow me to advise you on the correct approach for your situation.
That is such a great question. Before I can answer that, let’s talk about how insurance, specifically dental insurance works. Your insurance that you receive from your employer, union, etc., is a contract between your employer and the insurance company. If doesn’t make a difference whether you pay for all of the premium yourself, split it with your boss or it’s a freebie to you. It is still a negotiated contract. The rules and limitations of the contract are all spelled out before anyone signs anything or pays any premium. The problem usually is that unless you are a dentist, you may not understand the ramifications of all of the exclusions and rules. Almost every insurance plan that I see pays less or doesn’t pay at all for a white filling on a back tooth. I haven’t done silver fillings in over 12 years. So white fillings are not experimental or are they cosmetic per se. They are the way that dentistry has moved to fill back teeth.
However, silver filling still do exist. They are faster to do, they are less money than white fillings and easier for the dentist to perform. As such the fees for silver fillings are less. Since silver fillings are a legitimate way to fill a tooth, your insurance always reimburses your expenditure in the most favorable way to them. Translate this into English, that means giving your dentist the least amount of money for his work. The insurance company has fulfilled it’s part of their contract by providing you with a filling. If you want current and a state of the art procedure, you need to pay for this yourself.
White fillings are bonded into place and may cause teeth to fracture less over time. Silver as a metal will expand and contract differently and lead to fractures of teeth requiring removing of the tooth or crowning the tooth. Because the white filling is bonded into place, the hole that is made to hold the filling can be smaller than used for a silver filling. Translate this into more conservative dentistry.
Because of bonding reasons, many teeth can be held together better with a white filling than a silver filling. This is important when old silver fillings are replaced and the patient is complaining about developing sensitivity on the tooth.
These are some of the reasons that I choose to you use white fillings as my go to procedure when we find decay in the mouth. If you have any questions about this or any other procedure. Please feel free to call me at 440.951.7856 I am always happy to talk to you.
In all fields of medicine there are always more than one choice to solving a problem. Although implants have many advantages over other treatments, they may not be for everyone. A recent stud study just came out comparing the amount of missing teeth in an average American vs people who reside in the United Kingdom. For those under the age of 65, there was an average of 7 teeth missing vs 6 teeth missing in the UK. I am not focusing on the differences today, but on the fact that we are missing 20% of our teeth on an average.
This begs the question as to how to replace these teeth. One of the simplest ways to replace multiple teeth is with a partial denture that the patient may remove themselves. This has special applications. Some of these will have metal involved and others will not. We will talk about this in the future and delve into those options. Those of us in the dental field have attached ourselves to implants because they can function by themselves. What do I mean by that. It means that a dental implant can anchor to the jaw as opposed to anchoring to an adjacent tooth. This really big as we don’t have to involve more teeth than necessary. After all in most cases, our teeth are more apt to fail when compared to our jaws failing.
That being said, dental implants may not be for everyone. One of the biggest barriers to implant dentistry was cost. That is athing of the past with my new system and protocol for replacing teeth with implants. That will be another column. But putting cost aside, there may be other reasons for not choosing a dental implant. In those cases we have “fixed bridges” which are permanently attached to adjacent teeth. These bridges look and feel great. With some of our newer materials in dentistry, we don’t even have to use metal as a substructure for the bridge anymore. This allows some of the best cosmetics that I have seen in my four decades of dentistry
Aside from the cosmetics, there is a time or speed factor. In most cases, your missing tooth is filled in on the day that you come in to see me. You will leave the visit with a tooth or teeth to replace either your back or front teeth. This is always a plus as one of the most common questions that I get is how long will everything take to accomplish. Bridges can be made much faster than most cases of implant dentistry. Note that I said most, not all. That too is another column. So for someone who has a family gathering or other social event, the use of bridges allows me to correct your problem very quickly. I could go on and on as to the advantages of bridgework. If you are missing a tooth or teeth, please call us and come in for a complimentary consultation. It may be one of the best phone calls that you could ever make.
1. Doing 10 other things while you brush – We are very busy every minute of the day, so it is really tempting to brush your teeth while showering or as you are sitting and watching TV. But it’s really important to stand in front of the mirror and watch what you are doing to ensure you brush every single surface and angle of each tooth. If you aren’t distracted, you will be more thorough.
2. Using the web as your Dentist – The internet is full of amazing DIY dental tips that can hurt you more than help you. Use ADA approved products. Don’t try to whiten your teeth by just covering them in peroxide and don’t try to straighten them by putting rubber bands around them. Don’t think that you can learn how to make or fix dentures from all the “tips” that abound. Every case is unique and different and only years of experience will result in methodically working through problems.
3. Avoiding X-rays – Many of my patients are worried about radiation exposure from dental x-ray. There was some panic after a 2012 study that said there is a possible link between dental x-rays and brain tumors. That study did not actually establish the cause of the tumors. Some people in that study had radiation exposure years ago when x-rays were much higher than what we use today. We need x-rays to identify conditions that are not see during a visual exam. You may have a cavity, or even a cyst in your jaw. If you are concerned about x-ray exposure, please talk to me so we can discuss ways to get the most minimal amount. If dental x-rays were really a problem, wouldn’t you think that those of us in the dental field would be at a higher risk for issues. The truth is that dentists and their staff show no untoward problems in life from their use.
4. Traveling with a wet toothbrush – Bacteria thrives in wet environments. When you put a wet toothbrush in a travel case, it is important to remove it from the case as soon as possible to let it air dry. Placing it upright in a cup will do the trick.
5. Overcleaning your toothbrush – Do you think that running your toothbrush through a cycle in the dishwasher or throwing it in the microwave will zap away all the bacteria? Think again. There is no evidence that anyone has ever gotten sick from their own toothbrush. Just rinse it off with water and store upright, making sure it doesn’t touch anyone else’s brush. The dishwasher or microwave will just damage it.
6. Ignoring your clenching teeth – Bruxism, aka clenching, can lead to headaches, chipped teeth, and jaw soreness. I can make you a night guard to wear out of thin plastic that you can grind away at so that you won’t hurt your teeth. It will also train your mouth to put less pressure on your jaw.
There is so much misinformation that is out there for people to read. Always ask a professional before you try or believe something. I will be happy to be that professional for you. Please feel free to call me at 440.951.7856. I am always excited to talk to my readers.
Remember there are less than 2 weeks left to take advantage of the 20% discount for services begun by the end of the year*. Call today and take advantage of this great offer which ends on December 31, 2015
Root canal treatments are performed when a tooth becomes extremely painful. It is an alternative to removing the tooth and placement of an implant or bridge. As such, it is a quite necessary procedure. Patients usually feel better after the initial appointment. Therfore, they only do half the procedure because they figure that they are out of pain, so why finish?
Root canal treatments aim to remove pulpal disease and save infected teeth by eliminating bacteria from the root canal system. When you begin root canal treatment without seeing it through to the end, an open space is left behind which can cause bacteria to grow, infecting your body.
A study was just published recently where a total of 283,590 participants who received at least one root canal with no cardiovascular history before 2005 were followed until 2011. An unfinished root canal was defined as a tooth that a root canal as started on but never finished. A total of 3626 participants underwent hospitalization for cardiovascular disease. Compared to the participants who had finished root canal treatment, the rate of hospitilzation was 1.22 for those with 1 or 2 unfinished root canals and 3.61 with those who had 3 or more.
Although interesting this study has less of an impact in my practice. Let me explain what that means. I use new instruments that allow me to start and finish a root canal in 1 visit. I hate to say never, but almost never, is a tooth left with a “half of a root canal procedure”. This means that the tooth is always sealed and chances for bateria to get into the tooth, followed by a penetration into the body is reduced signicantly.
Not only can I finsh an entire root canal in one visit, but the instruments and techniques that I use make most root canals a very quick procedure. Most teeth go from start to finish in less than an hour, with many teeth being even quicker. The result of all this is that you, the patient, are in and out of the office faster. You have to hold your mouth open less and spend less time in the chair. Now, which of you would not like to get in and out of a dentist’s office as fast as possible. Many times a root canal is followed by a crown. With al the time that we save, oftentimes the crown could be done at the same visit. That is a real time saver. We can eliminate one entire appointment.
So if you have a tooth that you are nursing along and just waiting to remove it, please consider saving the tooth and getting more years out of it. Don’t let a nagging tooth spoil the holidays. Our new, state-of-the-art of art instruments make is easier and more comfortable to accomplish this. Please call me at 440.951.7856 and let me and my wonderful staff help you to a pain free holiday season.
Lastly, we have launched our new Social Media campaign. For those of you who may be into Facebook, please go to www.facebook.com/jeffreygrossdds and like us!