Implant or Bridge? How to Decide (Part 1)

We hope we will never lose a single tooth.  Unfortunately, it happens sometimes.  We can lose a tooth for many reasons. I won’t delve into them in this article.  The purpose here is to help you to decide between a bridge and an implant, in the event that you have to make that choice.

Just so we are clear: No two situations are completely alike. I have neither seen nor evaluated your case and am simply discussing general principles. You should always consult a competent and licensed professional to assess your specific circumstance before making a decision that will affect both your health and finances. Nevertheless, here you are.  Either a tooth has been compromised and is lost already, or it is about to be extracted. If the idea of dental implants has crossed your mind, your dentist first has to determine whether you are a good candidate for the implants. The criteria can be broken down into three broad categories:

  1. Do you have any medical issues that may prevent successful placement of an implant?
  2. Do you have sufficient bone?
  3. Will your existing bite allow it?

So let’s get into it:

1. Medical Issues. Health conditions that could prevent an implant being placed may include, but are not limited to:

  • Diabetes
  • Recent heart attack or stroke
  • Immunosuppression
  • Drug abuse
  • Active treatment of malignancy
  • Intravenous bisphosphonate use

You should disclose anything you think could be a matter of concern with your dentist.  The success rate with dental implants is very high, but careful case selection is the key to success.

2. Sufficient Bone. Again, this needs to be determined by the implant surgeon. Your bone needs to be high enough and wide enough to accommodate the implant. If it isn’t, you may still qualify for a dental implant, but will likely require an additional procedure called bone grafting. Your dentist or implant specialist will determine your specific needs.

3. Your Bite. What does the bite have to do with anything?  There was a tooth there to begin with, right? Both implants – and natural teeth – survive longer when your teeth and jaw are in harmony. If your bite has collapsed – meaning the upper jaw and lower jaws are now too close to each other – there may not be enough room to place an implant without orthodontic (braces), or surgical, intervention.

Starting to sound a bit complicated?  Don’t worry, in most cases, the dentist can tell you pretty quickly if he feels implants will work for you. Sometimes, he needs additional screening tools to make the final call but, if he does, he’ll let you know that too.

Your Dental Insurance and the End of the Year

As the year’s end approaches, I am taking this opportunity (yet again) to share a tip that can help you take full advantage of any dental insurance benefits you may have.

While some patients well understand how their insurance operates, I have learned that others do not.  So let’s undertake a quick review:

The way your dental insurance benefits work is that you are provided with a certain dollar amount of benefits each year. If you do not use those benefits you will lose them! (Unused benefits do not carry over to the next year). Many people do not realize this and allow hundreds (sometimes even thousands) of dollars worth of benefits to remain right in the insurance company’s bank account. While treatment should never be dictated by insurance, if you have any treatment that remains to be completed, or you have any dental concerns at all, it would be very useful for you to come in before the end of the year.

Our goal for each of our patients is to help them enjoy the best oral health possible for their circumstances. For you, that probably means that you look good, you feel good, you have strong teeth and gums, and you enjoy the benefits of a healthy, attractive smile over your lifetime.

If you would like to make an appointment, just give us a call and we will find a time that is convenient for you. Just remember that when the clock strikes 12 midnight on December 31st, you will lose unused dental benefits. We will be happy to help you get the full benefits to which you are entitled under your dental benefits policy.  If you know you’ll need more than one visit, give yourself enough time to have your work completed with whatever benefits you have remaining, so call today.

Laser Dentistry

Lasers are familiar to many of us from science fiction (think of the Star Wars light saber) to comedy (remember Austin Powers’ Dr. Evil?).  The fact is that lasers surround us in every-day life.  For example, in the home you will find them in CD players, while industry uses them for high-speed metal cutting machines and measuring devices.  Hair replacement, tattoo removal, dermatologists, eye surgeons — they all use lasers.

So do dentists.  And so does our office."La-ser"

This begs the question, just what is a laser?  How is it different from any other kind of light?  “If Dr. Evil planned to destroy the world with one, why won’t it hurt me when you use it on my gums?!”  Actually, that’s three questions . . . .

Anyway, let’s try take them in order:

The word “LASER” itself is an acronym that stands for light amplification by stimulated emission of radiation.  This concisely describes exactly how a laser works.   The laser is a device which controls the way that energized atoms release photons (a quantum of electromagnetic energy).  When we say “radiation” however, we are not talking about ionizing radiation — such as would be produced by an x-ray.

Laser light is very different from normal light or radiation emitted by an x-ray.  Laser light has the following properties:

  • The light released is monochromatic. It contains one specific wavelength of light (one specific color). The wavelength of light is determined by the amount of energy released when the electron drops to a lower orbit.
  • The light released is coherent. It is “organized” — each photon moves in step with the others. This means that all of the photons have wave fronts that launch in unison.
  • The light is very directional. A laser light has a collimated (very tight) beam.  This makes it stronger and concentrated. A flashlight, on the other hand, releases light in many directions, and the light is very weak and diffuse.

Why won’t it burn you to a crisp when we use it on your gums?  Clearly, we’re using a controlled power setting (in our office we use a diode laser) — in fact, most patients tell us they don’t feel anything when we use it in conjunction with their dental cleanings.  But that doesn’t mean it isn’t effective!

Watch the video below for a demonstration and explanation of how a dental laser is being used during a routine cleaning.

If you would like to read more about how we use a dental laser in our office and how it can benefit your health, check out the following article posted in the Services section of our website:


Toothpaste and Your Dental Work

Very often patients ask me about what toothpaste they should use.  Seldom, however, am I asked about the best technique for cleaning teeth, when brushing should be done, how often they should brush, or for how long.

The subject of tooth cleansers can be confusing.  There are pastes, powders, cavity-fighting and gum-protecting formulas, as well as whitening varieties.  Most toothpastes use some form of mild abrasive to clean teeth, while others rely on enzymes to lift the stains out of your teeth. Some are foaming and some are not.  Most contain fluoride, while others don’t.

While I do have a personal favorite toothpaste, I honestly believe that an effective job of cleaning can be accomplished with the vast majority of toothpastes available on the market.  Why are there so many out there?  In a word: marketing.  I’m pretty sure toothpaste companies have discovered that if a toothpaste has the word “whitening” on it, they are likely to sell more than if it is omitted — even if the whitening benefit is small.

Some people have even taken to the idea that almost anything will work to clean your teeth.  Even soap.  Here is a short video I ran across recently that discusses this, and also why you may not want to wash your mouth out with soap.  I tend to agree that you should use the right product for the correct purpose.

 Click on the toothbrushes below to view the VIDEO:

For the curious, here is an earlier posting that answers some of the other questions discussed above, including how often you should brush.

Cracked Tooth: Yet Another Example

Just last week I encountered another case of a cracked tooth needing to be extracted.
I can’t say this is uncommon. Yet something about this one stuck with me . . . probably because I felt it was avoidable.

Cracked teeth as a result of the grinding and clenching of teeth — also known as bruxism — appears to be reaching epidemic levels. Frankly, that wasn’t the only case of of problems I saw as a result of tooth clenching that day.

The patient I treated right after him had a series of problems connected to clenching as well: among them, bone loss — (with at least one tooth that will have to be removed as a result), front teeth that were chipped, and another that that developed an abscess. Yes, all of these problems had direct connections to the patient’s habit of clenching his teeth.

Cracked Tooth

But let’s return to original patient for a moment. When he first came in and saw me for his initial consultation six months earlier, I pointed out that there was evidence of bruxism. I recommended doing something about it at that time.

The patient looked at me funny — it was clear that he didn’t think he had that problem. I explained why I thought he clenched his teeth and pointed to several things that indicated that condition. He handled a few other problems, but decided to let this one go (“for now”). I’m not going to put a gun to anyone’s head when it comes to my recommendations, but inwardly I wished him good luck.

While conducting my follow-up exam I observed a crack running through his root. Given it’s size and location, his only option is removal. It didn’t hurt him as much as it could have because the nerve had already been removed, but I couldn’t help thinking this was a shame. Had we followed the recommendations I made six months ago, we probably wouldn’t be dealing with this now.

It’s too late for that patient, but the underlying message here is simply this: if a dentist tells you there is a body of evidence suggesting you grind your teeth — don’t ignore it. Most people simply don’t know if they grind because they often do it while they are sleeping. What is more, they don’t do it consistently. Remember, damage can occur in many different ways. It can be slow and steady, like wind erosion wearing down mountains or very quick and short-term, like a bullet to the head. Either way, there is visible change in the end.

Here is a link to an earlier article I wrote about grinding. If a dentist has ever told you that you might grind or clench your teeth, take it to heart. You may be saving yourself a few dollars . . . as well as a few teeth.

Cracked Tooth Syndrome

No matter how you slice it, tooth problems can be a pain. Among these, cracked teeth stand out for their confusing and erratic nature. A cracked tooth can be painful, annoying, and an exercise in frustration for patients and dentists alike. While there can be many factors that contribute to cracked teeth, the bottom line is that if your tooth is cracked the solution is often involved, potentially expensive — and, despite best efforts, tooth loss is still a very real possibility. Clicking on the picture below will take you to a compilation of questions and answers about cracked teeth. It covers a lot of ground, but if you think you may have a cracked tooth, it is worth reading so that you can know what to expect.

Oral Bacteria and General Health

Did you know that there are way more bacteria in your mouth than there are people on the planet? By some estimates: 120 BILLION bacteria can grow in 24 hours!

That’s really a lot of bugs!

Germophobes might get a little skittish reading this, so it may make you feel better to know that most of them are harmless.

Typically, the body’s natural defenses and good oral health care — such as daily brushing and flossing — can keep these bacteria in check. However, without proper oral hygiene, bacteria can reach levels that might lead to oral infections, such as tooth decay and gum disease.  After more than twenty years of practice I have also observed that oral health can act as a window to your overall health.

For example, your oral health might be affected by, may itself affect, or may contribute to, various diseases and conditions — including:

  • Cardiovascular disease. Some research suggests that heart disease, clogged arteries and stroke might be linked to the inflammation and infections that oral bacteria can cause.
  • Endocarditis. Endocarditis is an infection of the inner lining of your heart (endocardium). Endocarditis typically occurs when bacteria or other germs from another part of your body, such as your mouth, spread through your bloodstream and attach to damaged areas in your heart.
  • Pregnancy and birth. Periodontitis has been linked to premature birth and low birth weight.
  • Diabetes. Diabetes reduces the body’s resistance to infection — putting the gums at risk. Gum disease appears to be more frequent and severe among people who have diabetes. Research shows that people who have gum disease have a harder time controlling their blood sugar levels.
  • Osteoporosis. Osteoporosis — which causes bones to become weak and brittle — might be linked with periodontal bone loss and tooth loss.
  • HIV/AIDS. Oral problems, such as painful mucosal lesions, are common in people who have HIV/AIDS.
  • Alzheimer’s disease. Tooth loss before age 35 might be a risk factor for Alzheimer’s disease.
  • Other conditions. Other conditions that might be linked to oral health include Sjogren’s syndrome — an immune system disorder that causes dry mouth — and eating disorders.

Because bacteria can proliferate as quickly as they do, we now provide our patients with a way to minimize bacterial risks during their cleaning appointments.  We have the ability to use a laser decontamination process that dramatically reduces bacterial levels in your gum pockets painlessly, without the need for anesthesia, and in as little time as 5 to 10 minutes.  Better still, the lowered bacterial levels are expected to continue for six to eight weeks.

Unfortunately, dental insurance still tends to be a little behind the times in terms of their coverage for the procedure.  We have kept the cost low, however, in order that most patients can benefit from this exciting new technology.  You can read more about it by clicking HERE.