Of all the of amazing procedures in today's dentistry, surgery that causes new bone to grow — in places where it had previously been lost — is high on the list of the most extraordinary. (When bone is lost or resorbed, it is broken down into its mineral components, which are dissolved into the bloodstream. Resorption of tooth-supporting bone often takes place after teeth are lost.) Dental techniques that cause new bone growth are important because a certain amount of bone is needed to replace lost teeth with dental implants.

Today's dental implants themselves are an amazing innovation. Implants consist of a replacement for the tooth's root, usually made of a metal called titanium. A replacement for the crown, the part of the tooth that is visible above the gums, is attached to the titanium root. Titanium has the remarkable quality of being able to fuse with the bone in which it is anchored. This process, first discovered in the 1950s, is called osseointegration.

In the case of missing upper back teeth, many people who wanted dental implants in the past were told that they did not have enough bone to anchor the implants and that they had to get removable dentures instead.

But now a new surgery called maxillary sinus augmentation can cause your body to regenerate bone where it was lost and is needed to anchor dental implants.

Bone in the upper jaw or maxilla usually supports your upper back teeth. Inside the maxilla, on either side of your upper jaw, are air spaces in the bone, which are lined with a membrane. These spaces, called the maxillary sinuses, are generally shaped like pyramids; but their shape and size is different in each person. The new surgical procedures involve lifting up the sinus membrane in the area where bone is needed and filling the space thus created with a bone grafting material. Your body then creates new bone to fill the space. This usually takes about six months. If you have almost enough bone to stabilize the implants, they can be placed simultaneously with the graft, thus saving time and avoiding a second surgical procedure.

All grafting materials used today are approved by the Food and Drug Administration (FDA) and must be prepared according to their guidelines. They are specially treated to render them completely safe for human use.

After the surgery there is usually no more than mild to moderate swelling and some discomfort, about the same as having a tooth removed.

If you are missing upper back teeth, contact us to schedule an appointment to evaluate your upper jaw. You can also learn more about this procedure by reading the Dear Doctor magazine article “Sinus Surgery.”

If you cringe at the appearance of your less than pearly whites when you look in the mirror, you are not alone. A frequently requested cosmetic procedure, teeth whitening is a very successful and relatively inexpensive way to enhance your smile. We can determine which whitening treatment will work best for you after performing a basic oral examination in our office. When will it work and when won't it? Here's some background:

Teeth most commonly become stained or discolored due to surface (extrinsic) changes, the most common of which are dietary and smoking. Foods including red wine, coffee, and tea can cause extrinsic staining. Teeth can also commonly become discolored or stained due to intrinsic (internal) reasons, such as changes in the structure of enamel or dentin or by incorporation of chromogenic (color generating) material into tooth tissue during formation or after eruption.

1. Toothpastes that claim to whiten teeth are only effective in removing plaque and other surface stains. Although most of these products contain mild abrasives that remove the plaque, they aren't capable of changing the underlying color of stained teeth.
2. Tooth polishing by your dentist or dental hygienist is effective in removing superficial staining, but will not change tooth color.
3. Teeth whitening systems work by bleaching, generally with the use of hydrogen peroxide. Using bleaching gels in custom made trays or whitening strips can be done at home, but is slow and the changes are gradual. We can perform quicker and more effective “power bleaching” in our dental office when precautions can be taken to ensure safety due to the higher concentrations of bleaching gels used. Teeth with intrinsic (internal) staining may need internal bleaching to whiten them and this can only be done in the dental office.
4. Teeth whitening results fade over time, but optimally last from six months to two years. Taking care of your newly whitened teeth by avoiding the foods, beverages, and habits that cause staining will help them remain whiter for longer.
5. If you have had previous cosmetic dentistry performed, including the placement of composite restorations, porcelain veneers, or crowns, teeth whitening may not be for you. Bleaching agents have little to no effect at all on the materials used to create these restorative products.

If you would like to discuss whitening your teeth with us, call today to make an appointment. To learn more about the various teeth whitening procedures, read the Dear Doctor magazine article “Teeth Whitening: Brighter, Lighter, Whiter…”

Even with all the medical know-how we possess at the dawn of the 21st century, complete tooth loss is still a big problem. In this country, more than a quarter of all adults between ages 65 and 74 have lost all of their teeth. For these individuals, removable full dentures are often still used as an affordable and effective way to replace missing teeth.

Success with dentures originates from a collaboration among dentist, laboratory technician, and, of course, the denture-wearer. Creating false teeth that look natural is as much an art as it is a science. We take a number of steps to make sure you will get the best results. These include:

• Positioning the teeth. Using facial landmarks and photographs of how you used to look before your teeth were lost helps us determine where to place each tooth and how the upper and lower teeth should line up in relation to each other. For example, we will consider what size the teeth should be; how close to the lip they should be; and how much space should exist between the upper and lower teeth when they are at rest.
• Simulating natural gums. If you are someone with a “high lip dynamic” (a lot of gum shows when you smile), it is particularly important to simulate real gum tissue in a set of full dentures. Fortunately, there are many colors and textures available to create a realistic effect. Again, photographs can be helpful in achieving this.
• Balancing the bite. We must make sure that your upper and lower dentures come together in a way that facilitates normal biting, chewing, and speech.

As a denture wearer, you will need to visit our office regularly to make sure the gum tissue and bone upon which your dentures rest stay healthy. It's common to see a gradual loss of bone in people who wear dentures at a rate that varies from person to person. This bone loss can affect the fit of your dentures and lead to other health problems, which we can address if we are monitoring you on an ongoing basis.

If you have any questions about dentures, please contact us or schedule an appointment for a consultation. You can learn more about this topic by reading the Dear Doctor magazine article “Removable Full Dentures.”

The term “root canal” strikes fear into many dental patients. But rest assured that this procedure is the best solution to many severe dental problems. It can be pain-free and will actually relieve pain and suffering from infections and dental injuries.

Why would you need root canal treatment? This procedure becomes necessary when the pulp, the nerve tissue on the inside of a tooth's root, becomes inflamed or infected because of deep decay, or when it has suffered a severe injury as a result of an accident or blow to the mouth. The pulp is composed of living tissues including nerves and blood vessels.

Root canal treatment may be necessary if you have a wide variety of signs or symptoms. The pain can feel sharp or intense when biting down, or linger after eating hot or cold foods. Sometimes it can be a dull ache or there may be tenderness and swelling in your gums near the site of the infection.

After trauma, the pulp of a tooth can be exposed or damaged because a tooth has fractured or cracked, necessitating root canal treatment. And the procedure is often needed for permanent teeth that have been dislodged or knocked out.

What exactly is root canal treatment? Root canal treatment is also called endodontic treatment, from the Greek roots “endo” meaning “inside” and “odont” meaning “tooth.” During the procedure, the area is numbed to relieve pain. A small opening is created in the chewing surface of the tooth and very small instruments are used to remove dead and dying tissue from the inside. The pulp is needed during a tooth's growth and development, but a mature tooth can survive without it. The canal is disinfected and then sealed with filling materials. Sometimes root canal specialists use microscopes to work at an intricate level of detail on these tiny areas of the tooth's root.

By having root canal treatment, you prevent inflammation and infection from spreading from the root of a particular tooth to other nearby tissues. Infection can result in resorption, an eating away of the root and its anchoring bone, and you could lose your tooth or teeth. So please don't hesitate when we recommend this treatment. It's not as bad as you think, and you will feel significantly better afterwards.

Contact us today to schedule an appointment to discuss your questions about root canal treatment. You can also learn more by reading the Dear Doctor magazine articles “Common Concerns About Root Canal Treatment” and “Trauma & Nerve Damage to Teeth.”

There's a lot to like about dental implants, today's state-of-the-art tooth-replacement system. We consider them the best choice for replacing missing teeth because implants are:

Healthy
You may not realize this, but when a tooth is missing, the bone underneath it begins to melt away. That's because bone needs constant stimulation to rebuild itself and stay healthy, and it receives this stimulation from teeth. It's a delicate balance that's disrupted by the loss of even one tooth. Because implants are made of biocompatible titanium, they actually fuse to the bone and prevent bone loss.

Strong
The fusion of implant to bone is an extremely solid connection. Not only does it offer a strong replacement for a missing tooth, but it can also offer support to other tooth-replacement methods such as fixed bridges or dentures. By themselves, these other methods would not preserve bone and might even hasten its loss in the case of dentures. But with implants, bone-loss is prevented — as is embarrassing and uncomfortable slippage of dentures.

Aesthetically Pleasing
When you receive your implant, it is left alone for a few months to complete the fusion process described above. Then it is topped with a crown made of a realistic tooth-like material. The result is so convincing as a tooth replacement, only you and your dentist may be able to tell it's not a natural tooth.

Long-Lasting
Dental implants have an amazing success rate — over 97%. And once they fuse to the jawbone, they should never need replacement. In fact, they will likely outlast the crowns to which they are attached, but this is not a problem. Implant crowns are precision components that detach for easy replacement, should the need arise.

Economical
Implants have a higher initial cost than other forms of tooth replacement, but when you consider how long they last, they are very economical. Consider it an investment in your health, appearance and self-confidence.

If you have any questions about dental implants, contact us today to schedule an appointment for an implant consultation.

You can read more about this topic in the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”