Missing Teeth

Missing Teeth

  • Missing Teeth

Fixed bridges and implants are often used to replace missing teeth and to correct some kinds of bite problems.

Crowns and bridges are the most effective procedure for replacing missing teeth or bite problems.

    • Bridges

Bridges are natural-looking dental appliances that can replace a section of missing teeth. Because they are custom-made, bridges are barely noticeable and can  restore the natural contour of teeth as well as the proper bite relationship between upper and lower teeth.

Bridges are sometimes referred to as fixed partial dentures, because they are semipermanent and are bonded to existing teeth or implants. Some bridges are removable and can be cleaned by the wearer; others need to be removed by a dentist.

Porcelain, gold alloys or combinations of materials are usually used to make bridge appliances.

Appliances called implant bridges are attached to an area below the gum tissue, or the bone.

    • Implants

The concept of implanting metal or prosthetic roots into the jaws to support
teeth is not new. Archeologists have uncovered attempts at dental implants in mummies found in ancient Egypt.

Early tooth replacement from ancient Mediterranean civilization
Over the centuries this concept has been attempted in a variety of ways, but has been unsuccessful until recently.

Dr. Per-Ingvar Branemark is credited with the discovery and development of the technique of osseointegration. Osseointegration is defined as a chemical and mechanical bonding of a titaniumimplant (essentially a titanium screw or fixture) to the surrounding bone. These implants act as artificial roots, or anchors, for the replacement of missing teeth. Implants give replacement teeth a more stable base and improve the use one can get out of bridgework and dentures.

Dental implant treatment is performed with a team.The team consists of a restorative dentist who will ultimately fabricate the prosthesis or teeth that are to be replaced; and an experienced surgeon who will place the dental implants in the jaw bone. Careful evaluation of the patient and meticulous planning is essential in providing predictable and satisfactory results.

The treatment consists of 3 phases. The first phase of treatment is the placement of the implants by the surgical specialist. The second phase of the implant treatment is performed after an appropriate period of healing. Bone heals slowly. A period of approximately 3-6 months is required for the process of osseointegration to be complete. The second phase of treatment consists of the placement of abutments or small metal posts to the implanted fixtures. The third phaseof treatment consists of the restorative phase. In this phase the new replacement teeth are fabricated and placed on the implants and abutments.

In the case where there is inadequate bone to support a removable denture, or if the length of the gap is too long between the supporting teeth for a bridge, implants are a versatile means to obtain the necessary anchorage for solid tooth replacement. Implants may be used in the following situations:

There is now over 40 years of experience with dental implants. The success
rates have been measured worldwide. Over 95% of the implants placed into the jaw have a greater than 5 years success rate. Loss of implants after 5 years is extremely rare.

Maxillofacial Surgery

Maxillofacial Surgery

When facial reconstruction, including procedures involving the oral cavity, is called for, a specialist is needed. Surgical procedures of the neck and head area are performed by a maxillofacial surgeon.

Common maxillofacial procedures include denture-related procedures and jaw surgery.

Jaw Correction
Protruding chins, crooked or buck teeth or misaligned teeth are good candidates for maxillofacial surgery.

In some people, jaws do not grow at the same rate; one may come in larger than the other, or simply not be aligned properly with other bony structures in the skull. This can cause problems other than appearance issues; an improperly aligned jaw can cause problems with the tongue and speech and chewing problems as well. Jaw surgery can move jaws into their proper place.

Other kinds of maxillofacial surgery can correct problems with upper facial features such as the nose and cheek.

In addition to correcting jaw problems surgically, orthodontic appliances such as braces may be needed to restore bite relationship and ensure continued proper alignment of the jaw. In some cases, tiny wires or small rubber bands may be needed to keep the jaws in place and promote faster healing. In other cases, small “fixation” screws or plates may need to be inserted in the jaws to facilitate easy movement of the jaws following surgery.

Mouth Rinses

Mouth Rinses

There are two types of mouth rinses. These are cosmetic and therapeutic. Cosmetic mouth rinses, or mouth wash as they are sometimes referred as, mainly serve the purpose of freshening breath. The act of gargling and swishing the rinse in the mouth will remove some bacteria and debris. A therapeutic mouth rinse will do all of this but it also contains fluoride and has been proven to reduce plaque buildup, fight cavities and help to prevent gum disease (gingivitis).

It is important to note that mouth rinses, even therapeutic rinses, are only somewhat effective. This should be part of the daily routine in conjunction with flossing and brushing. Regular rinsing with water and a fluoride toothpaste is just as effective as a therapeutic mouth rinse.

Medication and Oral Health

Medication and Oral Health

There are some medications that can have an adverse effect on your mouth and teeth.

Tetracycline Staining
In North America, in the 60’s and early 70’s, children who were exposed to an antibiotic called tetracycline developed varying degrees of dental problems, including discoloration of the teeth. The medication had its negative effect when either given to patients below 8 years of age, or to pregnant mothers. The medication is no longer given by dentists or physicians to these two groups.

Dry Mouth Syndrome (Xerostomia)

Dryness of the oral cavity can result from a number of factors. Medications can influence the secretion of saliva from the salivary glands. The lack of normal saliva production leads to a very dry environment in the mouth. This dry environment results in an imbalance in the normal bacteria in the mouth and can lead to an overgrowth of microorganisms that result in increased dental decay and soft tissue infections of the mouth. Without saliva, your body losses one of its natural defenses to cleanse the mouth of harmful cavity causing bacteria.

Common causes of dry mouth include certain prescription medications (eg. Antidepressants, antihistamines, pain medications, etc.), anxiety states, certain cancer therapies that might involve irradiation of the head and neck, chemotherapy, states of anxiety, Sjogren Syndrome, HIV/AIDS, diabetes, Parkinson’s disease, and certain foods and tobacco.

Jaw Disorders

Jaw Disorders

People who grind their teeth can sometimes develop a serious problem with their jaw, which left untreated, can adversely affect the teeth, gums and bone structures of the mouth. One of the most common jaw disorders is related to a problem with the temporomandibular joint, the joint that
connects your lower jaw to your skull, and allows your upper and lower jaw to open and close and facilitates chewing and speaking.

People with temporomandibular joint disorders (TMD) often have a clicking or popping sound when opening and closing their mouths. Such disorders are often accompanied by frequent headaches, neck aches, and in some cases, tooth sensitivity.

Some treatments for TMD include muscle relaxants, aspirin, biofeedback, or wearing a small plastic appliance in the mouth during sleep.

Minor cases of TMD involve discomfort or pain in the jaw muscles. More serious conditions involve improperly aligned joints or dislocated jaws. The most extreme form of TMD involves an arthritic condition of the jaw joint.

Jaw/TMJ

Jaw/TMJ

People who grind their teeth can sometimes develop a serious problem with their jaw, which left untreated, can adversely affect the teeth, gums and bone structures of the mouth.

One of the most common jaw disorders is related to a problem with the temporomandibular joint, the joint that connects your lower jaw to your skull, and allows your upper and lower jaw to open and close and facilitates chewing and speaking.

People with temporomandibular joint disorders (TMD) often have a clicking or popping sound when opening and closing their mouths. Such disorders are often accompanied by frequent headaches, neck aches, and in some cases, tooth sensitivity.

Some treatments for TMD include muscle relaxants, aspirin, biofeedback, or wearing a small plastic appliance in the mouth during sleep.

Minor cases of TMD involve discomfort or pain in the jaw muscles. More serious conditions involve improperly aligned joints or dislocated jaws. The most extreme form of TMD involves an arthritic condition of the jaw joint. Traumatic injuries also can cause jaw dislocation.

In these cases, jaw surgery, may be required to correct the condition. Some jaw surgery can be performed arthroscopically.

Infection Control

Infection Control

Universal Precautions
With increased public awareness of global bacterial and viral outbreaks, we would like to provide you with some information about how modern dental offices are required to practice infection control.

Universal precautions were described in directives and guidelines issued by the Centers for Disease Control and Prevention (CDC) and the American Dental Association in 1987, and in standards published by the Occupational Safety and Health Administration (OSHA) in 1991. They are a ‘single standard of infection control’ that is used for each and every patient. These precautions require all dental staff involved in patient care to use appropriate protective garb such as gloves, masks and eyewear. After each patient visit, gloves are discarded, hands are washed with an antibacterial soap or a hand sanitizer, and a new pair of gloves is used for the next patient.

All instruments used on patients are either discarded or sterilized after every patient use. The sterilization procedure involves a series of thorough steps that are performed after each use on a single patient. The instruments are first washed. Then they are soaked in a disinfectant while run through an ‘ultra-sonic’ machine to further loosen any remaining particles from the instruments. Finally, they are sterilized under pressure with chemicals, or steam.

Gum Disease

Gum Disease

Gingivitis is the medical term for early gum disease, or periodontal disease. In general, gum disease can be caused by long-term exposure to plaque, the sticky but colorless film on teeth that forms after eating or sleeping.

Gum disease originates in the gums, where infections form from harmful bacteria and other materials left behind from eating. Early warning signs include chronic bad breath, tender or painful swollen gums and minor bleeding after brushing or flossing. In many cases, however, gingivitis can go unnoticed. The infections can eventually cause the gums to separate from the teeth, creating even greater opportunities for infection and decay.

Although gum disease is the major cause of tooth loss in adults, in many cases it is avoidable.

If gingivitis goes untreated, more serious problems such as abscesses, bone loss or periodontitis can occur.

Periodontitis is treated in a number of ways. One method, called root planing, involved cleaning and scraping below the gum line to smooth the roots. If effective, this procedure helps the gums reattach themselves to the tooth structure.

Pregnancy has also been known to cause a form of gingivitis. This has been linked to hormonal changes in the woman’s body that promote plaque production.

Fluorosis

Fluorosis

Fluorosis is a condition in which your body has been exposed to too much fluoride. In normal doses (typically found in a safe drinking water system and an ADA-approved toothpaste), fluoride is a healthy compound that promotes strong teeth, which has the ability to fight cavities and other problems.

But sometimes, fluorosis occurs when fluoride-containing toothpastes or rinses are swallowed, instead of expelled.

Fluorosis causes a number of aesthetic problems, including abnormally darkened or stained teeth. While such problems are generally harmless to your health, they can create concerns with your appearance.

Flap Surgery

Flap Surgery

Your bone and gum tissue should fit snugly around your teeth like a turtleneck. When you have periodontal disease, this supporting tissue and bone is destroyed, forming “pockets” around the teeth. Over time, these pockets become deeper, providing a larger space for bacteria to thrive and wreak havoc.

As bacteria accumulate and advance under the gum tissue in these deep pockets, additional bone and tissue loss follow. Eventually, if too much bone is lost, the teeth will need to be extracted.

Flap surgery is sometimes performed to remove tartar deposits in deep pockets or to reduce the periodontal pocket and make it easier for you or your dental professional to keep the area clean. This common surgery involves lifting back the gums and removing the tartar. The gums are then sutured back in place so that the tissue fits snugly around the tooth again.

A pocket reduction procedure is recommended if daily at-home oral hygiene and a professional care routine cannot effectively reach these deep pockets.

In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone.