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.”

For generations, root canal treatment has received a bad rap. Thought to cause pain, it is actually just the reverse. The truth is that root canal treatment does not cause pain but actually relieves it. Not only does root canal treatment relieve pain, it literally saves the affected tooth or teeth from further damage and/or loss.

To get started, let's define this procedure. A root canal treatment is a procedure in which the diseased pulpal tissue in the root canals are removed, disinfected, cleaned, and sealed. This is usually necessary following inflammation and infection of the pulp — which is the cause of your pain — as a result of severe decay or in a very heavily filled or damaged tooth.

However, if left untreated, an infected tooth can spread into the bone and even cause an abscess — and that can be more painful and impact your overall general health. The good news is that once a tooth has had the appropriate endodontic treatment (“endo” – inside; “dont” – tooth) followed by a proper restoration, it can last as long as your other teeth. The key is to take proper care of your teeth, have routine cleanings, and visit our offices as soon as you feel you have a problem with a tooth.

If you are having pain from a tooth or several teeth, you may need a root canal treatment. Please contact us today to schedule an appointment before it gets worse. To learn more about the signs, symptoms, and treatment for a root canal, read the article “Common Concerns About Root Canal Treatment.”

If an adult has lost his or her teeth (a condition called “edentulism”), full removable dentures (false teeth) can restore the person's appearance and ability to bite, chew, and talk properly. Even with our current extensive knowledge about tooth care and restoration, over 25 percent of Americans have lost all their teeth by the time they are 65.

How much do you know about dentures? Test yourself below.

How does tooth loss affect your bones?
Bone is a living substance that is constantly changing and rebuilding itself, depending on signals it receives from surrounding tissues. The bone that surrounds your teeth is called alveolar bone (from “alveolus,” meaning sac-like). To keep healthy, alveolar bone needs stimulation or function such as chewing and your teeth touching your opposing teeth. If you lose your teeth, bone begins to melt away (resorb).

How can we minimize bone loss during tooth extraction?
We can maintain bone volume by using bone grafting techniques. While this sounds scary, it is a relatively easy procedure. The principle of bone grafting is to build a sort of scaffolding on which your body begins to build and maintain its own bone. Bone loss can be prevented by the placement of a few dental implants.

How are dentures designed and created?
The dentures that look best and work best for you are based on your original teeth. We often utilize photographs of how you looked with your natural teeth, along with your input about possible changes you would like to see. First we take detailed impressions (molds) of the residual ridges in which your teeth once rested. From these we make denture bases of a light cured plastic resin. We attach horseshoe-shaped rims made of wax to the bases, to simulate the position of the teeth as we work out their design and spacing, based on both appearance and function. The prosthetic teeth are then tried out in your mouth, adjustments are made, and the dentures are processed in a dental laboratory. The final product substitutes a pink colored plastic (methyl methacrylate) to represent the gums and white plastic material as the teeth, created to make them look as natural as possible.

What is your part in the denture fitting process?
As a patient with new dentures, you must learn to use your jaw joints, ligaments, nerves, and muscles in new ways to help stabilize your dentures and to relearn to speak, bite, chew, smile, and laugh with these new structures. It takes a little practice, but with your removable dentures you can once again enjoy a complete and normal life.

Contact us today to schedule an appointment to discuss your questions about full removable dentures. You can also learn more by reading the Dear Doctor magazine article “Removable Full Dentures.”

Quiz: What Is Smile Design?

All cultures worldwide recognize a smile as positive nonverbal communication. Yet many people are insecure about the way their smile looks. Modern cosmetic dentistry can completely change your smile through a comprehensive technique called Smile Design.

Take the following quiz to find out how much you know about your smile and smile design.

1. What is the basic reason we consider straight, healthy teeth to be attractive?
1. An article in a beauty magazine.
2. An instinctive understanding of health and survival.
3. Our first grade teacher said so.
4. A talk show on television.
2. What must we take into account in designing an attractive, balanced smile?
1. The shape of your face.
2. Your skin color and complexion.
3. The form of your lips.
4. All of the above.
3. As your dentist, we consider each of the following in evaluating your current smile except:
1. Your marital status.
2. The health of your bone and gum tissues.
3. How your jaw joints function.
4. The stability of your bite.
4. What do we use to evaluate your smile?
1. X-rays and photographs.
2. Models of your teeth and gums.
3. Photographs and computer graphics.
4. All of the above.
5. Bonding is one method that may be used to test or enhance your smile. It is used as:
1. A way of making friends with your dentist.
2. A way of training secret agents.
3. A method of repairing chipped, broken or decayed teeth and testing changes before they are made permanent.
4. None of the above.

Answers

1. b. What we consider an attractive smile is rooted in instinctive understanding of health and survival. We value straight, white, healthy teeth — only a few centuries ago, a person with few or no teeth was likely to starve.
2. d. All of these factors must be taken into consideration in order to design a smile that is in balance with your face.
3. a. While satisfaction with your life partner may make you smile, our priority in smile design is to make sure that the basic structures of your teeth are healthy and function properly.
4. d. All of the above are used in evaluating your current condition to design a new smile.
5. c. In bonding, a composite resin tooth colored material is shaped and physically bonded to a tooth or teeth that are chipped, broken, or decayed to restore both aesthetics and function.

After careful analysis and planning, a variety of techniques can be used to redesign an attractive and healthy new smile, so you can feel confident about smiling and sharing it with the world. To learn more about Smile Design, read “Beautiful Smiles by Design.” Or contact us to discuss your questions or to schedule an appointment.

“Smile, and the world smiles with you,” the old saying goes. For people who are afraid to smile because they don't like how their smile looks, the twenty-first century offers a myriad of solutions. Smiling shows your teeth in their various shapes, colors, and sizes, your gums and gum line, your tooth alignment, spacing, and bite all in relation to the rest of your face. Any of these can now be improved.

Through the knowledge, skills, and combined experience of our dental team, it is now possible to make teeth whiter, brighter, and more evenly aligned, to alter tooth shape and size, and to make the teeth and gum line more proportionally balanced. Here are some options for cosmetic dentistry:

• Polish. Remove unwanted stains on outside tooth surfaces by having your teeth polished.
• Teeth Whitening. If teeth are stained or have just lost their luster, whitening is a safe and effective way to lighten a smile.
• Porcelain veneers. Applying a thin layer of dental porcelain restorative material to replace stained or damaged tooth enamel can truly change a smile.
• Porcelain crowns. If teeth are damaged by decay or trauma, porcelain crowns can replace the parts of the teeth that show above the gum line.
• Orthodontics. For teeth that are not in their correct and functional position, a variety of orthodontic techniques can be used including traditional braces, clear aligners and more—to improve crooked teeth or a malaligned bite.
• Dental implants. Nothing ruins a smile more than missing teeth. Entire teeth can be replaced, including the roots and the crowns, using dental implants. These are exact replicas of the natural teeth and can be made to match their neighbors exactly.

To learn more about all types of cosmetic dentistry, read “Cosmetic Dentistry, a Time for Change.” Or if you prefer, you can contact us to discuss your questions or to schedule an appointment.