Are you interested in dental implants but a little hesitant about the surgery? Don’t be—this procedure to imbed an implant’s titanium post in the jawbone is relatively minor with little to no discomfort for most patients.

Some time before, however, we’ll need to pre-plan the surgery to pinpoint the best location for the implant, critical to achieving a solid hold and a life-like appearance. During these first visits we often create a surgical guide, a device inserted in the mouth during surgery that identifies the exact location for the hole (or channel) in the bone we’ll drill to insert the implant.

On surgery day, we’ll prepare you for a pain-free and relaxing experience. If you’re normally anxious about dental work, we may prescribe a sedative for you to take ahead of time. As we begin we’ll thoroughly numb the area with local anesthesia to ensure you won’t feel any pain.

The surgery begins with an incision through the gum tissue to access the underlying bone. Once it’s exposed, we’ll insert the surgical guide and begin a drilling sequence to gradually increase the size of the channel. This takes time because we want to avoid damaging the bone from overheating caused by friction.

Once we’ve created a channel that matches precisely the implant’s size and shape, we’ll remove the implant from its sterile packaging and immediately fit and secure it in the channel. We’ll then take x-rays to ensure it’s in the best position possible.

Satisfied we’ve properly situated and secured the implant, we’ll suture the gum tissue back in place to protect the implant with or without attaching a healing abutment to it as it fully integrates with the jawbone over the next few months (after which you’ll come back to receive your permanent crown). After a short recovery, you’ll return to full activity. Most patients only experience mild to moderate discomfort usually manageable with over-the-counter pain medication like aspirin or ibuprofen.

While implantation is a long process, you’ll be obtaining what’s considered by most dentists and their patients as the most durable and life-like tooth replacement available. Your new attractive smile will be well worth it.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implant Surgery: What to Expect Before, During and After.”

While the sport of golf may not look too dangerous from the sidelines, players know it can sometimes lead to mishaps. There are accidents involving golf carts and clubs, painful muscle and back injuries, and even the threat of lightning strikes on the greens. Yet it wasn’t any of these things that caused professional golfer Danielle Kang’s broken tooth on the opening day of the LPGA Singapore tournament.

“I was eating and it broke,” explained Kang. “My dentist told me, I've chipped another one before, and he said, you don't break it at that moment. It's been broken and it just chips off.” Fortunately, the winner of the 2017 Women’s PGA championship got immediate dental treatment, and went right back on the course to play a solid round, shooting 68.

Kang’s unlucky “chip shot” is far from a rare occurrence. In fact, chipped, fractured and broken teeth are among the most common dental injuries. The cause can be crunching too hard on a piece of ice or hard candy, a sudden accident or a blow to the face, or a tooth that’s weakened by decay or repetitive stress from a habit like nail biting. Feeling a broken tooth in your mouth can cause surprise and worry—but luckily, dentists have many ways of restoring the tooth’s appearance and function.

Exactly how a broken tooth is treated depends on how much of its structure is missing, and whether the soft tissue deep inside of it has been compromised. When a fracture exposes the tooth’s soft pulp it can easily become infected, which may lead to serious problems. In this situation, a root canal or extraction will likely be needed. This involves carefully removing the infected pulp tissue and disinfecting and sealing the “canals” (hollow spaces inside the tooth) to prevent further infection. The tooth can then be restored, often with a crown (cap) to replace the entire visible part. A timely root canal procedure can often save a tooth that would otherwise need to be extracted (removed).

For less serious chips, dental veneers may be an option. Made of durable and lifelike porcelain, veneers are translucent shells that go over the front surfaces of teeth. They can cover minor to moderate chips and cracks, and even correct size and spacing irregularities and discoloration. Veneers can be custom-made in a dental laboratory from a model of your teeth, and are cemented to teeth for a long-lasting and natural-looking restoration.

Minor chips can often be remedied via dental bonding. Here, layers of tooth-colored resin are applied to the surfaces being restored. The resin is shaped to fill in the missing structure and hardened by a special light. While not as long-lasting as other restoration methods, bonding is a relatively simple and inexpensive technique that can often be completed in just one office visit.

If you have questions about restoring chipped teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Porcelain Veneers” and “Artistic Repair of Chipped Teeth With Composite Resin.”

There are a variety of methods for treating periodontal (gum) disease depending on its severity — from routine office cleanings to periodontal surgery. But the goal behind all of them remains the same: remove bacterial plaque and calculus (tartar), the root cause for gum disease, from all tooth and gum surfaces.

The traditional method for doing this is called scaling in which we use special hand instruments (scalers) to mechanically remove plaque and calculus. Scaling and a similar procedure called root planing (the root surfaces are “planed” smooth of plaque to aid tissue reattachment) require quite a bit of skill and experience. They're also time-consuming: full treatment can take several sessions, depending on how extensive the infection has spread.

In recent years, we've also seen a new method emerge for removing plaque: lasers. Commonly used in other aspects of healthcare, lasers utilize a focused beam of light to destroy and remove diseased or unhealthy tissue while, according to studies and firsthand accounts, minimizing healthy tissue destruction to a better degree than traditional techniques. Procedure and healing times are likewise reduced.

Because of these beneficial characteristics, we are seeing their use in gum disease treatment, especially for removing diseased and inflamed tissues below the gum line and decreasing sub-gingival (“below the gums”) bacteria.

Dentists who have used lasers in this way do report less tissue damage, bleeding and post-treatment discomfort than traditional treatments. But because research is just beginning, there's not enough evidence to say laser treatment is preferably better than conventional treatment for gum disease.

At this point, lasers can be an effective addition to conventional gum disease treatment for certain people, especially those in the early stages of the disease. As we continue to study this technology, though, the day may come when lasers are the preferred way to stop gum disease from ruining your dental health.

If you would like more information on treating gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Lasers Versus Traditional Cleanings for Treating Gum Disease.”

The “magic” behind a dental implant’s durability is the special affinity its imbedded titanium post has with bone. Over time bone grows and attaches to the titanium surface to produce a strong and secure hold.

But there’s one important prerequisite for ultimate implant success—there must be an adequate amount of bone available initially to properly position the post during implantation. Otherwise, the implant may not have enough support to position it properly or cover the implant surface completely with bone.

Inadequate bone can be a problem for patients who lost teeth some time before and now desire to an implant restoration. This happens because when teeth are missing, so are the forces they generate during chewing. These forces stimulate new bone growth around the tooth root to replace older, dissolved bone at a healthy rate. If that replacement rate is too slow, the volume and density of bone may gradually diminish.

There is a way, though, to build up the bone for future implantation. Known as bone preservation procedure or a ridge augmentation, it’s a surgical procedure in which the dentist adds bone grafting material to the extraction socket or the bony ridge. The graft serves as a scaffold for new bone cells to grow and multiply. If successful, there will be enough new bone volume after several months of healing to support proper implant placement.

Bone grafting can add more time to the implant process. It may also mean you will not be able to undergo immediate crown placement after implantation (a “tooth in one day” procedure). Instead we would probably suture gum tissue over the implant to protect it and allow for full integration with the bone over a few more months. In the meantime, though, we could fit you with a temporary restoration like a removable partial denture (RPD) or a bonded bridge to improve the appearance of the space while the bone continues to heal.

After several months, your implant will have a better chance of a secure hold and we can then attach a life-like crown. Even if you’ve suffered bone loss, you’ll then have the benefit of not only a durable implant but also a new smile.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation.

A relatively easy and inexpensive way to improve your smile is to whiten your teeth. In fact, you may even be able to do it yourself at home. Although there are differences between at-home and professional whitening, the former can still be effective.

That effectiveness, though, might be dependent on how well you understand what home whitening can do and what it can’t. So before you purchase your kit, here are a few things to know about DIY teeth whitening.

Home kits are safe—when used as directed. Although nothing in life is completely risk-free, home whitening kits are relatively safe. But only if you follow the directions: If you overuse the bleaching solution beyond its intended use, you could wind up with permanent damage to your tooth enamel that can be costly to treat.

Bleaching solutions are relatively mild. Nearly all home kits use carbamide peroxide, a form of hydrogen peroxide, as their bleaching agent. Home kits usually contain no more than 10% of this agent, much lower than professional solutions. Used as directed, this amount of bleaching agent poses little to no risk to dental or general health. On the other hand, the weaker home kit solution does limit the extent of brightness you can achieve compared to stronger professional treatments.

For top results (or certain conditions), consider professional whitening. While you can obtain good results with a home whitening kit, professional whitening provides more precise brightness control and range, and may possibly last longer. That’s because your dentist has more advanced techniques and equipment, as well as stronger bleaching solutions. And, if your discoloration originates inside your teeth, a home kit won’t help—only a dentist can address that kind of discoloration.

Even if you decide to “go solo,” your dentist can still give you advice on what to look for in a home kit, as well as tips for the actual procedure. But whether you whiten at home or let your dentist do it, teeth whitening can take years off your smile and give you a more attractive look.

If you would like more information on teeth whitening, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Whitening Safety Tips: Are Bleaching Products Safe?”