The Vital Role of Bone Preservation in Dental Health

The Vital Role of Bone Preservation in Dental Health

Bone health is a crucial aspect of overall dental care, but its importance goes beyond just supporting our teeth. Both natural teeth and dental implants play significant roles in maintaining jawbone integrity. This blog explores how teeth and implants contribute to bone preservation, discusses the importance of ridge preservation when considering implants, and delves into the procedures and timelines involved in dental implantation.

How Teeth and Implants Preserve Bone

Teeth: Natural teeth are embedded in the jawbone, and each time you chew, they stimulate the bone around them. This mechanical stimulation is critical for maintaining bone density and volume, as it signals the body to continually rebuild and repair the surrounding bone.

Implants: Like natural teeth, dental implants help preserve and stimulate the jawbone. When an implant is placed in the jaw, it acts similarly to a natural tooth root, providing the necessary stimulation to keep the bone intact and healthy. Without this stimulation, the bone area would resorb or shrink over time.

The Importance of Ridge Preservation

When teeth are extracted, it’s vital to consider ridge preservation to maintain bone health and volume. Ridge preservation involves placing a bone graft material into the tooth socket immediately after extraction. This procedure helps prevent the jawbone from collapsing and losing density, which is crucial for future implant placement or even for the aesthetics and functionality of dentures.

Materials Used in Ridge Preservation:

  • Autografts: Bone taken from another site in the patient’s own body.
  • Allografts: Processed bone obtained from a human donor.
  • Xenografts: Bone derived from animal sources, typically bovine.
  • Alloplasts: Synthetic bone-like materials.

These materials help support the structure of the jaw and provide a scaffold for new bone growth.

Bone Maturation Process

Bone maturation is a time-consuming process, typically taking several months. The timeline can vary depending on the individual’s health, the location of the graft, and the type of graft material used. Bone in the maxilla (upper jaw) generally takes longer to mature than in the mandible (lower jaw) due to differences in bone density and blood supply.

When to Consider a Sinus Lift

A sinus lift, or sinus augmentation, is necessary when there is insufficient bone height in the upper jaw, or the sinuses are too close to the jaw for implants to be placed. This procedure involves lifting the sinus membrane and placing a bone graft onto the sinus floor, allowing implants to be secured properly.

Guided Tissue Regeneration (GTR)

Guided tissue regeneration is a technique used to encourage the body to grow bone and tissue at an implant site. It involves placing a barrier membrane around the bone graft to protect it from fast-growing soft tissue, ensuring that bone cells have the space and time to proliferate. This technique is essential for successful implant integration.

Timeline and Phases of Dental Implant Procedures

The process of getting a dental implant can take several months to over a year, depending on the healing and bone maturation stages. The extended timeframe ensures that the implant is fully integrated into the bone, providing a stable foundation for the artificial tooth.

Immediate vs. Delayed Implant Placement

Some dentists prefer to place an implant immediately after tooth extraction to reduce the overall treatment time and preserve the bone. Others opt to wait until after a bone graft has matured to ensure the area is sufficiently stable to support the implant. The choice often depends on the specific conditions of the patient’s jawbone and overall dental health.

Using Sites with Existing Teeth for Implants

In cases where the jawbone is overly resorbed, sites that still contain teeth might be considered for implants. These areas can provide better bone quality necessary for successful implantation, especially if other regions are not viable due to severe bone loss.

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Understanding the complex interplay between bone health and dental treatments is key to maintaining a healthy, functional smile. Whether through natural teeth or implants, preserving jawbone integrity is essential. For anyone considering dental implants, being informed about the procedures, materials, and timelines involved can make the journey smoother and more predictable.

Hold Up Your Toothbrushes, Folks! Top 5 Dental Trends of 2024 Are Smile-Worthy!

Hold Up Your Toothbrushes, Folks! Top 5 Dental Trends of 2024 Are Smile-Worthy!

Brace your pearly whites, dental enthusiasts, because the future of oral health is shining brighter than a dentist’s headlamp! From AI superheroes to 3D printed smiles, 2024 is packing some game-changing trends that’ll make your smile wider than a Cheshire Cat (minus the creepiness, of course). So, buckle up, floss fam, and let’s dive into the top 5 dental trends that’ll have you saying “Awwww yeah!”

1. Tech Takes on Teeth: AI to the Rescue!
Imagine robots helping with your oral care (without the Terminator vibes, we promise!). AI is swooping in, analyzing X-rays like a digital Sherlock Holmes, spotting cavities faster (and earlier) than you can say “floss fairy.” Plus, chatbots are becoming friendly faces, answering your questions 24/7, making booking appointments a breeze. It’s basically having your own personal dental Yoda in your pocket!

2. Smile From Afar: Teledentistry Takes Center Stage
Remember those days of dreading the dentist chair? Well, teledentistry is waving goodbye to that anxiety! Virtual consultations let you chat with your dentist from the comfort of your couch, perfect for check-ups, consultations, and even monitoring certain conditions. It’s like having a dental appointment in your PJs – talk about convenience with a capital “C”!

3. Smile Reimagined: 3D Printing Steps In
Think 3D printing is just for fancy figurines? Think again! This tech wizard is revolutionizing dentistry, creating custom-fit crowns, bridges, and even implants with incredible precision. No more gooey impressions, just a scan and voila – your perfect smile, printed like magic! Plus, it’s less time in the chair, which means more time for…well, smiling!

4. Data Detectives: Personalized Care Takes the Lead
Forget one-size-fits-all treatments! 2024 is all about personalized dental care. By analyzing your unique data (think genetics, oral microbiome, and lifestyle habits), dentists can tailor treatment plans just for you. It’s like having a detective for your teeth, sniffing out potential problems before they even start!

5. Communication Revolution: Patients in the Driver’s Seat
Gone are the days of feeling out of the loop. Dentists are embracing open communication, using online portals and apps to keep you informed every step of the way. You can access treatment plans, track progress, and even message your dentist directly. It’s all about putting you in control of your oral health journey!

So, there you have it, folks! These are just a taste of the exciting trends transforming the world of dentistry. With these innovations, 2024 is shaping up to be a year where your smile can truly shine its brightest. Now, go forth, brush with gusto, and embrace the future of happy, healthy teeth!

Dentures: Holding On or Letting Go?

Dentures: Holding On or Letting Go?

I’m willing to bet that many people have a favorite pair of shoes – worn, comfortable, familiar. But what if those shoes start causing more harm than good? The same can be true for dentures, especially when we cling to them long after they’ve overstayed their welcome. In my years as a dentist, I’ve seen countless patients holding onto ill-fitting dentures. Often, the only reason they were I my office at all is that they were brought in by concerned family members who noticed that their dentures looked more like dancing puppets than teeth.

Holding on to dentures for too long is like driving a car with bald tires. You might convince yourself it’s okay, but the risks lurk beneath the surface. Over time, dentures lose their fit as bone recedes, causing instability and potentially painful sores. And let’s not forget the impact on digestion and even your appearance. That sunken profile you’ve gotten used to? A new, properly fitted denture can restore it, sometimes even shaving years off your look.

The American Dental Association recommends a refresh about every five years. That could be a reline or a remake, to keep your dentures in harmony with your changing mouth. Some scoff at that, claiming their ten-year-old choppers are doing just fine. But here’s the secret: small, incremental changes are much easier to swallow than a giant leap many years down the line. When you update regularly, the transition is seamless, like slipping into a well-worn but freshly polished pair of shoes. When you wait fifteen, twenty, or twenty five years before replacing dentures, getting use to the new set can seem impossible.

Implants offer a revolutionary option for some, anchoring dentures like sturdy roots. But not everyone can or wants to go that route. For them, the choice boils down to two paths: hold on to the familiar, wobbly comfort, or take a leap of faith with new dentures.

Today, I wear a different hat. Experience has taught me to read the situation, to gauge whether my efforts will truly benefit the patient. If stubbornness trumps logic, it might be time to let go of the case, especially if it doesn’t appear that any help will be well received. But for those open to rediscovering the joys of proper fit, improved digestion, and a revitalized smile, I am ready to guide them on that journey.

Holding onto old dentures, like those worn-out shoes, can be tempting. But remember, comfort shouldn’t come at the cost of your health and well-being. Talk to your dentist, explore your options, and embrace the possibility of a brighter, healthier smile. After all, sometimes, letting go is the best way to move forward.

Do Dental Implants Make Financial Sense?

Do Dental Implants Make Financial Sense?

Because tooth-loss so often creates long-lasting and generally negative effects for personal health and, not infrequently, appearance – the entire array of tooth replacement options has long been an important subject in the dental field.  Dentists not infrequently discuss which options are best for their patients, given different circumstances.  And if there is any debate in the profession at all, you can be sure the public will also question which options make the most sense for them.

The truth is there is no one right answer.  Each person’s circumstances differ – whether the reasons are anatomic, functional, emotional, or financial.

But the question is still an important one to ask, because patients face new realities when they lose even one tooth.  These changes include (but are not limited to):

  • Difficulty chewing
  • Altered speech
  • Food impaction
  • Jaw pain
  • Drifting teeth

And, then there are the secondary effects:

  • Poor health resulting from a changing diet
  • Compromised appearance
  • Self-consciousness/embarrassment
  • An inability to wear dentures
  • Financial challenges created by the need to address these problems

It is this last point that I want to touch upon here, because I have observed a good deal of confusion surrounding dental implants.  As a dentist, I am obligated to review all options with an individual when discussing their tooth replacement options – regardless of affordability.  I can’t, and don’t, pre-judge anyone financially when discussing their choices.

Commonly, though, when I raise the subject of dental implants, I get an immediate reaction along the lines: “Oh, forget it. I could never afford that.  How about a bridge?”

Now, I’m not going to try to convince you that implants are cheap. Restore a full mouth with dental implants and it is likely to be costly.  Nevertheless, cheap is relative.  For some of my patients, even a small filling can be perceived as expensive.  For my wealthy patients, they might be prepared to spend any price for what they perceive will serve them best.  Lucky them.  Right?

What I hope to do here, however, is to show you when an implant may make the most sense for a person. And — at least, when when it comes to replacing a single tooth — a dental implant may just be the way to go.

But first, permit me to remind you again – there is no one right answer for everybody.  Your choices may be very different depending upon whether you are 25 or 85 years old, for example.

I’m sure you can fill-in still other reasons that affect your decision-making process.  But for now, let’s consider the following scenario:

A patient loses one tooth.

For the sake of argument, we’ll call it a lower right first molar.   Suddenly, the patient realizes this is annoying.  Their bite is changing; their gums are sore.  They feel the need to do something.  Now.

Here are a few options. I’m just going to list the main ones, but there are sub-sets to some of these:

  1. Do nothing anyway.
  2. A removable denture.
  3. A non-removable bridge,
  4. A dental implant.

For the purposes of this discussion, the patient has already decided that doing nothing isn’t working for them.

So, the next option is a removable denture.  I usually get “the face” on this one.

And with good reason.  Food gets caught around partial dentures every time you eat.  You will have to remove the appliance after EVERY meal and clean it separately from your own teeth.  Certain foods will also cause it to dislodge as you eat, allowing some of the food to get caught between the denture and your gums.  The cost – depending upon what kind of partial you have made – will typically range between $750 and $1,500. The recommended replacement time: every 5 to 7 years.  The reality – people replace them roughly every 15 years.  Sometimes more.  The longer they put off the replacement though, the more issues they may face with the replacement.

Bottom line:  Removable dentures are potentially uncomfortable.  Average lifetime replacement cost if you are 25 years old, (based on an average life expectancy of about 79 years, and an average 10-year replacement rate – not adjusting for inflation) is going to be nearly $7,000.

Next, we’ll take up considering a “bridge.”  It’s called a bridge because it spans a gap (like a bridge spans a body of water) with a fake tooth, or teeth, in between the ones that are still there.  The trouble is that you must shave down the supporting teeth to little stubs so that the result will look natural and be strong enough to take the force of daily chewing.  For the most part, bridges look, and can often feel like, your natural teeth; but you do have to floss under the fake tooth after every meal.  Food will get caught under there, whether you perceive it or not.  If you don’t clean it regularly, the life expectancy of your bridge will be shorter.

Now, the cost on this option can really be widely variable, because some teeth need to have fillings replaced before they can be used as supports for the bridge.  In other cases, the teeth may end up with root canals if the process of shaving them down results in lingering sensitivity.  This doesn’t always happen, but it is a risk.  If the tooth needs that additional treatment it will cost you more.

The average cost to replace a single tooth with a bridge is about $3,500.  Again, that can be a little more, or less, depending upon what part of the country – or even what part of a city, you live in.

If, on the other hand, you also need to place or replace fillings on the teeth being used as supports, and you need to do root canals as well, it could be as much as $7,000.

Roughly, double.

The average lifetime replacement cost with the same parameters given above (25 years old with an average life expectancy of 79 years and a 10-year average replacement rate) is going to be: $31,500.  And that assumes that the underlying teeth will be strong enough to survive that many replacements.

That brings us to dental implants.

Here is the breakdown:  The average implant cost in many metropolitan areas is around $1,800 – $2,200.  If you end up needing a bone graft before the implant can be placed, though, add another $550.  (Basically, a graft is adding bone to your jaw when you don’t have enough for the implant.) So far, these costs are just for the implant.  It doesn’t include the cost of the crown.  Add about another $2,100 for the parts needed to make up what supports the crown above the gumline, and the crown itself.  If your tooth is short, and there isn’t enough tooth height to which your crown can be easily cemented, you might need something called a UCLA abutment — it lets your dentist screw down the crown instead of cementing it.  That could cost you more.  How much depends upon the lab your dentist uses, but $500 more wouldn’t be unusual.

On the low end, one implant may cost $3,900.  On the high end, let’s round up to $4,900.

So, what about the average lifetime cost?

$4,400.

That’s less than either partial dentures or bridges!

Why?

Because, unless you bite into a rock, grind your teeth uncontrollably, or have some serious illness that causes you to lose bone around the implant – any of which can happen to you with the other options as well – you will probably have your implant for life.  Still, no one can guarantee this because, sometimes, plain ol’ dumb luck will factor into any equation.

But, you can’t get a cavity on an implant.  On the other hand, you still can get a cavity on the teeth that support your partial denture, or bridge (and crowns, for that matter).

So, do the math.  Look at your circumstances, and decide what is right for you.  But when your dentist starts talking to you about dental implants, hear them out.  It just might be more cost effective than you realize.

[Note: The prices mentioned here are just averages in US Dollars at the time of this writing.  Actual costs could be more, or less, depending upon where you live.]

Implant or Bridge? How to Decide (Part 2)

Implant or Bridge? How to Decide (Part 2)

OK. So let’s say it has been decided: you are a candidate for an implant.

Now what?

You may have heard that getting an implant can take a long time. By contrast, you can have a bridge to replace your missing tooth in about two weeks or less. Isn’t that better?

Not so fast. It all depends.

Let’s look at a couple of scenario

s. If you are replacing only one tooth and have two adjacent teeth here is what you should consider:

In order to place a bridge, you have to shave down those teeth so that they will support the bridge. This limits their longevity and may open the door to the need for additional work, such as root canal therapy in the future.

You should also understand that bridges don’t last forever.  The national average, according to university studies and insurance company estimates, is only five to fifteen years. If, you are in your twenties, a bridge can turn out to be much more costly over your lifetime.

Let’s see how this plays out:

For the sake of argument, consider that a person has lost their first molar. The 2013 national average price for crowns (the individual units that make up a bridge) was about $1160.  Since our hypothetical bridge has three units, that adds up to $3,480.  If existing fillings need to be replaced due to decay, it could cost another $500.  And if a root canal is needed because the filling is now closer to the nerve, this can cost as much as another $1,100 for a molar. Suddenly, the total bill can exceed $5,000 using our example.

In five to fifteen years the bridge may need replacement. Let’s be generous and say it lasts fifteen. Between the ages of 25 and 85, that’s four replacements – nearly an additional $14,000 – if nothing else is needed.

In the long run, replacing one tooth using a bridge can cost nearly $20,000 over your lifetime. And that’s assuming it is still in a condition that permits a new bridge.

What if instead we replace the tooth with an implant? At today’s rates, a traditional root form implant runs between $1,800 and $2,000 in my area.  An abutment (that’s the part which ties the implant and the implant crown together) will range in price from an average of $850 to $1,200.  Prices for implant crowns vary widely – though many dentists charge the same fee as they do for regular crowns. In this example, we’ll use the fee given above, so $1,160.

If we take the higher estimates here, we’re up to $4,360.  That’s only $880 more than our bridge in the earlier example’s “best case” scenario.

The difference? That implant (barring situations like an accident causing physical injury to the implant) has a good chance of lasting a lifetime. That’s a lot less than $20,000 over time if you go the bridge route.

I have had patients react in various ways to this analysis. Some tell me “I really don’t want to wait three to nine months, while wearing a temporary partial, for the implants to be ready.”  Others have said, “Well, if I’m going to have to replace a bridge down the road, or even end up with an implant later anyway – I might as well just do it now.”

Both arguments have their merits. But at least now you have some information that can help you make an informed choice.

Implant or Bridge? How to Decide (Part 1)

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 comp

etent 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.