Posts for: December, 2018
Your front teeth are the stars of your smile — so it makes perfect sense to replace them if they’re missing. But is it really necessary to replace a largely unseen back tooth with an implant or bridgework?
The answer is an unequivocal yes. Your individual teeth are an interactive part of a dynamic mechanism that enables you to eat, speak and smile. They’re highly adaptable and can move incrementally to accommodate mouth changes — especially when one of them is lost.
Back teeth not only help us chew food efficiently, they also ease some of the pressure from front teeth as we chew. Our efficiency while chewing suffers when they’re missing; other teeth will wear faster and tend to move out of position, “drifting” into the space left by the missing tooth. And without their stimulation during chewing, new bone may grow at a slower rate to replace older bone, reducing bone volume over time.
So, whether visible or not, replacing a back tooth is the best course to take to prevent these adverse consequences. Your two best options are fixed bridgework or dental implants, each with their own advantages and disadvantages.
Bridgework has been the traditional method for replacing one or a few missing teeth: they’re long-lasting if cared for properly, have a life-like appearance that blends well with other teeth and are a good option when implants aren’t. But they require extensive altering of the anchor teeth (those used on either side of the bridge to secure it) and they’re highly prone for trapping food between them and the gums, increasing the risk of disease.
Dental implants are easily maintained and their installation doesn’t affect adjacent teeth as with a bridge. They’re also durable with a 95% success rate after ten years. On the other hand, the installation process can take several months and visits, and they require a certain amount of bone mass for proper placement and so aren’t ideal for certain patients.
Regardless of its location, if you have a missing tooth or one that may need to be removed, you should visit us for a complete examination. From there we can tell you how your mouth has been impacted by the missing tooth and which replacement option is best for you.
If you would like more information on tooth replacement options, 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 “Replacing Back Teeth.”
On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.
“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”
Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.
Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.
A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.
Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.
So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.
If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”
Dental implants are today’s closest restorative facsimile to natural teeth. And they’re versatile: not only can they replace single teeth but they can also support bridges or dentures.
But since one of their crucial components is made of metal, are you out of luck obtaining this state-of-the-art dental restoration if you have a metal allergy?
The answer is: probably not—it’s rare for implants to cause an allergic reaction. Still, metal allergies can be a potential problem within your mouth as with other areas of health.
An allergy originates from the body’s necessary response to potentially harmful microorganisms or substances. Sometimes, however, this response becomes chronic and exaggerated, creating an allergy. People can have allergies to nearly anything with responses ranging from a minor rash to a potentially life-threatening multi-organ system shutdown (anaphylactic shock).
A small number of people have allergies to particular metals. One of the most common is nickel, which affects an estimated 17% of women and 3% of men; cobalt and chromium are also known to cause allergies. Consumer exposure, particularly metal contact with the skin through jewelry or clothing, is the most prevalent, but not the most concerning. That’s reserved for metal allergies related to medical devices like coronary stents or hip and knee prostheses. And in dentistry, there are rare occasions of inflammation or rashes from metal amalgam fillings.
Which brings us to dental implants: the main metal post that’s inserted into the jawbone is usually made of titanium. It’s the metal of choice for two reasons: it’s bio-compatible, meaning the body normally accepts its presence; and it’s osteophilic, which means bone cells readily grow and adhere to it, a major reason for implant durability.
While it’s possible for someone to have an allergy and subsequent reaction to implants with titanium, the occurrences appear to be extremely low. In one study of 1,500 patients, titanium allergies were estimated to be a factor in implant failures in less than 1% of those studied.
Even so, if you have known metal allergies you should make sure your dentist knows. Being aware of all the facts will help them recommend the best tooth replacement choice for you—and hopefully it will be dental implants.
If you would like more information on dental implant restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Metal Allergies to Dental Implants.”