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Posts for category: Dental Procedures

By SCV Oral and Maxillofacial Surgery
May 02, 2020
Category: Dental Procedures
Tags: dentures   dental implants  
Implant-basedOverdenturesmaybeaBetterLong-TermFitOption

Although dental disease prevention has made great strides over the last century, tooth decay and periodontal (gum) disease continue to pose a major health threat. People who’ve lost all of their teeth (edentulism) or most of them suffer the most with adverse effects on their overall health, function and appearance.

Removable dentures have been the traditional and most affordable means to treat edentulism. But even with material and construction advances in recent years, dentures can still lose their fit over time as the bone in the jaw shrinks. This happens because the bone no longer has the stimulus of natural teeth and older cells can’t be replenished at a healthy rate; the continuing compression of traditional dentures on the jaw’s bony ridges compounds the problem.

As the bone shrinks the dentures become loose and uncomfortable to wear. Among other results, this poor fit can drastically affect how you eat: studies of denture wearers have found a decrease in their diet’s nutritional value because they’re eating fewer vegetables or fibrous, “chewy” foods and more foods with refined carbohydrates and fats that are easier to eat but less nutritious.

There is an alternative, though, that might slow bone loss and provide a better long-term fit: an overdenture supported by dental implants. With this appliance, a few implants are strategically installed in the upper or lower jaw. Matched attachments securely fasten the denture to the implants. In this case, the implants not the jaw ridge and gums support the denture thereby preserving the bone.

If you’re healthy enough to undergo a tooth extraction, you should be able to handle implant surgery, a minor procedure usually performed with local anesthesia and with little to no discomfort afterward. It may even be possible to retrofit your current denture to work with the implants, but that will need to be determined during the planning stages.

Although more expensive than a traditional denture, overdentures are much more affordable than fixed restorations stabilized with implants. The difference, though, is the increase in your quality of life — for better nutrition, physical health and social confidence.

If you would like more information on treatment for teeth loss, 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 “Implant Overdentures for the Lower Jaw.”

By SCV Oral and Maxillofacial Surgery
April 12, 2020
Category: Dental Procedures
WisdomTeethCanStillbeaProblemfortheWorldsYoungestBillionaire

According to Forbes Magazine, Kylie Jenner is the world's youngest billionaire at age 22. Daughter of Caitlyn (Bruce) Jenner and Kris Jenner, Kylie is the founder and owner of the highly successful Kylie Cosmetics, and a rising celebrity in her own right. But even this busy CEO couldn't avoid an experience many young people her age go through each year: having her wisdom teeth removed.

At around 10 million removals each year, wisdom teeth extraction is the most common surgical procedure performed by oral surgeons. Also called the third molars, the wisdom teeth are in the back corners of the jaws, top and bottom. Most people have four of them, but some have more, some have fewer, and some never have any. They're typically the last permanent teeth to come in, usually between ages 17 and 25.

And therein lies the problem with wisdom teeth: Many times, they're coming in late on a jaw already crowded with teeth. Their eruption can cause these other teeth to move out of normal alignment, or the wisdom teeth themselves may not fully erupt and remain fully or partially within the gums (a condition called impaction). All of this can have a ripple effect, decreasing dental function and increasing disease risk.

As Kylie Jenner has just experienced, they're often removed when problems with bite or instances of diseases like tooth decay or gum disease begin to show. But not just when problems show: It's also been a common practice to remove them earlier in a kind of “preemptive strike” against dental dysfunction. But this practice of early wisdom teeth extraction has its critics. The main contention is that early extractions aren't really necessary from a medical or dental standpoint, and so patients are unduly exposed to surgical risks. Although negative outcomes are very rare, any surgical procedure carries some risk.

Over the last few years, a kind of middle ground consensus has developed among dentists on how to deal with wisdom teeth in younger patients. What has emerged is a “watch and wait” approach: Don't advise extraction unless there is clear evidence of developing problems. Instead, continue to monitor a young patient's dental development to see that it's progressing normally.

Taking this approach can lead to fewer early wisdom teeth extractions, which are postponed to a later time or even indefinitely. The key is to always do what's best for a patient's current development and future dental health.

Still, removing wisdom teeth remains a sound practice when necessary. Whether for a high school or college student or the CEO of a large company, wisdom teeth extraction can boost overall dental health and development.

If you would like more information about wisdom teeth and their impact on dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth: To Be or Not to Be?

By SCV Oral and Maxillofacial Surgery
March 13, 2020
Category: Dental Procedures
PorcelainVeneersALessInvasiveWaytoTransformYourSmile

There are a number of ways to improve unsightly teeth. You can, of course, replace them with dental implants — but not if they're still viable. You can crown them: however, you'll have to significantly reduce their structure for the crowns to fit over them.

There is another less invasive option for teeth with mild to moderate imperfections — you can cover them with porcelain veneers. As the name implies, a veneer is a thin covering of dental porcelain bonded to the outside surface of a tooth. They literally put a “new face” on chipped, stained or slightly gapped teeth.

You'll first need a dental examination to ensure your teeth are reasonably healthy and that you don't have any significant dental problems that could interfere with the veneers. We can then design your veneers' shape and color to achieve the look you desire. We can also create a temporary “trial smile” with acrylic replicas of your proposed veneers to give you a realistic impression of your future smile.

The next step is the possibility the teeth need to be prepared for the veneers. Although quite thin, veneers can still make the teeth look larger or bulky. To compensate, we remove some of the tooth enamel. Although much less than for a crown, this alteration is still permanent: your teeth will need some form of restoration from now on. There are also “no-prep” veneers, which require no tooth surface reduction.  Ask us if this is an option.

We then make an impression of the teeth, which with other information will guide a technician at a dental laboratory to manually create your new veneers. This can take several weeks and requires a high degree of artistry to produce a custom product that will match your teeth.

Once they've arrived, we'll use a permanent bonding process to precisely attach them to your teeth.  It will then be up to you to care for your veneers, especially not biting down on anything hard that could chip or crack them. You should also maintain regular dental visits and proper oral hygiene to keep your smile as bright and attractive as possible.

Although small in size, veneers can make a big impression. They can restore the smile you once had — or give you the look you've always wanted.

If you would like more information on porcelain veneers, 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 “Porcelain Veneers: Strength & Beauty as Never Before.”

By SCV Oral and Maxillofacial Surgery
March 03, 2020
Category: Dental Procedures
TheRealTruthBehindEdHelmsMissingToothinTheHangover

Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.

In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.

Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.

Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.

If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.

The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.

Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.

If you would like more information about restoring missing teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Dental Implants.”

By SCV Oral and Maxillofacial Surgery
February 02, 2020
Category: Dental Procedures
DoYouHaveAdequateBonetoSupportanImplant

Besides their life-likeness, implants are also prized for their high success rate. More than ninety-five percent of implants continue to function effectively after ten years.

Implants’ advanced technology explains some of their reliability and longevity—they’re as close to natural teeth as we’re now able to achieve. But their impressive success rate also owes to the detailed protocols that dentists follow to install them. One critical part of these protocols is ensuring a patient has enough bone in their jaw to support and precisely situate the implant for the best functional and aesthetic outcome.

Unfortunately, there are situations where a patient doesn’t have enough bone to achieve a satisfactory result. This often happens if there’s been months or years between losing the tooth and considering an implant. The reason why relates to the nature of bone as living tissue.

Like other cellular tissues in the body, bone has a life cycle: Older, worn-out cells die and are absorbed by the body, and new cells form to replace them. The growth cycle in the jaw receives stimulation from the forces generated when we chew, which travel up through the teeth to the bone.

However, this stimulation stops after tooth loss for the related area of bone, which can slow new bone growth. Over time, the volume and density of the bone around a missing tooth gradually decreases, enough eventually to make an implant impractical.

Insufficient bone volume, though, doesn’t necessarily mean an implant is out of the question. We may be able to address the problem by attempting to regenerate the bone through grafting. This is a procedure in which we insert graft material into the affected area of the jawbone. The graft then becomes a scaffold upon which bone cells can grow.  After several months, we may have enough regenerated bone to support an implant.

If there’s been too much bone loss, we may still need to consider another form of restoration. But if we can successfully build up the bone around your missing tooth, this premier restoration for replacing lost teeth could become a reality for you.

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