By now it seems like most people have at least heard of dental implants.  But the process and specifics are probably still a little fuzzy unless you’ve actually had an implant placed.

Dental implants are essentially small metal (nickel titanium) rods that are surgically placed into the jaw bone to replace a single missing tooth.  Often an oral surgeon or periodontist will  place the implant.  After it is placed, there is usually at least a 6 week waiting period to allow the bone to heal around the implant.  During this time of healing, no restoration is put on top of the implant.  The next step is to go to the restoring dentist who will take an impression of your mouth to send to the lab.  A waiting period (usually 2-3 weeks) follows while the laboratory fabricates the restoration.  At the final appointment, the crown is seated and secured in your mouth using either cement or a screw.  I tend to prefer the screw-retained type (no chance of cement remaining to irritate your gum tissue, and the dentist can go back and tighten or remove the restoration if necessary for some reason.)

The major benefit to having an implant to replace a tooth rather than a 3-unit bridge are that you do not have to cut into teeth on either side of the edentulous space (space with no tooth).  Negatives include having to wait for healing, and being dependent on the patient’s bone quality and quantity.

7. Materials

6. Gloves

5. Pain Relief

4. Prevention

3. Education

2. Replacing Teeth

1. Digital X-Rays

Digital radiographs may be the best thing to come into the dental field since, well, radiographs.  One reason is that they emit significantly less radiation- up to 80% less!  So that entire series of x-rays you get once every three to five years that gives your dentist valuable information about almost every aspect of your teeth and surrounding hard tissues isn’t too much different radiation-wise from sitting out in the sun for 5 minutes.

Another amazing thing about digital x-rays is that we can enlarge them, zoom in on a particular area of the x-ray, and adjust the contrast of the image. This not only makes diagnosing dental cavities and other infections easier for the well-trained practitioner, it also makes it fairly easy for the average dental patient to be able to see what the heck we’re talking about.

Don’t hard bristles clean better?

I can see why this seems to be the obvious assumption.  It’s HARDER, so it must work harder, right?  Nope.  Not only are the medium- and hard- bristled toothbrushes much harsher on your enamel and gum tissue, often leading to gum recession and abrasion of enamel, they also just don’t clean as well.  Soft bristles are significantly more flexible, so they can reach between your gum and tooth and into your biting-surface grooves much better.  Give your teeth a break and switch to a soft or extra-soft brush if you haven’t already.

7. Materials

6. Gloves

5. Pain Relief

4. Prevention

3. Education

2. Replacing Teeth

1. Digital X-Rays

If we can’t preserve teeth for whatever reason, there are now many more ways to replace missing teeth.

Complete and partial removable dentures are available.  These prosthetic teeth and gum combos can replace many teeth.  The biggest negative is that they do come in and out of your mouth.

Bridges are fixed (don’t come in and out) prosthetics that cement onto either side of the space where you are missing a tooth.  The space is occupied by a “pontic” crown- it looks just like your other teeth but relies on it’s neighbors (abutments) for support instead of a root.  Biggest negative?  You have to floss underneath that pontic tooth.

One of the newer options are dental implants- these are metal posts placed into your jaw bone.  You wait for your bone to heal around the implant, then restore the “crown” just as you would with a crown on a tooth.  The implant is supposed to essentially replace your tooth’s root.  Negatives: many insurance companies still don’t contribute to this type of restoration, and there is a slightly longer waiting period to account for healing.

In the future, tooth buds may be an option.  From what I’ve read, these are like tooth “seeds” placed into an area where you’re missing a tooth.  These “seeds” grow (much like your permanent teeth did the first time) in the  socket to replace your tooth.  Pro tip: don’t hold out for this type of restoration as it might be a LONG ways off!

7. Materials

6. Gloves

5. Pain Relief

4. Prevention

3. Education

2. Replacing Teeth

1. Digital X-Rays

Speaking of education, we will gladly dispense with our knowledge of the oral cavity to you.  Instead of thinking of our little talk about flossing as “nagging,”  why don’t we call it a “complimentary course of study in preserving our healthiest possible oral condition.”  Eh?  Sounds great, doesn’t it?

Don’t hesitate to use your dental professional as a free resource to answer whatever dental-related questions you may have.  (Here are some suggestions: Are electric toothbrushes better than manual?  What the heck is an implant?  Why does this cost x amount?  What’s your favorite movie?)

Let’s just get this off our chests now: Mouth rinses do NOT replace flossing.

Commercials touting all of the amazing benefits to the newest mouthwash coupled with a walk down the toothpaste aisle at your local Target can leave a person totally overwhelmed.  I’d like to break down some of the basic types of mouth rinses available and how/if they might benefit you.

Bacteria-killing Rinses

(Listerine, Crest ProHealth. Peridex, etc.) These are great for people who have trouble with bad breath, or with swollen gum tissue as they kill the bacteria that cause those things.  Some people really like that burning sensation they get with Listerine and rinses like it, but I am not one of those people.  The ProHealth has less of a burn to it because it does not contain alcohol.  You really need to keep these in your mouth for 30 seconds for them to make a difference.  Peridex is a prescription strength antibacterial rinse that your dentist may prescribe you.  If you’ve heard your dentist or hygienist use terms like “gum disease,” “gingivitis,” “periodontal disease,” or “inflammation” to describe your mouth, then one of these rinses might be for you.

Restoring/Fluoride Rinses

ACT is probably the best known brand of this type of rinse, but more brands, such as Listerine and Colgate, are developing this type of oral health aides.  Fluoride is most often recommended to younger kids to help prevent cavities, but it’s great for adults as well.  Particularly if you have dry mouth (a common side effect of many medications) these rinses can help strengthen your enamel and ward off future cavity lesions.

Bad Breath Rinses

Scope is probably the most common brand of this type of rinse.  While these do leave your mouth feeling minty and fresh, they do little to nothing to actually improve your oral hygiene.  So if you like the minty breath you’re left with, keep on keepin’ on!

Dry Mouth Rinses

These mouth rinses help patients with true dry mouth issues.  Biotene is one brand.  These leave your mouth feeling moisturized and enhance what saliva you do have.

Salt Water Rinse

The old classic.  This rather cost-effective rinse is still great for soothing tender gums that have been worked on.  I recommend using a salt water rinse a couple times a day (one teaspoon in a glass of warm water) after any tooth extraction and even after fillings that are near the gumline and crown preparations.

7. Materials

6. Gloves

5. Pain Relief

4. Prevention

3. Education

2. Replacing Teeth

1. Digital X-Rays

We aren’t just nagging you about flossing because we think it’s fun.  Taking that extra minute or so per day to floss can make a world of difference on keeping your mouth healthy.  We also have a lot of knowledge about various mouth rinses and hygiene aids that might help your individual situation.  In addition to your complimentary bi-yearly lecture on brushing and flossing, dentists promote preventative care in other ways.

Dentists fight for optimal water fluoridation in their own cities and states and speak to school-aged children in our community about taking care of their teeth and gums.  Not to mention we try to diagnose any problems patients might have as early as possible so you can get away with the simplest solution (example: sealant or small filling rather than huge filling/root canal and crown).

7. Materials

6. Gloves

5. Pain Relief

4. Prevention

3. Education

2. Replacing Teeth

1. Digital X-Rays

Dentists really, really don’t want you to be able to feel any pain or even discomfort while you’re in our chair. (So get those images of Steve Martin in Little Shop of Horrors right out of your head!)  We have different types of local anesthetics (the dreaded “shot”), nitrous oxide (laughing gas), and some offices even offer oral medications and general anesthesia.

By the way, we don’t want you to feel any pain after you’ve left our chair, either.  We will gladly educate you on how to minimize post-operative pain.  Even if the problem is your jaw being sore after stretching open for the past hour, I’ll always be glad to dispense some ibuprofen to you before you leave the office.

7. Materials

6. Gloves

5. Pain Relief

4. Prevention

3. Education

2. Replacing Teeth

1. Digital X-Rays

Is anyone else slightly disturbed that in the not-so-distant past dentists didn’t wear gloves?  While the taste of latex may not exactly be appetizing, I’ll take it over the taste of someone’s SKIN!

In addition to the gross-out factor, wearing gloves provides a barrier between you and the dentist (and the dentist’s previous patient) to prevent the spread of bacteria.  Pay attention and you may notice a bordering-on-compulsive hand washing tendency with your doctor as well.  The gloves, handwashing, and sterilizing/disinfecting trifecta should help you rest easy that you won’t be leaving the dental office with a host of new microscopic buddies (aka germs).

You hear a lot about silver fillings containing mercury.  Here is the American Dental Association’s official take on the safety of amalgam:

http://www.ada.org/2468.aspx

And here’s a more in-depth article from 2009:

http://www.ada.org/1741.aspx