Family Dentistry of Ocean City
Robert W. Yaskin, D.M.D. LLC
421 15th Street
Ocean City, NJ 08226
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Tooth decay (also known as caries by professionals and as cavities by consumers) is an infectious disease process that damages tooth structure. Cavities, hollowed-out holes in the teeth, are the most common result of untreated caries. It affects millions of Americans, young and old alike.
How does this destructive process happen? It begins when acid-producing bacteria multiply beyond normal levels in the mouth. Dental plaque, a film of remnant food particles and bacteria, cover the teeth due to poor oral hygiene. The bacteria break down sugars and carbohydrates present in the mouth, which in turn produces acid. Too many “bad bacteria” can raise the acidic level in the mouth.
The normal pH level of the mouth is neutral — 7 on the pH scale. But when the acidic level increases, dropping the pH to 5.5, the calcium and phosphate minerals in the hard, protective layer of tooth enamel begin to dissolve in a process known as de-mineralization. A healthy flow of saliva, however, acts as a buffering agent to return the pH level of the mouth back to neutral. Saliva also contains calcium and phosphate that can replace those lost from the enamel and is referred to as re-mineralization.
So, a constant battle rages within the mouth. On one side acid-producing bacteria, the possible absence of saliva, and poor diet and hygiene habits create the conditions where teeth enamel loses its mineral strength, allowing decay to eventually invade the fragile inner dentin of the tooth; on the other side is an adequate flow of saliva, a good diet and hygiene, boosted by treatment options like sealant application, antimicrobials and the topical application of fluoride.
The key, of course, is prevention. We add protection to the teeth by strengthening them; applying fluoride topically is the best approach, along with sealants that can be applied in our office. We reduce the level of acid-producing bacteria, usually with an anti-bacterial mouth rinse. You can also adopt a healthier diet that limits sugars and carbohydrates and reduces snacking between meals.
These preventive measures, along with early treatment of known tooth decay, can help you avoid the full impact of this destructive disease.
If you would like more information on tooth decay and how to prevent it, 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 Decay.”
As dental implants increase in popularity, the surgical procedures to install them are becoming quite commonplace. Still, many people are nervous about this procedure, perhaps not really knowing what to expect. So if you're considering dental implants, here's a rundown of what happens before, during and after the procedure.
Dental implants are actually a tooth root replacement system. A post made of titanium is inserted into the jaw bone at the site of the missing tooth. Because of titanium's bone-friendly molecular structure bone cells naturally gravitate to its surface; over time the inserted post and bone will fuse. After a few weeks of this process, the post will be ready for a porcelain crown, bridge or overdenture to be attached to it.
Before the implant surgery you will undergo a complete dental exam. Everything is planned out in advance so that we know the exact location along the jaw to place the implants. In many cases we create a surgical template that can be used during surgery to identify these precise locations.
The procedure itself is painless for most patients, requiring only a local anesthesia. The procedure begins with small incisions in the gum tissue to allow us to see the precise point in the bone for the implant. We then create a small hole in the bone, using a drilling sequence of successive larger holes until we've achieved the best fit for the implant (during drilling you may experience a mild vibration). We then remove the implants from their sterile packaging, place them immediately into the drilled hole, then stitch the gum tissue back into place.
After surgery, most patients encounter only a mild level of discomfort for a day or two. This can be managed by prescription doses of common pain relievers like aspirin or ibuprofen, although we will use surgical strength ibuprofen. Rarely do we need to prescribe something stronger.
Once the implant fuses permanently with the bone, we then affix the final crown or other dental device in a painless procedure. This final step will give you back not only the use of your teeth, but a more appealing smile as well.
If you would like more information about dental implant surgery, 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.”
You've taken good care of your teeth all your life, with brushing, flossing and regular visits to the dentist. But chances are that someday (or maybe even now) you may be told that you need a restoration on one or more of your teeth. Oftentimes, that means a crown.
But what exactly is a crown, and why is it used? We're glad you asked!
In the course of time, natural teeth may need to be restored for a variety of reasons. As we age, our teeth may eventually become chipped or discolored. They can become weak and prone to cracking, or actually break due to tooth decay or trauma. Treating tooth decay may require a filling so large that there isn't much tooth surface left. Or, getting a dental implant (which replaces the roots of the tooth) means that you will need a replacement for the visible part of the tooth as well.
A crown (sometimes called a cap) is a common type of dental restoration. It's a way of replacing the tooth structure, in part or in full. A crown can cover the whole visible portion of the tooth, right down to the gum line. Since it's custom-made just for you, it is designed to fit in and function just like the rest of your teeth. And because it's composed of an extremely hard substance (gold, porcelain, ceramic, or some combination of these materials) it's made to last for a long time.
If a dental examination shows that you need a crown, here's how the process works: First, any decay is removed from the affected tooth, and it is prepared for restoration. Then, a 3-D replica of the tooth (and adjacent teeth) is made. This model is used to create a crown that matches your natural teeth. If you're getting a tooth-colored crown, the exact shade of the adjacent teeth will be duplicated as closely as possible.
After the crown has been fabricated, the tooth is made ready to receive the restoration. The crown is adjusted to mesh perfectly with the prepared tooth, and to function with the whole bite. Then, it is cemented or bonded into place. When it's all done, it can be hard to tell that you had any dental work done at all.
If you're thinking that it's a challenge to make an “artificial” tooth fit in with your natural teeth, you're right — but we do it all the time! Creating a superb-looking restoration is a blend of science and art. It takes a careful eye to match tooth colors and to adjust biting surfaces and spacing for a perfect fit. But when experienced dental professionals and patients work together, the results can make us both proud of the achievement.
If you would like more information about crowns, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “Gold or Porcelain Crowns.”
You've probably heard about dental implants — today's best option for replacing missing teeth; maybe you even have one or more already. A dental implant is a tiny screw-shaped metal post that sits in your jawbone and supports a lifelike dental crown. Natural teeth and implant-supported teeth have differences and similarities.
The main difference between implants and natural teeth — besides the fact that you were born with one and not the other — is the way they attach to your bone. Implants actually fuse to the bone, becoming part of it. This is a unique property of titanium, the metal from which implants are made. Maintaining that attachment is extremely important; we will discuss how best to ensure that in a moment.
Natural teeth do not ever become part of the bone that surrounds them. Instead, they attach to it via the periodontal ligament (“peri” – around; “odont” – tooth), which is made up of tiny fibers that go into the tooth on one side and the bone on the other. These fibers form a sort of hammock for each tooth.
Another difference is that natural teeth can decay while implant-supported teeth can't. But that doesn't mean you don't have to worry about dental hygiene — far from it! And here's where we get to the main similarity: oral hygiene is extremely important to maintain both teeth and implants. Lax oral hygiene for either can result in bacterial infections that may lead to gum disease, and even bone loss.
The main enemy of a properly fused implant is a bacterial infection known as “peri-implantitis” (“peri” – around; implant “itis” – inflammation), which starts when bacterial biofilm (plaque) is allowed to build up on implant-supported crowns. Peri-implantitis can lead to a well-like or dish-shaped loss of bone around the implant, which in turn can cause the implant to lose its attachment to the bone. If this happens, the implant can no longer function. Fortunately, this infection is preventable with good brushing and flossing techniques at home, and regular professional cleanings here at the dental office.
So another similarity, then, is that natural teeth and implants can last a lifetime with proper care. And that's the result we're aiming for!