Family Dentistry of Ocean City
Robert W. Yaskin, D.M.D. LLC
421 15th Street
Ocean City, NJ 08226
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For a predictable outcome, a dental implant should be placed as soon as the bone and gum tissues following a tooth extraction have healed. But what happens if the tooth has been missing for months or years? You might then run the risk of not having enough bone to properly place an implant.
This can happen because of a disruption in the growth cycle of living bone tissue. As older bone cells dissolve (resorption), new bone develops to take its place. This is a dynamic process, as the amount and exact location of the new growth is in response to changes in the mouth, particularly from forces generated by the teeth as we chew. If, however, this stimulation transmitted to the bone no longer occurs because the tooth is missing, the bone will tend to dissolve over time.
In fact, within the first year after a tooth loss the associated bone can lose as much as a quarter of its normal width. This is why we typically place bone grafting material in an empty socket at the same time as we extract the tooth. This encourages bone growth during the healing period in anticipation of installing a dental implant or a fixed bridge. If, however, the bone has diminished to less than required for a dental implant, we must then use techniques to encourage new bone growth to support a future implant.
One such technique for restoring bone in the back of the upper jaw is to surgically access the area through the maxillary sinus (a membrane-lined air space within the bone structure of the face) positioned just over the jawbone to place grafting material. During surgery performed usually with local anesthesia, the surgeon accesses the sinus cavity, lifts the tissue membrane up from the sinus floor and applies the grafting material on top of the bone. Eventually, the new bone growth will replace the grafting material.
If successful, the new bone growth will be sufficient to support an implant. Thanks to this renewed growth, you’ll soon be able to enjoy better function and a transformed smile provided by your new implant.
If you would like more information on forming new bone for implants through sinus 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 “Sinus Surgery.”
Dental implants to replace teeth are a popular choice as much for their durability as their life-likeness. Most implants last for decades, which can result in lower long-term maintenance costs than other replacement options.
But to achieve this longevity, you must take care of your implants. You should brush and floss them daily right along with your remaining natural teeth — and continue regular semi-annual dental visits for cleanings and checkups.
You may be wondering, though: if they're made of inorganic materials, why worry with brushing them? It's true that bacterial plaque, the thin film of food particles most responsible for dental disease, doesn't affect them.
Your implants, though, don't exist in a bubble: they're imbedded in real bone, surrounded by real gum tissue and placed next to real teeth. All these other living tissues are susceptible to infection caused by plaque, even from plaque on non-organic implants.
The bone and tissues around an implant can even have a higher susceptibility to infection. This is because an implant's attachment in the jaw differs from that of natural teeth. An implant is imbedded directly into the bone; a natural tooth, on the other hand, maintains its hold through an elastic gum tissue between it and the bone called the periodontal ligament. Tiny fibers from the ligament attach to the tooth on one side and to the bone on the other.
Besides holding the tooth in place, the ligament also contains blood vessels that supply the tooth and surrounding tissues not only with nutrients but also antibodies that help fight infection. Due to the absence of a ligament connection, an implant doesn't enjoy the same level of protection from infection. Â It's much easier for tissues and teeth around an implant to become infected, and harder to stop it.
That's why prevention through daily hygiene is so important. So, be sure to brush and floss all your teeth — including implants — every day, and keep up your regular dental visits. And at the first sign of a possible infection — swollen, red or bleeding gums — see us as soon as possible for an examination.
Consider your implants a long-term investment in both your smile and dental health. Taking care of them will pay dividends for many years to come.
If you would like more information on taking care of your dental implants, 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 Maintenance.”
Today, dental implants are an increasingly popular option for replacing lost teeth — an issue faced by many older Americans. It’s not hard to see why these high-tech prosthetic teeth are preferred: They look, “feel” and function just like natural teeth… and with proper care they can last the rest of your life. Unfortunately, many people who could benefit from implants also face an additional health problem: diabetes, a metabolic disease that can affect many different parts of the body, sometimes severely.Â Uncontrolled diabetes can lead to nerve and tissue damage, and may adversely impact your oral health. So if you have diabetes, does it mean you won’t be able to get dental implants?Â
The short answer is no — but there are some considerations that diabetics (and their health care providers) need to keep in mind. For example, it has been demonstrated that wounds in diabetics tend to heal more slowly, and are more prone to infection than those in non-diabetics. Also, people with diabetes sometimes experience a chronic inflammatory response, which can eventually lead to tissue damage or other problems.
Because the placement of dental implants requires minor surgery, dentists and researchers have questioned whether people with diabetes are good candidates for implants. Now there’s encouraging news: Several recent studies have come to the conclusion that many diabetics can indeed undergo an implant procedure without undue risk.
One key consideration is how well an individual can control his or her blood glucose levels. Researchers have found that diabetics with good blood glucose control, those with poor glucose control, and non-diabetics all have similar implant success rates (above 95%). However, in diabetics with poor glucose control, more time may be needed for the jawbone to heal in the area where the implant procedure was done. That doesn’t by any means rule out the placement of a dental implant — but it does mean that special considerations apply to individuals in this situation.
So if you are considering an implant procedure but have trouble controlling your blood glucose levels, ask us how we can help. Just remember that in most cases, having diabetes doesn’t mean you won’t be able to enjoy the benefits of dental implants. If you have additional questions, contact us or schedule an appointment.
If you've lost a tooth or need to have one extracted, you have to decide how to replace it. Of all the options available none can match both the lifelikeness and function of a dental implant.
A dental implant is a prosthetic (false) tooth that mimics the root of a natural tooth. Once that implant root form fuses to the surrounding bone, we attach the crown, which is the part of the tooth you can see.
While other replacement options like bridges or dentures can restore the lifelikeness of the tooth crown, they don't replace the root. An implant's titanium post can: using a minor surgical procedure we imbed the post into the bone. Because bone cells have a natural affinity with titanium, they will grow around and adhere to the post over a few weeks after surgery. This further adds strength to the implant's hold in the bone.
Although the attachment isn't exactly like natural teeth, it can maintain this hold for many years. And because it encourages bone growth, a dental implant will help minimize bone loss, a natural consequence of losing teeth. Other replacement options can't do that.
Of course, implants are more costly than other restorations. With an attached crown, an implant can replace any number of teeth. But if you have extensive tooth loss, bridges or dentures would be more cost-effective selections.
But even then, implants could still play a role. We can strategically place a small number of implants as supports for a bridge or even a removable denture. Not only will the implants better secure their attachment, they'll also stimulate bone growth.
Is a dental implant the right choice for you? Visit us for a complete examination and evaluation. Afterward we can discuss your options and whether this phenomenal tooth restoration method could help restore your smile.
If you would like more information on dental implants, 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 Implants: Your Best Option for Replacing Teeth.”
It’s a common problem for denture wearers: after years of a comfortable fit, your dentures now seem to be uncomfortably loose. The reason, though, may have more to do with bone loss than the dentures.
Bone is a living tissue with a life cycle — it forms, it ages, and it eventually dies and dissolves (resorbs). It’s replaced with new bone and the cycle repeats. Additionally, the forces generated when we bite or chew are transmitted from the teeth to the jaw, which helps stimulate new bone growth. When the natural teeth are missing, however, the bone no longer receives this stimulus. Resorbed bone isn’t replaced at a healthy rate, which leads over time to bone loss.
Denture construction can also contribute to bone loss. The denture palate rests for support on the bony ridges that once held the teeth. Over time the compressive forces of the dentures apply damages and reduces the volume of gum tissue and eventually does the same to the bone. Combining all these factors, the reduced gum and bone volume will eventually alter the denture fit.
There are a few alternatives for correcting loose dentures. One is to reline them with new plastic, as either a temporary fix performed during an office visit or a more permanent relining that requires sending your dentures to a dental lab. Depending on the rate of bone loss, a patient could go through several denture relinings to accommodate ongoing changes in the jaw. At some point, though, it may be necessary to create a new set of dentures.
A third alternative that’s becoming increasingly useful is to incorporate dental implants into the denture design. Implants can of course be used to replace individual teeth, but a few strategically placed implants (usually of smaller dimension) can serve as a support platform for a removable denture. This relieves some of the compression force of a traditionally worn denture and can slow bone loss.
If you’re having problems with your denture fit, call us for an appointment. We’ll help you decide on the best alternative to improving the fit and making your dentures more comfortable and secure.
If you would like more information on refitting loose dentures, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Loose Dentures.”