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Implant Treatment For Problems That Can Occur

Implant Treatment For Problems That Can Occur

Implant bone loss
Last months topic pertained to dental implants and what you can do to ensure your dental restorations serve you for the longest time.  Yet even with our best efforts a few implants will develop bone and soft tissue problems.  This month I will discuss treatment options for the problems that can arise.

Implant infection and bone loss:
Dental implant infections can happen but are not common.  The good news is rarely do these infections cause significant symptoms.   The other good news is just because you have bone loss on an implant does not mean it must be removed.  If the implant is stable and functional it can remain in place as long as the infection can be controlled.  However the minimal symptoms associated with these infections often permit patients to ignore the problem until there is a substantial amount of bone loss.

Treatment:
If there is only inflammation in the gum tissue with minimal one loss, nonsurgical approaches alone or in conjunction with topical antibiotics can often address the problem.     More commonly there is significant bone loss present around the implant.  These situations will require some form of surgery to remove foreign material, clean and decontaminate the surface of the implant.  Placing graft materials and/or growth factors to regenerate bone support is often included in these procedures.

Lasers
While effective, conventional surgery carries significant downsides such as post treatment pain and significant gum tissue recession.  While recession may not be an issue for implants in the molar areas that are not visible, it can be disastrous for implants in the front.  In areas where post surgical recession of the gum tissue cannot be tolerated surgery can be done with a Laser, which can preserve the gum tissue in most cases.  Laser based therapy, according to patient feedback, is significantly less painful and conventional surgical approaches.

Fortunately, more than 90 percent of dental implants will never experience bone loss problems.  Keeping you implants clean and having the bite checked periodically to protect from overload are the most important aspects of maintaining these type of restorations.   If problems arise early treatment is always best.  If the problem have progressed beyond the early stages fortunately there are good treatment options that can repair and maintain your implant restorations.

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Dental Implants

Dental implants have been a boon to many patients. Not only do implants provide options to avoid loose and poorly fitting dentures, they can be used to provide crowns and bridges avoiding placing at risk the natural teeth that traditionally have been used to secure fixed dental work. Implants have truly revolutionized modern dentistry.

Dental Implants Billings MT

With all the good news about implants it is easy to overlook the few but important problems that can arise with this type of treatment. Implants can experience bone loss. This can happen for several reasons. First is inadequate home care.   Although implants cannot decay they still must be cleaned daily to the best of your ability. Bacterial accumulation around the base of the implant where it meets the gum tissue will cause inflammation and if left long enough can induce bone destruction. Therefore it is essential that you clean the implants daily. Each implant and restoration is unique so there is no cookbook approach to what works best. Certainly brushing is essential. Automated brushes can be more effective in some case but are not usually mandatory. Using some thicker forms of floss that can frame out and adapt to the implant surface. Some patients find that a thin yarn works very well.

Dental Implants Billings MT

Regardless of your efforts some bacterial will work into places your homecare cannot reach. Professional cleanings on a regular basis will be needed to address this problem and maintain health tissue around your implant. The frequency of such cleanings will be based on you previous history of periodontal disease problems. If you have a history of periodontal bone loss you need to be seen on a more frequent basis. If you have active periodontal disease on your natural teeth it is essentially guaranteed that your implants will lose bone as well.

Other health issues can affect the survival of your implants. First among these is smoking and other uses of tobacco. Tobacco use shortens the life of dental implants. Ideally you should quit before beginning the treatment process. If you have implants and are currently smoking quit or at the very least reduce your frequency of smoking dramatically. While you still with have the systemic smoking risks the topical effect on the gum tissue will be lessened.

Poor management of systemic diseases, particularly diabetes, can make bone loss more likely around your implants. High blood sugar depresses your immune system function allowing more aggressive bacterial to grow around your implants. Following your doctors recommendations to keep blood sugars under control will help limit any damage.

Excessive bite forces can induce bone loss around implants. Unlike natural teeth, implants do not move, they are fixed into the jawbone.   Great care is taken during the construction of your dental restorations to minimize the risk of too much force being placed on the implants. However as time goes forwards your teeth can shift and wear, you may have other restorations placed the shift the bite slightly and in younger patients some delay facial growth can result in the implants coming und increasing bite forces. This happens slowly so it is not very noticeable to you. After a certain point the increased forces can begin to cause small fractures in the bone where it meets the implant. If not dealt with early this bone loss is progressive and can result in the loss of the implant.

To minimize these problems the bite on the implant should be checked at least once a year. It must be checked any time you have other dental work done.

Even with the best care, some problems may be unavoidable. We are just now reaching a time where a significant number of implants are in the range of 20+ years old. Most of these implants have reached this age with minimal problems. It does appear however that due to long term bone turnover some implants develop gum tissue problem for no apparent reason other than they have been in service for a long time. Fortunately most of these problems can be dealt with and rarely do they cause the implant to fail.

Checklists for implant care:

1) Avoidance. Be sure to check with your dentist that you do not have active periodontal disease before beginning implant treatment.

2) Quit smoking and other uses of tobacco. Keep other systemic disease such as diabetes well managed.

3) Once your implants are restored have your dentist check the bite, several times if needed, to assure the implant is not overloaded.

4) Be sure to do your best to clean your implants daily.

5) Remain faithful with your professional cleaning visits.

6) Ask to have the bite checked anytime you have new dental restorations placed.

7) If you have problems with your implants deal with it early. Small problems are easier and less expensive to fix.

Dental implants have been truly revolutionary. Yet no treatment is a panacea. Each therapy option brings with it a unique set of risks that if ignored can endanger the long-term success of your implants. Taking these simple steps can go a long was to assuring the comfortable functions of your implants for many years.

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Gum Disease Treatment Billings MT

Hooka smoking more dangerous than cigarettes

PR Newswire, CHICAGO, October 28, 2015
According to the Centers for Disease Control and Prevention, 2.3 million Americans smoke tobacco from pipes, and many of those who smoke waterpipes, or hookahs, believe it’s less harmful than cigarettes. However, research published in The Journal of the American Dental Association (JADA) suggests hookah smoking is associated with serious oral conditions including gum diseases and cancer.

“We found that waterpipe smoking is associated with serious health problems affecting the head and neck region,” said study author Teja Munshi, B.D.S., M.P.H of Rutgers University. “The public needs to know they are putting themselves at risk. They should be made aware of the dangers of smoking hookahs.”

The authors conducted a literature review that focused on waterpipe smoking and head and neck conditions. They found waterpipe smoking to be associated with gum diseases, dry socket, oral cancer and esophageal cancer among other conditions. According to the World Health Organization, smoking a hookah is the equivalent of smoking 100 cigarettes, based on the duration and number of puffs in a smoking session.

“This study sheds light on the common misconception that smoking from a waterpipe is somehow safer than smoking a cigarette,” said JADA Editor Michael Glick, D.M.D. “Whether you are smoking a cigarette, an e-cigarette, a cigar, or tobacco from a waterpipe, smoking is dangerous not only to your oral health but to your overall health.”

Think hookahs are safer than cigarettes? @amerdentalassn JADA study tells another story. #hookah

The American Cancer Society is hosting The Great American Smokeout on November 19, 2015, an annual event that encourages smokers of all kinds to give up the habit. The event asks smokers to quit even for just one day to take a step toward a healthier life.

Millions of Americans still use traditional methods of smoking, but emerging trends in the smoking industry, such as hookah smoking and e-cigarettes pose dangers as well. E-cigarettes are devices that turn liquid into a vapor containing nicotine. In an editorial in the September 2015 issue of JADA, authors warned readers of the potential dangers of e-cigarettes, indicating that oral health effects of their use has been inadequately investigated.

“Additional research is needed on the impact smoking has on overall health, but it’s clear that smoking of all kinds has the potential to be dangerous,” said Dr. Glick.

Dentists have an important role in advising patients of the dangers of smoking. The American Dental Association has long been a proponent of educating the public about its hazards and has urged for continued research into the adverse health effects of tobacco use. For more information on smoking and its oral health effects, visit MouthHealthy.org.

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Bacteria in Our Mouths That Causes Tooth Decay

Tooth Decay Treatment Billings MT

 

 

There are thousands of different types of bacteria that live within our mouths. Our tongues, gums, and teeth are loaded with them. Most bacteria within our bodies are very helpful, but some bacteria can cause our bodies problems. For instance, some types of bacteria that live in our mouths can cause tooth decay. Tooth decay happens when the bacteria in our mouths use the sugars in the foods that we eat, producing in an acid that can cause a cavity within a tooth. The bacteria can use sugars and also starches to produce acid. While it is widely regarded that foods such as candy and sugary drinks such as soda, juice and milk cause cavities, foods such as breads and pastas, which contain starches, also help the bacteria to produce acids.

gum diesease treatment billings mt

A cavity develops through the constant exposure to acid. These prolonged exposures break down the enamel, removing its minerals; a small white spot on the tooth is evidence that this has occurred. Following an acid attack the enamel can harden again, by using minerals from saliva and fluoride. However if the acid attacks are too frequent or prolonged, decay can result.

Fluoride is very important to preventing tooth decay, because it can stop decay from progressing, but, also, fluoride can reverse or stop an early decay of the tooth. Fluoride is in our toothpastes and even in most community water supplies. Most bottled waters do not contain enough fluoride to prevent tooth decay, so if a person only drinks bottled water, fluoride should be supplemented in other ways.

Diet is very important to the prevention of tooth decay. Eat and drink sugary foods and drinks on special occasions. Try not to snack all day long; enamel needs some time to repair itself between meals. Do not eat or drink anything that contains sugar, after you have brushed your teeth for the night. Bacteria will have ample time to convert those sugars to acids while you sleep. Also, make sure to brush your teeth at least twice a day, and brush with fluoride toothpaste.

For more information on tooth decay and other dental related issues, please contact Healthy Gums Montana.

 

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periodontic services billings mt

Procedure Focused versus Problem Focused Dentistry

The first decision you must make is what dentist you are going to see. While individual practitioners have their specific approach to treatment, the fundamental issue for you is the choice between the Procedure Focused practices versus a Problem Focused office. Procedure focused offices tend to look at individual tooth problems, i.e drill and fill. You have pain from a particular tooth, the dentist treats that particular issue with minimal regard for other issues you may be unaware of. For many people the course of dental diseases is protracted over many years. This fact allows you to get away with a procedure focus for a while. However, this approach will often lead to more work needing to be redone in the future.

Problem focused practices (sometimes called Holistic practices) take into account the overall dental and medical conditions as well as potential future dental problems as part of making treatment decisions for the immediate concerns. This approach emphasizes the treatment and control of dental disease and the overall function of the dentition. Such an approach tends to address more than your immediate perceived problems but leads to more predictable restorations and avoidance of large-scale failures. Such practices emphasize a long term Doctor/Patient relationship compared to the episodic relationship of Procedure Focused practices based on emergent dental problems. This approach focus’ on the establishment and maintenance of dental health.

Is one approach better?
That depends on many factors. If your needs are minimal, procedure focused practices are very efficient in treating the few isolated concerns you may have. However in the early stages, most dental disease has minimal symptoms so patients are usually in a bad position to assess their needs. Waiting for symptoms such as pain and swelling means problems have progressed much further than they should have and treatment will be far more complicated.

Patients with several different dental problems tend to do better with Problem Focused practitioners. In this setting finding treatment solutions that achieve a harmony in addressing the multiple concerns is best. As we get older the complications from the accumulation of multiple past dental procedures tends to magnify. In adults the need to view cases in the entirety is essential to achieve the highest levels of success.

By their very nature, some dental specialties are more procedure oriented. Orthodontists, Oral Surgeons and Endodontists are specialty-trained dentists that are seen only when specific procedures are needed. Once the specific treatment is completed you return full time to your general dentist to continue care. Periodontists, Pedodontists, Prosthodontists tend to have longer-term relationships with their patients due to nature of the problems they deal with. You may still see your general dentist as part of your care as well.

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periodontics billings mt

What exactly are teeth?

Sounds like a stupid question right? Nobody asks that question about hearts and livers. However few of us are really acquainted with this part of our bodies. This is in-part because the dental or stomatognathic system works well with few disruptions for most of our lives. This reliability also leads to the cultural view of what happens when the system goes on the fritz. Dental pain is one of the most debilitating pains a human being can experience. Prior to modern times, tooth pain had been represented in poems stories, art, and sculpture. We do not see the same for hip or knee pain.

Lets get acquainted
Teeth are one of the most amazing parts of the human body. They are composed of 3 specific hard tissues, Enamel, dentin and cementum. These occur nowhere else in the body. Dentin and cementum are related to bone but have a higher proportion of hard stuff (calcium and phosphorus) compared to bone. Enamel on the other hand is nearly pure mineral. So much so that for years nobody could figure out how it actually was made. Recently it has been shown that enamel is actually the original Nano-tech material. Once again millennia ago biology figured out how to do something that we humans are just beginning to understand.

Teeth are constructed similar to the windshield on your car and much for the same purpose: to limit breakage. Enamel is very hard second only to diamond. The problem with hard things is they tend to be brittle. If teeth were made only of enamel they would shatter. The dentin is the plastic layer, which can absorb the impact from biting, protecting the enamel from breakage. Enamel and dentin when formed correctly are capable of providing a lifetime of function.’

In order to function, teeth have to be attached to the jawbone. Teeth are not fused to the bone. They sit in a ligamentous joint that acts as a shock absorber. These ligaments insert into a specialized layer of the jawbone called the cribiform plate or bundle bone. This bone only forms in response to tooth development. This structure including the root, ligaments and bone that supports the teeth is referred to as the periodontal ligament or PDL for short.

Dentin and enamel, being much harder than bone, do not provide an adequate surface for ligaments from the bone to attach to the root: enter cementum. This third hard tissue is a layer of bone like tissue fused to the dentin of the root that provides attachment for the periodontal ligaments that attach to the bone. Teeth are not fused to the bone. They sit in a ligamentous joint that acts as a shock absorber. These ligaments insert into a specialized layer of the jawbone called the cribiform plate or bundle bone. This bone only forms in response to tooth development. This structure including the root, ligaments and bone that supports the teeth is referred to as the periodontal ligament or PDL for short.

The pulp:
Our lives may have been easier if dental pulp tissue did not exist. Dental pulp, also called the dental nerve is actually a neurovascular bundle consisting of and arteriole, vein and nerve tissue. This structure is left over from tooth development. This tissue supplies blood to the cells responsible for supplying nutrients and oxygen to the cells that produce the dentin. This process continues at a slow rate throughout our lives. The dental nerve actually serve a purpose in that it helps us sense how hard we are biting. This is one of the reasons why teeth lacking a living nerve are more likely to break.

The downside of having this nerve tissue inside teeth is pain. Unfortunately the only type of nerve receptor in the pulp are for pain. Not only are they pain nerves but they are slow reacting fibers. This means that it takes a lot of stimulation to get them to send messages but once they start they keep going which is the aspect that lends the special character to dental pain.

The Jaw bones
The jaw bones and other facial bones as well differ form the rest of the bones in the body.

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Periodontal Disease Billings MT

The Diseases: Decay, Occlusion/TMJ and Periodontal disease

First a definition:
Disease: disease is a particular abnormal condition, a disorder of a structure or function that affects part or all of an organism. It may be caused by factors originally from an external source, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune diseases. Diseases usually affect people not only physically, but also emotionally, as contracting and living with a disease can alter one’s perspective on life, and one’s personality.

In our every day lives we do not often consider dental disease to be the same as Medical diseases. This is false. In fact dental diseases are the most common diseases that affect people.

Decay
Dental decay or caries (caries is Latin for “rottenness), also known as cavities, is a breakdown of teeth due to acids produced by bacteria that live on and around the teeth. In a sense, teeth are essentially a form of limestone. If you have ever put an acid like vinegar or lemon juice on limestone the solution will bubble and fize. This action is the result of the acids eating away the calcium/phosphate structure of the rock. The same happens to teeth.

Where do acids come from?
Regarding decay, the acids come from the bacteria in the mouth fermenting residual sugars left over in your mouth after you eat. This fermentation produces acids that are held close to the tooth surface. The more sugar you eat and the more frequently you eat or drink the more opportunity the bacteria have to produce acids.

They are what you eat…Not all bacteria are equal.
The bacterial in your mouth is past on to you by your parents as is most of the bacteria that live on and around you. If you routinely eat a diet that has a high amount of refined carbohydrates the bacterial will shift to include more of the most efficient fermenters, which equals more acids and higher risk for decay. If you limit simple sugars in your diet the bacteria will shift away from this group. This is one reason why two people with equally poor oral hygiene can have very different decay rates.

Dietary and stomach acids can play a role in amplifying the effects of bacterial action. Just as acids produced by bacteria, acids in foods and drink also dissolve and weaken tooth structure. Most often damage from these agents affects the smooth surfaces of teeth. Bacterial activity affects the grooves and other surfaces where bacteria can hide.

Teeth are bathed in saliva and have a coating of bacteria on them (biofilm) that continually forms, almost from the moment they are cleaned. The minerals in the hard tissues of the teeth (enamel, dentin and cementum) are constantly undergoing processes of demineralization and remineralisation. Dental caries results when the demineralization rate is faster than the remineralisation and there is net mineral loss. This happens when there is an ecologic shift within the dental biofilm, from a balanced population of micro-organisms to a population that produce acids and can survive in an acid environment.[5] This shift to a cariogenic microbiological population (one which causes caries) is driven by (eaten) sugars. So, bacteria break down the hard tissues of the teeth (enamel, dentin and cementum) by making acid from food debris or sugar on the tooth surface.[6] Simple sugars in food are these bacteria’s primary energy source and thus a diet high in simple sugar is a risk factor.[6] Risk factors include conditions that result in less saliva such as: diabetes mellitus, Sjogren’s syndrome and some medications.[6] Medications that decrease saliva production include antihistamines and antidepressants among others.[6] Caries are also associated with poverty, poor cleaning of the mouth, and receding gums resulting in exposure of the roots of the teeth.[2][7]

Prevention includes: regular cleaning of the teeth, a diet low in sugar and small amounts of fluoride.[4][6] Brushing the teeth two times per day and flossing between the teeth once a day is recommended by many.[2][6] Fluoride may be from water, salt or toothpaste among other sources.[4] Treating a mother’s dental caries may decrease the risk in her children by decreasing the numbers of certain bacteria.[6] Screening can result in earlier detection.[2] Depending on the extent of destruction, various treatments can be used to restore the tooth to proper function or the tooth may be removed.[2] There is no known method to grow back large amounts of tooth.[8] The availability of treatment is often poor in the developing world.[4] Paracetamol (acetaminophen) or ibuprofen may be taken for pain.[2]

Worldwide, approximately 2.43 billion people (36% of the population) have dental caries in their permanent teeth.[9] The World Health Organizations estimates that nearly all adults have dental caries at some point in time.[4] In baby teeth it affects about 620 million people or 9% of the population.[9] They have become more common in both children and adults in recent years.[10] The disease is most common in the developed world and less common in the developing world due to greater simple sugar consumption.[2]

 

 

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Periodontal Disease Billings MT

Gum Disease

Gum Disease is a common ailment afflicting good oral Health. The most common form of gum disease is gingivitis. The harmful effects of gingivitis are rarely felt by the person who has them, although if gingivitis remains untreated, it can lead to the much more severe periodontitis. Gingivitis can be caused by a multitude of factors such as diabetes, smoking, stress, inadequate nutrition, and even puberty. While poor oral health is a primary cause of gingivitis, it is not always the only factor. When a person is suffering from gingivitis, his gums will become red and swollen, and may even bleed from contact with foods, or a scrubbing from a toothbrush. After gingivitis is located, a professional cleaning of the teeth and gums followed by the use of an oral rinse in the home will most likely treat gingivitis.

Periodontitis is caused when plaque grows below the gum line, and the toxins from the plaque enflame the gum tissue and, eventually if left untreated, the enflamed gum tissue will separate from the teeth. Periodontitis can occur in adults and children, and it can be brought on by untreated gingivitis, or if a person is chronically unhealthy, genetically predisposed to the disease, or suffering from a systemic disease such as heart disease, diabetes, and respiratory disease. Periodontitis has an array of treatments based upon severity that begin with non- surgical treatments and end at plastic surgery. Periodontists are trained to treat the effects of periodontal disease, and have undergone three additional years of specialized training to learn to treat it.

To help prevent Periodontal Disease, a person should perform the daily habits of good, quality oral health such as brushing ones teeth and flossing. Also, remember that a good diet helps your body to stay healthy, and areas like your mouth benefit from a good diet as much as anywhere else. Also, if you are a smoker or if you use chewing tobacco, it will give you another reason to add to the long list of reasons why you should quit. Remember, while some people may not be able to prevent Periodontal disease, many people can help to prevent the disease by simply living healthy.

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Restorative Dentistry Billings MT

Restorative Dentistry

Restorative Dentistry Billings MT

Most people that take the time to brush and floss their teeth regularly and practice preventative dental care, may never experience severe dental problems. However, some people won’t brush regularly, develop oral diseases or have an accident and require restorative dentistry. Fortunately, dentistry techniques have come a long way and improved greatly. Learn what restorative dentistry is all about and how you might benefit.

What is Restorative Dentistry?

Many people don’t realize that gums and teeth just don’t have the ability to heal themselves when they become damaged or develop gum disease. What may start as a simple cavity that could easily be filled could turn into a broken tooth down the road. Gum disease won’t heal on its own; periodontal disease requires treatment. In many instances, the problems don’t go away, but actually worsen with time. These are just a couple of examples where people can benefit from restorative dentistry once damage occurs.

Restorative dentistry can greatly improve or enhance your smile, repair or replace missing teeth and improve the health of your gums.

  • Dental Bridges and Crowns

Bridges and crowns can be used to eliminate spaces where teeth are missing and greatly improve your chewing function as a result. This type of restorative dentistry not only improves functionality, but it improves aesthetics as well.

  • Dentures

Dentists can easily restore functionality to improve your bite with the installation of dentures. This restorative procedure is a radical change that can improve oral health.

  • Mouth Reconstruction

Thanks to improved dental procedures, dentists can make restorative changes for crowded teeth, blemished or decaying teeth and split or missing teeth.

  • Dental Implants

Dental implants are another popular option for people with missing teeth. Once they are properly fitted, patients can talk, eat and laugh easier and be assured they are tightly fastened to the jawbone.

The Benefits of Restorative Dentistry

  • Restore the health of your teeth.
  • Resolve and correct bite issues.
  • Alleviate pain.
  • Prevent the spread of decay.
  • Restore dental functions back to normal.
  • Stop and prevent teeth from shifting when teeth are missing.
  • Reduce or stop pain all together when chewing.
  • Correct speech impediments caused from missing teeth.
  • Help you to regain your self-esteem and self-confidence.
  • Improve your looks with a beautiful smile.

Whether you have a missing tooth or could benefit from a full mouth restoration, it might be worth a consultation with your dentist. Restorative dentistry has come a long way, and you might just be pleasantly surprised at the results.

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