Bone Grafts and Dental Implants

dental implant bone graftIf a tooth is lost, the jaw bone can atrophy, leaving a level of basal bone. When a patient gets a dental implant, it may be necessary to perform a bone graft to rebuild the jaw.

Bond grafts for dental implants can often be performed in an office setting. Processed bone from cows is typically used. It prevents the surrounding tissues from collapsing and is gradually resorbed and replaced with the patient’s natural bone.

When a tooth is lost, the remaining alveolar bone is resorbed unless it is replaced immediately with another tooth, an implant, or a ridge preservation graft (socket graft). This fills the space left by the missing tooth and allows natural bone to fill the space. Cow bone in a granular form is usually used and secured with a pledget of collagen and dissolvable sutures. An implant can be placed three to six months after a ridge preservation graft.

In some cases, bovine bone cannot provide enough bulk to replace the missing bone in the jaw. In that case, the patient’s own bone needs to be used. In an autogenous graft, a block of bone is taken from the lower jaw where the third molars used to be in a region called the mandibular ramus, or from the chin. A block approximately one square centimeter is transferred to the area with missing bone, secured with screws, and overlaid with particulate bovine bone and a collagen membrane. It generally takes four months for the graft to fuse to the jawbone so that an implant can be placed. After the graft has matured, it can house an implant in live bone that will support the tissue and will be aesthetically pleasing and easy to clean.

The maxilla, or upper jaw, has different requirements because of the presence of the maxillary sinus. If a tooth is lost in the upper jaw, there may be very little bone left between the oral cavity and the sinus. A subantral graft, or sinus lift procedure, can be performed in which a small window is made in the sinus above the roots of the teeth in the upper jaw. It takes six to nine months for the bone to consolidate. Depending on the amount of bone present, it may or may not be possible to place an implant immediately after the graft is performed.

Is a Water Flosser Better Than Traditional Dental Floss?

Water FlosserAbout half of all American adults have gum disease, which can lead to tooth loss and can contribute to a host of medical problems outside the mouth. Dentists recommend flossing daily to prevent gum disease, but many people don’t do it because they find it difficult or uncomfortable.

The WaterPik Water Flosser is an easier and more effective way to clean between teeth and below the gum line than traditional floss. You just need to point the flosser tip between your teeth and along your gum line to remove food particles and plaque. Water flossing only takes about a minute per day and removes plaque and debris that can be difficult to reach with traditional brushing and flossing.

Several clinical studies have demonstrated that water flossing is more effective at cleaning between teeth than traditional flossing. Water flossing is 51 percent more effective than dental floss at reducing gingivitis, twice as effective at reducing bleeding caused by gingivitis, and 29 percent more effective than dental floss at removing plaque.

People with dental implants may find it difficult to floss. A Water Flosser can make cleaning between implants much easier. When used with medium pressure, a WaterPik Water Flosser was found to be 145 percent more effective than traditional dental floss at reducing bleeding. Using a Water Flosser with an antimicrobial rinse can help prevent inflammation and peri-implant disease.

It is important to remove food and plaque from between your teeth and below your gum line to prevent gum disease. If you find it difficult to use traditional dental floss, a Water Flosser can help you get a clean and healthy mouth.

Which Denture Adhesive Is Right for You?

denture adhesiveDentures can replace teeth that have been lost and restore your beautiful smile. In many cases, a well-made set of dentures will adhere to your gums on their own. However, in some cases your dentist may recommend using an adhesive to hold your dentures in place.

You may need a denture adhesive if the ridge of your jaw is very flat, thin, or irregular and cannot provide enough support to your dentures. Saliva acts as a natural denture adhesive. If you have a condition like diabetes or take certain medications that decrease your saliva production, you may need a denture adhesive. If you had a stroke or have another neuromuscular adaptation, or if you are wearing dentures for the first time and are concerned about them falling out, you can use an adhesive.

Adhesive is applied to the fitting surface of your dentures. When it comes into contact with the water in saliva, the material swells and adheres the dentures to your gums. This improves the retention and stability of your dentures.

Talk to your dentist about what type of adhesive is best for you. If your dentures are loose, your dentist should figure out the cause and adjust or repair them.

Chronic intake of zinc can be detrimental to your health. Choose a zinc-free denture adhesive.

Cream adhesives generally create the strongest grip, but some people dislike them because they can be difficult to remove. Cream denture adhesive can be removed with a soft but abrasive cloth. If you accidentally swallow it, the adhesive can cause an uncomfortable sticky feeling in your esophagus.

Denture powder is sprinkled onto dentures. Then they are placed in the mouth, where moisture mixes with the powder to form a paste. Powder is less messy than cream, but the grip is less secure.

Wafers or strips have double-stick sides that provide a firm grip. They are easy to use and remove and are not messy. The extra cushion between your mouth and the dentures makes strips or wafers more comfortable. They do not form the same type of barrier as other denture adhesives, so food particles can get trapped between the dentures and your gums.

Read the directions on the package before applying your denture adhesive. Always clean and dry your dentures before putting on adhesive. Don’t use too much. You only need two or three dots of a cream adhesive. Remove and clean your dentures before bed and wipe any adhesive residue from your gums and dentures. Avoid drinking hot liquids because they could dissolve the adhesive material. See your dentist regularly for checkups and adjustments.

Anutra Local Anesthetic Delivery System Can Eliminate Injection Pain

Anutra anesthetic delivery systemOne of the things many people dislike most about visiting the dentist is the pain of getting an injection of anesthetic before a procedure. Much of the burning feeling comes not from the needle, but from the anesthetic itself.

pH measures the acidity of a solution. A pH of 7 is neutral. A lower number is acidic, and a higher number is alkaline. The pH of the human body is neutral.

Local anesthetics used in dentistry are generally very acidic. When they are injected, they cause a burning sensation. Lidocaine with epinephrine, a popular anesthetic, has a pH of around 3.5, the same as the citric acid in fruits such as lemons.

The Anutra Local Anesthetic Delivery System can eliminate much of the pain of getting an injection at the dentist’s office. The system was created by a team of 10 dentists in North Carolina and was approved by the Food and Drug Administration for use in dentistry earlier this year.

The Anutra system buffers the anesthetic to raise the pH to a level that is closer to the body’s natural pH. Anutra buffers the anesthetic solution by adding a precise amount of sodium bicarbonate. When the anesthetic is mixed with sodium bicarbonate, it produces carbon dioxide, which can create a numbing effect. This dramatically reduces the acidity of the solution, eliminates the burning feeling, and reduces pain.

Buffered anesthetic crosses the nerve membrane faster, which speeds up the numbing process. Patients can often become anesthetized with just one injection. By helping patients get numb faster, the Anutra system can reduce the overall amount of time required for the dental procedure.

The device that does the buffering weighs just a couple of pounds. The Anutra system comes with disposable syringes.

Many Problems and Habits Can Affect Your Oral Health

problems habits oral healthWhen you go for a cleaning, your dentist is looking for more than plaque and cavities. He or she can tell a lot about your overall health and habits just by looking in your mouth.

A sugar imbalance caused by diabetes can cause swelling, bleeding, and sensitivity in the gums. It can also change the consistency of saliva and increase decay.

Breath that smells “fruity” can be a sign of uncontrolled diabetes or fasting. A “fishy” smell can be a symptom of kidney or liver failure. A very foul odor could be a sign of gastroesophageal reflux, a lung abscess, bronchitis, or a tonsil stone.

Oral cancer can cause unexplained bleeding; white, red, or speckled patches; a change in the way teeth fit together; swelling; thickening; lumps; bumps; and eroded areas on the lips, gums, or other areas.

A sinus infection often causes a toothache because the roots of the top teeth are in the same area as the floor of the sinuses. Both can cause pressure. A dentist can tell the difference.

A vitamin or mineral deficiency can cause burning tongue syndrome, sloughing off of tissue, infections, delayed healing, bone infections, and bleeding gums.

About 40 percent of pregnant women develop gingivitis because an increase in progesterone encourages bacteria to grow. Some women also develop pregnancy tumors, which are completely benign.

Bulimia causes a distinct pattern of wear on the tongue side of the front teeth. It can also lead to cavities.

Alcohol tends to dry out the mouth. Alcoholics are at increased risk of tooth decay because they don’t have enough saliva to neutralize acid in the mouth.

Your dentist can tell if you floss every day or if you just did it before your appointment. A person who doesn’t floss on a regular basis will have gums that are damaged or bleeding.

A dentist can tell if you bite your nails without looking at your hands. Nail biting can cause chips, cracks, and wear and tear on teeth. This can cause teeth to be uneven and can cause jaw pain.

Most kids who suck their thumbs or fingers don’t have any long-term effects, but those who do so after the age of 7 or 8 can have changes in the position of their teeth that may require orthodontic treatment.

Soda and other sugary beverages can soften teeth. This can make them more susceptible to chipping. Energy drinks have even more acid than soft drinks.

Treatments for Cracked Tooth Syndrome

cracked tooth syndromeTeeth sometimes have cracks that are too small to be seen on x-rays or that are located under the gums. This is known as cracked tooth syndrome. It is most common in the lower molars because they absorb most of the forces from chewing.

People who clench or grind their teeth are more likely to have cracked tooth syndrome. The way a person’s teeth come together can put too much pressure on one tooth and cause it to crack. Teeth that have large fillings or that have undergone root canal treatment are more likely to crack. A person with one cracked tooth is more likely to have other cracked teeth at the same time or in the future.

If you have a cracked tooth, it may hurt sometimes when you bite or chew. The pain can be mild or severe and can be brief or last a long time. It may hurt only when you eat certain foods or bite in a particular way. You will not feel constant pain. Your teeth may be more sensitive to cold.

If the crack gets larger, a piece of the tooth can break off or you can get an infection in your gums around the cracked tooth. You may develop a fistula, a pimple-like bump on your gums near the tooth. Pus may drain from the fistula.

People with cracked tooth syndrome often have symptoms for months. It is one of the most difficult problems to diagnose because the pain can be unpredictable.

Your dentist will examine your mouth and teeth and may use a sharp instrument called an explorer to search for cracks in your teeth. He or she will also examine your gums and may take x-rays, but the x-rays might not show a crack. Your dentist can use another instrument that fits over the tooth one part at a time as you bite down. If you feel pain, the part of the tooth that is being tested probably has a crack. Your dentist may examine your teeth with a very bright light or stain it with a special dye. If the tooth has a filling or crown, your dentist may remove it to examine the tooth.

Treatment depends on where the crack is located and how large and deep it is. Treatment does not always relieve the symptoms.

If the crack affects one or more cusps, or high points, of a tooth, it may be covered with a crown.

If the crack affects the pulp, a root canal will be needed. Approximately 20 percent of teeth affected by cracked tooth syndrome need root canals. The tooth will no longer be sensitive to temperature, but it will still respond to pressure. You may still feel pain after a root canal, but it may be less intense and less frequent.

If the crack affects the root of the tooth in your jaw, it cannot be fixed and the tooth will need to be removed. It can be replaced with an implant or a bridge.

If you grind or clench your teeth, talk to your dentist about treatment to reduce your risk of cracked tooth syndrome. Your dentist can make a custom night guard to keep you from grinding or clenching your teeth and relieve pain and sensitivity. You can wear it while sleeping or if you clench or grind your teeth while you are awake.

NTI Appliance Can Prevent Teeth Grinding and Relieve Pain

NTI appliance teeth grinding headachesTeeth clenching and grinding, or bruxism, can cause serious damage to teeth. When you clench your teeth, your jaw exerts a large amount of force to hold the upper and lower teeth together. This can wear away the teeth, leading to decay, chipped fillings, and even tooth loss.

Teeth clenching is also often responsible for migraines, an achy jaw, stiff neck, and morning headaches. When the muscles in the jaw contract, the force generated causes pain in surrounding tissues, joints, and muscles.

Bruxism is most often treated with a night guard. A night guard protects teeth from the effects of grinding but does not actually stop the behavior. This can protect teeth from wear and decay, but it might not eliminate jaw pain and migraines.

Reducing the intensity of the clenching can reduce or eliminate the pain. An NTI appliance is a type of mouth guard that uses a tension suppression system to stop the clenching action.

The NTI appliance is a bite guard. It takes advantage of the “nociceptive trigeminal inhibitory” reflex, which makes you open your mouth after biting down too hard on something with your front teeth. The appliance consists of an acrylic guard worn over your upper or lower front teeth while sleeping. If you begin to clench your teeth, you will bite down on the guard, which will activate the reflex and prevent clenching.

An NTI appliance is specially fitted by a dentist, but impressions and molds of the teeth are not required. It can be fitted in a dentist’s office in less than 30 minutes. It snaps into place and can only be removed by using your hands. The NTI appliance has been approved by the Food and Drug Administration and used by thousands of patients around the world.

An NTI appliance can suppress the clenching reflex in a matter of days or weeks. Headaches, neck pain, and jaw pain usually begin to resolve soon after starting to use the device. It can reduce your need for pain medication and make you more comfortable throughout the day.

Study Examines Drug Screenings by Dentists

drug screenings dentistsDentists are becoming more involved in screening for medical conditions beyond oral health, such as heart disease and diabetes. A new study conducted by researchers at Columbia University’s Mailman School of Public Health and published in the journal Addiction found that a majority of dentists also discuss drug misuse with their patients.

Having those discussions is important because for many people, a visit to the dentist is their only interaction with the healthcare system. Dentists may have an opportunity to diagnose substance abuse and recommend treatment that other medical providers might not have.

Drug use can affect oral health. For example, methamphetamine users can experience severe tooth decay, accelerated tooth wear, unexplained advanced gum disease, multiple missing teeth, and other problems. They often seek cosmetic dental treatments, which gives dentists an opportunity to discuss drug use and refer them for treatments.

Dentists are the second-largest group that prescribes opioid medication. Patients with substance abuse problems may exaggerate the severity of their pain, report that they lost prescriptions for opioid medications, or only seek sporadic dental treatment.

The researchers sampled 1,802 dentists in general practice from a nationally representative survey conducted by the American Dental Association Survey Center from 2010 to 2011. Among dentists who believed they had a responsibility to discuss drug use with their patients, 86 percent had those discussions, compared to 68 percent who believed that was not the dentist’s responsibility.

Dentists with more training and experience related to substance misuse were more likely to discuss drug use with their patients. Younger dentists were more likely to discuss substance misuse with their patients and to believe that that should be the dentist’s responsibility. Dentists who graduated recently were more likely to agree. Sixty-one percent of female dentists and 52 percent of male dentists believed that the dentist’s role should include discussing drug use.

The researchers believe that more studies are needed to evaluate patients’ attitudes on substance misuse screening by dentists. They also believe that dentists may need additional education to increase their awareness and comfort with discussing substance misuse so they can refer patients for treatment.

Cleaning Your Tongue Can Eliminate Bad Breath

clean tongue bad breathPeople brush their teeth to remove food debris and bacteria, but many neglect another important part of the mouth: the tongue. The most common cause of bad breath is food particles and bacteria on the tongue.

When you speak or swallow, the tip of your tongue comes in contact with your soft palate, which removes a lot of food and bacteria. The back part of the tongue is not cleaned through these natural processes and accumulates debris. When you clean your tongue, you should focus on the back part. You should not scrape or brush the tonsular tissue at the very back and on the sides.

Clean your tongue gently with only a little force to avoid irritation and bleeding. If you gag, you can try a different method of cleaning your tongue or do it when your stomach is relatively empty. You should clean your tongue at least once a day, but preferably every time you brush your teeth.

You can clean your tongue with a toothbrush, spoon, scraper, or cleaner. Use the one that is easiest for you to use and doesn’t make you gag.

If you want to use a toothbrush, moisten the bristles, stick out your tongue as far as you can, and look for a coating. Start in the back and use forward brush strokes to break up and remove the debris. Check your results, repeat if necessary, and then rinse your mouth. You can make your brushing more effective by putting toothpaste or mouthwash on your brush, but that is not necessary. If you put something on your toothbrush, use a product that neutralizes volatile sulfur compounds, such as chlorine dioxide or zinc, and has antibacterial properties.

You can also scrape your tongue with a spoon. Moisten it, stick out your tongue as far as you can, turn the spoon upside down, place it at the back of your tongue, and pull it forward. Clean thoroughly but gently. Repeat until you have removed as much debris as possible.

You can use a store-bought cleaner or scraper in the same way. A scraper lets you see the debris you are removing, but it tends to only clean the surface of the tongue and may be more likely to cause trauma. A cleaner combines aspects of a brush and a scraper and is the most effective tool.

Picasso Lite Diode Laser for Soft Tissue Procedures

Picasso Lite diode laserThe Picasso Lite diode laser allows dentists and dental hygienists to perform minimally invasive procedures on soft tissue with little or no pain. The Picasso Lite is a portable machine with multi-tip handpieces and fibers. It has a touch screen and wireless foot control. The device is made by AMD Lasers.

Procedures performed with the Picasso Lite diode laser often require no anesthesia. Patients have minimal pain during procedures and little to no discomfort after their operations. Patients wear goggles during procedures to protect their eyes from damage that could be caused by the laser.

The Picasso Lite diode laser can be used to treat a variety of problems, including periodontal disease, ulcers, sores caused by dentures, and hemangiomas on the cheeks and lips. It can be used to perform a frenectomy, gingival troughing for crown impressions, gingivectomy, gingivoplasty, gingival incision and excision, soft tissue crown lengthening, hemostasis and coagulation, biopsy, exposure of unerupted teeth, removal of fibromas, incision and drainage of abscesses, leukoplakia, pulpotomy, operculectomy, oral papillectomy, reduction of gingival hypertrophy, vestibuloplasty, laser soft tissue curettage, and removal of diseased, infected, or inflamed tissue from pockets in the gums.

Laser dental surgery has been used since the 1990s and has been approved by the Food and Drug Administration. It has become a popular form of treatment because it does not require a scalpel or sutures. The teeth and gums can naturally reattach after laser dental treatment. Procedures that used to be painful or require multiple visits can now be done with little or no pain in one appointment.