Posts for: June, 2020
Losing teeth to tooth decay or periodontal (gum) disease is never easy. But with implant-supported bridgework, you can regain lost function and appearance with a restoration that could last for many years.
Don’t think, though, that dental disease woes are a thing of the past with your new implants. Although your restoration itself can’t be infected, the supporting gums and underlying bone can, often through bacterial plaque accumulating around the implants. The bone that supports the implants could deteriorate, dramatically increasing your chances of losing your restoration.
It’s essential, then, that you keep the area between the bridge and gums clean of plaque through daily hygiene. This definitely includes flossing around the implants.
Flossing with an implant-supported bridge will be different than with natural teeth: instead of flossing between teeth you’ll need to thread the floss between the bridge and gums. Although this is a bit more difficult, it can be done with the help of a floss threader, a device with a loop on one end and a long, thin plastic point on the other—similar to a sewing needle.
To use it, thread about 18” of floss through the loop and then pass the threader’s thin end first through the space between the bridge and gums toward the tongue until the floss threader pulls through. You can then take hold of one end of the floss and then pull the threader completely out from beneath the bridge. Then, you wrap the ends around your fingers as you would normally and thoroughly floss the implant surfaces you’re accessing. You then release one end of the floss, pull out the remainder, rethread it in the threader and repeat the process in the next space between implants.
You also have other hygiene tool options: prefabricated floss with stiffened ends that thread through the bridge-gum space that you can use very easily; or you can purchase an interproximal brush that resembles a pipe cleaner with thin plastic bristles to access the space and brush around the implants.
Some patients also find an oral irrigator, a handheld device that sprays a pressurized stream of water to loosen and flush away plaque, to be an effective way of keeping this important area clean. But that said, oral irrigators generally aren’t as effective removing dental plaque as are floss or interproximal brushes.
Whatever flossing method you choose, the important thing is to choose one and practice it every day. By keeping bacterial plaque from building up around your implants, you’ll help ensure you won’t lose your restoration to disease, so it can continue to serve you for many years to come.
If you've been dealing with a tooth that needs to be removed—or it's already missing—you may be looking to replace it with a dental implant. And it's a great choice: No other restoration can provide the appearance and function of a real tooth like an implant.
You and your smile are ready for it. The question is, though, are your gums and underlying bone ready? These dental structures play a critical role in an implant's stability and eventual appearance. A problem with them may make placing an implant difficult if not impossible.
An implant requires around 2.0 millimeters of bone thickness surrounding the implant surface for adequate support and to minimize the chances of gum recession. But tooth loss often leads to bone loss that can drop its thickness below this threshold. This can make placing an implant problematic.
Fortunately, though, we may be able to address the lack of sufficient bone through bone grafting. By placing grafting material within the empty socket, we create a scaffold for new bone cells to grow upon. Over time this subsequent growth may be enough to maintain an adequate thickness of bone for an implant to be placed.
The gums may also pose a problem if they've shrunk back or receded from their normal positions, as often happens because of gum disease (which may also have precipitated the tooth loss). Again, grafting procedures can help ensure there's adequate gum coverage for the implant. And healthier gums may also help protect the underlying bone from loss.
There are several techniques for placing gum tissue grafts, depending on how much recession has taken place. One procedure in particular is often used in conjunction with implant placement. A small layer of synthetic collagen material or gum tissue referred to as pa dermal apron is included with the implant when its placed. Settling into the bone socket, this apron helps thicken the gum tissues, as well as preserve the underlying bone.
During your preliminary exams, we'll assess your bone and gum health to determine if we should take any steps like these to improve them. It may add some time to the implant process, but the end result will be well worth it.
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 “Immediate Dental Implants.”
Your nightly snoring has become a major sleep disturbance for you and other family members. But it may be more than an irritation — it could also be a sign of sleep apnea, a condition that increases your risk for life-threatening illnesses like high blood pressure or heart disease.
Sleep apnea most often occurs when the tongue or other soft tissues block the airway during sleep. The resulting lack of oxygen triggers the brain to wake the body to readjust the airway. This waking may only last a few seconds, but it can occur several times a night. Besides its long-term health effects, this constant waking through the night can result in irritability, drowsiness and brain fog during the day.
One of the best ways to treat sleep apnea is continuous positive airway pressure (CPAP) therapy. This requires an electric pump that supplies constant pressurized air to a face mask worn during sleep to keep the airway open. But although effective, many patients find a CPAP machine clumsy and uncomfortable to wear. That's why you may want to consider an option from your family dentist called oral appliance therapy (OAT).
An OAT device is a custom-made appliance that fits in the mouth like a sports mouthguard or orthodontic retainer. The majority of OAT appliances use tiny metal hinges to move the lower jaw and tongue forward to make the airway larger, thus improving air flow. Another version works by holding the tongue away from the back of the throat, either by holding the tongue forward like a tongue depressor or with a small compartment fitted around the tongue that holds it back with suction.
Before considering an OAT appliance, your dentist may refer you to a sleep specialist to confirm you have sleep apnea through laboratory or home testing. If you do and you meet other criteria, you could benefit from an OAT appliance. There may be other factors to consider, though, so be sure to discuss your options with your dentist or physician to find the right solution for a better night's sleep.
If you would like more information on sleep apnea treatments, 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 “Oral Appliances for Sleep Apnea.”