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Losing a tooth can be traumatic, but a dental implant can dramatically turn that experience around. Providing functionality, life-like appearance and durability, implants stand out as the premier restoration for lost teeth.
For adults, that is. An older child or teenager with a missing tooth may need to wait a few more years for an implant. The reason: jaw development. A person's jaws, particular the upper jaw, continue to grow with most growth completed by early adulthood. Natural teeth with their periodontal attachments develop right alongside the jaw.
But because an implant attaches directly to the jawbone, its position is fixed: it won't change as the jaw grows and may gradually appear to sink below the gum line. That's why we wait to place an implant until most of jaw maturity has occurred after full jaw maturity. For females, we try to wait until 20 years of age and for males, usually 21 years of age. These are guidelines as some people mature faster and some slower, so a discussion with your dentist or surgeon is necessary to make an educated decision.
While we wait, we can install a temporary replacement for a child's or teenager's lost tooth, usually a partial denture or fixed modified ("Maryland") bridge. The latter affixes a prosthetic (false) tooth in the missing tooth space by attaching it to the back of natural teeth on either side with bonded dental material. It differs from a traditional bridge in that these supporting teeth aren't permanently altered and crowned to support the bridge.
During the time before implants we should understand that the area where the implant will be placed will undergo some bone deterioration, a common consequence of missing teeth. Forces generated as we chew travel through the teeth to stimulate renewing bone growth all along the jawbone. But with a lost tooth the chewing stimulation ceases at that part of the bone, slowing the growth rate and leading to gradual bone loss.
Fortunately, the titanium posts of dental implants stimulate bone growth as bone cells naturally grow and adhere to their surfaces. Before then, though, if the bone volume is diminished, we may need to graft bone material to stimulate bone growth that will enlarge the jaw bone enough for an implant to be placed.
It usually isn't a question of "if" but "when" we can provide your child with an implant for their missing tooth. In the meantime, we can prepare for that day with a temporary restoration.
If you would like more information on dental restorations for teenagers, 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 for Teenagers.”
At the first-ever Players Weekend in August 2017, Major League Baseball players wore jerseys with their nicknames on the back. One player — Cleveland Indians shortstop, Francisco Lindor — picked the perfect moniker to express his cheerful, fun-loving nature: “Mr. Smile.” And Lindor gave fans plenty to smile about when he belted a 2-run homer into the stands while wearing his new jersey!
Lindor has explained that he believes smiling is an important part of connecting with fans and teammates alike: “I’ve never been a fan of the guy that makes a great play and then acts like he’s done it 10,000 times — smile, man! We’ve got to enjoy the game.”
We think Lindor is right: Smiling is a great way to generate good will. And it feels great too… as long as you have a smile that’s healthy, and that looks as good as you want it to. But what if you don’t? Here are some things we can do at the dental office to help you enjoy smiling again:
Routine Professional Cleanings & Exams. This is a great place to start on the road toward a healthy, beautiful smile. Even if you are conscientious about brushing and flossing at home, you won’t be able to remove all of the disease-causing dental plaque that can hide beneath the gum line, especially if it has hardened into tartar, but we can do it easily in the office. Then, after a thorough dental exam, we can identify any problems that may be affecting your ability to smile freely, such as tooth decay, gum disease, or cosmetic dental issues.
Cosmetic Dental Treatments. If your oral health is good but your smile is not as bright as you’d like it to be, we can discuss a number of cosmetic dental treatments that can help. These range from conservative procedures such as professional teeth whitening and bonding to more dramatic procedures like porcelain veneers or crowns.
Tooth Replacement. Many people hide their smiles because they are embarrassed by a gap from a missing tooth. That’s a shame, because there are several excellent tooth-replacement options in a variety of price ranges. These include partial and full dentures, bridgework, and dental implants. So don’t let a missing tooth stop you from being Mr. (or Ms.) Smile!
If you’d like more information about oral health or cosmetic dentistry, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Impact of a Smile Makeover.”
Cosmetic Dentistry Offers Improvements for the Appearance of Your Smile
Brighten Your Smile with Teeth Whitening
Restore Your Smile with Dental Implants
A Hollywood Smile with Veneers
Without effective treatment, periodontal (gum) disease can eventually lead to tooth loss. That’s why it’s imperative to remove bacterial plaque and calculus — the main cause of the disease — from all teeth and gum surfaces. For moderate to advanced gum disease, this could require a procedure known as flap surgery to gain access to deeper infected areas.
This type of procedure involves making scalpel incisions into the gum tissue to create a flap opening. Through this opening we’re able to gain access to the deeper pockets that have formed because of the tissue detachment that occurs following bone loss. The flap opening allows for better access to the root surfaces for removal of plaque and calculus (tartar). Once we’ve finished, we then suture the flap back into place to reduce the pockets and allow the area to heal.
While effective, flap surgery is considered moderately invasive and may produce mild post-procedural discomfort. Recently, however, a specially designed laser for periodontal therapy shows promise of less invasiveness and patient discomfort than traditional flap surgery.
A laser is an intense and narrow beam of light of a single wavelength. A periodontal laser can pass without effect through healthy cell tissue (like sunlight through a window pane) but interacts and “vaporizes” the darkly pigmented bacteria in diseased tissue. The laser energy is delivered in pulses to minimize any heat-related damage to healthy cells.
The periodontal laser can precisely remove diseased tissue, even where it mingles with healthy tissue. Once it’s removed, the root surfaces can be cleaned with ultrasonic scalers and/or hand instruments. And because a medical laser seals the tissue it cuts, it doesn’t produce open incisions as with flap surgery that require suturing afterward.
Studies of post-operative recovery after laser surgery showed similar infection reduction and renewed bone and tissue growth as with traditional surgery. Patients, however, reported much less discomfort after the laser procedure. Although more research is needed, it initially appears periodontal laser treatments can effectively treat gum disease with minimal interference with healthy tissue and greater comfort for patients.
My forty-five years of dentistry have taught me that, without a doubt, the most important service I can render to my patients is to teach them proper oral hygiene and to somehow have the ability to convince them how important it is. Without good oral hygiene, all dental treatment will fail. The patients leave themselves open for the dental bacteria to travel to other parts of their body…the infection does not stop suddenly at the neck. One cannot be totally healthy if he has a chronic low grade infection present in his mouth. The accomplishment that I am the most proud of in my dental career is the large number of patients who have listened to my oral hygiene instructions and now have healthy mouths. I am proud of my restorations but they can only be successful if the patients maintain them adequately. I also have contributed very much to these patients systemic health.
In 1967, I was introduced to the research of Dr. Surrindar Bhaskar, the commanding General of the U.S. Army Dental Corps. He was adapting the water irrigation principals that the Army Medical Corps was using to clean wounds inflicted by combat rifles. Dr. Bhaskar was a brilliant researcher and teacher. Two important points need to be made here. They are: 1. All of his research can and has been duplicated over and over. 2. He did not do this research for his own personal gain.
When I first started my own practice, in January of 1972, I referred the periodontal patients to the periodontist upon diagnosis of the condition and was met by a very high failure rate. After about six months I realized that unless I had successfully taught proper home care and the patients were completely compliant, the periodontist and I were going to fail and the patient would have undergone a painful and expensive treatment for no gain. After insisting that the patient modify their home care before any other treatment was rendered, I came to the conclusion that once the patients were doing the home care procedure that Dr. Bhaskar had developed, at least 70% of them no longer needed care by a periodontist.
The following pictures are of actual patients of Mendelson Family Dentistry. These are not in any way “touched up” and they are typical of the results of good oral hygiene.
Dental plaque and the resulting dental infection are very obvious in this picture. The plaque which causes dental disease is a biofilm which has the consistency of Elmer’s glue and cannot be adequately removed by flossing and brushing. Oral Irrigation, along with brushing, is the best way to remove this. Please note that this patient has no bone loss she has gingivitis. Her bone is very resistant to periodontal disease. If she continues to have poor oral hygiene, she will develop full blown periodontal disease and will lose her teeth. She has had cardiac bypass surgery. When she was informed on her March 13thappointment that dental disease plays a big role in heart disease, she was eager to learn just how to take care of her mouth and quite ready to do this on a DAILY BASIS.
March 13, 2007 March 20, 2007
The dental plaque is the white substance with that can be seen between her teeth. If one were to look at this plaque under a microscope, he or she would see that it is made up of living bacteria and their waste products. See how swollen and red the tissue is. At her March 13th appointment her teeth were cleaned and she was given oral hygiene instructions. She agreed to use oral irrigation along with brushing (water-pik appliance) twice a day and return to the office in one week for a follow up cleaning and photographs. You can easily see how much healing has taken place in just one week. She has continued to practice good oral hygiene and her tissue is now very healthy.
August 23, 2005 July 18, 2007
This patient is a young lady who has had several unsuccessful periodontal surgeries. She was referred to us by her mother. She has been a very compliant patient and has followed our instructions. She uses oral irrigation at night and regular tooth brushing. This has allowed her to bring her gums to maximum health without any surgeries or treatments by us except regular 6 month cleanings and exams. As you can see from these pictures taken two years apart, she has been well rewarded for her good oral hygiene.
HOW TO USE THE ORAL IRRIGATION DEVICE
Oral Irrigation devices such as the Water-Pik products and the Conair-Interplak products can be found at many local retail outlets.
- Fill the reservoir of the device with warm water. Do not use cold water. If you desire, add mouthwash (i.e. Listerine, Cepacol or Peridex).
- The power on the device should be set to a low number. It is not desirable to use it at maximum power.
- Place the tip in the mouth before turning the device on and turn it off before taking it out of your mouth.
- Shoot the water jet at right angles to the teeth, holding it in place for 5 seconds between each tooth.
- The best time to use this device is at bedtime. When you use it at other times of the day, try to not eat for at least 30 minutes following the procedure.
- In order for oral irrigation to be effective, it must be done on a daily basis.
- The best way to clean the irrigation device is to run apple cider vinegar through the appliance once every two to four weeks. Let it sit overnight with the vinegar in it. Rinse the appliance in the morning with cold water.
We urge out patients to use oral irrigation. It is, by far, the most effective way to rid our dentitions of the biofilm that causes dental caries and periodontal disease. Medical research has also shown a definite link between dental disease and blockage of the blood vessels that supply the heart. This is a very easy way to help both your dental and physical health.