If you have missing teeth, dental implants are the state-of-the-art tooth replacement system. They act as substitutes for natural tooth roots, stabilizing the bone with which they fuse and become integrated with. This protects the remaining bone and prevents its further loss, the natural occurrence after the natural teeth are lost. Done correctly, implants can offer a long-term solution to the problem of missing teeth.

Key factors assuring dental implant success are having an experienced dental team consisting of:

1. A surgeon (periodontist or oral surgeon, or dentist trained in surgical techniques to place the implants)
2. A dental technician who will design the crowns (tooth portion of the implant)
3. A restorative dentist to place the crowns

The whole team is necessary to plan the process as well as carry out their individual roles. They will ensure that there is enough bone and that it is in the right place prior to treatment to allow for proper implant position, and that the implant/s are correctly placed, which is necessary to allow for natural aesthetics and proper function.

Replacing missing teeth is imperative to maintaining normal oral health and function. Dental implants will help support the entire structure of the face. If back teeth are lost, the vertical height of the lower face and mouth can begin to collapse, negatively impacting biting function and causing creasing and cracking of the lips and facial skin, resulting in a prematurely aged look.

Implants differ from bridgework in several ways, making them the most favorable option for tooth replacement in many cases. For starters, they do not affect adjacent teeth, nor do they decay like teeth, and they are less susceptible to gum disease. In the long-term, implants are a more cost-effective solution based on the fact that once they are placed, their life expectancy is longer than bridgework.

If you have missing teeth that have negatively affected your appearance, self-confidence, and ability to chew, call us today to talk about the possibility of replacing them with dental implants. To learn more about the use and capabilities of dental implants, read the Dear Doctor magazine article “Dental Implants: Evaluating Your Options For Replacing Missing Teeth.”

You may have noticed, as you get older, that the enamel of your teeth is looking worn in certain areas. Sometimes tooth wear takes the form of a minor chipping or fracturing at the incisal (cutting) edges of the teeth, or a loss of tooth material from the area near the gum line. In more severe cases, worn teeth look quite a bit smaller than they used to. Why does this happen?

Some wear with age is natural. But too much wear can interfere with your bite, expose more sensitive inner parts of the tooth to decay, and give you a more aged appearance.

There are things you can control that affect wear:

Your habits: Clenching or grinding habits, also called “bruxism,” is a major cause of tooth wear. The motion of teeth sliding over each other with forces that are beyond what's normal for biting or chewing causes a mechanical removal of tooth enamel. This can happen during sleep or periods of high stress. In either case there are therapies available, such as a thin, professionally made mouthguard that prevents your teeth from coming into contact with each other. Holding foreign objects, such as nails and bobby pins, between your teeth can also cause wear.

Your diet: Tooth enamel can be eroded (dissolved away) by acidic beverages, such as sodas, sports drinks and juices. Frequent snacking on sugary foods encourages the growth of oral bacteria that produce acid as a byproduct — also leaving your teeth vulnerable to tooth decay. Your saliva can buffer the effects of the acid in your mouth in about half an hour; if you consume these types of foods and beverages continually, there won't be enough time for this to work.

We can restore the appearance and function of worn teeth in a variety of ways. Porcelain crowns and veneers, for example, can re-establish the normal thickness and length of teeth while improving their color and giving you a more youthful appearance.

If you have any questions about tooth wear, please contact us today to schedule an appointment for a consultation. You can learn more about tooth wear by reading the Dear Doctor magazine article “How And Why Teeth Wear.”

If your teeth have a worn appearance, it's possible you have a habit you're not even aware of: clenching or grinding your teeth. Also called “bruxism,” this destructive action causes your top and bottom teeth to come together or scrape past each other with a force that's many times what is normal for biting and chewing.

So what's normal? This can be expressed in terms of pounds. An adult usually exerts a force of 13-23 pounds to bite or chew food. But we have the potential to generate as much as 230 pounds of force, or 10 times what's normal. A “parafunctional” force of this magnitude applied repeatedly is bound to stress your teeth and other areas of your oral system. Besides wearing away the enamel of your teeth — and maybe even some of the softer dentin layer underneath — you may experience muscle spasms or pain in your jaw joints. Serious cases of wear can lead to “bite collapse” in which your face actually changes shape as your cheeks and lips lose support. This can make you look prematurely aged.

What can be done? To prevent further wear, we can fabricate for you a thin, plastic mouthguard that will protect your teeth at night or during times of intense stress. We can also recommend ways to temporarily relieve the discomfort that your grinding/clenching habits can cause. Heat and/or anti-inflammatory medication, for example, can be helpful.

If your tooth wear is minor (raggedness along the biting edge of a tooth or teeth) you may not need any restorative work. However, if tooth wear has already caused changes to your teeth and bite that you find aesthetically or functionally unacceptable, we can restore lost tooth structure in a variety of ways. Veneers and crowns are two examples.

If you have any questions about tooth wear or grinding habits, please contact us today to schedule an appointment for a consultation. You can learn more about this topic by reading the Dear Doctor magazine article “How And Why Teeth Wear.”

Getting enough sleep is necessary for good health. We all know how energetic we feel when we are sleeping well at night. Yet, many of us do not feel rested, even after seven or eight hours of sleep. Let's answer some common questions about snoring and sleep apnea, problems that are often called sleep related breathing disorders (SRBD).

What is the purpose of sleep?
Scientists know we need sleep, at a particularly deep level, to be rested, but they are not sure why we need sleep. Sleep may have evolved as a way to conserve energy in the body, to conserve food supplies, or to reduce our risk during darkness. Sleep appears to give the brain a chance to store and organize its information and the body a chance to recuperate. Sleep studies have shown that in order to get the full benefits of sleep we need to sleep long and deeply enough to enter into a series of sleep cycles including Rapid Eye Movement (REM) and Non-Rapid Eye Movement (NREM) sleep.

What kinds of problems get in the way of the type of sleep we need?
There are eight main categories of sleep disorders, but the ones affecting the largest numbers of people are insomnia, SRBD, and Circadian Rhythm Sleep Disorders. SRBDs include snoring and Obstructive Sleep Apnea (OSA), which is a serious health problem.

How do I know if I have OSA or another SRBD?
Often, your bed-partner will tell you that you snore. Chronic loud snoring is an indicator of OSA. To make a diagnosis your physician must take a thorough sleep and medical history. The diagnosis may then be confirmed by a study in a sleep lab.

What causes sleep apnea or OSA?
Snoring and OSA happen when your tongue and other soft tissues in the back of your throat collapse backwards and block airflow through your upper airway or windpipe. You may briefly awaken as many as 50 times per night because of these breathing lapses. These brief awakenings, called micro-arousals, keep you from reaching the deep stage of sleep your body needs.

What are the treatments for sleep apnea?
Treatments include CPAP therapy, in which patients wear a mask while sleeping. The mask pushes air through the airway, keeping it open. In Oral Appliance Therapy (OAT) patients wear a device that moves the lower jaw forward, allowing more room for air to move down the airway. Oral surgical procedures and orthodontic approaches also have the goal of moving the tongue away from the throat. These are all treatments that can be carried out by a dentist who has training and experience in treatment of sleep disorders.

Contact us today to schedule an appointment to discuss your questions about sleep disorders and their treatments. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Sleep Apnea Frequently Asked Questions.”

Guidelines regarding the concentration of fluoride in water have recently been changed by the US Government's Department of Health and Human Services (HHS) and the Environmental Protection Agency (EPA). These agencies recommended a reduction of fluoride in water supplies to 0.7mg/L, modifying the original recommendations provided in 1962 by the US Public Health Service.

What is fluoride, and why add it to water supplies?
Fluoride is a chemical form of fluorine, a naturally occurring element. For decades, scientists have carried out studies on the effects of fluoride in water, and they have proved that fluoride strengthens tooth surfaces and makes them resistant to decay. A fluoride concentration of about one milligram per liter (1 mg/L), or 1 part per million (1ppm), in the water supply is associated with substantially fewer cavities. This concentration of fluoride (equivalent to a grain of salt in a gallon of water) has been found to have no negative health effects.

The Center for Disease Control (CDC) says that fluoridated water is one of the ten most effective public health measures of the 20th Century. The optimal amount of fluoride necessary to make teeth resistant to decay turns out to be between 0.7 and 1.20 milligrams per liter (mg/L). A certain amount of fluoride occurs naturally in water supplies, and communities have added fluoride to bring the amount up to the optimal recommendations.

How does fluoride you drink get into your teeth?
The fluoride you drink in your water is deposited in your bones. Bone is an active living substance that is constantly broken down and rebuilt as a normal body process. As this happens the fluoride is released into the blood, from which it can enter the saliva and act on the tooth surface.

What about fluoride from other sources?
Americans now have access to many sources of fluoride in addition to the water they drink. These include foods, beverages and toothpaste. As a result, dentists have begun to notice an increased prevalence of a condition known as Dental Fluorosis.

What is Dental Fluorosis?
Dental Fluorosis can occur when teeth, particularly in children, receive too much fluoride. This condition is a mottling or uneven staining of the tooth surface enamel. There may be small white spots or extensive brownish discolorations. The mottled enamel is still resistant to decay, but it may be unattractive in appearance.

What is the idea behind the new guidelines?
With the new guidelines, fluoride is kept at the lower end of the scale of the optimal concentration for strengthening teeth against decay. At this end, there is room to add consumption of fluoride from other sources such as foods or toothpaste. In short, it is the best of both worlds.

Contact us today to schedule an appointment to discuss your questions about fluoride. You can learn more by reading the Dear Doctor magazine articles “Fluoride & Fluoridation in Dentistry” and “New Fluoride Recommendations.”