The month of May has been designated “Better Speech & Hearing Month” by the American Speech-Language-Hearing Association. Why would this be of interest to dental professionals? Because teeth are vital for good speech, and missing teeth can make it very hard to speak properly.
Speech is all about sounds, and forming sounds correctly requires proper positioning of oral structures such as the lips, tongue and teeth. For example, there are some words that are almost impossible to pronounce correctly without touching your tongue to your teeth. In fact, one of the hardest words to say without teeth…is teeth!
Missing teeth can affect speech indirectly as well, by reducing self-confidence. People who are missing front teeth often develop the habit of talking behind their hand or mumbling to avoid revealing the gap in their smile. Not being able to speak clearly and confidently can affect not only your appearance, but also your job prospects and social life. So what can you do about missing teeth?
Dental implants are today’s preferred tooth-replacement method. Implants are small titanium posts that are inserted in the jaw bone beneath your gums. They serve as “roots” to hold realistic-looking prosthetic (artificial) teeth in place. Implants can be used to replace one tooth, a group of teeth, or an entire row of teeth (upper or lower). Sometimes a dental implant can be placed the same day a failing tooth is removed so that you won’t need a second surgical procedure.
The healthy natural teeth on either side of the gap can also be used to support one or more replacement teeth. This method, called bridgework, can be used to replace a single tooth or several teeth in a row. Another option is removable dentures, which do not stay in the mouth all the time.
Each of these options has its benefits and risks. We’d be happy to discuss all of them in detail and help you decide which would be best in your own situation. To learn more about tooth replacement, please contact us or schedule a consultation. You can also read the Dear Doctor magazine articles “Dental Implant Surgery” and “New Teeth in One Day.”
Dental implants are considered the premier option for tooth replacement. While all implant procedures follow the same general concept — a titanium post surgically inserted into the jawbone with an attached life-like crown — the installation process can vary.
From their earliest history, implants have usually been installed through a two-stage process. In the first stage, the surgeon inserts the titanium post in the bone and leaves it “submerged” below the gum level to protect it from oral bacteria and the effects of chewing and biting. About three months later after the bone attaches to the titanium (a process called osseointegration), the surgeon then performs the second stage by re-exposing the implant and attaching a temporary abutment and crown for the patient to wear while the permanent abutment and crown are fabricated and later attached in 2-6 weeks.
In recent years, advancements in materials and design have made possible a one-stage process that allows the implant to protrude above the gum line during osseointegration and shortens the process. After the initial three-month healing period, the implant is ready for “loading” with the permanent crown.
The choice between which of these two procedures should be used for your implants will first depend on the type of tooth being replaced. A front tooth benefits from the one-stage procedure for cosmetic reasons because the surgeon can install a temporary crown to the exposed abutment during osseointegration (as long as the temporary tooth isn’t in functional contact with other teeth). An implant for a back tooth, on the other hand, doesn't have a large cosmetic demand so those one stage procedures usually end up with an exposed healing abutment but no temporary crown.
The strength of the bone is also a factor. Some bone tends to be softer, particularly in the back of the mouth. There’s a chance the implant could move in this softer bone, adversely affecting the outcome. For this reason, the two-stage procedure can be the preferred approach for posterior teeth as it offers more protection from movement.
You can be sure we’ll consider all these and other factors during your initial examination, and then advise you on the best approach. Above all, we want to make sure — whether a one-stage or a two-stage implant process — the result is a smile you can be proud of.
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 “Staging Surgery in Implant Dentistry.”
When Entertainment Tonight host Nancy O’Dell set out to teach her young daughter Ashby how to brush her teeth, she knew the surest path to success would be to make it fun for the toddler.
“The best thing with kids is you have to make everything a game,” Nancy recently said in an interview with Dear Doctor TV. She bought Ashby a timer in the shape of a tooth that ticks for two minutes — the recommended amount of time that should be spent on brushing — and the little girl loved it. “She thought that was super fun, that she would turn the timer on and she would brush her teeth for that long,” Nancy said.
Ashby was also treated to a shopping trip for oral-hygiene supplies with Mom. “She got to go with me and choose the toothpaste that she wanted,” Nancy recalled. “They had some SpongeBob toothpaste that she really liked, so we made it into a fun activity.”
Seems like this savvy mom is on to something! Just because good oral hygiene is a must for your child’s health and dental development, that doesn’t mean it has to feel like a chore. Equally important to making oral-hygiene instruction fun is that it start as early as possible. It’s best to begin cleaning your child’s teeth as soon as they start to appear in infancy. Use a small, soft-bristled, child-sized brush or a clean, damp washcloth and just a thin smear of fluoride toothpaste, about the size of a grain of rice.
Once your child is old enough to hold the toothbrush and understand what the goal is, you can let him or her have a turn at brushing; but make sure you also take your turn, so that every tooth gets brushed — front, back and all chewing surfaces. After your child turns 3 and is capable of spitting out the toothpaste, you can increase the toothpaste amount to the size of a pea. Kids can usually take over the task of brushing by themselves around age 6, but may still need help with flossing.
Another great way to teach your children the best oral-hygiene practices is to model them yourself. If you brush and floss every day, and have regular cleanings and exams at the dental office, your child will come to understand what a normal, healthy and important routine this is. Ashby will certainly get this message from her mom.
“I’m very adamant about seeing the dentist regularly,” Nancy O’Dell said in her Dear Doctor interview. “I make sure that I go when I’m supposed to go.”
It’s no wonder that Nancy has such a beautiful, healthy-looking smile. And from the looks of things, her daughter is on track to have one, too. We would like to see every child get off to an equally good start!
If you have questions about your child’s oral health, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Taking the Stress Out of Dentistry for Kids” and “Top 10 Oral Health Tips for Children.”
Losing a tooth affects not only your smile but your overall dental health too. A dental implant solves both issues: it replaces the whole tooth, including the root, to merge durability with a life-like appearance.
For teenagers with a missing tooth, however, an implant may not be a good idea, at least until they've physically matured. Although their permanent teeth have usually all come in by puberty, the jaws and facial structure continue to develop into early adulthood. An implant placed too early could appear misaligned when the jaw fully matures.
The best approach for teens is a temporary replacement until they're physically ready for an implant. There are two good options: a removable partial denture (RPD) or a fixed bonded bridge.
Common among adults, an RPD is also a viable replacement for a teenager's missing tooth. An RPD consists of a prosthetic (false) tooth set in a nylon or acrylic base that resembles gum tissue. Metal clips formed in the RPD fit over adjacent teeth to hold the appliance in place; this also makes it easy to remove for cleaning or sleep time. We typically recommend an acrylic base for teens because it's easier to adjust if the RPD's fit becomes loose.
To hold it in place, a traditional bridge uses crowns on either side of the replacement tooth to bond over the natural teeth next to the open socket. Because this requires permanently altering the support teeth, we recommend a bonded bridge that doesn't.
This modified bridge uses wing-like strips of dental material on the back of the false tooth that project outward. With the tooth in place, we bond the extending portions of these projections to the back of the adjacent teeth, which secures the false tooth in place.
Of the two options, the bonded bridge is more comfortable, buys the most time and looks the most natural. But it will cost more than an RPD. Bite issues, teeth grinding, overall gum health or your child's level of hygiene conscientiousness could also nix it as a viable option.
Either choice will effectively replace your child's missing tooth until it's time for a permanent restoration. We'll help you weigh all the factors to determine which one is best for your situation.
As we age we become more susceptible to dental diseases. A common but often initially unnoticed problem for seniors is root decay.
We’re all familiar with tooth decay in the crown, the visible tooth above the gum line. Bacteria feeding on leftover sugar in the mouth produce acid, which at high levels erodes the teeth’s protective enamel. This forms cavities and, if untreated, deeper infection within the tooth that could reach the bone via the root canals.
But decay can also directly attack a tooth’s roots below the gum line. Roots are made of dentin and covered by a very thin layer of mineralized tooth structure called cementum. Cementum, which is much softer than enamel, is often lost because of its thinness, thus exposing the root’s dentin. This can make the area more susceptible to decay than the enamel-covered crown. Normally, though, the roots also have the gums covering them as added protection against bacterial infection.
But gum recession (shrinkage), a common experience for people in their later years, can expose the root surfaces. As a result, the roots become much more susceptible to decay. And an ensuing infection could spread more quickly into the interior of the tooth than decay originating in the crown.
That’s why it’s important to remove the decayed material and fill the root cavity to prevent the infection’s spread. While similar to a crown filling, the treatment can be more difficult if the root cavity extends below the gum line. In this case, we may need to perform a surgical procedure to access the cavity.
There are other things we can do to help prevent root cavities or limit their damage. We can apply fluoride varnish to strengthen the teeth and provide extra protection against cavities, or prescribe a fluoride rinse for use at home. We can also keep an eye out and treat periodontal (gum) disease, the main cause for gum recession.
The most important thing, though, is what you do: brush and floss thoroughly each day to remove bacterial plaque and limit sugary or acidic foods in your diet. Preventing decay and treating cavities as soon as possible will help ensure you’ll keep your teeth healthy and functional all through your senior years.
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