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Implant-BasedRemovableDenturesaGoodChoiceforPatientswithExtensiveBoneLoss

People who’ve lost all their teeth (a condition known as edentulism) face a decision on how to restore their lost function and appearance. And there are a number of options to consider.

A fixed bridge supported by dental implants, for example, is a good choice for patients who still have sufficient bone structure in their jaw. It’s not a good choice, however, for those with the opposite situation — who’ve experienced significant bone loss which has also affected their facial structure. For them, there’s a better alternative that also uses implants for support — the overdenture.

An overdenture is similar to a traditional denture, in that it’s made of life-like crowns permanently set in denture plastic, and may either partially or fully cover the roof of the mouth. The main difference, though, is that unlike traditional dentures which rest for support on the gum ridges, an overdenture is supported by strategically placed implants that the denture fits over and connects to — hence the name “overdenture.”

There are a number of advantages for an overdenture, especially for patients with bone loss. A removable, implant-supported denture can be designed to replace lost tissues that have altered facial appearance — to “fill in” the face and restore aesthetic harmony. Patients who’ve previously worn dentures will also often find their speech better improved than with fixed bridgework.

Because it’s removable, an overdenture and the underlying gums are easier to clean, which helps inhibit disease and lessen further bone loss. It also allows you to properly care for the denture, which can extend its longevity and reduce future potential maintenance and replacement costs.

If you would like to consider removable overdentures as an option, you should begin first with a thorough oral exam that includes evaluating the status of your bone, jaw and facial structure. From there we can advise you if overdentures are the best choice for you.

If you would like more information on overdentures and other restoration options, 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 “Fixed vs. Removable.”

By Donald J. Swiatek, DDS
March 15, 2019
Category: Dental Procedures
LadyGagaWasntBornThisWay

Sometimes, looking at old pictures can really bring memories back to life. Just ask Stefani Germanotta—the pop diva better known as Lady Gaga. In one scene from the recent documentary Five Foot Two, as family members sort through headshots from her teen years, her father proclaims: "Here, this proves she had braces!"

"If I had kept that gap, then I would have even more problems with Madonna," Lady Gaga replies, referencing an ongoing feud between the two musical celebrities.

The photos of Gaga's teenage smile reveal that the singer of hits like "Born This Way" once had a noticeable gap (which dentists call a diastema) between her front teeth. This condition is common in children, but often becomes less conspicuous with age. It isn't necessarily a problem: Lots of well-known people have extra space in their smiles, including ex-football player and TV host Michael Strahan, actress Anna Paquin…and fellow pop superstar Madonna. It hasn't hurt any of their careers.

Yet others would prefer a smile without the gap. Fortunately, diastema in children is generally not difficult to fix. One of the easiest ways to do so is with traditional braces or clear aligners. These orthodontic appliances, usually worn for a period of months, can actually move the teeth into positions that look more pleasing in the smile and function better in the bite. For many people, orthodontic treatment is a part of their emergence from adolescence into adulthood.

Braces and aligners, along with other specialized orthodontic appliances, can also remedy many bite problems besides diastema. They can correct misaligned teeth and spacing irregularities, fix overbites and underbites, and take care of numerous other types of malocclusions (bite problems).

The American Association of Orthodontists recommends that kids get screened for orthodontic problems at age 7. Even if an issue is found, most won't get treatment at this age—but in some instances, it's possible that early intervention can save a great deal of time, money and effort later. For example, while the jaw is still developing, its growth can be guided with special appliances that can make future orthodontic treatment go quicker and easier.

Yet orthodontics isn't just for children—adults can wear braces too! As long as teeth and gums are healthy, there's no upper age limit on orthodontic treatment. Instead of traditional silver braces, many adults choose tooth-colored braces or clear aligners to complement their more professional appearance.

So if your child is at the age where screening is recommended—or if you're unhappy with your own smile—ask us whether orthodontics could help. But if you get into a rivalry with Madonna…you're on your own.

If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Orthodontics For The Older Adult.”

ATraditionalBridgeMightbetheRightSolutionforYourMissingTeeth

We can do a great many things to preserve diseased teeth, from filling cavities to crowning damaged but still viable teeth to protect them and restore their attractiveness. But there may come a point where continued treatment just isn't worth it, and it may be time to remove and replace your troubled teeth.

Dental implants have become the premier restoration for missing teeth. But they have some anatomical limitations and may not work for some situations like excessive bone loss or close nerve proximity. And while a removable partial denture is a solid option, perhaps you'd rather have a fixed solution.

You might then want to consider a fixed bridge to replace one or more missing teeth. This tried and true option has been a mainstay in dentistry for several decades; and while implants may have surpassed them in popularity, they're still available and effective as a restorative option.

A traditional fixed bridge is composed of three or more life-like crowns that are fused together like pickets in a fence. The crown or crowns in the middle fill the empty tooth space; the outside crowns fit over and are bonded to the natural teeth on either side of the empty space to support the bridge. These natural teeth must be reduced in size to accommodate the crowns to fit over them.

Depending on how many teeth are missing, fixed bridges can be a more affordable alternative to dental implants and can achieve life-like results in both form and dental function. But the alterations required for the supporting teeth are permanent and can weaken them. The interface between the natural teeth and the bridge crowns has a higher risk of decay and periodontal disease, so you'll need to be extra vigilant with daily hygiene and regular dental cleanings and checkups.

And even though implants can be more expensive in the short-term, they typically have better durability and less maintenance costs than other restorations. Over the long-term, an implant restoration might actually incur less cost than a fixed bridge.

Still, a fixed bridge can be an effective way to replace missing teeth. Depending on your finances and your overall dental health, a bridge could help you regain an attractive smile.

If you would like more information on options for replacing missing teeth, 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 “Crowns & Bridgework.”

NotJazzedAboutWearingBracesConsiderClearAlignersInstead

Wearing orthodontic braces brings challenges to daily life. During treatment a patient will need to avoid certain foods and habits, take more time to brush and floss properly, and may endure occasional discomfort. But the effect of metal braces on appearance can be especially difficult, especially for peer-conscious teens.

Clear aligners, though, offer an alternative to braces that could make some of these challenges easier, particularly with your appearance. Aligners are clear plastic trays that fit over the teeth to move them. They can be removed by the wearer for easier brushing and flossing or for special occasions. Best of all, they're much less noticeable than metal braces.

Clear aligners were developed thanks to advances in digital technology. An orthodontist uses a computer application incorporating the data from photographs, x-rays or CT scans of a patient's teeth and jaws to produce a series of clear plastic trays. The patient then wears each tray for about two weeks before changing to the next tray in the sequence.

The trays apply pressure much like metal braces to gradually move teeth to the desired position on the jaw. Each tray is slightly smaller in size than the previous tray in the sequence, so that the progression of tooth movement continues with each succeeding tray. The treatment time is about the same as with conventional braces.

This new orthodontic tool works well for many common bite problems, but until recently they've been limited in scope. But new designs in trays and attachments called buttons added to teeth to provide more leverage have greatly increased their use for more complex bite issues.

Clear aligners also have one other disadvantage, ironically due to one of their principal benefits, removability. Although they can be taken out, they must be worn consistently to achieve results. Some younger patients may not have the maturity level and discipline to responsibly wear their aligners as they should.

That's one issue you'll need to discuss with your orthodontist if you're considering clear aligners for your teen. But if they can maintain wearing consistency, and they have a bite problem that can be corrected with aligners, both you and your teen may find this choice more agreeable and attractive than braces.

If you would like more information on clear aligners, 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 “Clear Aligners for Teens.”

By Donald J. Swiatek, DDS
February 13, 2019
Category: Oral Health
Tags: oral hygiene  
TestYoureBrushingandFlossingSuccesswithaPlaqueDisclosingAgent

Brushing and flossing your teeth provides a lot of benefits, including a brighter smile and fresher breath. But the primary benefit—and ultimate goal—is removing dental plaque. This biofilm of bacteria and food remnants on tooth and gum surfaces is the number one cause for dental disease.

Brushing and flossing can effectively keep plaque under control. Unfortunately, plaque can be a stubborn foe, hiding in areas easily missed if you're not thorough enough.

So how do you know you're doing a good job brushing and flossing? One quick way is to use your tongue or dental floss to feel for any grittiness, a possible sign of remaining plaque. Ultimately, your dentist or hygienist can give you the best evaluation of your hygiene efforts during your three or six-month checkup.

But there's another way to find out more definitively how well you're removing plaque in between dental visits: a plaque disclosing agent. These over-the-counter products contain a dye solution that stains plaque so it stands out from clean tooth surfaces.

A disclosing agent, which can come in the form of tablets, swabs or a liquid, is easy to use. After brushing and flossing, you apply the agent according to the product's directions. The dye reacts with plaque to stain it a distinct color. You may also find products with two-tone dyes that stain older and newer plaque different colors to better gauge your overall effectiveness.

You then examine your teeth in the bathroom mirror, looking especially for patterns of missed plaque. For example, if you see dyed plaque running along the gum line, you'll know you need to concentrate your hygiene there.

After observing what you can do to improve your future efforts, you can then brush and floss your teeth to remove as much of the dyed plaque as you can. The staining from the dye is temporary and any remaining will fade over a few hours.

Using a disclosing agent regularly could help you improve your overall hygiene technique and reduce your risk of disease. Ask your dentist for recommendations on products.

If you would like more information on improving your oral hygiene, 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 “Plaque Disclosing Agents.”





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