Posts for category: Dental Procedures

By M. Kenneth Johnson, DMD, PA
February 14, 2022
Category: Dental Procedures
Tags: dental implants  
AnImplantCouldFailifSupportingStructuresBecomeDiseased

From an appearance standpoint, it might be difficult to tell a new dental implant and crown from a natural tooth. There is, however, one big difference between an implant and crown from a real tooth, one which could impact an implant's longevity: how each attach to the jaw.

A natural tooth is held in place by a tough, but elastic gum tissue called the periodontal ligament. The ligament lies between the tooth and the bone, extending out tiny fibers that attach to both. This holds the teeth firmly in place, while also allowing the tooth to gradually move in response to mouth changes. It also facilitates the delivery of infection-fighting agents to protect the teeth and gums against disease.

By contrast, an implant is imbedded in a prepared channel shaped into the jaw bone. Over time, bone cells grow and adhere to the titanium surface, which serves to fully secure the implant to the jaw. The periodontal ligament doesn't attach to the implant, so it relies solely for stability on its attachment to the bone.

Thus, although highly durable, implants don't share the properties real teeth have because of their connection with the periodontal ligament. They don't move dynamically like real teeth; and more importantly, they lack some of the disease-fighting resources available to natural teeth.

So, what difference would the latter make? Implants aren't composed of organic material, and are therefore unaffected by bacterial infection. The problem, though, is that the gums and bone supporting the implant are susceptible to disease. And, because an implant lacks the defenses of a real tooth that the periodontal ligament provides, an infection within these tissues could quickly undermine their support and cause the implant to fail.

To avoid this and protect the longevity of your implant, it's important that you practice daily oral hygiene. You should brush and floss your implant to clear away disease-causing plaque from the surrounding tissues just as you do natural teeth.

Your dental provider will also include cleaning around your implants during your regular visits, albeit with different tools that are more protective of the implant and crown surfaces. During these visits they'll also closely inspect the tissues around the implant for any signs of infection and initiate prompt treatment if necessary.

If you would like more information on taking care of your 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 “Dental Implant Maintenance.”

By M. Kenneth Johnson, DMD, PA
February 04, 2022
Category: Dental Procedures
Tags: dental implants  
3EmergingTechnologiesThatImproveDentalImplants

Historically speaking, implants are a recent blip on the centuries-long march of dental progress. But few innovations in dentistry can match the impact of implants in its short history on dental function and appearance.

Dental implant therapy has already established itself as a restoration game-changer. But it also continues to improve, thanks to a number of emerging technologies. As a result, implant restorations are far more secure and life-like than ever before.

Here are 3 examples of state-of-the-art technologies that continue to improve this premier dental restoration.

CT/CBCT scanning. Functional and attractive implants depend on precise placement. But various anatomical structures like nerves or sinuses often interfere with placement, so it's important to locate these potential obstructions during the planning phase. To do so, we're increasingly turning to computed tomography (CT). This form of x-ray diagnostics is the assembly of hundreds of images of a jaw location into a three-dimensional model. This gives us a much better view of what lies beneath the gums.

Digital-enhanced planning. Implant success also depends on careful planning. And, it isn't a one-sided affair: The patient's input is just as important as the dentist's expertise. To aid in that process, many dentists are using digital technology to produce a virtual image of a patient's current dental state and what their teeth may look like after dental implants. This type of imaging also allows consideration of a variety of options, including different sized implants and positions, before finalizing the final surgical plan.

Custom surgical guides. To transfer the final plan details to the actual implant procedure, we often create a physical surgical guide placed in the mouth that marks the precise locations for drilling. We can now produce these guides with 3-D printing, a process that uses computer software to produce or "print" a physical object. In this case, the 3-D printer creates a more accurate surgical guide based on the exact contours of a patient's dental arch that's more precise than conventional guides.

Obtaining a dental implant is a highly refined process. And, with the aid of other advances in dental technology, it continues to provide increasing value to patients.

If you would like more information on restoring teeth with 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 “How Technology Aids Dental Implant Therapy.”

By M. Kenneth Johnson, DMD, PA
December 26, 2021
Category: Dental Procedures
Tags: oral hygiene   dentures  
DoThese2ThingsForYourHealthsSakeIfYouWearDentures

Today's dentures are more comfortable, more functional and more life-like than ever before—so much so that you might forget you have them in. Even so, dentures do have some downsides, and constant wear only amplifies those.

Our biggest concern is the effect dentures can have on bone health. Older bone is constantly replaced by newer bone, and the forces generated while chewing help stimulate this new growth. When a tooth is lost, however, this growth stimulus vanishes with it for that area of the bone. This may result in a slower growth rate, which can eventually lead to lost bone volume and density.

Dentures can't restore this lost stimulus, and may even make the situation worse. That's because traditional dentures rest on the bony ridges of the gums where the teeth once were. This can put pressure on the underlying bone, which can accelerate bone loss—and even more so when wearers leave their dentures in continuously.

Dentures can also contribute to disease if they're not regularly removed and cleaned. Besides oral yeast infections, bacteria-laden dentures can contribute to the production of a protein called interleukin-6 produced by the white blood cells. If a significant amount of this protein passes into the blood stream, it can increase body-wide inflammation and foster a systemic environment conducive to serious diseases like pneumonia.

If you wear dentures, then, it's good for your health (oral and otherwise) to incorporate two practices into your daily life. The first is to remove your dentures at night while you sleep. Not only will this help slow the progression of bone loss, it will also give your gums a chance to rest and recover from denture wear.

It's also important to regularly clean your dentures, either with an antibacterial soap or a special denture cleanser. During storage, keep your dentures in clean water or a peroxide-based solution designed for dentures. This will reduce the accumulation of bacteria on your dentures that can cause disease.

Dentures restore the dental function and smile appearance that a person loses with their teeth. Taking care of your dentures (and giving your mouth a daily rest from them) will help promote good oral and general health for you and a longer life for your dentures.

If you would like more information on denture care, 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 “Sleeping in Dentures.”

By M. Kenneth Johnson, DMD, PA
December 06, 2021
Category: Dental Procedures
Tags: celebrity smiles   veneers   crowns  
HowGeorgeClooneyMadeOverHisSmileandHowYouCanToo

Since his breakout role as Dr. Doug Ross in the 90's TV drama ER, George Clooney has enjoyed a blockbuster career as an award-winning actor, director and producer. He's still going strong, as seen in the recent film The Midnight Sky, which Clooney directed and starred in. This sci-fi drama set a record as the most-watched movie on Netflix for the first five days after its late December release. And although now well into middle age, Clooney still possesses a winsome charm epitomized by his devil-may-care smile.

But he didn't always have his enigmatic grin. Early on, his struggles pursuing his burgeoning acting career triggered a stressful habit of grinding his teeth. This took a toll, as his teeth began to look worn and yellowed, giving his smile—and him—a prematurely aged appearance.

Clooney's not alone. For many of us, our fast-paced lives have created undue stress that we struggle to manage. This pent-up stress has to go somewhere, and for a number of individuals it's expressed through involuntary grinding or gritting of the teeth. This may not only lead to serious dental problems, but it can also diminish an otherwise attractive smile.

There are ways to minimize teeth grinding, the most important of which is to address the underlying stress fueling the habit. It's possible to get a handle on stress through professional counseling, biofeedback therapy, meditation or other relaxation techniques. You can also reduce the habit's effects with a custom-made oral device that prevents the teeth from making solid contact during a grinding episode.

But what if teeth grinding has already taken a toll on your teeth making them look worn down? Do what Clooney did—put a new “face” on your teeth with dental veneers. These thin layers of porcelain are bonded to teeth to mask all sorts of blemishes, including chips, heavy staining and, yes, teeth that appear shortened due to accelerated wearing. And they're custom-designed and fashioned to blend seamlessly with other teeth to transform your smile. Although they're not indestructible, they're quite durable and can last for years.

Veneers can correct many mild to moderate dental defects, but if your teeth are in worse shape, porcelain crowns may be the answer. A crown, which bonds to a prepared tooth to completely cover it, allows you the advantage of keeping your natural tooth while still enhancing its appearance.

Although different in degree, both veneers and crowns require permanently altering the teeth, such that they will require a dental restoration from then on. But if you're looking for an effective way to transform your worn or otherwise distressed teeth into a beautiful smile, it's a sound investment.

Just like George Clooney, your smile is an important part of who you are. We can help you make it as appealing as possible with veneers or other dental enhancements. Call us today to get started on the path to a more attractive smile.

If you would like more information about dental veneers and other smile enhancements, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Veneers.”

By M. Kenneth Johnson, DMD, PA
November 26, 2021
Category: Dental Procedures
Tags: crowns  
WhatYouNeedToKnowToChoosetheRightDentalCrown

In the realm of dental restorations, not all crowns are alike. And, one type isn't necessarily superior to the others. One type of crown may work better for a particular tooth, while a different crown is better suited to another.

Therefore, knowing your options can help you make a more informed choice with your dentist regarding the best crown for your needs. Here, then, is a quick primer on the main types of dental crowns used today.

Metal crowns. Early in the last century, crowns made of gold, silver or other metals were the go-to dental restoration. Because of their strength and durability, metal crowns are still used today, mainly in back teeth that encounter heavy biting forces. Their drawback: They're decidedly not the color of natural teeth and so can stand out if they're placed in the visible "smile zone."

PFM crowns. The first crowns made with dental porcelain solved the appearance problem, but couldn't adequately handle biting forces as well as metal. Out of this came the porcelain fused to metal (PFM) crown, which contains an inner core of metal overlaid with tooth-colored porcelain. Providing both strength and life-likeness, PFM crowns were immensely popular until the mid-2000s.

All-Ceramic crowns. The development of porcelains more durable than earlier versions eventually dethroned the PFM (although the latter is still used today). Sixty percent of the crowns installed in recent years are all-ceramic, many reinforced with a strength material known as Lucite. Many all-ceramic crowns reaching the 15-year mark are still in place and functioning.

All of these crowns continue to be viable options for dental patients. The biggest factor in choosing one particular crown over another is the type of tooth involved and its location. As mentioned before, metal or PFM crowns are usually better for back teeth where durability is a higher priority than aesthetics. All-ceramics work well in high-visibility front teeth that normally encounter lighter biting forces than back teeth.

Regardless of which kind eventually caps your tooth, any of today's modern crowns will function as intended. But the best crown for you will be the one that both protects your tooth and enhances your smile.

If you would like more information on dental crown restorations, 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 “Porcelain Dental Crowns.”