Complete tooth loss is a common condition among older adults, gradually occurring one or two teeth at a time. There often comes a point of realization, though, that all the teeth will eventually be lost.
This can create a dilemma: Do you replace teeth as they're lost, or go ahead and have all of them removed at one time?
Up until recently, the latter choice seemed the most practical and affordable. But most dentists would agree that keeping natural teeth for as long as practical is better for a person's overall oral health and to slow any potential bone loss.
The emergence of dental implants has made this less of a dilemma: We can use this technology to more affordably replace teeth in stages rather than all at once. This is because an implant is technically a root replacement: a dentist inserts a titanium metal post into the jawbone. Because of an affinity with titanium, bone cells grow and adhere to the implant surface, which creates a stronger hold. It also impedes bone loss.
We can, of course, use implants as individual tooth replacements. But the expense of this approach with multiple teeth puts it well out of reach financially for many people. But implants can also be used as connective points between the patient's jaw and other kinds of dental restorations like bridges, partial dentures, and full removable or fixed dentures.
Using this approach, we can adopt a strategy of allowing healthier teeth to remain until it's necessary to remove them. We initially place implants to support a bridge, for example; later we can use the same implants along with additional ones to support a larger restoration, even a fixed full denture.
An implant-supported restoration is typically more expensive than traditional bridges or dentures, but far less than replacing teeth with individual implants. And because the stages of restorations may occur over a long period of time, the cost can be spread out to make it more manageable.
If you're facing a future where it's likely you'll lose all your teeth, you don't have to lose them all at once. Staged restorations with implants could help you hold on to your natural teeth for as long as possible, slow bone loss and make for a healthier mouth.
If you would like more information on the wide array of dental 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 “Replacing All Teeth But Not All at Once.”
Dorit Kemsley isn't shy. Best known to fans as an outspoken and sometimes outrageous cast member of the reality show Real Housewives of Beverly Hills, Kemsley is never reticent about “mixing it up” with fellow castmates or their significant others. Recently, though, she confessed to something that left her less than confident: her smile.
Kemsley has been self-conscious about her smile because her teeth looked noticeably short, worn down from an unconscious habit of grinding her teeth. Although teeth grinding is more common among children (who normally grow out of it by adolescence), it can persist into adulthood, usually from difficulties managing high stress (a likely component in the fashion designer/reality show star's busy life).
Stress-induced teeth grinding can occur during waking hours or, more likely, during deep sleep. The accumulating, long-term effects from the habit can lead not only to worn teeth but to weakened gum support, a high risk of tooth fracture or jaw pain and dysfunction.
So, how do you know if you grind your teeth, especially if it's only happening at night? Typical signs include sore jaws after awaking from sleep, increased tooth pain or sensitivity or, like Kemsley, a noticeable difference in your tooth length. Your family or sleeping partner may also complain about the “skin-crawling” noise you make during the night.
There are ways to lessen the effects of teeth grinding. The first step is to have us verify the underlying cause for the habit. If it's tension from stress, then you might reduce the habit's occurrences by learning better stress management or relaxation techniques through individual counseling, group support or biofeedback therapy. We can also fit you with a mouth guard to wear at night or through the day that reduces the force generated during teeth grinding.
And if you've already experienced accelerated tooth wear like Kemsley with a resultant “small teeth” smile, you might pursue the same solution as the RHOBH star: dental veneers. These thin, life-like wafers of porcelain are custom-made to mask imperfections like chips, staining, slight tooth gaps and, yes, worn teeth.
Veneers are often less expensive and invasive than other cosmetic techniques, yet they can have a transformative effect, as Kemsley's Instagram followers have seen. In conjunction with other dental treatments needed to repair any underlying damage caused by a grinding habit, veneers are an effective fix for the smile you present to the world.
If you suspect you may have a grinding habit, see us for a complete examination. From there, we'll help you protect your teeth and your smile.
There are important reasons not to smoke, like minimizing your risk for deadly diseases like heart disease or lung cancer. But here's another good reason: Smoking increases your risk of gum disease and possible tooth loss. And although not necessarily life-threatening, losing your teeth can have a negative effect on your overall health.
According to the U.S. Centers for Disease Control, individuals who smoke cigarettes, cigars, pipes or e-cigarettes are twice as likely as non-smokers to develop gum disease, and four times as likely the infection will become advanced. Your risk may also increase if you're regularly exposed to second-hand smoke.
There are a number of reasons for this increased risk. For one, smokers are less likely than non-smokers to recognize they have gum disease, at least initially, because they may not display classic symptoms of an infection like red, swollen or bleeding gums. This happens because the nicotine in tobacco smoke interferes with normal blood circulation. As a result, their gums may appear healthy when they're not.
That same circulation interference can also inhibit the production and supply of antibodies to fight infection. Not only can this intensify the infection, it can also slow healing and complicate treatment. In fact, smokers are more likely to have repeated episodes of infection, a condition called refractory periodontitis.
But there is good news—smoking's effect on your gum health doesn't have to be permanent. As soon as you stop, your body will begin to repair the damage; the longer you abstain from the habit, the more your gum health will improve. For example, one national study found that former smokers who had not smoked for at least eleven years were able to achieve an equal risk of gum disease with someone who had never smoked.
Quitting smoking isn't easy, but it can be done. If abrupt cessation (“cold turkey”) is too much for you, there are medically-supported cessation programs using drugs or other techniques that can help you kick the habit. And while it may be a long road, leaving smoking behind is an important step toward improving and maintaining good dental health.
If you would like more information on protecting your gum health, 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 “Smoking and Gum Disease.”
Your tooth enamel’s main nemesis is oral acid: normally produced by bacteria, foods or beverages, acid can dissolve enamel’s mineral content and cause erosion and decay. But acid might be a bigger problem for you if you also have gastroesophageal reflux disease or GERD.
GERD is a digestive condition in which stomach acid backs up into the digestive tract. Normally, a ring of muscle at the end of the esophagus prevents stomach acid from coming up into it. But if it weakens, this powerful acid can splash up into the esophagus and irritate its more delicate lining and result in a burning sensation known as heartburn or acid indigestion.
The problem for teeth, though, is that GERD could cause stomach acid to potentially come up into the mouth. Because of its high acidic pH (2.0 or less), stomach acid can cause major erosion in tooth enamel, leaving them pitted, yellow and sensitive. If not caught and treated early, some of your teeth could be damaged to the point that they have a questionable prognosis.
There are some things you can do to minimize GERD’s effect on your dental health. First and foremost, see a doctor about managing your symptoms, which might include medication. Be sure you also inform your dentist that you have GERD and what medications you’re taking.
One way to lessen the effect of higher acid in the mouth is to stimulate saliva production, which helps neutralize acid. You can do this by drinking plenty of water, taking a saliva booster or chewing xylitol-sweetened gum. You can also rinse with plain water or water mixed with baking soda (1/2 teaspoon to a cup of water), or chew an antacid tablet to help balance your mouth’s pH level.
And don’t forget to look out for your enamel. Be sure you’re practicing daily brushing and flossing and using fluoride hygiene products to strengthen it. Your dentist can also apply topical solutions or prescribe special rinses with higher concentrations of fluoride.
GERD can be an unpleasant experience that escalates into major problems. Don’t let it compromise your dental health.
Approximately 4 million tweens and teens are currently undergoing orthodontic treatment for a poor bite (malocclusion) that can cost their families thousands of dollars in braces or clear aligners. But treatment doesn't always have to follow this track: Found early, many malocclusions can be corrected or minimized before they fully develop.
Known as interceptive orthodontics, this particular approach to bite correction often begins as early as 6-10 years of age. Rather than move existing teeth, interceptive orthodontics focuses instead on redirecting jaw growth and intervening in other situations that can cause malocclusions.
For example, a child's upper jaw may not be growing wide enough to accommodate all incoming permanent teeth, crowding later arrivals out of their proper positions. But taking advantage of a gap during early childhood that runs through the center of the palate (roof of the mouth), orthodontists can increase jaw width with a device called a palatal expander.
The expander fits up against the palate with “legs” that extend and make contact with the inside of the teeth. With gradually applied pressure, the expander widens the central gap and the body naturally fills it with new bone cells. The bone accumulation causes the jaws to widen and create more room for incoming teeth.
Another way a malocclusion can develop involves the primary or “baby” teeth. As one of their purposes, primary teeth serve as placeholders for the future permanent teeth forming in the gums. But if they're lost prematurely, adjacent teeth can drift into the vacant space and crowd out incoming teeth.
Dentists prevent this with a space maintainer, a thin metal loop attached to the adjoining teeth that puts pressure on them to prevent them from entering the space. This spacer is removed when the permanent tooth is ready to erupt.
These and other interceptive methods are often effective in minimizing the formation of malocclusions. But it's often best to use them early: Palatal expansion, for example, is best undertaken before the central gap fuses in early puberty, and space maintainers before the permanent tooth erupts.
That's why we recommend that children undergo an orthodontic evaluation around age 6 to assess their early bite development. If a malocclusion looks likely, early intervention could prevent it and reduce future treatment costs.
If you would like more information on interceptive orthodontics, 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 “Interceptive Orthodontics.”
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