Before determining if a bridge or an implant will work best for you, here is some useful background information. There are two main parts to a tooth; the crown or part that you see above the gum line and the root portion that is below the gum line and encased in bone — the part that is replaced by a dental implant.

A dental implant is inserted into the jawbone during a surgical procedure. The implant is actually a titanium screw-like device that is placed in contact with the bone. During a 3 to 6 month healing period, it subsequently fuses to the bone. A crown made from dental porcelain, gold or a combination of both is then attached to the implant to mimic a healthy, normal tooth.

There are two critical reasons why implants are the preferred method for permanently replacing an adult tooth. The first is that they are less susceptible to gum disease and they are not subject to tooth decay. The second is that because they attach to the jawbone and not to the adjacent teeth. And while an implant may cost a little more initially, when compared to the longevity and replacement cost of bridgework over a lifetime, they may cost less.

By contrast, a fixed bridge is also a non-removable restoration or prosthesis (replacement part) that is held in place by attaching it to your natural adjacent teeth. The treatment gets its name from the French word for bridge, “pont,” as the tooth being replaced is called a pontic. Before placing a bridge, the teeth on either side of the missing tooth must be prepared by removing layers of tooth enamel. Three new teeth are then crafted as a single unit from dental porcelain and/or precious metals with crowns on either side of the pontic. The pontic is held in place when the crowns are placed. Bridgework is at risk for gum disease and tooth decay and requires careful maintenance.

As with most dental procedures you have options and choices. Luckily, when it comes to determining whether a bridge or an implant will work best for you, you can rely upon our expertise. However, by having a clear understanding of these two options you are now better prepared for working with us should you require this treatment option. To learn more read the article, “Implants Vs. Bridgework.” Or, contact us to discuss your questions or to schedule an appointment.

Dental professionals agree that effective removal of plaque, the film of bacteria (also called a biofilm) that gathers on everyone's teeth, is the key to good dental health. Daily brushing and flossing are the usual recommendation for plaque removal. It is important to ask us about effective brushing and flossing. At your next appointment, ask us for a demonstration.

Effective brushing removes plaque from the easily accessed surfaces of the teeth. To remove plaque from between the teeth, you must floss.

Some people find it awkward to hold the floss with their fingers as they move it around their teeth. One technique for flossing, suggested by a dentist in Dear Doctor magazine, may make it easier than more traditional methods, although it does take a little practice.

Preparation
This method requires tearing off a 10 to 12 inch length of floss and tying it to form a circle big enough for your fingers, but not your thumbs, to fit within it. The circle should be knotted with a double knot.

To Clean Teeth and Gums
Keep the floss taut at all times, with about and inch or less between your thumb and index fingers for your upper teeth, or index fingers only for your lower teeth. Curve the floss around each tooth and gently move it up and down until you hear a squeaky clean sound. Extend the downward movement of the floss to just below the surface of the gum, without being too harsh and causing injury. As you move from tooth to tooth, move around the floss circle so that each tooth gets a clean section of floss.

Upper Teeth
Place all your fingers in the ring, with the floss over your left thumb and right index finger to floss your upper left teeth, and over your right thumb and left index finger to do the other side.

Lower Teeth
Use both index fingers to floss all your lower teeth.

You may only need to floss once a day before or after brushing to keep your gums health and ward off periodontal (gum) disease. Your dentist will guide you as to how often you may need to floss your teeth. Try this technique and see how it works for you.

Contact us today to schedule an appointment to discuss your questions about flossing techniques. You can also learn more by reading the Dear Doctor magazine article “Flossing — A Different Approach.”

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.”

When it comes to your oral healthcare, we strive to provide state-of-the-art care along with education to both our patients and community. One way we do this is by taking a moment to answer some of the questions we are most often asked about a certain topic. And one topic that almost always ignites questions is the subject of lumps and bumps in the mouth.

Help! I just found a small lump in my mouth — what should I do?
Not to alarm you, but your first priority is to contact us as soon as possible to schedule an appointment so that we can review it. Most often, we will know what it is by taking a history, knowing how long it's been there and what it looks like. Depending on what we find, we may want to take a biopsy so that we can determine exactly what it is and how we need to treat it.

What is involved in having a biopsy performed?
A biopsy is a normal and routine procedure that is used to definitively diagnose and confirm exactly what the abnormal lump, bump or other tissue is. It is typically performed with local anesthesia so that a small tissue sample can be removed without any pain for examination under a microscope. Depending on the size of the wound, it may require two to three sutures (stitches), leaving a flat and flush surface that heals in a few days to a week. The procedure usually lasts between 10 and 15 minutes with the lab results processed within a few days.

Does this mean I have cancer?
No, the chances are slim that you actually have cancer. However any change or sore in the mouth that does not heal in a week or two should be evaluated by a dentist and if necessary biopsied. If it is pre-cancerous and removed, it could save your life. The most important fact you need to remember is that no one can tell for sure what the abnormal tissue growth is until an expert in oral pathology (“patho” – disease; “ology” – study of) examines it under a microscope. While it is human nature to be concerned, until you have the facts, you are suffering needlessly.

To learn more about this topic, continue reading the Dear Doctor magazine article “Common Lumps and Bumps In The Mouth.” Or you can contact us today to schedule an appointment to discuss your specific questions so that we can put your mind at ease.

What does the term “two-implant overdentures” mean?
For more than a century, complete dentures were the only care option for edentulous (toothless) people. As a solution, these left a lot to be desired, particularly for the lower jaw. Now dental technology has developed a better alternative that combines two strategically placed dental implants and a traditional lower denture that has been modified to fit over the two implants — thus the term.

What are the problems with traditional dentures?
The problem is that when you lose teeth, the bone that supported the missing teeth begins to shrink away. This is known as resorption, and it is the reason that dentures fitted too soon after teeth are lost quickly become loose. Bone loss happens most rapidly during the first year and is four times greater in the lower jaw than in the upper.

Why not just use dental adhesives to hold dentures tightly to the lower jaw?
Zinc, a major ingredient in most dental adhesives, has been associated with neurological disorders and may be unsafe. In addition, dental adhesives are expensive and the cost of frequent usage adds up.

Besides dental adhesives, are other health problems associated with dentures?
Yes, edentulism has been related to poor nutrition. Many edentulous people switch to soft foods with high fat content because they find healthier foods like vegetables and proteins difficult to chew.

What are dental implants?
Dental implants are replacements for the roots of teeth, the parts that are below the gumline and anchored in bone. They are usually covered with a crown that shows above the line of the gums.

What are the benefits of implants?
Most importantly, implants reduce the amount of bone resorption. Studies have shown about 75% less resorption in parts of the jaw with implants compared to areas without them. Since most of the bone loss occurs within the first year after tooth loss, it is important to place implants within this time period.

Is a complete set of dental implants a good solution for edentulism?
Yes, it can be a good solution, but it is not for everyone. Some patients, who have lost a great deal of bone support, need another solution for cosmetic reasons that offer more facial support like an implant overdenture. In addition, depending on their resources and insurance, some people require a less expensive solution.

Why does the two-implant overdenture work better for the lower jaw?
Based on differences in bone volume, density and other factors, we think that four to six implants are needed to retain an upper implant overdenture. Thus a two-implant overdenture is a good solution to consider for a lower jaw, but other options might be preferred for an upper jaw.

Contact us today to schedule an appointment to discuss your questions about dentures and implants. You can also learn more by reading the Dear Doctor magazine article “Implant Overdentures for the Lower Jaw.”