You would love to replace a troubled tooth with a dental implant. But you have one nagging concern: you also have diabetes. Could that keep you from getting an implant?
The answer, unfortunately, is yes, it might: the effect diabetes can have on the body could affect an implant's success and longevity. The key word, though, is might—it's not inevitable you'll encounter these obstacles with your implant.
Diabetes is a group of metabolic diseases that interfere with the normal levels of blood glucose, a natural sugar that is the energy source for the body's cells. Normally, the pancreas produces a hormone called insulin as needed to regulate glucose in the bloodstream. A diabetic, though either can't produce insulin or not enough, or the body doesn't respond to the insulin that is produced.
And while the condition can often be managed through diet, exercise, medication or supplemental insulin, there can still be complications like slow wound healing. High glucose can damage blood vessels, causing them to deliver less nutrients and antibodies to various parts of the body like the eyes, fingers and toes, or the kidneys. It can also affect the gums and their ability to heal.
Another possible complication from diabetes is with the body's inflammatory response. This is triggered whenever tissues in the body are diseased or injured, sealing them off from damaging the rest of the body. The response, however, can become chronic in diabetics, which could damage otherwise healthy tissues.
Both of these complications can disrupt the process for getting an implant. Like other surgical procedures, implantation disrupts the gum tissues. They will need to heal; likewise, the implant itself must integrate fully with the bone in which it's inserted. Both healing and bone integration might be impeded by slow wound healing and chronic inflammation.
Again, it might. In reality, as a number of studies comparing implant outcomes between diabetics and non-diabetics has shown, there is little difference in the success rate, provided the diabetes is under control. Diabetics with well-managed glucose can have success rates above 95%, well within the normal range.
An implant restoration is a decision you should make with your dentist. But if you're doing a good job managing your diabetes, your chances of a successful outcome are good.
The Golden Globes ceremony is a night when Hollywood stars shine their brightest. At the recent red-carpet event, leading man Viggo Mortensen had plenty to smile about: Green Book, the movie in which he co-starred, picked up the award for Best Motion Picture—Musical or Comedy. But fans looking at the veteran actor's big smile today might not realize that it once looked very different. A few years ago, an accident during the filming of The Two Towers took a major chip out of Mortensen's front tooth!
That might be OK for some movies (think The Hangover or Dumb and Dumber)—but it's not so great for everyday life. Fortunately, Mortensen visited a dentist promptly, and now his smile is picture-perfect. How was that accomplished? He didn't say…but generally, the best treatment for a chipped tooth depends on how much of the tooth's structure is missing.
If the tooth has only a small chip or crack, it's often possible to restore it via cosmetic bonding. This procedure can be done right in the dental office, frequently in a single visit. Here's how it works: First the tooth is cleaned and prepared, and then a tooth-colored resin is applied to the area being restored. After it is cured (hardened) with a special light, additional layers may be applied to build up the missing structure. When properly cared for, a tooth restored this way can look good for several years.
For a longer-lasting restoration, veneers may be recommended. These are wafer-thin shells made of durable material (most often porcelain) that cover the front (visible) surfaces of teeth. Strong and lifelike, veneers can match the exact color of your natural teeth—or give you the bright, high-wattage smile you've always wanted. No wonder they're so popular in Hollywood! Because veneers are custom-made for you, getting them may require several office visits.
If a chip or crack extends to the inner pulp of the tooth, a root canal procedure will be needed to keep the tooth from becoming infected—a situation that could have serious consequences. But you shouldn't fear a root canal! The procedure generally causes no more discomfort than filling a cavity (though it takes a little longer), and it can help save teeth that would otherwise be lost. After a root canal, a crown (cap) is generally needed to restore the visible part of the tooth.
When a damaged tooth can't be restored, it needs to be extracted (removed) and replaced. Today's best option for tooth replacement is a dental implant—a small, screw-shaped post inserted into the bone of your jaw that anchors a lifelike, fully functional crown. Implants require very little special care and can look great for many years, making them a top choice for tooth replacement
If you have questions about chipped or damaged teeth, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Artistic Repair Of Front Teeth With Composite Resin” and “Porcelain Veneers.”
Dental implants are considered the best tooth replacement option available. An implant replaces the root of a tooth and allows for the replacement of the crown via attachments or abutments. They not only look like a real tooth, they function like one too.
Implants, though, for some are a significant investment and may be well beyond a person's financial means if they've experienced a sudden tooth loss. For that reason, many opt for a less expensive tooth replacement option like a removable partial denture.
Later when they can afford it, a person might consider an implant. But this could pose a complication. When a tooth is missing for some time, the underlying bone doesn't rejuvenate normally because it no longer receives stimulation from the tooth. Over time, the amount of bone may diminish. Restorations like dentures can't stop this bone loss and actually aggravates it.
For proper positioning, an implant requires a certain amount of bone volume. So, it's quite possible when the time comes to replace the old restoration with an implant that there may not be enough bone available.
We may be able to overcome this bone loss with bone grafting and regeneration. A specialist such as a periodontist or oral surgeon accesses the area surgically and inserts bone graft material, usually processed material that's completely safe. Properly placed, the bone graft serves as a scaffold that, along with growth stimulators, encourages bone cells to grow.
When the bone grafting has healed enough, we're then able to place the implant. Once imbedded in the bone, one of the implant's unique qualities comes into play. The imbedded post is made of the metal titanium, which is not only bio-compatible with body tissues, it also has an affinity with bone. Bone cells will easily grow and adhere to the implant surface. This further boosts bone growth in the area and strengthens the implant's hold.
These extra procedures to build back lost bone do add to the cost and time for installing an implant. But if you're ready for a more permanent restoration for a missing tooth — not to mention better bone health — the extra time and money will be well worth it.
Your teeth and gums are filled with nerves that make the mouth one of the most sensitive areas in the body. But thanks to local anesthesia, you won't feel a thing during your next dental procedure.
The word anesthesia means “without feeling or pain.” General anesthesia accomplishes this with drugs that place the patient in an unconscious state. It's reserved for major surgery where the patient will be closely monitored for vital signs while in that state.
The other alternative is local anesthesia, which numbs the area that needs treatment, while allowing the patient to remain conscious. The anesthetics used in this way are applied either topically (with a swab, adhesive patch or spray) or injected with a needle.
In dentistry, we use both applications. Topical anesthesia is occasionally used for sensitive patients before superficial teeth cleaning, but most often as an “opening act” to injected anesthesia: the topical application numbs the gums so you can't feel the prick of the needle used for the injectable anesthetic. By using both types, you won't feel any pain at all during your visit.
Because of possible side effects, we're careful about what procedures will involve the use of local anesthesia. Placing a sealant on the exterior of a tooth or reshaping enamel doesn't require it because we're not making contact with the more sensitive dentin layer beneath. We've also seen advances in anesthetic drugs in which we can now better control the length of time numbness will persist after the procedure.
All in all, though, local anesthesia will make your dental care more comfortable — both for you and for us. Knowing you're relaxed and comfortable allows us to work with ease so we can be unhurried and thorough. By keeping pain out of the equation, your dental care has a better chance for a successful outcome.
If you would like more information on managing discomfort during dental 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 “Local Anesthesia for Pain-Free Dentistry.”
Teeth grinding and other biting habits are more than a nuisance — they can generate twenty to thirty times the forces of normal biting. Over the long term, this can cause significant damage to teeth and supporting gums and bone.
This particular kind of damage is known as occlusal trauma (meaning injury from the bite). In its primary form, the habit itself over time can injure and inflame the jaw joints leading to soreness, swelling and dysfunction. The teeth themselves can wear down at a much faster rate than what normally occurs with aging. And although less common but even more serious, the periodontal ligaments holding teeth in place to the bone can stretch and weaken, causing the teeth to become loose and increasing the potential for tooth loss.
There are a number of techniques and approaches for treating excessive biting habits, but they all have a common aim — to reduce the amount of force generated by the habit and the associated problems that result. A custom occlusal guard, often worn while sleeping, helps lessen the force by keeping the teeth from making solid contact with each other. Tissue soreness and swelling can be relieved with anti-inflammatory drugs like aspirin or ibuprofen, muscle relaxants or physical therapy. In cases where stress is a main driver, behavioral therapy and counseling may also be helpful.
Biting forces are also an issue for patients with periodontal (gum) disease. In this case even biting forces within normal ranges can cause damage because the diseased gums and bone have already been weakened. If gum disease is a factor, the first priority is to treat the disease by removing built up plaque. Plaque is the thin film of bacteria and food remnant that’s both the cause and continuing growth of the infection, as well as tartar (calculus) from all tooth and gum surfaces.
A thorough dental exam will reveal whether a tooth grinding habit is playing a role in your teeth and gum problems or if it’s magnifying the damage of gum disease. In either case, there are appropriate steps to stop the damage before it leads to tooth loss.
If you would like more information on teeth grinding or other biting habits, 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 “Loose Teeth.”
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