TheProcessforanImplantMayBeLongorShortbuttheResultIstheSame

How long does it take to get a dental implant? That depends….

Really, it does! There are a number of factors that determine whether you can get a new implant tooth "in one day" or whether you'll need to wait several weeks or months after implant surgery. By far, the top factor will be the health of your implant's supporting bone.

The bone plays an essential role in both the durability and appearance of an implant. Bone cells begin to accumulate on the titanium metal post after its installment to form a solid hold that could last for decades. Positioning the implant just right within the bone also ensures the resulting tooth looks natural and attractive.

If the bone is healthy, you might qualify for the "tooth in one day" procedure in which the dentist places (or loads) a life-like crown onto the implant at the same time that they install the implant. Because the bone and implant still need to fully integrate, this is a temporary crown designed to apply less force while biting. After a few weeks, the dentist will then install the full-sized permanent crown.

Not everyone, though, has enough healthy bone to support the tooth-in-one-day procedure, or even to install an implant in the first place. A patient must have enough bone present to both support the implant and to ensure proper placement. Bone loss, a common malady for people who've lost teeth, could derail the implant process.

It's often possible, however, to reverse this situation. By grafting bone-like material into the site, a person may be able to eventually regain some of the bone they've lost, enough to support an implant. Even so, this adds time to the beginning of the process and the patient may still need to undergo full bone-implant integration before receiving any type of crown.

As you can see, how long the implant process takes can depend a great deal on the condition of the bone your dentist has to work. But regardless of the duration, the end result will be an attractive and durable implant tooth.

If you would like more information on 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 “Implant Timelines for Replacing Missing Teeth.”

WhatChrissyTeigensInaugurationNightCapMishapCouldMeanForYou

Inauguration night is usually a lavish, Washington, D.C., affair with hundreds attending inaugural balls throughout the city. And when you're an A-List celebrity whose husband is a headliner at one of the events, it's sure to be a memorable night. As it was for super model Chrissy Teigen—but for a slightly different reason. During the festivities in January, Teigen lost a tooth.

Actually, it was a crown, but once she told a Twitter follower that she loved it “like he was a real tooth.” The incident happened while she was snacking on a Fruit Roll-Up (those sticky devils!), and for a while there, husband and performer John Legend had to yield center stage to the forlorn cap.

But here's something to consider: If not for the roll-up (and Teigen's tweets on the accident) all of us except Teigen, her dentist and her inner circle, would never have known she had a capped tooth. That's because today's porcelain crowns are altogether life-like. You don't have to sacrifice appearance to protect a tooth, especially one that's visible when you smile (in the “Smile Zone”).

It wasn't always like that. Although there have been tooth-colored materials for decades, they weren't as durable as the crown of choice for most of the 20th Century, one made of metal. But while gold or silver crowns held up well against the daily grind of biting forces, their metallic appearance was anything but tooth-like.

Later, dentists developed a hybrid of sorts—a metal crown fused within a tooth-colored porcelain shell. These PFM (porcelain-fused-to-metal) crowns offered both strength and a life-like appearance. They were so effective on both counts that PFMs were the most widely used crowns by dentists until the early 2000s.

But PFMs today make up only 40% of currently placed crowns, down from a high of 83% in 2005. What dethroned them? The all-ceramic porcelain crown—but composed of different materials from years past. Today's all-ceramic crowns are made of more durable materials like lithium disilicate or zirconium oxide (the strongest known porcelain) that make them nearly as strong as metal or PFM crowns.

What's more, coupled with advanced techniques to produce them, all-ceramic crowns are incredibly life-like. You may still need a traditional crown on a back tooth where biting forces are much higher and visibility isn't an issue. But for a tooth in the “Smile Zone”, an all-ceramic crown is more than suitable.

If you need a new crown (hopefully not by way of a sticky snack) or you want to upgrade your existing dental work, see us for a complete exam. A modern all-ceramic crown can protect your tooth and enhance your smile.

If you would like more information about crowns or other kinds of dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Crowns & Veneers.”

RemovableorFixedChoosingtheRightOrthodonticRetainerforYou

Anyone who's worn braces celebrates that day they finally come off. But while this marks the end of the actual teeth-straightening process, it's just the beginning of the next phase—wearing a retainer to preserve those hard-earned gains.

A retainer is a dental appliance that keeps or "retains" straightened teeth in their new positions. Without it, there's a high chance the teeth would rebound to where they were before through a kind of tissue memory within the gum ligaments. In essence, the same natural mechanism that allows us to move teeth with braces can also work in reverse.

Most people are familiar with the removable retainer and its benefits. Being able to remove the device makes it easier to brush and floss teeth, and it's a convenience if you only need to wear it part of the time. But removable retainers can easily be misplaced and lost, requiring purchase of a replacement. And, there's always the temptation to wear it less than the recommended time.

There's also an alternative appliance that's growing in popularity known as a bonded or non-removable retainer. These are usually a thin wire bonded with a composite dental material to the back of the teeth. Unlike the removable retainer, only a dentist can remove the bonded variety.

Its fixed nature is its biggest advantage—since it's in to stay, there's no need to keep up with it. And because it's positioned behind the teeth, no one need know about save the wearer and their orthodontist. The bonded retainer can, however, take a little getting used to the fixed wire against the teeth, and it can make flossing more difficult.

Although more rigid than the removable type, a bonded retainer could still break while biting and chewing. Wearers need to exercise caution biting into hard foods like apples to avoid damage—and the added expense of repairing or replacing it.

As you or a family member approaches the day the braces come off, you'll surely be discussing with your orthodontist which type of retainer is best in your situation. Either way, wearing a retainer is an absolute must if you're going to protect that new smile you've endured so much to achieve.

If you would like more information on straightening teeth through 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 “Bonded Retainers.”

AlthoughItsOftenaLongRoadYouCanFindLastingReliefFromTMD

If you've been diagnosed with a temporomandibular joint disorder (TMD), you're likely no stranger to pain and dysfunction. And not just with your jaw joints: In a survey of approximately 1,500 patients, nearly two-thirds of them also reported at least three or more painful conditions like fibromyalgia, chronic fatigue syndrome or rheumatoid arthritis.

Researchers continue to gather evidence of possible connections between TMD and other physical conditions. Hopefully, this research will lead to better treatments for all of them, including TMD. But until then, patients must continue to rely on established methods for reducing TMD's severity.

Although new treatments like Botox injections have been proposed and tried in recent years, the most effective still seem to be long-standing techniques that are conservative and non-invasive in nature. On the other hand, TMD surgical procedures developed in recent years have yet to deliver on their promise: In one survey, only 6% of surgery patients gained significant relief from TMD symptoms, while nearly half reported feeling worse.

It seems the best advice, should you receive a definitive diagnosis of TMD, is to start with the more conservative measures. These treatments tend to be orthopedic in nature, generally treating TMD as a joint problem. Of these, the ones most people have found effective involve thermal therapies like hot or cold compresses against the jaw, or hot baths.

Medications like muscle relaxers or pain relievers can also play a role in reducing TMD discomfort and dysfunction. And, many patients gain benefit from physical therapy massage and exercises that target the jaw muscles. Switching to softer foods with smaller bites can help patients avoid over-stressing the jaw joints while chewing.

It's also important to understand that there is no "one-size-fits-all" treatment protocol: Individual patients and their doctors may need to experiment with different therapies to find the right combination that offers the most relief. Although this can take time, it can be well worth it if the eventual combination brings long-term relief.

From this standpoint, patients should avoid surgical options unless all other methods have been tried and still have not yielded significant relief. For most patients, however, conservative TMD treatment and lifestyle or diet changes will work—with enough time and patience.

If you would like more information on TMD, 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 “Chronic Jaw Pain and Associated Conditions.”

ThisTemporaryRPDCouldSustainYourSmileWhileYouWaitForImplants

Dental implants are often the ideal choice to replace missing teeth. Unfortunately, "ideal" and "affordable" don't always align simultaneously for people. Even if implants are right for you, you may have to put them off to a more financially appropriate season.

In the meantime, though, you're still missing teeth—and perhaps some of them are right square in the middle of your smile. What can you do now, even if temporarily?

The solution might be a flexible removable partial denture (RPD). These newer types of RPD fit somewhere between the lightweight "flipper" and the more traditional rigid plastic appliances often made for permanent use. The flexible RPD is made of nylon plastic (technically known as a super-polyamide), which although lightweight, is highly durable.

Super-polyamides change their shape under high heat, a characteristic dental technicians take advantage of by injection molding heated material into flexible denture bases, to which they then attach the replacement teeth. Like other RPDs, a flexible RPD is custom-designed for the individual patient to match their jaw contours, as well as the types and locations of their missing teeth.

Flexible RPDs also differ from other RPD types in how they stay in place. While the more rigid RPD depends on metal clasps that grip to some of the remaining natural teeth, a flexible RPD uses finger-like extensions of the nylon material to fit around teeth near the gum line where they're difficult to see. As such, the flexible RPD is both comfortable and securely held in place.

A flexible RPD, like their counterparts, does require regular maintenance. Any RPD can accumulate dental plaque, a thin biofilm buildup on teeth that causes dental disease. For this reason, wearers should regularly remove their RPD and clean it thoroughly with an antibacterial soap (never toothpaste). All RPDs should also be removed at night to limit bacterial growth.

With a little care, a flexible RPD could last for several years. It could be just the solution to buy you time while you're waiting to obtain dental implants.

If you would like more information on restoration options for 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 “Flexible Partial Dentures.”





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