Posts for category: Dental Procedures

By Shapiro & Rollman DDS
September 13, 2021
Category: Dental Procedures
Tags: dental implants  
HeresWhatYouCanExpectWithDentalImplantSurgery

Getting dental implants is going to require surgery. But don't let that concern you—it's a relatively minor procedure.

Currently the “gold standard” for tooth replacement, an implant consists of a titanium post surgically imbedded in the jawbone. We can affix a life-like crown to a single implant or support a fixed bridge or removable denture using a series of them.

Because placement will determine the restoration's final appearance, we must carefully plan implant surgery beforehand. Our first priority is to verify that you have adequate jawbone available to support an implant.

Additionally, we want to identify any underlying structures like nerves or blood vessels that might obstruct placement. We may also develop a surgical guide, a retainer-like device placed in the mouth during surgery that identifies precisely where to create the holes or channels for the implants.

After numbing the area with local anesthesia, we begin the surgery by opening the gum tissue with a series of incisions to expose the underlying bone. If we've prepared a surgical guide, we'll place it in the mouth at this time.

We then create the channel for the insert through a series of drillings. We start with a small opening, then increase its size through subsequent drills until we've created a channel that fits the size of the intended implant.

After removing the implant from its sterile packaging, we'll directly insert it into the channel. Once in place, we may take an x-ray to verify that it's been properly placed, and adjust as needed. Unless we're attaching a temporary crown at the time of surgery (an alternate procedure called immediate loading), we suture the gums over the implant to protect it.

Similar to other dental procedures, discomfort after surgery is usually mild to moderate and manageable with pain relievers like acetaminophen or ibuprofen (if necessary, we can prescribe something stronger). We may also have you take antibiotics or use antibacterial mouthrinses for a while to prevent infection.

A few weeks later, after the bone has grown and adhered to the implant surface, you'll return to receive your new permanent crown or restoration. While the process can take a few months and a number of treatment visits, in the end you'll have new life-like teeth that could serve you well for decades.

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 “Dental Implant Surgery.”

By Shapiro & Rollman DDS
August 24, 2021
Category: Dental Procedures
Tags: dental implants   crowns  
WhichImplantCrownAttachmentMethodisBestforYou

If you've decided on a dental implant to replace a missing tooth, you've made a great choice. Implants are a big favorite of both dentists and patients, not only for their life-likeness, but also their durability. Studies show that more than 95% of implants survive after ten years.

As you may know, single tooth implants are composed of two main parts: a metal post (usually titanium) imbedded in the jawbone; and a life-like crown affixed to the end of the post. But what you may not know is that there are two ways to attach the crown—either with screws or with dental cement.

Neither way is superior to the other—both have their own set of advantages and disadvantages. A cemented crown, for instance, usually looks more like a natural tooth than a screw-retained crown (more about that later) and dentists have more flexibility in making them look natural.

But cemented crowns require an additional piece of hardware called an abutment to better match it with the implant, something unnecessary with a screw-retained crown. Some people can also experience a reaction to the cement resulting in inflammation or even bone loss. And once installed, removing the crown later for repair or replacement is much more difficult than with a screw-retained crown.

Besides attaching directly to the implant, screw-retained crowns don't require cement and are more easily attached and removed. But the screw-hole can pose some aesthetic problems: Although it can be filled with a tooth-colored filling, the tooth's appearance isn't as ideal as a cemented crown.

So, which one is best for you? That will depend on the type and location of teeth being replaced, as well as your dentist's preferences. For instance, a more attractive cemented crown may be better for a visible front tooth, while a screw-retained crown might be a good choice for a back premolar or molar where appearance isn't as big a factor.

In the end, it's likely your dentist will discuss the pros and cons for each method as it pertains to your individual case. Whichever way your crown attaches, the end result will still be a life-like tooth that could last you for years to come.

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 “How Crowns Attach to Implants.”

HowYouTooCouldHaveLindseyVonnsViralVideoSmileMakeover

Instagram, America's humongous digital photo and video album, is chock-full of the silly, mundane, and poignant moments of people's everyday lives. That includes celebrities: Tom Hanks buying a used car; Ryan Reynolds sporting tiny sunglasses; Taylor Swift and Ed Sheeran taking a hike. And then there's former Olympic alpine skier, Lindsey Vonn—posting a video of her recent dental visit.

Winner of several World Cup competitions and the first woman to gain the gold for downhill racing at the 2010 Winter Olympics, Vonn broke her two front teeth during a—you guessed it—skiing competition a few years ago. This past September, she went to the dentist to update her restoration and gave her followers a fascinating firsthand look at dental bonding, a technique for repairing a chipped or broken tooth.

Although dental bonding has been around for decades, it's taken a leap forward in the last few years because of improvements in bonding material. A mixture of plastic and glass components, composite resins can produce a strong and durable result when bonded to teeth. To begin the technique, the tooth's surface is prepared so that the composite resin can better adhere. Along with an adhesive agent, the bonding material is applied as a paste, which makes it easier to shape and sculpt for the most realistic look. This is usually done layer by layer, with each individual layer hardened with a curing light.

The technique allows us not only to achieve the right tooth shape, but also to incorporate your natural tooth color. We can tint the composite resin as we work so that your restored tooth blends seamlessly with the rest of your natural teeth. The result: A “new” tooth that's both beautiful and natural-looking.

What's more, dental bonding is more affordable than veneers or crowns and can often be done in a single visit. You will, however, need to exercise care with your new restoration. Although highly durable, it can be damaged if you bite into something hard. You'll also need to watch foods and beverages like tea or coffee that can stain the dental material.

Even so, we can help you regain the smile you once had before you took your teeth skiing—Lindsey Vonn-style—or whatever you were doing that resulted in a “whoopsie.” All it takes is a call for an appointment to start you on the path to a more attractive smile.

If you would like more information about cosmetic dental enhancements, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Artistic Repair of Front Teeth With Composite Resin.”

YouCanHaveaSuccessfulImplantOutcomeifYourDiabetesisUnderControl

Around one in ten U.S. adults have diabetes, a metabolic disease that can disrupt other aspects of a person's health like wound healing and vision. It could also cause complications with dental implants, the premier replacement choice for missing teeth.

There are two basic types of diabetes. In type 1 diabetes, the pancreas stops producing insulin, a hormone needed to regulate the amount of sugar glucose in the bloodstream. With the more prevalent type 2 diabetes, the body either doesn't produce enough insulin or doesn't respond efficiently to the insulin produced.

Uncontrolled diabetes can contribute to several dangerous health conditions. In addition to vision impairment and poor wound healing, diabetics are at higher risk for other problems like kidney disease or nerve damage. Drastic swings in blood glucose levels can also cause coma or death.

Many diabetics, though, are able to manage their condition through diet, exercise, medications and regular medical care. Even so, they may still encounter problems with wound healing, which could complicate getting a dental implant.

An implant is composed of a titanium metal post imbedded into the jawbone. Because of its affinity with titanium, bone cells naturally grow and adhere to the implant's metal surface. Several weeks after implant surgery, enough bone growth occurs to fully secure the implant within the jaw.

But this integration process may be slower for diabetics because of sluggish wound healing. It's possible for integration to not fully occur in diabetic patients after implant surgery, increasing the risk of eventually losing the implant.

Fortunately, though, evidence indicates this not to be as great a concern as once thought. A number of recent group studies comparing diabetic and non-diabetic implant patients found little difference in outcomes—both groups had similar success rates (more than 95 percent).

The only exception, though, were diabetic patients with poor glucose control, who had much slower bone integration that posed a threat to a successful implant outcome. If you're in this situation, it's better if you're first able to better control your blood glucose levels before you undergo surgery.

So, while diabetes is something to factor into your implant decision, your chances remain good for a successful outcome. Just be sure you're doing everything you can to effectively manage your diabetes.

If you would like more information on diabetes and dental 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 “Dental Implants & Diabetes.”

By Shapiro & Rollman DDS
July 05, 2021
Category: Dental Procedures
HowAFVsAlfonsoRibeiroSavedHisTooth

Remembered fondly by fans as the wacky but loveable Carlton on The Fresh Prince of Bel-Air, Alfonso Ribeiro is currently in his fifth year hosting America's Funniest Videos. It's the perfect gig for the 48-year-old actor, who loves to laugh and make others laugh as well. This is quite the opposite experience from one he had a few years ago that he remembers all too well: a severely decayed tooth.

After seeing his dentist for an intense toothache, Ribeiro learned he had advanced tooth decay and would need root canal treatment. Ribeiro wasn't thrilled by the news. Like many of us, he thought the procedure would be unpleasant. But he found afterward that not only was the root canal painless, his toothache had vanished.

More importantly, the root canal treatment saved his tooth, as it has for millions of others over the last century. If you're facing a situation similar to Alfonso Ribeiro's, here's a quick look at the procedure that could rescue your endangered tooth.

Getting ready. In preparation for root canal therapy, the tooth and surrounding gums are numbed, often first with a swab of local anesthesia to deaden the surface area in preparation for the injection of the main anesthesia below the surface. A dental dam is then placed to isolate the infected tooth from its neighbors to prevent cross-contamination.

Accessing the interior. To get to the infection, a small access hole is drilled. The location depends on the tooth: in larger back teeth, a hole is drilled through the biting surface, and in front teeth, a hole is drilled on the backside. This access allows us to insert special tools to accomplish the next steps in the procedure.

Cleaning, shaping and filling. Small tools are used to remove the diseased tissue from the interior tooth pulp and root canals. Then the empty spaces are disinfected. This, in effect, stops the infection. Next, the root canals inside the tooth are shaped to allow them to better accept a special filling called gutta percha. The access hole is then sealed to further protect the tooth from future infection, and a temporary crown is placed.

A new crown to boot. Within a couple weeks, we'll cap the tooth with a long-lasting lifelike crown (or a filling on certain teeth). This adds further protection for the tooth against infection, helps strengthen the tooth's structure, and restores the tooth's appearance.

Without this procedure, the chances of a tooth surviving this level of advanced decay are very slim. But undergoing a root canal, as Alfonso Ribeiro did, can give your tooth a real fighting chance.

If you would like more information about root canal treatments, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: How Long Will It Last?