Of all the of amazing procedures in today's dentistry, surgery that causes new bone to grow — in places where it had previously been lost — is high on the list of the most extraordinary. (When bone is lost or resorbed, it is broken down into its mineral components, which are dissolved into the bloodstream. Resorption of tooth-supporting bone often takes place after teeth are lost.) Dental techniques that cause new bone growth are important because a certain amount of bone is needed to replace lost teeth with dental implants.

Today's dental implants themselves are an amazing innovation. Implants consist of a replacement for the tooth's root, usually made of a metal called titanium. A replacement for the crown, the part of the tooth that is visible above the gums, is attached to the titanium root. Titanium has the remarkable quality of being able to fuse with the bone in which it is anchored. This process, first discovered in the 1950s, is called osseointegration.

In the case of missing upper back teeth, many people who wanted dental implants in the past were told that they did not have enough bone to anchor the implants and that they had to get removable dentures instead.

But now a new surgery called maxillary sinus augmentation can cause your body to regenerate bone where it was lost and is needed to anchor dental implants.

Bone in the upper jaw or maxilla usually supports your upper back teeth. Inside the maxilla, on either side of your upper jaw, are air spaces in the bone, which are lined with a membrane. These spaces, called the maxillary sinuses, are generally shaped like pyramids; but their shape and size is different in each person. The new surgical procedures involve lifting up the sinus membrane in the area where bone is needed and filling the space thus created with a bone grafting material. Your body then creates new bone to fill the space. This usually takes about six months. If you have almost enough bone to stabilize the implants, they can be placed simultaneously with the graft, thus saving time and avoiding a second surgical procedure.

All grafting materials used today are approved by the Food and Drug Administration (FDA) and must be prepared according to their guidelines. They are specially treated to render them completely safe for human use.

After the surgery there is usually no more than mild to moderate swelling and some discomfort, about the same as having a tooth removed.

If you are missing upper back teeth, contact us to schedule an appointment to evaluate your upper jaw. You can also learn more about this procedure by reading the Dear Doctor magazine article “Sinus Surgery.”

There's a lot to like about dental implants, today's state-of-the-art tooth-replacement system. We consider them the best choice for replacing missing teeth because implants are:

Healthy
You may not realize this, but when a tooth is missing, the bone underneath it begins to melt away. That's because bone needs constant stimulation to rebuild itself and stay healthy, and it receives this stimulation from teeth. It's a delicate balance that's disrupted by the loss of even one tooth. Because implants are made of biocompatible titanium, they actually fuse to the bone and prevent bone loss.

Strong
The fusion of implant to bone is an extremely solid connection. Not only does it offer a strong replacement for a missing tooth, but it can also offer support to other tooth-replacement methods such as fixed bridges or dentures. By themselves, these other methods would not preserve bone and might even hasten its loss in the case of dentures. But with implants, bone-loss is prevented — as is embarrassing and uncomfortable slippage of dentures.

Aesthetically Pleasing
When you receive your implant, it is left alone for a few months to complete the fusion process described above. Then it is topped with a crown made of a realistic tooth-like material. The result is so convincing as a tooth replacement, only you and your dentist may be able to tell it's not a natural tooth.

Long-Lasting
Dental implants have an amazing success rate — over 97%. And once they fuse to the jawbone, they should never need replacement. In fact, they will likely outlast the crowns to which they are attached, but this is not a problem. Implant crowns are precision components that detach for easy replacement, should the need arise.

Economical
Implants have a higher initial cost than other forms of tooth replacement, but when you consider how long they last, they are very economical. Consider it an investment in your health, appearance and self-confidence.

If you have any questions about dental implants, contact us today to schedule an appointment for an implant consultation.

You can read more about this topic in the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”

Dental implants are a fascinating treatment option that can be life changing when used properly. They have also experienced tremendous scientific advancements and press over the years making them highly desirable by people of all walks of life. See how much you really know about dental implants by taking our quick and easy true/false self test.

1. Dental implants can produce lifelike results that are indistinguishable from natural surrounding teeth.
   True or False
2. Many dental professionals consider dental implants as a “third set of teeth,” as they can last a lifetime when properly maintained.
   True or False
3. A dental implant is a safe option that is suitable for all patients regardless of age.
   True or False
4. When properly placed and maintained, dental implants have a 90% success rate.
   True or False
5. If you do not have enough bone to support a successful dental implant, there is not much that can be done.
   True or False
6. When teeth are missing, the face tends to have a sunken-in appearance called, “posterior bite collapse.”
   True or False
7. One of the positives of dental implants is that they do not affect adjacent teeth.
   True or False
8. Dental implants typically cost significantly more than other options, such as a bridge, over the course of a lifetime.
   True or False
9. Dental implants are always more desirable than bridgework or other treatment options for missing teeth.
   True or False
10. Dental implants can lead to improved health due to better nutrition and proper digestion.
    True or False

1. True. Dental implants can appear as beautiful, natural teeth.
2. True. When properly maintained, implants provide the same function as natural teeth roots.
3. False. Dental implants are not suitable for replacing primary teeth or permanent teeth in young children or teenagers. They are best used when facial and jaw development is complete.
4. False. They have a 95% success rate.
5. False. If you do not have enough bone for a dental implant, you may be a candidate for a bone graft — a process in which we “grow” the bone we need for the implant.
6. True. This condition is often totally reversible once teeth have been restored through implants or bridgework.
7. True. Unlike bridgework, dental implants do not affect surrounding teeth.
8. False. They are less expensive in the long run.
9. False. Sometimes a bridge is better than an implant.
10. True. Once teeth are restored, chewing and digesting food is easier; thus health improves.

To learn more, continue reading the Dear Doctor magazine article “Dental Implants, Your Third Set of Teeth.” Or, you can contact us today to schedule an appointment or to discuss your questions.

When it comes to patient comfort, one of the most important developments of the 21st century has been sedation dentistry, which enables you to relax in both mind and body allowing you to focus on feeling peaceful rather than anxious. And the prescription medications we use are some of the safest on the “therapeutic index” (the scale pharmacists and health professionals use to measure the safety of medications.) However, it is critical that we are aware of any medications you are already taking and your medical health and history, so let us know all about you so that we can avoid adverse (negative) reactions. Please note that we will take a full history to gain this information prior to any treatment or sedation — our utmost concern is your safety. During this time, it is vital that you are honest and feel comfortable sharing your responses to our questions. It's also our way of getting to know you and the first stage in relieving your anxiety. We will need to know all about:

• All medical conditions for which you are currently being treated.
• All prescription medications you are taking.
• Over-the-counter (OTC) medications, remedies, or vitamins and/or supplements you are taking. This even includes aspirin, St. John's Wort, and Kava Kava. (Why? If taken daily for good heart health, aspirin thins your blood and thus may interfere with blood coagulation. And St. John's Wort and Kava Kava may be beneficial in helping relieve depression, but they can negatively impact how oral sedation medications work.)
• Foods and drinks you consume, such as alcohol and even grapefruit (juice or the fruit), can negatively impact how your body responds to both your treatment and sedation medications.
• And lastly, we need to know if you are a tobacco user — especially if you are a smoker. In addition to increasing your risks for oral and other cancers, tobacco can negatively influence the effectiveness of sedation medications.

To learn more about this topic, read the article “Oral Sedation Dentistry.” Or you can contact us today to discuss your questions or to schedule an appointment.

When you have your teeth bleached in a dental office, the results almost seem like magic. Let's push aside the magician's cape and see what is really happening in professionally-applied, in-office tooth whitening.

How do teeth become discolored?
A tooth's enamel covering is mostly composed of mineral crystals. At a microscopic level, you can see a framework or matrix of organic (living) matter interspersed between the crystals of enamel creating a very irregular surface capable of retaining stains. Chromagenic (color generating) organic compounds can become part of this organic matrix resulting in tooth staining. They can be bleached without affecting the mineral structure of the tooth's enamel.

As people get older and their teeth wear, the enamel loses its youthful translucency and the underlying layer, called dentin, thickens and becomes more yellow. Such changes to the actual tooth structure are called intrinsic staining. Other causes of intrinsic discoloration are exposure to high levels of fluoride or tetracycline antibiotic administration during childhood, tooth decay, or root canal problems, among others. Discoloration can also be caused by external staining from certain foods, drinks, or tobacco products. Such surface stains are called extrinsic staining.

Behind the Magic
Materials used for tooth bleaching are hydrogen peroxide and carbamide peroxide. Peroxides are commonly used as bleach, and you may have seen them used as hair bleaches, for example. Hydrogen peroxide is a strong oxidizing agent that attacks the organic molecules responsible for tooth discoloration, bleaching them until they lose their color. Carbamide peroxide also contains urea, which is a compound that permits the peroxide to remain in contact with the teeth for longer amounts of time without harming them.

Often called power bleaching, the in-office technique uses a high concentration of peroxide solution (35-45% hydrogen peroxide), placed directly on the teeth in the form of a gel. A heat or light source may enhance the peroxide release. The gel is applied with trays custom fitted to your mouth, and specific barriers are applied to protect sensitive gum tissue from the solution. Results show teeth becoming up to ten shades lighter in about an hour.

In-office bleaching under the supervision of my staff and me is recommended if you have severely stained teeth, and particularly if you are about to have veneers or crowns made. It's a way to rediscover the pearly translucency of your youthful smile.

Contact us today to schedule an appointment to discuss your questions about tooth bleaching. You can also learn more by reading the Dear Doctor magazine article “Teeth Whitening.”