Posts for: December, 2012
When a device meant to make your life easier doesn't function properly, it can be extremely frustrating. This is sometimes the case for people who wear lower dentures, which loosen over time. These removable replacement teeth can become less reliable and more uncomfortable. Why does this happen?
The answer is bone loss. When a tooth is lost, the bone surrounding it deteriorates and this will change the shape of the jawbone in your mouth. You may find that a lower denture that once had a snug fit on your lower jaw is now sliding around. This happens more often on the bottom because your muscular tongue pushes against the denture. Also, a top denture has more surface area due to an artificial palate to help create suction to the roof of the mouth and keep it in place.
Dental implants, which permanently replace the roots of teeth, do not loosen and they also prevent bone loss. But replacing a whole set of bottom teeth with dental implants and crowns is expensive. What to do?
There's a relatively new solution that combines the security of implants with the affordability of a removable denture. It's called an overdenture, and it may be something you want to consider. An overdenture is a lot like the removable lower denture you already have, only it fits over two implants strategically placed in your lower jaw. While the lower denture is still removable, its stability is greatly improved.
Studies have shown that people with two-implant overdentures have a higher quality of life, and receive better nutrition, than those wearing conventional dentures. It's not hard to figure out why: A more stable denture makes it easier to eat healthy foods such as vegetables — or, really, any foods — and prevents embarrassing slippage of false teeth.
You can read more about this topic in the Dear Doctor magazine article “Implant Overdentures for the Lower Jaw.”
A dental crown is a tooth-shaped “cap” or cover that we place over a tooth that is badly damaged from trauma or decay to restore its shape, strength, size and functionality. We also use them for cosmetic reasons to improve a tooth's appearance with natural, life-like results. Crowns are generally handcrafted by dental laboratory technicians using high-quality dental porcelains (ceramic materials) that are made to fit on precise replicas (molds) of the prepared teeth. In our office, we generally make temporary crowns to protect the teeth to keep them comfortable and functional while the permanent crown(s) is being made. And once a crown is placed (cemented into position), it fully encases the entire visible portion of the tooth that lies at and above the gum line.
When Are They Necessary?
There are many reasons a crown may be needed. Some of these include:
- To repair a tooth that is worn down, broken or badly damaged by decay or injury.
- To restore a tooth so severely damaged by decay that the tooth's structure is no longer intact enough to place a filling or where a filling can't restore the tooth to its former strength.
- To protect a tooth that has minor cracks or fractures from further damage.
- To create a bridge to replace a missing tooth, in which the teeth on either side, known as abutments, must be “crowned” to attach to the “pontic” (from the French word, “pont” that means bridge).
- To create the visible part of the tooth that sits atop a dental implant.
- To improve the appearance of a tooth providing a more appealing shape and color.
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.”
When treating Temporomandibular (jaw joint) Disorder (formerly known as Temporomandibular Joint Disorder, TMJ), we feel we have two equally important challenges facing us. First, we must start your treatment by relieving the symptoms of pain and discomfort. We typically accomplish this with heat, mild pain medications, a diet of soft foods, and some simple jaw exercises. Once we have begun to relieve your pain, our second critical objective is to identify and remedy what is causing the pain. It could be the result of an injury or trauma to the jaws and/or teeth or it could be due to a bite issue or a filling or crown that is too high and thus causing a misaligned bite. There are many other reasons, so it is first necessary to obtain a thorough medical history and conduct a comprehensive evaluation so that we can properly diagnose and treat the TMD condition and what is causing it.
Next to stress resulting in clenching and grinding habits, the four most common causes leading to TMD include:
- Underlying dental conditions that are triggering muscle pain
- Internal joint derangement (displaced or improperly positioned jaw joint)
- Osteoarthritis (degenerative joint disease)
- Synovitis — the painful inflammation of a synovial joint-lining membrane that is characterized by swelling, due to effusion (fluid collection)
If you or another family member suffer from chronic jaw pain, please let us know so that we can properly address your concerns and conduct a thorough examination. Or if you are in constant or severe pain, contact us as soon as possible to schedule an appointment. You can learn more about the signs, symptoms, and treatment options for TMD by reading “TMD — Understanding The Great Imposter.”