My Blog

By Gerald L Clark DDS
May 15, 2018
Category: Dental Procedures
Tags: tooth loss  
ToothLossAHealthRiskforOlderAdults

Tooth loss is a problem that affects many seniors—and since May is Older Americans Month, this is a good time to talk about it. Did you know that more than a quarter of adults over age 75 have lost all of their natural teeth? This not only affects their quality of life, but poses a significant health risk.

According to a study in The Journal of Prosthodontics, significant tooth loss is associated with increased risk for malnutrition—and also for obesity. If this seems like a contradiction, consider that when you have few or no teeth, it’s much easier to eat soft, starchy foods of little nutritional value than it is to eat nutritious fresh fruits and vegetables.

That’s just one reason why it’s important to replace missing teeth as soon as possible. There are several ways to replace a full set of missing teeth including removable dentures, overdentures, and fixed dentures.

Removable dentures are the classic “false teeth” that you put in during the day and take out at night. Dentures have come a long way in terms of how convincing they look as replacement teeth, but they still have some disadvantages: For one thing, they take some getting used to—particularly while eating. Also, wearing removable dentures can slowly wear away the bone that they rest on. As that bone gradually shrinks over time, the dentures cease to fit well and require periodic adjustment (re-lining).

Overdentures are removable dentures that hook onto a few strategically placed dental implants, which are small titanium posts placed in the bone beneath your gums. Strong and secure, implants prevent the denture from slipping when you wear it. Implants also slow the rate of bone loss mentioned above, which should allow the denture to fit better over a longer period of time. But overdentures, too, are not meant to be worn all of the time.

Fixed dentures are designed to stay in your mouth all the time, and are the closest thing to having your natural teeth back. An entire row of fixed (non-removable) replacement teeth can usually be held in place by 4-6 dental implants. Dental implant surgery is an in-office procedure performed with the type of anesthesia that’s right for you. After implants have been placed and have integrated with your jaw bone—generally a period of a few months—you can enjoy all of your favorite foods again without worry or embarrassment.

If you would like more information about tooth-replacement options, please contact us or schedule an appointment for a consultation.

DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”

WhyweNeedtoCareforaYoungerPatientsBoneafteraToothLoss

In an instant, an accident could leave you or a loved one with a missing tooth. Thankfully, we can restore it with a dental implant that looks and functions like a real tooth—and the sooner the better.

But if the patient is a teenager or younger, sooner may have to be later. Because their jaws are still developing, an implant placed now could eventually look as if it's sinking into the gums as the jaw continues to grow and the implant doesn't move. It's best to wait until full jaw maturity around early adulthood and in the meantime use a temporary replacement.

But that wait could pose a problem with bone health. As living tissue, bone cells have a life cycle where they form, function and then dissolve (resorption) with new cells taking their place. This cycle continues at a healthy rate thanks to stimulation from forces generated by the teeth during chewing that travel through the roots to the bone.

When a tooth goes missing, however, so does this stimulation. Without it the bone's growth cycle can slow to an unhealthy rate, ultimately reducing bone volume.  Because implants require a certain amount of bone for proper placement and support, this could make it difficult if not impossible to install one.

We can help prevent this by placing a bone graft immediately after the removal of a tooth within the tooth's "socket." The graft serves as a scaffold for new bone cells to form and grow upon. The graft will eventually resorb leaving the newly formed bone in its place.

We can also fine-tune and slow the graft's resorption rate. This may be preferable for a younger patient with years to go before their permanent restoration. In the meantime, you can still proceed with other dental treatments including orthodontics.

By carefully monitoring a young patient's bone health and other aspects of their dental care, we can keep on course for an eventual permanent restoration. With the advances in implantology, the final smile result will be worth the wait.

If you would like more information on dental care for trauma injuries, 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 for Teenagers: Factors Influencing Treatment Planning in Adolescents.”

By Gerald L Clark DDS
April 15, 2018
Category: Oral Health
Tags: oral hygiene   flossing  
NotCrazyaboutFlossingTryaWaterFlosser

The most important part of dental health maintenance isn’t what your dentist does—it’s what you do every day when you brush and floss your teeth. And all you really need is a multi-tufted, soft bristle toothbrush, toothpaste, a roll of dental floss—plus a little effort from your hands and fingers.

Of course, manual power isn’t your only option—an electric or battery-powered toothbrush is a convenient and, for people with strength or dexterity issues, a necessary way to remove disease-causing plaque from tooth surfaces. You have a similar option with flossing—a water flosser.

Although water flossers (or oral irrigators) have been around since the early 1960s, they’ve become more efficient and less expensive in recent years. A water flosser delivers a pulsating stream of pressurized water between the teeth through a handheld device that resembles a power toothbrush, but with a special tip. The water action loosens plaque and then flushes it away.

While the convenience these devices provide over traditional flossing is a major selling point, they’re also quite beneficial for people with special challenges keeping plaque from accumulating between teeth. People wearing braces or other orthodontic devices, for example, may find it much more difficult to effectively maneuver thread floss around their hardware. Water flossing can be an effective alternative.

But is water flossing a good method for removing between-teeth plaque? If performed properly, yes. A 2008 study, for example, reviewed orthodontic patients who used water flossing compared to those only brushing. The study found that those using water flossing were able to remove five times as much plaque as the non-flossing group.

If you’re considering water flossing over traditional flossing thread, talk with your dental hygienist. He or she can give you advice on purchasing a water flosser, as well as how to use the device for optimum performance. It could be a great and more convenient way to keep plaque from between your teeth and harming your dental health.

If you would like more information on water flossing, 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 “Cleaning between Your Teeth: How Water Flossing can help.”

4ReasonsWhyYouMayNeedtoSeeaPeriodontistforYourGumDisease

After treating you for periodontal (gum) disease for some time, we may suggest you see a periodontist, a specialist in gum conditions and diseases. There are a number of reasons for a referral, including the specific type of gum disease you may have developed.

Here are 4 more reasons why seeing a periodontist might be advantageous at this stage in your dental care.

Advanced treatment. All dentists are skilled in basic treatment procedures for gum disease, particularly removing plaque and calculus (hardened plaque deposits) that cause and sustain infections. But if your disease has advanced deeper below the gum line and has resulted in infection-filled void pockets between teeth and gums or in gum recession (the tissues shrinking back from the teeth), you may need more advanced techniques and equipment provided by a periodontist.

Advanced Cleanings. Regular, twice-a-year office cleanings are part of every dental care program. But depending on the severity of your gum disease (and your own hygiene efforts) you may need more frequent and advanced cleanings to keep recurring infections at bay. A periodontist can provide this, as well as help you develop a daily hygiene plan that meets your needs.

Your general health. There are a number of systemic conditions like diabetes, cardiovascular disease or pregnancy that can affect gum health. Many of these issues are tied to tissue inflammation, a major component of chronic gum disease, as well as slower tissue healing. As specialists in the gums and their relationship with the rest of the body, a periodontist can develop a treatment approach that coordinates with these other health issues.

Future restoration preparation. One of our treatment goals with gum disease is to try to prolong the life of natural teeth for as long as possible. In reality, though, some or all of your teeth may have a shortened life expectancy. If a comprehensive dental restoration is in your future, a periodontist can help prepare your gums for the inevitable. They may also be able to repair or restore gum tissues that enhance the appearance of a restoration to create a more attractive smile.

If you would like more information on advanced treatment for periodontal disease, 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 “Referral to a Dental Specialist.”





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