My Blog
By John Kelmenson, D.D.S.
February 26, 2020
Category: Dental Procedures
Tags: dental implants  
DentalImplantsBetterthanEverthankstoOngoingTechAdvances

While many people still consider dental implants the "new kids on the block" in dental restoration, they're now in their fourth decade of use. And since their inception implant technology has continued to improve and revolutionize how we replace missing teeth.

Implants are a different "species" compared to other restoration methods. To be precise, an implant is a tooth root replacement—usually a titanium metal post imbedded directly into the jaw bone. Titanium is not only a biocompatible metal, but bone cells naturally grow on its surface to create a strong and durable hold. It's this secure hold that's most responsible for implants' high long-term success rate.

But we should also credit some of this success to the steady stream of advances over the years in implant construction and supporting technologies. For one thing, we're now more accurate and precise with implant placement thanks to advances in computer tomography (CT) and cone beam CT (CBCT) scanning.

These digital processes merge a series of images taken by a special camera to form a three-dimensional model of the jaw. We can manipulate this model on a computer monitor to view it from different vantage points. It can help us locate and avoid anatomical structures like nerves and sinuses when determining where to place a future implant. CT and CBCT are especially useful when there's a concern about adequate available bone, a necessity for stable implants.

Technology has also improved how we create surgical guides, often used during implant surgery to obtain the most accurate results. Surgical guides are custom-made devices that fit over the teeth with the drilling locations for the implants marked on them. Recent advances in 3-D printing have made these guides even more accurate so that they fit more securely in the mouth. This greater stability increases their accuracy during the drilling sequence during surgery.

These and other advances are helping ensure every implant is a success story. The end result is both a functional restoration and a beautiful smile.

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 Technology Aids Dental Implant Therapy.”

WhatTaraLipinskiDoestoProtectOneofHerMostValuableAssets-HerSmile

Tara Lipinski loves to smile. And for good reason: The Olympic-gold medalist has enjoyed a spectacular career in ladies' figure skating. Besides also winning gold in the U.S. Nationals and the Grand Prix Final, in 1997 Lipinski became the youngest skater ever to win a World Figure Skating title. Now a sports commentator and television producer, Lipinski still loves to show her smile—and counts it as one of her most important assets. She also knows the importance of protecting her smile with daily hygiene habits and regular dental care.

Our teeth endure a lot over our lifetime. Tough as they are, though, they're still vulnerable to disease, trauma and the effects of aging. To protect them, it's essential that we brush and floss every day to remove bacterial plaque—that thin accumulating film on teeth most responsible for tooth decay and gum disease.

To keep her smile in top shape and reduce her chances of dental disease, Lipinski flosses and brushes daily, the latter at least twice a day. She also uses a tongue scraper, a small handheld device about the size of a toothbrush, to remove odor-causing bacteria and debris from the tongue.

Lipinski is also diligent about visiting the dentist for professional cleanings and checkups at least twice a year because even a dedicated brusher and flosser like her can still miss dental plaque that can then harden into tartar. Dental hygienists have the training and tools to clear away any lingering plaque and tartar that could increase your disease risk. It's also a good time for the dentist to check your teeth and gums for any developing problems.

The high pressure world of competitive figure skating and now her media career may also have contributed to another threat to Lipinski's smile: a teeth-grinding habit. Teeth grinding is the unconscious action—often while asleep—of clenching the jaws together and producing abnormally high biting forces. Often a result of chronic stress, teeth grinding can accelerate tooth wear and damage the gum ligaments attached to teeth. To help minimize these effects, Lipinski's dentist created a custom mouthguard to wear at night. The slick plastic surface of the guard prevents the teeth from generating any damaging biting forces when they clench together.

The importance of an attractive smile isn't unique to celebrities and media stars like Tara Lipinski. A great smile breeds confidence for anyone—and it can enhance your career, family and social relationships. Protect this invaluable asset with daily oral hygiene, regular dental visits and prompt treatment for disease or trauma.

If you would like more information about protecting your smile, please contact us or schedule an appointment. To learn more, read the Dear Doctor magazine articles “Tooth Decay” and “Teeth Grinding.”

By John Kelmenson, D.D.S.
February 16, 2020
Category: Dental Procedures
DoYouHaveAdequateBonetoSupportanImplant

Besides their life-likeness, implants are also prized for their high success rate. More than ninety-five percent of implants continue to function effectively after ten years.

Implants’ advanced technology explains some of their reliability and longevity—they’re as close to natural teeth as we’re now able to achieve. But their impressive success rate also owes to the detailed protocols that dentists follow to install them. One critical part of these protocols is ensuring a patient has enough bone in their jaw to support and precisely situate the implant for the best functional and aesthetic outcome.

Unfortunately, there are situations where a patient doesn’t have enough bone to achieve a satisfactory result. This often happens if there’s been months or years between losing the tooth and considering an implant. The reason why relates to the nature of bone as living tissue.

Like other cellular tissues in the body, bone has a life cycle: Older, worn-out cells die and are absorbed by the body, and new cells form to replace them. The growth cycle in the jaw receives stimulation from the forces generated when we chew, which travel up through the teeth to the bone.

However, this stimulation stops after tooth loss for the related area of bone, which can slow new bone growth. Over time, the volume and density of the bone around a missing tooth gradually decreases, enough eventually to make an implant impractical.

Insufficient bone volume, though, doesn’t necessarily mean an implant is out of the question. We may be able to address the problem by attempting to regenerate the bone through grafting. This is a procedure in which we insert graft material into the affected area of the jawbone. The graft then becomes a scaffold upon which bone cells can grow. ¬†After several months, we may have enough regenerated bone to support an implant.

If there’s been too much bone loss, we may still need to consider another form of restoration. But if we can successfully build up the bone around your missing tooth, this premier restoration for replacing lost teeth could become a reality for you.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation.

By John Kelmenson, D.D.S.
February 11, 2020
Category: Oral Health
Tags: tooth pain  
SeeYourDentisttoFindouttheRealCauseforYourToothPain

If you have tooth pain, we want to know about it. No, really—we want to know all about it. Is the pain sharp or dull? Is it emanating from one tooth or more generally? Is it constant, intermittent or only when you bite down?

Dentists ask questions like these because there are multiple causes for tooth pain with different treatment requirements. The more accurate the diagnosis, the quicker and more successful your treatment will be.

Here are 3 different examples of tooth pain, along with their possible causes and treatments.

Tooth sensitivity. If you feel a quick jolt of pain when you eat or drink something hot or cold, it may mean your gums have drawn back (receded) from your teeth to leave more sensitive areas exposed. Gum recession is most often caused by gum disease, which we can treat by removing dental plaque, the main cause for the infection. In mild cases the gums may recover after treatment, but more advanced recession may require grafting surgery.

Dull ache around upper teeth. This type of pain might actually be a sinus problem, not a dental one. The upper back teeth share some of the same nerves as the sinus cavity just above them. See your dentist first to rule out deep decay or a tooth grinding habit putting too much pressure on the teeth. If your dentist rules out an oral cause, you may need to see your family physician to check for a sinus infection.

Constant sharp pain. A throbbing pain seeming to come from one tooth may be a sign the tooth's central pulp layer has become decayed. The resulting infection is attacking the pulp's nerves, which is causing the excruciating pain. Advanced decay of this sort requires a root canal treatment to remove the diseased tissue and fill the empty pulp chamber and root canals to prevent further infection. See your dentist even if the pain stops—the infection may have only killed the nerves, but is still present and advancing.

Pain is the body's warning system—so heed the tooth pain alert and see your dentist as soon as possible. The sooner the problem is identified and treated, the better your chances of returning to full dental health.

If you would like more information on tooth pain and what it means, 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 “Tooth Pain? Don't Wait!

By John Kelmenson, D.D.S.
February 06, 2020
Category: Oral Health
Tags: tooth decay  
ManageTheseRiskFactorstoReduceYourRiskofToothDecay

Tooth decay doesn't occur out of thin air, but is the end result of bacteria feeding on sugar, multiplying and producing acid. High acidity erodes tooth enamel and creates an environment for cavity development.

Modern dentistry can effectively treat cavities and often save the tooth from further damage. But you don't have to wait: You can reduce your chances of cavities by managing risk factors that contribute to decay.

Here are 4 top risk factors for tooth decay and what you can do about them.

Poor saliva flow. Saliva neutralizes acid and helps restore minerals to enamel after acid contact. But your enamel may not have full protection against acid if you have diminished saliva flow, often due to certain medications. You can help increase your saliva by consulting with your doctor about drug alternatives, drinking more water or using a saliva boosting product. Smoking can also inhibit saliva, so consider quitting if you smoke.

Eating habits. High sugar content in your diet can increase bacterial growth and acid production. Reducing your overall sugar consumption, therefore, can reduce your risk of decay. Continuous snacking can also increase your decay risk, preventing saliva from bringing your mouth back to its normal neutral pH. Instead, limit your snack periods to just a few times a day, or reserve all your eating for mealtimes.

Dental plaque. Daily eating creates a filmy buildup on the teeth called dental plaque. If not removed, plaque can then harden into a calcified form called calculus, an ideal haven for bacteria. You can help curtail this accumulation by thoroughly brushing and flossing daily, followed by dental cleanings at least every six months. These combined hygiene practices can drastically reduce your cavity risk.

Your genetics. Researchers have identified up to 50 specific genes that can influence the risk for cavities. As a result, individuals with similar dietary and hygiene practices can have vastly different experiences with tooth decay. Besides continuing good lifestyle habits, the best way to manage a genetic disposition for dental disease is not to neglect ongoing professional dental care.

If you would like more information on managing your tooth decay risk factors, 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 “What Everyone Should Know About Tooth Decay.”





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