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By Eric Romano DDS
July 26, 2019
Category: Dental Procedures
Tags: dental implants   smoking  
DentalImplantsandSmoking-CauseforConcern

You probably already know that using tobacco causes significant health risks: It increases your odds of getting various cancers and coronary diseases, to name just a few. Unfortunately, not everyone is able to kick the habit, even when they know they should. Tooth loss is another issue that can cause trouble for your health, in the form of bone loss, malnutrition, and social or psychological problems. Dental implants are a great way to replace missing teeth — but does smoking complicate the process of getting implants?

The short answer is yes, smoking can make implant placement a bit riskier — but in the big picture, it doesn’t mean you can’t (or shouldn’t) have this procedure done if it’s needed.

Smoking, as you know, has harmful effects in your mouth (even leaving aside the risk of oral cancer). The hot gases can burn the oral cavity and damage salivary glands. Nicotine in smoke reduces blood flow to the soft tissues, which can affect the immune response and slow the processes of healing. At the same time, smoking promotes the growth of disease-causing oral bacteria.

How does this affect dental implants? Essentially, smoking creates a higher risk that implants may not heal properly after they are placed, and makes them more likely to fail over time. Studies have shown that smokers have an implant failure rate that’s twice as great as non-smokers. Does this mean that if you smoke, you shouldn't consider implants to replace missing or failing teeth?

Not necessarily. On the whole, implants are the most successful method of replacing missing teeth. In fact, the overall long-term survival rate of implants for both smokers and non-smokers is well over 90 percent — meaning that only a small percentage don’t work as they should. This is where it’s important to get the expert opinion of an implant specialist, who can help you decide whether implants are right for your particular situation.

If you do smoke, is there anything you can do to better your odds for having a successful dental implant? Yes: quit now! (Implants are a good excuse to start a smoking-cessation program.) But if you can’t, at least stop smoking for one week before and two weeks after implant placement. And if that is not possible, at least go on a smoking diet: restrict the number of cigarettes you smoke by 50% (we know you can at least do that!) Try to follow good oral hygiene practices at all times, and see your dentist regularly for checkups and cleanings.

If you have questions about smoking and dental implants, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine article “Strategies to Stop Smoking.”

By Eric Romano DDS
July 31, 2018
Category: Dental Procedures
Tags: dental implants  
ImplantSurgeryASafeandRoutineProcedure

Unlike other tooth replacement options, dental implants require a surgical procedure. But don't let your imagination run wild — the procedure is relatively minor and easy for most people to undergo.

Implants are unique among restorations because they replace a tooth's root. A metal titanium post, substituting for the root, must be surgically placed into the jawbone. While the procedure itself is simple and no more involved than a tooth extraction, it does require careful attention to detail before, during and afterward.

Our first step is to examine the target site with x-rays (often CT scanning) to pinpoint the best location for placement. This is critical because where we place the implant will have a huge bearing on how attractive and natural the implant finally appears. From this evaluation we frequently create a surgical guide.

Surgery begins with a local anesthesia to completely numb the site. You will feel no pain during the procedure and only minimal discomfort for a few days afterward. We then make small incisions in the gums to access the bone and create a small channel or hole.

Using the surgical guide, we then initiate a drilling sequence that gradually increases the size of the channel until it's the size and shape of the implant post. One thing we must do at this point is take our time: we use gentle pressure and water-cooling to avoid overheating and damaging the bone.

Once we're finished with drilling we remove the implant from its sterile packaging and imbed it directly into the prepared channel. It's then a matter of verifying the location with x-rays and then closing the gum tissue with self-absorbing sutures if necessary.

Most patients only need mild pain medication like aspirin or ibuprofen to manage discomfort afterwards. You won't even notice it in a week or less. After several weeks in which the bone grows and adheres to the implant (a process called osseointegration), you'll be ready for the final step, attaching the life-like porcelain crown to the implant.

Although the process can take several weeks to months, your discomfort should be minimal at any stage. In the end, your patience will be rewarded with a new, more attractive smile.

If you would like more information on the process of obtaining 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 Eric Romano DDS
April 12, 2018
Category: Dental Procedures
Tags: dental implants  
GettingDentalImplantsRequiresMinorSurgery

Dental implants are best known as restorations for single missing teeth. But there’s more to them than that—they can also be used to support and secure removable dentures or fixed bridges.

That’s because a dental implant is actually a root replacement. A threaded titanium post is inserted directly into the jawbone where, over time, bone cells grow and adhere to it. This accumulated bone growth gives the implant its signature durability and contributes to its long-term success rate (95%-plus after ten years). It can support a single attached crown, or serve as an attachment point for a dental bridge or a connector for a removable denture.

The method and design of implants differentiates it from other restoration options. And there’s one other difference—implants require a minor surgical procedure to insert them into the jawbone.

While this might give you pause, implant surgery is no more complicated than a surgical tooth extraction. In most cases we can perform the procedure using local anesthesia (you’ll be awake the entire time) coupled with sedatives (if you have bouts of anxiety) to help you relax.

We first access the bone through small incisions in the gums and then create a small channel or hole in it. A surgical guide that fits over the teeth may be used to help pinpoint the exact location for the implant.

We then use a drilling sequence to progressively increase the size of the channel until it matches the implant size and shape. We’re then ready to insert the implant, which we remove at this time from its sterile packaging. We may then take a few x-rays to ensure the implant is in the right position, followed by closing the gums with sutures.

There may be a little discomfort for that day, but most patients can manage it with over-the-counter pain relievers like aspirin or ibuprofen. It’s what goes on over the next few weeks that’s of prime importance as the bone grows and adheres to the implant. Once they’re fully integrated, we’re ready to move to the next step of affixing your crown, bridge or denture to gain what you’ve waited so long for—your new implant-supported 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 “Dental Implant Surgery: What to Expect Before, During and After.”

CouldaMetalAllergyKeepYouFromGettingaDentalImplant

The dental implant is the closest thing in modern dentistry to a natural tooth. This is because an implant replaces more than the visible crown — it also replaces the root, thanks to a metal post imbedded in the bone.

But what if you have a metal allergy — are you out of luck replacing a tooth with an implant? Before answering this question, let's take a closer look at metal allergies.

An allergy is an overreaction of the body's immune system to a particular foreign substance. This response can be as inconsequential as a minor rash or as life-threatening as a shutdown of the body's organ systems. You can be allergic to anything, including metals.

Usually, these allergies are to specific kinds of metals. For example, about 17% of women and 3% of men are allergic to nickel, while smaller percentages are allergic to cobalt or chromium. Most allergic reactions to metal occur from external contact with jewelry or similar metal items that create rashes or other anomalies on the skin. On a more serious note, an allergy to metal in a body replacement part could result in the body rejecting it.

Metals have also played an important role in dental care, particularly dental amalgam used for tooth fillings. Dental amalgam is a mixture of a precious metal like gold or silver with other metals like copper, tin and, in small amounts, mercury. While dental amalgam has been used safely for decades, there have been rare cases of inflammation or rashes.

This brings us to dental implants and the most common metal used in them, titanium. The commercial version of this metal is highly prized in medical and dental applications because it has a special affinity with bone. Bone cells readily grow and adhere to the metal, which strengthens the bond between the implant and the jawbone.

Even if you have a rare allergy to certain metals, it's even rarer that would include titanium. In one particular study of 1,500 implant patients less than 1% reported any reaction at all.

If you're concerned, you can undergo testing to see if you react to titanium. More than likely, though, you'll be able to join the millions of other patients who have successfully restored their smiles with dental implants.

If you would like more information on dental implants as a tooth replacement option, 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 “Metal Allergies to Dental implants.”

3CuttingEdgeWaysYouCouldBenefitfromDentalImplants

Since their introduction over thirty years ago, dental implants have become the most popular choice for dental restoration. Their large variety of shapes and sizes — a far cry from the limited choices of the 1980s — has only served to increase their popularity.

In recent years there's also been an expansion in their applicability. Most people recognize them as replacements for individual teeth — but they can do much more. They're now playing a pivotal role in other dental restorations or situations.

Here are 3 of those “cutting edge” ways implants could change your dental health and smile for the better.

Fixed bridgework. In a traditional bridge, prosthetic (false) teeth use the natural teeth on either side of the empty space for support. In this updated version, implants become the support base for the bridge. For example, a bridge as small as three crowns can be supported by two implants attached to the outside crowns of the bridge. Four to eight implants can support a bridge as large as an entire arch of teeth.

Over-dentures. In cases of significant bone loss, a full or partial denture may be a better option than a fixed bridge. Traditional dentures, though, can contribute to even more bone loss, which can cause the dentures to eventually lose their fit. Implants not only can help stop further bone loss but can also stimulate increased bone density. Two or more standard or mini-sized-sized implants can support a full or partial denture.

Orthodontics anchorage. People with missing teeth aren't the only ones who can benefit from implants. While most bite repairs only require the back teeth to provide anchorage for braces, certain complex bites may need a different point of anchorage. Orthodontists can create a more feasible anchorage point with an implant or a temporary anchorage device (TAD) imbedded in the jaw. This can help isolate teeth that need to be moved from those on the arch that don't.

If you would like more information about how dental implants could improve your dental health and appearance, 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: Your Best Option for Replacing Teeth.”