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April 2017

Apr 30

Is surgery usually recommended for gum disease?

By Gum Disease, Oral Health

I have 4 crowns that I got in 2002. My gums are inflamed around all of the crowns. The inflammation became noticeable in January. My dentist has tried antibacterial liquid. She asked me to start flossing 2 times a day. The gums around my natural teeth are fine. It’s just the teeth that have crowns that are presenting the problem. My dentist is suggesting gum surgery to trim my gum tissue. She says it might not work but if there is a problem with the way the crowns fit, trimming my gums will help. I’m wondering why after 15 years there would be a problem with the way my gums fit. For some reason, after examining my teeth and gums my dentist is confident that I don’t have gum disease. That’s somewhat of a relief but I am wondering what’s going on. If she isn’t sure that gum surgery will work, why is she recommending it? Is this normal procedure? Thanks. Norm

Norm – Gum inflammation that is around teeth with crowns, but not around your natural teeth, can result from several issues.

Some possible causes are listed below, but in each case, the reaction would be immediate. It wouldn’t take 15 years to surface:

  • The area around the crowns wasn’t thoroughly cleaned and left free of cement.
  • The crowns don’t fit correctly.
  • The crowns fit too deeply below the gumline.

Other possibilities that are not necessarily immediate include:

  • Metal sensitivity to porcelain-fused-to-metal crowns.
  • Periodontal (gum disease) that can be related to your oral health or your general health.

If you have gum disease, the treatment includes regular, deep cleanings to remove plaque and bacteria from the pockets between your teeth and gums. Gum surgery is not the first resort. If your dentist doesn’t understand how to address the problem, you should be referred to a periodontist—a specialist in gum tissue.

Your dentist hasn’t referred you to a periodontist, so it’s probably best to find one on your own. You can look for online reviews or call other dentists’ office to ask which periodontists they use for their own patients. Don’t allow your dentist’s lack of understanding to delay you from getting help.

This post is sponsored by Naperville dentist Dr. Anthony LaVacca.

Apr 27

Will All-On-4 Implants Conflict with My Metal Allergies?

By All-on-4 Dental Implants

I have metal allergies and I’m wondering how I would react with All on 4 dental implants. Since 2001 I’ve worn dentures and I’ve started noticing some bone shrinkage and difficulty keeping my dentures in. I went to an implant dentist who recommended All on 4. Whenever any dental treatment is recommended to me, I ask about the metal. I’m told that titanium is used for the implant fixtures. The implant dentist quickly said that it won’t be any problem but I’m not sure that he understands metal allergies. My ears, neck, and wrists easily break out from jewelry. I switched to cotton cord jewelry and I only wear sterling silver post earrings. I’m going to get a second opinion, I think. Before I schedule anything, I’m wondering if you know anything about dental implants and how they work for people with metal allergies. I can’t move forward with a maybe it will be okay. Thank you. Madeleine

Madeleine – If you have a metal allergy, it usually presents in a reaction like hives or anaphylactic shock. Your description of breaking out only in places where you’re wearing jewelry is a localized reacation—not throughout your body—so it’s considered a metal sensitivity. It’s unlikely that All-On-4 implants will present a problem.

Nickel is the most common metal that causes sensitivities. The fact that you can tolerate sterling silver suggests that your sensitivity is mainly to nickel. You might have other metal sensitivities that you’ve been tested for or are aware of.

So what should you consider?

  • Visit an allergist to be tested for metal allergists.
  • Ask your implant dentist about the composition of the All-On-4 implant fixtures that will be used in your case. It makes a difference whether the fixtures are all titanium or titanium alloy.
  • It might help to get a second opinion from an experienced implant dentist. Find a prosthodontist or implant surgeon who has successfully placed at least hundreds of implants.

Most manufacturers list the composition of implant fixtures on the packaging. An implant dentist who uses high-quality fixtures will have no problem identifying the composition of the fixtures for you.

Ensure you’re comfortable with the response you get regarding your metal concerns before you get All-On-4 or any other type of implants and before you select a provider.

This post is sponsored by Naperville board-certified prosthodontist and implant dentist Dr. Anthony LaVacca.

Apr 23

Can a prosthodontist find out why CEREC crowns messed up my bite?

By Prosthodontist

I have been to 3 CEREC dentists and nobody can figure out why my bite has been off since I got the crowns. Would a prosthodontist do anything differently or should I just get new crowns? These crowns are 5 months old. The first dentist who placed the crowns talked a good game before I got the crowns but after I pressed him about why my bite is off and why my teeth hurt, he admitted that he has only been during CEREC for 7 months. He lied to me before I got the crowns. When I asked him about his first claim to have been doing for CEREC for years, he said that I must have understood. He has been doing crowns for 7 years but CEREC crowns for 7 months. This was no misunderstanding. My wife was with me when we discussed getting these crowns and she remembers the dentist saying 7 years for CEREC. I quit that dentist and have been to 2 other dentists to figure out what’s going on with my bite. I thought this was standard procedure to place crowns and get the bite right but evidently not. My good friend’s wife is a dental hygienist and she suggested that I see a prosthodontist. Is this really going to make a difference? What will done differently? Thanks. Blake

Blake – Most likely, the CEREC dentists you visited are general dentists. A prosthodontist is a specialist with two years of post-graduate training in tooth restoration. Prosthodontists receive extensive education in occlusion, or the way your teeth fit together when you bite down. You will receive a thorough examination of your crowns and natural teeth to determine why your bite is off.

Crown construction – Your prosthodontist will ensure that impressions of your teeth were properly taken to ensure the crowns were properly sized.

Natural tooth structure – Each natural tooth is tapered to allow the crown to fit securely over it. If your teeth weren’t tapered enough, the crowns can sit to high.

Internal condition of teeth – When your bite is off from crowns, it stresses and puts pressure on your natural teeth. The pressure can cause damage to tooth nerves or pulp—the living tissue inside your teeth.

After your visits to three different dentists without a resolution, it’s time to see a prosthodontist. If there is a board-certified dentist in your area, his or her expertise will benefit your case. A board-certified specialist has completed rigorous testing and submitted patient cases that prove his or her skill.

Don’t delay getting a second opinion. Prolonged pressure on your teeth from an improper bite can create even more problems.

This post is sponsored by Naperville board-certified prosthodontist Dr. Anthony LaVacca.

Apr 19

My affordable dental implant is crooked. Shouldn’t it be redone?

By Affordable Dental Implants

I got an affordable dental implant and it’s crooked. This implant wasn’t cheap but it was more affordable than implants from most of the other dentists I contacted. I didn’t go with the cheapest one because I was afraid that it wouldn’t really be any good. So the surgery was done in February but the implant is crooked. I didn’t notice myself that the implant is crooked but I started feeling pain in the tooth in front of it. It was more like a toothache. I went to my dentist and he did an x-ray. He said it looks like his partner put the implant in at a slight tilt. I’m not sure why my dentist didn’t notice it because he put the crown on himself. Anyway I’m still having pain. So far, nothing has been done yet. My dentist says he needs to talk with his partner. I’m not sure what a discussion would be about. If the thing is tilted and the tooth in front of it hurts, the only thing that makes sense to me is that it needs to be taken out and put in the right space. It’s not an affordable dental implant anymore because it has cost me a lot of time and money taking off work and going back and forth to the dentist, and it’s not even fixed yet. Shouldn’t it be redone? Thanks Reilly

Reilly – You’re right. Your affordable dental implant needs to be removed and replaced. Insufficient training in implantology can result in improper placement.

You should choose your implant surgeon carefully. There is a multi-step process for a successful outcome.

Three-dimensional x-rays – The diagnostic studies will help to determine if the issue was a misjudgment of where the implant should be placed or if there is inadequate jawbone density to support the implant. Lack of jawbone density will cause the implant to shift.

Surgical removal of the implant – Your implant needs to be carefully removed to prevent nerve damage or damage to nearby teeth.

Implant replacement – The extraction site will need to heal. You might require bone grafting to support the implant. If you need bone grafting, it will need to heal and bond to your natural bone before the replacing the implant fixture. Your new dental implant will need to be placed with precision.

We suggest that you schedule a consultation with board-certified prosthodontist. Prosthodontists are specialists in tooth restoration and replacement. You can receive an accurate diagnosis and learn about your treatment options. Affordable dental implants don’t have to be problematic. But you must carefully choose the right provider.

This post is sponsored by Naperville implant dentist Dr. Anthony LaVacca.

Apr 11
pediatric-dentist-xray-child-blog

Should the pediatric dentist do x-rays on a 4 year old?

By Pediatric Dentist

Starting at age 2 I take all of my kids to the pediatric dentist. X-rays are not something that any of my older children got when they were so young. But my youngest daughter is now 4 years old. Over the past 2 dental checkups, she has had 4 cavities. On her last appointment, our pediatric dentist took x-rays. I know she is concerned about the cavities, but why can’t she just fill the teeth without the x-rays. Naturally, I’m concerned about the radiation on a young child. Is it normal to do x-rays on young kids? I’m not really sure why my daughter is getting cavities. I don’t give my kids sugar at all and I make sure all of their teeth are brushed and flossed every day. I’m just concerned. What’s your take on the x-rays? Simone

Simone – Your concern about your children’s oral health and overall health is completely understandable. Your daughter’s pediatric dentist likely took x-rays for good reasons.

Reasons a Pediatric Dentist Might Take X-rays

The American Academy of Pediatric Dentistry (AAPD) doesn’t have set guidelines on age for dental x-rays. The Guideline on Prescribing Dental Radiographs for Infants, Children, Adolescents, and Persons with Special Health Care Needs states that diagnostic studies should be based on each patient’s needs, not on age alone.

The AAPD has recommendations for when dental x-rays for a child patient might be needed, regardless of age. The recommendations are based on certain conditions, some of which are listed below:

  • A history of dental caries, or cavities – Posterior bitewing x-rays every 6 to 12 months if the teeth can’t be examined visually or with a probe.
  • Tooth pain or trauma
  • Family history of unusual dental issues
  • Periodontal (gum) disease
  • Loose teeth
  • Unexplained bleeding or sensitivity
  • Unusual characteristics of teeth, including abnormal eruption, growth/development, color, or other unusual factors
  • Erosion
  • Swelling

Some Interesting Facts

  • There is minimal radiation exposure with dental x-rays.
  • Every year, we are exposed to natural background radiation from air, wind, water, the ground, and other environmental factors. Millisievert (mSv) is the measurement used for radiation exposure.
  • The mSv of natural background radiation is greater than the exposure from dental x-rays.
  • Visit the Image Gently website for a comparison chart of natural background radiation and dental x-rays.

Safety First

Although dental x-rays are safe, extra care is taken with radiographs for children. For example:

  • X-rays are not given as a routine, but only when necessary.
  • Patients are protected with a thyroid shield and an apron to minimize exposure.
  • Exposure parameters are set as slow as possible.
  • X-ray exposure time is shortened because children have smaller teeth than adults.

Speak with your children’s pediatric dentist for additional information on why x-rays are needed for your daughter. Learn about the safety precautions that are taken to minimize your daughter’s exposure. Cooperate with the dentist to help identify underlying causes of the recurring cavities to help limit future cavities and improve your daughter’s oral health.

This post is sponsored by Naperville dentist Dr. Anthony LaVacca.

Apr 06
dental implants years extraction

Can dental implants be done years after extraction?

By Dental Implants

Can dental implants be done years after extraction? This is 7 years to be exact. In 2010 I had 3 extractions on the top left side. I started out with a partial denture and never really liked it. Now I just hate my partial denture. I am exploring my options and I definitely don’t want a dental bridge. I’m looking for something more permanent that won’t affect my remaining teeth. I’m guessing that having to grind down teeth for a bridge is almost like losing even more teeth. What I don’t know is how difficult it will be for me to get implants now that I’ve waited so long. Should I have started out with implants in the first place or is there some way to get them even though I’ve been wearing a partial for years? Thanks Salvi

Salvi,

Provided you are a candidate for dental implants, it’s not too late to get them. Although it’s been ten years since your tooth extractions, dental implants are probably still an option for you. There are several considerations before your teeth are restored. We’ll discuss three.

Jawbone shrinkage

It’s been ten years since your teeth were extracted, so you might have some jawbone shrinkage. Your body resorbs the bone in places where teeth are missing. Sufficient bone density is needed to support dental implants. If you have bone shrinkage, bone grafting will build it back up. After the grafting procedure, a healing period of a few months is needed before dental implants are placed.

Individual implants

It sounds like you prefer individual implants. One dental implant is used to replace each missing tooth. There are several advantages, including:

  • Single implants look better than a dental bridge.
  • Individual implants are easier to keep clean.
  • Each implant will stimulate your jawbone and prevent further shrinkage.
  • Your gums are less likely to recede and show the framework of a dental bridge.

Implant-supported bridge

This option is more affordable, and it can be used to replace several missing teeth in the same area. The bridge is anchored with dental implants, instead of being placed on natural teeth that have been shaved down. Replacement teeth are suspended between the anchors. Over time, your gums can recede and the appliance will be visibly exposed.

Schedule Consultations for Dental Implants

We suggest that you schedule two or three consultations with experienced implant dentists—preferably board-certified prosthodontists, because they specialize in tooth replacement and restorations.

  • Ask friends and family members for recommendations, and compare patient reviews.
  • In advance of your consultations, write down any questions you might have or record them in a mobile device. Ask the same questions of each specialist.
  • Compare your options, the estimated cost, and your interaction with each dentist.
  • Ask to see before-and-after pictures of each prosthodontist’s work for individual implants and implant-supported bridges.

You’ll learn about reliable alternatives to your partial denture that will be durable and natural looking.

This post is sponsored by Naperville implant dentist Dr. Anthony LaVacca.

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