Implants: Options

Twenty-five years ago, if someone described how missing teeth could be replaced with implants, it might have been called a miracle. Ten years ago, the use of dental implants to replace missing teeth might have been called astounding. Today, implant procedures are called routine. We would like you to have a basic understanding of what implants are, what can be expected from them, and what limitations they might have in your specific area of need.

A dental implant is a synthetic metallic root substitute that is placed or implanted in the jaw bone. It can be used to replace a single missing tooth, provide an abutment (anchor or retainer), replace several missing teeth, or provide added retention to a removable dental appliance such as a full denture. In fact, if you are missing all of your natural teeth, it is possible to have maxillary (upper) and mandibular (lower) fixed replacements. The replacements do not come out and you cannot remove them yourself.

Two separate events are needed when replacing a missing tooth with an implant. First, is the surgical phase in which the implant is placed. In the second phase the replacement teeth are constructed and fixed into proper position.

The implant placement procedure involves making a small incision in the gum area where the implant is to be placed, preparing a site in the underlying bone, inserting the implant into the prepared site, and closing the tissue over the implant with several sutures. This area is left undisturbed, usually for 4 to 6 months. More healing time may vary due to the density of your bone. The lower jaw is composed of bone that is more dense than that of the upper jaw. This healing time allows for the slow integration of the implant within your jaw. The implant is held in place by the bone.

After the healing and integration of the implant, the placement site is exposed by reopening the gum. A post will then be fastened to the implant by cement or with internal threads. The crown, bridge, or other type of replacement will be attached to this post. Some dentists prefer to do all phases of the implant procedure themselves, but many choose to perform either the surgical or prosthetic (the actual construction of the replacement device) only. If this is the case, you will be referred to a periodontist or oral surgeon who will perform the surgical portion of the implant placement.

Implants are very successful. Maxillary and mandibular implants are more than 90% successful. Lower implants have a somewhat higher success rate than upper implants. Occasionally, implants fail, but it is not common. Chances of an implant failure, many times, can be determined during or after the surgical phase before the replacement tooth or teeth are constructed.

*Smokers take note:  There is a heightened risk of dental implant failure among smokers - as much as 20% greater failure rate!

We will discuss with you the requirements and options for your particular situation. There are usually several possibilities for effectively replacing missing teeth. It is important to decide on the design of the implant-retained replacement prior to the actual implant surgical procedure. Position and alignment of the replacement teeth need to be carefully considered before determining the location of the implant.

If you have any questions about implants, please feel free to call Omni Dental Group.

North location on Hymeadow Drive: (512) 250-5012
Central location on Jollyville Road: (512) 346-8424
South location on William Cannon Drive: (512) 445-5811

Scaling and Root Planing: Reevaluation

The goal of scaling and root planing is to remove all plaque, toxins, and calculus both above and below the gumline. After healing has occurred, the tissues will shrink, and a reevaluation of the condition of the gum and supporting structures will reveal any areas that may need re-treatment. Your oral self-care habits will be reevaluated at the same time and any revisions to our recommendations will be made. We will be polishing your teeth at this appointment. As you will recall, we did not polish your teeth during the root planing and scaling appointments. Although the polishing can, in theory, be done then, we believe that allowing tissues proper time to heal will allow us to make the best reevaluation of our treatment and oral self-care recommendations. That is why there is a time period of several weeks between the root planing and scaling appointment and this prophylaxis and evaluation. Once all tissues have responded and the goals of scaling and root planing are met, a recare interval will be established for you.

At the recare appointment, we will once again be evaluating your oral self-care to determine whether we need to recommend different procedures to keep your oral health at its best. We will reexamine your periodontal tissues for evidence of healing by remeasuring the probing depths around each tooth. Any areas of bleeding will be noted and treated; your teeth will then be polished and a topical fluoride treatment will be applied.

Topical fluoride provides a bacteriostatic action to the oral bacteria during treatment and for several hours afterward. It appears to be harder for the bacteria that cause gum disease to multiply and cause problems when topical fluoride is used.

If the goals of scaling and root planing have not been met, we will either re-treat those areas that have reinfected or refer you to a periodontist for specific periodontal surgery. The periodontal surgery will correct some of the hard (bone) and soft tissue defects that were caused by the periodontal infection.

At this time we may also consider using one or more of the newer nonsurgical therapies available for localized sites that have not healed as much as we would like. The site-specific therapy may be recommended for the first time or as a re-treatment. We will then monitor the results to determine whether a referral to a periodontist is appropriate.

A final word about how often you should have your teeth cleaned:  modern dentistry considers a patient who has had gum disease to be always recovering, never completely "cured." If you do not take care of your teeth and gums, the problem can come back again. It is in the best interest of your oral health to have your teeth examined and cleaned at an interval of 3 to 4 months in most cases, not every 6 months as you have heard for years.

If you have any questions about the prophylaxis and reevaluation appointment, please call Omni Dental Group at (512) 250-5012.

How Can I Keep My Mouth Healthy?: Oral Health for Children

Children's teeth begin forming before birth. As early as 4 months, the first primary, or baby teeth, erupt through the gums. All 20 of the primary teeth usually appear by age 3, although their pace and order of eruption varies.

Permanent teeth begin appearing around age 6. This process will continue until approximately age 21.

Oral Health for Children

To help ensure oral health and a lifetime of good oral care habits:

• Limit children's sugar intake
• Make sure children get enough fluoride, either through drinking water or as a treatment at the dentist's office
• Teach children how to brush and floss correctly
• Supervise brushing sessions and help with flossing, which can be a challenge for small hands

Major Obstacles to Children's Oral Health

Babies

"Baby bottle tooth decay"

• Wipe gums with gauze or a clean washcloth and water after feeding. When teeth appear, brush daily with a pea-sized amount of fluoride toothpaste.
• Put child to bed with a bottle of water, not milk or juice

Thumb sucking

• Not a concern until about 4 years of age or when permanent teeth appear; after this time, it could cause dental changes

White spots on teeth

• As soon as the first tooth appears (at about 6 months), begin cleaning child's teeth daily and schedule a dental appointment

Toddlers

Fear of the dentist

• Hold the child in the parent's lap during the exam

Difficulty creating an oral care routine

• Involve the whole family - brush together at the same time each day to create a good habit

Gradeschoolers

Love of sweets

• Give children healthy snack options, like carrots, raisins, and yogurt

Stains from antibiotics

• Speak to the pediatrician before any medication is prescribed

Teenagers

Braces

• Make sure that teens brush well around braces, using a floss threader to remove all food particles

Oral accidents from sports

• Encourage children to wear mouthguards during sports

The following are key preventative measures to preserve oral health through childhood:

Fluoride treatments to strengthen tooth enamel and resist decay.

Dental sealants to provide a further layer of protection against cavities. Sealants are made of plastic and are painted on the teeth  by a dentist.

A fun oral care regimen to help encourage children to brush more regularly. 

If you have any questions about your child's oral health, please call Omni Dental Group. We have three locations to serve you and your family.

North Austin on Hymeadow Drive:  (512) 250-5012

Central Austin on Jollyville Road:  (512) 346-8424

South Austin on William Cannon:  (512) 445-5811

Source:  Crest