By Mario A. Vilardi, DMD
January 27, 2021
Category: Dental Procedures
Tags: dental implant  
SmokingCouldIncreasetheRiskofanImplantFailure

Although they can be expensive upfront, dental implants often prove to be a wise investment in the long-term. With a success rate that outperforms other teeth replacement restorations, dental implants could be the answer to a more attractive smile that could last for decades.

But while their success rate is high (95% still functioning after ten years), they can and do occasionally fail. Of those that do, two-thirds happen in patients who smoke.

This unfortunate situation stems from smoking's overall effect on dental health. The nicotine in tobacco constricts oral blood vessels, inhibiting the flow of nutrients and antibodies to the teeth and gums. Inhaled smoke can scald the inside skin of the mouth, thickening its surface layers and damaging salivary glands leading to dry mouth.

These and other effects increase the risk for tooth decay or gum disease, which in turn makes it more likely that a smoker will lose teeth than a non-smoker and require a restoration like dental implants. And blood flow restriction caused by nicotine in turn can complicate the implant process.

Long-term implant durability depends on bone growth around the imbedded implant in the ensuing weeks after implant surgery. Because of their affinity with the titanium used in implants, bone cells readily grow and adhere to the implant. This integration process anchors the implant securely in place. But because of restricted blood flow, the healing process involved in bone integration can be impaired in smokers. Less integration may result in less stability for the implant and its long-term durability.

To increase your chances of a successful implant installation, you should consider quitting smoking and other tobacco products altogether before implant surgery. If that's too difficult, then cease from smoking for at least one week before surgery and two weeks after to better your odds of implant success. And be as meticulous as possible with daily brushing and flossing, as well as regular dental visits, to reduce your risk of disease.

There are many good reasons to quit smoking. If nothing else, do it to improve your dental health.

If you would like more information on tobacco use and dental health, 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 & Smoking.”

WisdomTeethCanStillbeaProblemfortheWorldsYoungestBillionaire

According to Forbes Magazine, Kylie Jenner is the world's youngest billionaire at age 22. Daughter of Caitlyn (Bruce) Jenner and Kris Jenner, Kylie is the founder and owner of the highly successful Kylie Cosmetics, and a rising celebrity in her own right. But even this busy CEO couldn't avoid an experience many young people her age go through each year: having her wisdom teeth removed.

At around 10 million removals each year, wisdom teeth extraction is the most common surgical procedure performed by oral surgeons. Also called the third molars, the wisdom teeth are in the back corners of the jaws, top and bottom. Most people have four of them, but some have more, some have fewer, and some never have any. They're typically the last permanent teeth to come in, usually between ages 17 and 25.

And therein lies the problem with wisdom teeth: Many times, they're coming in late on a jaw already crowded with teeth. Their eruption can cause these other teeth to move out of normal alignment, or the wisdom teeth themselves may not fully erupt and remain fully or partially within the gums (a condition called impaction). All of this can have a ripple effect, decreasing dental function and increasing disease risk.

As Kylie Jenner has just experienced, they're often removed when problems with bite or instances of diseases like tooth decay or gum disease begin to show. But not just when problems show: It's also been a common practice to remove them earlier in a kind of “preemptive strike” against dental dysfunction. But this practice of early wisdom teeth extraction has its critics. The main contention is that early extractions aren't really necessary from a medical or dental standpoint, and so patients are unduly exposed to surgical risks. Although negative outcomes are very rare, any surgical procedure carries some risk.

Over the last few years, a kind of middle ground consensus has developed among dentists on how to deal with wisdom teeth in younger patients. What has emerged is a “watch and wait” approach: Don't advise extraction unless there is clear evidence of developing problems. Instead, continue to monitor a young patient's dental development to see that it's progressing normally.

Taking this approach can lead to fewer early wisdom teeth extractions, which are postponed to a later time or even indefinitely. The key is to always do what's best for a patient's current development and future dental health.

Still, removing wisdom teeth remains a sound practice when necessary. Whether for a high school or college student or the CEO of a large company, wisdom teeth extraction can boost overall dental health and development.

If you would like more information about wisdom teeth and their impact on dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth: To Be or Not to Be?

By Mario A. Vilardi, DMD
January 07, 2021
Category: Dental Procedures
Tags: dental implants  
HowLongIstheImplantProcessItDependsonYourBoneHealth

If you're thinking about getting dental implants, you may be curious about how long it might take. The answer depends on the health of your supporting bone.

Bone is an integral part of implant functionality as bone cells gradually grow and adhere to the newly placed implant to give it its characteristic strength. The implant also requires an adequate amount of bone to accurately position it for the best appearance outcome.

If the bone is sufficient and healthy, we can proceed with the surgical placement of the implant. The most common practice following surgery is to allow a few weeks for the bone integration described previously to take place before finally attaching the crown. With an alternative known as a “tooth in one day” procedure, we install a crown right after surgery, which gives you a full smile when you leave.

There's one caveat to this latter method, though—because the implant still requires bone integration, this immediate crown is temporary. It's designed to receive no pressure from biting or chewing, which could damage the still integrating implant. We'll install the permanent crown after the implant and bone have had time to fully mesh.

So, if your supporting bone is sound, the complete implant process may only take a few weeks. But what if it's not—what if you've lost bone and don't have enough to support an implant? In that case, the length of process time depends on the severity of the bone loss and if we're able to overcome it. In some cases, we can't, which means we'll need to consider a different restoration.

But it's often possible to regenerate lost bone by grafting bone material at the implant site. If the bone loss is moderate, it may take 2 to 4 months of regrowth after grafting before we can perform implant surgery. If it's more significant or there's disease damage to the socket, it may take longer, usually 4 to 6 months. It largely depends on the rate of bone regeneration.

In a nutshell, then, the health of your jaw's supporting bone has a lot to do with whether the implant process will take a few weeks or a few months. Regardless of the time, though, you'll gain the same result—new, functional teeth and a more attractive smile.

If you would like more information on dental implant restorations, 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 “Implant Timelines for Replacing Missing Teeth.”

By Mario A. Vilardi, DMD
December 28, 2020
Category: Oral Health
Tags: loose tooth  
CalltheDentistImmediatelyIfYouHaveaLooseTooth

Do you remember when one of your baby teeth began to wiggle? You knew it wouldn't be long before it came out, followed by a little something from the “tooth fairy” under your pillow.

Those were the days! But a loose permanent tooth is something else entirely: Often a sign of advanced periodontal (gum) disease, you may be on the verge of losing the tooth forever.

This sad affair begins with dental plaque, a thin biofilm found on tooth surfaces and the ideal haven for oral bacteria that can trigger a gum infection. You might not notice such an infection in its early stages, other than a few initial signs like gum redness, swelling, or bleeding. If these occur, it's imperative you seek treatment promptly.

Without treatment, the infection can spread below the gum line, weakening gum attachments to teeth (which actually hold teeth in place) and eventually doing the same to underlying bone. All of this damage can lead to a tooth becoming loose and eventually falling out.

But it's not inevitable a loose tooth will eventually be lost, though it may require long-term efforts to save it. We may first need to do a bite adjustment, which will often allow a tooth to decrease its mobility. If the mobility has not been reduced enough, we may recommend stabilizing the teeth through splinting: These are techniques used to join the loose tooth to more stable teeth, usually with a thin strip of metal or other dental material.

We'll also need to treat the underlying cause, which in the case of gum disease requires aggressive plaque removal. Our goal is to manually remove all plaque and tartar (calcified plaque) deposits, particularly below the gum line. It may also require surgery to fully access deep pockets of infection. But once we remove the offending plaque, the gums can begin to heal.

The best strategy, though, is to avoid gum disease altogether. You can substantially lower your infection risk by brushing and flossing daily and getting a dental cleaning every six months. Dental visits also allow us to check your gums for any signs of infection that might require prompt action.

A loose tooth for a kid is a cause for celebration. It's the exact opposite for an adult loose tooth. Taking care of your gums with daily hygiene and receiving prompt treatment for any emerging infection could help you avoid it.

If you would like more information on treating gum 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 “When Permanent Teeth Become Loose.”

By Mario A. Vilardi, DMD
December 18, 2020
Category: Oral Health
Tags: gum disease   oral hygiene  
PreventingGumDiseaseCouldHelpMoreThanYourTeethandGums

The top cause for adult tooth loss isn't decay or trauma—it's periodontal (gum) disease. The disease may begin with the gums, but it can ultimately damage underlying bone enough to weaken its support of teeth, causing them to loosen and fall out.

But that's not the end of the havoc gum disease can wreak. The consequences of an uncontrolled infection can ripple beyond the mouth and worsen other health problems like diabetes, heart disease or arthritis.

The common link between gum disease and these other conditions is the inflammatory response, a natural mechanism to fight infection caused by disease or trauma. This mechanism changes blood vessels to increase blood flow to hasten the travel of protective white blood cells to the injury or disease location.

But if this mechanism that supports healing becomes chronic, it can actually do harm. The chronic inflammation that occurs with gum disease can damage mouth structures, just as inflammation from diabetes or arthritis can damage other parts of the body. And any form of chronic inflammation, even that found in gum disease, can worsen other inflammatory diseases.

You can lessen this link between gum disease and other conditions—as well as improve your oral health—by preventing or seeking prompt treatment for any periodontal infection in the following ways:

  • Practice daily brushing and flossing to clear away bacterial dental plaque, the main cause of gum disease;
  • See your dentist regularly for more thorough dental cleanings and checkups;
  • See your dentist promptly if you notice red, swollen or bleeding gums, common signs of a gum infection;
  • Stop smoking to lower your risk for both gum disease and tooth decay;
  • Adopt a healthy diet, which can help you lose weight (a factor in diabetes and other inflammatory diseases) and strengthen your immune system;
  • Manage other inflammatory conditions to lessen their effect on your gum disease risk.

Taking these steps can help you avoid the inflammation caused by gum disease that might also affect the rest your body. Seeking prompt treatment at the first sign of an infection will also minimize the damage to your teeth and gums and the effect it could have on the rest of your health.

If you would like more information on prevention and treatment of gum 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 “Gum Disease & Systemic Health.”





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