Posts for category: Dental Procedures

PromptTreatmentforGumDiseaseCouldUltimatelySaveYourTeeth

Your smile isn’t the same without healthy gums—neither are your teeth, for that matter. So, maintaining your gums by protecting them from periodontal (gum) disease is a top priority.

Gum disease is caused by bacterial plaque, a thin biofilm that collects on teeth and is not removed due to poor oral hygiene practices. Infected gums become chronically inflamed and begin to weaken, ultimately losing their firm attachment to the teeth. This can result in increasing voids called periodontal pockets that fill with infection. The gums can also shrink back (recede), exposing the tooth roots to further infection.

Although gum disease treatment techniques vary, the overall goal is the same: remove the bacterial plaque fueling the infection. This most often involves a procedure called scaling with special hand instruments to manually remove plaque and calculus (tartar). If the infection has spread below the gum line we may need to use a procedure called root planing in which we scrape or “plane” plaque and calculus from the root surfaces.

As we remove plaque, the gums become less inflamed. As the inflammation subsides we often discover more plaque and calculus, requiring more treatment sessions. Hopefully, our efforts bring the disease under control and restorative healing to the gums.

But while gum tissue can regenerate on its own, it may need some assistance if the recession was severe. This assistance can be provided through surgical procedures that graft donor tissues to the recession site. There are a number of microsurgical approaches that are all quite intricate to perform, and will usually require a periodontist (a specialist in gum structures) to achieve the most functional and attractive result.

While we have the advanced techniques and equipment to treat and repair gum disease damage, the best approach is to try to prevent the disease from occurring at all. Prevention begins with daily brushing and flossing, and continues with regular dental cleanings and checkups.

And if you do notice potential signs of gum disease like swollen, reddened or bleeding gums, call us promptly for an examination. The sooner we diagnose and begin treatment the less damage this progressive disease can do to your gums—and your smile.

If you would like more information on protecting your gums, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Periodontal Plastic Surgery.”

By Mario A. Vilardi, DMD
November 29, 2018
Category: Dental Procedures
Tags: dental implants  
TheManyAdvantagesofDentalImplants

Dental implants have become the standard for long-term tooth replacement. From mechanics to movie stars, people from all walks of life have discovered the advantages of replacing a missing tooth with an implant. Obviously, restoring your smile is a definite advantage, but an implant can also help to maintain the health of your jawbone and adjacent teeth.

The implant is a small, screw-like titanium post that is placed into your jawbone to function as the root part of the tooth. The living bone tissue will actually attach to the titanium post, fusing them together. This will not only provide a sturdy anchor for a natural-looking crown, but will provide stability for bridgework or dentures. You will then be able to smile, chew and talk as if all of your teeth are natural. The procedure will also help to stabilize the bone, reducing long-term bone loss that occurs when a missing tooth is not replaced.

At this point, if you are thinking that there must be a lot of pain involved, I have good news for you. There is very little pain involved after the procedure is completed and no pain at all during the procedure. Typically, it is a routine surgery that takes place in a dentist’s office under local anesthesia where the immediate area is numbed. If there is any apprehension at all about the procedure, we will offer alternative anesthesia or sedation options during the planning process.

To determine who will be a good candidate for the implant procedure, a plan must be in place to assure the success of the implant. Part of the plan includes:

  • Reviewing your past medical and dental history. We must know your complete past and present medical history and medication use, since good health is essential. There are certain conditions and diseases that can affect the healing of an implant.
  • Performing a comprehensive dental examination. An evaluation of your dental problems and needs will determine if implants are in your best interests. An assessment of the health and mass of the jawbone as well as the number and location of the implant(s) that are needed to restore your bite and smile back to health will also be determined.

When the implant procedure has been successfully completed, there is one more step. As with your natural teeth, preventive maintenance is crucial for long-term success. A daily routine of brushing and flossing along with regular professional dental cleanings and checkups will help ensure continued gum health and proper functioning of your implants.

If you are wondering whether dental implants are right for you, contact us for more information or schedule an appointment for a consultation. You can also learn more about dental implants by reading the Dear Doctor magazine articles “Dental Implants” and “Dental Implant Surgery.”

JulianneHoughSharesaVideo-andaSong-AfterWisdomTeethComeOut

Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.

That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!

Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.

Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”

One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.

Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.

Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”  Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.

If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

FixedorRemovableDecidingWhichImplant-SupportedBridgeisBestforYou

Although dental implants are best known as single tooth replacements, they can actually play a role in multiple or complete tooth loss (edentulism) restorations. While replacing multiple teeth with individual implants is quite expensive, there’s another way to incorporate them in a restoration at much less cost — as supports for bridges.

In this case, only a few strategically placed implants are needed to support restorations of multiple crowns fused together into a single unit. Implant-based bridges consist of two main types: the first type is a fixed bridge, which is permanently attached to the implants and can’t be removed by the patient. It’s often the preferred treatment for patients who’ve lost most or all of their teeth but have not yet experienced significant bone loss in the jaw.

This choice, however, may not be the best option for patients with significant bone loss. In these cases, there’s a second type of fixed bridge: an implant-supported fixed denture. This type of fixed denture provides support for the lost bone support of the lips and cheeks. If a fixed bridge is not possible due to finances or inadequate bone support to place 4 to 6 implants, a removable denture (also known as an overdenture) that’s supported and held in place by implants is the next best alternative. Unlike a fixed bridge, an overdenture can be removed by the patient for cleaning purposes, and will require less investment than a fixed bridge.

For people with bone loss, the overdenture does more than restore chewing and speech function. Because bone loss can diminish support of the facial structures — actually shorten the distance between the chin and the tip of the nose — an overdenture provides additional bulk to support these structures to improve appearance. Depending on what the patient needs for facial support, overdentures for the upper jaw can be designed as “full palates,” meaning the denture plastic completely covers the upper jaw palate, or open in which the plastic doesn’t completely cover the palate.

Besides the condition of your teeth, gums and bone, your own personal preferences and financial ability will also play a role in which option is best for you. After considering all these factors, we can recommend which of these types of implant-based restorations will fit your needs. With either bridge, fixed or removable, you’ll certainly benefit from the improvement to both your mouth function and your smile.

If you would like more information on implant-supported bridges, 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 “Fixed vs. Removable.”

By Mario A. Vilardi, DMD
September 20, 2018
Category: Dental Procedures
Tags: diabetes   dental implants  
DiabetesDoesntHavetoStopYouFromAcquiringDentalImplants

One of the best and most successful tooth replacement choices available is the dental implant. No other restorative method is as similar in both form and function to a real tooth as an implant; and with a success rate of 95-plus percent after ten years, it’s one of the most durable.

But there can be extenuating circumstances that make obtaining an implant difficult or sometimes impossible. One possible problematic situation is the systemic disease diabetes.

Diabetes is a hormonal condition in which the body is unable to sufficiently regulate the amount of glucose (a basic sugar that provides energy to the body’s cells) within the blood stream. Normally, the pancreas produces the hormone insulin to reduce excess glucose. But diabetes interferes with this insulin production: if you have Type 1 diabetes, the pancreas has stopped producing insulin altogether; if you have the more common Type 2, the body doesn’t produce adequate insulin or it doesn’t respond sufficiently to the insulin produced.

Over time diabetes can affect other areas of health, especially wound healing. Because the condition gradually causes blood vessels to narrow and stiffen, the normal inflammatory response to disease or trauma can become prolonged. This in turn slows the rate of wound healing.

Slow wound healing can have a bearing on the recovery period just after implant surgery, especially the necessary integration process that takes place between the bone and the titanium metal implant that provides its signature strength. If that process is impeded by slow wound healing caused by diabetes, the risk increases dramatically for implant failure.

That’s the worst case scenario if you have diabetes, but only if your condition is out of control. If, however, you have your blood sugar levels well regulated through medication, diet and exercise, then your chances for implant success could easily be on par with someone without diabetes.

So if you’re diabetic and are considering dental implants for missing teeth, it’s important to discuss the possibility of obtaining them with both your dentist and the physician caring for your diabetes. With your overall healthcare team working together, there’s no reason why diabetes should stop you from enjoying this premiere restoration for missing teeth.

If you would like more information on 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 Implants & Diabetes.”



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