Dental implants are a reliable way to replace teeth. More than 95% of implants survive ten years after their installation, and many of these could conceivably continue for decades.
But that still leaves a tiny few that don't reach the ten-year mark. Some fail early because the implant didn't integrate fully with the bone to create a durable hold. But others fail later—usually for one of two major causes.
Some failures occur due to over-stressing of the implant from abnormally high biting forces, usually because of teeth grinding. People who have this involuntary habit generate excessive force as they grind their teeth, which can damage implants (as well as natural teeth). To reduce this force, a patient's dentist can fit them with a biteguard they wear in the mouth to prevent teeth from making solid contact with each other during a grinding episode.
Fortunately, teeth grinding isn't that prevalent among adults—but that can't be said about the other major cause for implant failure: periodontal (gum) disease. This is a bacterial infection caused by dental plaque, a thin, bacterial film that accumulates on teeth. The implant itself isn't affected by the infection, but the gums and underlying bone supporting the implant can be.
Implants are most in peril from a form of gum disease called Peri-implantitis, which spreads deeper into the gum tissues around implants faster than infections around natural teeth. That's because implants lack the gum attachment of real teeth, which supply a collagen barrier that slows the spread of infection. Peri-implantitis can quickly infect the supporting bone and eventually weaken its connection with the implant.
Because of its aggressiveness and speed, we must diagnose and treat peri-implantitis as soon as possible to limit any damage to the support structures around an implant. If you notice any swollen, reddened or bleeding gums, you should call your dentist as soon as possible for an examination.
And in light of this potential danger to your implants, you should also strive to prevent gum disease through daily oral hygiene. Brushing and flossing your teeth, including around your implants, removes harmful plaque buildup. This daily habit and regular dental cleanings will help you avoid a costly gum infection and ensure your implants are there for years to come.
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 Implants: A Tooth-Replacement Method That Rarely Fails.”
The NBA's reigning MVP Giannis Antetokounmpo may seem unstoppable, but he proved no match for a troubled tooth. Antetokounmpo, the self-proclaimed “Greek Freak,” missed one of the final three 2020 regular season games for a dental issue that resulted in last-minute oral surgery. According to a Milwaukee Bucks spokesperson, the star underwent “a root-canal like procedure.”
Root canal therapy, often simply called “a root canal,” may be needed when there is an infection inside the tooth. When dental pulp becomes inflamed or infected, excruciating pain can result. Pulp is the soft tissue that fills the inside of the tooth. It is made up of nerves, blood vessels and connective tissue. During root canal treatment, the pulp is removed, the space inside the tooth is disinfected, it is filled with a special material, and then the hole is sealed up.
A root canal is nothing to fear. It relieves pain by getting rid of infection and is so effective that over 15 million of them are performed in the U.S. each year. This routine procedure generally requires only local anesthetic, and your mouth should be back to normal within a day or two after treatment. Antetokounmpo can attest to that, as he returned to play the next day.
However, delaying root canal treatment when you need it can have serious consequences. If left untreated, an infection inside the tooth continues to spread, and it may move into the gums and jaw and cause other problems in the body. So, how do you know if you may need a root canal? Here are some signs:
Lingering sensitivity to hot or cold temperatures. One sign of nerve damage inside your tooth is pain that is still there 30 seconds after eating or drinking something hot or cold.
Intense pain when biting down. You may feel pain deep within your tooth, or in your jaw, face or other teeth. The pain may be hard to pinpoint—and even if it improves at times, it usually comes back.
A chipped, cracked or discolored tooth. A chip or crack can allow bacteria to enter the tooth, and the tooth may darken if the tissue inside is damaged.
A pimple on the gum. A bump or pimple on the gum that doesn't go away or keeps coming back may signify that a nearby tooth is infected.
Tender, swollen gums. Swollen gums may indicate an infection inside the tooth or the need for periodontal treatment.
And sometimes there is no pain, but an infection may be discovered during a dental exam.
Tooth pain should never be ignored, so don't put off a dental visit when you have a toothache. In fact, if a bad toothache goes away, it could mean that the nerves inside the tooth have died, but the infection may still be raging. Also, be sure to keep up with your regular dental checkups. We may spot a small problem that can be addressed before it becomes a bigger problem that would require more extensive treatment.
Remember, for dental issues both large and small, we're on your team! If you would like more information about tooth pain, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Tooth Pain? Don't Wait!” and “Root Canal Treatment: What You Need to Know.”
Most dental problems are caused by tooth decay or periodontal (gum) disease, easily preventable with dedicated daily hygiene and regular dental care. But there are a few other rare conditions to be on alert for that could pose just as serious a threat to your dental health.
One of these is a phenomenon called root resorption. Put simply, certain cells arise within a tooth root that eat away and dissolve (resorb) tooth structure. Left unchecked, it could eventually lead to the tooth's demise.
Although its exact cause remains elusive, we suspect root resorption is associated with trauma to the gum ligaments earlier in life, perhaps from an injury or too much force applied during orthodontics. Other possible contributing factors include teeth-grinding habits or internal tooth bleaching procedures.
Root resorption in adults isn't that common, so your chances of experiencing it are low. But it is still possible, so you should be on the lookout for potential signs: Early on, it may appear as faint pink spots on teeth where the enamel has filled with the destructive cells eating away at the tooth. In time, these spots can increase to form cavities.
More than likely, though, your dentist may detect the problem during a dental exam. That's why regular dental cleanings and checkups are essential—a routine exam is a prime opportunity to uncover conditions like root resorption that silently undermine your teeth.
If found early, we can often treat root resorption effectively. We can often expose a small affected area with minor gum surgery, remove the harmful cells and fill any cavities with a tooth-colored filling. In some cases, we may recommend orthodontics beforehand to encourage a buildup of bone around the root by moving the affected tooth outward from the jawbone. If the resorption has affected the tooth pulp, you may also need a root canal treatment.
There is also the possibility with advanced resorption that the best course of action is to remove the tooth and replace it with a dental implant. So, keep up your regular dental visits—early detection and intervention can stop this destructive dental condition from destroying your tooth.
If you would like more information on root resorption, 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 “Root Resorption: An Unusual Phenomenon.”
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.”
What a difference forty years can make: Dental bridges once occupied the top spot for choices to replace missing teeth until the arrival of dental implants in the 1980s. Today, dental implants are the gold standard for dental restoration.
But although bridgework may have lost “first chair” in the orchestra of restorations, it's still a viable option. In fact, it can be the best option in certain situations.
Bridges consist of a series of porcelain crowns fused together like fence pickets. The center crowns, known as the pontics, “bridge” the gap left by a missing tooth or teeth. The crowns on each end, the abutment teeth, crown the natural teeth on either side of the gap to support the bridge.
Bridges are effective and durable, but with a major downside: To accommodate the abutment crowns, we must reduce the size of the natural teeth to which they'll be attached. This alteration can weaken those teeth's structure and require them from then on to have some form of restoration. They're also at higher risk for tooth decay.
Implants, on the other hand, don't require this alteration, and may also be more durable than bridges. Why then consider a bridge?
Price can be a factor: Implants may be more expensive, especially involving multiple teeth. Keep in mind, though, that this only compares the initial cost: Because implants have a 95% or more ten-year success rate, with further evidence they could potentially last for decades, they may actually cost less in the long-run than bridge restorations that have a higher chance of being replaced sooner.
But the prime reason is that some dental situations aren't suitable for dental implants. For instance, implants require a certain amount of bone for proper placement, so people with extensive bone loss may not be able to acquire them. Health conditions like uncontrolled diabetes or a compromised immune system can also complicate implant installation. A bridge in these cases may represent a better alternative.
With the help of your dentist, you'll need to consider your individual situation, dental and financial, in deciding between an implant or a bridge. And, if a dental bridge is your best option, it will be a solid choice for restoring your missing teeth and your smile.
If you would like more information on various dental restoration methods, 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 “Crowns & Bridgework.”
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