Bone loss following the loss of a tooth is inevitable. When you lose a tooth, the bone in your jaw no longer receives pressure signals when you bite down. Without these signals, the bone doesn’t get stimulated to keep regenerating & the body starts to resorb the bone material.

After tooth loss, this process starts immediately & progresses quite quickly: a year after tooth loss, a patient may have already lost up to a quarter of their bone width where the tooth used to be. The rapidity of bone loss is one the reasons it is important to have a plan to replace a lost tooth as soon as possible after loss.

Thankfully, dental implants can help prevent further bone loss because the titanium root structure reintroduces biting forces to your jawbone. However, if a good amount of bone loss has already taken place, bone grafting may be necessary in order to build up enough of a foundation for the implant to take hold.

What Is Bone Grafting?

Bone grafting is a surgical procedure that replaces missing bone that has been lost following the removal or loss of an adult tooth. Bone grafting usually takes place as a preliminary treatment before tooth replacement using dental implants.

While bone grafting is a fairly involved kind of oral surgery, it’s a procedure that makes it possible for more patients with a variety of dental situations to permanently replace their teeth. Not so long ago, patients who had lost significant amounts of bone due to missing teeth were told they weren’t eligible for dental implants. These patients were limited to less ideal or naturalistic solutions, such as bridges or dentures. Thankfully, dental technology & techniques have advanced so that bone grafting is a commonplace procedure that opens up a whole new world of beautiful & functional smiles to patients in need.

Procedure Overview

The details of a bone grafting procedure depend on the patient’s individual situation. Factors that determine the approach we take include where the bone grafting is taking place & how much time has passed since the missing tooth was removed. Bone grafting can occur immediately after a tooth extraction if necessary.

Think of a graft as a patch that fills in for missing material. In dental bone grafting, the materials that can be used are the patient’s own bone, donor bone from another person, animal bone, or a synthetic material. In all cases, the grafting material itself is not intended to fill the gap permanently, but to provide a foundation that encourages the patient’s own bone to re-grow into that space.

At the start of the procedure, an incision is made in the gums to expose the bone. Then, the bone surface is prepared & the transplanted material is placed. If your own bone is used, it is usually taken from another part of the jawbone, often near the back in the region of wisdom teeth. Finally, the bone graft is protected by the placement of a collagen membrane & the gums are closed back up with small sutures.

Discomfort after bone grafting is usually reported as minimal by patients. Over-the-counter anti-inflammatory painkillers, such as ibuprofen (Advil®), are usually all that’s needed to control pain during the recovery period. Depending on your health situation, we may also prescribe antibiotics as a precaution against infection. After the bone grafting procedure, we will monitor the healing & bone regeneration process. Several months may pass before the regeneration is sufficient to support an implant.

When you hear the world “crown” at the dentist, you probably think of the cap put over a tooth to repair & protect it. And you’d be correct. But there’s another meaning to the word “crown” in dentistry.

In general, “crown” refers to any tooth structure that sits above the gumline. The term can refer to the top part of your tooth that’s visible above your gums, a cap on a damaged tooth, or even the artificial tooth that is cemented to a titanium dental implant.

Crown lengthening is considered an oral surgery procedure & may be performed by either the dentist or a specialist, such as an oral surgeon or a periodontist (a dentist specializing in gum disease care). Based on your particular situation, crown lengthening may be done on one or several of your teeth, depending on what kind of other tooth repairs or replacements will follow. The procedure is simple enough that it can usually be performed right here in our office. To make you comfortable during the procedure, we will administer local anesthesia to keep you numb. If you are nervous about dental treatments, we can also discuss the possibility of using dental sedation to keep you relaxed.

What Is Crown Lengthening?

In a crown lengthening, the crown being referred to is the crown portion of your natural tooth. Dental crown lengthening is when gum tissue and/or bone is removed to expose more of a tooth, usually in order to repair it. If you have a tooth that is broken off at the gum line due to an accident or tooth decay, the dentist will need to perform a crown lengthening before repairing the tooth. That’s because there just isn’t enough tooth structure above the gums for an artificial crown (or a filling) to attach to. Trying to fit a crown on such a tiny foundation would make it ill-fitting, uncomfortable & at a higher risk of irritation, chronic inflammation, & further tooth decay & damage. It’s a better choice to remove some of the tissue around your tooth & seat the crown properly.

Procedure Overview

The first step in the procedure is to gain access to the structure of your tooth. The dentist will make small cuts in your gum tissue to pull it away from your tooth, allowing access to the tooth root & your bone. In many cases, the bit of bone will need to be removed in addition to gum tissue. After the bone has been reshaped, the entire area will be washed & the gums stitched back together. Remember, you will not be able to feel any of this during the procedure because we will keep the area totally numb.

Crown lengthening is considered minor surgery in part because patients report relatively little pain in the recovery period afterward. Nevertheless, we recognize that people’s pain tolerances vary & we’ll recommend or prescribe the proper pain management medications in order to keep you comfortable after your crown lengthening. We’ll also provide all the instructions you’ll need for home care in order to make sure the incisions heal properly & comfortably, including how to clean the area & brush your teeth.

After about a week, you’ll come back to the office & we’ll remove the stitches & check how the healing process is going. Once your gums are fully healed, we’ll make arrangements for you to come in for your permanent dental crown.

With today’s modern dental techniques & technologies, dental implants are the best choice for replacing missing teeth & restoring your smile to both beauty & functionality.

Because implanted teeth are fixed in the mouth—rather than being removable, like dentures—they allow a return to much of the comfort & function of natural teeth. Increased chewing ability means you can enjoy more nutritious foods, contributing to your overall health & wellbeing. Dental implants can help prevent future dental problems, especially the gradual bone loss in the jaw associated with missing teeth.

The biggest advantage implants have over dentures is that they’re permanent. Unlike removable dentures or partial dentures, implants do not involve messy adhesives or false teeth getting in the way of speech or eating. Also, because they’re permanent, implants will always be a perfect fit, unlike dentures which may need to be refitted or replaced over time.

What Are Dental Implants?

Dental implants are man-made replacements for natural teeth. The implants themselves are artificial tooth roots made from titanium & are anchored in the gum & jawbone. The implant’s screw-like shape helps it stay in place by providing more surface area for your bone to grow into, a process called osseointegration. Replacement teeth, referred to as crowns, are then permanently secured to these metal implants. They can improve your appearance, boost your self-confidence & allow you to speak with greater clarity than you would with missing teeth or ill-fitting dentures.

What are the quality of life benefits?

In addition to being beneficial to your nutrition, no longer being restricted from eating certain foods can certainly improve your mood! Most people with dental implants are able to enjoy all the same foods as people with natural teeth.

Of course, you may be even more excited about your beautiful smile. If you’ve had missing teeth or poor-fitting dentures, chances are you haven’t been confident in your smile for a while. You may have even been hiding it behind your hand or avoiding smiling completely. Many patients who have gotten dental implants report a spike in confidence & the urge to smile a lot, just because they can!

Some implant patients also experience an improvement in facial aesthetics. Your new implants mean your jaws will align properly, giving your face a more balanced & often more youthful appearance.

How long does treatment take?

Depending on your health condition & the type & number of implants you need, the implant procedure can take a day or a total of a few months.

In most cases when only one or a few implants are being placed, the first phase of treatment involves placing the implant in the bone of the jaw & allowing the bone to heal around it. The procedure itself takes 1-2 hours & the healing time can be 3-6 months. Once the dentist is satisfied that the implant is securely healed in place, the crown (i.e. the artificial tooth) will be attached to the implant. This takes one or two visits, depending on the situation.

For patients who are replacing all of their teeth at once, getting implants & prosthetic teeth placed in a single day is possible, though the overall healing time is usually about the same (3 months).

How long do implants last?

When properly taken care of just like natural teeth, dental implants should last a lifetime. In order to make sure your implants last, it’s important to follow all of the post-procedure instructions from your dentist. If you experience any pain or discomfort for an unusually long time after your procedure, please contact us right away.

Can anyone get implants?

Not all patients are eligible for dental implants. Generally, you must be in good general & oral health to be a candidate for implants. Those who are undergoing cancer treatment, have uncontrolled diabetes or uncontrolled periodontal (gum) disease, may not be eligible for dental implants. These conditions can affect whether the dental implant can be properly secured into the bone of your jaw, & can also affect post-operative outcomes. In creating your dental implant treatment plan, the dentist will assess all of the relevant health factors & advise you accordingly.

What are mini dental implants?

Those who may not be eligible for standard implants due to bone loss may be eligible for mini implants. Mini implants are smaller than standard implants so they don’t need as much space in the bone to be installed. Mini implants are used to secure an advanced kind of dentures or partial dentures. These dentures are much more secure than standard dentures because they clip on to the mini implants instead of being attached by adhesives. Patients who have implant-supported dentures are often able to eat many foods that they might not have been able to with standard dentures.

Mini dental implants can also be a slightly more affordable option for whole-mouth restoration than a full set of standard dental implants. You will need to have a consultation with the dentist in order to determine if mini implants are a good option for you.

What kind of care do implants require?

You care for your implants just as you would care for natural teeth: by brushing them for two minutes twice a day or after meals, & by flossing daily. With proper oral hygiene, your implants should give you a healthy smile that lasts the rest of your life.

How much do implants cost?

Because dental implants are a permanent solution & don’t need to be adjusted, refitted, or replaced, they are often more cost effective in the long run than bridges or dentures. At a minimum, you will usually pay at least several thousand dollars for dental implants, but costs vary greatly depending on the specifics of your dental condition & the dental plan we are recommending. We understand that many patients have concerns about the cost of dental implants, & while the initial cost may seem high, having a permanent replacement for your teeth may ultimately mean you pay less for dental care in the future. Dental implants are a great investment in the long-term health of your smile. If you are interested in dental implants but have concerns about the cost, we encourage you to talk to us about your financial options.

How are implants better than bridges?

The main way implants are better than bridges for replacing missing teeth is they don’t rely on attaching to surrounding healthy teeth in order to stay in place. Because bridges are attached to surrounding teeth, they require these healthy teeth to be reshaped in order to replace the missing tooth between them. Bridges can also put you at a higher risk of tooth decay in the supporting teeth, while a standalone implant does not.

For patients who have lost more than one tooth, an implant-supported bridge offers a secure & permanent solution.

Replacing missing or rotten teeth is essential to keeping your mouth healthy in the long run. A missing tooth can cause more trouble than just an unsightly gap in your smile. Tooth loss can cause your remaining teeth to shift around the gap, changing the alignment of your smile & even causing changes in your facial aesthetics.

Having missing teeth can also affect your ability to chew nutritious foods. Other tooth replacement options, such as removable partial dentures, aren’t as stable as implant-supported bridges. An implant bridge can return the majority of your chewing function so you can eat what you want again.

What Is An Implant-Supported Bridge?

While a standard dental bridge can prevent most tooth-loss-related problems, an implant-supported bridge has several advantages. Traditional bridges rely on adjacent teeth for support. These nominally healthy teeth need to be reshaped before the bridge is secured in place using dental cement. Using implants to secure the bridge instead means that no healthy teeth need to be ground down in order to replace a missing tooth.

How Many Implants Are Used?

An implant-supported bridge is a replacement for several teeth that is secured permanently to dental implants. The number of implants used to secure the bridge varies depending on the patient’s situation, but a common configuration is two implants supporting three teeth: two “cap” teeth on either end bridged by another tooth in the middle.

Dental implants can prevent the continuation of bone loss that occurs when a tooth is removed. When you lose a tooth, the bone in your jaw no longer gets the sensations of pressure from the force of your bite that tell the bone to regenerate. As a result, your body starts to resorb the bone & your jawbone shrinks in that area. With an implant-supported bridge, the implants help your bone feel the force of your bite so your bone stays stimulated. Bone resorption may still occur under the middle of the bridge, but it will be less problematic than bone loss associated with having a removable bridge or no bridge at all.

A fixed implant-supported bridge is a more cost-effective solution than individually replacing each missing tooth with its own implant & crown. However, it is more costly than most removable solutions because of the implant surgery involved. Which treatment you choose to replace missing teeth depends on your individual health & financial situation. We are always happy to discuss all the options with you.

Procedure Overview

Getting an implant-supported bridge takes several appointments.

• The first step is the placement of dental implants.
• After initial placement, it usually takes several months for the bone & gums around the implants to heal.
• Once implant sites are healed, the dentist will take impressions of your mouth in order to make a mold.
• Using the resulting model of your teeth, the lab technician will create your custom crown, color matched to your existing teeth.
• While the lab technician works on the final bridge, you may be fitted with a temporary bridge.
• Once the final bridge arrives the dentist will either screw or cement it in place on the implants.

Implant-supported dentures are a more permanent & secure option for replacing your teeth & restoring your smile. Implant-supported dentures combine the best parts of dental implants & dentures, providing a foundation for many teeth to be placed at once.

If you have lost all of your teeth on your upper jaw, lower jaw, or both, dentures can give you your teeth back. However, traditional dentures are not perfect. Because they sit on the gums, they might not be very secure, especially lower dentures, & you might be limited to eating more soft foods than you’d like.

Not everyone who has lost their teeth is eligible for regular dental implants. That’s because tooth loss (& dental diseases like periodontitis) leads to bone loss in your jaw. If too much of the bone in your jaw has dissolved away over time, there may not be enough bone structure left to anchor a full set of implants. However, because implant-supported dentures only require a few implants, the dentist can place them where bone density is best able to support them. If bone grafting is needed for implant-supported dentures, it will only be needed where the few implants will go & not the entire top or bottom jaw.

What Are Implant-Supported Dentures?

Implant-supported dentures are used as the foundation for a removable arch of replacement teeth—in other words, dentures. Unlike traditional dentures that are held on with suction or adhesive, implant-supported dentures clip onto the implants for a very secure fit. This added security is especially attractive to people who are replacing their bottom arch of teeth, because standard lower dentures are less stable than top dentures. This added stability allows most patients to start reintroducing tougher & harder foods back into their diet, which is great for both quality of life & nutrition.

In addition to a more secure fit, there are a few more major advantages to getting implant-supported dentures:

Implant-Supported Dentures Are More Affordable

Implant-supported dentures can be more affordable than regular implants because fewer implants are needed. Two, four, or six dental implants is often all you need to secure dentures. Another added cost-saving factor is the possibility of retrofitting your existing dentures to clip onto implant-supported dentures. If you’re already a denture wearer & are happy with your existing dentures or want to save money, it’s often possible to add snaps to your existing dentures so you can keep wearing them with your new dental implants. Of course, if you want to upgrade or redo the look of your teeth, we can create new custom dentures to go with your new dental implants.

Implant-Supported Dentures Can Help Stop or Prevent Bone Loss

One of the reasons you lose bone structure when you lose your teeth is because of the lack of sensation from biting & chewing. The roots of your teeth naturally transfer the force of your bite into your jawbone, thus stimulating bone to renew & regenerate itself continuously. When you lose teeth or have them removed, your jawbone no longer gets the signal to regenerate, even if you chew with dentures. With implant-supported dentures, the force of your bite can travel through your false teeth, into the implants & then into the bone. This can stimulate your bone & prevent future bone loss.

Talk to us at your next appointment about whether implant-supported dentures are a fitting restorative solution for you.

As dental professionals, our goal is to help you live a healthy life with all of your original teeth. However, there are times when we cannot save a tooth.

Sometimes it becomes necessary for a tooth to be removed because of crowding, disease or trauma. No matter the reason, we use a conservative approach with all tooth extractions. While the title of “oral surgery” sounds serious, most oral surgeries & extractions are routine procedures. Our experienced doctor will perform your procedure with expert skill to ensure the most comfortable recovery & the best possible result.

If not removed, a tooth that needs to be extracted can become problematic, resulting in pain, infection & other dental problems. But getting them removed doesn’t have to be an ordeal.

What Is A Tooth Extraction?

The kind of tooth extraction you are probably most familiar with is wisdom tooth removal. Because they often cause problems to nearby teeth & can get infected, wisdom teeth are often removed before or after they come in. Other causes for extractions include:

• Severe tooth decay
• Damaged, broken or infected teeth
• Teeth that do not come in correctly (or at all)
• Gum disease
• Making room for teeth to shift during orthodontic treatment
• Side effects from certain medications or treatments

Determining The Type Of Extraction You Need

We will determine which kind of extraction you need by taking x-rays beforehand. If the dentist decides that you need to have a tooth pulled, they will inject a local anesthetic drug to numb the tooth & the surrounding area. If you are anxious about this procedure, dental sedation can make you more comfortable. Please note that you will need someone to drive you home if you are given sedation.

If you need a simple extraction, the process is straightforward. The goal is to lift your whole tooth out of its socket. To do this, the dentist needs to widen the socket so the tooth can easily come out. Using a tool known as an elevator, they gently wiggle your tooth around to make a wider opening. When the tooth is loose enough, it can be pulled out with forceps (a tool similar to pliers or tweezers). You may feel some pressure as the tooth comes out of its socket. This surprises some patients, but there is no reason to worry about it; the local anesthesia ensures you will not feel pain. Once the tooth has been completely removed, the dentist will clean out the now-empty socket & apply medical gauze to stop any bleeding.

Surgical Extraction vs. Simple Extraction

There are two types of tooth extractions. The first is called a simple extraction. As you can probably tell from the name, this is a basic, minimally invasive procedure. When a tooth is entirely visible in the mouth, we can remove it without affecting the surrounding bone or gums.

The other type of extraction is known as a surgical extraction. Sometimes, a tooth or a piece of a tooth will be stuck below the gumline. In these cases, the dentist or oral surgeon has to move or remove gum or bone tissue in order to extract what is left of the tooth.

A surgical extraction is more complex. It differs from a simple extraction in two ways. First, your gums need to be moved away so the dentist or oral surgeon has direct access to the jawbone. The doctor will make a small incision & pull back your gums to make a “gum flap.” Second, they sometimes need to remove a small amount of bone from your jaw so they can remove stubborn tooth fragments that are stuck in the socket. Using a drill, they carefully remove as little bone as possible. This is surgery, so you will need stitches after undergoing a surgical tooth extraction. Your dentist or oral surgeon may also need to prescribe you pain medication for a few days following your procedure.

Aftercare

The most important part of tooth removal is the aftercare. Whether you have a simple or surgical extraction, you need to carefully follow your dentist’s or oral surgeon’s directions. Failing to properly care for the tooth socket makes it much more difficult to heal.

After you have a tooth removed, the empty socket eventually fills with a blood clot. Like a scab, a blood clot helps stop the bleeding. This is the beginning of the healing process, so your job is to make sure that nothing happens to that blood clot. Do not touch it!

For about three days after the extraction, you also need to avoid smoking, drinking out of straws, spitting or blowing your nose. All of these things create a level of pressure that can dislodge the blood clot & open the socket. If this happens, you will get what is known as a dry socket. Dry sockets are painful & require intervention. Please call us right away if you get one.

If you follow your instructions & avoid a dry socket, most of the major healing takes place within one or two weeks of the appointment.

After having a tooth removed, you may notice changes in your jaw. With a newly opened space, your teeth & jawbone can shift. Losing a tooth can have a major impact on your dental health & quality of life. If you want to prevent this, you can fill that space with a dental bridge or a dental implant. Contact us if you want to know more about your options for replacing a missing tooth.

Wisdom teeth, if not removed, can become problematic, resulting in pain, infection & other dental problems. But getting them removed doesn’t have to be an ordeal.
Some people get wisdom teeth that aren’t out of alignment, aren’t partly covered, & are easy to floss. However, wisdom teeth can continue to cause problems as you age, so they will still be monitored going into the future. Because it is often easier for a young adult to have their wisdom teeth removed, some dentists advocate for preventive removal. Consult your dentist to find out the right solution for your specific situation.

What Is Wisdom Tooth Extraction?

Wisdom teeth are the last molars that an average person grows, usually emerging in the late teens to early twenties. They are considered vestigial—important in a previous era, but no longer necessary—& the most common theory is that they helped early humans break down and chew tougher foods in ancient times. Sometimes, wisdom teeth do nothing strange & work perfectly well when they grow in, despite being technically unnecessary. For many people, however, they can cause serious problems.

Wisdom teeth can be impacted, or grow out of alignment with your other teeth. This means they might crowd nearby teeth, become trapped within the jawbone or grow out at a different angle. In extreme cases this can affect your other teeth. When this happens, they cause pain or damage other teeth, the jawbone or nerves.

Problems Caused By Wisdom Teeth

Even if they do not affect other teeth, wisdom teeth can be problematic in other significant ways. For example, sometimes they are partially covered by the gums. When this happens, food & bacteria often accumulate on & around the wisdom teeth, because the gum coverage—combined with their inconvenient position in the mouth—makes them difficult to brush & floss. This makes them more susceptible to tooth decay.

In some rare cases, wisdom teeth that don’t emerge can cause cysts to form in the gums above them. These can damage nearby teeth & bone. Even more rarely, the cyst might form a tumor, which can further damage your mouth & might require serious steps for removal.

Procedure Overview

The actual process of wisdom teeth removal is simple & painless. Depending on the situation, your dentist can perform the procedure, but it may require an oral surgeon’s expertise. Your dentist might refer you to an oral surgeon for complicated cases, such as teeth stuck under the gums. You will receive anesthesia or sedation, which come in a few different forms. Sometimes local anesthesia that causes localized numbing is enough, & you will feel pressure but no pain. Other times you will be sedated to a lower level of consciousness & will remember very little of the process. Rarely, you might be administered general anesthesia, be completely unconscious for the process & remember nothing afterward. In all of these cases, the wisdom teeth are removed while you feel no pain. When removed, any problems caused by your wisdom teeth should be resolved.

After wisdom teeth removal, it is important to listen to your dentist or oral surgeon’s advice on what to do. You do not want to cause any complications in the recovery process! While your practitioner will cover everything you need to know, there are some general tips that anyone who has just gotten their wisdom teeth removed should follow during the recovery process:

• Do not drink alcohol or smoke.
• Rinse your mouth very gently.
• Do not use a straw to drink.
• Do not blow your nose.
• Do not eat hard, crunchy or sticky foods—stick to soft foods like yogurt, broth & applesauce.

Some of these rules might be difficult to remember or seemingly insignificant, but it’s important to take them to heart—not doing so can make your recovery take longer! Following these general rules as well as anything else recommended by your dentist will ensure an easy recovery from your wisdom teeth removal.