Dental Questions: Why do I have to wait for my implant crown?

If you have had an implant placed at our office or one of our specialists' offices, chances are you had to wait three to four months for the implant to heal before having a crown placed on it. Conversely, you may know someone who had an implant placed and left the same day with a (temporary) Crown. Why did you have to wait all that time for your crown? The reality is that there are hundreds of approaches to implant placement, and our office uses the most predictable and conservative method possible. 

Dental implants gain their rigidity in the mouth from two primary sources: the physical retention of the implant screw in bone and the growth of new bone around the implant. The screw force that develops immediately as the implant is placed is formally known as primary stability. This type of retention locks the implant and allows the new bone to form around the it, creating a phenomenon known as osseointegration or secondary stability. Osseointegration creates the definitive force that stabilizes the implant crown for daily use. 

Some techniques will rely on primary stability to support a crown on the implant immediately. In these methods, the screw force of the implant is absorbing all the forces of biting or chewing. Any movement or looseness would prevent new bone growth and could lead to implant failure. At Thousand Oaks Family Dentistry, we know a dental implant is a big investment into your future comfort and quality of life. We prefer to use the most predictable implant techniques and wait for secondary stability to develop. Waiting three to four months for your implant to fully heal is a small price to pay for better chances at success!

We know that choosing a treatment to replace a missing tooth can be overwhelming. At our office, we pride ourselves in offering patients all their treatment options, along with a thorough evaluation to help you pick the right choice. If you have any questions about dental implants, bridges or other tooth replacement methods, please give us a call!

Dental Questions: Can all teeth be saved with crowns?

Its easy to think of crowns as a save-all for cavities, cracked teeth and other dental disasters. Unfortunately, this is not the case. There are many situations where a crown will simply not improve the condition or longevity of a damaged tooth. The main benefit of crowns is that they restore strength to broken down teeth by creating a full coverage "cap" around the remaining structure. However, this means the tooth needs to have good gum and bone support along with some (minimal) amount of remaining tooth to hold on to. 

Firstly, a crown will do nothing to benefit a tooth with severe bone loss or gum disease. Splinting a tooth with periodontal disease to a healthy tooth may seem like a great way to stabilize roots and create a more sturdy anchor. However, research shows this is not the case and splinting teeth can actually create plaque traps that accelerate bone loss. In most instances, placing a crown on a tooth with poor bone support is ill advised and can further hinder its longevity in your mouth. 

In terms of restoring severe tooth decay or fractured teeth, crowns still have certain limitations. There needs to be a minimal amount of dental enamel and dentin above the gum line for the crown to be cemented upon. Procedures like root canals/posts, crown lengthening and orthodontics allow dentists to create more structure for the crown. However, there is a limit to how much can be done for a specific tooth. Generally speaking, teeth that are broken off at or below the gum line are usually impossible to save with a crown. If saving them is an option, it is almost always more economical and predictable to remove the tooth and replace it with an implant. 

Overall, crowns are an excellent way to recreate the bulk or body of a damaged tooth. Still, it is important to acknowledge their limitations. In some circumstances, removing the tooth in question and replacing it with a bridge or implant is the more favorable option. If you would like to know more about crowns, implants, bridges or other tooth replacement procedures, please give our office a call!

Dental Questions: Flossing around implants

Dental implants are a new and exiting technology that has changed the way dentistry is practiced. The ability to add single teeth (or spans of teeth) back to the mouth in a non-removable fashion is a miracle for many patients. However, implants must be maintained with the same hygiene routines as natural teeth, if not more rigorously. Flossing is a particularly important step, as it directly targets the leading cause of implant failure. 

A dental implant is essentially a titanium screw that is placed beneath the gums and into the jaw bone. A crown is either cemented or screwed on to the implant, allowing the gum tissue to heal around it and create the appearance of a natural tooth. While the bones will eventually integrate with the titanium in the screw, the gums never truly "attach" to the sides of the implant crown. The result is a deeper pocket than a natural tooth, with much more potential for food collection and inflammation. Flossing is an essential part of cleaning the sides of the implant and removing irritants and plaque from its pockets. Much like the progression of natural gum disease, unclean implants can develop gum irritation and accelerated bone loss. When used correctly, floss reaches areas that the toothbrush cannot reach and keeps inflammation to a minimum. Don't worry- the floss won't damage the implant crown or the screw underneath!

Implants are an investment that begs to be protected. Regular brushing, flossing and dental cleanings are the only way to ensure your new teeth for many years to come. If you have any more questions about cleaning implants, brushing your teeth or using dental floss, please give our office a call!

Dental Implant vs Bridge: Single Tooth Replacement

For most patients missing a single tooth, a fixed (non removable) and natural looking replacement is the number one priority. Historically, dental bridges offered these results by crowning the teeth adjacent to the missing space and "bridging" it with a false tooth. However, the rise of dental implants has created new opportunities to restore missing teeth without needing to modify the neighboring dentition. The best choice for your mouth depends on a number of biological and cosmetic factors. Take a look!

Dental bridges are an excellent way to restore missing teeth without requiring surgery or implant placement. The most obvious drawback is that the adjacent teeth need to be modified to receive crowns to support the bridging tooth. However, if both teeth already have crowns or large fillings, a bridge can seem like a more attractive option. The biggest hesitation towards placing a bridge is when one of the neighboring teeth is completely healthy and free of any previous dental work. From a oral hygiene standpoint, bridging two teeth creates a potential food trap and an area that is difficult to floss. You will probably need to use floss threaders to clean under and around this area. Cosmetics are difficult to judge on bridges. The height of remaining soft tissue, space to be covered by the false tooth and angulation of adjacent teeth will all influence the final outcome. 

Likewise, implants allow dentists to restore missing teeth independently of neighboring teeth. In fact, an implant does not even need a tooth on both sides of it to be placed. This is why implants are the first choice for replacement when the last teeth in the dental arch are lost. Since an implant is placed surgically, cosmetics can be managed via bone remodeling and gum grafting. A well placed implant is indistinguishable from natural teeth. However, implants have a long healing time, typically requiring 6+ months from insertion to final crown placement. In the meantime, patients are provided with a temporary denture called a flipper if cosmetics are a concern. Another consideration with implants is bone height and health. There needs to be ample space and width for the implant to be placed without damaging nerves, blood vessels or sinuses. Not every patient will qualify for implant surgery. 

Deciding between an implant or a bridge is ultimately your choice. However, an exam and conversation with your dentist can alleviate concerns and help guide you towards the option that suits your needs best. If you would like to schedule an exam or consultation, please give our office a call today!

Specialist Spotlight: Westlake Oral and Plastic Surgery

At Thousand Oaks Family Dentistry, we are proud of the network of skilled dental specialists we have created. Whether you are in our office or one of our associates’ offices, know that you will be treated with respect, kindness and experience. Today, we would like to highlight the surgical services offered by Westlake Oral and Plastic Surgery.

At Westlake Oral and Plastic Surgery, Doctors Donald Nikchevich, Michael Newton and Scott Bennion provide our patients with the best in surgical care. They approach every situation with years of experience and the latest in dental technology. We typically refer to Westlake Oral and Plastic Surgery for patients requiring dental extractions or implants. In both situations, technologies like cone beam CT scans and platelet rich plasma (PRP) applications ensure the best outcomes coupled with speedy and predictable recovery. 

With your referral appointment, be sure to check out the Westlake Oral and Plastic Surgery website to register with their office and add your medical history online. This helps streamline your surgical consultation and ensures accuracy of information. If you have any questions on your upcoming dental referrals or would just like to recap your treatment plan/options, feel free to give our office a call!

Website: www.scoms.com

Address: 911 Hampshire Road, Westlake Village, CA, 91361

 

Temporary tooth replacement for implants

This is an example of a typical stayplate with hidden metal/acrylic.

If you have been looking to have a tooth replaced with a dental implant, you were probably surprised to learn about the treatment time line. Some television shows and ads make implants seem like a single step process- you go to the dentist, they place the titanium anchor and attach a crown in a single visit. On the contrary, most implants need about six months to fully heal before being fitted with a crown. For patients replacing anterior teeth, this can be a huge esthetic concern. 

When preparing for anterior implants, careful planning and consideration can make the difference between "acceptable" results and "outstanding" results. With this in mind, we typically do not recommend putting an immediate load on the implant (placing a crown at the same visit as the surgery). This allows time for proper bone healing and gives us a chance to perfect the soft tissue around the anchor and create a natural gum line. However, you certainly can't walk around for six months with a missing front tooth!

To fill in the time between implant surgery and crown placement, we typically have our lab create a temporary partial denture called a stayplate. These devices, also known as flippers, are removable partial dentures that are made prior to implant placement. At the same visit as your surgery, you leave the office with the fitted stayplate replacing the missing tooth or teeth. They are typically made out of acrylic and metal and more closely resemble orthodontic retainers than traditional dentures. In most instances, the clasps, wires and acrylic are fully hidden from your smile, presenting only the replaced tooth!

We use stayplates as temporary tooth replacements in a number of circumstances. However, we do not use them on the back teeth (molars and premolars) to restore chewing function. Due to the design and materials used in stayplates, they cannot be used for eating and can cause irritation to the underlying gum tissue. For a full picture on stayplates and what they can accomplish, please give our office a call! 

Dental Questions: Who Places Dental Implants?

Implants represent a new shift in how dental offices can replace missing teeth. Never before have dentists been able to reproduce one or more teeth in a non-removable fashion without altering adjacent teeth. In the midst of this new treatment trend, many different general practices and specialists are placing implants. In this article, we hope to make sense of who offers implant surgeries and why they do so!

For starters, almost any licensed dentist can become trained to place implants. There is no specific requirement for a specialist to place them, and training programs are very common. As such, our office places implants on healthy, long standing patients in uncomplicated scenarios. We feel that any case beyond these parameters requires the expertise of a specialist.

Many times, an oral surgeon will place implants. They benefit from years of surgical training and managing medically complex patients. Most offices will offer various sedation options when providing the surgery. Periodontists also frequently perform implant treatment. Here, their specialized knowledge of gum tissue, bone characteristics and healing allows them to place implants in highly esthetic areas. They also typically offer sedation as a part of treatment. Other specialists, such as prosthodontists and endodontists may place implants on a case-by-case basis.

No matter who places your implant, know that your referral from Thousand Oaks Family Dentistry was made with the highest quality care in mind. We take surgical treatment very seriously and only refer patients to our trusted network of specialists. If you want to know more about implants and how they might improve your treatment options, please give our office a call!