Rebuilding bone in dentistry

Rebuilding bone in dentistry

I need to “grow” more bone before implant treatment, how do dentists rebuild bone? Thanks to research and technology, bone regeneration for implant dentistry is a usual and routine procedure in oral surgery. Understanding the principles of wound healing now allows for regeneration of bone to occur using a variety of techniques. Most include cutting through the gum to expose the bone and then augmenting the existing (insufficient) bone by adding bone grafting materials to it. Hence the name “bone grafting”. Grafting materials include your own bone (sourced from a secondary site), cadaver bone, bovine bone, or synthetic bone. All of these grafting materials have been processed so that they are inert and certified safe for human use. Your body will then grow its own bone around the graft, eventually replacing volume. Healing of the grafted material can be enhanced by using membranes which cover the grafts to promote and enhance healing. See more about how we do our bone grafts...
The hidden cost of missing molars

The hidden cost of missing molars

“I’m only missing a back tooth, you can’t even see it!” The real problem with tooth loss isn’t just aesthetics, it’s the subsequent bone loss. The alveolar bone, which surrounds the teeth, requires regular stimulation (piezoelectric effect – tiny stresses transmitted via the tooth) in order to stay healthy. Without such stimulation the bone will gradually be lost. It is a process of the body to take bone from where it’s not ‘needed’ to where it is needed. Studies have proven that a lost tooth can result in a 25% decrease in bone width in the first year alone, and will continue to decrease in subsequent years. As bone loses width and height, gum tissue also gradually decreases. Ability to chew and to speak can be impaired. The more teeth lost, the more function is lost. Bite collapse can occur when only some of the back teeth, which support the height of the face, are missing. This can cause the front teeth to be more stressed, squashed or pushed forward. Severe bone loss will also result in uncomfortable dentures or the inability to wear one at all. Fortunately, there is way to keep tooth loss from becoming bone loss: it’s the dental implant. Because the implant actually becomes fused to the living bone, it will continue to stimulate the bone and prevent loss. Molars, in fact, are usually the first teeth to be lost. Dealing with that first missing molar will help maintain the integrity of the jaw and the structures they support. Read here for an in-depth discussion on the benefits of dental implants and facial collapse. Photo...
Small procedure, big benefits – what is “crown lengthening”?

Small procedure, big benefits – what is “crown lengthening”?

Help! I recently broke a tooth at gum level when I bit down on an olive stone. I am worried that I might lose it. Can it be saved? Please come and see us as soon as possible! Crown lengthening is a common treatment procedure used to expose more tooth above the gum line where a tooth has broken at, or near, gum level. In order for your dentist to make a restoration such as a composite filling or a crown, sufficient healthy tooth has to be exposed above the gum line so that a restoration can be securely bonded. Crown lengthening is a surgical procedure that can be carried out using local anesthesia. Numbing is the same as numbing a tooth for a filling. Tiny little incisions are made inside the gum-line, both cheek and tongue side and the gum is teased open like a little flap. A minor amount of bone is then sculpted away from the tooth to “lengthen” the tooth surface, and this is where this treatment procedure gets its name. The gum is then replaced against that tooth leaving no open wounds, therefore, healing is quick and uneventful. Self-dissolving sutures are often used and minor anti-inflammatory drugs are given after surgery. These drugs are used for comfort and aim to reduce post-surgical swelling. This procedure should not be painful. There is the same amount of pressure and vibration as that which occurs during a typical filling.  A typical crown lengthening procedure takes about 60 – 90 minutes. Post-operative discomfort is minimal and you can go about normal activities the following day, avoiding vigorous exercise...
New crown sensitivity

New crown sensitivity

I just had a crown inserted and my tooth feels sensitive, what can I do? Yay, you have a new crown, but after a day that tooth starts to feel sensitive. Sensitivity vary from person-to-person so this can be a difficult question to answer unless you consult the dentist who placed your crown. It is helpful if you have identified as many of the facts and/or triggers for any symptoms you have. For example, are your teeth sensitive to temperature, taste, touch, pressure, or biting a certain way? It may be as simple as adjusting a minor high spot when you bite. It may even be the adjoining tooth that is sensitive. If you are having a cold, hayfever allergies or sinusitis, it may be referred pain due to the pressure in the sinuses. Some sensitivity is normal after a crown as the tooth settles down; however, increasing sensitivity or pain after a week or more warrants a follow up visit to your dentist to re-adjust and rule out newly developed...
Is oral surgery safe when I’m on Warfarin?

Is oral surgery safe when I’m on Warfarin?

Warfarin, and even more commonly used aspirin, are potent blood thinners and many people forget or don’t realise the need to tell their dentist they are taking it before undergoing surgery. Warfarin treatment does not automatically mean you can’t have teeth removed or undergo dental implant treatment. Indirectly though, surgery for anyone on blood thinners can be more complicated because blood will not clot normally and bleeding could be more difficult to stop. However, tooth removal is usually considered minor oral surgery, especially with a minimum of trauma in careful and experienced surgical hands. The surgeon who assesses your condition should work with your medical doctor to determine the risk and monitor your Warfarin dosage appropriately. Maintaining or reducing your dosage to accommodate minor oral surgery will depend on what condition you are taking the thinners for and the type of surgery you need. Your medical doctor may reduce your Warfarin dosage based on the PT/INR levels, which together with local treatment (ie stitching) will ensure that you have sufficient ability to stop bleeding and heal well. The key is communication between you, your doctor, and your dentist. It is not considered safe for you to stop Warfarin completely without your doctor’s approval. For the surgical procedure, your dental surgical specialist will take special precautions to help insure blood clotting and healing after surgery. These include treatment of the surgical site with special haemostatic agents which helps stabilize a blood clot, carefully suturing the gum tissues to reduce the surface area of the wound opening, and putting pressure on the wound edges to prevent the capillaries (tiny blood vessels)...
Chip off the white block….

Chip off the white block….

“Is it that big of a deal? It’s only a tiny chip…” Chipping a tooth means you have lost valuable tooth structure and potentially compromised the integrity of the tooth. It may be bad enough that you may need a root canal if the chip is close to the pulp containing the nerve. Better to have it checked out sooner than be sorry later! As for repairing a chipped tooth, our dentists can usually fix minor chips with modern bonding techniques using composite tooth-colored filling materials. For larger chips that involve more tooth structure, they may suggest a crown (cap) or a veneer. Composite resins are tooth-coloured. They are a mixture of a plastic-based matrix with inorganic glass filler. The glass filler gives the resin wear resistance and translucency. The ratio of plastic matrix to glass filler in composite resins can vary depending on the circumstance it’s to be used for; biting areas will require more filler for strength, and smile zones- less. We want translucent, pearly teeth, not Tic Tacs! But there are some limitations. The larger the chip, the less effective composite fillings become as a long term solution because the material itself is not as strong as the tooth structure it is replacing. The composite can also stain and dull as it ages. However, it’s a good interim material until a patient can receive a porcelain restoration, which could be a better long-term material selection. But for a child or teenager, composite resins are an ideal material choice because their upper and lower jaws are still developing. The pulp chambers containing the nerves of their teeth...