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 here.

The post Rebuilding bone in dentistry appeared first on South Steet Dental.

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.

The post The hidden cost of missing molars appeared first on South Steet Dental.

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 that may cause bleeding. Healing is usually evaluated in about a week to ten days. A period of approximately six to eight weeks is required prior to going ahead with final tooth restorations as it is important for the gum tissues to have fully matured.

There will be limitations as to the amount of crown lengthening that can be carried out in situations where teeth have more severe fractures. Orthodontic treatment may be recommended in some instances.

Having a small procedure such as crown lengthening will predispose successful, more permanent restoration and the survival of the remaining healthy tooth structure, so yes, if that broken tooth was healthy, it can be saved if you get it attended to immediately!

The post Small procedure, big benefits – what is “crown lengthening”? appeared first on South Steet Dental.

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 issues.

The post New crown sensitivity appeared first on South Steet Dental.

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) from bleeding excessively. It is also common practice to place a bone graft into an extraction socket to replace bone volume, especially important if you are contemplating implant tooth replacement.

This graft procedure may reduce the amount of bleeding.

Good pain control and anti-inflammatory medication, together with rest and avoidance of vigorous activity or aggressive irrigation of the wound will all help ensure a comfortable and safe recuperative period.

We will always give you aftercare instructions and provide you with after hours contact details should any concerns arise. You will usually be able to resume Warfarin (or aspirin for those who take it) afterwards under the direction of your doctors.

Be sure to consult with both your physician and dentist or surgical specialist even if you think you are on a low dose of blood thinners.

The post Is oral surgery safe when I’m on Warfarin? appeared first on South Steet Dental.

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 are still probably quite large. If permanent restorations like porcelain veneers or crowns were used instead of composite fillings, it would mean more tooth structure will need to be removed. In most cases it is better to use a temporary composite filling, and then consider a more permanent restoration once their teeth have fully developed.

The most important thing to remember is that if you chip a tooth, you should see a dental professional for proper evaluation and treatment. Problems are easier to fix when they are still small.

The post Chip off the white block…. appeared first on South Steet Dental.

Found during one of Henry’s travels:
A painting in the Leopold Museum in Vienna demonstrates the effects of facial collapse.

Facial collapse is a condition that occurs when a person has lost their teeth and his or her body starts to absorb the bone that once supported those teeth. It happens over a period of about 10 years as the bone in the jaw shrinks substantially.A person who suffers from facial collapse has a significantly altered appearance and looks much older than he or she actually is. In addition to the physical toll facial collapse takes on a person, it negatively impacts health.

How does facial collapse occur?

Bones need proper chewing forces to maintain their form and density. The compressive and tensile forces teeth exert on the surrounding bone stimulates the growth and density of the jawbone . When a tooth is lost, the lack of stimulation to its supporting bone will thus cause a decrease in bone volume and integrity. According to credible research, 25% of bone loss occurs during the first year after tooth loss and continues, sometime to the point of fracture.

A tooth is necessary for the development of facial bone, and stimulation of this bone by chewing forces is vital for maintaining its structure. This phenomenon has been ignored in the past and is currently being ignored by traditional dentistry. Dentists most often overlook facial bone loss that occurs after tooth extraction. The general public is often not educated about the anatomic, aesthetic, and functional consequences of continued bone loss. In actual fact, the bone loss often accelerated if the patient wears removable dentures.

Just as the body can absorb bone, the good news is that it can also rebuild.When teeth or dental implants are present in the jaw, a stimulus is sent to the bone that keeps it from dissolving away. This is called the piezoelectric effect, and it is one of the most important reasons for restoring missing teeth with dental implants.

If you’re missing all your teeth, it will be worthwhile in consider investing in dental implants. Placing eight dental implants in each jaw is optimal in preserving your bone. If that doesn’t fit your budget, then the more dental implants you can afford to have placed, the better.

To find out more in detail contact us for our free publication “Dental Implant Reference” where it addresses everything about dental implants.

The post Facial collapse documented on canvas appeared first on South Steet Dental.

Stationed in a foreign country, Alison sought to have a root canal treatment for a cracked front tooth, but awoke from sedation with all her healthy teeth removed.

In pain, unable to eat and ashamed of her appearance, she endured dentures which were “loose, bulky … uncomfortable”.

But in a turn of events, Alison is now smiling again after having implant surgery which restored her health and confidence.

Her case was documented by UK TV series Botched up Bodies.

To see a recent article on her horror story, read here.

The post Implants deliver a second chance appeared first on South Steet Dental.

Dentists are joining other health care practitioners who deliver these services. In fact dentists are the primary health care practitioners who would be best at delivering these procedures to the facial area in patients.

Expertise, safety and convenience can be achieved by combining cosmetic dentistry with enhancing surrounding tissues, all in one location, and at one appointment (see, it is about time, really!)

People often challenge that these procedures are best left to physicians, though nowadays registered nurses or physicians’ assistants are performing cosmetic treatments, from chemical and laser microdermabrasion, sclerotherapy (treatment of veins), to mesotherapy (injections as a form of fat reduction). Some registered nurses or “injection nurses” also deliver Botox and dermal fillers. Most would not have had the advanced tertiary training in facial anatomy and physiology, or understand pharmacology of the products and adverse affects.

But Dentists?

Dentists are advanced in their training in the oral and maxillofacial areas (that means the face from chin to forehead) than just about any other healthcare professional that is now allowed to deliver Botox and dermal fillers to patients. The dental operatory is a perfect (and convenient) setting for precise and safe delivery of Botox and fillers, and is equipped to handle complications should any arise.

Every dentist that has been trained in Botox and dermal fillers completely understands why they should be performing these procedures. Dental professionals already understand the physiology, skeletal structures, vascular and nervous system of the face, as well as overall facial balance and aesthetics.

There are not many healthcare professionals that know, or are concerned about, the proper ratios of lips to teeth as a dentist. Or study the smile considerations when patients go into a partial or a full smile, the “smile zone”, and how the teeth relate to the soft tissue surrounding the mouth.

Dentists are also much more familiar with how to handle complications in these facial areas than most other healthcare providers. Dentists do many more invasive procedures in the facial areas than all general physicians. The facial, peri-oral, and oral areas are what they work on every single day!

Botox and dermal fillers may seem foreign to our dental mindset. When teeth-whitening was first introduced into the dental market, many dentists called it malpractice! Dentistry today is about building confidence as well as a great smile. A smile is not just only about teeth.

It is time to really start seeing how Botox and dermal fillers in dentistry can help us.

The post About time! (and botox) appeared first on South Steet Dental.

She had a problematic canine which required a root canal and a crown. CEREC technology allowed this procedure to be done in minimal time, and in one single procedure. (Come on, which lion really wants to go back for that second appointment?) Importantly, it saved her from having a second round of anaesthesia – had it have been a conventional two-visit restoration.

Our patients too, can benefit from this technology here and now. Instead of waiting for 1-3 weeks for a new tooth to be created by the dental lab, patients can have their new tooth in one visit, one procedure.

CEREC is “Chairside Economical Restoration of Esthetic Ceramics”, or “CEramic REConstruction”, using CAD/CAM (computer aided design and computer aided manufacturing) technology.

For those who don’t like injections, CEREC technology is ideal. Patients can have the procedure carried out in one session so there is only the need to have one set of injections, if at all.

And hands up to those who like impression material? The gaggy expanding-foam-no-more-gaps type substance which comes in an oversized horseshoe-like tray. Be gone! 3-D scanners, like our dentists, are good-looking, slim, quick, precise and very safe.

CEREC technology also takes the control of the tooth creation away from the lab, who never sees the patient, and enables the dentist to create the tooth making any minor adjustments without having to send the tooth back and forth to the lab. The 3D scanner maps the whole surrounding including opposing teeth for a precise bite. Those with most of the original but compromised tooth can have it “copied” precisely.

A major bonus is that there is no need for the dentist to make, place and adjust a temporary crown while waiting for a dental lab to create the final tooth. Milling is done by a separate unit to the scanner, and takes around 10mins for a relatively simple crown. Colour is matched and applied onsite to closely resemble surrounding teeth.

To read the article and view the footage of Naomi having her tooth restored click here.

Of course, as each case is unique, there are some instances where CEREC would not be the best option. There is never a one-size-fits-all situation, so patients should always question which method is best for them and why.

There are increasing applications for CAD/CAM technology then ever before, and we are proud to say that we are, and will be, on top of these advances.

A new set of fangs (for Halloween perhaps), anybody?

The post CEREC technology makes instant crown for a lioness appeared first on South Steet Dental.