FAQs About This New and Miraculous Procedure

How can sinus surgery contribute to the replacement of missing back teeth with dental implants?
Dental implants must be anchored the in bone to be successful. Maxillary sinus surgery can help regenerate bone that has been lost and is critically needed to anchor dental implants.

What are the maxillary air sinuses?
Inside the upper jaw, or “maxilla,” are structures known as the maxillary air sinuses, one on either side of the upper jaw. Each sinus is an air-filled space lined by a membrane. Upper back teeth are normally encased in the bone of the maxilla, below the sinuses.

Why is it important to replace missing back teeth?
Replacing back teeth restores the ability to eat, chew, and talk properly. The back teeth also provide facial and cheek support.

Why use dental implants?
Dental implants are the state-of-the-art method for replacing missing teeth.

Why does bone loss occur?
Unless special precautions are taken to prevent it, when teeth are lost, the bone supporting them is also lost.

If there is insufficient bone to anchor dental implants, what are the alternatives?
If all the back teeth are lost and dental implants cannot be placed, removable upper dentures may be the only alternative.

How do you determine whether a sinus surgical procedure is necessary?
The size, shape, and remaining bone of the maxillary sinuses influence whether you can have dental implants with or without a sinus surgical procedure.

How does surgery grow bone?
A small window is created in the sinus wall above where implants need to be placed. The sinus membrane is lifted and the space thus created filled with bone grafting and biologically active bone generating materials. The window is then closed and simply heals.

How is the surgery done?
The surgical procedures are performed from inside the mouth in the area just above the missing back teeth. They are generally carried out under local anesthesia (small shots, just like for a filling), sometimes with the addition of sedation or anti-anxiety medication.

How do bone grafts work?
Bone grafts act as scaffolds that the body replaces with its own bone. The most well researched bone substitute grafting material is currently bovine (cow) bone. All grafting materials are approved by the Food and Drug Administration. They are specially treated to render them completely sterile, non-contagious, and free of rejection factors.

What can I expect after surgery?
Moderate swelling and discomfort after surgery generally lasts for a few days to a week, about the same as having an upper impacted wisdom tooth removed. Supportive treatment usually includes a course of antibiotics to prevent infection and prescription strength medication of the aspirin or ibuprofen type. A decongestant may also be prescribed, if necessary. Healing is generally uneventful.

Who performs this surgery?
Maxillary sinus augmentations are usually carried out by oral surgeons, periodontists, or appropriately trained general dentists. Proper assessment of your situation and diagnosis are critical pre-requisites to the right procedure.

If you are missing upper back teeth, contact us today to schedule an appointment and discuss maxillary sinus augmentation. You can also learn more about this procedure by reading the Dear Doctor magazine article “Sinus Surgery: Creating Bone for Dental Implants out of Thin Air.”

When dentists talk to patients, they often use specialized vocabulary referring to various dental conditions. Do you understand what they mean when they use these words — or are you wondering what they are talking about?

Here's your chance to test your knowledge of ten words that have a particular meaning in the context of dentistry. If you already know them, congratulations! If you don't, here's your chance to learn what these words mean in the dental world.

Enamel
In dentistry, enamel is the hard outer coating of your teeth. It is the hardest substance produced by living animals. It is a non-living, mineralized, and composed of a crystalline form of calcium and phosphate.

Dentin
The dentin is the layer of a tooth that is just beneath the enamel. It is living tissue similar to bone tissue.

Pulp
When dentists speak of pulp, we mean the tissues in the central chamber of a tooth (the root canal) that nourish the dentin layer and contain the nerves of the tooth.

Bruxism
Many people exert excess pressure on their teeth by clenching or grinding them. This is called bruxism, a habit that can be very damaging to teeth.

Occlusion
By this we mean how the upper and lower teeth are aligned, and how they fit together. This can also be referred to as your bite.

Dental caries
This term refers to tooth decay. Dental caries and periodontal disease (see below) are two of the most common diseases known to man. Today, these diseases are not only treatable, but they are also largely preventable.

Periodontal disease
A term for gum disease, this term comes from “peri,” meaning around and “odont,” meaning tooth. It is used to describe a process of inflammation and infection leading to the progressive loss of attachment between the fibers that connect the bone and gum tissues to the teeth. This can lead to loss of teeth and of the bone itself.

Erosion
When you consume acidic foods or drinks, the acids in your mouth react directly with minerals in the outer enamel of your teeth, causing chemical erosion. This is not the same as tooth decay, which is caused by acids released by bacterial film that forms on your teeth (see below).

Dental implant
A dental implant is a permanent replacement for a missing tooth. It replaces the root portion of the tooth and is most often composed of a titanium alloy. The titanium root fuses with the jaw bone, making the implant very stable. A crown is attached to the implant and can be crafted to match your natural teeth.

Plaque
Dental plaque is the whitish film of bacteria (a biofilm) that collects on your teeth. Your goal in daily brushing and flossing is to remove plaque.

Contact us today to schedule an appointment to discuss any questions you may have about your teeth and gums. You can also learn more by reading Dear Doctor magazine article “How and Why Teeth Wear.”

Guidelines regarding the concentration of fluoride in water have recently been changed by the US Government's Department of Health and Human Services (HHS) and the Environmental Protection Agency (EPA). These agencies recommended a reduction of fluoride in water supplies to 0.7mg/L, modifying the original recommendations provided in 1962 by the US Public Health Service.

What is fluoride, and why add it to water supplies?
Fluoride is a chemical form of fluorine, a naturally occurring element. For decades, scientists have carried out studies on the effects of fluoride in water, and they have proved that fluoride strengthens tooth surfaces and makes them resistant to decay. A fluoride concentration of about one milligram per liter (1 mg/L), or 1 part per million (1ppm), in the water supply is associated with substantially fewer cavities. This concentration of fluoride (equivalent to a grain of salt in a gallon of water) has been found to have no negative health effects.

The Center for Disease Control (CDC) says that fluoridated water is one of the ten most effective public health measures of the 20th Century. The optimal amount of fluoride necessary to make teeth resistant to decay turns out to be between 0.7 and 1.20 milligrams per liter (mg/L). A certain amount of fluoride occurs naturally in water supplies, and communities have added fluoride to bring the amount up to the optimal recommendations.

How does fluoride you drink get into your teeth?
The fluoride you drink in your water is deposited in your bones. Bone is an active living substance that is constantly broken down and rebuilt as a normal body process. As this happens the fluoride is released into the blood, from which it can enter the saliva and act on the tooth surface.

What about fluoride from other sources?
Americans now have access to many sources of fluoride in addition to the water they drink. These include foods, beverages and toothpaste. As a result, dentists have begun to notice an increased prevalence of a condition known as Dental Fluorosis.

What is Dental Fluorosis?
Dental Fluorosis can occur when teeth, particularly in children, receive too much fluoride. This condition is a mottling or uneven staining of the tooth surface enamel. There may be small white spots or extensive brownish discolorations. The mottled enamel is still resistant to decay, but it may be unattractive in appearance.

What is the idea behind the new guidelines?
With the new guidelines, fluoride is kept at the lower end of the scale of the optimal concentration for strengthening teeth against decay. At this end, there is room to add consumption of fluoride from other sources such as foods or toothpaste. In short, it is the best of both worlds.

Contact us today to schedule an appointment to discuss your questions about fluoride. You can learn more by reading the Dear Doctor magazine articles “Fluoride & Fluoridation in Dentistry” and “New Fluoride Recommendations.”

There's a lot to like about dental implants, today's state-of-the-art tooth-replacement system. We consider them the best choice for replacing missing teeth because implants are:

Healthy
You may not realize this, but when a tooth is missing, the bone underneath it begins to melt away. That's because bone needs constant stimulation to rebuild itself and stay healthy, and it receives this stimulation from teeth. It's a delicate balance that's disrupted by the loss of even one tooth. Because implants are made of biocompatible titanium, they actually fuse to the bone and prevent bone loss.

Strong
The fusion of implant to bone is an extremely solid connection. Not only does it offer a strong replacement for a missing tooth, but it can also offer support to other tooth-replacement methods such as fixed bridges or dentures. By themselves, these other methods would not preserve bone and might even hasten its loss in the case of dentures. But with implants, bone-loss is prevented — as is embarrassing and uncomfortable slippage of dentures.

Aesthetically Pleasing
When you receive your implant, it is left alone for a few months to complete the fusion process described above. Then it is topped with a crown made of a realistic tooth-like material. The result is so convincing as a tooth replacement, only you and your dentist may be able to tell it's not a natural tooth.

Long-Lasting
Dental implants have an amazing success rate — over 97%. And once they fuse to the jawbone, they should never need replacement. In fact, they will likely outlast the crowns to which they are attached, but this is not a problem. Implant crowns are precision components that detach for easy replacement, should the need arise.

Economical
Implants have a higher initial cost than other forms of tooth replacement, but when you consider how long they last, they are very economical. Consider it an investment in your health, appearance and self-confidence.

If you have any questions about dental implants, contact us today to schedule an appointment for an implant consultation.

You can read more about this topic in the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”

If your teeth have a worn appearance, it's possible you have a habit you're not even aware of: clenching or grinding your teeth. Also called “bruxism,” this destructive action causes your top and bottom teeth to come together or scrape past each other with a force that's many times what is normal for biting and chewing.

So what's normal? This can be expressed in terms of pounds. An adult usually exerts a force of 13-23 pounds to bite or chew food. But we have the potential to generate as much as 230 pounds of force, or 10 times what's normal. A “parafunctional” force of this magnitude applied repeatedly is bound to stress your teeth and other areas of your oral system. Besides wearing away the enamel of your teeth — and maybe even some of the softer dentin layer underneath — you may experience muscle spasms or pain in your jaw joints. Serious cases of wear can lead to “bite collapse” in which your face actually changes shape as your cheeks and lips lose support. This can make you look prematurely aged.

What can be done? To prevent further wear, we can fabricate for you a thin, plastic mouthguard that will protect your teeth at night or during times of intense stress. We can also recommend ways to temporarily relieve the discomfort that your grinding/clenching habits can cause. Heat and/or anti-inflammatory medication, for example, can be helpful.

If your tooth wear is minor (raggedness along the biting edge of a tooth or teeth) you may not need any restorative work. However, if tooth wear has already caused changes to your teeth and bite that you find aesthetically or functionally unacceptable, we can restore lost tooth structure in a variety of ways. Veneers and crowns are two examples.

If you have any questions about tooth wear or grinding habits, please contact us today to schedule an appointment for a consultation. You can learn more about this topic by reading the Dear Doctor magazine article “How And Why Teeth Wear.”