20737 13 Mile Rd. Roseville, MI 48066

43570 Garfield Clinton twp., MI 48038

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Posts for: May, 2015

UsingSinusSurgerytoStimulateBoneGrowthforImplants

For a predictable outcome, a dental implant should be placed as soon as the bone and gum tissues following a tooth extraction have healed. But what happens if the tooth has been missing for months or years? You might then run the risk of not having enough bone to properly place an implant.

This can happen because of a disruption in the growth cycle of living bone tissue. As older bone cells dissolve (resorption), new bone develops to take its place. This is a dynamic process, as the amount and exact location of the new growth is in response to changes in the mouth, particularly from forces generated by the teeth as we chew. If, however, this stimulation transmitted to the bone no longer occurs because the tooth is missing, the bone will tend to dissolve over time.

In fact, within the first year after a tooth loss the associated bone can lose as much as a quarter of its normal width. This is why we typically place bone grafting material in an empty socket at the same time as we extract the tooth. This encourages bone growth during the healing period in anticipation of installing a dental implant or a fixed bridge. If, however, the bone has diminished to less than required for a dental implant, we must then use techniques to encourage new bone growth to support a future implant.

One such technique for restoring bone in the back of the upper jaw is to surgically access the area through the maxillary sinus (a membrane-lined air space within the bone structure of the face) positioned just over the jawbone to place grafting material. During surgery performed usually with local anesthesia, the surgeon accesses the sinus cavity, lifts the tissue membrane up from the sinus floor and applies the grafting material on top of the bone. Eventually, the new bone growth will replace the grafting material.

If successful, the new bone growth will be sufficient to support an implant. Thanks to this renewed growth, you’ll soon be able to enjoy better function and a transformed smile provided by your new implant.

If you would like more information on forming new bone for implants through sinus surgery, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sinus Surgery.”


ThatSpaceBetweenYourFrontTeethMaybeCausedbyOvergrownMuscle

The various structures in your mouth — your teeth and gums, of course, as well as periodontal tissues that hold teeth in place within the jaw — all function together to create your smile. This includes muscles like the frenum, a fold of muscle tissue that connects the gums to the upper lip, which helps pull the lip upward when you smile.

Unfortunately, an overly large frenum could contribute to an unattractive space between your two upper front teeth. The problem occurs when the frenum grows beyond its normal range and runs between the front teeth to connect with the gums behind them at the forefront of the roof of your mouth. The resulting space that may develop can be closed with orthodontics, but unless the excess frenum tissue is addressed the space may eventually reopen.

The frenum is just one cause among many for a noticeably wide space, including bite problems (malocclusions), finger-sucking habits or missing teeth. We would, therefore, need to examine your mouth to determine the exact cause before beginning any treatment. If indeed the frenum is the source of the problem, it will be necessary to ultimately remove the excess portion through a procedure known as a frenectomy.

A frenectomy is a minor surgical procedure performed by a periodontist, oral surgeon or a general dentist with surgical training. After numbing the area with local anesthesia, the tissue behind the teeth is dissected or reduced in size with a small scalpel or a surgical laser. The wound is then closed with a few stitches; any post-surgical discomfort is usually minimal and managed with non-steroidal anti-inflammatory pain medication. The wound will completely heal within a few weeks.

Most frenectomies are performed after orthodontics to close the space. Removing it prior to tooth movement may result in scar tissue that prevents the space from closing. It’s also easier for the surgeon to gauge how much tissue to remove after space closure to avoid removing too much, which can leave a “black” triangular hole where gum tissue should normally be.

Treating an abnormally large frenum isn’t difficult, but it needs to be coordinated with orthodontic treatment for the best outcome. The end result is a smile that’s both healthy and attractive.

If you would like more information on teeth spacing problems, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Space between Front Teeth.”


By David A.Susko DDS, PC
May 16, 2015
Category: Oral Health
Tags: oral health   nutrition  
UseSweetenerSubstitutesWiselytoReduceSugarinYourDiet

Although a variety of foods provide energy-producing carbohydrates, sugar is among the most popular. It’s believed we universally crave sugar because of the quick energy boost after eating it, or that it also causes a release in our brains of serotonin endorphins, chemicals which relax us and make us feel good.

But there is a downside to refined sugars like table sugar or high-fructose corn syrup: too much in our diets contributes to conditions like cardiovascular disease, diabetes, and dental disease. On the latter, sugar is a primary food source for oral bacteria; the more sugar available in the mouth the higher the levels of bacteria that lead to tooth decay and gum disease.

Moderating your intake of refined sugars and other carbohydrates can be hard to do, given that many processed foods contain various forms of refined sugar. A diet rich in fresh fruits and vegetables helps control sugar intake as well as contribute to overall health. Many people also turn to a variety of sugar substitutes: one study found roughly 85% of Americans use some form of it in place of sugar. They’re also being added to many processed foods: unless you’re checking ingredients labels, you may be consuming them unknowingly.

Sugar substitutes are generally either artificial, manufactured products like saccharin or aspartame or extractions from natural substances like stevia or sorbitol. The good news concerning your teeth and gums is that all the major sugar substitutes don’t encourage bacterial growth. Still, while they’re generally safe for consumption, each has varying properties and may have side-effects for certain people. For example, people with phenylketonuria, a rare genetic condition, can’t process aspartame properly and should avoid it.

One alcohol-based sweetener in particular is of interest in oral care. A number of studies indicate xylitol may actually inhibit bacterial growth and thus reduce the risk of tooth decay. You can find xylitol in a variety of gum and mint products.

When considering what sugar substitutes to use, be sure you’re up to date on their potential health effects for certain individuals, as well as check the ingredients labels of processed foods for added sweeteners. As your dentist, we’ll also be glad to advise you on strategies to reduce sugar in your diet and promote better dental health.

If you would like more information on your best options for sweeteners, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Artificial Sweeteners.”


PreplessVeneerscanTransformYourSmileWithoutAlteringYourTeeth

Porcelain veneers represent one of the best values in cosmetic dentistry, capable of radically changing a person’s smile with little tooth surface preparation. Still, the small amount of tooth enamel usually removed to accommodate them will permanently alter the affected teeth, to the point they will require a veneer or other restoration from then on.

The traditional veneer has remarkable versatility for solving a number of minor cosmetic problems, correcting mild tooth positioning problems and replacing lost or damaged enamel. But to avoid an unnatural bulky appearance, a portion of the tooth enamel must be permanently removed to accommodate them.

In recent years, though, a new concept known as “prepless veneers” has emerged in the field of cosmetic dentistry. Understandably, this new, “drill-free” veneer application has caused a lot of debate among dentists and patients alike, with concerns of bulky, overly-contoured teeth resulting from the technique. But the concept is growing as many well-regarded dentists have incorporated both minimal prep and prepless veneers into their service offerings.

The prepless veneer offers a cosmetic solution that doesn’t alter the tooth permanently. Using techniques such as feathering, which tapers and blends the veneer seamlessly with the tooth at the gum line, we can avoid an unnatural appearance while offering patients a much less invasive outcome.

The main disadvantage of prepless veneers at this time is that they’re not appropriate in every case. In fact, careful patient selection is a key to a successful outcome. For example, relatively large teeth or teeth positioned too far forward don’t work well with an added layer of thickness.

If, on the other hand, you have small, short or worn teeth, or teeth overshadowed by your lips — just to name a few likely scenarios — then you may benefit immensely from prepless veneers without permanent alteration to your teeth. A detailed examination is your first step to finding out if this new technique could provide you with a less-invasive smile makeover.

If you would like more information on drill-free porcelain veneers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Porcelain Veneers without the Drill.”




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