While dental implants can eliminate many problems associated with missing teeth and give you back your smile, they are not for everyone. If implants interest you, make sure you understand their pros and cons.

What Are Dental Implants?

Dental implants offer an alternative to removable dentures and bridges. They replace the roots of teeth with a screw into the jawbone that supports a fake tooth or crown. Getting implants requires dental surgery, which takes about 90 minutes to complete. This can be completed with local anesthesia only, but many patients prefer additional sedation therapy such as I.V. Sedation, oral sedation, or nitrous oxide sedation. The process is not over in just one appointment. You typically need multiple dental visits over 4-12 months depending on multiple factors. Your dental implant surgeon and a restorative dentist should give you a plan outlining the timing of appointments as well as special instructions during the healing phase.

The decision to get dental implants requires careful consideration and a discussion with your dentist. Here are the pros and cons of dental implants:

Advantages of Dental Implants

One advantage significant to many patients is that most dental implants look natural. The crown that attaches to the screw going into the jawbone mimics a real tooth. Besides improving your smile, dental implants can solve other cosmetic issues, like collapsed cheeks, crooked teeth, and sagging skin.

Dental implants do not just look like natural teeth; they also function like so. The crown attached to the implant allows you to chew and drink with the ease you might not get from dentures or bridges. You may also see improvements in how you talk because the air passing through your mouth when speaking will not be affected by any holes or gaps.

Perhaps more important than aesthetics is that implants are durable, especially the titanium kind. With a success rate of over 97% for 10 years, implants last a long time. Even after 15 years, the success rate of dental implants can be as high as 94%. In contrast, dental bridges need replacing every 5-15 years.

Replacing lost teeth with implants helps keep your remaining teeth in place. Gaps can cause the other teeth to shift around to make up for the space, becoming misaligned. This often results in a compromised appearance and eating difficulties.

Dental implants are also helpful in preventing bone loss. When you lose a natural tooth, the empty tooth socket and that section of the jawbone no longer have a purpose. Because there’s no more pressure from the lost tooth, the body eventually breaks down and absorbs some of that bone. Evidence shows that an implant preserves that part of the bone, slowing the absorption rate.

Alternatives to implants are dentures and dental bridges, typically less expensive but not permanent. Also, compared to dentures and bridges, implants tend to look and feel more natural, require less daily care, are more comfortable when chewing, and last longer.

Drawbacks of Dental Implants

For some people, the most significant disadvantage of implants is the cost. They can be more expensive than other options, and dental insurance might not cover them. The price for just one dental implant can be around $5,000. Fees are region specific and can vary from dentist to dentist based on experience and reputation. There can also be additional expenses for extracting a tooth or placing a bone graft. If you replace all your teeth with a full mouth of implants, your bill can go up to $50,000-$100,000.

Implants require dental surgery, which can be intimidating to many anxious patients. As previously stated, the process can take up to 12 months and requires multiple appointments. As with any dental surgery, getting implants poses some risks, including infection, potential implant failure, early stages of receding gums, bleeding, nerve and tissue damage, and adverse reactions to anesthesia. However, all these risks are rare, and most people find the advantages of dental implant therapy far outweighs the risk.

Another con is that dental implant surgery is not for everyone. To be a good candidate for the procedure, you must be in relatively good dental and overall health. A blood clot disorder, uncontrolled diabetes, or metabolic bone disease may make ineligible. You also should not have implant surgery if you smoke heavily or are undergoing cancer treatment.

Finally, even if you go through with the procedure, a dental implant might not take if you are experiencing stages of receding gums. The gums are crucial in supporting teeth and their roots, or screws in the case of implants. Any receding gum stages may compromise the stability of implants and increase their chance of failure. Gum recession can also interfere with proper maintenance, making cleaning in and around the implants difficult. Patients at risk due to gum disease are advised to have gum disease treated and under control prior to dental implant therapy.

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Is periodontitis contagious? There is research suggesting that it can spread from person to person through saliva. With over 47% of adults having some form of periodontal disease, it is important to understand periodontitis and the conditions that increase its likelihood of spreading.

What Is Periodontitis?

Gum diseases vary from mild gum inflammation to more severe stages that involve damaged soft tissues and bone, ultimately leading to tooth loss. The earliest stage is gingivitis, when a bacterial infection develops from a buildup of plaque, the sticky substance that accumulates on teeth even with regular brushing.

With early gum disease, the gums can be tender, swollen, and red. These reactions are the result of the body’s immune system attacking the bacteria to protect against an infection. If you identify gingivitis early enough, you may be able to prevent some or all of the damage.

Gingivitis that goes untreated typically evolves into periodontal disease, which not only infects the gums but also starts to break down the connective tissues and bone. This is all the result of the body trying to protect itself against a foreign body stuck in the gums like a splinter in your skin. Unfortunately, that tarter, also known as calculus, which is cemented to the tooth now makes the tooth the target. If the calculus isn’t removed from the tooth, it may result in bone loss, tooth mobility and eventual loss of the tooth/teeth. Periodontal infections are also common with more advanced forms of severe periodontitis. The immune system plays a huge roll in the progression of gum disease. Factors that affect the immune system include: stress (both physical and emotional), diet, health, age, weight, and medications.

You may have periodontal disease if you experience any of these symptoms:

• Bleeding when brushing or flossing, or red on your toothbrush bristles
• Changes in how your teeth fit together when you bite down
• Dark red or purple gums
• Gums that bleed easily or are tender or swollen
• Pain when chewing
• Persistent bad breath
• Pus between gums and teeth
• Receding gums
• Spaces that look like black triangles between teeth
• Teeth that are loose or falling out

While gum disease is not curable, treatments are available, depending on its severity. If you experience any of the symptoms of periodontal disease, see your dentist as soon as possible.

Is Periodontal Disease Contagious?

You may wonder “Can gum disease spread to another person?” While you are probably safe with brief, casual contact, long-term behaviors like kissing could increase another person’s risk for periodontal disease. You should also be wary of family settings where people share food and utensils or cough and sneeze near each other. Family members may also share some of the same habits such as diet and oral hygiene which can be significant factors contributing to the gum disease progression.

Researchers are still studying the extent to which periodontitis is contagious. Children whose parents have advanced gum disease are at greater risk for developing it, as are spouses and romantic partners. However, being in close contact that involves the exchange of saliva or bacteria does not automatically mean that you will develop periodontal disease.

Preventing the Spread of Bacteria Causing Gum Disease

Anyone can adopt behaviors that help prevent or control periodontal disease. The most effective prevention method is brushing and flossing daily to eliminate the bacteria that lead to gum disease. You should also schedule a dental check-up once or twice a year for a professional cleaning and to diagnose any early signs of gingivitis or other issues.

If you do develop gum disease, its progression depends to a large extent on your oral hygiene habits. Keeping the bacteria at bay or treating gum disease early may reduce the risk of spreading gingivitis or periodontal disease through saliva exchange.

Reducing the risk of infection among other family members or romantic partners requires good oral hygiene and treatment in more severe cases. If you need treatment, it is best to avoid kissing or other close contact until after recovery from your dental procedure.

Treating Periodontitis

If you have any symptoms of periodontal disease, seeing a dentist right away is crucial. After a thorough exam, they can recommend the best treatment for you.

If you have mild gum disease, you might be a good candidate for scaling and root planing. This procedure is like professional cleaning, but it extends to below the gums to remove plaque, tarter and/or calculus unreachable by a toothbrush or floss.

During scaling and root planing, the dental hygienist cleans or scales the tarter and then smooths (planes) the root surfaces to prevent new bacteria from accumulating. You may need a second appointment for the treatment to be effective, and you will likely receive local anesthesia. Once the tarter is removed and root is smoothed, it is critical to keep those surfaces clean with daily oral hygiene and regularly scheduled professional cleanings. This is a case where prevention is the best medicine.

Your dentist may recommend flap surgery if your gum disease is more advanced. During flap surgery, the dentist lifts back the gums to remove the tartar and plaque. After cleaning, the dentist sews the gums back together so that they close around the tooth.

Bone or gum grafting may be the best approach if you have bone or tissue damage. Grafting usually involves taking healthy bone or tissue from another part of the mouth and placing it where it can regenerate and replace the damaged parts.

To maintain the benefits of periodontal treatment, you must continue your oral hygiene to keep your gum disease under control. Although there is no cure for periodontitis, a reduction in the condition is possible with continued dental care and healthy dental habits at home. Even after successful treatment, you need life-long care to prevent the recurrence of infection and reduce the risk of spreading it to others.

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Dental implants are a popular way to replace missing teeth and restore your smile. More importantly, getting implants can help you avoid serious dental problems later.

What Are Dental Implants?

Dental implants are prosthetics that a dentist surgically attaches to the jawbone to hold dental restorations in place. An implant has a titanium (sometimes ceramic) screw resembling a root, which has a specialized surface that the bone fuses with over a 3-4 month healing time. This intimate connection between the dental implant and the bone is referred to as osseointegration. Once osseointegration is established, a dental restoration can be fabricated using a connector or abutment that holds the artificial tooth, bridge, or crown in place.

Although only 6% of people in the United States have implants, experts estimate that figure to grow to 23% by 2026. You also might not know dental implants can last a lifetime with proper care. However, the crown, bridge, or dentures on top may need replacement every 7-15 years. Those numbers can vary greatly depending on the technician, doctor and choice of materials selected for the dental restoration.

Different Types of Dental Implants

Patients considering dental implants should consult their dentist about the different dental implant types, including their pros and cons. The type of implant a dentist recommends depends on factors such as the number of missing teeth and the causes of tooth loss.

Endosteal Implant

Endosteal implants are the most common type, usually consisting of small, threaded titanium posts screwing into the jawbone – these are commonly termed “root form implants”. The new tooth (crown or bridge) attaches to the top part of the implant by way of a connector or abutment. Dental implants are commonly referred to a singular item when in fact they are three items: implant, abutment and crown or bridge (dental restoration). Some dentists are able to provide all the three services to complete a tooth replacement in one office while some other dentists prefer to refer to a specialist for the surgical or restorative aspects of the dental implant replacement. Endosteal implants are suitable for patients with removable dentures, missing teeth replacement, or as replacement for bridges. To be a viable candidate for endosteal implants, a patient must have good oral health and enough healthy gum tissue and jawbone.

Subperiosteal Implant

Subperiosteal implants may be ideal for patients without enough healthy jawbones to support endosteal implants. The dentist places this implant on top of the jawbone and under the gum, adequately holding it in place. This can be a wonderful service for some patients but it requires a very specialized lab working closely with a dental surgeon. Unfortunately, there are few of these teams left offering this service.

People who cannot wear traditional dentures might find subperiosteal implants ideal. However, as with endosteal implants, these implants are not suitable for people with poor dental health. Also, a patient still needs enough jawbone for this type of implant to be viable.

Mini Dental Implant

Mini dental implants are ideal for patients unable to get the traditional kind. While conventional implant screws consist of two pieces up to 5 mm in diameter, mini dental implants use only one screw that has a diameter of 3 mm or less. Some patients opt for these implants because they are less surgically invasive, and do not require as much jaw bone width. Typically, more mini dental implants are necessary to support a dental restoration vs. traditional root form dental implants. Additionally, mini dental implants are much more restrictive when it comes to a final dental restoration. They are typically reserved for supporting dentures and not crowns or bridges.

However, mini dental implants would not be ideal for patients wanting a permanent solution because they are only temporary. Also, they are not recommended for all types of tooth loss.

Zirconia Implant

Dentists began using Zirconia implants in the United States in 2007. Like titanium, Zirconia is biocompatible with the natural bone and gum tissue. This means the bone can grow around the implant forming a rigid connection with the body – known as osseointegration. Once integrated in 3-4 months, the implant is restored with a dental restoration such as a crown, bridge, or implant retained denture (full arch restoration).

While most titanium implants have two parts, most Zirconia implant have only one, giving dentists less control when placing them. There are some two-piece zirconia implants on the market, but they have not yet passed the test of time regarding durability. Another potential disadvantage of these implants is the cost per implant. Also, additional expenses are associated with materials, the procedure, mapping, and aftercare check-ups, bringing the per-implant cost to between $3,000 and $7,000. Many factors need to be considered to get an accurate estimation of fees, please consult a dental team to discuss your particular needs.

Zygomatic Implant

Zygomatic implants get their name from the cheekbone, into which the dentist inserts them. These implants only replace the teeth in the upper jaw, which can includes an entire upper arch of teeth.

Dentists can usually place zygomatic implants immediately. This type of implant can be an alternative for patients with insufficient jawbones or individuals who have had unsuccessful attempts at traditional implants or the bone grafts they often require. People with tooth loss in the lower jaw must explore additional tooth implant options such as subperiosteal implants or a ridge augmentation with bone grafting.

Same-Day Implant

Most patients who receive traditional dental implants usually have to go through months of visits and procedures. This wait typically includes getting temporary crowns while waiting for the permanent ones that come with the implants. In contrast, same-day dental implants are placed immediately after tooth extraction. It still constitutes an immediate implant if it goes in up to two weeks afterward.

Patients getting same-day or immediate dental implants undergo a single surgery, which means less pain and a much shorter recovery. Also, same-day dental implants can preserve gum tissue and bone, which may resulting in an enhanced esthetic result. In some cases, immediate dental implants can be restored with temporary crowns or bridges. While in other cases, they must be allowed to heal for 3-4 months prior to fabrication of a final dental restoration. It all depends on the patient specific factors and the stability of the dental implant upon insertion.

Patients trying to avoid multiple dental visits, wearing traditional dentures, or having a drawn-out recovery might opt for all-on-4 or full-arch immediate implants. As the name implies, all-on-4 implants consist of four dental implants supporting a full arch of teeth. Another term commonly used is all-on-X where “X” is the number of implants needed to restore the arch. The immediate teeth are usually acrylic teeth such as a denture or computer designed acrylic PMMA material. Either way, a strict soft food diet must be maintained for 3 months following immediately loaded all-on-4 implants. After healing, a final full arch implant restoration is fabricated. The final restoration can be made of either metal reinforced acrylic or porcelain. Porcelain is generally more durable than acrylic if done correctly.

All-on-4 implants can replace upper teeth, lower teeth, or both. Implantation requires a minor surgery, which involves inserting a small titanium screw to which the dentist attaches a denture or bridge. Patients needing between six and 10 implants or additional bone grafting after extraction should consider other options such as ridge augmentation and second stage implant surgery.

Blade Implant

Blade implants were among the first types used in North America, but dentists rarely recommend them today. To place blade implants, a dentist creates a tunnel(slot) in the bone, into which they press the blade, with the support or prong for the crown sticking out.

Blade implants are strong and hold well under stress. They provide the most function in the back of the mouth, which requires significant biting and chewing. However, other implants are more advantageous because they are root-based. Also, the failure rate for blade implants is higher when the dentist lacks adequate experience and knowledge of ideal candidates for the procedure.

Dental Implant Considerations

Regardless of which type of implant a patient chooses, they should expect some discomfort, swelling, bleeding, and bruising after the procedure. A dentist can prescribe pain medication to help make the patient more comfortable during recovery. Also, sedation dentistry is usually well accepted for dental implant procedures.

With proper dental hygiene and care, dental implants can last a lifetime. Healthy habits like flossing and twice-daily brushing can preserve their look and survival rate. Follow-up visits with a general dentist or periodontist can contribute to recovery and help address complications early.

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What Is Gum Disease?

Gum disease involves inflammation of the gums (gingiva), periodontium (supporting structures around each tooth), or both. Gingivitis is the mildest form of gum disease resulting from plaque, a sticky film of oral bacteria and food particles. Gingivitis only affects the gums, not the supporting structures of the tooth. Plaque contains bacteria that create acids, causing the surrounding gums to become swollen, red, and prone to bleeding.⁴ Plaque can also lead to cavities.

When plaque is not removed, it hardens into tartar, a hard substance covering teeth and requiring removal by a dental professional. Over time, tartar and plaque can damage the periodontium, which consists of the bones and connective tissue surrounding each tooth. This leads to periodontitis, a chronic disease resulting in tooth loss, and is one of the most severe forms of gum disease. Many factors contribute to gingivitis becoming periodontitis, but smoking and diabetes are the most significant.¹ Periodontitis can also occur around dental implants and is referred to as peri-implantitis.

Signs and symptoms of gum disease include:⁵

• Gums pulling away from teeth or teeth appearing longer
• Swollen, puffy, and red gums (healthy gums are pink)
• Painful gums
• Bleeding when you brush your teeth
• Adult tooth loss or loose teeth
• Continual bad breath

Your hygienist and dentist will evaluate your gums and determine the stage of gum disease present. If gingivitis is present, regular cleanings every six months should suffice as long as oral hygiene is maintained. If periodontitis is present, your dentist may recommend a professional treatment called scaling and root planing, which involves removing plaque and tartar below the gumline. The process of scaling and root planning may require more than one appointment and more frequent hygiene appointments. However, you may be wondering does mouthwash help with gingivitis or periodontitis.

Can Mouthwashes Prevent or Treat Gum Disease?

One of the primary ways to prevent or improve gum disease is to create a better oral hygiene routine, including using mouthwash. Oral hygiene begins with proper tooth brushing using fluoride toothpaste and flossing daily. You should brush twice daily for at least 2 minutes and always floss after brushing to remove any remaining plaque between the teeth. Colgate TotalSF is one of the best toothpastes for reducing plaque buildup, plaque-induced gingivitis, sensitivity, and stains. According to multiple studies, electric toothbrushes are more effective at removing plaque than manual toothbrushes.²

Mouthwash is not a substitute for brushing. Using mouthwash in conjunction with toothbrushing can improve the health of your mouth overall. While mouthwash can help prevent and treat gum disease, it is only effective if you brush and floss twice a day. Choosing the right mouthwash depends on your individual needs and preferences. So, the answer to whether mouthwash is good for gums is yes!

Which Is the Best Mouthwash for Gum Disease?

Cosmetic and therapeutic mouthwashes are the two main types of mouthwash, according to the American Dental Association (ADA). Cosmetic mouthwashes may assist with whitening teeth or masking bad breath (oral malodor). On the other hand, therapeutic mouthwashes are formulated to remove and prevent plaque buildup and are also called antibacterial mouthwash. If you have gum disease, you need an antibacterial mouthwash. In addition to over-the-counter antibacterial mouthwashes, prescription mouthwashes are also available.

Active mouthwash ingredients for periodontitis prevent plaque accumulation and can include fluoride, cetylpyridinium chloride, and chlorhexidine. Some mouthwashes also use hydrogen peroxide for whitening, and others use potassium nitrate to help sensitive teeth. However, the most effective mouthwash to combat plaque is chlorhexidine mouthwash, which is available only by prescription.⁶ Some clinical studies have shown that essential oils such as eucalyptus oil are just as effective at removing plaque as prescription mouthwashes.

Your local grocery store or pharmacy may have an overwhelming selection of oral care products and mouthwashes. It is best to avoid mouthwashes containing alcohol, as they can cause your mouth to become dry. Talk to your dentist about the best mouthwash for you.

Can I Prevent Gum Disease?

While certain health conditions may predispose someone to develop gum disease, most people can prevent gum disease by following these tips:

• Create a daily oral care routine
• Visit your dentist twice a year for regular cleanings and exams
• Avoid smoking and chewing tobacco
• Consume sugar in moderation

To learn more about how Sarasota Dentistry can help you maintain excellent oral health, visit our site.

References

1. Gasner, N. S., & Schure, R. S. (2022). Periodontal Disease. In StatPearls [Internet]. StatPearls Publishing.
2. Jain Y. A comparison of the efficacy of powered and manual toothbrushes in controlling plaque and gingivitis: a clinical study. Clin Cosmet Investig Dent. 2013;5:3-9. Published 2013 Feb 27. doi:10.2147/CCIDE.S40656
3. Rajendiran M, Trivedi HM, Chen D, Gajendrareddy P, Chen L. Recent Development of Active Ingredients in Mouthwashes and Toothpastes for Periodontal Diseases. Molecules. 2021;26(7):2001. Published 2021 Apr 1. doi:10.3390/molecules26072001
4. Rathee, M., & Jain, P. (2022). Gingivitis. StatPearls. https://www.statpearls.com/ArticleLibrary/viewarticle/22251
5. Torpy, J. M., Burke, A. E., & Glass, R. M. (2008). JAMA patient page. Periodontal disease. JAMA: The Journal of the American Medical Association, 299(5), 598. https://doi.org/10.1001/jama.299.5.598
6. Van der Weijden, F. A., Van der Sluijs, E., Ciancio, S. G., & Slot, D. E. (2015). Can chemical mouthwash agents achieve plaque/gingivitis control? Dental Clinics of North America, 59(4), 799–829. https://doi.org/10.1016/j.cden.2015.06.002

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What Is an Implant Overdenture?

An overdenture is a denture that fits over, and his held in place, buy either natural teeth, teeth roots and/or dental implants. These differ from implant bridges or hybrid dentures because they are removable. Dentists sometimes use these devices when they can save some implants or natural teeth to preserve the jawbone supporting and stabilizing the dentures.

Dr. Carl Misch classified two types of overdentures: RP-1 and RP-2. RP-1 overdentures are removable overdentures which are completely supported by implants. RP-2 overdentures are removable overdentures which are partially supported by implants/teeth and partially supported by soft tissue or gums. Here are three of the most common overdentures used today:

• Implant-supported bar overdentures require 3-6 implants inserted into the upper and/or lower jawbones. Each arch/jaw has a precisely fabricated bar permanently fastened to the implants. The overdenture then fits precisely over the bar to establish a snug adaptation to the jaw that is secure during rest and function of the mouth. Dentists and patients generally opt for this type to improve bone strength and keep the existing bone to prevent further weakening or corrosion, as well as, the better fit of a removable prosthesis. This is an example of an RP-1 overdenture.
• Implant-supported partial overdenture suite some patients who need a partial denture because they miss only a few teeth. Patients can remove these prosthetics, but they might not always be comfortable to wear because they can push against adjacent teeth and gums. This is an example of an RP-2 overdenture.
• Implant-supported ball overdentures contain ball-shaped struts or braces that connect the dentures to the implants. Compared to traditional dentures, this construction provides more functionality and stability. However, compared to the bar overdenture, they move more easily and require added maintenance. This is another example of the RP-2 overdenture.

The difference between regular dentures vs. overdentures can seem minimal regarding appearance and function. Like traditional dentures, the purpose of overdentures is to replace some or all of your teeth. Otherwise, most overdentures have added retention gained by remaining teeth or dental implants, therefore, cannot easily become loose like regular ones. Also, they tend to cost more, but they are more effective than conventional dentures at preventing bone deterioration and providing more comfortable chewing.

Implant Overdenture Procedure

As with any dental surgery, the first step to any overdenture implant procedure is to consult your dentist to determine whether you are a good candidate. Your dentist will carry out a thorough examination and ask about your dental and medical history. They will also take photographs and impressions to fit your teeth and bones properly. These images will also reveal the need for bone grafting or other supplemental surgeries. When talking with your dentist, discuss your budget and ask questions.

During implant placement, you will receive a local anesthetic. Additionally, you may desire oral or I. V. sedation for added comfort. After you are numb, the dentist screws the implants into the jaw bone, sometimes using 3-D imaging to know precisely where to place the implants. The surgery concludes with stitches to close the incisions.

Post-procedure care is essential for osseointegration, during which the bone grows around the implants to secure them. This healing process usually requires 3-6 months. After recovery, you will return to the dentist, who will verify the implants are stable and prepare them for impressions.

Now the dentist will take digital scans or make traditional impressions of your teeth and dental implants to send to a lab. Then, a lab technician will take your impressions and create your overdenture.

Once the overdenture comes back from the lab, the dentist will fit it in, making any necessary adjustments. A good fit means that the overdentures are stable and do not hurt when inserting, removing or using the prosthesis. The dentist will also provide instructions on cleaning and caring for your new prosthetic.

How Much Does an Overdenture Cost?

The cost of implant overdentures typically varies by procedure, the number of implants needed, and the specialist who places them. In general, they are more expensive than traditional dentures. Each implant can cost $2,000-$5,000, and patients can expect to pay $25,000 and up for one overdenture arch. The need for additional bone grafting must also be considered when factoring costs.

Pros and Cons of Overdentures

Patients choosing implant overdentures can enjoy their numerous benefits. For example, they allow for eating, talking, or sneezing without the possibility that dentures will slip or fall out. Although, still removable they are a wonderful remedy for missing teeth. Stable and secure overdentures can increase the wearer’s confidence and help them retain a more youthful look. More importantly, they help preserve the jawbone from further deterioration.

Despite their benefits, implant overdentures are not for everyone. They can be cost-prohibitive for some patients. Also, the procedure might not be successful if the patient does not have an adequate amount of jawbone to support the necessary implants.

Patients can turn to alternatives like removable dentures when cost and bone issues make implant overdentures unattainable. The traditional versions can provide comfort and give the wearer a more natural appearance. Another option is the partial denture, which restores function and prevents nearby teeth from moving because of tooth gaps or spaces. Finally, patients who want permanent prosthetics can opt for dental implant bridges which are by far the most superior option for permanent replacement of missing teeth. These permanent implant bridges are also referred to as full arch dental implants or implant hybrid dentures. These are considered the ultimate tooth replacement option since they are permanent replacement teeth which are never removed by the patient.

If you are considering implant overdentures, schedule a consultation with your dentist to learn about the different types, benefits, and risks. Your dentist will also recommend the best overdentures based on your budget and dental needs. They will also answer your questions and work with you to develop a treatment plan.

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More than half of adults in the United States have some form of gum disease, also called periodontal disease. Some individuals have inflamed gums, while others suffer from damage to tissues and tooth-supporting bone. If left untreated for too long, periodontal disease will result in tooth loss.

Maintaining dental health makes it easier to ward off other conditions like diabetes and heart disease. Preventing or treating periodontal disease can help protect teeth and gums for a lifetime.

Table of Contents

• Symptoms of Gingivitis and Periodontal Disease
• How Long Can Teeth Last with Periodontal Disease?
• Risk Factors For Developing Periodontal Disease
• Options for Reversing Periodontal Disease

Symptoms of Gingivitis and Periodontal Disease

Healthy gums are pink and firm, and brushing or flossing should not make them bleed. Every day, the teeth accumulate a hard-to-see film called plaque, which contains bacteria. Without proper brushing, this plaque-related bacteria remain on the teeth and can irritate and inflame the gums. Periodontal disease begins at the gums and can progressively affect the supportive tissues and bone.

Gingivitis can occur from bacteria build-up and is the mildest and earliest stage of periodontal disease. It causes symptoms like persistent bad breath, gum redness and swelling, painful chewing, tooth sensitivity, and gum recession that makes teeth appear longer. Gingivitis also makes gum bleed easily. Patients can often reverse early phases of gingivitis with daily brushing and flossing, antiseptic mouthwash, and regular dental cleanings.

Although gingivitis is considered a non-destructive form of periodontal disease, it can progress if it remains untreated. Over time, the accumulated plaque turns into tartar, which only professional cleaning can remove. If tartar builds up below the gum line, it can cause the gums to separate from teeth. The disease can move to the underlying bone and lead to further damage.

Teeth with Periodontitis

Periodontitis is a more advanced stage of periodontal disease. It occurs when gingivitis goes untreated and infection sets in. It can cause tooth loss, painful chewing, further separation of gums from teeth, bleeding gums, and other health problems. Eventually, periodontitis can break down the gums, connective tissues, and bones supporting the teeth.

Compared to the signs of gingivitis, symptoms of periodontitis can seem more severe. Indications include shifting or loosening of teeth, changes in how teeth come together when biting, pus between teeth and gums, as well as bleeding, and changes in how partial dentures fit.

How Long Can Teeth Last with Periodontal Disease?

Gingivitis can start small and seem unnoticeable at first, but it can manifest as gum inflammation and other uncomfortable symptoms. Over time Stress is a major factor in susceptibility to periodontal disease due to it’s ability to suppress the immune system. Age or disease may also, patients may experience widening pockets between the gums and teeth and destruction of the bone underneath. Although each patient is different, advanced and untreated periodontitis can eventually lead to tooth loss.

Loss of teeth is just one complication of periodontal disease. The damage-causing bacteria can also enter the blood via the gums and affect other body parts. There is a connection between periodontitis and other health conditions like diabetes, coronary artery disease, and respiratory disease.

What Are Risk Factors For Developing Periodontal Disease

• Stress – Probably the most important risk factor. It can be physical stress such as teeth grinding or emotional stress that affects the body’s immune defenses.
• Smoking or Chewing Tabacco – Major Risk Factor
• Poor Oral Hygiene
• Systemic Disease: Such as Diabetes or Immunocompromising Disease
• Malnutrition
• Pregnancy
• Cancer Therapy
• Medication
• Obesity

Options for Reversing Periodontal Disease

So can you reverse periodontal disease? Patients with milder cases of gingivitis can learn how to reverse periodontal disease with proper oral hygiene at home. If gingivitis does not go away or develops into periodontitis, some form of dental intervention will likely be necessary.

Some treatments include initial care by a dentist and follow-up treatment at home. For instance, a dentist might recommend scaling and root planing. Scaling involves removing the tartar below the gum line and root planing smooths over the roots’ surfaces so that the gums can reattach to the teeth. This dual procedure removes bacterial deposits and allows the gums to heal. Depending on the extent of the damage, scaling and root planing may require more than one dental appointment. Patients might need follow-up visits to monitor and treat reoccurrences.

Some patients with advanced periodontitis might need the help of a dentist who knows how to shrink gum pockets. Surgical pocket reduction or flap surgery removes tartar from the gaps. The surgeon also lifts the gums to clean thoroughly underneath them before suturing them. This procedure reduces or eliminates the pockets and prevents future infections. When insufficient amounts of the gums exist, a dental surgeon can perform a gum graft to regenerate the missing tissue.

Surgery cannot repair some advanced periodontitis cases, which is when tooth loss usually occurs. In such cases, patients can opt for dental implants to restore their smiles and everyday functions like talking and eating. Implants look natural and can last a lifetime with proper at-home care and regular dental check-ups.

In addition to surgery, prescription medication can provide relief and treat advanced periodontitis. A dentist can deliver antibiotic or antimicrobial medicine to target the bacteria and slow the progression of periodontal disease.

Although many individuals can learn how to reverse gum disease, the best treatment is prevention. Maintaining a consistent routine of daily flossing and twice-daily brushing with an electric toothbrush can go a long way toward preventing periodontal disease and subsequent tooth loss. Individuals might also incorporate regular rinsing with an antiseptic mouthwash. Eating a healthy diet and getting regular dental check-ups should also be part of an oral hygiene regimen.

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A winning smile can be an important part of a person’s look. However, when brown spots start to appear on teeth, self-confidence can diminish. Moreover, discoloration can signal underlying problems that require a dentist’s attention.

Brown spots on teeth can be prominent or barely noticeable and range from light yellow to dark brown. Some spots might not be spots at all but irregular or uniform lines. So, what causes brown spots on teeth? While brown spots often result from poor hygiene and pose an aesthetic concern, they could also be symptomatic of other health conditions, like celiac disease.

Table of Contents

• • Potential Casues of Brown Spots on Teeth
    • Poor Oral Care
    • Staining Foods and Drinks
    • Dental Fluorosis
    • Aging and Health Conditions
  • Symptoms Associated with Brown Spots
  • Treating Brown Spots on Teeth
    • Teeth Whitening
    • Porcelain Veneers and Dental Bonding
  • Prevention

Potential Causes of Brown Spots on Teeth

A person asking, “Why do I have brown spots on my teeth?” will find that this problem has several potential causes. One is the build-up of tartar, which consists of the plaque and other minerals that harden when brushing does not remove them. Tartar above the gum line leaves yellow, tan, or brown spots that can spread. When below the gums, tartar can look brown or black or cause gum recession and other dental problems.

Poor Oral Care

Poor oral care can result in tooth decay extensive enough to require a root canal. In some cases, the pulp, or connective tissue and nerves inside the tooth and root, can die, turning the tooth brown. Sometimes, damage to the nerves and roots and the resulting discoloration come from injury or trauma.

Staining Foods and Drinks

Individuals should watch what they eat or drink to prevent or minimize yellow, gray, or brown spots in their teeth. Caffeinated drinks like coffee and tea, red wine, blackberries, blueberries, and pomegranates can cause stains to accumulate if a person does not brush soon after consumption. Foods rich in carbohydrates and sugar can also cause discoloration. Finally, tobacco products can leave unattractive spots and stains, and it is best to avoid or quit this habit.

Dental Fluorosis

Sometimes in oral health care, there can be too much of a good thing, such as fluoride. Although it protects teeth, too much fluoride can lead to dental fluorosis, typically occurring in children whose baby teeth have yet to push through. Although fluorosis usually manifests in white markings, teeth can have pits and brown spots in rare, severe cases.

Aging and Health Conditions

Although many brown spots can be linked back to poor oral hygiene, some of them result from genetics or aging factors like darkening of the enamel. Also, medications like prescription mouthwash and some antibiotics can cause brown spots. Another cause not related to hygiene includes old dental work like metal fillings that cause brown spots and white fillings that accumulate stains over time.

Some health problems can create conditions that lead to brown spots on teeth. One such condition is enamel hypoplasia, resulting from malnutrition during pregnancy, vitamin deficiencies, or toxin exposure. Enamel hypoplasia can leave teeth with brown spots and a rough, pitted texture. Brown spots and other oral symptoms can also be a concern for people with celiac disease, an intolerance of food with gluten. People with celiac disease also have an increased risk for canker sores, dry mouth, and mouth ulcers.

Symptoms Associated with Brown Spots

Discoloration could be an early sign of a cavity that requires dental care. In addition to spots, a person might also experience gum bleeding, sensitivity, pain, or bad breath. An untreated cavity could result in gingivitis, which is a common form of gum disease. In any case, a patient should see a dentist as soon as possible if they notice brown spots on teeth near gums that bleed.

Treating Brown Spots on Teeth

A dentist can advise a patient on how to get rid of brown spots on teeth. Good at-home oral hygiene, including brushing twice and flossing once each day, is a good start. Smoking can cause brown spots over time, so it is best to avoid the habit or quit.

Teeth Whitening

Individuals might also consider over-the-counter whitening products, such as strips, toothpaste, or bleaching kits. Consumers should use products endorsed by the American Dental Association (ADA) and apply them regularly. However, they should avoid using whitening products too much because they could start to wear down the enamel.

People whose teeth do not respond well to at-home whitening methods should ask their dentist about professional whitening treatments. While they often require several appointments, professional whitening can remove brown spots on teeth effectively. Results can last a few years. The downside is that whitening only works on natural teeth and not on crowns or bonding.

Porcelain Veneers and Dental Bonding

A dentist can recommend other professional treatments for permanent or semi-permanent results. One type includes porcelain veneers, which are customized thin layers of ceramic that fit over front teeth. Not only do veneers cover up brown spots, but they can also correct teeth that are crooked, chipped, or have suffered decay.

Another professional solution to brown spots on teeth is cosmetic bonding, which involves fusing material to a tooth’s enamel to alter its shape and color. This process not only improves the look but also strengthens the tooth while helping it feel natural.

An alternative to traditional bonding and veneers is Bioclear, a treatment that restores teeth to their original, healthy look. During this process, the dentist wraps a thin sheet of mylar around the teeth and under the gum line to create a mold. Then, the dentist injects a liquid resin into the mold to generate a new surface. After hardening, the resin gets shaped to produce a natural, smooth look.

Prevention

Good oral hygiene will help keep teeth strong and healthy, as well as regular dental cleanings. Flossing daily and brushing at least twice a day will prevent many problems in the long run, including brown spots on teeth. Another excellent practice is to avoid smoking, which leaves unsightly stains on teeth.

Certain foods and beverages can leave stubborn brown spots over time. For instance, sugary treats like candy, desserts, and soda can cause tartar to build up. Other foods to avoid or consume minimally are white bread, potato chips, and other simple carbohydrates because they turn into sugars after consumption. Beverages like coffee and tea can also leave brown stains, but rinsing the mouth afterward can limit their impact on teeth.

Whenever eating sugars and carbs, a person should brush as soon as possible afterward. Foods that can enrich teeth include those with calcium, like cheese, milk, and yogurt. Calcium-based items can help prevent erosion of the enamel.

The post Brown Spots on Teeth: Causes, Prevention, and Removal appeared first on Sarasota Dentistry.

Patients dissatisfied by the color, look, or shape of their teeth might consider getting porcelain veneers. They are custom-made, thin layers of ceramic porcelain that provide a covering for the front of teeth.

Veneers can correct crookedness, stains, discoloration, chipping, and decay, thus improving the overall appearance of a patient’s smile. Veneers can also fix gaps and lengthen or shorten teeth, making them look more even and producing a natural look. Patients who experience acid reflux might also appreciate the benefits of veneers in restoring their smile.

Veneers typically require 3-4 visits to the dentist. To create a veneer, your dentist first has to mock up a design in the mouth using composite filling material. This allows the patient and the dentist to evaluate if the desired shape and color of the teeth are appropriate. After the mock up is completed, a full mouth digital impression is taken and full set of oral photos to document the accepted design. This information is then transferred to the dental lab. At the dental lab, a cosmetic dental technician then uses this data to help them design a digital wax-up of final porcelain veneers. The digital wax-up is then returned to the dentist for the veneer preparation appointment.

Veneer Preparation: In some cases, this requires no more than an impression of the teeth and is termed: No-Prep Veneers or Micro-Thin Veneers. While a traditional veneer preparation requires a very small amount of enamel removal be completed prior to the impression. The lab fabricated digital wax-up is then used to fabricate acrylic veneers in the mouth as temporary restoration while waiting on the final porcelain veneers. These temporary veneers aren’t required to stay on the teeth while you wait but they are critical to the cosmetic laboratory technician. It is critically important to take photos and an impression of the digital wax-up to share with the lab. That is the technicians blue print for the final design.

Veneer Delivery: during this visit, your dentist chemically bonds the veneer to your natural tooth. Before they are bonded, they must be tried in and verified by the patient. This is done by placing the veneers on the teeth one by one – checking and adjusting the fit. Once all of the veneers are placed on the teeth with try-in paste, the patient gives them a good examination and approval before the final bonding process begins. Once approved, they are cleaned carefully and prepared for bonding. The teeth are then cleaned, isolated and primed for bonding, removing a small amount of enamel to make enough room for the veneer. Thin resin cement is applied to each veneer prior to careful placement on the veneer to the tooth surface. All excess resin is removed prior to the application of a powerful curing light, which permanently bonds the veneer. Finally, any excess resin cement is cleaned from the teeth and veneers and the bite is checked and adjusted if necessary. The veneer placement procedure requires little to no anesthesia, making it a comfortable option for patients who worry about pain or discomfort.

Once installed, porcelain veneers require regular brushing and dental check-ups, making them relatively easy to clean and preserve. Patients who tend to grind their teeth while sleeping should wear a mouthguard (aka. TMJ Splint or Nightguard). Certain oral habits like biting nails or using one’s teeth to tear thread or open wrappers can damage veneers.

Table of Contents

• • Types of Veneers
  • Cost of Veneers
  • Advantages of Veneers
  • Disadvantages of Veneers

Types of Veneers

Veneers vary in type, depending on the procedure a dentist uses to install them. Traditional veneers are those previously described, which involve buffing down the enamel and some of the layers underneath to accommodate the shell. No-prep veneers require less or no alteration of the original tooth and usually require no anesthetic.

Not all porcelain veneers have the same appearance. Patients can choose from 12 styles to have their teeth reflect specific characteristics.

1. Aggressive—This style suits women and men who want to convey a strong personality. The design is generally square, with lateral and central incisors slightly curved or semi-straight.
2. Hollywood—Some men who want a robust set of teeth without appearing too aggressive might choose this style. These teeth look similar to Aggressive, but the lateral incisors are mildly offset or shorter than the central incisors.
3. Mature—This style is also similar to Aggressive, but the Mature set has slightly more pointed canines.
4. Vigorous—Another style like the Aggressive, the Vigorous has more pronounced canines, almost protruding like fangs.
5. Oval—The canines and incisors are more oval or rounded compared to the Aggressive.
6. Softened—This style looks like the Oval, but with less curving of the tooth edges.
7. Youthful—Another style similar to Oval, Youthful includes more protruding canines like the Vigorous.
8. Dominant—This style has square and round central incisors and pointed canines. The lateral incisors rest a bit higher than the central incisors and have rounded far corners.
9. Enhanced—Many beauty pageant contestants and female models who desire perfect-looking white teeth or photos choose this style. The Enhanced includes central and lateral incisors with slightly rounded edges, but the lateral incisors are shorter and higher than the central incisors. The canines have a blunt point.
10. Focused–This style is similar to Enhanced, except that the central incisors have square edges.
11. Functional–Another style like the Enhanced, the Functional has more pointed canines.
12. Natural–Except for canines that are even more pointed than the Functional, the Natural style looks similar to Enhanced.

Cost of Veneers

Veneer placement might seem daunting to patients who ask, “How much do a full set of veneers cost?” Because veneers are considered cosmetic, most insurance plans don’t cover the cost. Prices for traditional veneers typically range from $1800 to $2,500 per tooth, while no-prep veneers can cost between $1700-$2,500 for each tooth. An upper smile is 8-12 teeth and a full mouth can require 20+ veneers. Many factors are considered to come up with an appropriate number of veneers needed.

Advantages of Veneers

Porcelain veneers are a suitable option for patients who want a look just as natural as their original teeth and provides a more youthful appearance. Veneers can be an excellent solution for people who want to remove teeth stains but don’t see much improvement from whitening products or procedures. Compared to bonding, veneers tend to last longer and provide a more consistent color over time than bonding. Veneer surface texture and wear resistance are also superior to bonding.

As stated earlier, veneers take little more than regular oral care, such as brushing, flossing, and regular dental check-ups. While the procedure itself is not very invasive, it is time consuming in order to achieve optimal results. Therefore, you may be more comfortable working with a cosmetic dentist that offers oral or I.V. Sedation to perform the procedure. Sedation is not required but can make each visit much more comfortable.

Disadvantages of Veneers

One downside of porcelain veneers is that placing them requires more than one visit to the dentist. That’s because, after producing the mold, the dentist has to send that mold to a dental lab where a technician creates it. Patients have to go back to the dentist to have the veneers attached. However, this is not always true if the patient is seeing a CEREC dentist that offers same-day veneers.

Once you get veneers, you cannot go without them. Veneer placement is permanent because the dentist has to remove a bit of the enamel from the original tooth to fit the attached layer. Once you lose that enamel, you can’t get it back. However, if you have prep-less, no-prep or micro-thin veneers, the procedure is reversible.

Additionally, a set of veneers won’t last forever. Most shells are designed to last up to 15 years, but some patients can wear them for as many as 30. However, patients should expect to plan to replace them.

Although veneers consist of very strong material, they’re not damage-proof. It’s possible for veneers to chip or crack, which is why caring for them is important.

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A person’s smile is their calling card. Missing teeth can diminish that smile and rob them of their confidence and ability to talk or eat contentedly. That’s why permanent dentures might be an option for someone who has lost some or all of their original teeth. Permanent dentures, also called implant-supported dentures, are similar to traditional ones, but they provide the benefits that removable dentures often cannot deliver.

Permanent dentures can be complete or partial. While removable dentures rest on the gums, permanent dentures remain fixed to the jawbone with two or more implants. With their implant supports, permanent dentures are more robust and secure than alternative methods for replacing teeth.

Regardless of the method, replacing missing teeth preserves a person’s smile and facial appearance. On the other hand, leaving tooth gaps causes facial muscles to droop, making a person look older. Also, it’s more difficult to eat foods and talk without a full set of teeth.

Table of Contents

• • Cost of Permanent Dentures
  • Advantages of Permanent Dentures
  • Disadvantages of Permanent Dentures
  • Alternatives to Permanent Dentures
    • Removable Dentures
    • Permanent Dentures vs. Implants

Cost of Permanent Dentures

The cost of permanent dentures varies based on patient needs. More specifically, procedure pricing depends on whether the patient needs tooth extraction before the implants can be placed and how many implants are required. Nevertheless, the range for a permanent implant denture is between $20,000-$50,000 per arch (upper/lower). The fees can vary greatly depending on the bone quality, number of implants required and the quality of the restoration desired. Dental insurance doesn’t usually help too much with these cases. The maximum yearly benefit of a dental plan is usually capped at $1,000-$2,000. Financing options are usually available through third-party lenders if needed.

Advantages of Permanent Dentures

Overall, dental implant surgery is safe and effective, and permanent dentures can last a lifetime. Also, unlike traditional dentures that can rub against the gums and move around, implant-supported dentures stay in place, preventing discomfort and pain.

Permanent dentures are also easier to keep clean than removable ones. This is because the wearer doesn’t need to remove and soak them at the end of the day. Care is relatively simple with twice-daily brushing, Waterpik, interdental brushing, and regular dental check-ups.

Removing all of the teeth from the bone generally leads to progressive bone loss in a denture patient. When dental implants are placed in the jaw and loaded with an implant denture, it stimulates the bone and leads to preservation of the existing bone. Some studies have even showed bone growth to occur following a full arch implant denture functioning for years.

Permanent dentures can give the patient more confidence when speaking or eating. That’s because, unlike traditional dentures, permanent false teeth are more stable, and they won’t slip or become dislodged. Wearers can avoid embarrassment when sharing meals or engaging in conversation. Moreover, food might taste better because permanent dentures don’t cover the roof of the mouth.

Disadvantages of Permanent Dentures

Installation of permanent false teeth can be a complex process, especially if existing teeth need extraction. When a patient has teeth removed, they receive temporary dentures and have to go through a waiting period before they can undergo implants. Also, patients who don’t have enough healthy bone in their jaw will require bone grafting for the implants to attach properly. It is a bit more straight-forward of a procedure for patients already wearing a removable denture but the procedure is also done routinely on patients having teeth removed. There is still a transitional period in which your diet is restricted to soft/liquid foods for 12 weeks to allow the dental implants to adhere to the bone (called osseointegration).

Expense is another factor that patients should consider. Permanent dentures’ cost, including prosthetic replacement and surgery, makes them less affordable than other teeth replacement options.

As with any dental surgery, permanent denture placement comes with a slight risk of infection and inflammation. Also, chronic conditions like diabetes can get in the way of proper healing after surgery. Therefore, not all patients are good candidates for permanent dentures.

Although permanent dentures come with relatively few risks, they do require a well-trained dental specialist for placement. As of 2021, the ADA does not recognize dental implants as a specialty, however, the MIII (Misch Implant Institute) and ICOI both offer recognized fellowships in dental implant therapy. Patients should always discuss the procedure in detail with a provider to ensure they know all the pros and cons.

Alternatives to Permanent Dentures

Removable Dentures

With today’s technology, removable dentures are more comfortable than ever before. Although this solution might not always feel as natural as real teeth, traditional dentures look very realistic and fit securely. However, patients need to remove their dentures before going to bed and for regular cleaning.

It can take a few months to build dentures that look natural and fit properly in the mouth. Patients will need to replace or reline their dentures due to weight fluctuations or changes in the shape of the mouth or jaw. A reline is usually required once every three years due to the progressive bone loss which occurs under a complete denture.

Removable dentures consist of acrylic and replace a complete set of teeth on the lower or upper jaw. Upper dentures cover the gum area and the roof of the mouth, and they stay in place with suction. Lower dentures are shaped like a horseshoe, leaving space for the tongue, and they don’t require suction to remain secure.

Permanent Dentures vs. Implants

Patients who are only lacking a few teeth or need partials or bridges might consider dental implants. Whereas traditional bridges require that teeth adjacent to the gap be reduced, alteration of healthy teeth isn’t necessary for implants. As with permanent dentures, implants don’t become dislodged or move around, which can cause embarrassment and pain. Also, the patient doesn’t need to remove implants to clean them.

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