Office News

Posts for category: Dental Procedures

By J. Bradford Smith, D.D.S.
December 11, 2018
Category: Dental Procedures
CharlizeTheronBackinActionAfterDentalSurgery

When they’re introducing a new movie, actors often take a moment to pay tribute to the people who helped make it happen — like, you know, their dentists. At least that’s what Charlize Theron did at the premiere of her new spy thriller, Atomic Blonde.

"I just want to take a quick moment to thank my dentists," she told a Los Angeles audience as they waited for the film to roll. "I don’t even know if they’re here, but I just want to say thank you."

Why did the starring actress/producer give a shout-out to her dental team? It seems she trained and fought so hard in the action sequences that she actually cracked two teeth!

“I had severe tooth pain, which I never had in my entire life,” Theron told an interviewer from Variety. At first, she thought it was a cavity — but later, she found out it was more serious: One tooth needed a root canal, and the other had to be extracted and replaced with a dental implant — but first, a bone grafting procedure was needed. “I had to put a donor bone in [the jaw] to heal,” she noted, “and then I had another surgery to put a metal screw in there.”

Although it might sound like the kind of treatment only an action hero would need, bone grafting is now a routine part of many dental implant procedures. The reason is that without a sufficient volume of good-quality bone, implant placement is difficult or impossible. That’s because the screw-like implant must be firmly joined with the jawbone, so it can support the replacement tooth.

Fortunately, dentists have a way to help your body build new bone: A relatively small amount of bone material can be placed in the missing tooth’s socket in a procedure called bone grafting. This may come from your own body or, more likely, it may be processed bone material from a laboratory. The donor material can be from a human, animal or synthetic source, but because of stringent processing techniques, the material is safe for human use. Once it is put in place your body takes over, using the grafted material as a scaffold on which to build new bone cells. If jawbone volume is insufficient for implants, it can often be restored to a viable point in a few months.

Better yet, when grafting material is placed in the tooth socket immediately after extraction, it can keep most of the bone loss from occurring in the first place, enabling an implant to be placed as soon as possible — even before the end of a movie’s shooting schedule.

Will Atomic Blonde prove to be an action-movie classic? Only time will tell. But one thing’s for sure: When Charlize Theron walks down the red carpet, she won’t have to worry about a gap in her smile.

If you have questions about bone grafting or dental implants, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Immediate Dental Implant.”

By J. Bradford Smith, D.D.S.
December 01, 2018
Category: Dental Procedures
Tags: dental implants  
WithProperManagementDentalImplantscanbeaRealityforDiabetics

Many people with diabetes are hesitant about getting dental implants because they’re under the impression their chances of failure are greater than for non-diabetics. But if you’re one of the 26 million Americans with diabetes, that isn’t necessarily so — with a little extra precaution before, during and after implant surgery.

Diabetes is a group of diseases that affect how the body processes glucose. This simple sugar is used by the body to provide energy to cells, but can also cause damage if its volume level in the bloodstream is too high. The body normally regulates this through the hormone insulin produced by the pancreas.

The pancreas in people with Type 1 diabetes doesn’t produce insulin and so they must receive an outside source of the hormone through daily injections with careful daily monitoring of glucose levels. Those with Type 2 diabetes, the most common form of the disease, don’t produce a sufficient amount of insulin or the body no longer responds to the insulin produced. For either type, abnormal glucose levels — either too high or too low — can have adverse affects on the body, including blindness, nerve damage, gangrene, coma or death.

Diabetes can also slow wound healing, increase the risk of infection, and alter the body’s inflammatory response, all of which are major concerns when placing implants. Because implant placement involves minor surgery in which a wound results, there’s been wide concern that a slower healing process could increase the risk of implant failure.

Recent studies, though, are encouraging especially for patients who have their diabetes under control through medication, diet and exercise. Patients with poor glucose control are at higher risk, because it can take longer for the bone to heal around an implant after placement. For such individuals special considerations to guard against infection may be needed during implant surgery.

In fact, the implant success rate for most diabetics is about the same as for non-diabetic patients, 95%. With proper disease management and a little extra wound care, you can be among the many that experience a favorable outcome and a more attractive smile with dental implants.

If you would like more information on diabetes and dental care, please contact us or schedule an appointment for a consultation.

By J. Bradford Smith, D.D.S.
October 22, 2018
Category: Dental Procedures
Tags: dental implants   smoking  
DentalImplantsandSmoking-CauseforConcern

You probably already know that using tobacco causes significant health risks: It increases your odds of getting various cancers and coronary diseases, to name just a few. Unfortunately, not everyone is able to kick the habit, even when they know they should. Tooth loss is another issue that can cause trouble for your health, in the form of bone loss, malnutrition, and social or psychological problems. Dental implants are a great way to replace missing teeth — but does smoking complicate the process of getting implants?

The short answer is yes, smoking can make implant placement a bit riskier — but in the big picture, it doesn’t mean you can’t (or shouldn’t) have this procedure done if it’s needed.

Smoking, as you know, has harmful effects in your mouth (even leaving aside the risk of oral cancer). The hot gases can burn the oral cavity and damage salivary glands. Nicotine in smoke reduces blood flow to the soft tissues, which can affect the immune response and slow the processes of healing. At the same time, smoking promotes the growth of disease-causing oral bacteria.

How does this affect dental implants? Essentially, smoking creates a higher risk that implants may not heal properly after they are placed, and makes them more likely to fail over time. Studies have shown that smokers have an implant failure rate that’s twice as great as non-smokers. Does this mean that if you smoke, you shouldn't consider implants to replace missing or failing teeth?

Not necessarily. On the whole, implants are the most successful method of replacing missing teeth. In fact, the overall long-term survival rate of implants for both smokers and non-smokers is well over 90 percent — meaning that only a small percentage don’t work as they should. This is where it’s important to get the expert opinion of an implant specialist, who can help you decide whether implants are right for your particular situation.

If you do smoke, is there anything you can do to better your odds for having a successful dental implant? Yes: quit now! (Implants are a good excuse to start a smoking-cessation program.) But if you can’t, at least stop smoking for one week before and two weeks after implant placement. And if that is not possible, at least go on a smoking diet: restrict the number of cigarettes you smoke by 50% (we know you can at least do that!) Try to follow good oral hygiene practices at all times, and see your dentist regularly for checkups and cleanings.

If you have questions about smoking and dental implants, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine article “Strategies to Stop Smoking.”

By J. Bradford Smith, D.D.S.
October 02, 2018
Category: Dental Procedures
Tags: dental implants  
WhatYouShouldKnowAboutAntibioticTherapyBeforeImplantSurgery

Placing a dental implant within the jawbone requires a surgical procedure. For most people it’s a relatively minor affair, but for some with certain health conditions it might be otherwise. Because of their condition they might have an increased risk for a bacterial infection afterward that could interfere with the implant’s integration with the bone and lead to possible failure.

To lower this risk, dentists for many years have routinely prescribed an antibiotic for patients considered at high-risk for infection to take before their implant surgery. But there’s been a lively debate among health practitioners about the true necessity for this practice and whether it’s worth the possible side effects that can accompany taking antibiotics.

While the practice still continues, current guidelines now recommend it for fewer health conditions. The American Dental Association (ADA) together with the American Heart Association (AHA) now recommend antibiotics only for surgical patients who have prosthetic heart valves, a history of infective endocarditis, a heart transplant or certain congenital heart conditions.

But patients with prosthetic joint replacements, who were once included in the recommendation for pre-surgical antibiotics, are no longer in that category. Even so, some orthopedic surgeons continue to recommend it for their joint replacement patients out of concern that a post-surgical infection could adversely affect their replaced joints.

But while these areas of disagreement about pre-surgical antibiotics still continue, a consensus may be emerging about a possible “sweet spot” in administering the therapy. Evidence from recent studies indicates just a small dose of antibiotics administered an hour before surgery may be sufficient to reduce the risk of infection-related implant failure with only minimal risk of side effects from the drug.

Because pre-surgical antibiotic therapy can be a complicated matter, it’s best that you discuss with both the physician caring for your health condition and your dentist about whether you should undergo this option to reduce the infection risk with your own implant surgery. Still, if all the factors surrounding your health indicate it, this antibiotic therapy might help you avoid losing an implant to infection.

If you would like more information on antibiotics before implant 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 “Implants & Antibiotics: Lowering Risk of Implant Failure.”

By J. Bradford Smith, D.D.S.
September 02, 2018
Category: Dental Procedures
Tags: dental implants   smoking  
WhySmokingandDentalImplantsDontMix

With a 95-plus percent survival rate after ten years, dental implants are one of the most durable replacement restorations available. Implants can potentially last much longer than less expensive options, which could make them a less costly choice in the long run.

But although a rare occurrence, implants can and do fail—often in the first few months. And tobacco smokers in particular make up a sizeable portion of these failures.

The reasons stem from smoking’s effect on oral health. Inhaled smoke can actually burn the outer skin layers in the mouth and eventually damage the salivary glands, which can decrease saliva production. Among its functions, saliva provides enzymes to fight disease; it also protects tooth enamel from damaging acid attacks. A chronic “dry mouth,” on the other hand, increases the risk of disease.

The chemical nicotine in tobacco also causes problems because it constricts blood vessels in the mouth and skin. The resulting reduced blood flow inhibits the delivery of antibodies to diseased or wounded areas, and so dramatically slows the healing process. As a result, smokers can take longer than non-smokers to recover from diseases like tooth decay or periodontal (gum) disease, or heal after surgery.

Both the higher disease risk and slower healing can impact an implant’s ultimate success. Implant durability depends on the gradual integration between bone and the implant’s titanium metal post that naturally occurs after placement. But this crucial process can be stymied if an infection resistant to healing arises—a primary reason why smokers experience twice the number of implant failures as non-smokers.

So, what should you do if you’re a smoker and wish to consider implants?

First, for both your general and oral health, try to quit smoking before you undergo implant surgery. At the very least, stop smoking a week before implant surgery and for two weeks after to lower your infection risk. And you can further reduce your chances for failure by practicing diligent daily brushing and flossing and seeing your dentist regularly for cleanings and checkups.

It’s possible to have a successful experience with implants even if you do smoke. But kicking the habit will definitely improve your odds.

If you would like more information on dental implants, 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 “Dental Implants & Smoking.”