My Blog
By James V Gagne, DMD
November 15, 2019
Category: Dental Procedures
Tags: dental implant  
GettingaNewToothinOneDayWillDependonYourBoneHealth

If you've thought the ads for a “new tooth in one day” seemed too good to be true, we have…sort of good news. You can get a new “tooth” in one visit, but only if your dental situation allows it.

The restoration in question is a dental implant, a metal post (usually titanium) surgically imbedded into the jawbone. They're especially durable because bone cells naturally grow and adhere to an implant's titanium surface, a process called osseointegration. Over time this process creates a strong bond between implant and bone.

Usually, we allow a few weeks for the implant to fully integrate with the bone before attaching the visible crown. With “tooth in one day,” though, we attach a crown at the same time as we install the implant, albeit a temporary crown. It's more aesthetic than functional, designed to avoid biting forces that could damage the implant while it integrates with the bone. When that process finishes, we'll install a permanent porcelain crown.

The health of your supporting bone and other structures will largely determine whether or not you're a candidate for this “tooth in one day” procedure. Your bone must be sufficiently healthy, as well as the gums surrounding the implant and the tooth's bony socket.

If, on the other hand, you have significant bone loss, gum recession or socket damage, we may first need to deal with these, usually by grafting tissue to the affected areas to stimulate new growth. Your implant, much less a temporary crown, will likely have to wait until the affected tissues have healed.

The bone can also be healthy enough for implant placement, but might still need time to integrate with the implant before attaching any crown. Instead, we would suture the gums over the implant to protect it, then expose and attach a permanent crown to the implant a few weeks later.

Obtaining even a temporary crown the same day as your implant can do wonders for your appearance. A more important goal, though, is a new tooth that you can enjoy for many, many years. To achieve that may mean waiting a little longer for your new beautiful smile.

If you would like more information on restoring missing teeth with 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 “Implant Timelines for Replacing Missing Teeth.”

By James V Gagne, DMD
November 05, 2019
Category: Oral Health
Tags: fluoride  
FluoridatedDrinkingWaterHelpsCurbToothDecaySafely

The U.S. Centers for Disease Control and Prevention calls it “one of the ten most important public health measures of the 20th Century.” A new vaccine? A cure for a major disease? No—the CDC is referring to the addition of fluoride to drinking water to prevent tooth decay.

Fluoride is a chemical compound found in foods, soil and water. Its presence in the latter, in fact, was key to the discovery of its dental benefits in the early 20th Century. A dentist in Colorado Springs, Colorado, whose natural water sources were abundant with fluoride, noticed his patients' teeth had unusual staining but no tooth decay. Curious, he did some detective work and found fluoride in drinking water to be the common denominator.

By mid-century, fluoride was generally recognized as a cavity fighter. But it also had its critics (still lively today) that believed it might also cause serious health problems. Ongoing studies, however, found that fluoride in tiny amounts—as small as a grain of sand in a gallon of water—had an immense effect strengthening enamel with scant risk to health.

The only condition found caused by excess fluoride is a form of tooth staining called fluorosis (like those in Colorado Springs). Fluorosis doesn't harm the teeth and is at worst a cosmetic problem. And it can be avoided by regulating the amount of ingested fluoride to just enough for effectively preventing tooth decay.

As researchers have continued to learn more about fluoride, we've fine-tuned what that amount should be. The U.S. Public Health Service (PHS), which sets standards for fluoride in drinking water, now recommends to utilities that fluoridate water to do so at a ratio of 0.7 mg of fluoride to 1 liter of water. This miniscule amount is even lower than previous recommendations.

The bottom line: Fluoride can have an immense impact on your family's dental health—and it doesn't take much. Excessive amounts, though, can lead to dental staining, so it's prudent to monitor your intake. That means speaking with your dentist about the prevalence of fluoride in your area (including your drinking water) and whether you need to take measures to reduce (or expand) your use of it.

If you would like more information on how best fluoride benefits your family's dental health, 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 “Fluoride & Fluoridation in Dentistry.”

WhyemBigBangTheoryemActressMayimBialikCouldntHaveBraces

Mayim Bialik has spent a good part of her life in front of TV cameras: first as the child star of the hit comedy series Blossom, and more recently as Sheldon Cooper’s love interest — a nerdy neuroscientist — on The Big Bang Theory. (In between, she actually earned a PhD in neuroscience from UCLA…but that’s another story.) As a child, Bialik had a serious overbite — but with all her time on camera, braces were just not an option.

“I never had braces,” she recently told Dear Doctor – Dentistry & Oral Health magazine. “I was on TV at the time, and there weren’t a lot of creative solutions for kids who were on TV.” Instead, her orthodontist managed to straighten her teeth using retainers and headgear worn only at night.

Today, there are several virtually invisible options available to fix orthodontic issues — and you don’t have to be a child star to take advantage of them. In fact, both children and adults can benefit from these unobtrusive appliances.

Tooth colored braces are just like traditional metal braces, with one big difference: The brackets attached to teeth are made from a ceramic material that blends in with the natural color of teeth. All that’s visible is the thin archwire that runs horizontally across the teeth — and from a distance it’s hard to notice. Celebs like Tom Cruise and Faith Hill opted for this type of appliance.

Clear aligners are custom-made plastic trays that fit over the teeth. Each one, worn for about two weeks, moves the teeth just a bit; after several months, you’ll see a big change for the better in your smile. Best of all, clear aligners are virtually impossible to notice while you’re wearing them — which you’ll need to do for 22 hours each day. But you can remove them to eat, or for special occasions. Zac Efron and Katherine Heigl, among others, chose to wear clear aligners.

Lingual braces really are invisible. That’s because they go behind your teeth (on the tongue side), where they can’t be seen; otherwise they are similar to traditional metal braces. Lingual braces are placed on teeth differently, and wearing them often takes some getting used to at first. But those trade-offs are worth it for plenty of people. Which celebs wore lingual braces? Rumor has it that the list includes some top models, a well-known pop singer, and at least one British royal.

So what’s the best way to straighten your teeth and keep the orthodontic appliances unnoticeable? Just ask us! We’d be happy to help you choose the option that’s just right for you. You’ll get an individualized evaluation, a solution that fits your lifestyle — and a great-looking smile!

For more information about hard-to-see (or truly invisible) orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Orthodontics for the Older Adult” and “Clear Aligners for Teenagers.”

ItTakesBothYouandYourHygienisttoKeepYourSmileHealthyandBeautiful

To have a beautiful, healthy smile you’ll need to keep those pearly whites clean and plaque-free. Good dental hygiene, though, isn’t a solo act: It’s a duet best performed by you and your dental health provider. While you’re responsible for brushing and flossing every day, your dental hygienist gives your teeth a thorough cleaning every six months (or more). The American Dental Hygienists Association commemorates every October as National Dental Hygiene Month to recognize both the importance of hygiene and the professionals who assist you in keeping your teeth as clean as possible.

The focus for this emphasis on brushing, flossing and professional cleaning? A slick, slimy substance called dental plaque. This thin film of bacteria and food particles builds up on tooth surfaces after eating and gives rise to infections that cause tooth decay and gum disease. And it doesn’t take long without proper brushing and flossing, for a gum infection called gingivitis to start in only a matter of days. Daily hygiene reduces your risk of that happening: Brushing removes plaque from the broad, biting surfaces of the teeth, while flossing takes care of the areas between teeth that brushing can’t access.

So, if you can remove most of the plaque yourself, why see a dental hygienist? For two reasons: First, while daily hygiene takes care of the lion’s share of plaque, it’s difficult to clear away all of it. Over time, even a small amount of missed plaque can increase your disease risk. However, a professional cleaning that uses special hand tools and ultrasonic equipment can easily clean away this leftover plaque.

Second, some of the soft plaque can interact with saliva to form a hardened, calcified form called calculus or tartar. It can harbor bacteria just like the softer version, and it’s next to impossible to dislodge with brushing and flossing. Again, a trained hygienist with the right tools can effectively break up and remove calculus.

There are also additional benefits that come from regular dental visits to your hygienist. For one, hygienists can provide practical instruction and tips to help you brush and floss more effectively. And, after cleaning your teeth, they can point out areas with heavy plaque and calculus deposits. That can help you focus more of your future brushing and flossing efforts on those areas.

So, a shout-out to all the dental hygienists out there: These dedicated professionals work hard to keep your teeth clean. And a big high-five to you, too: Without your daily commitment to brushing and flossing, your smile wouldn’t be as beautiful—and healthy.

If you would like more information about best dental hygiene practices, please contact us to schedule a consultation. To learn more, read the Dear Doctor magazine articles “Dental Hygiene Visit” and “10 Tips for Daily Oral Care at Home.”

By James V Gagne, DMD
October 06, 2019
Category: Oral Health
Tags: gum disease   oral health  
HeresWhatYouCanDotoAvoidGumDisease

Here's an alarming statistic: Nearly half of adults over 30—and 70% over 65—are affected by periodontal (gum) disease. It's sobering because if not caught and treated early, gum disease can lead to not only tooth loss but also an increased risk of heart attack or stroke.

Gum disease most often begins with dental plaque, a thin film of bacteria and food particles that builds up on tooth surfaces mainly from poor oral hygiene. Undisturbed plaque can become a breeding ground for bacteria that cause gum infections.

Daily brushing and flossing can remove most of this plaque buildup, but you also need to get professional dental cleanings at least twice a year. This is because any plaque you missed brushing and flossing can interact with saliva and harden into calculus or tartar. This hardened plaque can't be dislodged through brushing and flossing alone, but requires special instruments used by dental professionals to remove it.

You should also be aware of other risk factors you may have that increase your chances of gum disease and take action to minimize them. For instance, you may have a higher genetic propensity toward gum disease. If so, you'll need to be extra-vigilant with personal hygiene and watch for any signs of disease.

Tobacco use, especially smoking, can double your chances of gum disease as well as make it difficult to notice any signs of disease because your gums will not bleed or swell. Quitting the habit can vastly improve your odds of avoiding an infection. Your disease risk could also be high if you have a diet heavy in sugar, which feeds bacteria. Avoiding sugary foods and eating a more dental-friendly diet can lower your disease risk.

Oral hygiene and managing any other risk factors can greatly reduce your risk for gum disease, but it won't eliminate it entirely. So, be sure you seek professional dental care at the first signs of swollen, reddened or bleeding gums. The sooner you undergo treatment for a possible gum infection, the better your chances of avoiding extensive damage to your teeth, gums and supporting bone.

The risk for gum disease goes up as we get older. But by following good hygiene and lifestyle practices, you can put yourself on the healthier side of the statistics.

If you would like more information on gum disease care and treatment, 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 “How Gum Disease Gets Started.”





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