Without natural tooth roots in place to provide stimulation, the jaw bone will begin to deteriorate. Dental implants act as substitute tooth roots and provide the same function as natural roots, including stimulating and preserving the jawbone, thereby preventing the bone loss that normally occurs with the loss of teeth.

Dental implants can be placed in the mouth of any individual provided he/she fulfills certain criteria. Your Plano/Dallas implant dentist will conduct a thorough dental and medical exam to confirm that you are a candidate for dental implant surgery. Dental implants are not placed in children and are only advised after facial growth is complete.

Factors that may rule out implant surgery:

• Insufficient bone height and width
• Unhealthy gums with untreated gum disease
• Patient with history of clenching of teeth (bruxism)
• Patients with previous history of failure of dental implants
• Improper/inadequate opening of the mouth

• Pregnancy
• Severe dermatological diseases
• Malignancy (cancer)
• Smoking
• Diabetes
• Hemophilia and bleeding disorders
• Epilepsy
• Impaired movement

Today with proper medication, patients with diabetes and bleeding disorders can also undergo implant surgery; therefore they are not automatically excluded.

Contact your implant dentist to determine if implants are right for you.

A dentist will clean, care for, and treat your teeth, gums, and mouth to ensure optimal dental health. It is recommended that you visit the dentist every six months – more frequently if you are deemed “high risk.”

Normally, oral cancers, and other diseases of the mouth do not make themselves evident to the untrained eye until they are far along. Regular checkups with a dentist can help identify an oral disease in the early stages, thus increasing your chances of successfully combating them.

In between dental visits, daily brushing and flossing helps prevent the onset of cavities, gum disease and improves your overall health. A Plano dentist can tell you more about dental hygiene.

To provide an alternative solution to these problems implant manufacturer Nobel Biocare, along with celebrated implant dentist Paulo Malo devised a technique that uses fewer dental implants without the need for bone graft surgery. Highly esthetic results can be achieved in the shortest time possible with this technique. This method is suited for patients who have lost most or all of their teeth.

The technique called All-on-4 utilizes four dental implants that are angled to achieve maximum support from the bone. Four implants are placed strategically in each jaw to support a fixed bridge. You can receive your full set of new teeth in one appointment; therefore this procedure is also called ‘teeth in a day’.

You can start chewing on your newly received teeth immediately after placement. In certain cases 4-6 implants maybe needed in your upper arch. The dentist will use your first visit to ensure you are a candidate for the All-on-4 procedure and conduct a thorough examination. X-rays and CT scans are needed to complete the evaluation. You receive your new permanent fixed teeth on the day of the procedure, without the need for temporaries. You can visit your Dallas implant dentist in the morning and leave with a set of new teeth the same day.

Porcelain veneers are thin shell like pieces of porcelain that are placed over the front surface of teeth to hide imperfections.

Porcelain veneers can be used to:

• Correct chipped teeth
• Close gaps in between front teeth
• Masking discolored teeth
• Minor straightening of crooked teeth

Porcelain veneers provide excellent results and are more natural looking than bonding, which can make the tooth look bulky. A smile makeover with porcelain veneers can greatly improve your self esteem and the way you smile, which can last for at least 10-15 years with proper care.

Steps to a smile makeover with porcelain veneers

• The dentist will conduct a thorough dental examination and record a detailed dental and medical history.
• The dentist will discuss with you the treatment plan to determine the number of veneers needed for an optimal makeover.
• Any existing dental decay and gum disease will be corrected before treatment begins.
• The dentist will then proceed to remove a thin layer of enamel on the front surface of teeth.
• Dental impressions will be taken and models of your teeth will be prepared and sent to the lab.
• Temporaries will be placed until the next visit, which may take 5-7 days.
• Once the permanent veneers arrive, they will be placed and you can leave with a completely new smile.

* What are dental implants?
Dental implants are commonly titanium implants that are placed within the jaw to support artificial teeth. They are placed to replace missing teeth. The most common type of implants is the ‘endosteal’ or ‘root form’ implant that resembles the root of a tooth. Other types include: subperiosteal, transosteal, plate-form, intra-mucosal, etc. Dental implants are a suitable alternative to conventional dental bridges, which are placed after preparation of the adjacent teeth.

* Are Implants aesthetic? Are they comfortable for chewing?
Once the gum tissue around the implant has healed properly, the implant looks completely natural. The skill of the restorative dentist plays a great role in determining the final appearance. Once the final prosthesis or crown is placed, the patient can chew naturally. Some experts say up to 90 percent of the chewing efficiency of natural teeth can be restored with dental implants.

* Are dental implants costly?
The placement of implants includes the cost of surgery, the implant, the final crown, radiographs, including CT (if needed) etc.. It can vary from one dentist to another and can depend on the type of implant being placed. Ask your dentist for further information regarding the fee.

* Is the implant surgery painful? Do I have to miss work the following day?
With modern local anesthetics and anti-inflamatories, the incidence of discomfort is extremely low. In fact implant surgery is less invasive than having a tooth pulled. Minimal discomfort and swelling can be expected after any surgical procedure. You may be given anti-inflamatories and antibiotics for a few days after the procedure. A day’s rest is normally advised. Avoid strenuous exercise and chew only soft food for a few days.

* What are the different methods of placing implants?
The placement of implants can be classified by timing of placing implants after extraction of tooth/teeth into:
1. Immediate post-extraction implant placement.
2. Delayed immediate post-extraction implant placement (2 weeks-3 months after extraction).
3. Late implantation (>3 months after extraction).

Dental implants can be classified into: Immediate loading, early loading and delayed loading depending on the timing of placement of load on the implant. Delayed loading implants take 3-6 months for the entire procedure to heal.

In some countries, restorative dentistry is considered a specialty of its own and dentists receive additional training in this field. In most countries, restorative dentistry is also practiced by a team of dental specialists from various other specialties. Your restorative dentist must be an expert in all the different disciplines that make up restorative dentistry, but he should be able to integrate the knowledge in a seamless and sensible manner. There is considerable interactivity between the different specialties and the treatment planning can become highly complex, testing the diagnostic and clinical skill of your restorative dentist. Preventing damage to the teeth also comes under the umbrella of restorative dentistry; your dentist has to be able to teach you to maintain your oral hygiene and prevent future damage.

What are the common reasons for restoring teeth?

• Dental decay
• Fractured tooth
• Dental abrasion
• Misaligned teeth
• Closing gaps
• To improve the aesthetics of teeth

How does the dentist restore decayed teeth?

Dentists have been using dental amalgam or silver amalgam for over 100 years. Even today, most developing countries still use dental amalgam due the low cost and durability. Your Dallas cosmetic dentist uses dental composites and glass ionomer cements to restore teeth for patients who need a more aesthetic option for restoring their teeth. More extensive decays can be restored with onlays and inlays.

• The dentist will first diagnose the type of dental decay. He will determine the extent of decay with the help of a dental explorer and mouth mirror.
• He will proceed to take x-rays to determine the extent of decay within the tooth.
• Pulp vitality tests will be conducted to rule out inflammation of the pulp. If the pulp test elicits no response, the tooth is dead. The tooth will need a root canal.
• The dentist will use the dental drill to remove a major portion of the decay.
• He will remove the remaining decay with help of a slow-speed drill or hand instrument.
• He will then proceed to include retentive features and finish the margins to ensure a perfect fit for the filling.
• The extent of tooth preparation will depend on the type of filling. A dental amalgam will require ore tooth preparation than dental composites or cements.
• If the decay is extremely deep, the dentist will place a dressing made of calcium hydroxide.
• A base of dental cement is placed to protect the pulp from sudden thermal and electric changes that can affect the pulp adversely. If dental composites or cements are used as restoration material, a base is usually not placed.
• A band is placed to support the filling if the decay has extended into the margins of the tooth.
• The cavity is filled incrementally with the restorative material.
• High points in the filling is marked out with articulation paper and reduced to proper height.

Several facial muscles are attached to the jaws and the forces applied on the jaw act through the TMJ, which act as a fulcrum around which the whole jaw hinges. The TMJ is vulnerable to any disorder affecting the joints in any part of the body, including arthritis, dislocations, ankylosis, trauma, etc.

What are the common symptoms of TMJ disorder?

• Pain in the muscles of the face that can radiate to the side of the face and neck. Swelling and pain is experienced near the joint, in front of the ear, around the eyes and side of the face and head. Pain is commonly experienced when chewing, talking and yawning.
• Deviation of the jaw to one side when opening the mouth. You may also experience “lock-jaw.” With lock-jaw, the patient will complain of difficulty closing the mouth after opening.
• Clicking or popping sound from the joints is heard while opening and closing the mouth.
• Ear pain, ringing in the ears and loss of hearing.
• Headache, nausea and dizziness

What are the common treatment options available to treat TMJ disorders?

Most treatment options available are conservative and involve medications and jaw exercises.

• If the cause of pain is trauma or if the pan is acute in nature the first thing you can do is apply an ice-pack to the joint intermittently while allowing the jaw to rest.
• Eat soft foods items that require little or no chewing. Avoid foods like hard candy, steak and raw carrots. Some patients are advised to eat hot soups or baby food for a few days until the pain subsides. Try eating food without opening your mouth too wide.
• Anti-inflammatory medications and pain killers can be consumed to reduce the inflammation and pain. Skeletal-muscle relaxants help relax tight muscles. Anti-anxiety medications can help reduce stress that can aggravate TMJ pain.
• Avoid resting your jaw on your hands while working or studying. Try to sleep on your back rather then your stomach. Maintain a good body posture while working.
• Your Dallas dentist will advise jaw exercises to help stretch and relax your jaw muscles. You can do these exercises at home in front of a mirror. End the exercises by applying a moist cloth to the affected side of the face. Repeat the exercises 4-5 times daily.
• An occlusal splint may be placed to establish a harmonious relationship between jaw muscles, teeth and TMJ. Splints will also help reduce teeth clenching and grinding which can exert unwanted pressure on the joint. Avoid over-the-counter mouth guards.
• Orthodontic treatment may also be done to establish uniform occlusion. Replacement of lost teeth with properly designed dentures, replacing old dentures, replacing defective fillings, crowns and dental bridges can also help. Improperly designed dentures can also cause TMJ pain. Orthodontic treatment is used as an adjunct to occlusal splint therapy.
• Corticosteroid injections into the TMJ can help reduce inflammation in chronic cases.
• A TMJ wash, which comprises inserting two needles into the TMJ and washing out the joint with water or anesthetic solutions, has been found to be effective.
• TMJ Surgery. Usually done as a last resort. Arthroscopy or open joint surgery can be done. The entire joint can be replaced with TMJ implants.
• Other options include: Transcutaneous electrical nerve stimulation (TENS), ultrasound therapy, etc.

The Centers for Disease Control has laid down infection control guidelines that a dental office should adhere to:

Good dental infection control starts with the dentist’s room itself. A well-ventilated room with air-circulating devices prevents building up of aerosols produced from the dental drills. The sterile dentist and assistant are immunised against hepatitis, wear clean personal protective equipment—a scrub apron, eyewear, disposable gloves and facemasks. The patient is draped, and may be given a protective “face shield” to prevent skin contamination from the dental drill’s water spray. An anti-microbial mouth rinse just before a dental procedure is important to reduce contamination.

The dental chair’s knobs and handles need to be chemically disinfected between patients. All the dental instruments that go into patient’s mouth need to be subjected a high-degree sterilization procedure, such as “autoclaving,” which destroys all microbial contamination. These instruments are then stored in a dry, sterile, contained area such as disposable pouches or cassettes, and removed just before using for the patient. Local injections require disposable needles with single-use syringes or sterile cartridges for each patient.

Surgical procedures require more stringent measures to eradicate all chances of infection and need special preparation of the dentist’s room. The dentist, assistant and patient all need sterilized gowns, and all instruments, drills, suction apparatus has to be completely sterilized. These procedures require sterile saline within the drills. Bone grafts, membranes and suture packets are all intended to be used once opened and cannot be reused at later appointments.

Sarah, a nursing aide by profession who recently got dental implants in Plano, said: “One reason I chose my Plano dentist to have implants was that I could see the utmost importance his office gives to maintaining sterilisation, which I know is crucial to the success of implant surgery. Not only that, it reflects on the commitment my Plano dentist has to care for his patients like his own family!”

Infection control measures not only reduce the chances of getting a dental infection, they also reduce the risk of catching serious diseases like HIV and hepatitis, so choosing a sterile dentist is important to stay healthy!

Earlier implant surgery procedures were conducted after taking standard x-rays. The challenge was always that, once the implant dentist began the procedure, he often encountered unexpected issues. A standard x-ray does not allow the dentist to visualize the bone height and width in all three dimensions. Therefore the placement of the implants are decided on the basis of guesswork. Certain bone deformities can be seen only after an incision is made. In the end, he will have to make several compromises and the overall result may not be satisfactory.

With computer-guided dental implant surgery, the dentist views multiple radiographs of the same area. This is done with the help of cone-beam radiography or 3-D CT scans. This can greatly improve the dentist’s visualization. He can view the entire jaw from multiple angles on the computer screen, and, with the help of planning software, the CT images help generate a comprehensive virtual treatment plan.

Who is a good candidate for guided dental implant surgery?

Guided implant surgery is particularly useful in patients needing multiple implant surgeries, such as patients who have lost all their teeth. Patients with severe bone loss due to trauma, genetic disorders or diseases are also prime candidates for guided implant surgery. Patients who need quick rehabilitation with implants also prefer guided implant surgery. Although it can also be used when placing single implants.

There are two guided implant systems commonly used today: Nobel guide from Nobel-Biocare and Simplant from Materialise.

What are the advantages of guided dental implant surgery?

• There is less guess-work required on the part of the dentist.
• Accurate visualization of the bone height and width is possible.
• Reduced healing time
• There is considerably less swelling.
• More accurate final result.
• It also allows the dentist to create the permanent crowns before doing the surgery.
• The crowns can be placed soon after the implant surgery is over. Therefore  temporary crowns can be avoided
• Lower cost, due to fewer number of visits.
• With guided implant surgery, patients can receive their implants in hours, instead of weeks or months.

Contact Plano dental implant dentist Dr. Hucklebridge for additional information a no-obligation assessment of your dental implant options.

Invisalign

The Invisalign system of invisible braces works without any brackets or wires and is equally and, in some cases, more effective than conventional braces in producing an aesthetic and stable orthodontic result. The Invisalign system uses a series of sheer removable aligners, similar to bleaching trays, which the patient needs to wear most of the day. These aligners, like retainers, while are easy to wear and almost unnoticeable though they cover the front surfaces of teeth.

The clear aligners generate forces on teeth similar to conventional braces. Each tray is designed from special Invisalign software, which uses computerized images of your teeth to design a series of trays, each tray causing a small force to shift the teeth slightly–about 0.25mm–to a more desirable position. Thus, when worn in succession, the teeth are progressively moved into alignment.

The Invisalign system actually virtually simulates the treatment outcome on the computer, which you can also see in the consultation phase, and actually see how the teeth will look after orthodontics. These computerized images are then used to produce the aligner series specifically for you. Each aligner is worn for about two weeks and an average patient would need about 18 to 30 aligners over a year to year and a half.

The Invisalign aligners are matchless in comfort because they can be removed while eating, brushing or flossing, so you enjoy your food more and oral hygiene is not a problem, unlike with regular braces. Plus you can smile without anyone noticing them, which makes them worth the higher expense when compared to regular orthodontics!

The Invisalign system works best for mild to moderate bite corrections and is well researched and clinically proven, but may not be suited to all cases. Visit your Dallas Invisalign dentist for a consultation to determine if Invisalign is the right orthodontic choice for you!