My Blog

Posts for: June, 2018

By David J. Adams, DMD, MS, PA
June 28, 2018
Category: Dental Procedures
Tags: dental implants  
TheImplantProcesscanbeShortenedDependingontheToothType

Dental implants are considered the premier option for tooth replacement. While all implant procedures follow the same general concept — a titanium post surgically inserted into the jawbone with an attached life-like crown — the installation process can vary.

From their earliest history, implants have usually been installed through a two-stage process. In the first stage, the surgeon inserts the titanium post in the bone and leaves it “submerged” below the gum level to protect it from oral bacteria and the effects of chewing and biting. About three months later after the bone attaches to the titanium (a process called osseointegration), the surgeon then performs the second stage by re-exposing the implant and attaching a temporary abutment and crown for the patient to wear while the permanent abutment and crown are fabricated and later attached in 2-6 weeks.

In recent years, advancements in materials and design have made possible a one-stage process that allows the implant to protrude above the gum line during osseointegration and shortens the process. After the initial three-month healing period, the implant is ready for “loading” with the permanent crown.

The choice between which of these two procedures should be used for your implants will first depend on the type of tooth being replaced. A front tooth benefits from the one-stage procedure for cosmetic reasons because the surgeon can install a temporary crown to the exposed abutment during osseointegration (as long as the temporary tooth isn’t in functional contact with other teeth). An implant for a back tooth, on the other hand, doesn't have a large cosmetic demand so those one stage procedures usually end up with an exposed healing abutment but no temporary crown.

The strength of the bone is also a factor. Some bone tends to be softer, particularly in the back of the mouth. There’s a chance the implant could move in this softer bone, adversely affecting the outcome. For this reason, the two-stage procedure can be the preferred approach for posterior teeth as it offers more protection from movement.

You can be sure we’ll consider all these and other factors during your initial examination, and then advise you on the best approach. Above all, we want to make sure — whether a one-stage or a two-stage implant process — the result is a smile you can be proud of.

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 “Staging Surgery in Implant Dentistry.”


By David J. Adams, DMD, MS, PA
June 18, 2018
Category: Oral Health
Tags: sensitive teeth  
ReducingToothSensitivitywillDependontheCause

If you're one of over 30% of Americans who wince in pain when eating and drinking certain foods and beverages, you may have tooth sensitivity. Although there are a number of possible causes, the most common place to look first is tooth dentin.

Lying just under the enamel, dentin consists of tiny tubules that transmit sensations like pressure or temperature variation to the nerves of the inner pulp. The enamel, the gums and a covering on the roots called cementum help dampen these sensations.

But over-aggressive brushing or periodontal (gum) disease can cause the gums to shrink back (recede) and expose the dentin below the gum line; it can also cause cementum to erode from the roots. This exposure amplifies sensations to the nerves. Now when you eat or drink something hot or cold or simply bite down, the nerves inside the dentin receive the full brunt of the sensation and signal pain.

Enamel erosion can also expose dentin, caused by mouth acid in contact with the enamel for prolonged periods. Acid softens the minerals in enamel, which then dissolve (resorb) into the body. Acid is a byproduct of bacteria which live in dental plaque, a thin film of food particles that builds up on teeth due to poor oral hygiene. Mouth acid may also increase from gastric reflux or consuming acidic foods or beverages.

Once we pinpoint the cause of your tooth sensitivity we can begin proper treatment, first and foremost for any disease that's a factor. If you have gum disease, we focus on removing bacterial plaque (the cause for the infection) from all tooth and gum surfaces. This helps stop gum recession, but advanced cases may require grafting surgery to cover the root surfaces.

You may also benefit from other measures to reduce sensitivity: applying less pressure when you brush; using hygiene products like toothpastes that block sensations to the dentin tubules or slow nerve action; and receiving additional fluoride to strengthen enamel.

There are effective ways to reduce your tooth sensitivity. Determining which to use in your case will depend on the cause.

If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity: Understanding Your Options.”


By David J. Adams, DMD, MS, PA
June 08, 2018
Category: Oral Health
Tags: tooth wear  
3AreastoWatchtoAvoidExcessiveToothWear

Just like other parts of your physical body, teeth naturally wear as we get older. Just the effect from chewing during hundreds of thousands of meals in a lifetime can take its toll.

But there are some factors that can make tooth wear worse. By addressing them promptly should they arise, you can keep age-related tooth wear to a minimum.

Here are 3 areas to watch for to avoid excessive tooth wear.

Dental disease. Tooth decay and periodontal (gum) disease are most responsible for not only the loss of teeth but for compromising tooth health overall. But the good news is they’re largely preventable through proper oral hygiene practices to remove bacterial plaque, the main trigger for these diseases. Prompt treatment when they do occur can also minimize any damage and help your teeth and gums stay strong and healthy.

Your bite. Also known as occlusion, the bite refers to how the upper and lower teeth align with each other when you bite down. When they don’t align properly, regular chewing and biting can create abnormally high forces in the teeth and cause them to wear unevenly and more rapidly. Correcting the bite through orthodontic treatment won’t just improve your smile, it can improve bite function and decrease accelerated tooth wear.

Bruxism. This is a general term describing habits like teeth clenching and grinding in which the teeth forcefully contact each other beyond normal parameters. There are a number of causes for bruxism, but for adults it’s typically related to stress. Over time, bruxism can accelerate tooth wear and cause other problems like TMD. There are a number of ways to stop or at least reduce the effects of bruxism like relaxation techniques or a night guard worn during sleep that prevents the teeth from making forceful contact.

If you suspect you’re experiencing any of these factors, see us for a full examination. We’ll then be able to discuss your condition, the potential impact on tooth wear, and what we can do to protect your teeth.

If you would like more information on protecting your teeth as you age, 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 and Why Teeth Wear.”