Avoid Dental Implant Failure

Posted on Apr 04, 2024 by William J. Claiborne, DDS MS

There are reasons to go to an expert for certain things. For example, I’d never try to do electrical work around my house on my own; I’d call an electrician.

When it comes to dental implants, there are also reasons to seek out an “expert.” In this article, I’ll explain why it’s best to have your dental implants selected and placed by a periodontist.

First, let’s look at the structure of an implant. Serving as a replacement for a missing tooth, the implanted portion is a titanium screw that is positioned into the jawbone. Over the course of 3-6 months, the jawbone grows around the implant, securing it in place. It can now support an artificial tooth or crown.

Dental implants have many benefits when it comes to restoring biting/chewing/speaking function and smiling appearance, including:

• enhancing the appearance of a smile
• improving biting and chewing function
• stabilizing surrounding teeth and jaw tissue
• halting the process of bone loss, known as resorption
• an increased quality of life for many people

Dental implants have an excellent success rate – 90-95%. However, there are instances where a dental implant can fail.

Dental implant complications can occur from infections, gum recession, and nerve and tissue damage. There is also a higher risk of implant failure for individuals who smoke or have diabetes, gum disease, have radiation therapy to the jaw area or take certain medications.

A periodontal specialist has advanced training and skills in the diagnosis and placement of all types of dental implants. This means that this dental specialist can determine which implant system will work best for your individual needs. For example, a person who has lost a great deal of bone mass may only be a candidate of certain implant types or may need a sinus lift prior to placement. A periodontist can make these determinations so your potential for implant success is higher.

One of the most common causes for implants failure is due to an infection at the implant site. Because a periodontist specializes in the care of gum tissues in the mouth, he or she can take measures to treat the infection at early stage to resolve the problem. However, in some cases, treating the infection may require implant removal in order to reach the infected bone tissue.

Using advanced skills, a periodontist can also assess your gum health prior to implant placement. He or she can pretreat any periodontal diseases so the implant has a healthy foundation. When the gum tissues around the implant are inflamed or have receded, the implant is at risk for entry of bacteria into the area where it is implanted.

After the implant is placed, it should fuse with the bone. A complication that prevents this may require the dental surgeon may remove it. Fortunately, after the implanted area is restored to a healthy state, the implant procedure can be redone.

Another benefit in using a periodontal specialist for implant placement is in their in-depth understanding of the nerves and tissues surrounding the jaw bones. There is a risk for failure when a dental implant is placed too close to a nerve. For example, there is a nerve that runs horizontally through the lower jaw. If the implant is placed in close proximity, it can cause numbness, tingling, or pain.

Nerve or tissue damages can result in:

• • numbness on the side of the implant, including the lower lip and chin
  • persistent pain or discomfort
  • tingling, tickling, or burning sensations in the gums and skin

While precision placement (depth, position and angle) is a bonus of a periodontist’s skills for implant patients, our Asheville periodontal dental patients have the benefits of advanced technology. Our Computerized Dental Implant Placement system is designed for pre-surgical positioning of dental implants that uses a 3D model of the patient’s jaw.

Once the implant type is selected, a template is developed for optimal treatment success, even for complex cases. This minimizes disruption of gum tissues and targets implant placement at ideal depths and angles. Thus, treatment success rates are higher with faster (and more comfortable) healing time.

An example of this precision placement guidance in with upper dental implants. With declined bone mass of the upper jaw (typically from years of missing tooth roots), the sinus cavities can hover too close to the position(s) where implants are to be placed. In these cases, we can perform a sinus lift.

Should the dental implant protrude into the sinus cavity, the sinuses can become inflamed, causing:

• pain, tenderness, or swelling around the cheeks, eyes or forehead
• nasal blockage, often with green or yellow mucus
• a reduced sense of smell
• headaches
• toothache
• persistent bad breath

Of course, like a natural tooth, excessive force or impact can cause a dental implant to crack or become loose. For example, for people who grind or forcefully clench their teeth (“bruxing”) during sleep may need to wear a bite guard to prevent damage to the implant as well as their natural teeth.

In some instances, it can take up to 5 years for implant-related problems or infections to become apparent to the patient. Any issues that arise around the site of the dental implant should be examined and addressed without delay.

We want your dental implant(s) to last your lifetime and bring you as much eating and laughing pleasure as they are known to give. The best way to ensure the success of a dental implant is to follow the aftercare advice your periodontist and dentist provide.

As with a person’s natural teeth, an implant and the tissues surrounding it require regular cleaning. Daily flossing in the area at least once per day is needed after the gums have healed. Some patients prefer interdental brushes to access areas that are more difficult to reach.

Regular dental check-ups and appointments for cleanings should occur at least twice a year to ensure the longterm success of your implants. Once a quarter may be advised for some individuals who have higher risks for plaque development.

Optimal comfort for our Western Carolina patients has always been a priority. For many, a desired level of comfort and relaxation includes sedation options. Here, we offer several sedation options, including oral and IV sedation (“twilight sleep”). These are administered safely by an anesthesiologist who uses advanced safety equipment throughout your treatment.

If you are considering dental implants, you may wish to begin with a consultation appointment. During this time, we can explain the vast difference in comfort, treatment time, and success available through our specialized skills and extensive technology.

Call 828-274-9440 to schedule. New patients are always welcome.

As You Age, Avoid A ‘Melting’ Face With Dental Implants

Posted on Feb 26, 2024 by William J. Claiborne, DDS MS

It seems the older one gets, the more conscious he or she is to the need for good health practices. While periodic exams and check-ups are part of this, eating healthy and getting ample exercise are practical ways to support a healthy body.

The same principles apply to oral health. While annual physical exams are needed, regular check ups and dental hygiene cleanings are as well. Through decades of research, “bad” bacteria in the mouth can lead to inflammatory reactions that can offset or worsen a number of health problems far beyond the mouth.

For now, let’s focus on your gum health and the presence of teeth. While natural teeth are the ideal structure for biting, chewing and speaking, the rigors of age – the natural wear and tear – can take its toll on teeth. Decay, gum disease, accidents and certain illnesses can lead to losing a tooth or teeth over the span of a lifetime.

There are several ways to replace a missing tooth (or teeth). A crown-&-bridge is a longstanding method to replace one or several teeth in one area. Or, a partial denture can replace a “scattering” of teeth in the same arch. However, the downside of these oral prosthetics is what’s beneath the gum line.

Your natural teeth are supported by your upper and lower jaw bone, known respectfully as the maxilla and mandible. With these strong, study bones, tooth roots are held securely. Thus, biting and chewing occurs comfortably.

The jaw bones are actually kept healthy by the presence of tooth roots. These roots provide stimulation to the bone as well as nourishment that feeds through the tooth’s interior.

When a tooth is removed, so is the stimulation and nourishment to that area of the jaw bone. Without it, the bone begins to shrink. As it declines in height, the adjacent teeth are more vulnerable to loss. Statistics show that teeth adjacent to areas where natural teeth are missing will be the most likely to be lost next.

This has a domino effect. Partials can replace the presence of teeth above the gum line, but there is nothing to benefit the jaw bones below. Thus, tooth loss continues and can go from a few missing teeth to losing all teeth (being “edentulous”).

According to the Center for Disease Control & Prevention (CDC), 69 percent of adults between the ages of 35 – 44 have lost at least one permanent tooth. By age 50, Americans are missing an average of 12 teeth. For adults between the ages of 65 – 74, 26 percent are missing all of their natural teeth. That’s over one-fourth of the adult population over age 65.

Although dentures and partials mimic the presence of teeth, the jaw bones below are shrinking away, and at a rather rapid pace. The pressure of wearing a denture or partial actually speeds this process up, known as “resorption.”

As these bones decline in mass, deep wrinkles form around the mouth. The corners of the mouth turn downward. The chin takes on a more pointed form and the mouth sinks into the face. The nose seems to get closer to the chin as the jaw bones thin. Jowls form as facial muscles detach from shrinking bone structure.

Changes in facial appearance also take place when bone structures shrink. For example, as the jaw bone thins, deep wrinkles form around the mouth. The corners of the mouth will start to turn down, even in a smile. Jowls form on each side of the face as facial muscles detach from the shrinking bone structure.

As the jaw bone declines further, the chin becomes more pointed and the nose seems to get closer to it. This leads to a collapsed mouth that is known as a “granny look.” This look ages the appearance of an individual far beyond their actual years.

Not to be overlooked is the ability to comfortably bite and chew food. This is essential for the digestive process, since the first stage of digestion begins in the mouth. When adults struggle to eat with a denture or partial, the efficiency of this initial stage of digestion is compromised.

It’s not unusual for adults who have “rocky” or “slippery” dentures to opt for soft foods that dissolve easily in the mouth. These are often carb heavy and lack the nutritional value of a diet that combines healthy proteins, fruits and vegetables.

However, missing teeth or dentures that move when eating can cause other detrimental problems. When people sense their dentures may cause embarrassment when eating, speaking or laughing with others, social involvement can take a hit. According to a 2012 statement by the World Health Organization:

“Oral health is essential to general health and quality of life. It is a state of being free from mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal (gum) disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psycho-social well-being.”

As an Asheville periodontist, my dental specialty includes the diagnosis and placement of dental implants. Dental implants are the closest thing to natural teeth.

Dental implants were designed to recreate the presence of natural teeth both above and below the gum line. Because teeth attached to the implants are supported by the jaw bone, the study foundation restores the ability to bite and chew without movement or fear of embarrassing slips.

For patients who are missing a great deal of bone, we offer bone rebuilding that does not require a bone graft. We also perform sinus lifts (when the upper jaw has declined to a significant level) to restore sufficient bone distance between vital structures.

For many of our dental implant patients, their lives become more active with the restored confidence. They become more socially involved, have more self-confidence and higher self-esteem. And the advantages of dental implants over other tooth replacement options are numerous.

• Dental implants are designed to last your lifetime. They do not decay, need root canals or compromise neighboring teeth or bone structure.

• Because dental implants are positioned in the jaw, they recreate stimulation to the bone. This helps to preserve the bone’s mass, halting the pace of jaw bone shrinkage (known as resorption).

• Resorption is what causes changes in one’s facial appearance, aging one’s appearance far older than their actual age.

• Dental implants do not move or slip when eating, speaking or laughing. A denture is designed to fit the contours of one’s gum ridge; contours that exist at the time the denture is made. However, as resorption reduces bone height, the ridge that holds the denture flattens out over time. This is why a denture becomes ‘wobbly’ or ‘slippery.’

• Dental implant treatment is largely determined by the number of implants placed. In most cases, one implant can support more than one tooth. A full arch (all upper or lower) of teeth are typically supported by several strategically-placed implants.

• Unlike a crown-&-bridge, dental implants so not need the support of adjacent teeth. Therefore, it is not necessary to have teeth shaved down for crowning simply to serve as supports for a bridge.

In our Asheville periodontal dental office, we have highly-advanced technology that aids in the diagnosis and placement process of dental implants. These features help to enhance patient comfort, shorten treatment time, and provide optimal results. Advanced technology includes:

– Computerized Dental Implant Placement – an advanced system for pre-surgical positioning of dental implants using a 3D model of the patient’s jaw. Once the implant type is selected, a template is developed for optimal treatment success.

– Cone Beam Imaging – is ideal for diagnoses and treatment planning through images that provide a clear view of the upper and lower jaw (including nerve canals), with rotations that show sagittal, axial, and coronal planes in a process that is quick, painless and at minimal radiation levels.

– Dental Laser – This small, hand-held device is a tremendous asset when it comes to both the health and appearance of gum tissues. Not only does the laser eliminate or greatly minimize bleeding during procedures, it reduces numbing requirements, removes bacteria and easily uncovers gum tissue where dental implants have been placed. Additionally, laser dentistry can beautifully re-contour or repair gum tissue with a precision line.

As a periodontal specialist serving Western NC, I take great pride in the diagnosis and placement of dental implants with each selected based upon the patient’s individual needs and goals. We provide oral or I.V. sedation to ensure a comfortable experience and a friendly, respectful environment.

To schedule an examination appointment or to begin with a consultation, call 828-274-9440. A referral is not always necessary.

Dental Implants – Advantages of Specialized Skills, Advanced Technology, Optimal Comfort

Posted on Jan 10, 2024 by William J. Claiborne, DDS MS

It wasn’t that long ago when shopping for Christmas presents was quite the time-consuming ordeal. Today, we do searches for gift ideas online, check price comparisons, and have the items show up on our doorstep within a day or so.

Advancements through computerized technology have things running more efficiently and, in many cases, culminate into superior outcomes. This is true in dentistry, especially for those who opt for dental implants to replace missing teeth.

There are many reasons for people to choose dental implants, including:

– Designed to last a lifetime

– Look, feel and function like natural teeth

– Won’t decay or need repairs

– Restore chewing and biting comfort and stability

– Enhance overall health and confidence

– Halt the process of facial bone loss

Occasionally, dental implants are occasionally offered by general dentists. As a periodontist, however, I am referred most of our dental implant patients by other dentists and dental specialists. This is because a periodontist has advanced education and skills in the diagnosis and treatment of all areas of the tissues in the mouth (including the reshaping of gum tissues).

Periodontists are also specialists when it comes to the diagnosis and placement of dental implants. They are trained to understand the intricate concepts involved in selecting the proper type of implant based on each individual. These skills include the understanding of precision placements of implants at proper depths and angles. Additionally, periodontists are able to optimize your comfort and treatment outcome.

Still, another reason we are referred patients for dental implants because we can offer patients a wider variety of choices when it comes to implant systems.

There are many types of dental implants. Various systems are designed to support one replacement tooth (the “restoration”), a bridge of two or more teeth, or a full denture supported by several strategically-placed implants. Understanding the unique advantages of all systems enables us to choose the best type for the patient’s individual needs and goals.

For example, the All On Four dental implant system is designed to support non-removable teeth on just 4 implants (per arch). With its specially-designed implanted portions, these longer implants can fully distribute biting and chewing forces.

All-On-4 is an ideal choice for people who have lost bone mass due to lengthy periods of tooth loss. Because “All On 4” implants can be placed in minimal bone, many patients are able to avoid the need for bone rebuilding procedures prior to traditional implant placement.

In the placement, a periodontist is also the best “go-to” in dental implant skills. Here’s why…

For a dental implant to serve as a lasting tooth replacement system, it must be positioned in the jaw bone to specific depths and angles. An implant that is wrongly positioned can function less efficiently and lead to the need for removal.

For example, a periodontist can incorporate bone rebuilding procedures into treatment to a proper depth for patients missing a great deal of bone mass (typically due to missing natural teeth for many years). This can help to restore bone that has occurred in the mandible (lower jaw) or maxilla (upper jaw), which may also require a sinus lift.

Another example is a patient who has lost teeth due to periodontal (gum) disease. Because a periodontist combines advanced skills in treating gum disease as well as in dental implants, these patients have an added advantage when it comes to treatment success.

When it comes to the best way to pinpoint and tackle specific issues with our health, it makes sense to see a doctor who has received specialized training in that area. This helps to take the guesswork out of diagnosis and enhances the potential for a successful outcome in an efficient process.

A periodontist also has a reputation for being able to optimize patient comfort. Because a periodontal specialist is uniquely skilled in the care of gum tissues, he or she can provide a conservative approach to the placement process. Through respectful treatment of oral tissues (in both placement and exposure for restorations), less disruption to the gums allows for faster healing and higher comfort levels.

In our Western NC periodontal dental office, we incorporate our care with the advantages of some of the most advanced technology in dentistry; many options which are not readily available in other dental offices in our region. These computerized images offer advantages to patients in helping to minimize treatment needs.

These include:

• LANAP (Laser-Assisted New Attachment Procedure) with PerioLase MVP 7 – an advanced protocol that efficiently and effectively treats advanced gum disease with the added advantages of a dental laser. This offers a non-surgical alternative for patients with moderate to severe periodontal disease and has even been found to stimulate bone regrowth in damaged areas.
• Cone Beam Imaging – is ideal for diagnoses and treatment planning through images that provide a clear view of the upper and lower jaw (including nerve canals), with rotations that show sagittal, axial, and coronal planes in a process that is quick, painless and at minimal radiation levels.
• CareStream Cone Beam Computer Tomography Imaging – is enhanced tomography that works with 3D imaging for exceptional detail and range.
• CS 3600 Intraoral Scanner – quickly and comfortably captures digital impressions to create precision models or appliances accurately and easily (crowns, inlays, onlays, bridges, orthodontic appliances, aligners, custom abutments) without the need for bulky, goopy trays.
• Computerized Dental Implant Placement – an advanced system for pre-surgical positioning of dental implants using a 3D model of the patient’s jaw. Once the implant type is selected, a template is developed for optimal treatment success.

For optimal comfort, we offer several sedation options, including oral and IV sedation. Oral sedation is a pill that helps patients relax. It also has an amnesiac effect, leaving most with little or no memory of treatment afterward. I.V. sedation (also known as “twilight sleep”) places the patient in a deeper sleep state and erases memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety.

In our Western NC periodontal dental office, anesthesia is overseen by a Medical Doctor (MD) who is a board certified Anesthesiologist. With both sedation options, patients are closely monitored with advanced safety equipment throughout treatment.

Our goal is to help people move forward with treatment affordably for enhanced appearance, self-confidence and sense of security.

For those who have bypassed dental implants because of cost, our payment plans are often able to help patients enjoy the benefits of their dental implants without straining their budget. Most of these payment plans require no down payment, are interest-free, and have no prepayment penalty.

If you’ve considered dental implants in the past but have held back because of obstacles that may actually be overcome, begin by calling our Asheville periodontal dental office and speaking to our friendly staff at: 828-274-9440. Many dental implant patients find they were able to achieve the healthy smile they desired once they consulted with us and learned the options based upon their individual needs.

Achieve Smile Goals With A Periodontist

Posted on Dec 11, 2023 by William J. Claiborne, DDS MS

If you’re like me, I’m usually looking at the end of each year feeling like there are several things I wanted to accomplish for the year, but kept putting them off until I ran out of time.

For some people, their oral health and appearance goals are on this list, with some who keep moving the goals to the next year and the next. These goals may include:

• Improving the appearance of a smile

• Having a “cleaner” mouth with fresh breath, etc.

• Replacing missing teeth

• Getting past fear or anxiety of dental visits

If you have one of these on your list, you may be surprised that a periodontal specialist can play a major role in helping you achieve your goals. And, because of the advanced skill level of a periodontist, your comfort, time in treatment and overall results can make the process easier for you.

Many general dentists and other dental specialists refer their patients to a for their specific skills. A periodontist is a dental specialist who is the expert in caring for the gum tissues in your mouth and in the placement of dental implants.

The majority of patients arrive because of periodontal (gum) disease. Common symptoms are red, swollen and tender gums. It often causes gum that bleed easily (often noticed when brushing teeth) and persistent bad breath.

Gum disease (sometimes referred to as ‘perio’ disease) only worsens without treatment. It is the leading cause of adult tooth loss. Additionally, it has been linked to the development or worsening of a long list of serious health problems elsewhere in the body.

Because the inflammatory bacteria disease can enter the bloodstream through diseased gums, their presence can activate conditions that are seemingly unrelated to oral health. Yet, the connection is severe. These health problems include stroke, heart attack, Alzheimer’s disease, dementia, preterm babies, some cancers, arthritis, diabetes, and erectile dysfunction (ED).

In our Asheville periodontal dental office, we are able to treat all stages of gum disease to restore your oral health and minimize the risk of tooth loss. For those who have developed gum disease because they’ve been afraid of dental visits, we offer oral and IV sedation (“twilight sleep”).

Sedation is administered safely by a doctor in anesthesia who uses advanced safety equipment. Our priority is always patient comfort with their safety equally so.

Too, our advanced technology is able to minimize treatment time with amazing results. For example, LANAP (Laser-Assisted New Attachment Procedure) combined with PERIOLASE MVP-7 is designed to efficiently and effectively treat periodontitis (advanced gum disease) with the advantages of a dental laser. This offers non-surgical treatment for patients with moderate to severe periodontal disease. LANAP treatment minimizes discomfort and has a quick recovery time. It has also been found to stimulate bone regrowth in damaged areas.

When tooth loss has occurred (whether from gum disease, an accident, or due to genetics), our NW NC dental specialty office also works with a number of dentists in the diagnosis and placement of dental implants.

With over 40 different implant systems, the one suited best for you depends on factors that an experienced dentist must take into consideration. For example, the number of implants you need and how much jaw bone mass exists.

For individuals who have lost a great deal of bone, specific implant types may be recommended. Some, like the “All On 4” implant system, uses specially designed implants which are placed at specific angles.

Bone loss can also be overcome by incorporating a bone rebuilding process into treatment. This is done prior to implant placement and does not require a bone graft. In many cases, we can apply a bone rebuilding material that restores ample bone mass.

The same is true when the sinus cavity will be too close to the proximity. This can be remedied through a “sinus lift.” We provide complete services of these procedures as well as dental implant placement – all performed with advanced skills and technology, such as our Cone Beam 3D imaging.

These images are ideal in diagnosis and treatment planning by giving a clear view of the mandible and maxilla (upper and lower jaw). Cone beam radiographs provide images in sagittal, axial, and coronal planes. This makes it possible to locate and trace the mandibular nerve canal for pre-surgical planning for an ideal implant position. Patients are exposed to only minute levels of radiation through a process that is fast and comfortable.

When the enhanced appearance of a smile is being sought, a periodontist also plays a part in helping to create a balanced smile line. In the procedure known as “crown lengthening,” the arch of gum tissues over teeth visible in a smile can be repositioned. This is done in a procedure known as a gingivectomy.

A gingivectomy is also performed to repair a “gummy smile.” This is when too much gum tissue shows above the teeth most visible in a smile. While the condition is not detrimental to oral health, some individuals seek to have it corrected by a periodontist.

Get the coming year started with your smile goals achieved! Call our Asheville periodontal dental office to schedule a consultation. Our friendly staff can help you arrange this private time together by calling 828-274-9440.