Dental Implants Not ‘One Size Fits All’

Posted on Sep 21, 2021 by William J. Claiborne, DDS MS

A periodontist specializes in the diagnosis and placement of dental implants, in addition to the treatment of all stages of periodontal disease.

For people who are considering dental implants to replace teeth, this level of expertise provides greater reassurance of successful treatment outcomes. A periodontist can also offer patients with a wider choice of implant systems.

How can patients have more dental implant options through a periodontist?

When general dental offices offer dental implants, some general dentists offer implant selection and placement along with the restoration of the implant. (“Restoration” refers to the replacement crown that is attached to the implanted portion.)

Although generalists complete training in dental implants, most courses are offered by particular implant manufacturers. This means that the course focuses on the systems available through this one maker, which may or may not include the one most appropriate for your individual needs.

This is why most generalists refer the placement portion to a periodontal specialist. For their patient, this can mean a higher level of success, especially for complex needs.

For example, a patient who is missing a lot of bone mass (due to missing natural teeth for many years) benefits from the specialized skills of our Asheville periodontal office. A periodontist can incorporate bone rebuilding procedures into treatment to a proper depth. This specialist 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.

For many reasons, dental implants have become the preferred tooth replacement option. There are over 40 different implant systems, each designed to accommodate various challenges and preferences. Some of the more common types include:

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Traditional Dental Implants: In this process, dental implant treatments is done in a couple of stages. In the first stage, placement of each implant is performed. This involves small incisions in pre-selected placement points. In our Asheville periodontal dental office, these points are determined through computerized imaging, taking the guesswork out of the depth and angle of each implant placed. Once the implant is in proper position, the gum tissue is closed over the implant sites.

The second stage involves a “healing period” of 3 – 6 months. During this phase, the bone grows around the implant(s) to secure each in place. The patient’s denture or partial denture can be comfortably worn during this time. This process is known as osseointegration, which describes the jaw bone growing around the implanted portion. This is what secures the implant so it provides stable, dependable biting and chewing strength.

After osseointegration is complete, the implant sites are uncovered and a post is positioned in the implant’s interior. Onto the posts, replacement teeth are attached. Once the final teeth are secured, patients can enjoy their confident smile along with the biting and chewing comfort like that of natural teeth.

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Non-Removable Teeth Attached To Implants: In the past, the more affordable ‘full arch’ systems were typically those designed to support removable teeth. (An ‘arch’ is a full arrangement of all upper or all lower teeth.) However, some people feel removable teeth are too similar to the denture they wish to replace. Although firmly secured, the chore of having to remove teeth to clean them is a task many people want to eliminate.

A number of affordable implant systems are now available, designed to provide non-removable options that are more affordable. For example, the All On 4 dental implant system is made to support non-removable teeth on just 4 implants. With the implanted portions placed at unique angles, these longer implants can fully distribute biting and chewing forces.
 Another advantage of All On Four is their ability to be placed in minimal bone.

This is good news for people who are long-time denture wearers and were told they have too little bone to support implants. Or, they may have been advised to have bone grafts to rebuild the bone to an adequate height. This adds time and expense to implant treatment. Often, the All On 4 design is able to overcome this obstacle.

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‘Same-Day’ Dental Implants: Advancements in dental implant systems and technology have evolved into implant placement and teeth attachment that can be accomplished in a single day. Some implant designs can position implants in the jaw bone in a way that they are able to support replacement teeth immediately.

With the replacement teeth created prior, the teeth may be attached without delay.
 In some cases, a previously-made denture or partial can be reconfigured to attach to newly placed implants. However, mounting replacement teeth to a just-placed implant isn’t wise for certain situations. This option should be diagnosed and performed by an experienced, skilled and highly-trained dental specialist in order to achieve a successful outcome. While “same-day” procedures can sound appealing, choose care where your individual needs are a priority.

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Modern implant dentistry is successful, safe, dependable and can provide nearly immediate benefits. Our office enjoys a reputation for being on the cutting edge of implant dentistry’s techniques, technology and materials. This assures our patients of care that minimizes discomfort and treatment time while optimizing their final results.

Dental implants are designed to last a lifetime, making them an excellent investment. They are the closest thing to the natural teeth you once had, restoring the ability to bite, chew, speak and laugh confidently.

Over the years, I have been a witness to the transformations many implant patients undergo after treatment. They seem to smile and laugh more, become more social, and focus on their oral and overall health to a greater extent.

The type of dental implant best suited for you can be determined after an examination and review of x-rays (we use Cone-Beam digital imaging). Call 828-274-9440 to begin with a private, no obligation consultation to discuss your best options.

Please know that, if cost is a concern, payment plans can help you enjoy your beautifully restored smile while making easy monthly payments. Too, in many cases, an implant is not needed to replace each missing tooth. Often, when several teeth are missing in one area, one or two implants can support a “bridge” of several teeth. This curtails the treatment costs by reducing the number of implants needed.

If dental fear or anxiety is a concern, please mention this during our consultation. In our Asheville office, our entire team strives to provide a respectful, compassionate environment. We offer oral and I.V. sedation (twilight sleep) for nearly any procedure as well as a gentle touch at every visit.

Know The Qualifications of Who Places Your Dental Implants.

Posted on Apr 05, 2021 by William J. Claiborne, DDS MS

When someone has lost a natural tooth, the word that stands out for me is “lost”. A missing tooth means a lot can be lost.

Tooth loss not only leaves a gap in the appearance of a smile, its absence can lead to movement of surrounding teeth.

For example, some people assume that a lost back tooth that is not visible doesn’t need replacing. This is an incorrect assumption. Without all teeth in their proper positions, a gap can cause others to tilt and turn. Additionally, the one above or below will grow longer. These misalignment issues can lead to broken, fractured, or chipped teeth.

Misaligned teeth can also lead to strain on the TMJ, or jaw joints. These joints, located on each side of the head just in front of the ears, are hinges that connect the lower jaw bone to the skull. They are in motion almost constantly.

When the jaw joints experience frequent strain from misaligned teeth, they can cause pain that extends out to head, neck and shoulder muscles. TMJ-related pain can be the source for headaches, migraines, facial pain, ear ringing, dizziness, pain when chewing and difficulty opening the mouth fully.

Obviously, replacing teeth is important. Because of many factors, a dental implant is the superior choice in tooth replacement. A dental implant is a lifetime replacement option. Dental implants restore the ability to bite, chew, speak and laugh confidently without worry. The security of their strength and stability can also be greatly beneficial to one’s self-esteem and self-confidence.

Too, dental implants actually enhance the well-being and lifespan of surrounding teeth. They are an exceptional value when considering their ability to restore the most natural look, feel and function.

In dental implant treatment, the implanted portion is positioned in the jaw bone as a tooth root replacement. This provides attached teeth with the same foundation as natural tooth roots. A partial or bridge simply sits on top of gum tissues and relies on adjacent teeth for support.

Yet, it can be in WHO is involved in your dental implant diagnosis and placement that can provide you with optimal comfort and lifelong success.

When dental offices offer dental implants, many general dentists refer the placement portion to a periodontal specialist. For their patient, this can mean a higher level of comfort and success, especially for complex needs.

However, some dentists offer dental implant placement in their offices. While some have taken extensive courses in implant dentistry, others may have taken a weekend course here and there. These quick courses are typically hosted by an implant manufacturer who trains attendees with a limited selection of implant types. This can limit the patient’s choices when relying on appropriate recommendations for his or her unique needs.

Although there are many factors to go forward with a dental implant, your choice of doctor to place the implanted portion can greatly increase your potential to enjoy your dental implant for a lifetime.

As a periodontist, an aspect of the specialty is the advanced training in the diagnosis and placement of dental implants. This specialized expertise affords patients with a wider variety of choices when it comes to implant systems as well as success in treatment outcome.

For example, consider a patient who is missing a lot of bone mass (often due to missing natural teeth for many years). An implant placed in the upper jaw in too-shallow bone can work its way into the sinus cavity. A lower implant in insufficient bone depth can reach a nerve that runs horizontally through the lower jaw (the mandible).

Additionally, the shape, size and the number of teeth to be attached to an implant have much to do with the type of implant system selected. When the placement doctor is only familiar with one or two types, the limitation may pose problems for the patient in the future.

Along with an intricate knowledge of the specific type of implant needed, proper placement angles and depth have much to do with the overall success of the implant. For optimal results, the doctor placing the implant should be skilled in the selection of the implant angles and positioning depths.

In our Asheville periodontal office, we restore the well-being of smiles. We also help patients replace bothersome dentures or partials so they can resume eating the foods they love and laugh confidently in social gatherings.

The doctor is not the sole factor in success, however, Along with proper selection and placement, a patient must take measures to ensure proper oral hygiene at home. Oral bacteria can contribute to an infection that works its way into the bone surrounding the implant. In some cases, the only way to resolve the infection is to remove the implant.

The most troubling thing I see in implant dentistry is when a patient opted for a “good deal” with a less-experienced doctor, and having to remove a ‘failed’ implant.

When a patient entrusts their implant treatment to a skilled doctor and adheres to hygiene and healing guidelines, having an implant fail is very unlikely. The success rate of today’s implant dentistry is excellent – over 97 percent.

Today’s implant dentistry is successful, safe, dependable and can provide nearly immediate benefits. As a dental specialist who has stayed on the cutting edge of implant dentistry’s techniques, technology and materials, I am pleased to witness the transformations our patients undergo after treatment.

The type of dental implant best suited for you can be determined after an examination and review of x-rays (we use Cone-Beam digital imaging). Call 828-274-9440 to begin with a private, no obligation consultation to discuss your best options.

Tooth Loss Cause of Shrinking Face, Sunken-In Mouth

Posted on Jan 14, 2021 by William J. Claiborne, DDS MS

The aging process is not an easy one. Joints begin to creak, muscles are more easily strained, skin dries out, eyesight wanes and hearing declines.

Yet, throughout the aging process, some adults seem to go through it as less of an ordeal than others. Although diseases and certain health conditions can occur regardless of how well some people manage, some people take a number of steps that can have a significant impact on aging well and “getting old.”

The basics of good health include a diet low in sugar, alcohol and unhealthy fats. NOT smoking is a big factor in maintaining a healthy body. Regular exercise, sufficient sleep and regular physicals and dental check-ups are all beneficial.

A factor that plays a bigger role in having good overall health is having natural teeth. Having the ability to comfortably bite and chew food is important to effective digestion, since the digestive process 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.

An extensive study on “The Link Between Teeth and Emotions” was published by Clinical Psychology of Oral Health (https://journals.sagepub.com/doi/full/10.1177/2158244017728319) in 2017.

In the study, the concept of quality of life was categorized in five dimensions: physical well-being, material well-being, social well-being, emotional well-being, and development and activity”.

The authors found that oral health is “an integral part of general health and well-being” and examined how oral disorders may impair at least three of the five dimensions: the physical, emotional, and social well-being.

The authors found also an association between oral health and late life depression (LLD) in older adults, who experienced “compromised social function and impaired self-maintenance skills (e.g., bathing, dressing, hygiene).” This depression can cause a loss of pleasure and interest for daily life activities, and even in the interest in personal oral hygiene.

Oral health not only has an impact on the psychological well-being of older adults, the physical changes attributed to tooth loss are of equal concern to many denture wearers.

Let’s look at your oral anatomy for a moment…

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.

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 bones, 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.

Although dentures and partials may seem to be a less-expensive way to replace teeth, the savings is hardly worth the detrimental repercussions associated with them. Too, the upkeep required for dentures over time is actually high, considering replacement, relines and repairs.

As a periodontal specialist serving Western NC, I take great pride in the diagnosis and placement of dental implants. Each is 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.

Begin with a friendly conversation in our private consultation room. In this comfortable setting, we’ll discuss your options and I’ll answer your questions. For many people, they are able to make a decision on how they wish to proceed after this conversation, even if it’s to go forward with dentures. We are supportive of each person’s preferences.

Call 828-274-9440 to schedule a consultation in our state-of-the-art Asheville periodontal dental office. I think you’ll feel especially confident in learning about our specialized skills and highly-advanced technology, not available in many dental offices in this area.

 

 

 

 

The 1-2-3’s Of Dental Implants

Posted on Apr 29, 2020 by William J. Claiborne, DDS MS

Over time, certain things are often referred to in catchphrases that simplify what is being described. For example, “Kleenex” is actually a brand name that refers to tissues. “Clorox” is commonly used as a generic for bleach, even though it’s a specific brand. And, “Uber” has become a way to describe a paid means of auto transportation, even if a taxi or Lyft is being used.

This is why the term “dental implant” may be confusing to some people. This implies the replacement of a missing tooth or teeth with a base that is implanted  into the jaw bone. However, to be clear, a dental implant is not an entire structure. Let’s look at the various components of a complete dental implant system.

Although there are different types of implant systems (designed to accommodate specific needs), all work in in a similar fashion. The actual “implant” is a hollow, screw-like cylinder. This is the portion that is actually “implanted” in the jaw bone at a strategic angle and depth.

Once placed, the implant is covered over with gum tissue. For several months after, the implant goes through a process known as “osseointegration.” In this, the bone grows around the implanted portion, which secure it in place. This restores the foundation like that of natural teeth for dependable and comfortable biting and chewing stability.

This stage, often referred to as the “healing” process, typically takes several months. However, a denture or temporary can be worn comfortably so going without teeth is not a worry.

Once healing is complete, a post is secured inside the hollow core of the implant. This post will support your final replacement tooth or teeth. Most replacement teeth are made of porcelain, which provides the most durable of all materials used in dental restorations.

Porcelain is an ideal material for replacement teeth. It is less resistant to stains and provides an exceptionally natural look and feel, even reflecting light as a natural tooth.

A successful outcome in any Dental Implant treatment begins with the selection and placement process. A Periodontist has specialized training in the diagnosis and placement of all types of implant systems. This means the implant system recommended for you will be the type most suited to your individual needs and goals.

An important aspect of implant success also relies on the assessment of bone mass. When the upper or lower jaw has insufficient bone to support the implant being placed, there is a risk of failure. This can occur in implants placed too close to the sinus cavity (for upper implants) or a nerve that runs through the mandible (lower jaw).

Too, an implant requires careful selection and placement in order to adequately support the replacement teeth being attached. In some cases, as few as 4 – 6 implants can support a complete arch of teeth. This decision is best left in the hands of a periodontal specialist.

In cases of severe bone loss, a periodontist can also perform bone rebuilding procedures prior to implant placement. This is sometimes through bone grafting but most commonly the application of a bone-rebuilding material. Additionally, some implant systems, such as the “All On 4” utilize unique angles to provide support in minimal bone depth with no bone rebuilding necessary.

The best implant system for you can be determined after an examination. During this time, I can discuss options best for you and explain the process. Call 828-274-9440 to schedule an appointment. Or, ask to begin with a Consultation.

We also encourage you to share any concerns about comfort options or treatment fees. Many people avoid looking into dental implant treatment because they are afraid of the procedure or fear they cannot manage the fees. Rather than assume these are obstacles, share your concerns so we can address them head on!