My Blog

Posts for: November, 2019

By George R. Shepley, DDS
November 26, 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 George R. Shepley, DDS
November 16, 2019
Category: Oral Health
Tags: oral health   vaping  
VapingCouldBeJustasHarmfultoYourTeethandGumsasSmoking

The electronic cigarette (e-cig), the much-acclaimed smoking alternative, has recently been linked to hundreds of lung-related illnesses and deaths among otherwise healthy young adults. But dentists were actually among the first to sound alarm bells on the potential harm of “vaping,” particularly to dental health.

If you're vaping as a substitute for smoking, you may be trading one set of oral health risks for another. Many dentists believe vaping may be no safer for your mouth than traditional tobacco.

An e-cig is a small, handheld device that holds a mixture of water, flavoring and chemicals. The device heats the liquid until it becomes a gaseous aerosol the user inhales into their lungs. Proponents say it's a safer and cleaner alternative to smoking. But, like cigarettes, vaping mixtures can contain nicotine. This chemical constricts blood vessels, decreasing nutrients and infection-fighting agents to the gums and increasing the risk of gum disease.

And although vaping flavorings are FDA-approved as a food additive, there's some evidence as an aerosol they irritate the mouth's inner membranes and cause mouth dryness similar to smoking. Vaping liquids also contain propylene glycol for moisture preservation, which some studies have shown increases a buildup of plaque, the bacterial film most responsible for dental disease.

All of these different effects from vaping can create a perfect storm in the mouth for disease. So, rather than switch to vaping, consider quitting the tobacco habit altogether. It's a solid thing to do for your teeth and gums, not to mention the rest of the body.

As we commemorate the Great American Smokeout on November 21, this month is the perfect time to take action. Here are some tips to help you kick the habit.

Don't try to quit all at once. Your body has developed a physical connection with nicotine, so quitting “cold turkey” can be extremely difficult and unpleasant. Although different approaches work for different people, you may find it easier to overcome your habit by gradually reducing the number of cigarettes you smoke each day.

Enroll in a cessation program. There are a number of step-by-step programs, some involving medication, that can help you quit smoking. Talk to us or your doctor about using a cessation program to end your tobacco habit.

Seek support from others. Beating the smoking habit can be tough if you're trying to do it solo. Instead, enlist the help of family and friends to support you and keep you on track. Consider also joining a supervised support group for quitting smoking near you or online.

Smoking can harm your dental health and vaping may be just as harmful. Distancing yourself from both habits will help you maintain a healthier smile and a healthier life.

If you would like more information about the effects of vaping and tobacco use, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Vaping and Oral Health” and “Smoking and Gum Disease.”


TheRealTruthBehindEdHelmsMissingToothinTheHangover

Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.

In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.

Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.

Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.

If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.

The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.

Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.

If you would like more information about restoring missing teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Dental Implants.”