Posts for: January, 2019
With their durability, versatility and life-likeness, there’s no doubt dental implants have revolutionized teeth replacement. If you’re considering dental implants, however, there are some issues that could impact how and when you receive implants, or if you should consider another type of restoration.
Cost. Dental implants are initially more expensive than other tooth restorations, especially for multiple tooth replacement. However, be sure you consider the projected cost over the long-term, not just installation costs. Because of their durability, implants can last decades with little maintenance cost. In the long run, you may actually pay more for dental care with other types of restorations.
Bone health. Dental implants depend on a certain amount of bone to properly situate them for the best crown placement. If you’ve experienced extensive bone loss, however, there may not be enough to support the implant. This can often be overcome with grafting — immediately after extraction, at the time of implantation or a few months before implantation — to encourage bone growth. In some cases, though, bone loss may be so extensive you may need to consider an alternative restoration.
Gum Health. While implants themselves are impervious to infection, they’re supported by gum and bone tissues that can be affected. Infected tissues around an implant could eventually detach and lead to implant failure. If you have periodontal (gum) disease, we must first bring it under control and render your gums infection-free before installing implants. It’s also important to maintain effective oral hygiene and regular dental cleanings and checkups for optimum implant health.
Complications from osteoporosis. People with osteoporosis — in which the bones lose bone density and are more prone to fracture — are often treated with drugs known as bisphosphonates. In less than 1% of cases of long-term use, a patient may develop osteonecrosis in which the bone in the jaw may lose its vitality and die. As with bone loss, this condition could make implant placement difficult or impractical. Most dentists recommend stopping treatment of bisphosphonates for about three months before implant surgery.
If you have any of these issues or other complications with your oral health, be sure to discuss those with us before considering dental implants. With proper planning and care, most of these difficulties can be overcome for a successful outcome.
If you would like more information on pre-existing conditions that may affect 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 articles “Osteoporosis & Dental Implants” and “Infections around Implants.”
You've been treating a persistent rash around your mouth with medicated ointments, but it's not going away. The problem may be the ointment — it could actually be sustaining the particular rash you have.
Peri-oral dermatitis is a scaly rash with small bumps (some filled with pus) around the mouth, eyes or nose. It's especially common among women ages 20-45, possibly due to hormonal factors or cosmetic use. Other than its unattractiveness you might not otherwise notice it, although it can cause stinging, itching or burning. There are ways to treat it effectively, though not necessarily the way you might think.
Many skin conditions respond well to topical steroids, like ointments or lotions containing hydrocortisone. But prolonged use of a steroid for skin irritations might actually increase risks for peri-oral dermatitis. Applying it to an existing rash may also deceive you — the steroid constricts some of the skin's tinier blood vessels, which will make the rash appear as if it's fading. The effect, though, usually doesn't last more than an hour. If you continue to use the steroid, the rash won't get better.
The key to alleviating peri-oral dermatitis requires treatment from a physician, dermatologist or dentist, who will also be able to accurately diagnose the specific skin condition you have. If it is peri-oral dermatitis, the first step is to stop using any topical steroids and only wash with mild soap or similar substitute. You'll have to be patient because the rash may at first appear to flare up and worsen before getting better.
Instead of steroids, we may prescribe antibiotics to help clear the rash, typically tetracycline. It may take several weeks of use before the rash begins to clear; as it does clear, you would either stop the antibiotic treatment or taper off over a four-to-five week period.
While some cases of peri-oral dermatitis will clear up and remain that way, some people may experience chronic reoccurrences. Even so, by using the same treatment approach we can still effectively manage the condition for the long-term.
While oral hygiene, a nutritious diet and regular dental visits are all crucial to long-term oral health, these efforts complement what your body already does to keep your mouth healthy. One of the major players in this function is saliva.
Produced by hundreds of glands located throughout the mouth, saliva does much more than help you swallow and wash away food. As you chew, an enzyme in saliva known as amylase breaks down starches in your food to make it easier to digest in the stomach. Saliva also contains antibodies, similar to what’s in tears, which can fight bacteria and other disease-causing organisms.
Perhaps its most important function, though, is its ability to protect and maintain healthy tooth enamel. The strongest substance in the body, enamel nevertheless has one primary enemy — the acid found in certain foods or as a byproduct of bacteria feeding on sugar and other carbohydrates.
When the ideally neutral pH level of the mouth becomes too acidic (nearly every time you eat), minerals in the enamel begin to soften and dissolve. The increased saliva flow when we eat floods the mouth with buffering agents that neutralize the acid and restore the mouth’s normal pH level. Not only does saliva stop demineralization, but it also restores a good bit of the enamel’s mineral content.
In recent years, a new role for saliva has begun to emerge as a means to diagnose disease. Like blood, urine and other bodily fluids, saliva contains molecules that serve as biological markers for disease. Given the right equipment, saliva has the potential to indicate early signs of cancer (including oral), diabetes and other systemic conditions. As the means to examine saliva for these markers increases it promises to be easier and less expensive to collect and sample than blood, while reducing the chances of transmitting bloodborne diseases to healthcare workers.
It’s a lot to consider with this fluid that you hardly notice, except when it isn’t there. Saliva is proof that our efforts at keeping our mouths healthy cooperate and depend on our bodies’ amazing systems.
If you would like more information on saliva and other ways your body maintains a healthy mouth, 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 “Saliva.”