Dental implants are far and away the most “tooth-like” restoration available today for missing teeth. Not only do they look real, they also mimic dental anatomy in replacing the tooth root.

To install an implant, though, requires a minor surgical procedure. And, as with any surgery, that includes a slight risk for a post-surgical infection. For most patients this isn't a major concern—but it can be for people with certain medical conditions.

One way to lessen the risk for implant patients whose health could be jeopardized by an infection is to prescribe a prophylactic (preventive) antibiotic before implant surgery. The American Dental Association (ADA) recommends the measure for patients with artificial heart valves, a history of infective endocarditis, a heart transplant and other heart-related issues.

In the past, their recommendation also extended to people with joint replacements. But in conjunction with the American Academy of Orthopedic Surgery (AAOS), the ADA downgraded this recommendation a few years ago and left it to the physician's discretion. Indeed, some orthopedic surgeons do recommend antibiotic therapy for patients before surgical procedures like implantation for up to two years after joint replacement.

These changes reflect the ongoing debate over the proper use of antibiotics. In essence, this particular argument is over risks vs. benefits: Are pre-surgical antibiotics worth the lower infection risk for patients at low to moderate risk in return for increased risk of allergic reactions and other side effects from the antibiotic? Another driver in this debate is the deep concern over the effect current antibiotic practices are having on the increasing problem of antibiotic-resistant bacteria.

As a result, dentists and physicians alike are reevaluating practices like prophylactic antibiotics before procedures, becoming more selective on who receives it and even the dosage levels. Some studies have shown, for example, that a low 2-gram dose of amoxicillin an hour before the procedure can be effective with much lower risks for side effects.

If you're considering dental implants and you have a medical condition you think could be impacted by the procedure, discuss the matter with your dentist and physician. It may be that pre-surgical antibiotics would be a prudent choice for you.

If you would like more information on getting 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 “Implants & Antibiotics.”

The 2019 Grammy Awards was a star-studded night packed with memorable performances. One standout came from the young Canadian singer Shawn Mendes, who sang a powerful duet of his hit song "In My Blood" with pop diva Miley Cyrus. But that duo's stellar smiles weren't always quite as camera-ready as they looked that night.

"I had braces for four and a half years," Mendes told an interviewer not long ago. "There's lots and lots and lots of photo evidence, I'm sure you can pull up a few." (In fact, finding one is as easy as searching "Sean Mendes braces.")

Wearing braces puts Mendes in good company: It's estimated that over 4 million people in the U.S. alone wear braces in a typical year—and about a quarter of them are adults! (And by the way: When she was a teenager, Miley Cyrus had braces, too!)

Today, there are a number of alternatives to traditional metal braces, such as tooth-colored braces, clear plastic aligners, and invisible lingual braces (the kind Cyrus wore). However, regular metal braces remain the most common choice for orthodontic treatment. They are often the most economical option, and can be used to treat a wide variety of bite problems (which dentists call malocclusions).

Having straighter teeth can boost your self-confidence—along with helping you bite, breathe, chew, and even speak more effectively. Plus, teeth that are in good alignment and have adequate space in between are easier to clean; this can help you keep your mouth free of gum disease and tooth decay for years to come.

Many people think getting braces is something that happens in adolescence—but as long as your mouth is otherwise healthy, there's no upper age limit for orthodontic treatment. In fact, many celebrities—like Lauren Hutton, Tom Cruise and Faith Hill—got braces as adults. But if traditional braces aren't a good fit with your self-image, it's possible that one of the less noticeable options, such as lingual braces or clear aligners, could work for you.

What's the first step to getting straighter teeth? Come in to the office for an evaluation! We will give you a complete oral examination to find out if there are any problems (like gum disease or tooth decay) that could interfere with orthodontic treatment. Then we will determine exactly how your teeth should be re-positioned to achieve a better smile, and recommend one or more options to get you there.

If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Lingual Braces: A Truly Invisible Way to Straighten Teeth.”

Complete tooth loss is a common condition among older adults, gradually occurring one or two teeth at a time. There often comes a point of realization, though, that all the teeth will eventually be lost.

This can create a dilemma: Do you replace teeth as they're lost, or go ahead and have all of them removed at one time?

Up until recently, the latter choice seemed the most practical and affordable. But most dentists would agree that keeping natural teeth for as long as practical is better for a person's overall oral health and to slow any potential bone loss.

The emergence of dental implants has made this less of a dilemma: We can use this technology to more affordably replace teeth in stages rather than all at once. This is because an implant is technically a root replacement: a dentist inserts a titanium metal post into the jawbone. Because of an affinity with titanium, bone cells grow and adhere to the implant surface, which creates a stronger hold. It also impedes bone loss.

We can, of course, use implants as individual tooth replacements. But the expense of this approach with multiple teeth puts it well out of reach financially for many people. But implants can also be used as connective points between the patient's jaw and other kinds of dental restorations like bridges, partial dentures, and full removable or fixed dentures.

Using this approach, we can adopt a strategy of allowing healthier teeth to remain until it's necessary to remove them. We initially place implants to support a bridge, for example; later we can use the same implants along with additional ones to support a larger restoration, even a fixed full denture.

An implant-supported restoration is typically more expensive than traditional bridges or dentures, but far less than replacing teeth with individual implants. And because the stages of restorations may occur over a long period of time, the cost can be spread out to make it more manageable.

If you're facing a future where it's likely you'll lose all your teeth, you don't have to lose them all at once. Staged restorations with implants could help you hold on to your natural teeth for as long as possible, slow bone loss and make for a healthier mouth.

If you would like more information on the wide array of dental restoration options, 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 “Replacing All Teeth But Not All at Once.”

We all want to look young and vibrant, or at least “age gracefully.” If you're seeking to reduce the visible effects of aging for a more youthful appearance, be sure you include one very important feature—your smile.

Like other aspects of body and health, our teeth and gums can be affected by aging. Even if you've managed for the most part to avoid the ravages of disease or injury, teeth will still naturally wear from a lifetime of biting and chewing food. The attractive shine of young teeth can also give way to yellowing and other discolorations later in life.

But there are ways to turn back the clock, so to speak, through cosmetic dentistry. And you won't necessarily break the bank to gain a more youthful smile: Many cosmetic procedures are quite affordable and minimally invasive.

If your teeth have become worn and edgy, for example, we may be able to soften those sharper edges with a dental drill. Known as enamel contouring (or reshaping), the single-visit procedure is relatively minor and inexpensive, usually without the need for anesthesia. For heavily worn teeth, you may need to step up to veneers, thin layers of tooth-colored porcelain, or crowns that cover the teeth and make them appear longer.

Mild enamel yellowing and staining often responds well to professional teeth whitening. Using a safe bleaching solution, we can temporarily restore brightness to your teeth that you may be able to maintain for a few years with proper care and occasional touchups. For a more permanent solution you can also turn to veneers, crowns or dental bonding for a brighter smile, especially for discolorations that don't respond well to teeth whitening.

While these techniques can restore a youthful appearance to your smile, don't discount the effect of daily care and regular dental visits. Brushing and flossing are fundamental to healthy teeth and gums—and health and beauty go hand in hand.

Age can take its toll on all of us, especially our smiles. But with proper care and perhaps a little cosmetic magic, you can have an attractive smile throughout your lifetime.

If you would like more information on improving your smile 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 Your Dentist Can Help You Look Younger.”

Losing your teeth can be a traumatic experience with serious consequences for your overall health. Fortunately, you have great options for replacing lost teeth that can restore both appearance and dental function.

One such option is a fixed bridge supported by dental implants. While implants are best known for single tooth replacement, they can also be used with other restorations like bridges. In this case, the bridge is screwed into a few well-placed implants to support it.

Implants can provide bridges with more security and support, and without the need to alter adjacent teeth that are commonly used for traditional tooth replacement. They may also slow or stop bone loss because the titanium in implants naturally attracts bone cells that grow and adhere to its surface and provide stimulation to the bone cells during function.

Because of these benefits an implant-supported bridge could be a life-changer that provides years of satisfaction. But we can’t simply “set them and forget them”: They require dedicated oral hygiene just like natural teeth.

While the bridge materials and implants themselves are in no danger from disease, the same can’t be said for the implant’s supporting gums and bone. Dental plaque, the main driver in gum disease, can place these tissues at risk for infection that could eventually lead to implant failure.

It’s important, then, for you to floss around your new implants to remove any plaque. This differs from regular flossing in which you work the thread between teeth. Instead, you’ll have to maneuver the floss between the bridge and gums with the help of a floss threader, a small slender tool with a loop at one end and a stiffer plastic edge at the other (similar to a sewing needle).

To use it, first run 18” of floss through the loop until you get equal lengths and then work the tail of the floss threader between the bridge and gums while holding one end of the floss. Once through, you pull the floss threader through so that the floss is on either side of the bridge. Then grab each end of the floss and pull it snug to floss up and down one side of the implant. Go to the next side and repeat this procedure for all the implants.

As an alternative, you could use an oral irrigator, which emits a pulsating spray of water to loosen and wash away plaque. Either way, though, it’s important to floss around implants to get the most life out of your bridge.

If you would like more information on proper care for implant-supported restorations, 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 “Oral Hygiene for Fixed Bridgework.”