Why is it important to replace missing teeth with restorations such as dental implants? You might be surprised to find that the damage caused by missing teeth is much greater than the simple gaps left in your smile.

As the years go by, teeth lost early in adulthood cause structural changes in a person's face. By age 45 changes in facial structure are already visible in the form of sunken cheeks. By 60, cheeks and lips lose their support, resulting in an aging look. This process continues and if the teeth are not replaced, much of the structural support of the person's face is lost.

These changes are caused by loss of bone. Although it may seem static, bone is actually living tissue that needs constant stimulation to maintain its form and density. With normal stimulation it is in a constant state of resorption (breaking down) and deposition (building up). Teeth provide the needed stimulation for the bone that surrounds them (called alveolar bone) as they meet each other during biting, chewing, and speech. When the stimulation continues, the bone continues to rebuild itself. Without this stimulation, the bone resorbs, does not build up again, and loses substance.

Without stimulation, alveolar bone loses width, height, and volume. Since your teeth and their surrounding bone support your chin, cheeks, and lips, this has a powerful effect on your appearance. It may also affect your ability to chew and to speak.

As alveolar bone diminishes, the next layer of bone also begins to resorb. This is the bone of the jaw itself. The lower part of the face begins to collapse, and the cheeks become hollow. This effect is especially noticeable for people with no teeth (edentulous).

Usually the first tooth to be lost, due to infection and decay, is a molar (back tooth). In the past, a missing single back tooth was frequently replaced by a fixed partial denture (FPD). A crown is provided for each of the two teeth on the sides of the gap, called abutment teeth, to support a false tooth in the middle. However, if they are not well cared for, the abutment teeth may be the next to succumb to decay.

Today the treatment of choice is an implant. A dental implant is a tooth-root replacement made of titanium, which fuses with the bone — making it very stable. Above the gums it is covered by a crown that looks like a natural tooth. The benefit of the implant is that it continues to provide stimulation to the alveolar bone, preventing bone loss.

Implants are also a good choice in the case of multiple missing teeth. They can be used to support bridges or false teeth (dentures). The results are an improved, younger appearance and better functionality.

Contact us today to schedule an appointment to discuss your questions about missing teeth. You can also learn more by reading the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”

Both diabetes and gum (periodontal) disease are chronic inflammatory diseases that have negative consequences for millions of people worldwide. But before we continue, let's define these two diseases:

Periodontal disease is a condition in which biofilms of dental bacterial plaque stick to teeth near the gum lines causing the gum tissues to become inflamed and infected. If not treated properly and in an early stage, it can cause severe damage to the bone that supports the teeth, resulting in tooth loss. It occurs in the absence of good oral hygiene which includes ineffective daily brushing and flossing and neglecting to see your dentist.

Diabetes is a chronic condition in which blood glucose (sugar) levels become excessive. Glucose is the body's main source of sugar for energy. The hormone insulin, among other mechanisms, normally controls glucose. Prolonged elevated blood sugar levels are harmful and ultimately can even be life threatening if left untreated. With type 1 diabetes, insulin injections (shots) are required to maintain the proper blood sugar levels because the body no longer produces its own blood sugar. Type 2 diabetes is generally less severe and can usually be treated with a combination of diet and medication.

And while both of these diseases share the same common enemy, you, there is scientific evidence revealing links between the two. Diabetes increases the risk factor for developing periodontitis, and conversely, periodontal disease makes it more difficult for diabetics to control blood glucose levels.

Want To Learn More?

Learn more about these two diseases and their relationship by reading, “Diabetes & Periodontal Disease.” Or if you have diabetes but haven't had a dental exam and cleaning in a long time, contact us today to schedule a consultation. You can also use this consultation to discuss any questions or concerns you have about your oral health and its relationship to your diabetes.

Many youngsters look forward to finding a surprise under their pillow after a visit from the “tooth fairy.” This fable may comfort children who wonder why their first teeth come out. Parents need to know that losing baby teeth, also called primary or deciduous teeth, is completely normal, but at the right time and the right “space.”

A child's first set of teeth must be lost to create room for the adult or permanent teeth that have been forming beneath them. The buds of the permanent teeth grow within a child's jawbone just under the baby teeth. The tops, or crowns, grow first, followed by the roots. Then as the roots develop, the permanent teeth push the baby teeth above them up through the gum tissues. As this happens, the roots of the baby teeth are resorbed, or melted away.

With their roots gone, eventually the baby teeth become so loose that they can be easily removed or fall out on their own, making room for the adult teeth to appear. Sometimes, when a baby tooth is so loose, it can be wiggled out. It leaves a little bleeding gum tissue that heals easily. This is also normal.

Besides making sure the tooth fairy comes, parents need to be sure that their children are evaluated to determine whether baby teeth are being lost in the right sequence so they will act as guides for the adult teeth. If teeth are lost prematurely because of decay or trauma, it is important that space is maintained for the adult teeth when they come in.

Contact us today to schedule an appointment or to discuss whether your child's baby teeth are being lost in the right sequence and the adult teeth are coming in correctly. To read more about losing baby teeth, see the article “Losing a Baby Tooth: Understanding an important process in your child's development.”

Periodontal (gum) disease, though it may be invisible to everyone but your dentist, can have a powerful effect on your entire body. Not only is it dangerous to your teeth and jaws, but it can increase your risk of heart attack and stroke, cause preterm births in pregnant women, and affect blood sugar control in diabetics.

Diabetics are our subject for today. Symptoms of diabetes include abnormally high levels of glucose (a form of sugar) in the blood, leading to frequent urination, excessive thirst, blurred vision, unexplained weight loss, and loss of energy. The disease can also cause severe complications in various parts of the body.

Normally, glucose, your body's main energy source, is kept under control by a hormone called insulin, which is made by an organ called the pancreas. In type 1 diabetes, a person's pancreas does not produce enough insulin to deal with all the glucose in his or her blood. In type 2 diabetes — a condition related to increased age, physical inactivity, overweight, and heredity — the pancreas may produce enough insulin, but the body is not able to use it effectively. This condition is called insulin resistance.

People with type 1 diabetes need insulin to survive. Type 2 may be treated with exercise, diet, medications, and insulin supplements.

Serious complications of diabetes range from kidney failure, blindness, and nerve damage to infections that do not heal, gangrene and amputation of limbs.

Diabetes and periodontal disease seem to have reciprocal effects on each other. Diabetics are more likely to have periodontal disease than non-diabetics; and those with periodontal disease are likely to face worsening blood sugar control over time.

Periodontal disease (from “peri”, meaning around and “odont”, meaning tooth), is caused by dental plaque — a film of bacteria that settles on your teeth and gums every day. It's what you remove with daily brushing and flossing. Any bacteria that remain cause inflammation, which can lead in the worst cases to loss of bone and eventual loss of teeth.

The close relationship of diabetes and periodontal disease probably results from changes in the function of immune cells responsible for healing. Inflammation is a part of normal wound healing — but chronic or prolonged inflammation can destroy the tissues it was meant to heal. This may be a major factor in the destructive complications of diabetes.

Many of these complications begin in the blood vessels. Like the eyes and the kidneys, gum tissues are rich in blood vessels. Gum tissues are also under constant attack from bacteria. If you are a diabetic, effective plaque control, along with regular professional dental cleaning, can have positive effects not only on periodontal disease, but also on control of your blood glucose level.

Contact us today to schedule an appointment to discuss your questions about periodontal disease and its connections with diabetes. You can also learn more by reading the Dear Doctor magazine article “Diabetes & Periodontal Disease.”

If your teeth have a worn appearance, it's possible you have a habit you're not even aware of: clenching or grinding your teeth. Also called “bruxism,” this destructive action causes your top and bottom teeth to come together or scrape past each other with a force that's many times what is normal for biting and chewing.

So what's normal? This can be expressed in terms of pounds. An adult usually exerts a force of 13-23 pounds to bite or chew food. But we have the potential to generate as much as 230 pounds of force, or 10 times what's normal. A “parafunctional” force of this magnitude applied repeatedly is bound to stress your teeth and other areas of your oral system. Besides wearing away the enamel of your teeth — and maybe even some of the softer dentin layer underneath — you may experience muscle spasms or pain in your jaw joints. Serious cases of wear can lead to “bite collapse” in which your face actually changes shape as your cheeks and lips lose support. This can make you look prematurely aged.

What can be done? To prevent further wear, we can fabricate for you a thin, plastic mouthguard that will protect your teeth at night or during times of intense stress. We can also recommend ways to temporarily relieve the discomfort that your grinding/clenching habits can cause. Heat and/or anti-inflammatory medication, for example, can be helpful.

If your tooth wear is minor (raggedness along the biting edge of a tooth or teeth) you may not need any restorative work. However, if tooth wear has already caused changes to your teeth and bite that you find aesthetically or functionally unacceptable, we can restore lost tooth structure in a variety of ways. Veneers and crowns are two examples.

If you have any questions about tooth wear or grinding habits, please contact us today to schedule an appointment for a consultation. You can learn more about this topic by reading the Dear Doctor magazine article “How And Why Teeth Wear.”