Posts for: August, 2018

Implant-SupportedDenturesProvideBetterFitandmayStopBoneLoss

Your dentures have served you well over the years. Lately, though, you’ve noticed the fit loosening in the lower denture. It’s not a new problem: you’ve had them refitted a few times already. But now it seems to be growing worse and you’re having more trouble chewing food or speaking clearly.

The problem isn’t all wear and tear with your dentures — the bone in your jaw is shrinking. A denture applies forces that are compressive. Natural teeth produce forces when we chew that travel through the tooth root and stimulate the bone to grow. Without teeth, there’s no such force to stimulate the bone. As a result, new bone cells don’t replace older cells at a healthy rate and bone volume diminishes over time. Because traditional dentures are supported by the gum ridges, the constant compressive forces on the gums can also contribute to bone loss.

As mentioned, we can refit dentures by lining them with new acrylic material. Eventually, though, it may be necessary to consider a new set of dentures that match the altered contours of your jaw. But continuing bone loss might lead to the same fate for your new dentures as your previous pair.

There’s a relatively new alternative, though, that could provide greater denture stability and help deter bone loss: implant overdentures. They’re actually a union between a traditional denture and a dental implant, a tooth replacement approach introduced over thirty years ago.

With this option, two strategically-placed implants are surgically inserted into the jaw bone. We then manufacture a denture (or retrofit your current dentures, if possible) with fittings that connect to the implants. Once in the mouth, the dentures gain their main support from the implants rather than the gum ridge, which relieves pressure on the bone. And because the titanium implant has a natural affinity with bone, new bone will grow and attach itself to it, increasing its stability and stopping bone loss.

Although more expensive than traditional dentures, implant overdentures are more affordable than individual teeth replaced by implants and are very cost-effective over time. What’s more, they can restore the comfort and confidence to eat, speak and smile that you once enjoyed when you had your own teeth.

If you would like more information on implant-supported dentures, 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 Overdentures.”


By John W. Cox DDS
August 20, 2018
Category: Oral Health
Tags: celebrity smiles   retainer  
MargotRobbieKnowsAGreatSmileIsWorthProtecting

On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.

“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”

Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.

Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.

A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.

Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.

So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.

If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”


By John W. Cox DDS
August 10, 2018
Category: Oral Health
Tags: gummy smile  
TheTrueCauseofYourGummySmileDeterminesHowWeTreatit

What makes a beautiful smile? The teeth, of course: bright, evenly shaped and precisely aligned with each other. But your teeth can be as perfect as can be and your smile will still appear unattractive.

The reason? Your gums show more than they should when you smile.

What's considered a gummy smile is largely a matter of perception that can vary from person to person. As a rule of thumb, though, we consider a smile “gummy” if four millimeters (mm) or more of the gums show.

Fortunately, we can minimize the gums' prominence and make your smile more attractive. But what methods we use will depend on why your gums stand out. And it's not always because of the gums themselves.

It could be your teeth didn't erupt normally during dental development. Mature crown (the visible part of the tooth) length is normally about 10 mm with a width about 75-85% of that. But an abnormal eruption could result in teeth that appear too short, which can make the gums stand out more. We can correct this with a surgical procedure called crown lengthening in which we remove excess gum tissue and, if necessary, reshape the underlying bone to expose more of the tooth crown.

Another potential cause is how far your upper lip rises when you smile. Normally the lip rises only enough to reveal about 4 mm of teeth. In some cases, though, it may rise too high and show more of the gums. We can modify lip movement in a number of ways, including Botox injections to temporarily paralyze the lip. A more permanent solution is a lip stabilization procedure. It sounds bad, but it's a fairly simple procedure to surgically reposition the muscle attachments to restrict movement.

Your gummy smile may also result from an upper jaw too long for your facial structure. We can correct this with orthognathic (“ortho” – straighten, “gnathos” – jaw) surgery. During the procedure the surgeon permanently positions the jaw further up in the skull; this will reduce the amount of teeth and gums displayed when you smile.

Discovering the true cause of your gummy smile will determine how we treat it. After a complete oral examination, we can then discuss your options to transform your smile into a more attractive one.

If you would like more information on treating gummy smiles and other cosmetic problems, 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 “Gummy Smiles.”




420 Harper Ave
Lenoir, NC 28645

405 Main Street
Valdese, NC 28690

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