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YoucanStillhaveImplantswithDiabetes-ifyouhaveitunderControl

If you're one of the more than 26 million people in the U.S. with diabetes, you know first hand how the disease impacts your life. That includes your dental health — and whether or not implants are a good tooth replacement option for you.

Diabetes is actually the name for a group of diseases affecting how your body processes glucose, a simple sugar that provides energy for the body's cells. The level of glucose in the blood is regulated by insulin, a hormone produced in the pancreas. Diabetes causes the pancreas to either stop producing insulin (Type 1) or not produce enough (Type 2). Also in Type 2, the body can become unresponsive to the insulin produced.

The implications for either type are serious and can be life-threatening. If glucose levels are chronically too low or high the patient could eventually go blind, suffer nerve damage, or develop kidney disease. Diabetes also interferes with wound healing and creates a greater susceptibility for gangrene: diabetics thus have a higher risk for losing fingers, toes and limbs, and can even succumb to coma or death.

Type 2 is the most common form of diabetes. Fortunately, most people with this type can effectively manage it through diet, exercise and regular glucose monitoring; if need be, prescription medication can help regulate their levels. Even so, diabetics with their disease under control must still be alert to slower wound healing and a higher risk of infection.

Because implant placement is a minor surgical procedure, the aspects of diabetes related to healing, infection and inflammation could have an adverse impact on the ultimate success of the placement. Implant surgery creates a wound in the surrounding gum tissues and bone that will need to heal; the body's immune response in a diabetic can interfere with that process. And if infection sets in, the risks of implant failure increase.

But research has shown that diabetics with good glucose management have as high a success rate (over 95% after ten years) as non-diabetic patients. That means the implant option is a viable one for you as a diabetic — but only if you have your disease under control.

If you would like more information on the relationship between dental implants and other health conditions, please contact us or schedule an appointment for a consultation.

By William G. Bender, DDS
June 13, 2018
Category: Dental Procedures
Tags: dental implants   bone graft  
BoneGraftingMightbeNecessaryBeforeYouObtainanImplant

Every year dentists place over 5 million dental implants for lost teeth, often removing the problem tooth and installing the implant at the same time. But getting a “tooth in a day” depends on a number of health factors, especially whether or not there’s adequate bone available for the implant. Otherwise, the implant’s placement accuracy and success could be compromised.

Bone loss can be a similar problem when a tooth has been missing for a long period of time. If this describes your situation, you may have already lost substantial bone in your jaw. To understand why, we need to know a little about bone’s growth cycle.

When bone cells reach the end of their useful life, they’re absorbed into the body by a process called resorption.  New cells then form to take the older cells’ place in a continuous cycle that keeps the bone healthy and strong. Forces generated when we chew travel through the teeth to the bone and help stimulate this growth. But when a tooth is missing, the bone doesn’t receive this stimulus. As a result, the bone may not replace itself at a healthy rate and diminish over time.

In extreme cases, we may need to consider some other dental restoration other than an implant. But if the bone loss isn’t too severe, we may be able to help increase it through bone grafting. We insert safe bone grafting material prepared in a lab directly into the jaw through a minor surgical procedure. The graft then acts like a scaffold for bone cells to form and grow upon. In a few months enough new bone may have formed to support an implant.

Bone grafting can also be used if you’re having a tooth removed to preserve the bone even if you’re not yet ready to obtain an implant. By placing a bone graft immediately after extraction, it’s possible to retain the bone for up to ten years—enough time to decide on your options for permanent restoration.

Whatever your situation, it’s important that you visit us as soon as possible for a complete examination. Afterward we can assess your options and hopefully come up with a treatment strategy that will eventually include smile-transforming dental implants.

If you would like more information on obtaining dental implants, please contact us or schedule an appointment for a consultation.

By William G. Bender, DDS
May 04, 2018
Category: Oral Health
StopGumDiseaseBeforeitThreatensYourDentalImplant

Teeth-replacing dental implants not only look life-like, they’re made to last. For one thing, the metals and dental materials used in them are impervious to bacterial infection.

But that doesn’t mean implants are impervious to failure. Implants depend on the bone and other natural mouth structures for support. If the bone becomes weakened due to disease, the implant could become unstable and ultimately fail.

Peri-implantitis, the condition that can lead to this kind of failure, is a major concern for implant longevity. It’s a type of periodontal (gum) disease triggered by plaque, a thin film of food particles that can build up quickly in the absence of adequate brushing and flossing. The gum tissues around the implant become infected and inflamed.

If the infection isn’t properly treated with renewed oral hygiene and clinical plaque removal, it could spread below the gum line and begin to damage the underlying gum tissues and bone. This could destroy the all-important connection between the titanium implant post and the bone. The implant could eventually loosen and become completely detached from the bone.

The key is early intervention before the bone becomes damaged. Besides plaque removal we may also need to apply antibiotics in some form to control the growth of disease-causing bacteria. If the disease has fairly advanced we may also need to consider surgical repair to strengthen the attachment between implant and bone.

You can help to avoid peri-implantitis altogether by practicing consistent daily brushing and flossing around all your teeth including the implant, and seeing your dentist at least twice a year for cleanings and checkups. And by all means see your dentist if you notice any signs of gum swelling, redness or bleeding. Staying on top of your gum health will help not only the natural tissues and remaining teeth in your mouth, it will help preserve your implants for decades to come.

If you would like more information on maintaining your dental implants, please contact us or schedule an appointment for a consultation.

By William G. Bender, DDS
December 14, 2017
Category: Dental Procedures
CleaningAroundImplantsCrucialtoProtectingThemfromLoss

Unlike the natural tooth it replaces, a dental implant is impervious to decay. But don’t think that means you can relax your oral hygiene habits — even though the implant itself can’t be infected, the surrounding gum tissues and bone can. And if they’re not properly cared for you might eventually lose the implant.

In fact, implants may be more susceptible to problems from impacted food that becomes wedged between the gums and teeth than their natural counterparts. Natural teeth are connected to the jaw by way of a resilient, elastic tissue known as the periodontal ligament: the ligament resides in the space between the tooth root and the bone and attaches to both through tiny fibers. The bone and ligament are protected by an attachment of gum tissue that covers all of the surrounding bone and attaches to the root surface. The outer gum tissue surface is covered by a protein called keratin that makes it resistant to wear.

On the other hand, these periodontal ligament fibers don’t exist when implants are present as the implant is fastened directly to the bone. Because it doesn’t have this ligament attachment, and the gum tissues around can’t attach to the implant as with natural teeth, it may be more vulnerable to bacteria or trauma caused by food impaction. So, cleaning and caring for dental implants is just as important, if not more so than with natural teeth.

If the gums around an implant become infected and inflamed it could lead to peri-implantitis, a condition that can destroy the bone attachment between the implant and the bone. In other words, the loss of bone support can weaken the integration of the implant with the bone. As more and more attachment is lost, the implant can loosen and eventually be lost.

The best way to avoid this is with consistent daily hygiene and regular dental checkups. And, if you notice any signs of swelling or redness of the gums around an implant, contact us as soon as possible. The sooner we begin treatment to alleviate the infection, the less danger there will be of losing your implant.

If you would like more information on how to care for dental implants and other 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 “Infections around Implants.”

By William G. Bender, DDS
November 29, 2017
Category: Dental Procedures
Tags: dental implants   crowns  
ChoosingaScreworCementtoAttachanImplantCrown

If you've lost a tooth, you have a number of options for replacing it. Perhaps the best choice in terms of lifelikeness and durability is a dental implant.

All implants have the same basic architecture: a titanium metal post imbedded in the jawbone to replace the root; and an abutment, a metal collar that links the post with a lifelike porcelain crown. But implants can vary in how the crown attaches to the abutment and post — either cemented to the abutment or screwed through the abutment to the post.

Either method will permanently secure the crown to the implant. But there are advantages and disadvantages for each.

A screw-retained crown may better facilitate any future repair that might be needed. For a skilled dentist it's a simple matter of removing the screw and then the crown from the abutment. There's less risk of damage to the implant during repairs or crown replacement. Many dentists also prefer screws for crowns placed at the same time they're installing the implant post (a procedure called immediate loading).

The screw access hole, however, could pose a cosmetic problem. Although we can cover it over with tooth-colored filling, it may still be noticeable and unattractive especially for a tooth visible when you smile (in the smile zone). There's also the possibility the porcelain around the access hole could chip.

By contrast, cemented crowns have a smooth, unbroken surface and are aesthetically ideal for smile zone teeth. But the cement could interact poorly with gum and bone tissue in some patients, causing inflammation and possible bone loss.

And unlike screw-retained crowns, cemented crowns are difficult to remove for implant repair. We may have to drill through the crown to access the screw between the abutment and the post, and then repair it cosmetically if we use the same crown. Again, the final result may not be quite as visually appealing.

In the end, it will depend on the implant's location, how your body reacts to the cement or your dentist's preference. In either case, though, you'll have a tooth replacement that's functional, life-like and able to endure for many years to come.

If you would like more information on 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 “How Crowns Attach to Implants.”