By Scott A. Leggio, DMD
August 23, 2021
Category: Dental Procedures
Tags: dental implants   crowns  
WhichImplantCrownAttachmentMethodisBestforYou

If you've decided on a dental implant to replace a missing tooth, you've made a great choice. Implants are a big favorite of both dentists and patients, not only for their life-likeness, but also their durability. Studies show that more than 95% of implants survive after ten years.

As you may know, single tooth implants are composed of two main parts: a metal post (usually titanium) imbedded in the jawbone; and a life-like crown affixed to the end of the post. But what you may not know is that there are two ways to attach the crown—either with screws or with dental cement.

Neither way is superior to the other—both have their own set of advantages and disadvantages. A cemented crown, for instance, usually looks more like a natural tooth than a screw-retained crown (more about that later) and dentists have more flexibility in making them look natural.

But cemented crowns require an additional piece of hardware called an abutment to better match it with the implant, something unnecessary with a screw-retained crown. Some people can also experience a reaction to the cement resulting in inflammation or even bone loss. And once installed, removing the crown later for repair or replacement is much more difficult than with a screw-retained crown.

Besides attaching directly to the implant, screw-retained crowns don't require cement and are more easily attached and removed. But the screw-hole can pose some aesthetic problems: Although it can be filled with a tooth-colored filling, the tooth's appearance isn't as ideal as a cemented crown.

So, which one is best for you? That will depend on the type and location of teeth being replaced, as well as your dentist's preferences. For instance, a more attractive cemented crown may be better for a visible front tooth, while a screw-retained crown might be a good choice for a back premolar or molar where appearance isn't as big a factor.

In the end, it's likely your dentist will discuss the pros and cons for each method as it pertains to your individual case. Whichever way your crown attaches, the end result will still be a life-like tooth that could last you for 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.”

By Scott A. Leggio, DMD
August 13, 2021
Category: Oral Health
Tags: dental injury  
HowYouCanReducetheImpactofanOralInjuryonYourStudentAthlete

August is the traditional "kickoff" month for football season with student athletes representing the vast majority of players. And, while a new season promises to be exciting for both players and fans, there are risks for potential injury to jaws, teeth and gums.

If your household includes a football player (or other contact sport participant), you'll want to do everything you can to reduce their chances for injury or long-term damage. That involves two aspects: prevention and immediate first aid after a potential injury.

In terms of prevention, your student athlete should wear a mouthguard to protect their teeth and gums from blows to the face or mouth. Constructed of soft, pliable plastic, these oral devices cushion an impact from a hard contact that might otherwise seriously injure them. A mouthguard should be worn for any physical activity associated with the sport—including practices.

There are various styles of mouthguards, but most fall within two categories: a retail version known as "boil and bite;" and a custom mouthguard created by a dentist. Regarding the first kind, as the name implies, a boil and bite is first softened with hot water right out of the packaging. The wearer then places it in their mouth while it's still soft and bites down to create an individual fit.

A boil and bite guard can achieve a reasonable fit and provide adequate protection for a wearer. But to gain a precise fit that provides better comfort and protection, a custom-made mouthguard by a dentist is worth the extra cost. We create a custom mouthguard using an impression mold of the individual wearer's mouth. The resulting guard is thinner and more compact than the typical boil and bite.

An athletic mouthguard can drastically reduce the risk of serious injury during sports play, but, as with any element of risk, it can't reduce that risk to zero. It's important then to know what to do if a rare dental injury does occur.

The key is to act quickly, especially if a tooth has been knocked out of its socket. Putting it back into the socket as soon as possible could help save the tooth long-term. To know what steps to take for this and other kinds of dental injuries, it's good to have a reference guide handy. Here's a printable dental injury pocket guide that gives you detailed instructions for dental first aid.

Sports participation can have a lasting, positive impact on your child. But the specter of injury can also have an impact, definitely not positive and with long-term consequences. With regard to their dental health, you can make that possibility much less likely.

If you would like more information about protecting your student athlete's teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Athletic Mouthguards.”

TakeItFromTaylorSwift-LosingYourOrthodonticRetainerisNoFun

For nearly two decades, singer-songwriter Taylor Swift has dominated the pop and country charts. In December she launched her ninth studio album, called evermore, and in January she delighted fans by releasing two bonus tracks. And although her immense fame earns her plenty of celebrity gossip coverage, she's managed to avoid scandals that plague other superstars. She did, however, run into a bit of trouble a few years ago—and there's video to prove it. It seems Taylor once had a bad habit of losing her orthodontic retainer on the road.

She's not alone! Anyone who's had to wear a retainer knows how easy it is to misplace one. No, you won't need rehab—although you might get a mild scolding from your dentist like Taylor did in her tongue-in-cheek YouTube video. You do, though, face a bigger problem if you don't replace it: Not wearing a retainer could undo all the time and effort it took to acquire that straight, beautiful smile. That's because the same natural mechanism that makes moving teeth orthodontically possible can also work in reverse once the braces or clear aligners are removed and no longer exerting pressure on the teeth. Without that pressure, the ligaments that hold your teeth in place can “remember” where the teeth were originally and gradually move them back.

A retainer prevents this by applying just enough pressure to keep or “retain” the teeth in their new position. And it's really not the end of the world if you lose or break your retainer. You can have it replaced with a new one, but that's an unwelcome, added expense.

You do have another option other than the removable (and easily misplaced) kind: a bonded retainer, a thin wire bonded to the back of the teeth. You can't lose it because it's always with you—fixed in place until the orthodontist removes it. And because it's hidden behind the teeth, no one but you and your orthodontist need to know you're wearing it—something you can't always say about a removable one.

Bonded retainers do have a few disadvantages. The wire can feel odd to your tongue and may take a little time to get used to it. It can make flossing difficult, which can increase the risk of dental disease. However, interdental floss picks can help here. ¬†And although you can't lose it, a bonded retainer can break if it encounters too much biting force—although that's rare.

Your choice of bonded or removable retainer depends mainly on your individual situation and what your orthodontist recommends. But, if losing a retainer is a concern, a bonded retainer may be the way to go. And take if from Taylor: It's better to keep your retainer than to lose it.

If you would like more information about protecting your smile after orthodontics, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Importance of Orthodontic Retainers.”

By Scott A. Leggio, DMD
July 24, 2021
Category: Dental Procedures
Tags: veneers  
YourNewPorcelainVeneersCanLastandLookGreataLongTime

Dental veneers are a popular way to improve teeth with chips, stains, gaps or other defects. They're typically made of dental porcelain, ceramic-like materials prized for their ability to mimic the texture, color and translucency of natural teeth.

But dental porcelain doesn't come in one form—a dentist can utilize variations of it to better match a patient's need. For example, one patient may need a porcelain with added strength, while another may need one that provides better coverage of underlying discoloration.

The foundational materials for veneer porcelain are glass ceramics. Also used for crowns, glass ceramics have been the preferred choice of dentists for some time to achieve life-like results. In terms of veneers, dental technicians first mix the powdered form of the porcelain with water to create a paste. They then use the paste to build up the body of a veneer layer by layer.

But while the high degree of silica (glass) in this type of porcelain best resembles the translucence of natural teeth, early forms of it lacked strength. This changed in the 1990s when technicians began adding a material called leucite to the ceramic mixture that enhanced its strength and durability.

Today, you'll also find lithium disilicate used, which is twice as strong as leucite and is quite useful when creating thinner veneers. Both of these strength materials can be pressed and milled into shape, which helps achieve a more accurate fit. Along with the underlying glass ceramic, the result is a veneer that's both durable and incredibly life-like.

Although today's porcelain veneers are far superior in durability than earlier forms, they can be damaged when biting down on hard objects. To make sure your veneers last as long as possible, you should avoid biting down directly on hard-skinned fruit, or using your veneered teeth to crack nuts or crunch ice (or any other teeth, for that matter).

But with proper care, today's veneers have exceptional longevity. And, thanks to the superior dental materials that compose them, they'll look great for years.

If you would like more information on dental veneers, 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 “Porcelain Veneers: Your Smile—Better Than Ever.”

By Scott A. Leggio, DMD
July 14, 2021
Category: Oral Health
Tags: jaw pain  
ThinkTwiceBeforeYouUndergoBotoxTreatmentforChronicJawPain

There's still much about the underlying nature of chronic jaw joint dysfunction we have yet to unravel. Treating these conditions known as temporomandibular joint disorders (TMDs) may therefore require some experimentation to find what works for each individual patient.

Most TMD therapies are relatively conservative: eating softer foods, taking anti-inflammatory pain relievers or undergoing physical therapy. There have been some surgical techniques tried to relieve jaw pain and dysfunction, but these have so far had mixed results.

Recently, the use of the drug Botox has been promoted for relieving jaw pain, albeit temporarily. Botox contains tiny amounts of botulinum toxin type A, a poisonous substance derived from the bacterium Clostridium botulinum, which can cause muscle paralysis. It's mainly used to cosmetically smooth out small wrinkles around facial features.

Because of these properties, some physicians have proposed Botox for TMD treatment to paralyze the muscles around the jaw to reduce pain and discomfort. While the treatment sounds intriguing, there are a number of reasons to be wary of it if you have TMD.

To begin with, the claims for Botox's success in relieving jaw pain have been mainly anecdotal. On the other hand, findings from randomized, double-blind trials have yet to show any solid evidence that Botox can produce these pain-relieving effects.

But even if it lived up to the claims of TMD pain relief, the effect would eventually fade in a few weeks or months, requiring the patient to repeat the injections. It's possible with multiple Botox injections that the body will develop antibodies to fight the botulinum toxin, causing the treatment to be less effective with subsequent injections.

Of even greater concern are the potential side effects of Botox TMD treatment, ranging from headaches and soreness at the injection site to more serious muscle atrophy and possible facial deformity from repeated injections. There's also evidence for decreased bone density in the jaw, which could have far-reaching consequences for someone with TMD.

The best approach still seems to lie in the more conservative therapies that treat TMD similar to other joint disorders. Finding the right combination of therapies that most benefit you will help you better manage your symptoms.

If you would like more information on treatments for TMD, 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 “Botox Treatment for TMJ Pain.”





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