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Posts for: June, 2018

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 John G. Fisher, DMD
June 21, 2018
Category: Uncategorized
BaseballsFranciscoLindorShinesasMrSmile

At the first-ever Players Weekend in August 2017, Major League Baseball players wore jerseys with their nicknames on the back. One player — Cleveland Indians shortstop, Francisco Lindor — picked the perfect moniker to express his cheerful, fun-loving nature: “Mr. Smile.” And Lindor gave fans plenty to smile about when he belted a 2-run homer into the stands while wearing his new jersey!

Lindor has explained that he believes smiling is an important part of connecting with fans and teammates alike: “I’ve never been a fan of the guy that makes a great play and then acts like he’s done it 10,000 times — smile, man! We’ve got to enjoy the game.”

We think Lindor is right: Smiling is a great way to generate good will. And it feels great too… as long as you have a smile that’s healthy, and that looks as good as you want it to. But what if you don’t? Here are some things we can do at the dental office to help you enjoy smiling again:

Routine Professional Cleanings & Exams. This is a great place to start on the road toward a healthy, beautiful smile. Even if you are conscientious about brushing and flossing at home, you won’t be able to remove all of the disease-causing dental plaque that can hide beneath the gum line, especially if it has hardened into tartar, but we can do it easily in the office. Then, after a thorough dental exam, we can identify any problems that may be affecting your ability to smile freely, such as tooth decay, gum disease, or cosmetic dental issues.

Cosmetic Dental Treatments. If your oral health is good but your smile is not as bright as you’d like it to be, we can discuss a number of cosmetic dental treatments that can help. These range from conservative procedures such as professional teeth whitening and bonding to more dramatic procedures like porcelain veneers or crowns.

Tooth Replacement. Many people hide their smiles because they are embarrassed by a gap from a missing tooth. That’s a shame, because there are several excellent tooth-replacement options in a variety of price ranges. These include partial and full dentures, bridgework, and dental implants. So don’t let a missing tooth stop you from being Mr. (or Ms.) Smile!

If you’d like more information about oral health or cosmetic dentistry, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Impact of a Smile Makeover.”


By John G. Fisher, DMD
June 16, 2018
Category: Oral Health
Tags: dry mouth  
3CommonCausesforChronicDryMouthandWhatYoucandoAboutIt

Like most people, you’ve no doubt experienced occasional dry mouth as when you’re thirsty or just waking from sleep. These are normal occurrences that usually don’t last long.

But xerostomia or chronic dry mouth is another matter. Not only is this continual lack of adequate saliva uncomfortable, it could increase your risk for tooth decay or periodontal (gum) disease.

What’s more, chronic dry mouth can have a number of causes. Here are 3 common causes and what you can do about them.

Inadequate fluid intake. While this may seem obvious, it’s still common—you’re simply not consuming enough water. This deprives the salivary glands of adequate fluid to produce the necessary amount of saliva. If you’re regularly thirsty, you’ll need to increase the amount of water you drink during the day.

Medications. More than 500 drugs, both over-the-counter and prescription, can cause dry mouth as a side effect. This is one reason why older adults, who on average take more medications, have increased problems with dry mouth. There are some things you can do: first, talk with your healthcare provider about alternative drugs for your condition that are less likely to cause dry mouth; drink more water right before taking your medication and right afterward; and increase your daily intake of water.

Diseases and treatments. Some systemic diseases like diabetes or Parkinson’s disease can lead to xerostomia. Autoimmune conditions are especially problematic because the body may turn on its own tissues, the salivary glands being a common target. Radiation or chemotherapy treatments can also damage the glands and lead to decreased saliva production. If you have such a condition, talk with your healthcare provider about ways to protect your salivary glands.

You can also ease dry mouth symptoms with saliva boosters like xylitol gum or medications that stimulate saliva production. Limit your intake of caffeinated drinks and sugary or acidic foods. And be sure you stay diligent with your oral hygiene habits and regular dental visits to further reduce your risks of dental disease.

If you would like more information on the causes and treatments of dry mouth, 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 “Dry Mouth: Learn about the Causes and Treatment of this Common Problem.”


ToothinOneDayProceduresRequireSpecialAttentionforSuccess

You've seen the ads for obtaining a new tooth in one day with a dental implant. Those aren't exaggerated claims — you can leave the dental office the same day with a new tooth that looks and functions like the old one.

But the dramatic marketing aside, there is a bit more to the story. Same day tooth replacement isn't appropriate in every situation. And even when it is, there are risks for failure.

We can minimize those risks, however, by focusing on certain goals during the three distinct phases in the process: removing the natural tooth; placing the metal implant into the jawbone; and affixing the visible, crown.

It's crucial during tooth extraction that we avoid damaging the socket bone that will ultimately support the implant's titanium post. If the socket walls break down it could set up future gum recession or cause us to abort the implant procedure altogether that day.

When placing the implant, we want to focus on achieving a strong hold. Due to its special affinity with titanium, bone cells gradually grow and adhere to the post to firmly anchor the implant in time. But since we're immediately loading a crown rather than allowing the bone to fully integrate first, we need to ensure the implant has a secure hold from the get-go. We can only achieve this with precise placement based on careful examination and planning, as well as adequate bone.

Even so, the implant still needs to integrate with the bone for a lasting hold, and that takes time. Even with normal biting forces the implant risks damage during this integration period. That's why we place a temporary crown a little shorter than the surrounding teeth. Those adjacent teeth will take the brunt of the biting force and not the implant.

Once the bone has fully integrated, we'll replace the temporary crown with a permanent one the proper height proportional to the other teeth. Even with the temporary crown, though, you'll still have a life-like tooth the day we removed the older one.

The key to success is planning — first determining if you meet the criteria for a same-day implant and then mapping out and carefully executing each succeeding step. Doing this will ensure your same-day implant is a success from day one.

If you would like more information on same-day tooth replacement, 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 “Same-Day Tooth Replacement with Dental Implants.”


By John G. Fisher, DMD
June 06, 2018
Category: Oral Health
Tags: oral health  
3ReasonsforBloodPressureChecksDuringDentalVisits

You may have been surprised by a new addition to your regular dental appointment routine—we took your blood pressure at the start. While you might expect this at a medical clinic, it seems unusual at the dentist’s office.

But not anymore: blood pressure checks at dental offices are quickly becoming routine, including during regular cleanings and checkups. Here are 3 reasons why checking your blood pressure is now part of your dental visit experience.

Your blood pressure could be an issue during dental work. While we do everything possible to make you comfortable, undergoing dental work can create stressful feelings. Blood pressure normally increases when stress occurs, including before dental procedures. If you already have issues with hypertension (high blood pressure), any circumstance that might increase it could lead to health problems or even an emergency like a stroke. If your blood pressure is high, we may forgo any planned procedures and refer you to a physician for further examination.

Local anesthesia can affect blood pressure. Local anesthesia is an important part of dental work—without it we couldn’t provide maximum comfort during procedures. But many anesthetics include epinephrine, which helps prolong the numbing effect. Epinephrine also constricts blood vessels, which in turn can elevate blood pressure. We may need to adjust the anesthesia drugs and dosages we use in your case if you have high blood pressure.

It could save your health—and your life. The symptoms for hypertension can be subtle and often go unnoticed. A blood pressure screening check is often the first indication of a problem. That’s why blood pressure screenings in a variety of healthcare settings are so important. A routine blood pressure check at your dentist (who hopefully sees you at least every six months) is one more opportunity to find out. Discovering you may have high blood pressure is the first step to controlling it and hopefully avoiding more serious conditions like diabetes or cardiovascular disease.

If you would like more information on monitoring vital signs during dental visits, 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 “Monitoring Blood Pressure.”