Information on Dental Implants

Dental implants are metal posts or frames which are placed in the jaw bone under the gums by surgery. After it is implanted surgically your dentist can put replacement teeth onto them.

How do Dental Implants Work
The implants after placement get fused with your jawbone. This then give a stable support for the artificial teeth or dentures and bridges. Dentures and bridges that do not slip or shift in your mouth is big advantage while eating and speaking. Another advantage of implants is that the healthy teeth adjacent to the implant don’t need to be prepared.

Where as standard bridges and dentures may not be as comfortable, and need to be fixed to teeth on either side of the missing tooth/teeth.

Prerequisite for an implant
Your gums should be healthy and there should be adequate bone to support the implant.
After implant you have to maintain good oral hygiene to keep these structures healthy.
Regular dental visits and cleaning as required will be needed for long-term success of dental implants. But remember that implants cost a lot more than the standard bridges and dentures. The two types of implants that are considered to be safe are endosteal implants and subperiosteal implants. When you consult your dentist for an implant he or she will advise regarding the appropriate implant for you.

Deciding if implants are right for you
Implants can not be placed in everyone who wants it. Your dentist after examining you will tell if you are suitable to get an implant.

Some considerations before you get an implant are
You should have healthy gums and enough bone in the jaw to allow an implant to be placed in.
If you have periodontal (gum) disease, infection or injury you may need antibiotics or other treatment for it before the implant is placed.
If there is a severe infection in your tooth root then after extraction the area will need time to heal before the implant can be placed.
At times uour jaw bone may need bone grafting or augmentation. In this procedure, before the implant is placed, your jaw bone is built up by bone grafting to increase the chance of implant success. Your dentist may do the bone grafting and place the implant at the same time. At times he or she may do the bone-graft procedure first and the place the implant after a few months (about 4 to 12 months). During this time you will be given dentures or bridge, so that you are not without teeth.
You should be ready to take good care of the implanted teeth and surrounding gums. You will have to maintain good oral hygiene by daily brushing and flossing and regular visits to the dentist for cleaning.

People who are not good candidates for implants include
Children whose jawbones are still growing
Pregnant women
Heavy smoker as smoking interferes with healing and can decrease the chance of implant success.
Excessive use of alcohol or substance abusers
Patients who have been administered high-dose irradiation to the head or neck
People with chronic diseases such as hypertension (high blood pressure), diabetes, connective-tissue diseases, hemophilia and certain immune deficiencies
Patients on medications that suppress the immune system such as steroids, immunosuppressant
People with severe bruxism (who severely grind or clench their teeth)
Your dentist after examining you will decide whether you can receive implants.

  Dr. Claudio A. Sorrentino

  www.dentalpalermo.com.ar

What is deep cleaning (deep scaling and root planing)?

If plaque and tartar is left on the teeth, as we mentioned before, it provides the right conditions for bacteria to thrive. The bacteria irritate the gums, which means that they bleed more easily. You may notice this if you are brushing your teeth, or eating, and sometimes your gums may bleed a bit. This is the early stage of gum disease called gingivitis. If you have gingivitis, your dentist or hygienist will clean your teeth by scaling and polishing them. They may also recommend an antiseptic mouthwash containing chlorhexidine (e. g. Plac-out), and show you how to brush and floss your teeth effectively. Most adults have some degree of gum disease.

If gingivitis not treated and nothing is done about it, the inflammation will work its way down towards the foundations of the tooth causing a “periodontal pocket”. Again, within the confines of the pocket, the conditions are such that the bacteria can have a right old party, and cause more damage. Gum disease can break down the support (bone) structures of the teeth, so that eventually, they will become loose. The problem is that until it gets quite severe, the person often has no symptoms. Sadly, the damage to the support structures of the teeth is irreversible. The good news is that if gum disease is caught in time, its progression can be halted and improved upon, and that is the key.

To stop gum disease from progressing, your dentist may advise periodontal therapy, or deep cleaning. This gets rid of the bacteria in the pocket and provides the necessary conditions for healing to occur.

What is the difference between an ordinary cleaning and deep cleaning?

There is some confusion about the difference between scaling and root planing. Scaling is basically the process of removing dental tartar from the surfaces of the teeth (see dental cleanings). Root planing is the process of smoothening the root surfaces and removing any infected tooth structure. If you have gum disease or gum pocketing, the gum pockets around the teeth will have deepened, thereby allowing tartar deposits to form under the gumline.

The two processes tend to blur together since during the cleaning process, the dental worker scales away tartar and performs any necessary root planing at the same time. Any roughness can be planed away to result in a silky smooth surface.

Does it hurt?

Depending on the depth of the pocket and severity of the root surface irregularity, the dentist may wish to make the area numb so that the process is comfortable for you. Don’t hesitate to discuss with your dentist  to best manage any discomfort.

 Sometimes if the pockets are not too deep, there may be little or no discomfort during the procedure – even without numbing. The only sensation may be the physical scraping feeling along the teeth as the area is cleaned and smoothened. A root planed root surface free of tartar has a better chance of allowing the gum tissues to heal and reattach to it. As a result, some deep gum pockets can be reduced after a deep cleaning.

How long does it take?

Typically with deeper pockets and extensive rough root surfaces, the deep scaling and root planing procedure might be broken down into quadrants of work per appointment. For example, the upper right side of the mouth might be worked on one day, and the three other parts worked on at separate appointments. Or alternatively, one half of the mouth (right or left, upper or lower) might be cleaned per appointment. This also allows for only a part of the mouth being frozen at a time and makes for more manageable, shorter appointments.

The dentist may use antibiotic gels within the periodontal pocket, again to remove any nasty bugs, or may rinse out the pocket with various medications such as chlorhexidine.

What can I expect afterwards?

• Discomfort can vary after root planing, but one can expect it to be more sore afterwards since it’s usually in a deeper region under the gums.
• The teeth themselves can become a bit more sensitive to temperature, and bleeding might occur for a little while.
• Over-the-counter painkillers such as ibuprofen work very well to alleviate discomfort, but stronger painkillers can be given should you need them.
• Brushing and flossing can be delayed or done more gently to avoid aggravating any bruised or tender gum areas.
• Your dentist or hygienist may recommend salt water or chlorhexidine rinses.

  Dr. Claudio A. Sorrentino

  www.dentalpalermo.com.ar