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.”

Chronic stress is like a tea kettle on the boil—all that “steam” has to go somewhere. We often do this through behaviors like biting our nails, binging on comfort food—or grinding our teeth. That latter habit, however, could have a detrimental effect on teeth, including excessive enamel wear or even fractures.

Also known as bruxism, teeth grinding is the forceful and often involuntary contacting of teeth that often generates abnormally high chewing forces. While not considered a relatively big problem with young children, it can be if you’re an adult. While there could be other causes, chronic stress is often a  prime factor for adults with bruxism.

While teeth grinding can occur during the day when you’re awake, it often occurs at night during sleep and may be associated with other sleep disorders like snoring. Although you might not be consciously aware of a grinding episode as it happens, you may notice its effects the next morning, including sore jaws or headaches. Over time, your dentist may begin noticing its effects on your teeth.

So, how can you lessen teeth grinding? For starters, if you’re a tobacco user, quit the habit. Many studies indicate tobacco users report twice the incidence of teeth grinding as non-users. Excessive caffeine, alcohol or drug use can also contribute.

People have also found it helpful to address chronic stress through a number of relaxation techniques like meditation, more relaxing bedtime preparation, bio-feedback or therapy to “de-stress.” Although there’s not a lot of empirical evidence for these techniques’ effectiveness, there’s much anecdotal data from people who’ve found stress relief from them.

There’s also a dental treatment using an occlusal guard that, while not stopping bruxism, can help prevent dental damage. Usually worn during sleep, the custom-made guard fits over the teeth of one jaw, usually the upper. Its high impact plastic prevents the teeth from making solid contact, thus reducing the biting force. You may also be able to reduce bruxism effects through dental work and orthodontics,

You and your dentist can explore the options to find the right treatment strategy for you. By taking action now, you may avoid much more extensive—and expensive—problems with your teeth down the road.

If you would like more information on teeth grinding and what to do about it, 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 “Teeth Grinding: Causes and Therapies for a Potentially Troubling Behavior.”

What’s the first thing that comes to mind when you think of the month of May? Balmy breezes? Sweet-smelling flowers? How about root canal treatment?

The last item might seem out of place…but for the last ten years, Root Canal Awareness week has been celebrated in May. So let’s take a closer look at this important—and often misunderstood—dental procedure.

What we commonly call a “root canal” is a special treatment that can save diseased teeth which might otherwise be lost. But the root canal itself is actually a set of hollow, branching passages deep inside the hard outer tissue of the tooth. The tiny “canals” contain the tooth’s soft pulp, including nerves, blood vessels and connective tissue. These tissues help teeth grow during childhood but aren’t necessary in healthy adult teeth—and, what’s worse, they can become infected via deep cavity or a crack in the tooth’s outer layers.

When bacteria infect the pulp tissue, the inflammation often causes intense discomfort. In time, the harmful microorganisms can also pass through the tooth’s root and into the tissue of the jaw, resulting in a painful abscess. Eventually, if it isn’t treated, the tooth will likely be lost.

Root canal treatment is designed to remove the infection, relieve the pain…and save the tooth. It is usually performed under anesthesia for your comfort. To begin the procedure, a small hole is made in the tooth’s enamel to give access to the pulp; then, tiny instruments are used to remove the diseased tissue and disinfect the tooth. Finally, it is sealed up against re-infection. Following treatment, a cap (or crown) is often needed to restore the tooth’s full function and appearance.

Despite some rumors you may have heard, root canal treatment is neither very painful nor likely to cause other health problems. So if you come across these discredited ideas, remember that dentists and dental specialists called endodontists perform some 25 million root canal procedures every year—and this treatment method  has been validated for decades.

Of course, like any medical procedure, root canal treatment is not 100% successful. While the procedure has a very high success rate, it’s possible that additional treatments will be needed in some cases. However, the alternative—extracting the tooth—has similar potential downsides; plus a replacement tooth will be needed to avoid the health and lifestyle troubles caused by missing teeth. But one thing is certain: Ignoring disease in the tooth’s soft tissues isn’t a good move, because the infection won’t go away on its own—and down the road it will only get worse.

So this May, while you’re taking time to smell the flowers, spare a thought for the often-misunderstood root canal. If you’d like more information on root canal treatment, please contact us or schedule a consultation. You can also learn more by reading the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: What You Need to Know.”