Missing Tooth Options.

A patient presented pain free with a fracture to the gum line ( upper left bicuspid tooth). He had minimal pain only  when he pressed his finger on the gum line of the remnant root area. There was no infection noted around the area. The incident when the tooth fractured, was unremarkable “The tooth just snapped off”, as he plainly stated.

Fractured Root canal treated tooth
Fractured Root canal treated tooth Pre-Op picture of Tooth #13

Options were discussed 

1- Doing nothing, essentially leaving the root in place. “Not a good idea”,  as I mentioned because the rotting root would act as potential source for a future infection.

2- Simple extraction of the remnant root. “A very good idea, but what about the space?” I asked. “You can’t walk around like a homeless guy. It’s near the front, for god sake.”

3- Simple extraction of remnant root combined with a bridge to span the gap. The question to ask one self when faced with this predicament, “Do you want to have two of your teeth ground down to stumps, in order to close the gap for the replacement of one tooth?”  I explained. The consequences of possibly creating an unwanted root canal in the process, seems to be an absurd option for a single tooth replacement.

4- Simple extraction of remnant  root and replacement with a removable device, a partial denture. “Terrible idea”, I said. “You are way too young to put your teeth in a cup at night!”

5-Simple extraction of remnant root, socket preservation combined with a staged implant approach…………….Excellent Idea…. we both agreed!

BINGO! And that’s what we did.

Extracted fractured tooth with bone graft
Extracted fractured tooth with bone graft
Post Op-Picture
Extracted Root with Bone graft and Barrier

The patient was informed to return for suture removal in 2 weeks.

I plan to place a dental implant fixture in 2 months via a guided surgical approach.

STAY TUNED !!!!  

You can Visit my You Tube site Robert Emilio DDS and Associates where you can find my entire official……Dental Implant Seminar for your review.

 

Dr. Emilio & Associates,  Always Accepts  New Patients. He especially exceeds at treating same day emergencies patients suffering from tooth ache pains.

His goal is to keep his patients’ Teeth and Gums Healthy For Life.

Feel Free to appoint a Consultation with the Doctor. Open Six Days A Week

OPEN on Weekdays.  7:30am -8:00pm  (M<T<W<T)

Fridays.  7:30am-2:00pm

Weekends (Saturday only).  8:00am-2:00pm

111 East Avenue, Norwalk, Connecticut 06851.

You can always contact me directly via email  blog@robertemiliodds.com

Instagram:  dentist_in_connecticut

Office (203)866-7164      www.robertemiliodds.com

Pass this Link to Your Friends:  robertemilioddsblog.wordpress.com

Teeth in a Day, Really?

 

The real question is, ” If you could do something…,should you do it? 

“TEETH-IN-A-DAY™ is a revolutionary concept providing patients with fully functioning teeth on dental implants in one single procedure on the same day. This procedure can be done on a single missing tooth or multiple missing teeth. This allows for you to have a temporary fixed prosthesis immediately, eliminating the need to go without teeth.”Dralijanian.com

How is that possible?  Sure, it’s possible.  Increased accessibility to advanced diagnostic technology  is responsible for driving the rapid acceleration towards getting your teeth sooner than ever. This incredible 3-D rendering technology takes a bit of the “foreseen unseen surgical unknown” out of the equation during the preplanning of the surgical event. Assuming excellent skill level and acuity of the dental implant surgeon is consistent, this technology  dictates a better outcome. Less complications from being under prepared allows a seamless transition and the smooth execution of surgical care. The prosthetic application of this process has virtually not changed over the decades. A denture is still a denture.

Are you a candidate for Teeth In A Day? The T.V. advertisements are a bit misleading. I do think they are potentially good because they start the conversation; not really informational in content. People are becoming more aware and educated of the possibilities out there. (That’s the purpose of my blogging BTW). Some of my colleagues frown upon the media advertisements feeling that dentistry has now been commoditized   like everything else in our society.  There is a very small percentage of our population who are everyday dental suffers who I consider as dental cripples who could benefit with this option.

Several Factors which need to be considered for this option are as follows:

You must have great bone quality and quantity to anchor those implants. I mean very good.

Non smoker ( smokers lose implants more than non smokers)

Infection free-no active disease process ongoing

Non Diabetic or Highly controlled diabetic healing is compromised with is this disease.

I.V. Sedation preferable ( It’s a 6-7 hour day in that chair) Two hours for the surgical. event and 2-3 for the prosthetic aspect where the screw down acrylic dentures is fitted.

Can not tolerate an upper dentures’ palate aspect. ( you gag easily)

Your job does not allow you to tolerate a non movable appliance ( T.V anchor?). It’s very arduous and emotionally challenging to retrain yourself on how to eat, and chew with newly acquired removable dentures.

 

The real question is, ” If you could….,should you?

My answer is no. I like the thought of staging a case 4 months to 1 year. First, removal of infected teeth, then natural healing of the surgical site, implant placement and then finally prosthetics from the ground up. This takes time.

There are many advantages of a staged approach to reconstruction/rehabilitation. Treating infection first, is one.  I will always push to remove those decayed infected teeth and eliminate all sources of draining  purulence first. Implant placement into an infection free mouth is critical. I don’t want the pathogenic destructive bacteria, that incidentally were  responsible for the original tooth loss, to “jump on to” the newly implanted sterile fixtures during the surgical process.  This jumping of bacteria  is called cross contamination and can be a big problem. Not all bacteria is bad. It’s the bad bacteria what we are concerned with contaminating implant threads in the surgical process. In addition, if no immediate emergency exists, anesthetic should not be directly injected into localized actively acute infected sites. Needle sticks physically displace and spread infection via facial planes remnant from embryological development. The surgeon must eliminate active infection first and then carefully prep for future implant placement with minimal trauma to the mouth. Allowing the patient to heal over several weeks eliminates the possibility of surgical cross contamination and infection spread.

Acrylic dentures can suck for most and for the few others, they are just perfect. No more cavities, no more tooth aches, no more of the bad memories relived in the chair. (Denture wears should still come in for a hygiene check or dentures reline once a year. Dentures do crack and sometimes need to be refitted due acrylic tooth wear, weight changes and medication changes. Sorry, you are not done with me yet!). After the extraction surgery in the non-immediate implant placement scenario (staged approach), you may be that unbelievably incredible patient doing just fine with that immediate temporary denture.  You never know.  One can never assume that you will or will not adjust to the dentures without implants. It’s hard to guess how you are going to feel emotionally and physically in the process. No one authority can force that issue of adaptation other than yourself. Assuming you do acclimate to the dentures, there is no possibility of buyers remorse. You can save yourself a boat load of money without the implants. A single arch fully implant supported implant fee can run $25,000-$40,00. A complete denture without implant support will be 10% of that. That’s something to think about.

Another advantage of staging is better esthetics. I want you to look great and feel great when it’s all done. There’s a big guess on how you should/could look upon delivery of the final acrylic dentures in the “Teeth in A Day Scenario”. A stranger laboratory technician decides for you denture tooth shape, shade and positioning of how you, “should look”. That’s a big jump to an unknown.   Esthetics need to evolve  during the healing process. Your facial features change dramatically after full mouth extractions and rapid bone loss occurs around non implant sites dramatically within the first several months after surgery. Most of the time, going slower in the prosthetic phase yields a better end result because the bone and soft tissues that support the final product will have healed to place. Harmony of the smile, bones and gums can best come together with a little patience.

In Italian, there’s a beautiful expression take rhymes and makes sense.

“Chi va piano, va sano e va lontano”

Translates into ” He who goes slowly, goes sanely and goes far”

Too  many more advantages to slow it down to mention. Come in for a consultation

 

Dr. Emilio & Associates,  Always Accepts  New Patients. He especially exceeds at treating same day emergencies patients suffering from tooth ache pains.

His goal is to keep his patients’ Teeth and Gums Healthy For Life.

Feel Free to appoint a Consultation with the Doctor. Open Six Days A Week

OPEN on Weekdays.  7:30am -8:00pm  (M<T<W<T)

Fridays.  7:30am-2:00pm

Weekends (Saturday only).  8:00am-2:00pm

111 East Avenue, Norwalk, Connecticut 06851.

You can always contact me directly via email  blog@robertemiliodds.com

Instagram:  dentist_in_connecticut

Office (203)866-7164      www.robertemiliodds.com

Pass this Link to Your Friends:  robertemilioddsblog.wordpress.com

 

 

 

“Does Candy and Drinking Hot Tea Give You Cavities?” …. Leslie asks

Yes, and most definitely yes.

Go to the interview Leslie and her Candy.

Candy and sugar are synonymous.

Black licorice a particular favorite of mine, I’ll admit is a triple threat. Consisting of sugar, it’s notorious for plucking away perfectly good dental work, such as crowns, off of unsuspecting teeth. The black coloring adds the extra drama of the unbrushed teeth look. Next Halloween, if want to give your hygienist a nightmare recall visit, make a quick snack of it on the way over to the office for your appointed time. Drinking hot tea just melts things away creating a more hydrodynamically  homogeneous sugary environment that will actually create the worst kind of cavities; root decay. The hot liquid sugar just sits on the soft vulnerable part of the tooth with the bacteria laying down acid  gnawing away creating big dental problems.

Dental decay involves plaque formation. When candy is consumed and if the sugars aren’t cleaned off your teeth, the naturally present bacteria in your mouth feed on the candy and produce destructive acids. The acids dissolve away the enamel of the tooth, hence a cavity.

There is some good news. If you want that candy, go for it!

Studies show that if you brush your teeth properly within 12 minutes of consuming the candy, no changes will occur in the enamel.

 

Dr. Emilio & Associates,  Always Accepts  New Patients. He especially exceeds at treating same day emergencies patients suffering from tooth ache pains.

His goal is to keep his patients’ Teeth and Gums Healthy For Life.

Feel Free to appoint a Consultation with the Doctor. Open Six Days A Week

OPEN on Weekdays.  7:30am -8:00pm  (M<T<W<T)

Fridays.  7:30am-2:00pm

Weekends (Saturday only).  8:00am-2:00pm

111 East Avenue, Norwalk, Connecticut 06851.

You can always contact me directly via email  blog@robertemiliodds.com

Instagram:  dentist_in_connecticut

Office (203)866-7164      www.robertemiliodds.com

Pass this Link to Your Friends:  robertemilioddsblog.wordpress.com

“I want a tooth.”

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Being a dentist, I do get that request by patients frequently.  My sportive response usually goes like this.  “Do you want that new tooth to stay in your mouth or do you want it to go into that tin cup on the side of your bed on  your bed stand?”

You have got several options to confront that gap.

1) You can Do Nothing. You are not going to die without that previously extracted tooth. An option,  but not a very good one. According to the Mayo Clinic: People who keep their teeth live an average of  10 years longer than people who lose their teeth due to proper nutrition….. Tooth loss can affect ones self confidence and can be emotionally traumatic. It’s a fact. People constantly judge everyday. Upon meeting you, a stranger will access you on your weight, choice of vocabulary and smile.

2) Removable Partial Denture. Its plastic, uncomfortable, difficult to chew with, traps food attacks to adjacent teeth with metal clasps. That same metal clasping will wear adjacent teeth down.  Yes, it’s in a cup at night. Relatively inexpensive. You should not sleep with the device in. “Do you sleep with your sneakers on?”  Life Span 5-10 years. A Four Visit Procedure.

3) Fixed Bridge. Looks natural. All Ceramic. Easy to chew with. Fixed into place with resin bonded adhesion. Adjacent teeth effected in the preparation of the bridge.  Can be a great option. More expensive than the removable option.  Life Span 5-10 years.  Two Visit Procedure.

4) Dental Implant. Looks great. Increased bite power. Fixed into place via osseointegration. Natural in form and shape to previous tooth. Preservation of surrounding bone. Competitive pricing with comparison to the fixed bridge option. Can last a lifetime. Multiple visit procedure.

Every Closure of Space Different and requires a complete discussion of pros and cons. Ask me on your next hygiene recall visit or request a dedicated consultation.

Go To My New YouTube Channel and You Will see My Seminar on This Topic

Robert Emilio DDS Seminar

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Implant Fixture
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Removable Partial
image.png
Fixed dental Bridge

 

Dr. Emilio & Associates,  Always Accepts  New Patients. He especially exceeds at treating same day emergencies patients suffering from tooth ache pains.

His goal is to keep his patients’ Teeth and Gums Healthy For Life.

Feel Free to appoint a Consultation with the Doctor. Open Six Days A Week

OPEN on Weekdays.  7:30am -8:00pm  (M<T<W<T)

Fridays.  7:30am-2:00pm

Weekends (Saturday only).  8:00am-2:00pm

111 East Avenue, Norwalk, Connecticut 06851.

You can always contact me directly via email  blog@robertemiliodds.com

Instagram:  dentist_in_connecticut

Office (203)866-7164      www.robertemiliodds.com

Pass this Link to Your Friends:  robertemilioddsblog.wordpress.com