My Blog
By Dr. Clementine C. Ignacio, DMD
March 15, 2018
Category: Oral Health
Tags: bone loss   missing teeth  

Losing teeth will certainly disrupt your otherwise beautiful smile. It could also potentially affect your food choices and whether or not you receive proper nutrition.

But something else just as consequential could be happening beneath the surface of your gums—you could be losing bone. Significant bone loss in the jaw could adversely affect remaining teeth and facial structure, as well as limit your future restoration choices.

To understand why this occurs we must first consider what bone is: living, cellular tissue. Like the body's other cells, bone has a life cycle: cells form, live and eventually dissolve (or resorb), and are then replaced by new cells. Stimulation from forces generated during chewing traveling up through the tooth roots to the jawbone keep this cycle going at a healthy pace.

But when a tooth is missing, so is this stimulation. This could slow the replacement rate and cause bone volume to gradually decrease. The jawbone width could decrease by as much as 25% the first year alone and several millimeters in height after just a few years.

Although dentures (a popular and affordable choice) can restore lost function and appearance, they can't duplicate this needed stimulation. They even accelerate bone loss by irritating and creating compressive forces on the bony ridges and the gums they rest upon.

One restoration, however, can actually help stop bone loss and may even reverse it: dental implants. This happens because an implant's metal titanium post imbedded in the jawbone attracts bone cells to grow and adhere to its surface. This could actually increase bone density at the site.

To gain this advantage, it's best to obtain implants as soon as possible after tooth loss. If you allow bone loss to occur by waiting too long, there may not be enough to properly support an implant. Even then it might be possible to build up the diminished bone through grafting. But if that's not possible, we'll have to consider a different restoration.

To determine the condition of your bone after losing teeth, visit us for a complete examination. Afterward, we'll be able to discuss with you the best way to address both your overall dental health and your smile.

If you would like more information on treating missing teeth, 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 “The Hidden Consequences of Losing Teeth.”

By Dr. Clementine C. Ignacio, DMD
February 28, 2018
Category: Dental Procedures

Your smile isn’t the same without healthy gums—neither are your teeth, for that matter. So, maintaining your gums by protecting them from periodontal (gum) disease is a top priority.

Gum disease is caused by bacterial plaque, a thin biofilm that collects on teeth and is not removed due to poor oral hygiene practices. Infected gums become chronically inflamed and begin to weaken, ultimately losing their firm attachment to the teeth. This can result in increasing voids called periodontal pockets that fill with infection. The gums can also shrink back (recede), exposing the tooth roots to further infection.

Although gum disease treatment techniques vary, the overall goal is the same: remove the bacterial plaque fueling the infection. This most often involves a procedure called scaling with special hand instruments to manually remove plaque and calculus (tartar). If the infection has spread below the gum line we may need to use a procedure called root planing in which we scrape or “plane” plaque and calculus from the root surfaces.

As we remove plaque, the gums become less inflamed. As the inflammation subsides we often discover more plaque and calculus, requiring more treatment sessions. Hopefully, our efforts bring the disease under control and restorative healing to the gums.

But while gum tissue can regenerate on its own, it may need some assistance if the recession was severe. This assistance can be provided through surgical procedures that graft donor tissues to the recession site. There are a number of microsurgical approaches that are all quite intricate to perform, and will usually require a periodontist (a specialist in gum structures) to achieve the most functional and attractive result.

While we have the advanced techniques and equipment to treat and repair gum disease damage, the best approach is to try to prevent the disease from occurring at all. Prevention begins with daily brushing and flossing, and continues with regular dental cleanings and checkups.

And if you do notice potential signs of gum disease like swollen, reddened or bleeding gums, call us promptly for an examination. The sooner we diagnose and begin treatment the less damage this progressive disease can do to your gums—and your smile.

If you would like more information on protecting your gums, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Periodontal Plastic Surgery.”

By Dr. Clementine C. Ignacio, DMD
February 13, 2018
Category: Oral Health

Sure, it’s big news when celebs tweet selfies from the dental office… if you’re still living in the 20th century. But in Hollywood today, it’s harder to say who hasn’t posted snaps of themselves in the dentist’s chair than who has. Yet the pictures recently uploaded to Twitter by Mark Salling, the actor and singer who regularly appears as Noah “Puck” Puckerman on the popular TV series Glee, made us sit up and take notice.

“Getting my chipped tooth fixed. Also, apparently, I’m a big grinder,” read the caption. The photo showed a set of upper front teeth with visible chips on the biting surface. What’s so special about this seemingly mundane tweet? It’s a great way of bringing attention to a relatively common, but often overlooked problem: teeth clenching and grinding, also called bruxism.

Although bruxism is a habit that affects scores of people, many don’t even realize they have it. That’s because the condition may only become active at night. When the teeth are unconsciously ground together, the forces they produce can wear down the enamel, cause chipping or damage to teeth or dental work (such as veneers or fillings), or even loosen a tooth! While it’s common in children under 11 years old, in adults it can be a cause for concern.

Sometimes, mouth pain, soreness and visible damage alert individuals to their grinding habits; other times, a dental professional will notice the evidence of bruxism during an exam or cleaning: tooth sensitivity and telltale wear and tear on the chewing surfaces. Either way, it’s time to act.

Bruxism is most often caused by stress, which can negatively impact the body in many ways. It may also result from bite problems, the overuse of stimulating substances (caffeine, alcohol, tobacco, and illegal drugs), and as a side effect of certain medications. Sometimes, simply becoming aware of the habit can help a person get it under control. Common methods of stress reduction include exercise, meditation, a warm bath or a quiet period before bedtime; these can be tried while we monitor the situation to see if the problem is going away.

If stress reduction alone doesn’t do the trick, several other methods can be effective. When bruxism is caused by a minor bite problem, we can sometimes do a minor “bite adjustment” in the office. This involves removing a tiny bit of enamel from an individual tooth that is out of position, bringing it in line with the others. If it’s a more serious malocclusion, orthodontic appliances or other procedures may be recommended.

When grinding is severe enough to damage teeth or dental work, we may also recommend a custom-made night guard (occlusal guard), which you put in your mouth at bedtime. Comfortable and secure, this appliance prevents your teeth from being damaged by contacting each other, and protects your jaw joints from stresses due to excessive grinding forces.

Whether or not you have to smile for a living, teeth grinding can be a big problem. If you would like more information about this condition, call our office to schedule a consultation for a consultation.

By Dr. Clementine C. Ignacio, DMD
January 29, 2018
Category: Dental Procedures
Tags: dental implants  

When it comes to replacing a missing tooth, you have several options, including a removable partial denture or a fixed bridge. But the premier choice is “the new kid on the block” at just over thirty years old: dental implants. Implants are by far the most popular tooth replacement choice among both patients and dentists.

But they also happen to be the most expensive option, at least initially. So the question is, why invest in dental implants over less costly choices?

Here are 3 reasons why implants could be well worth their price.

More Like a real tooth than other restorations. Implants can match the life-like appearance of any other replacement choice, often utilizing the same types of materials. But where they really excel is in function—how they perform while biting and chewing. This is because the dental implant’s titanium post imbedded in the jawbone replaces the tooth root. No other dental restoration can do that—or perform better when comparing the resulting functionality.

Best long-term solution. As we mentioned before, the initial implant cost is typically higher than either dentures or bridges. But you should also consider their durability compared to other choices. It could be potentially much longer—possibly decades. This is because the titanium post creates an ultra-strong hold in the jawbone as bone cells naturally grow and adhere to this particular metal. The resulting hold can withstand the daily forces generated during eating and chewing. With proper care they might even last a lifetime, and actually cost you less in the long run over other choices.

Adaptable to other types of restoration. Implants have greater uses other than as individual tooth replacements. A few strategically placed implants can also be used to support removable dentures or a fixed bridge for multiple teeth or an entire dental arch. As the technology continues to advance, implants are helping to make other restoration options stronger, more stable and longer lasting—and adding more value to your investment.

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 “Dental Implants 101.”

By Dr. Clementine C. Ignacio, DMD
January 21, 2018
Category: Oral Health
Tags: tooth decay  

As we age we become more susceptible to dental diseases. A common but often initially unnoticed problem for seniors is root decay.

We’re all familiar with tooth decay in the crown, the visible tooth above the gum line. Bacteria feeding on leftover sugar in the mouth produce acid, which at high levels erodes the teeth’s protective enamel. This forms cavities and, if untreated, deeper infection within the tooth that could reach the bone via the root canals.

But decay can also directly attack a tooth’s roots below the gum line. Roots are made of dentin and covered by a very thin layer of mineralized tooth structure called cementum.  Cementum, which is much softer than enamel, is often lost because of its thinness, thus exposing the root’s dentin. This can make the area more susceptible to decay than the enamel-covered crown. Normally, though, the roots also have the gums covering them as added protection against bacterial infection.

But gum recession (shrinkage), a common experience for people in their later years, can expose the root surfaces. As a result, the roots become much more susceptible to decay. And an ensuing infection could spread more quickly into the interior of the tooth than decay originating in the crown.

That’s why it’s important to remove the decayed material and fill the root cavity to prevent the infection’s spread. While similar to a crown filling, the treatment can be more difficult if the root cavity extends below the gum line. In this case, we may need to perform a surgical procedure to access the cavity.

There are other things we can do to help prevent root cavities or limit their damage. We can apply fluoride varnish to strengthen the teeth and provide extra protection against cavities, or prescribe a fluoride rinse for use at home. We can also keep an eye out and treat periodontal (gum) disease, the main cause for gum recession.

The most important thing, though, is what you do: brush and floss thoroughly each day to remove bacterial plaque and limit sugary or acidic foods in your diet. Preventing decay and treating cavities as soon as possible will help ensure you’ll keep your teeth healthy and functional all through your senior years.

If you would like more information on preventing and treating tooth decay, please contact us or schedule an appointment for a consultation.

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