Years ago, disease or trauma robbed you of one of your teeth. At the time you might have opted for an affordable solution, like a partial denture. But now you'd like to restore that missing tooth with a dental implant, the most life-like tooth replacement available.

That's a great decision. But there may be a hiccup along the way to your new implant: the state of the underlying jawbone. Implants need a certain amount of bone for proper placement. If not enough is present, that may cause an interruption in your plans—and that could be a real possibility if your tooth has been missing for some time.

That's because, like other living tissues, bone has a growth cycle: Old bone cells die and dissolve, while new cells form to take their place. In the jaw, the force produced by teeth during chewing helps to keep this growth process in the bone functioning at a healthy pace.

When a tooth goes missing, though, so does this chewing stimulation. A lack of stimulation can slow the growth rate for that part of the bone and its volume can diminish over time. It's possible for a quarter of the bone volume to be lost within the first year after losing a tooth.

If you've experienced that level of bone loss, we may not be able to place an implant—yet. You might still have a few options. For one, we could attempt to regenerate some of the bone through grafting. Bone material grafted into the affected area can serve as a scaffold for new bone cells to form and adhere. Over time, this could result in a sufficient amount of regenerated bone to support a dental implant.

Another possibility might be to install a smaller diameter implant like those used to support removable dentures. Because they're smaller they require less bone than standard-sized implants. They're not for every situation, though, and are best suited for situations where aesthetics isn't a priority.

To know what your options are regarding an implant-based restoration, you'll need to undergo a thorough evaluation of your oral health, including supporting bone. Depending on your situation, you may still be able to renew your smile with this premier tooth replacement option.

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 After Previous Tooth Loss.”

Vitamins play a key role in your body’s health, including your teeth and gums. A vitamin-deficient diet is an invitation to all sorts of disease.

But what are vitamins? Although they differ individually in what effect they have on the body, they’re all organic compounds found in foods, especially fruits and vegetables. Each in a different way helps with bodily processes.

Vitamin C, for example, helps the body repair tissue. Without it, tissue breaks down easier, as British sailors discovered centuries ago on long sea voyages. Deprived of vitamin C in their diets they soon encountered health issues like bleeding gums. Eating limes — chock full of vitamin C—helped to clear up such problems (and also why they were called “limeys”).

Scientists have discovered thirteen vitamins, four of which—A, D, E and K—are soluble (dissolvable) in fat; the body stores these in the liver and fat tissue where they issue out into the body slowly. The rest—C and eight types of B vitamin—are soluble in water. Unlike the fat-soluble vitamins, these are used quickly and any remaining are excreted from the body.

When it comes to teeth, gums and the mouth, a rich assortment of vitamins helps maintain good oral health. For the teeth especially, vitamin D plays a critical role—it helps the body absorb the mineral calcium necessary for strong bones and teeth. You’ll find this vitamin plentiful in dairy products, but also fatty fish like salmon and tuna.

While vitamins occur naturally in foods, they can be manufactured in the form of dietary supplements. Unfortunately, the world of dietary supplements is a murky one, ungoverned by the restrictions and clinical trials that drugs undergo before they go to market. And, it’s big business: vitamin supplements are promoted as “insurance” for good health.

But while some people have conditions that may require a vitamin supplement, research has shown that most of us can effectively get our vitamins through a diet rich in fresh fruits and vegetables. So, do your teeth and gums (as well as the rest of your body) a favor—eat your fruits and veggies. Along with daily brushing and flossing, getting enough vitamins can go a long way toward keeping your mouth healthy and disease-free.

If you would like more information on nutrition and dental health, 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 “Vitamins & Dietary Supplements: What Every Consumer Should Know.”

After living with braces for a couple of years, the “big reveal” finally happens and you see your new smile for the first time. But then you’re told you have to wear another mouth appliance—around the clock to start and then just at night. After all the new smile excitement, wearing a retainer can be a little anticlimactic.

But this part of your orthodontic treatment is as important as the earlier tooth movement phase. That’s because your new “forever smile” doesn’t necessarily come with a “forever” guaranty. In fact, your teeth could quickly begin moving back to where they were before braces if you don’t wear a retainer.

The reason why is because of a tough but elastic gum tissue called the periodontal ligament. This ligament lies between the teeth and the jawbone, attaching to both through tiny extending fibers. The periodontal ligament actually does most of the anchoring work to hold your teeth in place.

The ligament is also why we’re able to move your teeth to different positions: As braces apply pressure to the teeth and jaw in the direction of desired movement, the ligament remodels itself to allow the teeth to take up these new positions.

The tissues involved, though, still retain a kind of “memory” of where the teeth used to be. This creates an immediate tendency for the teeth to revert to these old positions. To prevent this, we use a retainer that when worn keeps or “retains” the teeth in their new positions until they’ve stabilized and the old tissue “memory” fades.

There are different types of retainers, some removable and some fixed in place. Choosing the best one for a particular patient will depend on the complexity of the bite treatment, the patient’s age and level of self-responsibility and the preferences of the orthodontist. Whichever type of retainer you eventually use, it’s important you wear it to preserve all of the time and effort that went into transforming your smile.

Wearing a retainer might not be high on your “exciting things to do” list. But it’s the best way to guarantee you’ll enjoy your new smile for years to come.

If you would like more information on keeping your new smile after braces, 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 Importance of Orthodontic Retainers.”