My Blog

Posts for: June, 2021

By Stephen J. Wessels, DMD
June 24, 2021
Category: Oral Health
UntreatedGumDiseaseCouldCostYouYourImplant

Your teeth can take decades of daily biting and chewing and not miss a beat. But they do have a nemesis, dental disease, which can easily get the upper hand. As a result, millions of people lose teeth each year to tooth decay and periodontal (gum) disease.

But while both the living tissue that makes up teeth and gums are susceptible to bacterial attack, the non-living materials in a life-like dental implant are impervious to disease. That being the case, you would think your implants wouldn't need as much hygiene as your other teeth.

But they still do. True, implants in themselves aren't affected by infection, but the bone and other tissues that support them can become diseased. This often happens with advanced cases of gum disease.

There is, in fact, a particular form of gum infection associated with implants called peri-implantitis ("peri"—around; "it is"—inflammation), which occurs in the gums around an implant. Once it starts, peri-implantitis can advance at a rapid pace.

This is because implants don't have the gum attachment of real teeth, which can fight and slow the advance of a gum infection. Because an implant doesn't have this attachment, any infection around it continues virtually unimpeded. If the bone supporting an implant becomes infected, it can weaken to the point that the implant fails.

But this dire scenario can be avoided with continuing hygiene and maintenance of the gum tissues surrounding the implant. You should brush and floss every day around implants to remove dental plaque, the bacterial film most responsible for dental disease, just as you do with natural teeth.

It's also important to keep up regular dental visits for cleanings to remove lingering plaque and tartar (hardened plaque). Your dentist may also notice and clean away any residual cement from the restoration, which can also cause gum inflammation.

And, you should promptly see your dentist if you notice any telltale signs of a gum infection, such as swelling, redness or bleeding, especially around implants. The quicker we diagnose and treat a case of gum disease, particularly peri-implantitis, the less likely it will endanger your implant.

If you would like more information on maintaining dental implant restorations, please contact us or schedule an appointment for a consultation.


By Stephen J. Wessels, DMD
June 14, 2021
Category: Oral Health
Tags: tmj disorder  
YourToothacheMightActuallybeUnrelatedtoYourTeeth

When you see your dentist about mouth pain, you expect to hear that it's a decayed or fractured tooth, or maybe a gum infection. But you might be surprised if your dentist tells you there's nothing going on inside your mouth to cause the pain.

It's not that far-fetched: The pain could be originating elsewhere. This is known as referred pain, where pain radiates from its origin to another part of the body.

Unless there's an obvious oral cause for the pain, it's best not to undertake any treatment involving the mouth until we've pinpointed the actual cause. That said, the cause is usually not too far away.

Facial nerve disorders. The trigeminal nerve courses on either side of the face from the upper skull through the cheeks and ends around the lower jaw. But if portions of the nerve's protective sheathing become damaged, the slightest touch on the face could trigger prolonged pain. Because of its proximity to the jaw, the pain can often be misidentified as a toothache.

Jaw joint pain. When joints connecting the lower jaw to the skull become traumatized and inflamed, a condition known as Temporomandibular joint disorder (TMD), the pain can radiate toward the jaw. In some cases, the person may easily mistake the muscle pain and spasming for a toothache.

Ear infection. As with TMD, your "toothache" may actually stem from an ear infection or congestion radiating pain into the jaw. It can also happen in the opposite direction—ear pain could actually be the referred pain of an infected back tooth—emphasizing the importance of precisely determining the originating source of any pain in the jaws or face.

Sinus pain. The large maxillary sinuses are located on either side of the face just above the back of the upper jaw. Because of its proximity, pain from a sinus infection can seem to be coming from one of the back molars. And as with ear infections, frequent sinus infections could in fact be caused by an infected tooth penetrating through the sinus floor.

These and other examples of possible referred pain illustrate how "tricky" a presumed toothache can be. Finding the true source of oral or facial pain will ensure you receive the proper treatment for lasting relief.

If you would like more information on oral or facial pain diagnosis and treatment, please contact us or schedule an appointment for a consultation.


YouCanHaveaSuccessfulImplantOutcomeifYourDiabetesisUnderControl

Around one in ten U.S. adults have diabetes, a metabolic disease that can disrupt other aspects of a person's health like wound healing and vision. It could also cause complications with dental implants, the premier replacement choice for missing teeth.

There are two basic types of diabetes. In type 1 diabetes, the pancreas stops producing insulin, a hormone needed to regulate the amount of sugar glucose in the bloodstream. With the more prevalent type 2 diabetes, the body either doesn't produce enough insulin or doesn't respond efficiently to the insulin produced.

Uncontrolled diabetes can contribute to several dangerous health conditions. In addition to vision impairment and poor wound healing, diabetics are at higher risk for other problems like kidney disease or nerve damage. Drastic swings in blood glucose levels can also cause coma or death.

Many diabetics, though, are able to manage their condition through diet, exercise, medications and regular medical care. Even so, they may still encounter problems with wound healing, which could complicate getting a dental implant.

An implant is composed of a titanium metal post imbedded into the jawbone. Because of its affinity with titanium, bone cells naturally grow and adhere to the implant's metal surface. Several weeks after implant surgery, enough bone growth occurs to fully secure the implant within the jaw.

But this integration process may be slower for diabetics because of sluggish wound healing. It's possible for integration to not fully occur in diabetic patients after implant surgery, increasing the risk of eventually losing the implant.

Fortunately, though, evidence indicates this not to be as great a concern as once thought. A number of recent group studies comparing diabetic and non-diabetic implant patients found little difference in outcomes—both groups had similar success rates (more than 95 percent).

The only exception, though, were diabetic patients with poor glucose control, who had much slower bone integration that posed a threat to a successful implant outcome. If you're in this situation, it's better if you're first able to better control your blood glucose levels before you undergo surgery.

So, while diabetes is something to factor into your implant decision, your chances remain good for a successful outcome. Just be sure you're doing everything you can to effectively manage your diabetes.

If you would like more information on diabetes 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 “Dental Implants & Diabetes.”