Diabetes and Implant Placement

This National Diabetes Awareness Month, we at Oral Surgery Consultants of Pennsylvania want to raise awareness of the unique challenges people with diabetes face regarding their oral health. People with diabetes are at elevated risk for tooth loss, so dentists have long been studying the question of what kinds of prosthetic teeth are effective for them.

Research indicates that people with controlled diabetes can generally receive implants successfully, but there are a few areas that require extra precaution. One is that people with diabetes take longer to recover from surgical incisions, which are necessary for the placement of implants. This means that people with diabetes may expect a longer osseointegration period before their new dental crowns are placed. The other concern is that, because people with diabetes have higher rates of gum inflammation, their implants are at greater risk of failing prematurely.

Fortunately, a recent systemic review found that people with controlled diabetes hardly experience greater rates of implant failures than non-diabetic people. The key is that their oral health needs to be more closely monitored for signs of gingivitis, so that they can receive necessary cleanings quickly. If a patient has great trouble controlling their diabetes, dentures may be more appropriate. We offer dental implants at our offices, and will give each patient the individual care they need for lasting oral health.

 Oral Surgery Consultants of Pennsylvania operate in Philadelphia, Folsom, and Clifton Heights. Visit Oral Surgery PA.

 

The Importance of Replacing Teeth

Suppose that you are missing one of your back teeth. Although this is not ideal, you may think that because the gap isn’t visible and you’re still able to chew and speak, there’s no pressing need for it to be replaced. Unfortunately, that would be incorrect. At Oral Surgery Consultants of Pennsylvania, some of our patients require extensive reconstruction due to the loss of bone structure around missing teeth. To help you avoid this, we wanted to say a bit about why you should replace teeth as soon as possible.

Our teeth are held in place by ligaments. When a tooth is lost, the supporting ligaments and muscles will atrophy, and no longer pull on the jaw bone. This causes the jaw bone to recede, as well, and it’s common for the section of jaw bone that supported a missing tooth to lose 25% of its width in the first year after the tooth’s loss. With less jaw bone tissue, it’s common for the remaining teeth to shift place, making it harder to chew and putting more pressure on the temporomandibular joints that connect the jaw to the head. If a person compensates for missing molars by chewing with their front teeth, their incisors may be pushed outward, causing the face to shrink vertically.

We offer dental implants for missing molars, but if the patient has lost jaw bone tissue, they may require a bone graft before receiving an implant. Another option is an implant-supported denture, which will help stabilize the jaw bone and stimulate new tissue growth.

  Oral Surgery Consultants of Pennsylvania operate in Philadelphia, Folsom, and Clifton Heights. Visit Oral Surgery PA.

 

Getting Implant Supports for Dentures

Do you have multiple teeth you need repaired or replaced? Are you concerned that standard dentures wouldn’t provide you with enough comfort and function? We at the Oral  Surgery Consultants of Pennsylvania hear those concerns all the time. One of our solutions is the implant-supported denture. This device stabilizes a denture, while still allowing it to be removed for convenient cleaning.

If a patient is a good candidate for implants, they will be inserted into the patient’s jaw and allowed to integrate with the surrounding jaw bone over a period of a few weeks or months. But implants that support dentures don’t require the patient to have as much jaw bone tissue as single-crown implants, either because the implants are smaller or angled differently. This means a person is less likely to need a bone graft and the implants may integrate with the bone more quickly.

While the implants integrate, the patient may wear a temporary denture. Once the implants have stabilized, your dentist will attach abutments to them that will allow them to snap onto the patient’s custom-fitted denture. The patient will remove the denture each night and brush it, as well as their mouth, but during the day, the denture will not be at risk of slipping and will not need to suction onto their natural palate. Implant supports can be used with both full and partial dentures.

The Oral Surgery Consultants of Pennsylvania operate in Philadelphia, Folsom, and Clifton Heights. Visit Oral Surgery PA.

 

 

Oral Bacteria in Aging Populations

Oral hygiene is crucial for the preservation of teeth and the integration of implants. At The Oral Surgery Consultants of Pennsylvania, we’ve seen a lot of people safely through the entire tooth replacement process. But as people age, their risk of oral health complications increases, which is why we wanted to provide some information about the connection between oral bacteria and overall health in the aging population.

Older Americans have higher rates of tooth decay than any population except young children. According to some estimates, 64% of them have periodontitis, which is the more advanced form of gum disease. People with periodontitis experience jaw bone deterioration, which makes their teeth likelier to come loose, migrate, or fall out. Their mouths also lose vertical dimension, causing bite problems. But oral bacteria will not necessarily remain confined to the mouth. They may enter the bloodstream through the dental pulp, an abscess in the gingival tissue, or through the lungs, and cause inflammation throughout the body. This would cause other prosthetics and replacement body parts, such as heart valves, to be at higher risk of premature failure. Oral bacteria that migrated to other parts of the body have also been implicated in rheumatism and Alzheimer's Disease.

It is certainly worthwhile for older people to maintain their regular brushing and flossing. They may want to consider electric toothbrushes and enlarged toothbrush grips. People with dry mouth may also want to use sugar-free gum to increase their saliva production and reduce their intake of sugary drinks, such as iced tea, sweetened coffee, and fruit juice. 

The Oral Surgery Consultants of Pennsylvania operate in Philadelphia, Folsom, and Clifton Heights. Visit Oral Surgery PA.

 

Surgeries for Cleft Palates

A cleft palate is a major health issue that takes significant expertise to correct. At Oral Surgery Consultants of Pennsylvania, our doctors have the training and experience to see each patient through to a healthy smile. Correcting a cleft palate will require time and cooperation with orthodontists, so we want patients’ families to know what to expect.

A gap in the upper palate will result in misaligned teeth. Besides being an aesthetic issue, teeth that are misaligned are difficult to use and clean. An orthodontist will make corrections that will leave a gap where an implant can be inserted, but before a post can be placed, there needs to be enough bone to place it in. The bone tissue used for a maxillary graft could come from several sources; it could be from another part of the patient’s mouth or body, from a donor, or a synthetic material. Regardless, it will take a few months for the new bone tissue to fuse into the cleft.

An implant can be placed into integrated bone tissue, but other prosthetics may be preferable if the patient needs multiple teeth replaced. In some situations, a partial denture may be preferable even after a cleft has been filled in. Children will need multiple surgeries over the course of their mouth’s development, so our doctors are dedicated to each patient’s long-term care.

Oral Surgery Consultants of Pennsylvania operate in Philadelphia, Folsom, and Clifton Heights. Visit Oral Surgery PA.

 

Surgery for Oral Cancer Patients

Oral Surgery Consultants of Pennsylvania are a crucial part of the care team for anyone in the Philadelphia area facing oral cancer. Not only are our surgeons able to perform soft-tissue biopsies, they are also able to assist with the construction of prosthetic teeth and mouth parts a patient may need following the excision of a tumor.

Sometimes tumors can be cut out of soft tissue, such as the tongue or inside of the lip. But when they are inside or behind a jaw bone, a section of the bone will need to be cut away. Following its removal, the section of bone may be reinserted or replaced with a prosthetic or a bit of donor tissue (possibly from another part of the patient’s body). If the hard palate on the roof of the mouth was removed, it can be replaced with a specialized prosthetic that may also include replacement teeth.

The silver lining of bone replacement is that the new bone tissue may be better suited for receiving implants. There needs to be a certain amount of healthy bone for an implant post to fuse with, and bone grafts are sometimes necessary for people who have been without teeth for a long time. A patient’s oncologist will likely want them to undergo a dental examination prior to radiation treatment to determine whether any pre-existing caries will be aggravated and if any teeth are likely to need replacements.

Oral Surgery Consultants of Pennsylvania operate in Philadelphia, Folsom, and Clifton Heights. Visit Oral Surgery PA or call 215-463-4141.

 

When a Tooth Cracks

Breaking a tooth is scary. While there’s no way to be completely prepared for when it happens, we at Oral Surgery Consultants of Pennsylvania want people to know that teeth often can be saved, and that getting treatment quickly increases their chance of successful treatment. In this blog post, we discuss what to do immediately after discovering a broken tooth and what treatments are likely.

The molars are the likeliest teeth to break. They are the ones that can normally withstand the force of the patient’s bite, although they may break against something extremely hard. When other teeth are used for chewing, they are much likelier to break or be pushed sideways. If a patient chips or cracks a tooth, they should rinse their mouth with salt water and cover the broken crown with dental wax if they have any on hand, or sugarless gum if they don’t.

A small chip may be repairable with bonding. For this procedure, a dentist would apply and contour an adhesive material onto the tooth. But if the tooth is significantly broken, a dentist may need to reshape it in preparation for an entire new crown. The crown would be custom-made to fit the patient’s mouth and cemented over the reshaped natural enamel, which would be left in place to cover the dental pulp. If an x-ray reveals that the tooth is cracked at the root, it will need to be removed. We’ll work with a patient to determine whether an implant or a partial denture would make a better replacement.

Oral Surgery Consultants of Pennsylvania operate in Philadelphia, Folsom, and Clifton Heights. Visit Oral Surgery PA or call 215-463-4141.

 

New Patients

At Oral Surgery Consultants of Pennsylvania, we are always looking to grow our family. To take advantage of all the services we offer, we want to give you a better idea of what your first visit with one of our doctors will look like.

First time patients will go through consultation to discuss the diagnosis and treatment options for your surgery. We ask that patients bring us some form of ID, a copy of their insurance x-rays (if applicable), surgical referral slip, and a list of medications you are taking. Any new patients under the age of 18 need a parent or legal guardian present.

Our doctors advise patients that surgery will most likely be performed on the second visit after an evaluation of your medical history and the treatment necessary.

If you have any questions about your first visit, please give us a call. To learn more about the services we provide at our practice, visit www.oralsurgery.pa.com for more information. To schedule an appointment with one of our doctors at Oral Surgery Consultants of Pennsylvania located in Philadelphia, call 215-463-4141.

Replace Teeth with Dental Implants

The doctors at Oral Surgery Consultants of Pennsylvania replace teeth and restore patient smiles with dental implants. Implants are a permanent restorative option for teeth that are missing or have been extracted.  They look and feel just like natural teeth, and are the most permanent and efficient means of replacing lost teeth.

An implant is placed over a series of appointments because of the healing time required.  Implants are titanium screws inserted through an incision in the gum. Over a period of 3-6 months, the jaw bone heals around the implant to become a solid, stable base for the new tooth. During this time a patient is fitted with a temporary crown, and a custom crown is created to match their smile perfectly.

After the jaw bone and gums have healed appropriately, the custom crown is placed in a second minor procedure.  The doctor may need to expose the head of the implant by removing some gum tissue, and the crown will be screwed to the top of the implant.  When this is complete the tooth looks like part of the natural smile, and with proper care will last for decades!

To learn more about dental implants and all the services we provide at our practice, visit www.oralsurgerypa.com for more information. To schedule an appointment with one of our doctors at Oral Surgery Consultants of Pennsylvania located in Philadelphia, call 215-463-4141.

Diabetes and Gum Disease

If you suffer from diabetes, your teeth may be in danger. At Oral Surgery Consultants of Pennsylvania, we often do full-mouth restorations on people who need all their teeth replaced. But restorations are easier when patients still have stable jaw bone material, which is why we want our diabetic patients to be on-guard against periodontal disease.

People with diabetes are prone to experience chronic inflammation. Their arteries thicken, making it more difficult for their blood to deliver nutrients and immune agents to locations of infections. Consequently, diabetic people have a more difficult time fighting off gum pocket infections and have higher rates of gingivitis and periodontal disease than the general population. At its most extreme, periodontal disease causes gum and bone tissue to recede, leaving the teeth vulnerable to falling out.

Some evidence has emerged that gum disease may also make it harder for patients to regulate their blood sugar level, worsening other symptoms of diabetes. However, treatment of periodontal disease is associated with improved health. Regular oral hygiene and professional cleanings can help diabetic patients to avoid gum infections, and avoiding smoking can prevent inflammation. If a patient has diabetes, it may be possible for them to get implants, but they will still need to be especially vigilant about their oral hygiene.

Oral Surgery Consultants of Pennsylvania operate in Philadelphia, Folsom, and Clifton Heights. Visit Oral Surgery PA or call 215-463-4141.

 

Peri-Implantitis

Implants are a highly effective means of replacing lost teeth. At the Oral Surgery Consultants of Pennsylvania in the Philadelphia area, we regularly see patients through the entire process of implant placement, osseointegration, and crown placement. But like natural teeth, implants need to be cared for, or else patients run the risk of developing inflammation or peri-implantitis.

The gum pockets are great places for bacteria to hide. As they feed, they produce acid that gets stuck to plaque, resulting in decay. But bacteria also inhabit the gum pockets of teeth that have been replaced by prosthetics and may cause inflammation there, as well. As with natural teeth, infected gums will swell and bleed, and prolonged exposure to acid can erode the metal implant post.

At its worst, peri-implantitis can dissolve the bone holding implants in place. This outcome is particularly unfortunate because an implant needs to be removed if it becomes mobile or more than 10% of the surrounding jaw tissue is lost in the first year after placement. However, if the infection can be caught in time and reversed, implants can stimulate the production of new jaw bone growth.

The Oral Surgery Consultants of Pennsylvania operate in Philadelphia, Folsom, and Clifton Heights. Visit Oral Surgery PA or call 215-463-4141.

 

Uses of a CT Scanner

The offices of the Oral Surgery Consultants of Pennsylvania are fully equipped for our patients’ diagnostic and treatment needs. One of the most important pieces of equipment we have is the computed tomography (CT) scanner. This kind of x-ray allows us to see the patient’s bone structure in much greater detail than can be done in most dental practices.

Typically, x-rays only allow a few views of a person’s mouth. By contrast, the CT scanner rotates around the patient's head, capturing images from every angle. This is important because the success of implant placement depends on where they are put and how much bone structure the patient retains. Following implant placement, the patient will need to periodically undergo imaging tests to ensure the bone and implant are integrating. If they are not, the implant must be removed. During apicoectomies, use of a CT scanner is also necessary to locate the tips of tooth roots. Often, an initial root canal fails because it did not account for an unusual tooth shape.

 The use of a CT scanner presents very little risk of radiation exposure to the patient. It takes less than a minute, is painless, and does not require any special preparation.

The Oral Surgery Consultants of Pennsylvania operate in Philadelphia, Folsom, and Clifton Heights. Visit Oral Surgery PA or call 215-463-4141.

 

Missing Incisors

At the offices of the Oral Surgery Consultants of Pennsylvania, we provide people with replacements for missing teeth. When most people hear this, they probably think of teeth that have been lost to injury or infection, but prosthetic teeth are also of great value to people whose teeth never developed at all. In about 2% of the population, the upper lateral incisors, which are the flat teeth on the sides of the two front teeth, fail to erupt.

Fixing this problem requires collaboration between the oral surgeon and an orthodontist, particularly when the incisors exist but never descended through the gum line. In these cases, it may be necessary for the oral surgeon to cut into the gum tissue and expose the teeth and attach brackets. The incisors may then be guided into place with wires  by the orthodontist.  But when the teeth are absent altogether, they have to be substituted. If an orthodontist is able to make enough space, the incisors can be replaced with several different kinds of prosthetics depending on the patient’s needs. These could be anything from fixed single implants or bridges to removable partial dentures. If the patient decides to go that route, it is very important for them to wear their retainer, or else their teeth may shift into a position that won’t work with the denture or bridge.

The Oral Surgery Consultants of Pennsylvania operate in Philadelphia, Folsom, and Clifton Heights. Visit Oral Surgery PA or call 215-463-4141.

 

Bite Collapse

People in need of an oral surgeon have often suffered extensive wear to their teeth. When teeth are worn down or absent, the patient may experience bite collapse, which is also known as loss of vertical dimension. Since fixing this is one of the most important aspects of what we do, we want to make sure our patients understand how it affects them.

Vertical dimension loss doesn’t only occur when tooth enamel is eroded; it can also occur when the front teeth are tilted outwards and back teeth are missing or broken. The loss of bite dimension is often evident from the appearance of the patient’s face, which may be wrinkled and have a mouth that is disproportionately small compared to the surrounding features. It also can be the cause of temporomandibular joint disorder (TMJD), which causes pain throughout the head, neck, and shoulder and can lead to more tooth grinding.

If your teeth are worn down extensively, your dentist might refer you to Oral Surgery Consultants of Pensylvania for extractions.  After healing, you would follow up with your dentist for any restorative work.

 

Drs. Bahram, Richman, Mohan and Dieu operate at Oral Surgery Consultants of Pennsylvania at 2546 S. Broad Street, Philadelphia, Pennsylvania, 19145. To schedule an appointment, call 215-463-4141 or visit Oral Surgery PA and fill out a contact sheet.

 

Diabetes and Implants

American Diabetes Month is observed in November, and we at the Oral Surgery Consultants of Pennsylvania want to send it off with a word about implants. Placing implants is one of our specialties which makes the biggest positive difference in patients’ lives, but people with diabetes were not always sure whether they could receive them.

Diabetics are at increased risk for gum inflammation (gingivitis) and periodontal disease. This means they are at increased risk of losing jaw bone structure and would benefit from implants, which help to stabilize other teeth. But implant failure was long associated with chronic inflammation and people with uncontrolled blood sugar take longer to recover from wounds. Placing implants requires surgical incisions, which led doctors to question diabetic patients’ candidacy.

In recent years, the American Dental Association has taken steps to resolve this problem by surveying the available scientific studies. Their conclusion is that diabetic people do not have higher rates of implant failure than the general population. In people with uncontrolled diabetes, the longer recovery time and need to control inflammation are important factors to consider, but fixed prosthetics are not off-limits to them.

Drs. Bahram, Richman, Mohan and Dieu operate at Oral Surgery Consultants of Pennsylvania at 2546 S. Broad Street, Philadelphia, Pennsylvania, 19145. To schedule an appointment, call 215-463-4141 or visit OralSurgeryPA.com and fill out a contact sheet.

 

Cleaning Fixed Bridges

Our focus on prosthetics at the Oral Surgery Consultants of Pennsylvania doesn’t mean we don’t value preventive care. In fact, our patients need to know how to adjust their hygienic practices so that their replacement teeth will last them a long time. We recently discussed cleaning single-crown implants; now let’s turn to fixed bridges.

Anybody who has ever worn braces should understand the basic idea of cleaning a bridge. When the bridge rests on reshaped natural teeth with artificial crowns, patients are advised to thread a strand of floss underneath it and rub the underside of the bridge in the same way they do the sides of their teeth. The floss may be looped around using a threader, which is a flexible device which pulls floss like a needle pulls thread. Some specialty floss is manufactured with a stiffened end so it may be pulled directly.

An implant-supported bridge is cleaned much the same way, except there may be a larger gap between the gum line and the prosthetic crowns. This may afford patients the opportunity to use a proxy brush, which is also known as a Christmas tree brush. A higher-tech option is a waterpick with a tip designed for use on implants.

Dr. Ramin Bahram operates the Oral Surgery Consultants of Pennsylvania at 2546 S. Broad Street, Philadelphia, Pennsylvania, 19145. To schedule an appointment, call 215-463-4141 or visit OralSurgeryPA.com and fill out a contact sheet.