When the topic of conversation in a dentist’s office is dentures, many patients assume that their only option is a complete denture that rests on gums and can be removed on a whim. Fortunately, for many who need dentures, there is a more permanent solution: implant-supported dentures.

What are Implant-Supported Dentures?

Unlike a regular denture that rests on a user’s gums, implant-supported dentures are a subset of dentures that are both supported by and attached to implants using special attachments that snap onto the dentures. When there are no teeth in the jaw, but the jaw has enough bone to support implants, a patient a great candidate for an implant-supported denture.

Usually, these kinds of dentures are made for the lower jaw. This is due to the fact that regular dentures are usually unstable in the lower jaw. While implant-supported dentures can also be used in the upper jaw, it is not always necessary as normal dentures in the upper jaw are usually much more stable than regular dentures in the lower jaw. While more stable than regular dentures, dentures that are supported by implants should still be removed at night like regular dentures and should still be cleaned thoroughly.

Various Types

This particular group of dentures can be separated into two types: ball-retained dentures and bar-retained dentures with both types being made with a base made out of acrylic that resembles gums and acrylic or porcelain teeth that mimic the look of a patient’s natural teeth. Ball-retained dentures are implanted into the jawbone using two implants. Each of these implants has a metal attachment that then fits into another denture attachment. The attachments are usually “ball-shaped,” hence the name, and they fit into little sockets on the denture itself. Following the curve of the jaw, bar-retained dentures, however, utilize a thin metal bar that is attached to the jawbone using anywhere from two to five implants. Various attachments like clips are then fitted to either the denture, bar, or both. The denture then fits precisely over the bar and is clipped into a secure position by the various aforementioned attachments.

The Procedure

The procedure ultimately depends on the location of the dentures. Usually, the implants are placed in the front of the mouth as there is typically more bone to work with. The shortest time frame one can expect is around 5 months for the lower jaw and 7 months for the upper jaw. If a patient is in need of bone grafting, however, the process can take up to one year or longer. For most, two surgeries are needed for the best chance at successful implantation. The first surgery consists of placing the implants into the jawbone under the patient’s gums. The second involves exposing the top of the implants and is usually scheduled for anywhere from 3 to 6 months after the first surgery. There is a procedure available that combines the two stages and carries with it a high success rate, but there are certain variables that an oral surgeon will take into account before opting to go that particular route. Despite the route you choose to take, your dentist will make you a temporary denture to use until the full implantation process has been completed.

Implant-Supported Denture Benefits

One of the benefits of opting for these dentures over traditional dentures is that they are more stable than their traditional counterparts. Because of their stability, users find speaking to be much easier and they do not have to worry about their dentures loosening or falling out of their mouths as they go through their days. Additionally, some foods that are off-limits with traditional dentures, are given the “green light.”. With that being said, hard and sticky foods should still be avoided in order to avoid damaging the dentures. Another benefit pertains to the upper jaw. Because implants hold the denture in place, it will not cover as much of your palate as a traditional denture. This, again, allows for easier speaking and eating.

Implant-supported dentures are certainly worth consideration. If your dentist has mentioned your or a loved one’s needs for dentures, talk to him or her about whether or not you (or your loved one) qualify for this specific subgroup of dentures.

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A “gummy smile,” also known as excessive gingival display, is a common dental complaint that is seen more often in women than in men. It is the result of a disproportionate ratio of gum tissue to teeth. When someone with excessive gingival display smiles, an above average amount of gum tissue is seen above the teeth. While this is not medically dangerous, a gummy smile can often bring about feelings of self-consciousness.

What Causes a Gummy Smile?

There are multiple causes of excessive gingival display. Genetics can play a role. If multiple family members have gummy smiles, for example, the cause is likely genetics. Other common causes are teeth that did not fully erupt (altered active eruption), an upper lip that is too short, long gums (also known as gingival hypertrophy), altered pass eruption (gums that do not recede as one ages), or an overgrowth of the upper jaw (also known as vertical maxillary excess). There is little one can do to prevent a gummy smile. However, there are non-surgical and surgical treatment options available to reduce the appearance of excessive gingival display.

Non-Surgical Treatments

Because there are multiple causes of a gummy smile, it is important to establish cause before researching treatment options. Once you have been given an accurate diagnosis from your dentist, ask if you qualify for non-surgical treatments. Sometimes, the fix is as simple as a round of orthodontic care. If a patient’s excessive gingival display is mild and is caused by something like overall wear or genetics, a round of orthodontics can be used to shift the patient’s bite into a more natural position; this will reduce the overall effect of excessive gingival display.

Veneers and Botox are two additional non-surgical, cosmetic options worth consideration. Applying veneers or crowns to the patient’s teeth will lengthen the teeth in a way that the disproportionate ratio of gums to teeth becomes proportional. Botox is another non-surgical treatment, however, it is not permanent. The doctor will inject a serum into the patient’s upper lip. This results in temporary (around three months) paralysis of the muscle and prevents the upper lip from rising too high whenever the patient smiles.

Finally, laser gum contouring is an additional procedure that is slightly more complex than the non-surgical treatments aforementioned, but it does not require general anesthesia and can be done at a dental office. The process involves removing excess gum tissue in order to produce an aesthetically-pleasing result. Recovery takes anywhere from a couple of days to a couple of weeks.

Surgical Treatments

If you have exhausted all non-surgical treatments and cannot utilize any of them due to a more complex cause of excessive gingival display, there are a few surgical treatments that have been shown to produce optimal results. Perhaps the most complex in regards to the overall procedure and recovery time is orthognathic surgery. In layman’s terms, orthognathic surgery is surgery of the jaw. If the jaw is what is causing a gummy smile, orthognathic surgery involves re-contouring and relocating the patient’s maxilla before

securing it with plates and screws. Before going under the knife, most patients with jaw protrusions that are moderate to severe will undergo a year of orthodontic treatment. The surgery requires a hospital stay and boasts a long recovery time, but those who have opted for orthognathic surgery to rid themselves of a gummy smile report very noticeable results.

Other surgical treatments that are not as extensive as orthognathic surgery include lip repositioning surgery and a gingivectomy. The latter is performed by a periodontist and involves the removal and reshaping of gum tissue in an attempt to expose more teeth and less gum. Lip repositioning surgery is utilized when the upper lip is the cause of a gummy smile. The muscles in the lip are severed so that the lip cannot excessively lift and expose too much gum tissue.

The best treatment for a gummy smile depends on the cause of a gummy smile. Because the procedure is not a medical necessity, it is wise to “shop” around and to get a second opinion if you have been told that surgery is your only option. If a gummy smile has you feeling self-conscious, ask your dentist to get to the bottom of why you have excessive gingival display and what the best treatment route is to take based on your overall diagnosis.

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In case you didn’t know, our mouths are full of bacteria, and at times it can get out of control. Often, we can keep it in check with a daily regimen of brushing, flossing, and rinsing with mouthwash, paired with regular dental visits. If bacteria start to build up on teeth or under the gum line, however, infection can spread, leading to issues like cavities, gum disease, and in severe cases, infected pulp inside the tooth that requires a root canal.

A root canal treatment is a procedure by which a dentist drills into your tooth to reach the pulp, removes the soft tissue and sanitizes the canals, and finally, fills and seals the tooth to protect against further infection. Dentists work hard to ensure that patients feel no discomfort during the procedure, and the treatment could help to save an infected tooth, which can survive even without pulp.

Of course, you first need a diagnosis that your pulp is infected, and this requires a visit to the dentist. How do you know if you need to see your dentist outside of your regular schedule of cleanings? How can you tell if something is wrong? Here are just a few common signs that you might need a root canal treatment.

1. Pain

The pulp of your tooth is soft tissue under the hard, outer layers of dentin and enamel. Pulp contains blood vessels, connective tissue, and nerves, and when it becomes infected, eventually it’s going to cause you pain.

Many patients will start to notice sensitivity first, but they might not think much of it. As we age, it’s natural to develop some sensitivity to cold or hot liquids, or when biting down on hard foods, for example. This is because enamel can weaken over time. However, infection is something different. If you notice sensitivity localized to one tooth, there’s a good chance you have some form of infection, either from a cavity or infected pulp.

If this condition goes untreated, you will probably start to feel more severe pain. This could be an ongoing ache, shooting pains when you bite down on the tooth, or both. As the infection advances, you might start to feel pain around the gum line and even the jaw where the tooth sits. Any time you experience unusual tooth pain, it’s best to contact your dentist to schedule an examination.

2. Swelling

An infected tooth will impact surrounding tissues, namely the gum tissue in direct contact with the tooth. If you notice that gum tissue surrounding a particular tooth becomes red, swollen, and tender, it could be a sign that you’re in need of a root canal, whether you’ve started to notice sensitivity or pain in the tooth or not. It could also be a sign of gum disease, in which case you also need to see your dentist, but gum disease more often affects a large swath of gum tissue, rather than centering on a specific tooth.

3. Gum abscesses

Infection in the mouth will spread, often to the nearest tissue first. Swollen, tender gums are a side effect of the infection in your tooth, and there will be further problems if you

don’t seek treatment. As the infection progresses, you might start to notice painful, pimple-like spots on the affected gum tissue. These abscesses are filled with fluid and they may leak pus that smells and tastes bad.

Naturally, the appearance of such abscesses should be cause for concern at any time. When paired with other symptoms of infected pulp, such as sensitivity and pain in one tooth, you should definitely seek professional help and undergo a root canal and related treatment (like a course of antibiotics) if necessary.

4. Tooth discoloration

It’s true that tooth discoloration could be related to a number of factors. Drinking beverages like coffee or soda, smoking, and taking certain medications (like tetracycline) could all cause teeth to become discolored. Of course, the chances that these factors will affect only a single tooth are pretty slim.

However, when the pulp of the tooth becomes infected and eventually starts to die, it could cause surrounding dentin to begin decomposing, as well. This portion of the tooth will begin to visibly darken, causing your tooth to become discolored.

When this happens, your tooth is likely in pretty bad shape, and if you take no action, you risk losing the tooth. Whether you’re experiencing unusual sensitivity or tooth pain, swelling and tenderness of the gums, gum abscesses, tooth discoloration, or other symptoms of infected pulp, you need to see your dentist immediately for diagnosis and treatment.