Dental implants are a popular and effective way to replace missing teeth and are designed to blend in with your other teeth. They are an excellent long-term option for restoring your smile. In fact, the development and use of implants is one of the biggest advances in dentistry in the past 40 years. Dental implants are made up of titanium and other materials that are compatible with the human body. They are posts that are surgically placed in the upper or lower jaw, where they function as a sturdy anchor for replacement teeth.

Most patients find that a dental implant is secure, stable and a good replacement for their own tooth. There are generally three phases to getting an implant:

• First, the dentist surgically places the implant into the jawbone. Your dentist may recommend a diet of soft foods, cold foods and warm soup during the healing process.
• Next, the bone around the implant heals in a process called osseointegration. What makes an implant so strong is that the bone actually grows around it and holds it in place. Osseointegration means “combines with the bone” and takes time. Some patients might need to wait until the implant is completely integrated, up to several months, before replacement teeth can be attached to the implant. Other patients can have the implants and replacement teeth placed all in one visit.
• Finally, it’s time for the placement of the artificial tooth/teeth. For a single tooth implant, your dentist will customize a new tooth for you, called a dental crown. The crown will be based on size, shape, color and fit, and will be designed to blend in with your other teeth. If you are replacing more than a single tooth, custom-made bridges or dentures will be made to fit your mouth and your implants. (Note: The replacement teeth usually take some time to make. In the meantime, your dentist may give you a temporary crown, bridge or denture to help you eat and speak normally until the permanent replacement is ready.)

If you are interested in dental implants, it’s a good idea to discuss it carefully with your dentist first. If you are in good general health this treatment may be an option for you. In fact, your health is more of a factor than your age. You may be medically evaluated by a physician before any implant surgery is scheduled.

Chronic illnesses, such as diabetes or leukemia, may interfere with healing after surgery. Patients with these issues may not be good candidates for implants. Using tobacco can also slow healing.

Veneers can improve the appearance of teeth that are:

• chipped or broken
• stained
• crooked or misshapen

Veneers also can mask the gaps in your smile. They are different from crowns because they cover only the front surface of a tooth rather than the entire tooth structure.

Types of veneers

The two main types of veneers are porcelain and composite. Each type has its benefits.

A porcelain veneer is a thin shell custom-made to fit on the front surface of your teeth. Porcelain veneers are strong, long-lasting and natural-looking. They tend to be the more expensive option.

A composite veneer is made from a tooth-colored filling material that is bonded to the tooth. Composite veneers may require less tooth enamel to be removed and fewer visits to the dentist. They are easier to fix if damaged but are not as stain- or wear-resistant.

Before you get a veneer

Understand the following before you get a veneer:

• Treatment is not reversible because tooth enamel is removed to place a veneer.
• Your dentist must first treat any dental issues you have like decay or gum disease. Placing veneers over unhealthy teeth may worsen existing dental problems.
• A veneer may chip, crack, wear down or loosen over time, requiring your dentist to re-bond, repair or replace it.
• If you clench or grind your teeth, or have a deep overbite, veneers may not be a good choice.
• Veneers are considered cosmetic dentistry so your veneer may not be covered by insurance unless it’s deemed medically necessary.

As with all your dental care, discuss your dental history, treatment expectations, and reservations with your dentist. They will help you determine if veneers are the right choice for your smile.

If you have a severely damaged, decaying tooth or a serious tooth infection (abscess), your dentist may recommend a root canal treatment. Root canals are used to repair and save your tooth instead of removing it.

What’s Involved in Root Canal Repair?

The pulp is soft tissue inside your tooth that contains nerves, blood vessels and provides nourishment for your tooth. It can become infected if you have:

• A deep cavity
• Repeated dental procedures that disturb this tissue
• A cracked or fractured tooth
• Injury to the tooth (even if there’s not a visible crack or chip)

If untreated, the tissues around the root of your tooth can become infected. When this happens, you will often feel pain and swelling and an abscess may form inside the tooth and/or in the bone around the end of the root of the tooth. An infection can also put you at risk of losing your tooth completely because bacteria can damage the bone that keeps your tooth connected to your jaw.

Can I Get This Treatment Done During My Regular Check-up Visit?

Your dentist will need to schedule a follow up appointment, or you may be referred to a dentist who specializes in the pulp and tissues surrounding the teeth. This specialist is known as an endodontist.

What Should I Expect?

A root canal treatment usually takes 1 or 2 office visits to complete. There is little to no pain because your dentist will use local anesthesia so you don’t feel the procedure. Once the procedure is complete, you should no longer feel the pain you felt before having it done.

Before treatment begins, your dentist will:

• Take X-rays to get a clear view of your tooth and the surrounding bone.
• Numb the area around and including your tooth so you are comfortable during the treatment.
• Put a thin sheet of latex rubber over your tooth to keep it dry, clean and protected from viruses, bacteria and fungus that are normally in the mouth.

During treatment, your dentist will:

• Create an opening in the top of your tooth.
• Remove the tooth’s nerve from inside the tooth and in the areas in the root, known the root canal.
• Clean inside the tooth and each root canal. Your dentist may treat the tooth with germ-killing medicine.
• Fill the root canals with a rubber-like material to seal them against future infection.
• Place a temporary filling on the tooth to protect it until a definitive restoration like a permanent filling or crown can be placed at the earliest opportunity.

After root canal treatment:

• Your tooth and the area around it may feel sensitive for a few days. You can talk with your dentist about how to relieve any discomfort you may have.
• Your dentist may prescribe antibiotics if the infection spread. Use as directed, and follow up with your dentist if you have any problems taking it.

You will need a follow-up visit after the root canal treatment. At this visit, your dentist will remove the temporary filling on the tooth and replace it with a regular filling or a crown to protect your tooth from further damage. A metal or plastic post may also be placed in the root canal to help make sure the filling materials remain in place. This helps support a crown if you need one.

How Long Will a Root Canal Filling Last?

With proper care, your restored tooth can last a lifetime. Make it a point to brush twice a day for two minutes with fluoride toothpaste, clean between your teeth once a day and see your dentist regularly to make sure your teeth are strong and healthy.

If your teeth are crowded, protrusive, spaced too far apart, meet in an abnormal way, or do not meet at all, correction may be recommended. Braces and aligners are the “appliances” orthodontists most commonly use to guide your teeth into their proper positions. Retainers preserve and stabilize the results of your orthodontic treatment.

In the past, orthodontic treatment was associated with children and teens, but today many adults seek orthodontic treatment to correct long-standing problems, or problems that stem from maturational changes. Orthodontists can help people of any age achieve a healthy and beautiful smile.

Here are some warning signs that can signal a problem:

• gums that bleed easily
• red, swollen, tender gums
• gums that have pulled away from the teeth
• persistent bad breath or bad taste
• permanent teeth that are loose or separating
• any change in the way your teeth fit together when you bite
• any change in the fit of partial dentures

Some factors increase the risk of developing gum disease. They are:

• poor oral hygiene
• smoking or chewing tobacco
• genetics
• crooked teeth that are hard to keep clean
• pregnancy
• diabetes
• medications, including steroids, certain types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers and oral contraceptives

See your dentist if you suspect you have gum disease because the sooner you treat it the better. The early stage of gum disease is called gingivitis. If you have gingivitis, your gums may become red, swollen and bleed easily. At this stage, the disease is still reversible and can usually be eliminated by a professional cleaning at your dental office, followed by daily brushing and flossing.

Advanced gum disease is called periodontitis. Chronic periodontitis affects 47.2% of adults over 30 in the United States. It can lead to the loss of tissue and bone that support the teeth and it may become more severe over time. If it does, your teeth will feel loose and start moving around in your mouth. This is the most common form of periodontitis in adults but can occur at any age. It usually gets worse slowly, but there can be periods of rapid progression.

Aggressive periodontitis is a highly destructive form of periodontal disease that occurs in patients who are otherwise healthy. Common features include rapid loss of tissue and bone and may occur in some areas of the mouth, or in the entire mouth.

Research between systemic diseases and periodontal diseases is ongoing. While a link is not conclusive, some studies indicate that severe gum disease may be associated with several other health conditions such as diabetes or stroke.

It is possible to have gum disease and have no warning signs. That is one reason why regular dental checkups and periodontal examinations are very important. Treatment methods depend upon the type of disease and how far the condition has progressed. Good dental care at home is essential to help keep periodontal disease from becoming more serious or recurring. Remember: You don’t have to lose teeth to gum disease. Brush your teeth twice a day, clean between your teeth daily, eat a balanced diet, and schedule regular dental visits for a lifetime of healthy smiles.

Possible causes of jaw pain or facial pain include:

• sinus problems
• toothache
• infections
• arthritis
• injury
• tooth grinding
• periodontal disease
• problems with your jaw or the temporomandibular joint

Your dentist’s plan for treatment will depend on the source of your facial pain, but recommendations may include:

• mouth protector
• muscle relaxants
• exercises
• anti-inflammatory drugs
• antibiotics
• root canal therapy
• periodontal treatment
• extraction

If you suffer from jaw pain or facial pain, speak with your dentist or physician for diagnosis and treatment.

Possible causes include:

• Tooth decay (cavities)
• Fractured teeth
• Worn fillings
• Gum disease
• Worn tooth enamel
• Exposed tooth root

In healthy teeth, a layer of enamel protects the crowns of your teeth—the part above the gum line. Under the gum line a layer called cementum protects the tooth root. Underneath both the enamel and the cementum is dentin.
Dentin is less dense than enamel and cementum and contains microscopic tubules (small hollow tubes or canals). When dentin loses its protective covering of enamel or cementum these tubules allow heat and cold or acidic or sticky foods to reach the nerves and cells inside the tooth. Dentin may also be exposed when gums recede. The result can be hypersensitivity.

Sensitive teeth can be treated. The type of treatment will depend on what is causing the sensitivity. Your dentist may suggest one of a variety of treatments:

• Desensitizing toothpaste. This contains compounds that help block transmission of sensation from the tooth surface to the nerve, and usually requires several applications before the sensitivity is reduced.
• Fluoride gel. An in-office technique which strengthens tooth enamel and reduces the transmission of sensations.
• A crown, inlay or bonding. These may be used to correct a flaw or decay that results in sensitivity.
• Surgical gum graft. If gum tissue has been lost from the root, this will protect the root and reduce sensitivity.
• Root canal. If sensitivity is severe and persistent and cannot be treated by other means, your dentist may recommend this treatment to eliminate the problem.

Proper oral hygiene is the key to preventing sensitive-tooth pain. Ask your dentist if you have any questions about your daily oral hygiene routine or concerns about tooth sensitivity.

Your mouth goes through many changes in your lifetime. One major dental milestone that usually takes place between the ages of 17 and 21 is the appearance of your third molars. Historically, these teeth have been called wisdom teeth because they come through at a more mature age.

When they come through correctly, healthy wisdom teeth can help you chew. It’s normal to feel a little discomfort when your wisdom teeth appear, but if you have pain, see your dentist immediately.

Room to Grow?

Wisdom teeth can lead to problems if there isn’t enough space for them to surface or they come through in the wrong position. If your dentist says your wisdom teeth are impacted, he or she means they are trapped in your jaw or under your gums.

As your wisdom teeth make their way through your gums, your dentist will be monitoring your mouth for signs of the following:

• Wisdom teeth that aren’t in the right position can allow food to become trapped. That gives cavity-causing bacteria a place to grow.
• Wisdom teeth that haven’t come in properly, which can make it difficult to floss between the wisdom teeth and the molars next to them.
• Wisdom teeth that have partially come through can give bacteria a place to enter the gums and create a place for infection to occur. This may also lead to pain, swelling and stiffness in your jaw.
• Wisdom teeth that don’t have room to come through are thought by some to crowd or damage neighboring teeth.
• A wisdom tooth that is impacted can form a cyst on or near the impacted tooth. This could damage the roots of nearby teeth or destroy the bone that supports your teeth.

Why You Might Need to Have Your Wisdom Teeth Removed

Every patient is unique, but in general, wisdom teeth may need to be removed when there is evidence of changes in the mouth such as:

• Pain
• Infection
• Cysts
• Tumors
• Damage to neighboring teeth
• Gum disease
• Tooth decay (if it is not possible or desirable to restore the tooth)

Your dentist may also recommend removal of wisdom teeth as part of treatment for braces or other dental care.

Before making any decisions, your dentist will examine your mouth and take an x-ray. Together, you and your dentist can discuss the best course of treatment.

Keeping Your Wisdom Teeth?

Wisdom teeth that are not removed should continue to be monitored because the potential for developing problems later on still exists. As people age, they are at greater risk for health problems—and that includes potential problems with their wisdom teeth. Be sure to floss around your wisdom teeth and visit your dentist regularly. Regular dental visits allow your dentist to evaluate your wisdom teeth and your overall dental health.

Over time, your teeth can go from white to not-so-bright for a number of reasons:

Food and Drink
Coffee, tea and red wine are some major staining culprits. What do they have in common? Intense color pigments called chromogens that attach to the white, outer part of your tooth (enamel).

Tobacco Use
Two chemicals found in tobacco create stubborn stains: Tar and nicotine. Tar is naturally dark. Nicotine is colorless until it’s mixed with oxygen. Then, it turns into a yellowish, surface-staining substance.

Age
Below the hard, white outer shell of your teeth (enamel) is a softer area called dentin. Over time, the outer enamel layer gets thinner with brushing and more of the yellowish dentin shows through.

Trauma
If you’ve been hit in the mouth, your tooth may change color because it reacts to an injury by laying down more dentin, which is a darker layer under the enamel.

Medications
Tooth darkening can be a side effect of certain antihistamines, antipsychotics and high blood pressure medications. Young children who are exposed to antibiotics like tetracycline and doxycycline when their teeth are forming (either in the womb or as a baby) may have discoloration of their adult teeth later in life. Chemotherapy and head and neck radiation can also darken teeth.

How Does Teeth Whitening Work?

Teeth whitening is a simple process. Whitening products contain one of two tooth bleaches (hydrogen peroxide or carbamide peroxide). These bleaches break stains into smaller pieces, which makes the color less concentrated and your teeth brighter.

Does Whitening Work on All Teeth?

No, which is why it’s important to talk to your dentist before deciding to whiten your teeth, as whiteners may not correct all types of discoloration. For example, yellow teeth will probably bleach well, brown teeth may not respond as well and teeth with gray tones may not bleach at all. Whitening will not work on caps, veneers, crowns or fillings. It also won’t be effective if your tooth discoloration is caused by medications or a tooth injury.

What Are My Whitening Options?

Talk to your dentist before starting. If you are a candidate, there are four ways to put the shine back in your smile:

Stain Removal Toothpastes
All toothpastes help remove surface stain through the action of mild abrasives that scrub the teeth. Look for whitening toothpastes that have earned the ADA Seal of Acceptance for stain removal (it will tell you on the package). These toothpastes have additional polishing agents that are safe for your teeth and provide stain removal effectiveness. Unlike bleaches, these types of ADA-Accepted products do not change the color of teeth because they can only remove stains on the surface.

In-Office Bleaching
This procedure is called chairside bleaching and usually requires only one office visit. The dentist will apply either a protective gel to your gums or a rubber shield to protect your gums. Bleach is then applied to the teeth.

At-Home Bleaching from Your Dentist
Your dentist can provide you with a custom-made tray for at-home whitening. In this case, the dentist will give you instructions on how to place the bleaching solution in the tray and for what length of time. This may be a preferred option if you feel more comfortable whitening in your own home at a slower pace, but still with the guidance of a dentist. Out-of-office bleaching can take anywhere from a few days to a few weeks.

Are There Any Side Effects from Teeth Whitening?

Some people who use teeth whiteners may experience tooth sensitivity. That happens when the peroxide in the whitener gets through the enamel to the soft layer of dentin and irritates the nerve of your tooth. In most cases the sensitivity is temporary. You can delay treatment, then try again.

Overuse of whiteners can also damage the tooth enamel or gums, so be sure to follow directions and talk to your dentist.