My Blog

Posts for: August, 2016

By Douglas Pennino, DDS
August 16, 2016
Category: Dental Procedures
NewFrontTeethforaTeenagedDavidDuchovny

In real life he was a hard-charging basketball player through high school and college. In TV and the movies, he has gone head-to-head with serial killers, assorted bad guys… even mysterious paranormal forces. So would you believe that David Duchovny, who played Agent Fox Mulder in The X-Files and starred in countless other large and small-screen productions, lost his front teeth… in an elevator accident?

“I was running for the elevator at my high school when the door shut on my arm,” he explained. “The next thing I knew, I was waking up in the hospital. I had fainted, fallen on my face, and knocked out my two front teeth.” Looking at Duchovny now, you’d never know his front teeth weren’t natural. But that’s not “movie magic” — it’s the art and science of modern dentistry.

How do dentists go about replacing lost teeth with natural-looking prosthetics? Today, there are two widely used tooth replacement procedures: dental implants and bridgework. When a natural tooth can’t be saved — due to advanced decay, periodontal disease, or an accident like Duchovny’s — these methods offer good looking, fully functional replacements. So what’s the difference between the two? Essentially, it’s a matter of how the replacement teeth are supported.

With state-of-the-art dental implants, support for the replacement tooth (or teeth) comes from small titanium inserts, which are implanted directly into the bone of the jaw. In time these become fused with the bone itself, providing a solid anchorage. What’s more, they actually help prevent the bone loss that naturally occurs after tooth loss. The crowns — lifelike replacements for the visible part of the tooth — are securely attached to the implants via special connectors called abutments.

In traditional bridgework, the existing natural teeth on either side of a gap are used to support the replacement crowns that “bridge” the gap. Here’s how it works: A one-piece unit is custom-fabricated, consisting of prosthetic crowns to replace missing teeth, plus caps to cover the adjacent (abutment) teeth on each side. Those abutment teeth must be shaped so the caps can fit over them; this is done by carefully removing some of the outer tooth material. Then the whole bridge unit is securely cemented in place.

While both systems have been used successfully for decades, bridgework is now being gradually supplanted by implants. That’s because dental implants don’t have any negative impact on nearby healthy teeth, while bridgework requires that abutment teeth be shaped for crowns, and puts additional stresses on them. Dental implants also generally last far longer than bridges — the rest of your life, if given proper care. However, they are initially more expensive (though they may prove more economical in the long run), and not everyone is a candidate for the minor surgery they require.

Which method is best for you? Don’t try using paranormal powers to find out: Come in and talk to us. If you would like more information about tooth replacement, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Crowns & Bridgework,” and “Dental Implants.”


ChangingAntibioticUseTodaywillHelpEnsureTheirEffectivenessTomorrow

It’s hard to imagine, but little more than a century ago today’s “minor” bacterial and viral infections were often deadly. This changed with the advent of antibiotics, drugs which kill disease-causing microbes. Decades after the development of penicillin and similar antibiotics, we routinely rely on them for treating infection. They’re quite prominent in dental care in treating advanced forms of periodontal (gum) disease or reducing bacteria that cause tooth decay.

But the age of antibiotics may be in danger: their overuse in medicine and the food industry has led to the rise of resistant microbial strains — “superbugs” — that no longer respond to first line antibiotics or, in some cases, to second or third line drugs. The U.S. Center for Disease Control (CDC) estimates more than two million people annually will contract one of these superbugs of which more than 20,000 will die. If current practices continue, the growth of resistant strains (as well as allergic reactions among users of antibiotics) will increase. The answer is a more modified use of antibiotics.

For healthcare providers, this means adopting new protocols in which we attempt to prescribe antibiotics that specifically target an identified microbe (which we’ve determined through more rigorous diagnostic testing), and in limited amounts. We must also rein in the practice of antibiotic use in the food industry, routinely administered to livestock to prevent disease or to enhance growth. Many countries, including the U.S., are now moving toward a more limited practice in which only animals that are demonstrably sick receive antibiotics. This will limit their release into the greater environment, which is a contributing factor to growing microbial resistance.

Patients also play a role in the better use of antibiotics. We must first change the perception that antibiotics are a “cure-all” — the answer to every illness. It’s also important for patients who’ve been prescribed antibiotics to complete the course of treatment, even if after a day or two they feel better; stopping antibiotic treatment prematurely increases the chances targeted microbes develop a resistance to that particular drug.

Altering our perception and use of antibiotics will require a tremendous effort for all of society. But making these changes will help ensure antibiotics continue to serve humanity as an important health benefit well into the future.

If you would like more information on the role of antibiotics in dentistry, please contact us or schedule an appointment for a consultation.