Wednesday, April 23, 2014

Dental Implants Single Tooth

tooth dental implant fixture Bellevue Family Dentistry

Dentistry today is vastly different due to increases in oral health research and technology, and dental implants is one of the leading services dentists are able to provide today for their patients.  Implants are many times a viable option as to afford a long term replacement and viable solution to missing teeth.

Today, let's go over the single tooth dental implant, which is also known as an endosseous implant or dental fixture.


A dental implant is a component that is surgically placed within the jaw bone, which in turn supports a prosthesis (ie. dental porcelain crown, bridge, or denture).  Via a biological process called ooseointegration, the implant fixture (typically made from titanium), forms an intimate bond to the bone.  At this point the dental surgeon would also determine if a bone graft is required.  If there is insufficient bone structure to hold the implant firmly in place, additional bone may need to be be added to the implant site via a bone graft.  If the implant area is in an area of esthetic importance (ie. front tooth with an exposed smile line) the dentist may elected to add additional gingival tissue to improve the appearance of the implant fixture via a soft tissue graft.

After the implant is placed, the implant fixture is given time to heal and integrate with the bone, usually for 3-6 months.  Once the implant osseointegrates with the bone, an abutment is attached to the implant which contains and hold the dental prosthetic (ie. crown, bridge, or denture).  The dental prosthetic may then be attached to the abutment and implant via cement or screw..


There are situations when a single implant may be desirable:
  1. Accidental trauma to a single tooth, while the teeth adjacent to the affected area are normal and healthy.  An example would the loss of a front tooth due to an accident.
  2. A tooth has cracked from heavy occlusal trauma (bruxism and nighttime grinding) and is not saveable with a root canal and/or dental crown.
  3. A tooth that has such severe decay it is no longer restorable with a root canal and crown.
  4. A tooth with an existing filling or crown that has such deep and severe decay it is not longer saveable with a new restoration.
  5. A tooth that has luxated (tooth fell out of its socket) from a sports or playground accident, or physical altercation. 
  6. A tooth has cracked and sustained a fracture after a root canal from normal chewing, and the tooth is no longer saveable and requires tooth extraction.
  7. A tooth that has severe localized periodontal disease with aggressive bone loss.  With such periodontal involvement and bone loss, the tooth may be mobile and have poor bone support and susceptible to infection.
  8. One particular area of the jaw has an inherent missing tooth.  For example, some people are genetically born with a single missing adult tooth, and this may cause difficulty chewing, self awareness in their smile, or food-induced gum trauma and irritation.


The dentist and surgeon would determine if you are a viable candidate for a single tooth dental implant.  A successful implant would require healthy jaw bone and gingiva.  Oral hygiene, diabetes, smoking, a compromised immune system, and heavy uncontrolled bruxism/grinding are important factors to take into consideration of the implant's success.  Age may be a factor; one may want to wait until the age of 20 as that is when the jaw bone has completed its full maturation growth cycle. 


What does a dental implant cost?  The costs of the implant from start to finish will vary widely and dependent on many factors. These factors include: type of material used, state where the service is performed, the type of insurance coverage, if a bone graft is required, the type of abutment used, and the type of crown that is placed.  The dentist's front office would be able to give you an estimate of the costs associated with the dental implant. 

If you have any questions or concerns regarding dental implants, the steps involved, and the costs involved, please consult with your family dentist.
From your gentle family dentist in Bellevue,
Dr. Peter Chien
(425) 614-1600

Friday, April 4, 2014

Medication Effects on Teeth, A Dental View

dental decay cavities drugs


There are unfortunate (sometimes emergency) cases where one can sustain a traumatic and inadvertent injury to the dentition and oral cavity.   Such dental trauma may also stem from a medical or pharmacological condition, such as a drug's side effect or due to a body's physical condition.
A cursory understanding of medical conditions, diseases, and side effects from drugs will help one see how said conditions relates from a dental point of view, and also allows one to see how the body and the oral cavity, teeth, and gums inter-relate with one another.

Let's examine some possible dental and teeth damage due to various medical conditions:
1) Xerostomia 2) Sjogren's syndrome 3) Bulimia and Gastroesophageal reflux disease 4) Methadone side effect 5) Recreational drug use side effect 6) Medication side effects 7) Chemotherapy and radiation


Xerostomia, or dry mouth, can be due to aging, immunosuppressive medications, prescription medications, and chemical and radiation therapy.  With dry mouth saliva production is lowered, placing the teeth at higher risk of dental decay, necessitating the need for tooth colored fillings (resins).
Medications are many but can include antihypertensives, antidepressnats, diuretics, steorids, anticonvulsants, antianxiety agents, antipsychotics, and acne treatments.


Sjogren's Syndrome is an autoimmune disorder that is characterized by excessive antibody production that are directed against certain tissues in the body.  Gland inflammation is a distinct characterization of Sjogren's, and affects the lacrimal glands in the eyes and also causes inflammation of the salivary glands.  The affected glands result in decreased tear production in the eyes and decreased saliva production in the mouth, hence dry eyes and dry mouth and lips are key indicators of this Sjogren's Syndrome.  With dry mouth dental decay may be more prevalent and may require tooth colored fillings to restore the dentition. 


Bulimia is a psychologically induced condition where vomiting is forced and self-induced. Patients have tremendous fear of weight gain and have a severe negative overweight image of their bodies, thus forcing themselves to vomit in order to lose weight .  Hence the teeth are constantly exposed to acids in the stomach, if untreated can lead to enamel erosion and deterioration, which can then affect the dentin.  Tooth colored fillings or porcelain crowns may be required.


Methadone, a prescription medication by one's physician, is used as an anti-addictive medication for opioid addiction (ie. oxycodone, hydrocodone), and may also be used as an analgesic and antitussive. 
Methdaone's damage on the teeth can be extremely extensive, from enamel and dentin erosion to teeth fracture.  Such cases often require extensive dental treatment including porcelain crowns, surgical tooth extractions, and dental implants.


Methamphetamine is a recreational drug when taken due to dependence, can cause severe teeth erosion and rampant dental decay / cavities.  Dental fillings, root canals, and porcelain crowns may be required in such cases to restore the dentition. 


Tetracycline is an antibiotic, when taken during tooth formation, can cause malformations of the teeth.  Malformations may range from relatively minor enamel striations to complete enamel discoloration and dentin weakness, causing eventual tooth failure and fracture.  If the effects are minor, treatment may not be required.  If the effects are major, dental treatments may include porcelain veneers, dental crowns, and/or root canal therapy.


Chemotherapy and radiation, commonly used for cancer treatment, can negatively affect salivary production and thus cause dry mouth, which increases one's risk of tooth decay and gum disease.  Common dental affects may include rampant and extensive cavities and swollen & bleeding gums.  Patients undergoing chemotherapy and radiation may thus be at increased need of fillings.


It is this author's hope that after reading this blog, one will have a little more appreciation of the negative side effects of various drugs and medical treatments on the oral dentition.  While in most cases dental treatment can be rendered to address aforementioned negative effects on the dentition, a close relationship between the patient's dentist and physician is necessary to control and maintain the drug side effects, and to prevent the drug from overpowering teeth and periodontal health.

From your family Bellevue dentist,
Dr. Peter Chien
(425) 614-1600