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OvercomingBoneLossPreventingYouFromGettinganImplant

Introduced to the United States in the 1980s, dental implants have quickly become the go-to restoration for tooth replacement. And for good reason: they're not only incredibly life-like, they're highly durable with a 95% success rate.

But as desirable as they are, you may face a major obstacle getting one because of the condition of the bone at your implant site. To position the implant for best appearance and long-term durability, we must have at least 4-5 mm of bone available along the horizontal dimension. Unfortunately, that's not always the case with tooth loss.

This is because bone, like other living tissue, has a growth cycle: Older cells die and dissolve (resorb) and newer cells develop in their place. The forces transmitted to the jaw from the action of chewing help stimulate this resorption and replacement cycle and keep it on track. When a tooth is lost, however, so is this stimulus.

This may result in a slowdown in cell replacement, causing the eventual loss of bone. And it doesn't take long for it to occur after tooth loss—you could lose a quarter of bone width in just the first year, leaving you without enough bone to support an implant. In some cases, it may be necessary to choose another kind of restoration other than implants.

But inadequate bone isn't an automatic disqualifier for implants. It's often possible to regenerate lost bone through a procedure known as bone augmentation, in which we insert a bone graft at the missing tooth site. The graft serves as a scaffold for new bone cells to grow upon, which over time may regenerate enough bone to support an implant.

Even if you've had a missing tooth for some time, implementing bone augmentation could reverse any loss you may have experienced. In fact, it's a common practice among dentists to place a bone graft immediately after a tooth extraction to minimize bone loss, especially if there will be a time lag between extraction and implant surgery.

Bone augmentation could add extra time to the implant process. But if successful, it will make it possible for you to enjoy this popular dental restoration.

If you would like more information on dental implant restoration, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants After Previous Tooth Loss.”

VanHalensPassingRemindsUsoftheDangersofOralCancerandHowtoHelpPreventIt

Fans everywhere were recently saddened by the news of musical legend Eddie Van Halen's death. Co-founder and lead guitarist for the iconic rock group Van Halen, the 65-year-old superstar passed away from oral cancer.

Van Halen's rise to worldwide fame began in the 1970s with his unique guitar style and energetic performances, but behind the scenes, he struggled with his health. In 2000, he was successfully treated for tongue cancer. He remained cancer-free until 2018 when he was diagnosed with throat cancer to which he succumbed this past October.

Van Halen claimed the metal guitar picks he habitually held in his mouth caused his tongue cancer. It's more likely, though, that his heavy cigarette smoking and alcohol use had more to do with his cancers.

According to the American Cancer Society, most oral cancer patients are smokers and, as in Van Halen's case, are more likely to beat one form of oral cancer only to have another form arise in another part of the mouth. Add in heavy alcohol consumption, and the combined habits can increase the risk of oral cancer a hundredfold.

But there are ways to reduce that risk by making some important lifestyle changes. Here's how:

Quit tobacco. Giving up tobacco, whether smoked or smokeless, vastly lowers your oral cancer risk. It's not easy to kick the habit solo, but a medically supervised cessation program or support group can help.

Limit alcohol. If you drink heavily, consider giving up alcohol or limiting yourself to just one or two drinks a day. As with tobacco, it can be difficult doing it alone, so speak with a health professional for assistance.

Eat healthy. You can reduce your cancer risk by avoiding processed foods with nitrites or other known carcinogens. Instead, eat fresh fruits and vegetables with antioxidants that fight cancer. A healthy diet also boosts your overall dental and bodily health.

Practice hygiene. Keeping teeth and gums healthy also lowers oral cancer risk. Brush and floss daily to remove dental plaque, the bacterial film on teeth most responsible for dental disease. You should also visit us every six months for more thorough dental cleanings and checkups.

One last thing: Because oral cancer is often diagnosed in its advanced stages, be sure you see us if you notice any persistent sores or other abnormalities on your tongue or the inside of your mouth. An earlier diagnosis of oral cancer can vastly improve the long-term prognosis.

Although not as prevalent as other forms of cancer, oral cancer is among the deadliest with only a 60% five-year survival rate. Making these changes toward a healthier lifestyle can help you avoid this serious disease.

If you would like more information about preventing oral cancer, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “How a Routine Dental Visit Saved My Life” and “Strategies to Stop Smoking.”

HowYouCanHelpYourSmileStayAttractiveasYouGetOlder

We can't stop getting older or completely avoid many of the consequences that come with aging. Even so, there are things we can do to age more gracefully.

That includes your smile, which can also suffer the ravages of time. Teeth naturally wear and yellow over the years. We're also more susceptible to both tooth decay and periodontal (gum) disease as we age.

You can help slow some of these age-related dental problems by simply caring for your teeth and gums. This includes not only brushing and flossing every day to remove dental plaque (which can cause disease and dull your smile), but also seeing a dentist every few months for more thorough cleanings.

You can also take advantage of certain cosmetic enhancements to address some of the age-related issues that could keep you from having a more youthful smile.

Discolored teeth. Teeth tend to get darker over time, the combination of stain-causing foods and beverages, habits like smoking and age-related changes in tooth structure. You may be able to temporarily attain a brighter smile with teeth whitening. For a more permanent effect, we can cover stained teeth with porcelain veneers, dental bonding or dental crowns.

Worn teeth. After decades of chewing and biting, teeth tend to wear, with habits like teeth grinding accelerating it. This can cause teeth to appear abnormally small with hard, sharpened edges in contrast to the soft, rounded contours of younger teeth. In some cases, we can restore softer tooth edges with enamel contouring and reshaping. For more severe wearing, veneers or crowns could once again provide a solution.

Recessed gums. Because of gum disease, over-aggressive brushing or a genetic disposition to thinner gums, gums can shrink back or “recede” from normal teeth coverage. This not only exposes vulnerable areas of the teeth to harmful bacteria, it can also make teeth appear longer than normal (hence the aging description, “long in the tooth”). We can address recession by treating any gum disease present and, in extreme cases, perform grafting surgery to help rebuild lost tissue.

Losing your attractive smile isn't inevitable as you get older. We can help you make sure your smile ages gracefully along with the rest of you.

If you would like more information on keeping a youthful smile, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Your Dentist Can Help You Look Younger.”

AreYouatRiskforToothDecayAnswerTheseQuestionsToFindOut

Tooth decay is a destructive disease that could rob you of your teeth. But it doesn't appear out of nowhere—a number of factors can make it more likely you'll get cavities.

But the good news is you can be proactive about many of these factors and greatly reduce your risk of tooth decay. Here are a few questions to ask yourself to point you in the right direction for preventing this destructive disease.

Do you brush and floss every day? A daily habit of brushing and flossing removes buildup of dental plaque, a bacterial film on teeth that's the top cause for tooth decay and periodontal (gum) disease. Hit or miss hygiene, though, can greatly increase your risk for developing a cavity.

Do you use fluoride? This naturally occurring chemical has been proven to strengthen tooth enamel against decay. Many locations add fluoride to drinking water—if your area doesn't or you want to boost your fluoride intake, use toothpastes, mouthrinses or other hygiene products containing fluoride.

Do you smoke? The nicotine in tobacco constricts blood vessels in the mouth so that they provide less nutrients and antibodies to the teeth and gums. Your mouth can't fight off infection as well as it could, increasing your risk of dental diseases like tooth decay.

Do you have dry mouth? This isn't the occasional bout of “cotton mouth,” but a chronic condition in which the mouth doesn't produce enough saliva. Saliva neutralizes mouth acid, so less of it increases your risk for decay. Chronic dry mouth can be caused by medications or other underlying conditions.

Do you snack a lot between meals? Sugary snacks, sodas or energy drinks can increase oral bacteria and acidity that foster tooth decay. If you're snacking frequently between meals, your saliva's acid neutralizing efforts may be overwhelmed. Coordinate snacking with mealtimes to boost acid buffering.

You can address many of these questions simply by adopting a daily habit of brushing and flossing, regular dental cleanings and checkups, and eating a healthy, “tooth-friendly” diet. By reducing the risk factors for decay, you can avoid cavities and preserve your teeth.

If you would like more information on preventing tooth decay, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Decay: How to Assess Your Risk.”

NotGettingaGoodNightsSleepYourDentistMayBeAbletoHelp

If you live an average lifespan, you'll spend more than 200,000 hours in blissful slumber. It's not a waste, though: You absolutely need this much sleep to maintain optimum physical and mental health. That's why the National Sleep Foundation recognizes each March as Sleep Awareness Month to highlight the obstacles to a good night's sleep. One such obstacle is obstructive sleep apnea (OSA)—and if you have it, we may be able to help you reduce the harm it may be causing you.

OSA is the blockage of the airway during sleep, usually when the tongue relaxes against the back of the throat. As the oxygen level falls, the brain arouses the sleeper to restore airflow. This only takes a few seconds before the person slips back into sleep, but it can occur several times an hour.

As this scenario repeats itself night after night, the person becomes deprived of the deeper stages of sleep they need to stay healthy. The long-term effect can even be life-threatening: Besides chronic fatigue and “brain fog,” there's also an increased risk of high blood pressure, disease or other serious health conditions.

But there are ways to reduce chronic OSA, the most common being a therapy known as continuous positive airway pressure (CPAP). A CPAP machine, prescribed by a medical doctor, consists of a small pump that streams pressurized air into the mouth through a hose and facemask; the increased air pressure in the mouth helps keep the airway open. It's a proven method, but not always a favorite with some patients who find it uncomfortable and restrictive to wear every night.

If you're in that camp regarding CPAP therapy, an alternative may be possible: oral appliance therapy (OAT), which dentists can provide. Worn in the mouth during sleep, this custom-fitted mouthguard-like appliance repositions the tongue so that it doesn't block the airway. There is a variety of mechanisms, but most involve a hinge that positions the lower jaw forward, which in turn pulls the tongue away from the back of the throat.

These less invasive OAT devices may be an alternative to CPAP therapy for people who have mild to moderate OSA and find CPAP machines difficult to use. If you've been diagnosed with OSA and CPAP therapy hasn't been a good fit for you, speak with us about an OAT device. It could help you overcome this common disorder and get the deep sleep you need for a healthy mind and body.

If you would like more information about a dental approach to obstructive sleep apnea, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Sleep Disorders & Dentistry.”





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Dr. George Salem and Associates, P.C.

Braintree, MA Dentist
Dr. George Salem and Associates, PC
60 Adams Street
Braintree, MA 02184

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