Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.
In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.
Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.
Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.
If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.
The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.
Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.
So, you’ve just acquired an attractive restoration with dental implants. You may be thinking at least with these teeth you won’t have to worry about dental disease.
Think again. While the implants and their porcelain crowns are impervious to decay the surrounding gums and bone are still vulnerable to infection. In fact, you could be at risk for a specific type of periodontal (gum) disease called peri-implantitis (inflammation around the implant).
Bacterial plaque, the thin bio-film most responsible for gum disease, can build up on implant crowns just as it does on natural tooth surfaces. If it isn’t removed with daily brushing and flossing and regular dental cleanings the bacteria can trigger an infection in the gums.
Besides weakening gum tissues, gum disease can also cause bone loss, of critical importance to dental implants. An implant depends on the bone they’re inserted in to hold them in place. If the bone around an implant becomes infected it could begin to be lost or dissolve (resorb), which could lead to loss of the implant.
That’s why it’s critical to keep the natural tissue structures supporting your implants infection-free. Not only is daily hygiene a must, but your implants and any remaining natural teeth should undergo professional cleaning at least twice a year or more if your dentist recommends it.
Cleanings involving implants will also be a bit different from natural teeth. While the dental materials used in the crown and implant post are quite durable, regular cleaning instruments can scratch them. Although tiny, these scratches can become hiding places for bacteria and increase your risk of infection.
To avoid this, your hygienist will use instruments (known as scalers and curettes) usually made of plastics or resins rather than metal. The hygienist may still use metal instruments on your remaining natural teeth because their enamel can tolerate metal without becoming scratched creating a smoother surface.
While keeping implants clean can sometimes be a challenge, it’s not impossible. Implants on average have a long-term success rate above 95%. With both you and your dentist caring and maintaining these state-of-the-art restorations, you may be able to enjoy them for decades.
If you would like more information on caring for dental implants, 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 Implant Maintenance: Implant Teeth must be Cleaned Differently.”
Along with daily oral hygiene and regular dental visits, a balanced and nutritious diet is another key part of great oral health. The foods you eat can have a profound impact on how well your teeth and gums withstand diseases like tooth decay and periodontal (gum) disease.
At the heart of proper nutrition are organic compounds called vitamins. Along with trace minerals, vitamins help the body convert food into energy, repair cellular and tissue damage and protect against environmental toxins. When you don’t receive an adequate amount of each vitamin your health can suffer; in terms of dental health, your teeth and gums can weaken and become more susceptible to disease.
Vitamins play a wide variety of roles, including within the mouth. The Vitamins A and C contained in fruits and vegetables and Vitamin E in vegetable oils are antioxidants that protect cells and their DNA from destructive elements in the environment. As such, they’re a major prevention factor against tooth decay and gum disease. Vitamin D, found in dairy products, eggs or certain seafood, is used by bone and teeth to absorb calcium. Without sufficient calcium, teeth and bone lose vitality and strength.
This recognized power of vitamins for optimum health has also fueled the multi-billion dollar nutritional supplement industry. But studies show that your best source for vitamins are the foods you eat—and the more natural foods and less processed products you eat, the better your vitamin and mineral intake. Taking supplements isn’t necessarily wrong—but it’s not in your best interest health-wise to depend on them for vitamins and minerals at the expense of healthier eating.
So in all you do to prevent dental disease, don’t overlook your diet. The vitamins and minerals you receive from foods in their most natural state will help you keep your teeth and gums healthy and your smile beautiful.
If you would like more information on the role of nutrition in dental health, 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 “Vitamins & Dietary Supplements.”
Think dental implants only replace individual teeth? Think again—this premier technology can also support other kinds of restorations to provide better stability and comfort. And, they also help improve bone health when incorporated with any type of tooth replacement options, especially dentures.
Although traditional dentures have enjoyed a long, successful history as a tooth replacement solution, they can interfere with bone health. That’s because regular dentures fit in the mouth by resting on the bony ridges of the jaw, which has implications for the bone.
As living tissue, bone goes through a growth cycle with older bone cells dying and dissolving and newer cells forming to take their place. The teeth play a role in this growth cycle — the forces generated when we chew travel up through the teeth and help stimulate bone growth. When teeth go missing, however, so does this stimulus.
Traditional dentures can’t replace this missing stimulus. In fact, the constant pressure of dentures on the jaw may even accelerate bone loss. A sign this is happening occurs when the dentures’ once tight fit begins to loosen and they become uncomfortable to wear.
Implant-supported dentures can help eliminate this problem. We first surgically place a few implants in the jaw, the number determined by which jaw (the lower requires less) and whether the denture is removable or fixed. If removable, the denture has connective points that match the implant locations — you simply connect them with the implants. If fixed, the denture is screwed into the implants to hold it in place.
So, how does this help bone health? For one, the denture no longer puts as much pressure on the jaw ridges—the main support comes from the implants. And, the implants themselves encourage bone stimulation: The titanium in the implant has a special affinity with bone cells that naturally grow and adhere to its metal surface. This natural integration between implant and bone can stop bone loss and may even help reverse it.
If you’re interested in implant-supported dentures, you’ll first need to undergo a full dental exam with your dentist. These restorations aren’t appropriate for all dental situations. But, if they can work for you, you may be able to enjoy the benefits of an implant-supported restoration.
If you would like more information on implant-supported restorations, 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 “Overdentures & Fixed Dentures.”
Professional Hockey player Keith Yandle is the current NHL “iron man”—that is, he has earned the distinction of playing in the most consecutive games. On November 23, Yandle was in the first period of his 820th consecutive game when a flying puck knocked out or broke nine of his front teeth. He returned third period to play the rest of the game, reinforcing hockey players’ reputation for toughness. Since talking was uncomfortable, he texted sportswriter George Richards the following day: “Skating around with exposed roots in your mouth is not the best.”
We agree with Yandle wholeheartedly. What we don’t agree with is waiting even one day to seek treatment after serious dental trauma. It was only on the following day that Yandle went to the dentist. And after not missing a game in over 10 years, Yandle wasn’t going to let a hiccup like losing, breaking or cracking nearly a third of his teeth interfere with his iron man streak. He was back on the ice later that day to play his 821st game.
As dentists, we don’t award points for toughing it out. If anything, we give points for saving teeth—and that means getting to the dentist as soon as possible after suffering dental trauma and following these tips:
- If a tooth is knocked loose or pushed deeper into the socket, don’t force the tooth back into position.
- If you crack a tooth, rinse your mouth but don’t wiggle the tooth or bite down on it.
- If you chip or break a tooth, save the tooth fragment and store it in milk or saliva. You can keep it against the inside of your cheek (not recommend for small children who are at greater risk of swallowing the tooth).
- If the entire tooth comes out, pick up the tooth without touching the root end. Gently rinse it off and store it in milk or saliva. You can try to push the tooth back into the socket yourself, but many people feel uneasy about doing this. The important thing is to not let the tooth dry out and to contact us immediately. Go to the hospital if you cannot get to the dental office.
Although keeping natural teeth for life is our goal, sometimes the unexpected happens. If a tooth cannot be saved after injury or if a damaged tooth must be extracted, there are excellent tooth replacement options available. With today’s advanced dental implant technology, it is possible to have replacement teeth that are indistinguishable from your natural teeth—in terms of both look and function.
And always wear a mouthguard when playing contact sports! A custom mouthguard absorbs some of the forces of impact to help protect you against severe dental injury.
If you would like more information about how to protect against or treat dental trauma or about replacing teeth with dental implants, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Dental Implants: A Tooth-Replacement Method That Rarely Fails” and “The Field-Side Guide to Dental Injuries.”
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