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Posts for: November, 2014

ReplacingMissingBackTeethIsImportant-JustAskChristieBrinkley

Supermodel Christie Brinkley has a one-in-a-million smile, but she is just one of millions who have benefited from today's preferred tooth-replacement technique: the dental implant. In a wide-ranging interview, Brinkley told Dear Doctor magazine about a helicopter accident she suffered while back-country skiing.

“I fractured two molars in the back of my mouth and I had to get two dental implants,” Brinkley told the magazine. “I am grateful for the dental implant technology that feels and looks so natural.”

You might think it serves little purpose to replace a missing back tooth that was barely visible in your smile to begin with — especially if you don't spend a lot of time posing for magazine covers. But this is actually not the case. Your molars are extremely important for chewing and even for maintaining a more youthful appearance.

Dentists generally agree that losing posterior (back) teeth can have many consequences for the remaining teeth and their surrounding structures, i.e., bone and gums. If back teeth are missing, the front teeth end up bearing more stress than they were built for. And there are certain things that happen when any tooth is lost, whether front or back, that can affect function and appearance.

For one thing, when a tooth is lost the adjacent teeth tend to drift into the empty space or tip towards it. This can adversely affect your bite. Too much shifting can render a tooth basically useless and also leave it more vulnerable to gum disease.

Another complication is the loss of tooth-supporting bone that inevitably occurs when teeth are lost. When a tooth comes out, the bone under it actually begins to melt away. Since back teeth support the vertical dimension of the face, their loss can cause what's known as “bite collapse” — a reduction in facial height that becomes increasingly noticeable over time and can make you look older.

A dental implant can prevent all of these things, while providing you with a replacement that looks and feels just like the tooth you lost.

If you are interested in learning more about implants, please contact us or schedule an appointment for a consultation. If you would like to read Dear Doctor's entire interview with Christie Brinkley, please see “The Secret Behind Christie Brinkley's Supermodel Smile.” Dear Doctor magazine also has more on “Replacing Back Teeth.”


TheTimeIntervaltoReplantaKnockedOutToothCanAffectitsLongevity

Contrary to what you might think, a knocked out tooth doesn’t inevitably mean tooth loss. Time is of the essence — the shorter the interval between injury and replanting the tooth, the better the tooth’s long-term survival. The longer the interval, on the other hand, the less likely the tooth can survive beyond a few years. That phenomenon is due to the mouth’s natural mechanism for holding teeth in place.

The tooth root maintains its attachment with the jaw bone through an intermediary tissue known as the periodontal ligament. Tiny fibers from one side of the ligament securely attach to the tooth root, while similar fibers attach to the bone on the opposite side of the ligament. This maintains stability between the teeth and bone while still allowing incremental tooth movement in response to mouth changes like tooth wear.

While the ligament fibers will attempt to reattach to a replanted tooth’s root, the longer the tooth is out of the socket the less likely the fibers will fully reattach. An “ankylosis” may instead form, in which the root attaches directly to the jaw bone without the periodontal ligament. In this situation the body no longer “recognizes” the tooth and begins to treat it like a foreign substance. In all but the rarest cases, the tooth root will begin to resorb (dissolve); at some point (which varies from patient to patient) the attachment becomes too weak for the tooth to remain in place and is lost.

Ideally, a knocked out tooth should be replanted within 5 minutes of the injury (for step-by-step instructions, refer to The Field-Side Guide to Dental Injuries available on-line at www.deardoctor.com/dental-injuries). Even if you pass the 5-minute window, however, it’s still advisable to attempt replanting. With a subsequent root canal treatment (to remove dead tissue from the inner tooth pulp and seal it from infection), it’s possible the tooth can survive for at least a few years, plenty of time to plan for a dental implant or similar tooth replacement.

If you would like more information on treatment for a knocked out tooth, 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 “Knocked Out Tooth.”




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John D. Massey, DMD
4200 Columbia Road
Martinez, GA 30907

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