Dental Dictionary

Sedation is the process of administering a drug to produce unconsciousness, or various states of calm, loss of sensation, awareness of the procedure, or loss of memory. Intravenous (IV) sedation is typically administered through a vein in your hand or arm. With IV sedation, you remain conscious but may have the impression you are asleep and will most likely not have any memory of the procedure.

Traditional dental implants often take a relatively long time (typically three to six months) to heal and integrate into the bone around it. This healing and integration time is necessary so the bone around a dental implant can fully stabilize the implant.

In some cases, it is possible for your dentist to remove a badly-damaged tooth and replace it with a dental implant on the same day. This is called an immediate dental implant.

Once a tooth is removed, the bone in the jaw naturally resorbs and the gum tissues often lose their shape and flatten. Flattened gum tissues can be especially noticeable in the front teeth. An advantage of an immediate implant is that there is a significantly reduced chance of bone and gum tissue loss between the teeth. This may produce a better cosmetic result than a traditional implant. It may also be possible to attach a temporary crown to the implant at that time so you will not be without a tooth until your final crown is ready.

A disadvantage of immediate implants is an increased risk that they may not properly integrate with the surrounding bone. This is not typically a serious issue, as another implant can usually be placed after the site has sufficiently healed.

Not everyone is a good candidate for an immediate implant. In addition, there are pros and cons of immediate implants which your dentist will discuss with you. Be sure to discuss the implications and risks with your dentist before you commit to an immediate implant. Immediate implants may not be an appropriate alternative to a traditional implant for a variety of reasons:

• If the tooth-supporting bone is cracked, diseased or damaged, an immediate implant will likely not be recommended.
• Back teeth typically endure stronger chewing forces, which generally makes them poor candidates for immediate implants. However, they are also not as visible when speaking and smiling, so some loss of the soft tissue between them which can occur with a traditional implant is less of a factor in your appearance.

A tooth can become impacted when it is obstructed and cannot erupt normally. Another tooth often causes this obstruction.

• A bony impaction occurs when the impacted tooth fails to get out of the bone at all.
• A tooth is considered soft tissue impacted when it has emerged from the bone, but an obstruction prevents the tooth from making it through the soft tissue.
• If part of the impacted tooth is encased in bone, and part of it is covered by soft tissue, it is considered a partial bony impaction.
• Sometimes a tooth fails to move into the mouth normally for reasons other than an obstruction. The root may become fused to the jawbone in a condition known as ankylosis. Ankylosis is not uncommon, and can happen with either primary or permanent teeth. Your dentist or a specialist may be able to detach these teeth with a surgical procedure which may enable the tooth to move into the mouth normally.

An implant abutment is a device that attaches a crown, partial or complete denture, or other dental restoration to a dental implant. Implants are also available that incorporate the abutment and implant into one solid piece. Two-piece arrangements offer greater flexibility in the types of restorations that can be connected to the implant, as they can be changed to suit your needs over time.

The most natural replacement for a missing tooth is to have your dentist restore it by attaching a crown to a tapered implant abutment.

Dental implants enable your dentist to replace a missing tooth with a crown without reducing any natural tooth structure from the teeth on either side of the crown. Other tooth replacement options, such as bridges, require your dentist to remove tooth structure from otherwise healthy teeth.

If you are missing two adjacent front teeth, your dentist can place a single dental implant and restore it with two artificial teeth. One tooth attaches directly to the implant, while an underlying framework supports the other tooth.

Poorly adjusted or loose fitting complete dentures can cause denture sores. To address this problem, and provide for a better denture fit, your dentist can place as few as two dental implants. This allows the dentist to create a denture with special fittings that snap onto the implants. As a result, the denture fastens more securely. This not only reduces the likelihood of developing sores, but it also improves chewing and speaking.

If you have an implant-stabilized removable denture, it only needs to be removed to clean it and to allow your underlying soft tissues to rest.

It may even be possible for your dentist to place your implants and modify your existing denture so you can leave your dentist's office with a working overdenture on the same day. If this is possible, your dentist may still ultimately recommend a new denture for a better long-term solution.

If you are missing multiple teeth in one quadrant of your mouth, your dentist can place two dental implants and affix a bridge to them.

In some cases, your dentist can create a hybrid bridge known as a tooth implant supported prosthesis that connects to a dental implant on one side and a natural tooth on the other. These are not always recommended because the natural tooth may separate from the bridge.

If you are missing all of your teeth in either or both jaws, your dentist may be able to replace them with implant-supported fixed dentures. These dentures look and function like natural teeth, and you will not have to remove them at night.

Depending on the number of teeth to be replaced, your dentist will place four or more implants per jaw. The additional implants improve stability and reduce biting forces. After you heal, your dentist will make a denture that connects to the implants. Most often, the denture will be held in place with screws that only your dentist can remove.

For tooth replacement in the upper jaw, your dentist may place the rear implants at an angle. This will help the implants avoid coming into contact with the maxillary sinus. It can also eliminate the need for a sinus lift procedure, where your dentist surgically places bone graft material into your sinus cavity to support the implants.

This angled implant technique is most often used when only ten teeth in an arch need to be replaced by the denture. It cannot be used if molar teeth need to be replaced.

For tooth replacement in the lower jaw, the angled placement technique may be used to avoid nerves.

Getting your baby off to a safe and healthy start is an important part of your new journey. A critical area that is often overlooked is your baby's oral health. The good news is that there are simple steps you can take to ensure your baby's mouth stays clean and protected.

Your dentist may not be able to repair a chip or decay with a filling or a crown. Fillings may be difficult to place in certain locations or for certain types of damage. When a filling is not a good option, and the damage is not extensive enough to require a crown, there are two additional options: inlays and onlays.

Inlays and onlays differ by the amount of the tooth they cover. An inlay covers less tooth structure than an onlay. As the names imply, an inlay can be thought of as being placedinto a tooth and held to the inner surfaces of the tooth, while an onlay is placedonto a tooth and held to the outer surfaces of the tooth. Sometimes the dentist will combine features of both inlays and onlays.

Inlays are different from fillings and crowns. Your dentist typically shapes a filling from a soft material placed directly into the tooth. Inlays are usually made in a dental laboratory, although some dentists have the equipment in their office to make them. In addition, inlays require less tooth structure to be removed than crowns. This is important because preserving tooth structure can reduce the need for more extensive dental work in the future.

What to expect

• Your dentist will numb your tooth with a local anesthetic, remove any decay, prepare your tooth for the inlay.
• They will then make a mold of your tooth and then send the mold to the lab. If your dentist has the right equipment, they will use digital scanners to record the shape of the prepared tooth and make the final inlay in their office.
• If your final inlay or onlay will be made in a dental lab, your dentist will place a temporary filling on your tooth until your permanent inlay is ready.
• Lab technicians will then make the inlay from the mold or digital scan of your tooth. The inlay can be made from composite resin, gold and other metals, or with a variety of ceramic materials.
• At your second appointment, your dentist will glue the inlay into the tooth. They will also give you any guidance for at-home care that may be needed.

Interdental brushes are cone-shaped cleaning devices that are available in many sizes. They allow you to clean where regular toothbrushes and floss cannot easily reach. They can be especially effective as part of your daily oral health routine if you have fixed bridges or orthodontics, or if you have spaces between your teeth as a result of tooth loss or receded gums.