A dental implant is a titanium post designed to replace missing teeth. The post is surgically placed into the jawbone where the tooth is missing, and provides a more permanent solution.
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Crowns and conventional bridges or dentures may not be your only options when replacing missing teeth. For some people, dental implants offer a smile that looks and feels very natural. Implants are surgically placed below the gums over a series of appointments, and fuse to the jawbone. Implants offer stability because they fuse to your bone, a process called osseointegration. Integration of the implants into your jaw also helps your replacement teeth feel more natural, and some people find the secure fit more comfortable than conventional substitutes. Candidates for dental implants must have healthy gums and adequate bone to support the implant.
Reasons for Dental Implants
What Does a Dental Implant Involve?Implant Site Preparation
The gum tissue is opened to expose the bone area where the implant will be placed. In situations where there is insufficient bone structure, bone grafting may be a recommended procedure. Once healthy bone has been established, a special drill is used to prepare the bone to receive the implant.
Placing the Implant
After the bone has been prepared, the implant is placed and the tissue is sutured. After seven to ten days the sutures are removed. The healing process takes three to six months. This is the amount of time it usually takes the implant to become part of the bone of the jaw.
Attaching the Post
When the gum tissue is ready, a special post is attached to the implant; it is the support for the new porcelain crown. Today's technologies often include zirconium abutments attached to the implant post, to assure that the new porcelain tooth possesses translucency properties similar to a natural tooth.
Placing the Crown
After impressions are taken a crown is made and shaded to match your existing teeth. The crown is then slipped over the post and cemented. This final prosthetic crown appears as a natural tooth.
There is a high rate of failure of implants in patients who smoke, so dental implants tend to not be an option for patients who are actively smoking. We will help you determine whether dental implants will be a good tooth replacement option for you. Proper brushing and flossing will maximize the longevity of your new dental implant.
What Is Gum Disease?Gum disease, or periodontal disease, is an infection of the tissues that surround and support your teeth. Because gum disease is usually painless, you may not know you have it. Also referred to as periodontal disease, gum disease is caused by the bacteria that is constantly forming on our teeth.
Some Warning Signs
There are many factors that increase the risk of developing gum disease, including: smoking, pregnancy and diabetes. It is important to visit Yakima Valley Periodontics if you suspect you have gum disease, because the sooner you treat it the better.
The Early Stage of Gum Disease Is Called GingivitisIf you have gingivitis, your gums may become red, swollen and bleed easily. At this stage, the disease is still reversible and can usually be eliminated by a professional cleaning at your dental office, followed by daily brushing and flossing.
Advanced Gum Disease Is Called PeriodontitisChronic periodontitis can lead to the loss of tissue and bone that support the teeth and it may become more severe over time. If it does, your teeth will feel loose and start moving around in your mouth. It usually gets worse slowly, but there can be periods of rapid progression.
Aggressive periodontitis is a highly destructive form of periodontal disease that occurs in patients who are otherwise healthy. Common features include rapid loss of tissue and bone, and may occur in localized areas or in the entire mouth. Periodontal disease cannot be cured, however, we have measures to help slow or stop the progression.
Research between systemic diseases and periodontal diseases is ongoing. While a link is not conclusive, some studies indicate that severe gum disease may be associated with several other health conditions such as diabetes or stroke.
Regular dental checkups and periodontal examinations are very important. The treatment methods that Dr. Iasella diagnoses will depend upon the type of disease and how far the condition has progressed. Good dental care at home is essential for helping to keep periodontal disease from becoming more serious.
|If the term "impacted" has been used in regard to your canines, you might not be sure what exactly that means. An impacted tooth is one that is "stuck" and unable to erupt through the gums in order to function as intended. This often happens with the third molars, otherwise known as the wisdom teeth. These teeth tend to get stuck in the back portion of the jaw, and if left untreated, they can develop a painful infection as well as a host of other problems. Since most of us don't need the wisdom teeth, they are often extracted if they start to develop a problem.
The upper eyetooth, otherwise known as the maxillary cuspid, is the second most likely tooth to be impacted. This tooth plays a critical role both your bite and the dental arch. The cuspid teeth serve as strong biting teeth, and they will have the longest roots of any of your teeth. They will be the first teeth that touch when you close your jaws together, and they will serve as a guide to ensure the rest of your teeth are in proper alignment.
The cuspid teeth of the maxilla are usually the last of the front teeth to erupt and move into place. This typically happens around the time we turn 13 years old, and any space that was left between the front teeth on the top jaw will close together tightly. If a cuspid is impacted, Dr. Iasella will make every effort to get it to erupt into its proper position. These techniques can be used on any impacted tooth of either jaw, but mostly they are applied to the upper eyeteeth. About 60% of these impacted eyeteeth will be located on the roof of the mouth, and the remaining teeth are found in the supporting bone, but stuck in a position that leaves them elevated above the roots of the adjacent teeth.
Successful Treatment of Impacted Eyeteeth Requires Early RecognitionImpacted eyeteeth become more of a challenge as a patient gets older. Older patients will be more likely to experience an impacted tooth that doesn't erupt on its own, even if there is plenty of space available for it. According to the American Association of Orthodontists, it is recommended that a panoramic x-ray, known as a panorex screening, be taken after a thorough oral exam when patients are around seven years old. This will be done to count the teeth and to determine if there might be any problems with the adult teeth erupting as planned. It is also important to determine that all the adult teeth are present and that there are no issues with crowding or unusual growths that may prevent proper development.
Exams of these adult teeth in children will usually be done by your dentist, and if problems are detected, you can be referred to periodontist Dr. Iasella. Treatment of problems involving teeth that are failing to erupt can involve placing braces on open spaces to encourage proper eruption. Dr. Iasella may also extract baby teeth or select adult teeth that could be preventing the impacted eyeteeth from erupting. Any growths or extra teeth that could be blocking the eruption of healthy adult teeth will also need to be removed.
If treatment is taken so that an eruption path is created and the space can be opened up before the age of 12, there is an excellent chance that an impacted tooth will erupt on its own. However, if the eyetooth is allowed to continue developing up until 13–14 years of age, it likely will not erupt on its own even with the necessary space cleared. If a patient is much older, there is a higher chance that the eyetooth will be permanently fused into position, and the only way that tooth will budge will be to extract it. At that point, an alternate treatment like a dental implant can be used to replace the missing tooth and to improve the structure and appearance of the arch.
When Proper Space Is Available, But the Eyeteeth Don't EruptIn situations where the eyeteeth don't erupt on their own, Dr. Iasella and your dentist or orthodontist will collaborate to attempt to get these teeth to erupt. Each situation will be evaluated independently, but treatment will typically involve braces being put onto the teeth, at least those found on the upper arch. A space will then be opened so that there is plenty of room for the impacted tooth to erupt and move into its correct position. If the baby tooth in this position has not yet fallen out, it will typically be left alone until the space for the adult tooth is ready. Once the space has opened up, your periodontist Dr. Iasella will usually be consulted to have the impacted tooth exposed and to put a metal bracket into place.
The process of exposing the tooth will involve a simple procedure performed in Dr. Iasella's office. First, the gum situated on top of the tooth will be lifted so that it exposes the tooth that is hidden underneath. Any baby teeth that might be present and in the way will be removed at this time. Once the permanent, impacted tooth has been exposed, Dr. Iasella will bond a bracket to it, and this bracket will contain a tiny gold chain. The chain will be guided back to the orthodontic arch wires to temporarily attach it to the braces. In some cases, Dr. Iasella will leave the exposed tooth uncovered by stitching the gum up above it to make a window that covers the teeth. However, in most cases, the gum will be returned back to its original state and sutured so that only the chain remains visible and exits through a small hole within the gums.
Within two weeks of your surgery, you will return to see your orthodontist. At this time, a rubber band will be attached to the chain so that a light pulling force can be placed on the tooth that is impacted. This will slowly begin the process of moving the tooth up and out of the gums and into its proper position within the dental arch. This process will be carefully controlled and can take a full year to complete, and it is important to remember that the end goal is to get the tooth to move out of the gums, not to remove it.
After the tooth has been moved into its final position, the gum surrounding it should be evaluated to ensure that it is healthy and strong enough to last for a lifetime, especially considering all the teeth brushing and chewing activities it will be exposed to over the years. In certain situations, especially when a tooth has needed to move a considerable distance, minor gum surgery may be required in order to bulk up the tissue over a relocated tooth. This will help the gum to remain healthy, and your orthodontist will explain the process to you if it applies to your unique situation.
These principles can be used for virtually any impacted tooth in the mouth. It is common for both upper eyeteeth to be impacted, and in these situations, the space formed by the dental arch will be prepared on each side. When your orthodontist is ready, Dr. Iasella will expose and bracket both impacted teeth, and this can be done at the same time so that you only have to heal from one surgery.
The anterior teeth (cuspids and incisors) and bicuspids are small teeth that only have single roots, so they tend to be easier to erupt than the rear molars in the event of an impaction. The molars are much bigger and will have several roots, making it more difficult to move them. Therefore, the orthodontic techniques needed in moving an impacted molar tend to be much more complicated due to their location at the back of the arch.
What You Can Expect From Impacted Tooth Exposure SurgeryIf you will be having a surgery to expose an impacted tooth, you'll be happy to know that the procedure is fairly straightforward. For most patients, local anesthesia and laughing gas are enough to keep you comfortable during the procedure, but select cases may require IV sedation. Dr. Iasella will evaluate your situation to determine which option for sedation is right for you.
The procedure typically takes about 75 minutes for one side, and if both sides require exposure it will take 105 minutes. If bracketing isn't required, the time needed will also be cut in half. When you go through your pre-op consultation with Dr. Iasella, you'll learn exactly what will happen during your procedure and how long it should take.
After your surgery, you can expect to experience some bleeding. You may feel pain or discomfort, but most patients find that over-the-counter pain medications like Advil or Tylenol are more than enough to manage this pain, although prescription painkillers might also be prescribed. Within a couple of days following your surgery, you shouldn't have any additional need for medication for pain relief.
Swelling and bruising may also be experienced after surgery. Swelling can be minimized by applying an icepack to the lip or cheek immediately following the procedure. While bruising isn't as common, you shouldn't be surprised if you do notice some.
You'll also need to make a few changes to your diet right after your procedure. A diet of soft, bland foods is initially recommended, but if you begin to feel better, you can go back to eating your normal diet. You should avoid sharp or jagged foods like chips or crackers, as they could irritate the surgical site, but most foods are fine after the first day or two.
You'll also need to follow up with your surgeon from 7–10 days after your surgery. This appointment will be used to evaluate the healing process, and you'll need to follow up with your orthodontist so that the eruption process can be activated. As always, if you have additional questions or concerns about the treatment or your recovery, feel free to call our office at (509) 452-7115.
|Tooth loss often leads to bone loss in the jaw. A dental implant needs a solid foundation of bone to support it, and bone loss is a common issue when teeth have been missing for a significant period of time. When bone loss occurs in the upper premolar or molar areas the sinus can fill in the gap left by the receding bone. No harm is caused by the sinus filling in the gap left by receding bone, but if dental implants are desired a sinus lift may be necessary.
The upper premolar and molar teeth's roots can sometimes occupy the sinus cavity or be positioned very close to it. As a result, it is common for the bone loss associated with tooth loss to affect the sinus cavity. In circumstances such as these, before placing implants we will perform a sinus lift/augmentation.
What Is Involved In the Procedure?Before we start the procedure we prepare by taking x-rays of the jaw and sinus area so we know exactly what must be done. If the patient has seasonal allergies we strongly recommend that this procedure not be done while they are active.
Local anesthetic is applied to numb the site, then a small incision in the bone where the tooth used to be is made. We use this hole to gain access to the bottom of the sinus cavity (Schneiderian membrane). The sinus is carefully pushed up into a higher position in the cavity. The result is a free space between where the bone ends and the sinus begins, which encourages the bone to naturally grow and fill in that space. A bone graft will be placed into the space created by this procedure to prevent the sinus from falling back into its original position and to encourage bone growth.
When the graft is in place we suture the gum tissue closed and the site is allowed to heal for anywhere from four to nine months. The long recovery time allows the graft to meld with the jaw and varies depending on how much material needed to be placed.
Following Sinus AugmentationRecovery from the procedure is typically uneventful. Saline solution is prescribed for the patient to help mitigate dry nasal tissue. Blowing of the nose ought to be avoided and nosebleeds are common following sneezes.
At Yakima Valley Periodontics we are committed to your health and are proud to offer the best care available. Please give us a call at (509) 452-7115 to setup your appointment today!
|Sometimes, due to tooth loss or extraction, the bone underlying the gums will start to recede. This bone loss frequently results in the sinking of the ridge of the gums. The pocket that the tooth used to fill in the gums will widen and deepen as the bone continues to recede which can leave a large indentation where the tooth once was.
Ridge augmentation is a great solution to the issue of unsightly pockets in the gums that can give bacteria a place to build up. In addition to the potential health risk of bacteria formation, deep recesses in the gums can be unsightly and make it impossible to place needed dental implants. Implants have the ability to look and act just like a real tooth, which can prevent changes in your bite and bone loss, and restore function/aesthetic appeal to your mouth.
Ridge augmentation may also be needed to restore gum tissue in your mouth to give your teeth a more natural look. When gums recede they can leave teeth looking too tall, and often unsightly. This procedure is a fabulous answer to the problem of gum recession.
How is ridge augmentation accomplished?The process used to accomplish ridge augmentation depends upon where the issue lies—in the bone or the soft tissue (gum). If bone loss is the cause of the issue, hard tissue augmentation is required, which is often called a bone graft. If the gums themselves are receding the solution is a soft tissue augmentation, which is referred to as a gum graft.
As mentioned before, soft tissue augmentation is usually only performed to improve the look of the gums and teeth. Soft tissue augmentation starts with the retrieval of a tissue graft, usually from the roof of the mouth and numbing the area to be grafted. The graft is then placed and attached with sutures.
Hard tissue augmentation is done with the intent of restoring bone to a site that has experienced bone loss. The procedure is accomplished in much the same way a gum graft is accomplished. The site is numbed and an incision is made to lift the gum away from the bone. The bone graft will then be placed in the incision and attached with sutures.
Occasionally both soft and hard tissue augmentations are performed at the same time, depending on the situation and the patient’s needs. A recovery time of four to six months is needed to allow the augmentation to take and heal properly.
We are excited to help remedy any dental issues you may be experiencing and encourage you to give us a call at (509) 452-7115 today to setup an appointment!
|Bone grafting is a surgical procedure that is used to fix problems associated with the bone or joints. It involves transplanting bone tissue, and in the field of dentistry, it is most commonly completed so that there is enough bone available to support dental implants.
Major Bone GraftingBone grafting is essential in repairing implant sites to contain adequate bone structure. This may be needed due to tooth loss, previous extractions, trauma, or gum disease. The bone will either be harvested from somewhere else in your body, such as the tibia, hip or jaw, or it can be taken from a cadaver or animal source. Special membranes are also used to encourage bone regeneration and bone grafts, and the most successful regeneration efforts will occur when using live bone from your own body.
Major bone grafting is usually performed in order to repair jaw defects. These may have resulted from congenital defects, tumor surgery, or some type of traumatic injury. The largest defects are typically corrected using the patient’s own bone, and the procedures are generally performed in an operating room and may require an overnight hospital stay.
Benefits of Bone GraftingBone grafting will be done to restore the bone in your jaw to its previous form, and it may also be used to maintain the existing bone structure after you have had teeth extracted. These activities are important for several reasons. First, dental implant placement will require that the bone of the jaw is as close to the original dimensions as possible in order to achieve optimal results. Additionally, the jaw and facial bones will support the muscles and skin that make up your facial shape and appearance, and without this underlying support, your face may look prematurely aged.
Preparing for Your Bone Grafting ProcedurePrior to the surgery, you'll need to go through a periodontal treatment known as scaling and root planing. You should also be sure to care for you teeth properly by brushing and flossing twice per day.
Anesthesia will be used during the procedure, so it is important that you follow the steps outlined by your dentist or surgeon in order to prepare for the procedure. This will likely involve avoiding food and beverages for six hours prior to your appointment, not smoking, and taking other precautions. Our team will outline all of the preparation steps you need to take prior to your appointment.
After Your Bone Grafting ProcedureFollowing your bone grafting procedure, you'll likely be prescribed pain medication to help with your discomfort. Be sure to follow your surgeon’s instructions regarding how often and when to take any medications that you are prescribed. Swelling is also common, and you can use an ice pack placed on the outside of your mouth to help with this.
It is important to keep your mouth as clean as possible as you heal. Be sure to brush and floss the unaffected portions of your mouth normally. Your surgeon or dentist will provide additional tips on how to safely keep the rest of your mouth clean.
|At Yakima Valley Periodontics, our strongest commitment is to our patients' continued oral health. You may have heard the phrase, "tongue tied" used to describe someone who is having a hard time finding the correct word. Few people realize that a tongue tie is a real medical condition where excess connective tissue can prevent the patient's tongue from being able to achieve a normal range of motion. This tissue is called frenula. A related condition involves too much frenula between the gum line and inner lip, which can interfere with dental aesthetics and alignment of the teeth.
For patients with these conditions, we can perform a surgery called a frenectomy.
What is a Frenulum?Frenula are pieces of connective tissue that are found all over the human body. They are thin and typically intended to restrict the range of motion of some parts of the body. Prominent frenula can be found in the mouth. There are frenula that connect both the upper and lower lips to the gum line at the anterior (front) of the mouth as well as under the tongue. An issue can arise when this connective tissue is bound too tightly. When something like this occurs, we can perform a frenectomy to remedy the issue.
What is a Frenectomy?When a frenulum is too restrictive it can be corrected with a frenectomy. A lingual frenectomy is a simple procedure wherein we sever the tightly bound portion of the tongue from the base of the mouth. Other frenectomies are performed above the upper teeth, or below the lower teeth, but cutting away the excess frenulum. This can be done using either lasers or a scalpel.
When is a Frenectomy Necessary?For dental patients, frenectomies are usually performed when there is overly thick tissue connecting the gum line to the inner lip. This is commonly seen on the gums above the upper anterior teeth. This tissue can at times be thick enough to cause a separation between the teeth, creating a gap. A frenectomy by Dr. Iasella removes the excess tissue so that a patient can enjoy a more aesthetic smile, or, for patients undergoing orthodontic treatment, a frenectomy prepares the gum line for the realignment of the teeth.
Another need for the surgery is found in infants who have trouble latching onto their mother's breast. Because the tongue plays a key role in the sucking motion required to latch onto the breast, if an infant tongue is bound by the frenulum, the baby can experience trouble breastfeeding.
Do I Need a Frenectomy?If you are concerned about the appearance of your smile due to excess gum tissue, have trouble speaking due to thick frenula, or have received recommendation by an orthodontist to undergo a frenectomy, please call us at (509) 452-7115 to schedule an appointment.
At Yakima Valley Periodontics, we are committed to your ongoing oral health. Your comfort and safety is our top priority, so if you or your children have special concerns about visiting dental practices, please let us know in advance. We are more than happy to provide you and your family with an introduction to our facility and staff. We also have a wide variety of sedation options available.
Please call us today at (509) 452-7115 to setup your appointment.
Treating Your Gum RecessionThere are several ways that your gum recession can be treated. First, a professional cleaning can be used to stop the recession. This procedure is known as scaling and root planing, and it can help the gums to heal so that they don't recede further.
If you need more extensive treatment, a gum graft is often recommended. According to the American Academy of Periodontology, this option can repair the wounded areas where recession has occurred, and it can also help to prevent future infections.
What Happens During the Procedure?During your grafting procedure, you'll be given a local anesthetic to help with your discomfort. Then, a tiny incision will be made at the site of the graft, creating a small tunnel to accommodate the new gum tissue. The gum tissue will be sutured into place so that it won't shift, and the healing process will take about six weeks to complete.
Types of GraftsThere are several different types of gum grafts available if this is the treatment option that you need to pursue, and your periodontist will help you to choose the right option:
Benefits of Gum GraftingThere are a few great benefits associated with gum grafting:
This procedure is quite common, and while the name might sound scary, it is performed routinely and provides for excellent results. If you have any questions about the procedure and whether you might be a candidate, please contact our office at (509) 452-7115.
Gum ContouringAre you unhappy with the appearance of your smile because you believe it looks too "gummy"? Many people with excess gum tissue are, so you may be happy to hear that there is an option out there that will make your smile more esthetically balanced. To be a candidate for gum contouring, you will need to have healthy gums and teeth.
Reasons for Gum Contouring
In the past, gum contouring was performed with a scalpel in order to remove excess gum tissue. Fortunately, advances in dental technology have made the process faster and easier than ever before. A soft tissue laser will be used to gently remove a portion of the gums while sealing the tissue simultaneously in order to promote healing and to stop bleeding. The final result is a smile that instantly appears more balanced, and the entire procedure can be completed in a single visit.
Restorative Crown LengtheningWhen a tooth has a deep cavity, a crown and buildup are usually needed to restore the tooth. If the cavity extends too far below the gums, it becomes impossible to predictably make a crown that will last for any length of time. Performing crown lengthening where indicated improves the prognosis for the tooth.
Crown lengthening nearly always involves removing and recontouring some of the bone around the tooth. This results in more tooth structure above the gums and smooth flowing gum contours. Not every tooth that needs a crown also needs crown lengthening surgery, it is only necessary when a deep cavity or crack is present.
Reasons for Restorative Crown Lengthening
In the restorative procedure, first Dr. Iasella will thoroughly numb the tooth or teeth needing crown lengthening. During this procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. After the procedure, the tooth can then be prepared for a functional, long-lasting crown. As always, proper brushing and flossing is key to ensuring the maximum life of your new crown.
|A tooth extraction is the procedure done to remove a tooth that is damaged beyond repair from its socket in the jawbone. Extractions are also done to remove wisdom teeth that may be impacted or create future problems.
Why Are Teeth Extracted?
Extractions are generally classified as either non-surgical (also known as "simple") or surgical (involving cutting through the gums and tooth). A simple procedure can quickly become a surgical procedure if the tooth fractures or refuses to loosen under pressure. We perform these procedures only after making the extraction site(s) profoundly numb.
Tooth Extraction Post-Operative InstructionsFollowing tooth extraction you may experience bleeding, oozing, soreness or moderate to severe pain.
Bleeding should stop by 8-12 hours following the extraction. If you experience significant bleeding past this time please call our office at (509) 452-7115 immediately. Oozing of pink fluid for 1-2 days is normal.
Discomfort following the tooth extraction is best managed with a mild analgesic like Tylenol, Advil or Aleve. If you experience severe pain that lasts more than 2-3 days after your extraction please call our office.
Healing should be as smooth as possible following tooth extraction. It is important to not disturb the extraction site. Remember to eat a soft diet and avoid vigorous rinsing for 24 hours following the extraction.
After 24 hours rinse with strong warm salt water for 1 minute a couple of times daily for 3-4 days. This will reduce the number of bacteria in your mouth and will promote better healing.
If you have any further questions, please feel free to call us.
|Many patients have had traumatic experiences in dentistry or have other anxieties about their treatment. At Yakima Valley Periodontics, Dr. Iasella strives to meet your individual comfort needs. For surgical procedures, or for our patients with anxiety, sedation dentistry is offered. We offer both nitrous oxide and oral (conscious) sedation as options for our patients.
Nitrous OxideNitrous oxide is a safe and effective sedative agent that will help you relax. It is mixed with oxygen and inhaled through a small mask that fits over your nose.
Nitrous oxide, sometimes called "laughing gas," is one option we may offer to help make you more comfortable during certain procedures. It is not intended to put you to sleep. You will be able to hear and respond to any requests or directions we may have. Dr. Iasella will ask you to breathe normally through your nose, and within a few short minutes you should start to feel the effects of the nitrous oxide. You may feel light-headed or a tingling in your arms and legs. Some people say their arms and legs feel heavy. Ultimately, you should feel calm and comfortable. The effects of nitrous oxide wear off soon after the mask is removed. Talk to us about whether nitrous oxide would be a good option for you at your next appointment.
For more information, visit www.mouthhealthy.org
Oral (Conscious) SedationOral sedation dentistry allows Dr. Iasella to create a safe and comfortable dental experience for patients who avoid the dentist out of fear.
With sedation, Dr. Iasella can work more effectively by helping you become as comfortable as possible using well established and proven methods. There are a variety of sedation medications that are taken orally or "sublingually" (under the tongue). All sedation medicines are administered at our offices, under the care of an assistant.
This type of dental care does require that you have a driver to bring you home from your appointment, as it takes several hours for the medication to completely wear off. For more information about oral sedation at Yakima Valley Periodontics, please call us at (509) 452-7115 today!