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Posts for: December, 2017

By Thomas Leatherman, DDS
December 23, 2017
Category: Dental Procedures
Tags: tooth replacement  
TeensBenefitMostfromATemporarySolutiontoMissingTeeth

While tooth loss can occur at any age, replacing one in a younger patient requires a different approach than for someone older. It’s actually better to hold off on a permanent restoration like a dental implant if the person is still in their teens.

This is because a teenager’s jaws won’t finish developing until after nineteen or in their early twenties. An implant set in the jawbone before then could end up out of alignment, making it appear out of place — and it also may not function properly. A temporary replacement improves form and function for now and leaves the door open for a permanent solution later.

The two most common choices for teens are a removable partial denture (RPD) or a bonded fixed bridge. RPDs consist of a plastic gum-colored base with an attached prosthetic (false) tooth matching the missing tooth’s type, shape and jaw position. Most dentists recommend an acrylic base for teens for its durability (although they should still be careful biting into something hard).

The fixed bridge option is not similar to one used commonly with adult teeth, as the adult version requires permanent alteration of the teeth on either side of the missing tooth to support the bridge. The version for teens, known as a “bonded” or “Maryland bridge,” uses tiny tabs of dental material bonded to the back of the false tooth with the extended portion then bonded to the back of the adjacent supporting teeth.

While bonded bridges don’t permanently alter healthy teeth, they also can’t withstand the same level of biting forces as a traditional bridge used for adults. The big drawback is if the bonding breaks free a new bonded bridge will likely be necessary with additional cost for the replacement.

The bridge option generally costs more than an RPD, but buys the most time and is most comfortable before installing a permanent restoration. Depending on your teen’s age and your financial ability, you may find it the most ideal — though not every teen is a good candidate. That will depend on how their bite, teeth-grinding habits or the health of surrounding gums might impact the bridge’s stability and durability.

A complete dental exam, then, is the first step toward determining which options are feasible. From there we can discuss the best choice that matches your teen’s long-term health, as well as your finances.

If you would like more information on tooth replacement solutions for younger patients, please contact us or schedule an appointment for a consultation.


By Thomas Leatherman, DDS
December 08, 2017
Category: Oral Health
Tags: oral health   hiv  
LivingwithHIVincludesKeepingaCloseWatchonYourOralHealth

We’ve come a long way since the early 1980s when we first identified the HIV virus. Although approximately 35 million people worldwide (including a million Americans) now have the virus, many are living relatively long and normal lives thanks to advanced antiretroviral drugs.

Still, HIV patients must remain vigilant about their health, especially their oral health. ┬áIn fact, problems with the teeth, gums and other oral structures could be a sign the virus has or is moving into the full disease stage, acquired immunodeficiency syndrome (AIDS). That’s why you or a loved one with the virus should maintain regular dental checkups or see your dentist when you notice any oral abnormalities.

One of the most common conditions among HIV-positive patients is a fungal infection called candidiasis (or “thrush”). It may appear first as deep cracks at the corners of the mouth and then appear on the tongue and roof of the mouth as red lesions. The infection may also cause creamy, white patches that leave a reddened or bleeding surface when wiped.

HIV-positive patients may also suffer from reduced salivary flow. Because saliva helps neutralize excess mouth acid after we eat as well as limit bacterial growth, its absence significantly increases the risk of dental disease. One of the most prominent for HIV-positive patients is periodontal (gum) disease, a bacterial infection normally caused by dental plaque.

While gum disease is prevalent among people in general, one particular form is of grave concern to HIV-positive patients. Necrotizing ulcerative periodontitis (NUP) is characterized by spontaneous gum bleeding, ulcerations and a foul odor. The disease itself can cause loosening and eventually loss of teeth, but it’s also notable as a sign of a patient’s deteriorating immune system. The patient should not only undergo dental treatment (including antibiotics), but also see their primary care physician for updates in treating and managing their overall symptoms.

Above all, HIV-positive patients must be extra diligent about oral hygiene, including daily brushing and flossing. Your dentist may also recommend other measures like saliva stimulators or chlorhexidine mouthrinses to reduce the growth of disease-causing bacteria. Together, you should be able to reduce the effects of HIV-induced teeth and gum problems for a healthier mouth and better quality of life.

If you would like more information on oral care for HIV-AIDS patients, 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 “HIV-AIDS & Oral Health.”