By Michael C Scheske, DDS, PC
December 29, 2020
Category: Oral Health
Tags: dental implant  
AlthoughChallengingCleaningAroundImplantsBoostsTheirLongevity

Daily oral hygiene and regular dental cleanings help keep your natural teeth and gums healthy and disease-free. But they're also a priority with dental implants. Here's why.

Unlike other restorations, an implant replaces both a tooth's crown and root, the latter by way of a titanium metal post imbedded into the jawbone. Bone cells grow and adhere to the metal surface, forming a secure and lasting hold.

But although quite durable, this hold differs significantly from natural teeth, which are actually held in place by a tough, elastic tissue called the periodontal ligament. The attachment of the ligament's tiny fibers to both tooth and bone secure the tooth in place, as well as supply it and the surrounding gums with nutrients and defensive antibodies to fight infection.

Implants don't have this relationship with the periodontal ligament. The tissues around an implant are thus susceptible to an aggressive form of periodontal (gum) disease called peri-implantitis. This kind of gum infection can progress rapidly, leading eventually to bone loss and possible failure of the implant.

Daily brushing and flossing of both natural and implant-supported teeth lowers the risk of gum disease, particularly peri-implantitis. It's also imperative that you undergo regular cleanings, at least every six months, with your dentist or dental hygienist.

These, however, won't be the typical cleanings performed on natural teeth. Hygienists don't use metal cleaning implements to remove plaque and tartar deposits because they can scratch the metal materials of the implant and crown. These microscopic scratches can then attract bacteria that trigger gum infections. Instead, they'll use instruments made of plastics or resins.

Hygienists also rely heavily on ultrasonic equipment that vibrates plaque loose on or around implants, which are then flushed away with water. The tips used with these instruments are also typically made of nylon or plastic sheathing.

Even with the extra hygiene care needed, implants still enjoy a 95% or higher survival rate after ten years. You can ensure your implants achieve that level of durability by keeping them clean and seeing your dentist at the first sign of a gum infection.

If you would like more information on maintaining 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.”

By Michael C Scheske, DDS, PC
December 19, 2020
Category: Oral Health
Tags: oral health  
BoostYourDentalHealthWithSoon-To-ExpireFSAFunds

If you're among the estimated 14 million families with a healthcare flexible spending account (FSA), New Year's Eve has an added meaning—that's typically the deadline for using any current year funds. Since any remaining money in your FSA could go poof at the stroke of midnight on December 31st, you might be looking for a way to spend it. If so, consider a dental health boost for you and your family.

FSAs were created in the 1970s by the U.S. Government as a salary benefit that employers could offer employees. Instead of receiving all of their pay as taxable income, employees could designate a portion of it (currently up to $2,650) in a non-taxable account to use for certain medical and dental expenses. An FSA thus provides families a way to pay for uncovered healthcare costs while saving on their taxes.

But because most FSAs expire by the end of the year and then restart with a fresh balance in the new year, there's a natural concern that you will “use or lose” remaining money. People thus begin looking for eligible expenses like treatments, prescribed medications or eyeglasses. They can't, however, use them for items like over-the-counter medical products (though some pain relievers get a pass this year because of COVID-19), as well as most things cosmetic.

The same generally holds true for dental expenses—you won't be able to use FSA funds for procedures like teeth whitening or veneers. Toothbrushes and other routine oral care products are also ineligible, although you may be able to buy items like a water flosser if your dentist issues you a Letter of Medical Necessity (LMN).

Still, there's a wide range of eligible dental items you could pay for with remaining FSA funds.

Prevention measures. Any procedures or treatments intended to prevent disease are typically FSA-eligible. These can include measures like regular dental cleanings, sealants or fluoride applications.

Disease treatment. FSAs cover procedures like fillings, extractions, gum surgery or root canals. This could include repairing damage from disease through dental bonding or crowns, which might also improve your smile.

Dental restorations. Missing teeth restorations like bridgework, dentures or dental implants are also covered. These may improve your appearance, but they primarily restore disrupted dental function.

Out-of-pocket expenses. Although you can't pay for dental insurance premiums, an FSA may be able to help in other ways. You can use FSA funds for co-pays or any remaining out-of-pocket expenses.

If you're not sure what dental expenses might be eligible for FSA funds, give our office a call and we can provide you guidance. If FSA funds can help, you'll be able to improve your dental health—and possibly your appearance—before you ring in 2021.

If you would like more information about managing your dental care, please contact us or schedule a consultation.

TargetedToothRemovalCouldAidTreatmentforCertainBiteProblems

Before we begin correcting a malocclusion (poor dental bite), we need to ask a few questions: How extensive is the malocclusion? How far must we move the teeth to correct it? How might the patient's jaw size impact treatment?

Answering these and other questions help us develop an effective treatment plan. And depending on the answers, we might need to look at other procedures before we install braces—like removing one or more of the teeth.

This isn't a subject to approach lightly: All teeth play an important role in dental function and smile appearance, and ordinarily we want to preserve teeth, not remove them. Sometimes, however, it may be a necessary action to achieve our goal of an improved dental bite.

For example, it might be necessary for correcting a malocclusion caused by severe teeth crowding. This occurs when one or both of the jaws hasn't grown to a sufficient size to accommodate all of the teeth erupting on it. As a result, some of the teeth could come in out of their proper alignment.

If caught early before puberty, we may be able to use other techniques to alleviate crowding, like a device called a palatal expander that influences an upper jaw to widen as it grows. If successful, it could provide later teeth more room to erupt in their proper positions.

But even if additional jaw growth occurs, it may not be enough to avoid a malocclusion or treatment with braces. Alleviating further crowding by removing teeth in little noticed areas could help with subsequent orthodontics.

Removing teeth may also be the answer for other problems like an impacted tooth, in which the tooth has not fully erupted and remains submerged in the gums. It's sometimes possible to use a technique to “pull” the tooth down where it should be; but again, that will still require jaw space that may not be available. The more effective course might be to remove the impacted tooth.

Whether or not tooth extraction will be needed can depend on a thorough orthodontic evaluation and full consideration of all the available options. Even though the ideal situation is to correct a bite with all teeth present and accounted for, it may be for the better good to sacrifice some.

If you would like more information on orthodontic techniques, 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 “Removing Teeth for Orthodontic Treatment.”

By Michael C Scheske, DDS, PC
November 29, 2020
Category: Dental Procedures
Tags: loose tooth  
WeNeedtoActQuicklytoSaveYourLooseTooth

If you're an adult, your teeth shouldn't wiggle—not even a little bit. If you have a loose tooth, you need to see your dentist as soon as possible to avoid losing it permanently.

Loose teeth usually happen because of one of two kinds of bite-related trauma. One is known as primary occlusal, which usually happens when the periodontal (gum) structures that help secure teeth encounter higher than normal biting forces. This is usually due to a clenching or grinding habit.

The other and more common kind is secondary occlusal: This happens when the periodontal structures and supporting bone are in a weakened state, usually because of gum disease. In this condition, even normal biting forces can cause damage to a tooth's gum attachment and result in looseness.

To stop a loose tooth from becoming a lost tooth, we'll need to take these immediate steps.

Treat any underlying disease. If a gum infection is the culprit, our first priority is to stop it from doing any more damage. The main treatment for gum disease is to remove dental plaque, a thin film of bacteria and food particles that's the usual cause for the infection. Depending on how much the infection has advanced, this could take several sessions to bring it under control.

Reduce abnormal biting forces. If teeth are loose from abnormally high bite forces, there are a few things we can do. One is to selectively reshape the biting surfaces of teeth so that they receive less force while biting. Another approach is to minimize the effect of teeth grinding with an occlusal guard worn in the mouth: Its slick plastic surface prevents teeth from making solid contact while biting.

Splint loose teeth to secure them. We can secure loose teeth by splinting them to more stable teeth with metal strips or other means. Splinting is often done in conjunction with the aforementioned treatments, and is usually temporary until the tooth regains its periodontal attachments. Sometimes, though, it may be necessary to permanently splint a weakened tooth.

A loose tooth isn't necessarily destined to be lost. But we'll have to act quickly—if you have a loose tooth see us as soon as possible to determine how best to save it.

If you would like more information on saving loose teeth, 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 “Treatment for Loose Teeth.”

By Michael C Scheske, DDS, PC
November 19, 2020
Category: Oral Health
Tags: dental injuries  
ProtectYourChildFromaDevastatingDentalInjury

Parents love watching their kids grow up, from those early wobbly steps to their first solo car drive. Of course, you can expect a few mishaps along the way, most of which won't leave them worse for wear. But some risks are just too hazardous to ignore—including the potential for dental injuries.

Each year, one in ten children suffers a traumatic dental injury, many of which require extensive treatment. That's why during National Child Safety and Prevention Month in November, we're highlighting areas of risk for pediatric dental injuries, and how you can prevent them.

That risk changes depending on a child's stage of development. Teething infants, for example, relieve gum pressure by gnawing on things. Make sure, then, that you have items for teething made of cloth or soft plastic, and keep harder items that could damage their gums and emerging teeth out of reach.

Toddlers learning to walk encounter numerous injury opportunities, like a fall that lands them face first on a hard surface. You can reduce this risk by moving tables and other hard furniture out of your child's travel paths, covering sharp edges with padding, or simply isolating your child from home areas with hard furniture.

Pay attention also during bath time. Wet porcelain is notoriously slippery even for adults, and possibly more so for a child. A sudden slip in the bathtub could cause a mouth injury, so encourage your child not to stand until it's time to get out.

School-aged children face another set of perils to their mouth from outside play. At this stage, your best preventive measure is teaching them to observe play safety: Make sure they know not to aim balls, frisbees or other play items at others' heads, and to be on the lookout for the same. You'll also want them to be safety-minded playing on swings, monkey bars or other playground equipment.

If your older kids take an interest in sports, particularly the contact variety, you'll want to protect them with an athletic mouthguard (and encourage them to wear it during both practice and regular games). You can purchase a mouthguard at any retail or sporting goods store, but the most protective and comfortable to wear are custom-made by a dentist. Although more expensive, they'll still cost less than treatment for a traumatic dental injury.

The wonderful adventure of childhood does have its risks, and some are more serious than others. By following these prevention tips, you can help your child avoid a dental injury that could rob them of a healthy mouth.

If you would like more information about childhood dental concerns, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Dentistry and Oral Health for Children” and “An Introduction to Sports Injuries & Dentistry.”





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