Michael W. Dukes, DMD, PA

100 Royal Palms Dr Atlantic Beach, FL 32233-3921

My Blog

Posts for: July, 2018

By The Island Dentist
July 28, 2018
Category: Oral Health
Tags: oral hygiene  
ProperBrushingandFlossingRemovesDisease-CausingPlaque

You've been brushing your teeth since you were big enough to look over the bathroom sink: now you brush and floss every day. You do it because you know it's important — but do you know why?

It's because your teeth and gums have enemies: oral bacteria in particular, the major cause for tooth decay and periodontal (gum) disease. The vehicle for these infections is a thin-film of food particles on tooth surfaces called plaque.

Daily brushing removes plaque from broad tooth surfaces, while flossing removes it from between teeth. If you don't brush or floss every day — or you aren't effective enough — then plaque becomes a haven for bacteria which then produce high levels of acid that soften and erode enamel. Bacterial plaque can also trigger gum disease: gingivitis (inflamed gum tissues) can begin in just a few days of not brushing and flossing.

You could avoid these diseases and their high treatment costs with an effective, daily hygiene regimen. There are things you can start doing right now to improve your efforts: be sure to hold your toothbrush (soft, multi-tufted is best for most people) at a 45-degree angle to the gum line and gently scrub or wiggle the bristles across the teeth; cover all tooth surfaces on both sides of the teeth — about two minutes of brushing. Be sure to use a fluoride toothpaste to boost enamel strength and don't apply too much pressure when you brush to avoid damaging your gums.

With flossing it's best to hold a small amount of string between fingers from each hand and work it gently between the gaps of each tooth. You then wrap the floss around each tooth in the form of a “C” and gently move up and down three or four times.

You can check to see if you're performing these tasks adequately by running your tongue across your teeth — they should feel smooth and a little squeaky. The real test, though, is during your next checkup. Hopefully we'll find the hygiene habits you've been practicing your whole life are helping you keep your teeth healthy and disease-free.

If you would like more information on best oral hygiene practices, please contact us or schedule an appointment for a consultation.


RegeneratingLostBoneCanMakeDentalImplantsaReality

Every day the forces you generate when you bite or chew can exert enormous pressure on your teeth. And day after day your teeth remain stable and secure, thanks to an intricate system of periodontal ligaments, attaching gum tissue and bone. The latter element is especially important — healthy bone makes healthy teeth.

And vice-versa — the same biting forces are transmitted through the tooth root to the bone via the periodontal ligament to stimulate new bone growth to replace older bone that has dissolved (resorbed). If a tooth’s missing, however, the bone doesn’t receive that stimulation, and the resorbed bone isn’t replaced at a healthy rate. In fact, you can lose up to a quarter of bone width in the first year alone after tooth loss.

And this can cause a problem when you’re looking to replace that missing tooth with what’s considered the best restorative option available: dental implants. Known for their life-likeness and durability, implants nonetheless need sufficient bone to anchor properly for the best outcome. Without it, implants simply aren’t practical.

But that doesn’t have to be the end of the story: it’s quite possible to regenerate enough bone to support implants through bone grafting. Bone material from the patient (or another donor, human, animal or synthetic) is placed under the gum at the missing tooth site to serve as a scaffold for new growth. The new bone growth will eventually replace the graft material.

The size of the graft and extent of the procedure depends of course on the amount of bone loss at the site. Loss can be kept to a minimum, though, if the graft is placed immediately after a tooth extraction, a common practice now. After a few months, the bone created through the graft is sufficient for supporting an implant and gives you the best chance for a beautiful outcome.

If you’re considering an implant for a missing tooth, you should schedule a consultation appointment with us as soon as possible. After a thorough dental exam, we’ll be able to tell you if bone grafting to support implants is a good idea for you. It adds a little more time to the overall implant process, but the results — a new, more attractive smile — will be well worth it.

If you would like more information on bone regeneration, 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 “Can Dentists Rebuild Bone?


BoneGumsandImplants-KeepingaHealthyBalanceforaBeautifulSmile

Restoring a smile with implants involves more than the surgical procedure itself. We must also take into consideration the quality of the bone they’re placed into and the gums that will surround them — the “canvas” that showcases your new beautiful smile.

Bone — not only at the missing tooth site but supporting neighboring teeth as well — is the foundation for a successful implant. Without an adequate amount of bone, we can’t place an implant to achieve a final life-like appearance. Inadequate bone can be a problem if the tooth has been missing for awhile — without the stimulation of biting forces from the tooth, the bone can shrink gradually over time. Periodontal (gum) disease and other dental conditions can also cause bone loss.

The health of your gums — as well as the tissue type you’ve inherited from your parents, thin or thick — can also determine how natural the implant crown looks as it emerges from them. If they’ve receded due to gum disease they may not regenerate sufficiently, making your teeth longer-looking or leaving the triangular bit of gum tissue between the teeth, the papillae, noticeably missing. If you’ve inherited thin tissue gums, you’re also more susceptible to gum recession and there’s less margin for error during implant surgery.

There are some things we can do to minimize these problems. Tooth removal to make room for the new implant needs to be done carefully with as little tissue trauma as possible; it’s also helpful to place grafting material in the empty socket immediately after extraction, especially if there’s going to be a time gap before implant placement. If bone loss has already occurred, we can also use similar grafting techniques to rebuild the bone.

Likewise we need to take special care during implant surgery when dealing with thin or diseased gums. With the latter, it’s usually necessary to bring the gum disease under control and allow the gums to heal first. In extreme cases, cosmetic gum surgery may also help restore lost tissues and create a more natural look between the gums and the implant crown.

Creating a natural appearance with implants is a blend of technical skill and artistic insight. Keeping the balance between all these factors will produce a smile you’ll be proud to show.

If you would like more information on 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 “Matching Teeth & Implants.”