There are many surgical and invasive procedures carried out in the oral cavity by a dentist in houston, following which antibiotics need to be prescribed for a few days.  After periodontal therapy many a times our periodontist may advise the use of oral or topical antibiotics. Currently a lot of research is being done on the use of topical antibiotics as an alternative to periodontal surgery. One of the examples of such topically used antibiotics is Periostat which is a treatment proceure employing the usage of low doses of Doxycycline. WE are now using it with good results.

Low-dose Doxycycline therapy involves the usage of about 1/5^th of the usual dosage of Doxycycline. It works to prevent the action of collagenase. This is an enzyme that brings about the breakdown of connective tissues supporting the tooth.
Low-dose Doxycycline therapy also requires you continue with effective use of oral hygiene measures and routine appointments for scaling every month for about three months.

Following this therapy it has been observed that the gums reach a very healthy state and there are very few signs if any of gum inflammation.
Once healthy changes are seen the low-dose doxycycline therapy is brought to an end. You then return to your cosmetic dentists in Houston  for regular check-ups.

There are still doubts whether the use of low-dose doxycycline therapy might lead to the development of resistance in one or more bacterial forms or any other systemic complications. But what works in favor of this therapy is the fact that the dosage of the drug used is very low and as such the chances of it having any kind of effect on bacteria or any other micro-organism are very low.  There are also a few studies that have been conducted according to which the use of a common anti-inflammatory drug can add to the effects and help produce better results.
Low-dose doxycycline therapy is a very good alternative to periodontal surgery and the results seen until now are believed to be very promising.

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Dental abfractions are manifested as v-shaped notches or cracks in the neck region of the teeth. One can see these abfraction lesions by pointing a torch on the teeth and looking at their reflection in a mirror. Continuous pressure applied on the teeth over a long period of time leads to the formation of these cracks. Dental abfractions are more common in middle aged or elderly people who grind their teeth a lot. These are found mostly on the posterior teeth but may occur at times in the anterior teeth as well.

The patient who comes to a clinic usually complains of sensitivity problems on eating anything hot or cold due to exposure of the dentin. The dentist would diagnose the cracks during the examination of the oral cavity. These lesions or cracks are irreversible in nature and do not undergo healing. Patients who are suffering from dental abfractions due to grinding of teeth maybe advised by their dentist to wear a night guard appliance which works to decrease the force applied on the opposing teeth.

If the sensitivity problem is not too severe then there is not much treatment that needs to be done. The dental abfractions can be treated by restoring the affected area using a composite material or using a dental cement. Severe dental abfractions may weaken the teeth so it is always best to get the affected teeth restored.

Dental abfractions are not a very serious problem and in many cases do not even need to be treated so you do not need to rush to your dentist in an emergency. You can always put up your sensitivity problems in front of your dentist during your regular check-up visit unless the sensitivity is not troubling you too much. You should not confuse your abfraction problems with tooth fractures as you would feel a lot of pain in those situations.

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First Stages of Treatment

At the first appointment with the dentist, they will discuss with the patient their desired results and explain what is achievable given the patient’s budget and condition of the mouth. Patients often find it hard to visualize what their new smile will look like, and this is where composite mock-ups come into play.

What is composite?

Composite is a material which can be molded, and is the same color as your teeth. They are not a permanent fix for teeth, but can be left in the mouth for several weeks or months. The idea of using a composite is that while the composite mock-ups are in the mouth, both the patient and the dentist can made adjustments to them before the final teeth are created.

Advantages of composite

Composite is not bonded fully to the teeth and can be easily and quickly removed. Should the patient decide not to go ahead with further treatment, the composite mock-ups can be removed and the original teeth polished up to their original state. It also works far better than traditional wax impressions as the patient gets a far more accurate idea of what the end result of their dental treatment will be.

Process

After discussion with the dentist, they will prepare a set of composite mock-ups which will be placed into the patient’s mouth. Photographs may be taken to show the patient for a “before” and “after” effect. Once the mock-ups are in place in the mouth, the patient will be able to live with them for a short period to see how they like their new dental structure. If any adjustments need to be made, then the composite can be re-molded and the new effect evaluated. This process can be repeated several times until a result is achieved that both the patient and the dentist are pleased with. At this stage, the composite mock-ups are used as a blueprint to make a permanent set of teeth for the patient.

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Any dentist practicing cosmetic dentistry in Houston or rather in most areas who is carrying out minimally invasive dentistry would not reduce the tooth structure more than what is actually needed.  If one opts to get such a procedure done then one must plan regular visits to a dentist to ensure that all steps are properly carried out.

The very first step in minimally invasive dentistry is prevention for which the dentist would advise you various steps like regular use of an antibacterial mouthwash, decreased intake of sugars as well as making efforts to maintain a proper oral hygiene status.

For the next step the dentist focuses on using various techniques and procedures such as:-

1. Remineralization- one of the most important goals of this technique is to restore and maintain a proper fluoride level in the oral cavity so that decay chances are minimized.
2. Abrasion- is done using the help of air and is carried out on teeth which cannot be remineralized. This technique involves blasting a stream of air containing abrasive particles onto the tooth surface to remove the decayed part.
3. Sealants- composed of resin particles are placed in deep fissures and grooves that may be prone to tooth decay in future due to the action of bacteria.
4. Inlays- these are fabricated in the laboratory and are like restorations the difference being that the dentist does not need to remove as much tooth structure.
5. Use of splints and night guards- these are given to patients who suffer from problems such as compulsive or sub-conscious grinding of teeth which lead to wearing away of the tooth structure. The patient is advised to wear these appliances especially during the night to get relief from this habit.

If you are wondering where to locate a dentist that uses the concept of minimally invasive dentistry then you do not need to work too hard as most of the dentists these days are following these techniques.

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Before we discuss the details of connective tissue grafts let us talk a little about gum recession which is the reason behind people choosing to go for this procedure. Gum recession is a very common problem and a large number of people are affected by this problem. Most of us do not notice any recession in the gums till it reaches a point that it starts looking obvious. Teeth that have receded gums around them look bad and one can even start having sensitivity problems on eating hot or cold food. If gum recession is allowed to progress then it can be damaging to the tooth as it may become loose because of periodontal involvement.

Considering the above mentioned reasons it is important that some efforts are made to prevent further recession as well as restore the gums to their earlier levels. Placing a connective tissue graft is one of the most effective ways of dealing with gum recession and a lot of people have been satisfied with the results following this procedure.

For getting this procedure done one has to set up an appointment with a periodontist. our periodontist would start by administering anesthesia to the concerned area and then proceed with the procedure. When placing a connective tissue graft a piece of skin from the palate region of the mouth is cut out. Following this tissue from below the flap removed is taken out and is placed under the receded gums. The flap removed from the palate is then placed back into its position and then stitches are placed in both the regions.

There is also the option of placing an alloderm artificially prepared graft for this procedure depending on the affordability and other criteria. This procedure works well for enhancing the levels of the gums in front of the teeth but is not that effective in the region between the teeth.

The good thing about getting this procedure done is that it is effective and the effects remain in place for a long time. By opting to get connective tissue grafting done one can get a nice healthy smile back and look younger.

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Ask for advice

Firstly, ask advice from your Houston dentist or hygienist about how he or she would recommend you clean your teeth. If you are unsure, ask them to demonstrate the most effective brushing and flossing techniques. Brushing and flossing on a regular, twice-daily basis will ensure you are laying good foundations for ongoing oral health. It is important to take care to brush the full surface of the teeth, as well as the sides and up into the gum region as these are the areas most often missed when brushing and where bacteria are most likely to develop. Teeth should be brushed twice a day for at least two minutes each time, ideally after you have eaten. Flossing should be done daily, after you have brushed your teeth. Flossing is essential as it reaches parts of the teeth that are impossible to reach with just a toothbrush.

Bacteria Build-Up

It is impossible to stop some bacteria from developing in the mouth, however often and however diligently you brush and floss. 72 hours after cleaning, the bacteria in the mouth have already formed hard deposits on your teeth. If the teeth are not properly cleaned, the bacteria and hard deposits can start to cause problems with gum disease. At first, the gums will become red and sore, and you may notice blood when you brush. This first start of gum disease is known as gingivitis. If brushing techniques do not improve and the gum disease is left untreated, then gums can start to recede, causing a great deal of pain. If the gum disease progresses to the most extreme stage where the bone in the jaw is affected, then the only way of remedying the damage caused to the teeth is often to remove them completely. This advanced stage of gum disease is called periodontal disease.

Book Regular Dental checks and Cleaning

Despite the bad news about bacteria build-up, the good news is that it takes around 6 months for the bacteria to get to the stage of causing gum disease problems. Therefore it is important to have your teeth both examined and cleaned professionally at 4 or 6 month intervals.

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1)      The intensity of pain varies and it is based on encountering the complications during surgical procedure or in case of undergoing implant associated surgeries such as bone grafting procedures and other surgeries. You can experience pain more than usual and it is considered to be quite normal as it can be managed by following certain measures that are prescribed by your implant surgeon. In fact, the soreness is expected to subside by 3 to 5 days and the pain must subside by 7 to 10 days. However, the sensation of pain after soreness subsides is a common phenomenon that can be encountered post-surgically for 4 to 5 days as it occurs in all kinds of surgeries.

2)      The soreness must always subside. It is normal to have  pain  for around 2 to 3 days followed by slight discomfort from 4^th day which subsides and appears gradually. Presence of swelling indicates infection and you must contact your implant dentist. The infection can be managed with antibiotics.

3)      Healing factor is dependent on the severity of dental implant pain that you encounter. Few people respond quickly by experiencing less soreness and pain which hastens the healing process compared to others.

In general, implant pain must subside after a week to 10 days of procedure as it indicates implant failure if you still experience any eventful pain. Implant failure can occur due to many causes such as Infection, Improper placement of dental implant, long healing cap, nerve impairment, loose implant, Substandard fixtures, bone burn, gum pressure induced by a temporary bridge.

Infection: Dental implant infection is the main responsible factor of Implant failure which occurs at an area of jawbone where the implant fixture is placed and it is associated with pain, swelling with redness, unpleasant smell, and unpleasant taste. Sometimes, the nerve can get affected and pain cannot be experienced due to numbness. However, swelling with redness implies implant infection and it requires attention from an implant dentist. If left untreated, the infection from gums can spread deeper to bone resulting in bone loss and complications. Infection and pain can be alleviated with antibiotics and other medications as it occurs due to substandard fixtures, oversized crowns, loose implant or loose healing cap.

A loose healing cap: It comprises of a tiny screw that is placed on the top of the implant during gum healing stage which is later removed during a crown placement on the implant. This healing cap can get loose due to healing process causing gum irritation and soreness which can be managed by refitting the healing cap after removing it and cleaning the top of the implant.

A loose implant: A loose implant can cause severe pain and it has to be removed to avoid further complications however implant heals into the bone and merges with it in few cases. The use of substandard fixtures provide poor fitting resulting in gap formation on screwing which lodges bacteria causing pain and hence the use of well standardized fixtures can solve the problem.

Bone burn: The bone can get damaged rarely by the heat generation of a drill during an implant procedure which delays bone healing causing pain as an area of bone remains dead. As a result, removal of implant and a dead layer of bone with bone grafting to fill up the bone space can promote the healing process.

Gum impingement caused by temporary bridge: It can occur by the presence of temporary tooth (dental flipper tooth replacement) in the gap during healing process causing pain due to gum impingement over the implant.

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In this section we want to answer any questions you might have about your treatment and the follow-up care.

And as always, we are here to help !!   Just e-mail or give us a call.

• After a filling
• After a crown preparation
• After a new crown was placed
• After implant surgery
• After an extraction

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removable partial denture

Initially, the patient must be assessed thoroughly with radiographs and CT scan prior to considering an implant procedure and the person must meet all necessary requirements that result in implant success. However, additional treatment is required prior to implant placement in case of receding gums which commonly occurs due to the downward movement of gum tissue towards the root. The recession of gums progresses further resulting in bone exposure which hinders the esthetic appearance of an implant. Moreover, implants can cause further gum recession where the titanium screw of a dental implant can become visible and can cause compromise the health of a gum tissue resulting in severe bone loss and finally implant failure.  Hence receding gums must be corrected and treated by a surgical procedure called gingival grafts (gum graft). In this procedure, a soft tissue template is obtained from the roof of the mouth and it is transplanted into the site of recession. Furthermore, this treatment is performed in case of gums that are thin by grafting them in order to prevent the visibility of an implant. Following proper precautionary measures can prevent the recurrence of gum recession. Maintaining healthy oral hygiene, regular treatment follow ups and cessation of smoking can contribute to implant success.

Dental Implants are implanted directly into the jawbone and their functional properties are similar to natural teeth. They are custom made, fixed and permanent alternatives to denture. The major advantage is they stimulate the bone on mastication and avoid bone loss when compared to dentures. Implant success rate is higher in seniors on maintaining normal health and integrity of the gums and bone. Moreover, dental implants prevent the recession of gums and loss of bone in the jaw.

The commonly recommended implants in case of patients with receded gums and long term denture wearers are mini implants as they stabilize the denture. These are the implants with narrow diameter which can be inserted into the denture and jaw bone followed by relining of denture which is supported with implants. The heads of the mini dental implants secure the dentures by providing strong foundation. However, these implants do not stabilize the denture completely and carry a higher risk of failure. The bar over denture provides an option of stabilizing the denture completely. In contrary, conventional dental implants are often recommended as they carry a higher success rate for long term.

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Medical issues which may affect implants

A person’s medical health needs to be taken into account as smokers are more likely to suffer implant failure, as are people with systemic diseases such as diabetes.  This is because medical conditions can affect the health of the gum tissue, and the gums of smokers and diabetics are less able to fight off any infections such as periodontal disease.  Their condition can cause vascular changes to the gum tissue which inhibit its ability to receive sufficient nutrients and thus less make them less able to repair and produce the necessary antibodies to fight bacteria.  It’s quite likely that smokers may be recommended to give up the habit if they wish to have implants that last a lifetime.  Although diabetics or anyone else suffering from diseases which affect the immune system doesn’t have this luxury of choice, they can help prolong the life of their implants by following a good oral hygiene routine.

Avoiding periodontal disease

Periodontal disease can affect the gums and the site of the implants in the same way that it affects the gums around natural teeth, so it’s important to ensure that any signs of the disease are eliminated before implant placement, and that care is taken to avoid periodontal disease in the future.  The best way to ensure this is to visit the dentist regularly and to schedule cleanings with the hygienist at least every six months.  The hygienist is the best person to clean the implants thoroughly which will lessen the chance of gum disease.  They will also check that you are cleaning your teeth correctly.

Good oral hygiene helps prolong the life of implants

Anyone who has had implants should be prepared to take extra care of them, and this includes having regular dental check-ups as well as following an oral hygiene routine.  Teeth should be brushed after every meal, and a small toothbrush or interdental brush used to clean the abutments.  Floss can also be used to clean around the gums and abutments and prosthetic teeth.  Removable prosthesis should be taken out of the mouth so that the abutments can be cleaned and flossed thoroughly, while fixed prosthesis should be cleaned as thoroughly as natural teeth, and the interdental brush and floss can be used to clean in between and around the abutments.

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