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Imagine this: An implant surgeon is performing a thorough examination of your mouth. The surgeon rotates your jaw from side to side and up and down, looking for the optimal sites in which to place dental implants — and the proper size, shape and orientation for the implants to have. He or she may test several alternatives, considering the underlying anatomical structures, and the bone density and quality that the examination reveals. Finally, a surgical plan is developed: This includes a set of precise specifications for implant position, size and depth, and a template for creating a perfectly fitting set of replacement teeth. But no invasive procedures of any type have been performed so far. In fact, you aren't even present.

Welcome to the world of computer-guided dental implant surgery. What we have described is one step in the process that allows you to receive a set of replacement teeth with the minimum amount of surgery (and time spent in the dental chair), and the maximum level of preplanning foresight. It can result in faster overall treatment time, less discomfort, and an outcome that pleases everyone. Let's look a little more closely at the entire process of computer-guided implant surgery — a procedure at the forefront of dental implant technology.

The First Phase: Making A Virtual Model

It all begins with a complete examination and modeling of your existing teeth, gum and jaw structures. In many cases, a physical impression (replica) of the jaws is made, which will aid in planning the location of the new teeth. But the modeling doesn't stop there: A high-tech, three-dimensional CT (computed tomography) scan is also performed. This allows us to examine the structures (including bone, nerve tissue and sinus cavities) which lieinside the jaw. It is often accomplished using “cone-beam” CT technology, in which the scanning device quickly captures a complete digital image of internal structures as it rotates around your head.

The next step of the process relies on powerful computers and sophisticated software to take the raw CT scan data and translate it into a 3-D model of the jaw. This virtual model can be manipulated on a computer screen — rotated, measured, even “operated” on — so that we can visualize the placement of dental implants and determine their optimum position with a high degree of accuracy. Using this technology, it's now possible for us to evaluate anatomical structures virtually — structures it once would have taken surgery to reveal — and to plan out the implant procedure accordingly.

The 3-D model we have developed is then used for two purposes: to create a precise guide for the implant surgery, and to allow the dental laboratory to pre-manufacture a set of replacement teeth that will fit precisely in the jaw. An advanced set of CAD/CAM (computer aided design/manufacture) processes is used to generate the physical objects — in this case, the surgical guide and the prosthetic teeth. Depending on your individual situation, the new teeth may be attached the same day as implant surgery, or after a healing period of 6 to 12 weeks. In either case, our precision modeling ensures that they will fit perfectly with the implants and the jaw.

Implant Surgery: Following the Plan

The implant surgery itself is typically performed under local anesthesia, and often requires no sutures (stitches). In the surgical procedure, the template we have produced (which resembles a nightguard or athletic mouthguard) is securely (but temporarily) fixed in position on the jaw. The openings in this template form precise guides for the placement of the implants — accurate in terms of position, width and depth. In fact, the implants fit so perfectly into these prepared sites that we can have new teeth placed the same day as implant surgery.

Since so many of the details have been accomplished in the planning stages, computer-guided implant surgery is typically uneventful for the patient. It can result in shorter time in the chair, less discomfort during recovery — and a highly pleasing result. It has even been called the most significant innovation in implant technology since osseointegration — the fundamental process by which a dental implant becomes fused with the bone.

Tooth Decay.Tooth decay is often called the second most prevalent human disease, after the common cold. Without effective treatment (as was the case through most of history) it can lead to pain, tooth loss, and sometimes worse illnesses. Even today, it's estimated to affect over a quarter of U.S children from ages two to five, and half of those aged 12-15. But it doesn't necessarily have to! You can take steps to prevent tooth decay from harming your teeth — or those of your loved ones.

There's one important fact you should understand up front: No single “magic bullet” can stop tooth decay in every case. Instead, fighting decay should be viewed as a process of preventive maintenance, like taking care of your car — except that (unlike a car) your natural teeth, with proper care, can last a whole lifetime. The basic aspects of this process are practicing good oral hygiene at home, and coming in to the dental office for regular cleanings and checkups.

If you've been in the dental office for routine visits, you're probably already familiar with the special tools dentists use to remove buildups of plaque (a bacterial biofilm) and tartar (a hardened deposit, also called calculus) from your teeth. Hand-held instruments, ultrasonic scalers, or both may be used to give your teeth a thorough cleaning. Afterwards, your teeth are thoroughly checked for decay, and cavities are treated when necessary.

Yet there's still more that can be done to prevent tooth decay. Could your diet be a contributing factor? Is your brushing technique adequate? Could you benefit from additional preventive treatments? Today, with our increased understanding of what causes tooth decay and how to treat it, it is possible to focus on what decay prevention tactics would work best in your particular case. In fact, it's now possible to assess each individual's risk factors for decay, and concentrate on doing what's most effective for you.

How Does Decay Start?

Tooth Caries Balance.

It's useful to think of the mouth as a dynamically balanced ecosystem, in which living organisms, including helpful and harmful bacteria, are constantly interacting. When conditions are right — namely, in the presence of certain sugars — some pathogenic (harmful) bacteria produce acids that cause teeth to lose minerals and begin breaking down. Even a diet having excessive acidic foods can influence deminerialization of your teeth. But in more favorable conditions, the damage these pathogens do is undone by the body's own healing mechanisms — which includes your healthy saliva.

A major goal in decay prevention is to tip the balance in favor of the beneficial processes. Keeping up a regular habit of brushing and flossing, getting adequate fluoride, and a diet with limited acidic foods is certainly helpful. Yet even with these measures, some individuals will be more prone to tooth decay than others, and may need extra help and guidance.

Additional Steps to Prevent Tooth Decay

If you're one of these individuals, it may help you to learn effective brushing techniques and practice other measures at home — for example, using special toothpastes or mouthrinses. When necessary, in-office treatments such as topical fluoride applications are available. If you aren't getting enough fluoride through drinking water or other sources, this treatment can help prevent tooth decay. Anti-bacterial treatments may also be beneficial in some cases, as is nutritional counseling.

Dental Sealants.Finally, if your child's teeth are susceptible to tooth decay, consider having a dental sealant applied. This is a practically invisible layer of plastic resin that is placed on the top (chewing) surfaces of the back teeth. It's a painless procedure that fills in the natural pits and folds of the tooth, making them much more resistant to bacterial damage.

So, don't think that tooth decay is inevitable — instead, find out what you can do to help prevent this disease from affecting you or your loved ones.

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