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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.

Couple.Today, Americans are not only living longer — we're also retaining our natural teeth longer than ever before. But this rosy picture isn't free of thorns: Older adults tend to require increasingly complex dental treatments; are often more prone to contracting certain diseases; and sometimes find it challenging to keep up with daily oral health practices.

Yet maintaining good oral hygiene is critically important as we age. When problems occur in the mouth, they can cause difficulty chewing, swallowing, speaking and smiling — basic functions which can affect both physical and social well-being. It's possible that medications prescribed for other diseases can adversely affect a person's oral health; it's also possible that a decline in oral health can worsen existing maladies (such as diabetes), or even cause systemic (whole-body) inflammation. What other special dental issues do older people face — and what can be done about them?

Dental Concerns for Older Adults

If you think cavities are just for kids — think again! A recent study found that nearly one-third of people over 65 had untreated dental caries (cavities). In older people, these are found not only in the crown (chewing surface) of the tooth, but also in the root, which may become exposed due to gum recession. Regular dental checkups are the best way to find and treat dental caries; left untreated, they can cause pain, require more complex procedures, and eventually lead to lost teeth.

Gum disease is another major oral health issue faced by older people — and it's presently the leading cause of tooth loss in adults. The disease is caused by plaque bacteria, which thrive on the sticky biofilm that clings to the surface of teeth when they aren't properly cleaned. Poor-fitting dentures can make the problem worse, as can the presence of certain diseases (such as diabetes or cancer).

Sometimes, decreased mobility (due to arthritis or similar conditions) makes routine brushing and flossing more difficult. Special brushes with larger grips and floss holders can help make daily cleaning easier; additionally, therapeutic mouthrinses may be prescribed. In-office treatments can also be effective in bringing gum disease under control.

Blythe Danner Oral Cancer Video.

Oral cancer is a concern at any age, but it's 7 times more likely to show up in a person over 65 — and it causes more deaths in older Americans than skin cancer does. Early detection offers the best chance at controlling the disease, and improves survival rates significantly. A thorough screening for oral cancer should be a part of every older person's routine dental checkup.

Dry mouth (xerostomia) isn't just an annoyance — it can be harmful to your oral health. Aside from its lubricating qualities, saliva contains beneficial digestive enzymes, acid neutralizers, and bacteria-fighting agents. A number of factors may cause the body to produce less saliva than normal — but in older adults, this problem is often due to side effects from prescription or over-the-counter medications. If you're experiencing chronic dryness of the mouth, it's sometimes possible to change your medication, and/or use products designed to relieve these symptoms.

Oral Hygiene For Life

It was once commonly believed that dental problems and the loss of teeth were an inevitable consequence of aging. But here's the fact: Age itself isn't a risk factor for tooth loss; properly cared for, your teeth can last a lifetime. However, it's true that the mouth does change as you age. How can you give yourself the best chance of keeping your natural teeth? You guessed it: Maintain a regular practice of good oral hygiene!

Brush twice a day with a soft-bristled toothbrush — use one with a special grip, or an electric brush, if it helps. Clean in between your teeth with floss, or another type of interdental cleaner, at least once a day. If you wear dentures, regularly clean and care for them as instructed. Eat healthy foods and drink plenty of water. And don't forget to have regular dental exams so that little problems don't turn into major headaches!

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