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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.

Dry mouth.Everybody gets a dry mouth from time to time. Temporary mouth dryness can be brought on by dehydration, stress, or simply the normal reduction in saliva flow at night. But persistent mouth dryness, a condition known as xerostomia, is cause for concern.

Xerostomia occurs when your salivary glands, which normally keep your mouth moist by secreting saliva, are not working properly. A chronic lack of saliva has significant health implications. For one thing, it can be difficult to eat with a dry mouth; tasting, chewing and swallowing may also be affected. This could compromise your nutrition. Also, a dry mouth creates ideal conditions for tooth decay. That's because saliva plays a very important role in keeping decay-causing oral bacteria in check and neutralizing the acids these bacteria produce; it is the acid in your mouth that erodes tooth enamel and starts the decay process. A dry mouth can also cause bad breath.

Possible Causes

There are several possible causes for xerostomia, including:

  • Medications. For most people suffering from dry mouth, medications are to blame. According to the U.S. Surgeon General, there are more than 500 medications (both prescription and over-the-counter) that have this side effect. Antihistamines (for allergies), diuretics (which drain excess fluid), and antidepressants, are high on the list of medications that cause xerostomia. Chemotherapy drugs can also have this effect.
  • Radiation Therapy. Radiation of the head and neck can damage salivary glands—sometimes permanently. Radiation to treat cancer in other parts of the body will not cause xerostomia.
  • Disease. Some systemic (general body) diseases can cause dry mouth. Sjögren's syndrome, for example, is an autoimmune disease that causes the body to attack its own moisture-producing glands in the eyes and mouth. Other diseases known to cause dry mouth include diabetes, Parkinson's disease, cystic fibrosis and AIDS.
  • Nerve Damage. Trauma to the head or neck can damage the nerves involved in the production of saliva.

Getting Relief

If you are taking any medication regularly, it's possible that your physician can either suggest a substitute or adjust the dosage to relieve your symptoms of dry mouth. If this is not possible or has already been tried, here are some other things you can do:

  • Sip fluids frequently. This is particularly helpful during meals. Make sure what you drink does not contain sugar and isn't acidic, as these will both increase your risk of tooth decay. All sodas, including diet varieties, should be avoided, as they are acidic and attack the tooth surface.
  • Chew sugarless gum. This will help stimulate saliva flow if your salivary glands are not damaged. Choose a variety that contains xylitol, a natural sugar substitute that can be protective against tooth decay.
  • Avoid drying/irritating foods and beverages. These include toast and crackers, salty and spicy foods, alcohol and caffeinated drinks.
  • Don't smoke. This can dry out the mouth and also increase your risk of gum disease.
  • Use a humidifier. Running a cool-mist humidifier at night can be soothing.
  • Use saliva stimulants/substitutes. There are prescription and over-the-counter products that can either stimulate saliva or act as a substitute oral fluid. We can give you some recommendations.
  • Practice good oral hygiene. Brush at least twice a day with a fluoride toothpaste; this will remove bacterial plaque and add minerals to strengthen your teeth. Don't forget to floss.
  • Have an exam/cleaning. If you have dry mouth, it's more important than ever to maintain your regular schedule of visits to the dental office. Please be sure to let us know what medications you are taking, particularly if there have been any changes recently. We will do our best to help relieve any dry-mouth symptoms you are experiencing.

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Dry Mouth Dry mouth, caused by insufficient saliva flow, is more than a minor annoyance to the millions who suffer from it. That's because saliva helps maintain oral health in a variety of ways. If your mouth is persistently dry, here's what you should know... Read Article