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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.

Oral hygiene.What does good oral hygiene mean to you: Flashing a pearly-white smile? Having fresh smelling breath? Feeling that squeaky-clean sensation all around your teeth and tongue? All of these are important indicators about the state of your oral health — and they're often the first thing people notice when they meet you. But getting your teeth, gums and mouth really clean, and maintaining that healthy state throughout the day (and in the months between professional dental cleanings) can be challenging.

Of course, there's much more to oral hygiene than just a bright smile. Take tooth decay, for example: Despite all our efforts, it's still the single most common chronic disease of childhood, affecting two-thirds of U.S. kids aged 12-19. It is 5 times more common than asthma, 7 times more common than hay fever — and it's almost totally preventable. Several other diseases commonly affect the mouth, including periodontitis (gum disease), which, if left untreated, can lead to tooth loss and possibly systemic (whole-body) inflammation.

In many ways, the health of the mouth mirrors the health of the body. Diseases in other parts of the body often cause symptoms we can observe in the mouth; likewise, oral maladies (like tooth loss) not only reduce an individual's quality of life, but may also lead to problems in other areas. That's another reason why maintaining good oral hygiene is so important.

Keeping Up Your Oral Health

Regular dental visits play a critical role in maintaining your oral health — not only to find and remedy any problems with teeth or gums, but also to assess the general condition of your oral health, point out potential trouble spots, and offer suggestions for preventive care. In between visits, the best way to keep your teeth clean and free of disease, your gums pink and healthy, and your breath fresh, is a program of daily oral hygiene. Your regular routine should include the following:

  • Brush and Floss. You should brush at least twice a day and floss at least once daily. This will help remove plaque, a bacteria-laden biofilm, from the surfaces of your teeth. The bacteria in plaque can turn sugars from food into acids, which attack the tooth's enamel and cause tooth decay. Some bacteria can also cause gingivitis and other gum diseases.
  • Make sure you're getting the proper amount of fluoride. Fluoride strengthens tooth enamel — it's essential for children's developing teeth, and helps prevent decay in both kids and adults. Even if your municipal water is fluoridated, you should always use fluoride toothpaste. If more fluoride is needed, it can be applied directly to your teeth at the dental office.
  • Limit between-meal snacks. Sugary snacks are the perfect fuel for decay-causing bacteria — and when eaten throughout the day, they keep the acid constantly on the attack. So give your mouth a break, and (if you allow them) limit sugary treats to mealtime.
  • Use an appropriate mouthrinse — especially if you're at increased risk. Therapeutic mouthrinses do more than temporarily mask bad smells or tastes in your mouth — they can improve your overall oral hygiene. While some over-the counter products offer primarily “cosmetic” benefits, therapeutic rinses contain anti-bacterial and anti-cariogenic (cavity-fighting) ingredients. Using a therapeutic mouthrinse has been proven to control plaque bacteria and prevent cavities better than brushing and flossing alone.
  • Quit tobacco. Whether smoked or smokeless, tobacco use greatly increases your risk of oral cancer, gum disease, and tooth decay (not to mention heart disease and lung cancer… but you already knew that). If you use tobacco, ask us how to quit now.
  • Examine your mouth regularly. Once you've established a regular routine, you'll quickly recognize any changes in your mouth — like chipped teeth, red or swollen gums, or unusual sores. If you find something of concern, let us know. Early treatment offers the best chance to remedy many problems.

A major goal of modern dentistry is to help you keep your teeth and gums healthy for a lifetime. By following a conscientious program of oral hygiene, you have the best chance at making this goal a reality.

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