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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.

Kids.Teeth can last a lifetime if you take care of them right — and the best time to start is just as soon as they begin appearing. By establishing good oral hygiene routines for your children right from the start, you'll give them the best chance of keeping their teeth healthy — forever.

Tooth decay, the major cause of dental trouble that can eventually lead to tooth loss, is actually an infectious disease caused by bacteria. If it takes hold, it can form a cavity in the enamel and then progress deeper into the tooth — causing discomfort, difficulty eating and speaking, and a need for fillings or root canal treatment. The good news is that tooth decay (also called caries) is completely preventable.

The primary route to good dental health is plaque removal. Plaque is the sticky, whitish film that builds up on teeth in the absence of effective oral hygiene. Decay-causing bacteria thrive in plaque, where they break down any sugar that lingers in the mouth. In the process, they produce acid byproducts that erode teeth. This is how a cavity begins. What are the most effective techniques for plaque removal and decay prevention? That depends on the age of your child.

Babies

Age one dental visit video

Babies can develop a form of tooth decay known as early childhood caries. This occurs when they are allowed to go to sleep with a bottle that's filled with anything but water. The sugars in formula, milk (even breast milk) and juice can pool around the teeth and feed decay-causing bacteria. When it comes to bedtime soothing, a pacifier or bottle filled with water is safer for developing teeth — that is, until about age 3. At that point, sucking habits should be gently discouraged to prevent orthodontic problems from developing later on.

Brush your baby's first teeth gently with a small, soft-bristled toothbrush, using just a thin smear of fluoride toothpaste, at least once a day at bedtime. Before a tooth is fully erupted, you can use a water-soaked gauze pad to clean around the tooth and gums.

Make sure your child has his or her first dental visit by age 1. There, you can learn proper hygiene techniques; have your youngster examined for signs of early decay; and get a recommendation for fluoride supplements if needed.

Children

Tooth tips for tots video

Starting at age 2, you can begin teaching your child to brush with a children's toothbrush and no more than a pea-sized amount of fluoride toothpaste. But remember, children will need help with this important task until about age 6, when they have the fine motor skills to do an effective job themselves.

It's also extremely important to start encouraging healthy dietary habits at this time. Your child will have less plaque buildup and decay if you place limits on soda and sugary snack consumption. As a parent, you can model this behavior to instill it in your child. After all, monkey see, monkey do! Any sugary treats that are allowed should come at mealtimes, not in between. This will ensure your child is not creating favorable conditions for oral bacteria to grow around the clock.

At your child's regular, twice-yearly dental checkups and cleanings, topical fluoride can be applied to strengthen tooth enamel and make it more resistant to erosion and decay. If necessary, dental sealants can be applied to the back teeth (molars) to prevent food particles and bacteria from building up in the tiny grooves where a toothbrush can't reach (View Dental Sealant Video).

Teens

At this point, your children have the primary responsibility for maintaining their day-to-day dental health — but you can continue to help them make good dietary and behavioral choices. These include drinking plenty of water and avoiding soda, sports drinks and energy drinks, all of which are highly acidic; avoiding tobacco and alcohol; and continuing to visit the dental office regularly for cleanings and exams. This is particularly important if your teen wears braces, which can make it more difficult to keep teeth clean.

Remember, it's never too soon to help your child develop good oral hygiene habits that will last a lifetime.

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