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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.

New parents have plenty to worry about: making sure their baby is healthy and happy, re-arranging their lives around hectic schedules and lost sleep, and figuring out what to do in all sorts of novel situations. When it comes to your child's oral health, though, there's plenty of help available. It all begins when you bring your youngster in for his or her first visit to the dentist.

According to the American Academy of Pediatric Dentistry, a child's first checkup should occur by age one. Surprised? You shouldn't be! Even though there may only be a few baby teeth visible at that age, there are plenty of things to start working on — including the development of healthy habits that will make future visits to the dentist far more pleasurable.

Unfortunately, some kids develop tooth decay at an early age. We will be on the lookout for cavities — but that's only one reason for an early visit. Equally important is reviewing the proper ways to care for a young child's mouth, going over your child's developmental milestones, and discussing the importance of good oral hygiene.

Preparing for the Big Day

The way kids seem to pick up on their parents' feelings sometimes seems uncanny; so, if you're nervous about going to the dentist yourself, try not to let it show. Generally, this first visit involves simply talking to you and your child, looking in his or her mouth, and making oral health assessments. It's best to tell your child what to expect beforehand, without making too big a fuss about it. You could even build some excitement by helping them get ready for “the big day.”

It's a good idea to bring a comforting toy, a snack, and an extra diaper or two, just in case of fussiness. If possible, leave other kids at home, so the new patient can get all the attention. If not possible, bringing another adult along, however, may free your attention to focus on your child's oral health. Likewise, filling out forms in advance may save time and effort on the day of the visit.

The Checkup

When you and your child are comfortably seated in the office, a gentle examination of your child's mouth will be performed to uncover any early signs of dental problems such as tooth decay, and assess the risk that your child may develop the disease in the future. Often, this kind of risk assessment can help prevent — and even reverse — the early stages of tooth decay, without any drilling.

Finally, various ways to keep your child's oral health in top condition will be discussed. This may include how diet, eating habits and oral hygiene practices can help prevent tooth decay, the most common chronic disease of childhood. That's an important subject for everyone — even more so if your child is at greater risk. If any treatments (such as fluoride) are needed, a full explanation will be given. Tips on cleaning and brushing effectively will be reviewed and a follow-up visit will be scheduled as required.

Many habits are developed early in life. That's why it's important to “get it done by age one.” So when it's time for your child's first visit… don't hesitate! You'll be glad you came in.

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