When is it the right time to use implants to replace missing teeth in a teenager?

This is an important question and the current wisdom is not to have implants placed until jaw and facial growth are complete. Although it varies from person to person, growth of the jaws in most cases is not complete until late teens. Of course, we are faced with the dilemma of waiting for the optimal time to place implants so that they will succeed on the one hand, and respecting the psychological needs of a teenager missing front teeth on the other.

Well, you may say, that still doesn’t answer the question. The rest of the answer has to do with the difference in the way in which teeth and implants attach to bone in which they are embedded.

Teeth are attached to the bone through a membrane called the periodontal ligament (peri-around, odont-tooth). The ligament is a living network which is composed of tiny fibrils made of a protein called collagen. The fibrils insert into the bone on one side and the tooth on the other. The most fascinating thing about this very special structure is that it is living and therefore capable of change. And it does, all the time. Specialized cells continually remove collagen and bone and make it anew; this does two things – it allows the teeth to react to stress, as when forces are applied such as in eating and allows movement of the teeth themselves through the magic of orthodontic treatment (braces). In addition, as the face changes throughout life and the teeth themselves wear, minute changes in the position of the teeth within the bone are compensated for by changes in the periodontal ligament. This "remodeling" process accommodates these changes.

An implant connection to the bone is quite different. Dental implants join biochemically to the bone by a process called osseo-integration (osseo – bone, integrate-to join or fuse with). This fusion, almost like pillars in concrete, allows no movement at all and stresses, even biting forces, are absorbed quite differently.

Consequently and most importantly, as the jaws continue to grow, the upper jaw may move in an outward and downward direction. The teeth will accommodate and move with jaw growth, but implants will not. As the upper jaw moves, the implants (and the crowns attached to them) remain stationary and so appear to intrude i.e. go back up into the jaw. This also affects the position of the gum tissues which also will not follow the growth of the jaws around the implants.
For these reasons, and since implants are a relatively permanent and best current solution to the problem of tooth replacement, it is better to wait until growth of the jaws and face is complete. Your orthodontist will be able to tell you when growth is complete by examination and specialized radiographs (x-rays) which will provide a good guideline. However, this is a very inexact science; it’s not really possible to determine exactly when a person has finished growing. Other factors can be indicative and helpful: Is your daughter still changing shoe and clothes sizes? Is she comparable in stature to her siblings and you, her parent(s)? These are good intuitive signs, but in the end, we add the science to our experience and make a judgment call.

There are many other good interim options for temporarily replacing the teeth for a few years, both aesthetically and comfortably until implants can be placed. For example, temporary "fixed-in" options like bonded bridges can be attached to the adjacent teeth with little if any irreversible change to them. You should consult your dentist about them.
Ultimately dentistry is an art form as well as science. This issue has been studied in the scientific literature and also proven in clinical practice. Sometimes, placing implants too early can be remedied by changing the crowns which attach to them. Other times it may mean removing and replacing the implants which may require bone regeneration – expensive and difficult options. Neither is as good an option as waiting for the correct time in the first place, even if it means waiting a little longer.

Dr. Calvo is one of only 300 members in the world to achieve AACD Accreditation status.  Recently, she was honored by being selected as the featured dentist in an ad for Accreditation published in several dental journals.  Dr. Calvo is a well-respected Cosmetic Dentist in the Los Angeles and Beverly Hills areas.  Dr. Calvo is passionate about changing lives and increasing self-esteem in the patients she has helped serve through Smile Makeovers, Porcelain Veneers, Dental Implants and other artistic dental services. Click hereto view her blog for more information or become a Fan of her Facebook FanPage by Clicking Here.

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How dentistry can improve your sleep and health

Dear Doctor,
My husband’s snoring has gotten worse to the point where he almost stops breathing. His dentist recently told him this could be dangerous and should be treated. What can be done, and why is it a dental concern?

Snoring occurs when the soft tissue structures of the upper airway (back of the throat) collapse onto themselves, the tongue drops back, and air is obstructed in its movement through the mouth and nose into the lungs. As a result, these obstacles create the vibration that produces snoring. Large tonsils, a long soft palate, a large tongue, the uvula (the tissue that looks like a mini punch-bag dangling at the back of the mouth), and even fat deposits can also contribute to blockage and hence snoring.

Your husband may have a condition called Obstructive Sleep Apnea (OSA; “a” – without; “pnea” – breath), which occurs when the upper airway collapse becomes more profound causing significant airflow disruption, or even no airflow whatsoever for 10 or more seconds. This is often associated with many “micro-arousals,” one to three second waking episodes throughout the sleep cycle. This can be quite dangerous to health as blockage of the upper airway causes reduced airflow into the lungs and therefore low blood oxygen levels. And when oxygen levels drop low enough, the brain moves out of deep sleep and the individual partially awakens followed by a loud gasp as the flow of air starts again. This can happen many times during the night, sometimes more than 50 times an hour. The combination of low oxygen levels and fragmented sleep are the major contributors to most of the ill effects associated with sleep apnea. In addition to excessive daytime sleepiness, studies show that sleep apnea patients are much more likely to suffer from heart attack, congestive heart failure, high blood pressure, brain damage and strokes, as well as a higher incidence of work and driving-related accidents.

Some helpful things you can do for yourself if you have sleep apnea include losing weight and exercising. Medical and dental treatments include:

Continuous Positive Airway Pressure (CPAP): CPAP bedside machines generate pressurized air delivered through a tube connected to a mask covering the nose and sometimes mouth. The force of the pressurized air opens the airway (windpipe) in the same manner as blowing into a balloon; when air is blown in, the balloon opens and gets wider.

Oral Appliance Therapy: Here’s the dental connection. Oral appliances are worn in the mouth to treat snoring and OSA. These devices may look like orthodontic retainers or sports mouth guards but are designed to maintain an opened, unobstructed, upper airway during sleep. There are many different oral appliances available but less than 20 have been approved through the FDA (Food and Drug Administration) for treating sleep apnea. They may be used alone or in combination with other means to treat OSA. And they work in several ways: repositioning the lower jaw, tongue, soft palate and uvula; stabilizing the lower jaw and tongue; and increasing the muscle tone of the tongue.

Other Dental Approaches: Specially trained oral and maxillofacial surgeons may include more complex jaw advancement surgeries. Additionally, an Ear, Nose & Throat (ENT) specialist may consider surgery to remove excess tissues in the throat. It also may be necessary to remove the tonsils and adenoids (especially in children), the uvula, or even parts of the soft palate.

Since OSA is a serious medical condition, a physician specially trained in this area of medicine must diagnose it. Diagnosis is based on the results of an overnight laboratory sleep study called a polysomnogram (PSG; “poly” – many; “somno” – sleep; “gram” – record). However, determining the best treatment is enhanced by joint consultation with your physician and dentist. It is also important to note that only dentists trained in sleep disorders and related oral appliance therapy are familiar with the various designs of appliances. These experts can best determine what is suited for an individual’s specific needs as well as manage any unruly tooth, bite, gum, or jaw joint effects.

If your husband needs an oral appliance, it may take several weeks to months to complete. Afterwards, your husband’s dentist will continue to monitor his treatment and evaluate the response of his teeth and jaws. His dentist needs to work with a physician as part of the medical team in diagnosis, treatment, and on-going care of your husband’s sleep disorder.

In conclusion, chronic loud snoring, pauses in breathing during sleep, and daytime sleepiness are neither benign nor inconsequential and should be addressed early to avoid serious health problems. These can include heart problems, blood pressure issues, and brain and general health effects on the body — all of which can affect long-term health and well-being.

Dr. Calvo is one of only 300 members in the world to achieve AACD Accreditation status.  Recently, she was honored by being selected as the featured dentist in an ad for Accreditation published in several dental journals.  Dr. Calvo is a well-respected Cosmetic Dentist in the Los Angeles and Beverly Hills areas.  Dr. Calvo is passionate about changing lives and increasing self-esteem in the patients she has helped serve through Smile Makeovers, Porcelain Veneers, Dental Implants and other artistic dental services. Click hereto view her blog for more information or become a Fan of her Facebook FanPage by Clicking Here.

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Dear Dr. Calvo,

I just had dental crown placed and it’s been irritating me. When I contacted my dentist he asked if I was in pain. I said no… because it didn’t feel painful but rather ITCHY. He said it was normal and I just need to get used to the crown but it’s been 14 days already and although it has not gotten worse, the itching is still there.

I have since read online about dental allergies. Could I be allergic to my dental crown? If so, how can I get my dentist to listen to me!

Thanks,

Martha

Hello Martha,

There is definitely such a thing as ‘dental allergies’. There have even been quite a few studies that show women to be three times more susceptible to metals and metal mixtures than the opposite gender.

The thing is this: In the past, most dental work involved some form of metal being introduced in your mouth.  Nowadays, with new technology dentists can make restorations that have absolutely no metal, so before you have new restorations fabricated, make sure to discuss the dental material being used.  However, if the restoration is already made you may have DIRECT contact with this metal or alloy. If you are allergic to any specific metal (e.g., nickel, zinc, etc.) and your dental work has this metal as one of its elements, then you can suffer an allergic reaction to it.

Some of the symptoms of dental allergies are the following:

· Reddening or swelling of your gums;

· painful, or as you experienced, itchy gums;

· bleeding gums; and

· a peculiar or foul smell emanating from your mouth that was not there before.

As you have itchy gums, then you MUST indeed complain to your dentist. If necessary, go to a new dentist telling him/her the dental work you had done, how long it has been, and your symptoms. Don’t let up until you get the treatment you deserve! Dental allergies can lead to bigger problems so the sooner you this addressed the better.

Good luck!

Marilyn Calvo DDS

Smile Studio LA

Accredited Member, AACD

Dr. Calvo is one of only 300 members in the world to achieve AACD Accreditation status.  Recently, she was honored by being selected as the featured dentist in an ad for Accreditation published in several dental journals.  Dr. Calvo is a well-respected Cosmetic Dentist in the Los Angeles and Beverly Hills areas.  Dr. Calvo is passionate about changing lives and increasing self-esteem in the patients she has helped serve through Smile Makeovers, Porcelain Veneers, Dental Implants and other artistic dental services. Click here to view her blog for more information or become a Fan of her Facebook FanPage by Clicking Here.

Photo by: Pink Sherbet Photography

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This newsletter from Smile Studio LA  contains articles such as: What’s that about implants, Oral Cancer, The Heart and Dental Health, How to stay happy, healthy and smiling and How to say goodbye to a bad breath. This information is provided by Dr. Calvo (Accredited Member: AACD) of Smile Studio LA. Marilyn Calvo and her team provide both cosmetic and restorative dentistry services in the Beverly Hills and Los Angeles areas.

Smile Studio LA Newsletter Download Here.

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Review of Dr. Marilyn Calvo – General Dentist
Posted On DR.Oogle Dentist Guide

I had 3 cavities filled today along with a full cleaning. I usually dread going to the dentist and worry about it the night before. This was my first time in the chair having real work done by Dr Calvo and all I can say is the experience was just fabulous. She had me in and out of the chair in 1 hour and 15 minutes and with no shots for 3 cavities! and a full cleaning. She is the best dentist I have been to in the last 35+ years and I would highly recommend her.

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Dr. Calvo is amazing at the work she does. As far as I can remember going to the dentist I have always been with Dr. Calvo. She is such a caring dentist. Her motivation for the healthiest and best smile for her paitents is her number 1 priority. I LOVE visitng Dr. Calvo, I come out with a beautiful smile and healthy teeth. I have never had a cavity nor any problems with my teeth, its all because of Dr. Calvo!!!!!

Thanks Dr. Calvo for all your help in guiding me to the correct path in keeping my teeth healthy!!!

Thanks
MBA

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Dr. Calvo and her staff actually make it pleasant to go to the dentist. Everyone there is kind and considerate. Dr. Calvo has all the most up-to-date equipment and works in a very sanitary way that makes me feel comfortable and secure. Due to insurance coverage, I actually strayed for a short while but it was such a horrible experience that I discovered it’s well worth it to pay a little extra and get the excellent care that Dr. Calvo and her staff provide. Finally, although I truly like her staff, I appreciate that Dr. Calvo is very hands-on with the work that needs to be done.

I know that I will never change dentists as long as I live in Los Angeles and can see Dr. Calvo.

Sincerely,

Janet Grey
Interior Stylist
(323) 719-7327
janet@janetgrey.com
www.janetgrey.com

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This is Sandy. You’ll see her speaking about Dr. Calvo’s services in the Best of LA video.

She was unhappy with her dark stained teeth and got veneers to have brighter, more attractive, youthful looking teeth. 

For a complimentary smile evaluation, please call (818)788-1352.

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In an interview with Dental Tribune, Dr. Gy Yatros of Dental Sleep Solutions in Holmes Beach, Fla., discusses obstructive sleep apnea, its medical ramifications — and what dentists can do to treat the condition. Check out the article by clicking here.

If you have sleep apnea, we may be address this dangerous sleep disorder without the use of cumbersome CPAP (continuous positive airway pressure) machines.  Call our office today at (877) 704-5539 to schedule an appointment and see if we can sleep better.

Marilyn Calvo DDS of Smile Studio LA will be featured on Best of LA TV on Sunday February 28th, @ 2:00pm on KCAL 9

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Dental implants were the perfect solution for one newly retired man

George is the kind of person everyone loves to be around. Wherever he goes, he radiates optimism and enthusiasm. You can’t be around George without bursting into a smile. His laughter and positive outlook infect his family and friends with hope and joy.

For almost 50 years, George was a highly successful salesman and business owner. Recently retired, he shows no signs of slowing down. For people like George, retirement is a time for building stronger bonds with family and friends—and for nurturing new friendships.

George always put other people’s interests in front of his own. When his children were growing up, he spent money and time on them instead of indulging in expensive toys for himself. People all over town marveled at the life-size playhouse he built in the back yard for his daughter; before that, there was the two-story, frontier-inspired fort he built for his two sons.

George’s last two children, both girls, were born when he was in his forties. At a stage in life when most parents become empty nesters, George bought ponies for his little girls and financed their lifelong love of equestrian riding.

He put all five kids through college, of course, and still sends them money on their birthdays. This year George’s children made a special request: They asked their father to do something for himself. After a lifetime of putting others first, it was George’s turn.

The gift your loved ones wish they could give you

George knew what he needed to do. He hadn’t talked about it much, but everyone who was close to him had known for a long time. For years, George had neglected the very thing that drew others to him—his smile.

Dental implants were the perfect solution: They’re the closest thing to real teeth. If properly cared for, they will last the rest of George’s life. Dental implants were a much better solution than removable dentures, which are notorious for their poor chewing performance. More importantly, dentures contribute to gradual bone breakdown, which ultimately causes facial collapse.

Dental implants restored George’s smile. Permanently anchored in the underlying bone, implants never slip. Unlike denture wearers, implant wearers never get caught without their teeth.

George’s smile hadn’t been as bright in recent years. Consciously or unconsciously, he hadn’t wanted his family and friends to see how serious his own need had become. Dental implants gave George the confidence he needed to light up rooms again.

Find out how dental implants can restore your confidence and put the sparkle back in your smile. Give yourself the gift your loved ones wish they could give you.

It’s your turn.

Marilyn Calvo DDS of Smile Studio LA will be featured on Best of LA TV on Sunday February 28th, @ 2:00pm on KCAL 9

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