The World’s Oldest Dental Filling… From Beeswax?
The discovery of a 6,500-year-old piece of beeswax shines new light on ancient dentistry.
When you think about fillings, more times than not, the last thing to come to mind is beeswax (unless Dr. Heller is telling you one of his clever jokes). However, there was a recent discovery revealing the oldest filling was composed of beeswax about 6,500 years ago. This is a prime example of just how necessary proper dental care maintenance is with proof that dentistry has been practiced long before we were born.
PLoS One, a peer review journal, published this discovery, detailing how a group of theoretical physics researchers in Italy analyzed this human jaw bone from over a century ago. Unfortunately, Denver, CO cannot use this as a claim to fame as it was unearthed in Slovenia. This cracked Neolithic tooth is the earliest case of fillings in history!
Researchers believe this jawbone belonged to a man around his late twenties. As seen in some of these photos, the man experienced a crack on his left canine that exposed dentin. Dentin is the inner enamel and tissues inside the tooth. As you can imagine, a damaged tooth of this degree had to be quite painful and a job Dr. Versman, Dr. Heller, or Dr. Beckman could handle with caress. Due to the physical discomfort, researchers believe the beeswax was coated around and inside the damaged tooth to relieve the tenderness. However, it is ultimately unknown if the procedure was done before or after the man died.
Examples of ancient dentistry are rare finds, and it is startling to realize that this jawbone was first discovered 100 years ago without detection of this filling. It was not until recently researchers found the dental work. Once noticed, carbon dating was used to discover exactly how old this specimen of beeswax was. Then, voilà!
As exciting as it is to discover great ancient history, Periodontal Associates does not want you to take care of your teeth like a caveman. It is important to come in for bi-annual check-ups at a minimum to keep your teeth and gums in the healthiest shape possible.
Drs. Versman, Heller, and Beckman specialize in helping those with gum disease and dental implants. The best way to reduce the need for gum grafts, bone grafts, or dental implants is by allowing true professionals to care for your oral health. Our hygienists are specially trained to give cleanings to reduce gum irritation. Don’t need implants or don’t have gum disease? Well preventative care can help keep it that way!
Stop by our office in Aurora, CO, and Periodontal Associates will help you be proactive about your health. For more information, browse our website at www.periodontalhealth.com. Also feel free to call us at (303) 755-4500 or click here for an appointment. We look forward to seeing you and making good oral hygiene your ‘beesiness’.
Floss: Wax On or Wax Off?
The first step to establishing proper dental care techniques is finding products that fit every personal need and preference. For example, do you prefer hand held toothbrushes versus electric, or do you prefer floss that is coated with wax versus no coating? To help patients make these decisions, it is best to have an understanding of which is most effective. I know our Drs.Versman, Heller, and Beckman here at Periodontal Associates hopes you brush and floss no matter what types or brands of equipment you are using, but a new study did reveal if waxed or un-waxed dental floss is preferred.
The study was developed in order to challenge a prior study that was published in the Journal of Periodontology back in 1990. To best understand which form of floss is superior, we must not only discover which is most effective in the view of dentists but we must also find what consumers prefer.
So, what do Drs. Versman, Heller, and Beckman suggest? Based on their experience as well as other clinical studies, Periodontal Associates agree that there is no statistical difference or clinical significance. Simply, the best floss is the one that is being used. Even with free floss or floss sticks, Drs. Versman, Heller, and Beckman have no preference. If you do have any concern, feel free to ask at your next hygiene appointment, and we can guide you based on your individual needs.
What is the most popular choice made by patients? Dr. Robert H. Beaumont asked 100 patients which one they preferred. He gave every patients unmarked floss with instructions for use between two front teeth as well as two back teeth. He then gave another sample of floss, again unmarked, with repeated instructions. To make sure there was no bias, half the patients started with wax while the other half started with no wax floss.
After both flosses were used, Beaumont simple asked each patient which sample they liked most. “All had an immediate and clear floss preference after performing the test.” The conclusion: 79 percent preferred waxed floss, leaving 21% preferring non-waxed floss. This may be true for our Denver, CO patients, too.
Why is this so? “The most frequent objection to waxed floss was related to a feeling of ‘thickness’, not a specific objection of difficulty in use. Unwaxed was described as ‘thinner’ and when preferred was most often selected for that reason,” stated Beaumont after questioning each patient on why they made their decisions as they did.
Where do you stand? How do you floss, where do you floss, and when do you floss?Drs.Versman, Heller, and Beckman would say it is best to floss daily as gum disease is caused by bacteria that grow on the teeth at the edges of and underneath the gums, and flossing, along with periodontal care appointments, will help remove the bacteria around the teeth, preventing periodontal disease.
How to floss:
- Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
- Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
- Curve the floss into a “C” shape around each tooth and under the gum line. Gently move the floss up and down, cleaning the side of each tooth.
Floss holders are recommended if you have difficulty using conventional floss.
For further information, please call and schedule a consultation with Drs. Versman,Heller, or Beckman today, or please stop in for a periodontal care hygiene appointment where our hygienists are specially trained to treat patients with gum disease as well as prevent the onset of gum disease. We can be reached by phone at (303) 755-4500 or please click here for an appointment. We serve patients of all ages throughout the Denver metro area, and we will look forward to meeting you.
Mouth Full of Wood?
Happy President’s Day! President’s Day is often a day for people to sleep in late, hang with friends, and enjoy one less day of work. However, the origin and history of President’s day is often forgotten, and Drs. Versman, Heller, and Beckman want to share with you the true meaning on this holiday as well as some fun dental facts about our beloved presidents.
The beginning of President’s Day started with George Washington’s birthday becoming a federal holiday in 1879. His birthday was celebrated on the actual day of February 22nd; however, on January 1, 1971, the federal holiday changed to the third Monday in February. This date places it between February 15 and 21 so it never falls on Washington’s actual birthday. The change worked out well though as it was then renamed as “Presidents’ Day” to honor the birthdays of both Washington and Lincoln. Lincoln’s birthday is on February 12th so President’s Day is a good middle ground to celebrate the birth of two of the most influential presidents in history.
Drs. Versman, Heller, and Beckman love to look back on history but specifically on dental history. Not only is George Washington the reason for this extra day off work, but Washington has some interesting dental facts and misconceptions.
Washington’s teeth has seemed to be a well discussed and misleading topic. Many people are aware that Washington wore dentures. In fact, during Washington’s inauguration he only had 1 single real tooth. George Washington could really have used Dr. Versman, Dr. Heller, and Dr. Beckman’s help by providing some dental implants, but back then he did not have many options nor knowledge on proper oral hygiene.
It was also believed that Washington’s dentures were made out of wood until researchers in Baltimore performed laser scans on a set of the dentures at the National Museum of Dentistry. What were they made out of then? The scan revealed gold, ivory, lead, human, and animal teeth as ingredients for these famous chomps. The dentures also had springs and bolts to assist Washington with opening and closing. During the times of Washington’s life, these dentures were very high tech; however, dental implants have evolved greatly over time and Drs. Versman, Heller, and Beckman provide the highest quality and lifelong lasting dental implants to their Aurora patients (without wood, lead, or animal teeth).
Washington resorted to the use of dentures for multiple reasons. At Periodontal Associates, our patients come to Drs. Versman, Heller, and Beckman for dental implants as the result of physical harm, gum disease, grinding, bone loss, or other factors. In George Washington’s case, he was an avid horseman which involved some physical accidents, and oral hygiene practices were not what they are today causing him to severe gum disease.
Many people, including other presidents, suffered the consequences from improper oral care. For example, Ulysses S. Grant smoked 20 cigars a day! Little did he know that this habit would ultimately cause his death due to oral and throat cancer. Smoking is a habit that Drs. Versman, Heller, and Beckman strongly suggest their Aurora patients to stray from as it results in not only cancers but severe gum disease. At Periodontal Associates we know that research has indicated that smoking and tobacco use is one of the most significant factors in the development and progression of gum disease. In addition to smokers experiencing a slower recovery and healing rate, smokers are far more likely to suffer from calculus (tartar) build up on teeth, deep pockets in the gingival tissue and significant bone loss. If only Ulysses S. Grant was able to come to our office in Aurora, CO think of the way we could help him!
But on a lighter note, did you know that Ulysses S. Grant loved to play ding-dong ditch? He would ring the doorbell at the White House and then run and hide. I guess no matter our position or age, we are all still kids at heart.
Periodontal Associates honors George Washington and former presidents for their good influences on our country, and it is nostalgic for Drs. Versman, Heller, and Beckman to look back on not only America’s history but the also the history of dental health and technology. Luckily, Periodontal Associates contains specialists in providers of dental implants and treating gum disease without the uses of wood or ivory. To learn more about the latest in dental implants and how to prevent periodontitis, please contact us at (303) 755-4500 or visit our website at www.periodontalhealth.com. We highly encourage you to call or click here to make an appointment to see Drs. Versman, Heller, or Beckman at our office in Aurora, CO, serving the Denver metro area. We look forward to helping you have a smile worthy to be placed on the dollar bill!
Are your Two & Four-legged Kids Brushing?
February is a month filled with many holidays such as President’s Day, Valentine’s Day, Groundhog Day, Mardi Gras, and many others. However, February is also a great month in dentistry! February celebrates National Children’s Dental Health Month as well as National Pet Dental Health Month. Drs. Versman, Heller, and Beckman do not practice dentistry on pets, but this is still something to celebrate and bring awareness to. Let us explore how these two topics bring better dental health to the whole family.
During February, The American Dental Association, Denver Dental Association, Periodontal Associates and other dental offices in Denver and nationally rally together during this month to raise awareness among families about the importance good oral health habits in children.
Dental awareness specifically for kids originally began in Cleveland, Ohio in 1941. Then the American Dental Association held the first national observance of Children’s Dental Health Day on Feb. 8, 1949. This single day observance became a week-long event in 1955, and in 1981 the program was extended to a month-long celebration known today as National Children’s Dental Health Month.
Local dental societies take great pride in celebrating National Children’s Dental Health Month during the month of February. Dentists, hygienists, and dental assistants throughout Colorado volunteer their time and expertise to conduct oral health screenings and provide educational programs in schools and for community organizations. In fact, Dr. Eric Beckman worked an entire day giving free exams to children and checked not only for cavities, but for early signs of periodontal problems. Dr. Beckman was a part of Give Kids a Smile. This is a campaign that has been running for the past 9 years. This event was held in Denver, CO on February 3rd this year. Dentists like Drs. Versman, Heller, and Beckman, as well as general dentists, come together to provide free dental care for thousands of children every year. Give Kids a Smile focuses on providing dental education and services to not just families without dental insurance but focuses on low income families.
Dr. Versman, Dr. Heller, and Dr. Beckman hope to raise awareness about the epidemic of untreated dental disease occurring in Aurora, Denver, and across Colorado and across the country. Low income families and children are more at risk for dental disease as access to dental clinics is limited for families when they are unable to afford proper transportation or a day off of work. Not only do financially strained families have difficulty seeing a dental professional, but the education about proper home oral care is lacking. The average person in Colorado only brushes their teeth for thirty seconds which is less than the recommended two minutes twice daily.
Periodontal Associates is a kid friendly periodontal office. Although we do dental implants on adults, many kids seek out Drs. Versman, Heller, and Beckman to deal with receding gums, especially when going through orthodontic care. Chronic gingivitis is common in children. Gingivitis is when gum tissue swells, turns red and bleeds easily. More aggressive periodontitis is seen in teenagers, but nevertheless, gum disease does occur in children.
Drs. Versman, Heller, and Beckman do suggest parents to establish proper oral hygiene habits in their children as early as one year old. Also, it is important for parents to be a good role model for their children to follow, making brushing and flossing more exciting and not a chore. Lastly, be sure to schedule regular visits to Periodontal Associates for periodontal exams and cleanings.
February is Children’s Dental Health month and to some families, their pets are their children so it is fitting that February is also Pet Dental Health month. Dogs and cats can have gum disease? Yes, many pets suffer from gum disease and tooth decay just like us. According to the American Veterinary Dental Society, more than 85 percent of dogs and cats show signs of oral disease by age four. Dr. Ken Versman and Dr. Doug Heller both have dogs, and just as they come to Periodontal Associates for their bi-annual cleanings, their pooches also visit their local veterinarian for deep cleanings. Just like with humans, food particles and bacteria build up in the dogs’ mouths, forming plaque and tartar, which leads to inflamed gums. With a lack of oral hygiene, periodontal disease can progress into an irreversible condition causing decay, bleeding gums, bad breath, and tooth loss. This is the same for both humans and dogs, but most people do not realize when their pet is dealing with gum disease until a tooth becomes stuck in their favorite squeaky toy. Unfortunately, Drs. Versman, Heller, and Beckman can provide you with dental implants, but your pup would be left with a gummy smile. The image of a smiling, gummy mouthed dog might be cute, but severe gum disease can lead to infections, sometimes serious enough to cause organ damage or even death.
Cats also suffer from dental problems. One significant concern for cats includes tooth resorption. Dental resorption is when the body cells destruct part of a tooth. It is unknown if this is a result from periodontal disease or an autoimmune disease so it is important to keep your pet on regular oral hygiene maintenance as well as up to date on check-ups. Whenever these cavity-like defects occur in pets’ teeth, it can become very painful if left untreated. In most cases, extracting these teeth is best for your furry friend. However, without proper regular hygiene maintenance dental disease like this and severe periodontal disease can lead to full mouth extractions for your kitty. Drs. Versman, Heller, and Beckman do not treat cats, but the education they give to their patients is still applicable to their pets, too!
There are many commonalities between oral health for both two-legged and four-legged children. With each category, good early habits are important in making dental care both fun and tolerable in kids and pets. Regular cleanings, at home and dental offices, and exams by dentists like Drs. Versman, Heller, and Beckman or veterinarians are the only ways to prevent gum disease and maintain a beautiful healthy smile.
Although, Periodontal Associates cannot answer all of your questions regarding your pet’s health, we strongly urge you to call our office at (303) 755-4500 or click here with any questions and to set up your next exam or cleaning. Drs. Versman, Heller, and Beckman are specialists in treating gum disease for both you and your child. To learn more, please visit our website at www.periodontalhealth.com.
Eating Disorders and your Teeth
Want your kids to be friendly and fear free at the dentist? It is up to you, Dads! A new study reveals that parent’s attitude towards oral health and dental visits predict how their children will react in the same situations. It is a good thing Dr. Doug Heller is a periodontist, his two kids will have some bright oral health futures.
The University of Madrid conducted a study comparing the views of children versus their parents when it comes to visiting dental offices like Periodontal Associates. Participants included 183 children between the ages of 7 and 12. Forty-three experimental studies from across six continents were also included in this review.
The majority of studies confirmed a relationship between parental and child dental fear. This relationship is most evident in children aged 8 and under. The study then concluded that, yes, there is an association between parental and child dental fear. This is good to know as many people have anxiety and negative thoughts about dental work, and if we know where it begins, then Drs. Versman, Heller, and Beckman and others can put a stop to the fear.
América Lara Sacido, one of the authors of the study, said that “along with the presence of emotional transmission of dentist fear amongst family members, we have identified the relevant role that fathers play in transmission of this phobia in comparison to the mother.”
More so than mothers, fathers sway their children in how to react to the dentist. In fact, the reaction from their dad will often over shadow the mother’s regardless if it is negative or positive.
“Although the results should be interpreted with due caution, children seem to mainly pay attention to the emotional reactions of the fathers when deciding if situations at the dentist are potentially stressful,” said Lara Sacido.
To help this cycle, Drs. Versman, Heller, and Beckman strongly suggest finding a steady, primary dental provider that the entire family can bond with and trust like Periodontal Associates. Then, both parents should be active in the children’s dental appointments to assure they will be in good hands. Anxiety is a strong consequence of trips to the dentist office; however, as the industry advances routine dental procedures are becoming more and more comfortable.
“Through the positive emotional contagion route in the family, the right attitude can be achieved in the child so that attending the dentist is not a problem.”
Need a dentist to trust? Call Periodontal Associates today as Dr. Versman, Dr.Heller, and Dr. Beckman are the best doctors in Denver! We provide dental implants, gum grafts, bone grafts, treat gum disease, and even provide regular hygiene cleaning appointments. Our patients travel from all over Denver, CO to see our specialists here in Aurora,CO, and some of our patients have even been with us for over 35 years! We can be reached by call (303) 755-4500 or by clicking this link. Visit our website for more information about common dental practices and more about Periodontal Associates.
Holiday Cravings and Cavities
Happy Hanukah, Merry Christmas, and Happy Kwanzaa from your friends at Periodontal Associates – the dental implant team! With the Holiday season among us and treats eaten, carols sung, parties thrown, and gifts given, Dr. Versman, Dr. Heller, and Dr. Beckman want to take a look a closer look about what that means.
The end of the year is often a time of over indulgence, and with the constant snacking on sweets, Americans run the risk of increasing cavities and weight gain. One study suggests that the average American citizen gains 7-10lbs over the holiday season (Thanksgiving to New Year’s). Now brace yourself, if we estimate that everyone in American gains 9lbs that means the nation would gain 3 BILLION POUNDS!
Don’t worry, there is hope as another study by Yanovsky in 2000 in the New England Journal of Medicine stated the average American gains less than 1 lb. However, this weight is never lost in the upcoming year. Even so, that equates to a gain of almost 315 million pounds that are never lost! Each kid eats about 6,000 calories on Christmas Day alone, and Dr. Versman, Dr. Heller, and Dr. Beckman fear this is mainly all in sweets. No wonder The Biggest Loser is planned to air at the beginning on January.
Now let’s think about how this weight gain and the consumption of sweets affect your health, and most importantly, your oral health. Dr. Versman, Dr. Heller, and Dr. Beckman wants everyone to enjoy themselves and celebrate over the holidays, but they wish to pass along some advice to make sure the next year is not negatively affected by these holiday traditions.
First thing first, sugar! Between the sugar cookies, egg nog, candy canes, and pumpkin pie, sugar can be found everywhere! Christmas is the 3rd largest day for candy consumption after Halloween and Easter. Each household spends and average of $94.04 on holiday candy and the nation spending $1.4 billion. Americans use an average of 7lbs of sugar over the holidays in baked good, drinks, etc. There are 1.8 billion candy canes are made every year which is enough to travel from Arkansas to the North Pole and back 32 times!
Just writing those statistics almost gives Dr. Versman, Dr. Heller, and Dr. Beckman a heart attack. Here at Periodontal Associates, our Denver and Aurora clients are not immune to the holiday sugar high, and we want to make sure you are taking care of your teeth and gums to help prevent cavities, gum disease, and the need for dental implants in 2013. Dr. Versman says, ‘You don’t have to brush your teeth, just the ones you want to keep.’
Yes, brushing is one of the best things you can do, along with flossing, on a regular basis. Dr. Heller often tells his patients that slowly snacking on sugar is worse than sugar itself as it continuously feeds bacteria in the mouth, and most people only brush once or twice a day. Think about eating a breakfast cake at work around 9am then letting that sugar sit on your teeth for another 13 hours until brushing before bed!
Go ahead and make a New Year’s resolution with Periodontal Associates – The Dental Implant Team before the New Year begins. Let us all brush often, floss regularly, graze less, and visit our great doctors (Ken Versman, Doug Heller, and Eric Beckman) along with our specially trained hygienists for bi-annual cleanings and check-ups. By developing these great habits, Periodontal Associates can help treat and prevent periodontal disease (gum disease), fight bad breath, and give you a cosmetically beautiful smile with or without dental implants.
Periodontal Associates is located in Aurora, CO, but we happily serve patients in Denver,CO and all surrounding areas like Centennial, Parker, Lone Tree, Thornton, etc. Drs. Versman, Heller, and Beckman are specialists in gum disease, dental implants, gum grafts, bone grafts, sinus lifts, and other dental needs. Please give us a call at (303) 755-4500 to schedule your dental implant consultation or hygiene cleaning today! To learn a little more about us, please visit our website www.periodontalhealth.com or visit us on Facebook www.facebook.com/periodontalhealth. We look forward to getting to know you and helping you keep your New Year’s resolution for a healthier smile!
Oral Health and Chemotherapy
Periodontist or oncologist? For those dealing with cancer treatment, a relationship with your oncologist may be just as important as the one with your dentist. Chemotherapy offers many positives in preventing the growth of cancers; however, this powerful treatment can cause a few issues along the way. Oral health complications is one common discomfort many chemo patients face, but Drs. Versman, Heller, and Beckman want to shed some light on how to practice the best oral health habits to maintain hygiene and comfort during chemo treatment.
There are many different types of chemotherapy so it is important to talk with your doctor for more specific information, but we will discuss a few side effects. One of the more common side effects is mucositis. Mucositis is the ulceration of the mucosa lining in the digestive tract which includes the oral cavity. When this occurs, the feeling for each patient varies as some can experience inflammation and redness while others succumb to more severe ulceration. Mouth sores can occur on your tongue and mouth. Periodontal Associates give this advice in preventing and treating these sores:
- Drink plenty of water – at least 64 ounces – although more than 64 ounces is suggested especially when living in dry climates such as Denver, CO.
- Stay hydrated with drinks enhanced with electrolytes
- Avoid caffeine and alcohol as they dry out your tongue and gum tissue
- Eat soft foods – Drs. Versman, Heller, and Beckman will be happy to give you a list of good foods to eat as we suggest the same thing for our Aurora patients after gum graft and dental implant treatment.
- Avoid citric and spicy foods and/or juices
- For denture patients, use them for meals only allowing your gums to rest when not eating
- Brush with soft toothbrushes and floss gently to avoid gum irritation – Stop by Periodontal Associates and we will give you a brush for free.
Other side effects can be impaired taste buds, erosion of tooth enamel, and ulcerated gingival tissues. Dr. Versman, Dr. Heller, and Dr. Beckman are gum specialists, and visiting them regularly is important. Our doctors examine each patient at every visit monitoring the progression of gum disease, mouth sores, and oral cancers. For discomfort, Drs. Versman, Heller, and Beckman will not hesitate to prescribe or educate you in oral hygiene procedures, pain control medications, or oral mouth rinses to alleviate any tenderness. Your oncologist should stress the importance of visiting your dentist before starting chemotherapy to discuss and prepare for possible mouth concerns.
Periodontal Associates patients are treated more gently as many of our patients experience gum disease. Our doctors and hygienists are specially trained to treat our Aurora patients more gingerly as many with periodontal disease or chemotherapy patients need special attention to overcome sensitive gums. If you have any concerns about bleeding gums, mouth sores, tenderness, recession, or any discomforts in your mouth, do not hesitate to call Periodontal Associates and schedule an appointment with Dr. Ken Versman, Dr. Doug Heller, or Dr. Eric Beckman. We strive to offer each patient individual treatment plans that revolve around your personal health needs to offer not only protection and optimal health but also comfort and aesthetics.
Click here to schedule an appointment, call us at (303) 755-45000, or browse our website at www.periodontalhealth.com for more information. Don’t be in the dark when it comes to your oral health especially when dealing with other diseases and medication uses. Let Drs. Versman, Heller, and Beckman be a role in your team of specialists to provide you relief and health.
To Save a Tooth or Replace It: That is the Question
One of the most difficult decisions Periodontal Associates has to make is when to save a tooth and when to remove and replace it. This is a difficult decision on many levels. Numerous factors must be considered including the restorability of the tooth, the patient’s susceptibility to disease, gingival and papillary conditions, and esthetics in weighing the benefits vs. risks of retaining a compromised tooth. The decision may be based on one critical issue or on a collection of factors. In this blog entry, Drs. Versman, Heller, and Beckman will discuss these factors which need to be considered in deciding whether to remove or save a tooth. As always, Periodontal Associates welcomes your comments and suggestions so feel free to comment here, call our Aurora office at (303) 755-4500, or please stop in!
Our goal at Periodontal Associates is to maintain or reinstate good form and function to the dentition with excellent esthetics and health. Fundamental to developing a dental treatment plan, a prognosis must be assigned to each tooth. Can it be saved? Should it be removed and replaced with an implant?
Osseointegration and periodontal regeneration are two significant advances in contemporary dental care and each should be utilized when appropriate. The natural dentition responds very well to definitive periodontal treatment. And there is significant evidence that efficacious periodontal treatment can change the prognosis of a tooth from hopeless to good. Dr. Versman, Dr. Heller, and Dr. Beckman always try to use periodontal cleanings and treatment first if they believe the tooth is savable. Extracting teeth which had lost supporting periodontium and replacing them dental implants is not always the preferred treatment approach.
Implant replacement is not infallible and does not mean the patient will not experience future complications. While osseointegration has reduced the need to save teeth with a marginal prognosis, there has been a significant rise in the incidence of peri-implant disease and bone loss associated dental implants.
Greenstein et al raise several questions when deciding whether a tooth should be saved or replaced.
1. Can the tooth be restored effectively?
2 Will endodontic treatment be successful?
3. Is periodontal therapy a reasonable option?
4. What effect will extraction have on the final treatment plan , particularly with respect to esthetics?
Drs. Versman, Heller, and Beckamn know that an effective restoration can return teeth to normal function and acceptable esthetics. Teeth without extensive caries, a favorable crown/root ratio and adequate tooth structure offer the best prognosis for effective restoration.
Fracture and Faulty Restorations. If a tooth is fractured, Dr. Versman, Dr. Heller, and Dr. Beckman man their best judgement to determine restorability.
Restorations must not infringe on the biologic width which can result in chronic gingival inflammation, pain, and clinical attachment loss.
Problematic teeth in the esthetic zone which require a crown lengthening procedure should be evaluated for replacement because these measures may result in an unesthetic appearance due to excessive tooth length.
Essential to cosmetic success, Drs. Versman, Heller, and Beckman perform a complete evaluation of the smile line and other factors.
Caries. Decay which extends beyond or to the level of the alveolar bone usually represents a restorative challenge for Drs. Versman, Heller, and Beckman and increased treatment costs for the patient.
If a tooth is restorable, orthodontic extrusion, crown lengthening, or mucogingival surgical procedures may be required to salvage the tooth. If this is necessary, Periodontal works closely with your general dentist in the Denver area to provide a thorough and individualized treatment plan.
Crown/Root Ratio. Teeth without loss of attachment or destruction of periodontal tissues usually present a favorable crown/root ratio and consequently are good candidates for restoration.
A 1:1 crown to root ratio is the minimum acceptable assuming the periodontium is healthy and the occlusion is controlled.
Remaining Tooth Structure. Teeth with 5mm suprabony structure, 2mm for the biologic width, 2mm for the ferrule and 1mm sulcus depth are candidates for effective restoration.
Often the length of the available tooth structure is insufficient to ensure the preservation of the biologic width and crown lengthening may be required. Crown lengthening is a routine procedure that periodontists like Drs. Versman, Heller, and Beckman are specialists in.
Depending on if the patient need additional treatment like crown lengthening, this makes the final cost similar change.
The final decision to save the tooth or place an implant is often linked to financial considerations and the concerns for longevity of the results as opposed to the possibility of saving an already compromised tooth. Periodontal Associates prides ourselves in working with our patients to come up with a treatment plan that fits each individual best in terms of finances but most importantly health.
Survival rates for endodontically treated teeth have been estimated to be as high as 95% when associated with an excellent full coverage restoration — if the tooth is treated with a well-fitting single-tooth crown with adequate ferrule.
Avila et al suggest the clinician should consider removing the tooth and replacing it with a dental implant if:
- The tooth has a large apical lesion (greater than 5mm).
- The tooth has had apical surgery.
- The tooth needs a large post and core for support.
- The tooth has inadequate ferrule.
- The tooth has an abnormal root anatomy precluding successful endodontic obturation.
- Th tooth has a root which is short or thin which will cause a post to predispose the tooth to post loosening or root fracture.
- There is a misaligned post that will weaken the root structure.
In deciding whether to save or replace a periodontally involved tooth, the Dr. Versman, Dr. Heller, and Dr. Beckman considers the severity of the periodontal condition and the likelihood of recurrence. Periodontal Associates in Aurora, CO specialized in treating periodontal or gum disease, and Drs. Versman, Heller, and Beckman are the highest qualified doctors to make this decision.
If the periodontal prognosis is poor and/or the possibility of recurrence of the disease is high, such teeth may be candidates for removal and replacement with dental implants. However, Periodontal Associates can help treat gum disease better with hygienists who are specifically trained to treat patients with severe gum disease.
Drs. Versman, Heller, and Beckman suggest regeneration will most likely be successful in teeth with pocket depths greater than 6mm. pocket depths are determines by measuring the gums to see how large a pocket is or how far under the gums bacteria is spreading. Those with pockets depths beginning at 5mm is considered to have periodontal disease and is in need of immediate and frequent periodontal treatment. Do you have gum disease? Click here to see all symptoms and warning signs.
In addition, Avila et al suggest regeneration will most likely be successful in the following cases:
- Teeth with mobility greater than normal and up to 1mm in any direction. In addition to periodontal regeneration, these teeth can also be considered for splinting in case of secondary occlusal trauma.
- Teeth with no recurrent periodontal abscess.
- Teeth with less than 30% alveolar bone loss.
- Teeth with deep, localized narrow intrabony defects.
- Teeth without invasive furcation involvement.
- Teeth without interproximal bone levels equal to or apical to the level of the furcaton.
- Teeth with no root anomalies.
- Teeth which would benefit from root resection as a conservative, therapeutic option.
Aviva et al suggest teeth should be considered for replacement if:
- Pockets are deeper than 8mm.
- Teeth are extensively mobile.
- Teeth have recurrent periodontal abscesses.
- Teeth have root anomalies — cervical enamel projections, enamel pearls or root grooves.
If function and cosmetics can not be maintained or improved, this may be an indication for tooth removal. The decision to retain a tooth or remove and replace it with an implant is dependent on the ability to achieve a functional and cosmetic results for our Aurora patients.
The Effect of Retention or Replacement on the Final Treatment Plan
The strategic value of a particular tooth is an important parameter to be considered when designing a treatment plan. The decision to extract or retain teeth affects adjacent teeth, especially is the plan is for the teeth to function as abutments for a fixed or removable partial denture.
It is essential to determine if a compromised tooth can withstand the functional load anticipated in the future.
Other factors in the decision to retain or remove teeth are:
- Smoking Habits
- Use of IV bisphosphonates and other drugs
- Patients with uncontrolled systemic conditions such as Type 1 diabetes
Tooth extraction and implant placement may not be the best therapeutic approach in all patients. The decision to save a tooth or extract it and place an implant must include a consideration of a multitude of factors.
To help decide what is best for you, Periodontal Associates strongly suggests you stop by for a FREE dental implant consultation in their Aurora, CO office. As you have read, every individual can experience different needs, wants, and concerns when deciding what is right for them. A consultation with Dr. Ken Versman, Dr. Doug Heller, or Dr. Eric Beckman allows one on one time and communication to resolve your questions, and provide you with excellent dental care.
Our office is located in Aurora, but we serve patients from all surrounding Denver metro areas. Our patients respect Drs. Versman, Heller, and Beckman so much that some patients travel from Wyoming and Colorado cities hours away.
Please contact Periodontal Associates at (303) 755-4500 or click here for an appointment. Our website may also provide you more information to any questions that you have, and we urge you to to browse our website at www.periodontahealth.com. Drs. Versman, Heller, and Beckman are Denver’s premiere providers of dental implants and periodontics. We look forward to meeting you and providing you with a life changing and beautiful smile!