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August 12, 2010

My nine year old daughter just lost one of her adult teeth. What do you recommend that I do about this? I know dental implants are expensive but I am willing to get her one if that is the best option.

Filed under: Uncategorized — Tags: , , , — Dr. John Paul Gallardo @ 6:24 am

Although a dental implant will probably be the best option for her, she may not be ready to have a dental implant placed just yet because of her age and incomplete gowth. But that doesnt mean we should ignore some very important considerations. Yes, a dental implant will probably be her best option in terms of replacing a tooth in the most natural, least invasive way. This is beacuse an implant tooth replacement does not require the dentist to cut healthy natural teeth adjacent to the tooth that is being replaced as a conventional bridge would. Also, if the bone and gum after a tooth removal is left to heal on its own without the use of a bone and tissue preservation protocol, it usually begins to shrink or atrophy. The consequences could be cosmetic in that the missing tooth space when replaced may require an unsightly longer artificial tooth. Bone requires function to maintain itself. In the mouth this can only be accomplished with a health tooth root or a dental implant. The atrophy, if allowed to take place, could also lead to a more complex and more expensive bone grafting surgery in the future. So my advice is to have a consultation to evaluate for the following among other things: 1. Bone preservation/augmentation procedure. 2.Temporary tooth for cosmetic and space maintenance that would help transition the case until she is old enough for the implant (when she stops growing). 3. An Orthodontic consult to determine whether there is a general need for braces as well as specifically looking at the spacing remaining in the area of the missing tooth ( since teeth can be moved orthodontically but implants can’t). Finally, consider that implants may not be as expensive as you think when you compare them to the cost of reversing the negative changes that could take place if a good treatment plan is not developed.

August 10, 2010

I will be getting several teeth pulled at once. What type of anesthesia do you use for this? Do you have to stitch the gums closed afterwards?

Filed under: Uncategorized — Tags: , , , — Dr. John Paul Gallardo @ 5:47 am

Although conscious sedation could be achieved using only pills, we have found over many years of practice that IV sedation works best because we can “titrate to effect” which is another way of saying we can safely sedate you to a level which is appropriate for the planned dental procedure and for your anxiety level. Another benefit is that we can keep you comfortable even after you’ve left the office and the local anesthesia has worn off. This is done through IV analgesics and anti-inflammatory drugs administered during the procedure.
When a sedative is administered into the blood system during dental treatment, this is referred to as Intravenous Conscious Sedation (aka “IV sedation”).Conscious sedation is sometimes referred to as “twilight sleep” or “sleep dentistry”.
As far as sutures are concerned, they may be used if the soft tissues (gums) need to be separated from the teeth for better access during removal or if any bone regeneration techniques are performed.

August 5, 2010

I am 76 years old and have osteoporosis. This has never interfered with any dental procedures that I have had, but now I need several dental implants. Could there be a problem with getting the implants to embed in the bone of the jaw in my case?

Filed under: Uncategorized — Tags: , , — Dr. John Paul Gallardo @ 6:12 am

The risk of having a problem could be greater than that of a patient who does not have osteoporosis but that doesn’t necessarily mean you cannot have dental implants. Of most importance is to know whether or not you are taking bisphosphonates. Second, we need to learn more about your specific circumstances regarding the osteoporosis. Third, we need to evaluate your specific dental needs as well as expectations you have regarding the implants. Assuming that you have been cleared for treatment, the surface of the implants should be highly advanced for bone integration. Most modern surface are but this must be confirmed. One of the things we do is “wet” the implant surface in the patients own growth factors (isolated from the blood plasma) just seconds before placing it to aid in the bone to surface integration. Because most of the load or force occurs in the top third of the implant once integrated, wider is better. The length of the implant will influence the initial stabilization and healing period. Immediate or early loading of the implants should be avoided and more time than usual should be given for healing and integration before the teeth are attached. Once the teeth are attached, it would be beneficial to “tie” or splint the implants together with the prosthesis or by connecting the crowns to help dissipate the chewing forces

August 4, 2010

Could Good Oral Health Help Prevent Dementia?

Filed under: Uncategorized — Tags: , , — Dr. John Paul Gallardo @ 5:55 pm

In a editorial commentary. Dr. Robert Stewart at the Institute of Psychiatry Kings College London, notes the oral health of people with cognitive impairment should, at the very least, receive more clinical attention.

He adds: “If there are good reasons to suspect a link between oral health and cognition, why has this received so little attention to date? The obvious but rather prosaic reason is the historic separation between medicine and dentistry. Clinical specialists have long been a hindrance to effective research (an example being the lack of attention paid to the vascular etiology of dementia) and it is about time that we accepted that disorders do not necessarily follow the way we structure our professions.”

New Affordable All-on-4™ Dental Implants

Filed under: Implant Dentistry, Uncategorized — Tags: , , , , , — Dr. John Paul Gallardo @ 2:16 pm

All on 4™ is a relatively new implant option in the United States but has been done for many years with great success in Europe. This technique uses fewer implants that are placed at mechanical inclinations to maximize support. Because fewer implants are used this means lower treatment fees. Because we have a CT Scan in our facility, the deliberate use of angled implant placement allows us to avoid important anatomical areas that previously required bone grafting. Eliminating the need for costly bone grafting saves money as well as months of healing. We could perform the implant placement with sedation and place teeth later the same day if you wish. The All on 4™ option provides a comparable long term outcome to Teeth in An Hour™ by attaching teeth that do not have to be removed. All on 4™ saves time and money and we are excited to make this option available to our patients.

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