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How long will my dental implants last? We hear this question so often. To ensure that your new, teeth last as long as possible, good care is important. But how can you clean your implants and dentures optimally? NextSmile spoke with Dr. Wilson, an expert in dental implants. And here we will tell you how you can clean your implants like a professional!

The Key facts:

• Dental implants need to be cleaned regularly to avoid bacterial inflammation around the implant.
• The greatest danger to the retention of dental implants is peri-implantitis (similar to periodontitis on natural teeth).
• Cleaning your implants requires experience and requires special procedures. Prophylactic staff in the dental practice will clean implants with special aids.

Why do dental implants and dentures need to be cleaned?

With regular prophylaxis at the dentists, chronic inflammation and its accompanying symptoms are recognized early. The professional removal of bacterial deposits on the implant surface is an important part. Thus, the cleaning process done by the specialists should take place regularly. Part of this regular appointment should also be the examination and documentation of the jawbone condition.

Modern prophylaxis concepts include an individual health plan for teeth and dentures. The goal: to recognize potential risks early, to avoid diseases and to keep the often expensive dentures intact for as long as possible.

These factors are critical to long-term success of dental implants:

• The prosthetic restoration should be of high quality.
• The implant must grow in healthy and without inflammation.
• The teeth must remain healthy.
• The diet should be balanced and healthy.
• Best not to smoke!

However, risks and complications can also arise if you neglect your regular check-ups in the dental practice and/or your oral hygiene.

Peri-implantitis puts the dental implant at risk

Peri-implantitis, the inflammation and loss of bone around the implant, is similar to the periodontitis on the natural tooth. Both diseases are caused by bacteria. Thus, an untreated periodontitis may also pose risks for an implant.

In peri-implantitis, just as in periodontal disease, the jawbone recesses. The implant loses its hold and loosens. In fact, peri-implantitis is the most common cause of implant loss. If you notice one of the following warnings, you should make an appointment with the dentist immediately.

• Severe bleeding during teeth cleaning
• Pus formation around the dental implant
• Reddish colored gums around the implant

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In a nutshell, this is how a sports mouth guard works: By distributing and spreading the impact energy and force over a wider area, tooth fractures or bite wounds are significantly reduced.

A good mouth guard therefore needs to be made of an elastic material that is also sufficiently rigid to distribute the pressure. The mouth guard
must also be biocompatible and fit securely in the mouth. It must also be durable and be easy to handle. It is very important that the athlete’s breathing, speech and performance are not negatively affected by wearing the device. Ready-made mouth guards that are readily available in stores may not meet all these requirements as well as they should.

However, an individually designed sports mouth guard, that is manufactured in the dental laboratory and dental practice, will meet all of these requirements of the athlete. An individually designed sports mouth guard, that is specifically designed and adapted to the athlete’s mouth, will preserve teeth, oral mucosa, tongue, lips, jaws and the temporomandibular joints optimally against injuries. Even the risk of a concussion will be reduced significantly.

Therefore, the professionally manufactured individual mouth guard does a much better job of protecting the athlete’s teeth, gums, tongue and alveolar ridge from injury. Patients are impressed by the high level of comfort and the snug and comfortable fit. It sits firmly on the teeth, allows normal breathing and the position of the jaw is not affected. After a short period of acclimatisation to get used to the mouth guard, the athlete will even be able to speak normally. In children the mouth guard can be adapted to newly erupting teeth or any orthodontic appliances that the child is wearing.

Variants of the sports mouth guard

The design of the individual sports mouth guard is based on an impression, or a ‘situational model’, that is individually made of the patient’s mouth. The specialised provider and partner for dentists and dental technicians is the Erkodent company, and with Playsafe different variants of the mouth guard are available as recommended. An ethylene vinyl acetate (EVA) is used as the material for manufacturing sports mouth guards. It is nontoxic, highly elastic and chemically inert.

The sports mouth guard consists of at least two laminated layers with a bite for the lower jaw. Depending on the oral status of the athlete and the type of sport being practised, four different variants of thickness of the layers are available.

1. The 2-layer light sports mouth guard

This mouth guard is recommended for smaller mouths, ie for children, and for sports where a helmet protects the midface area. It is also suitable for contactless sports. The light sports mouth guard is suitable for the following sports: gymnastics, biking, basketball, soccer, horse riding, handball, water polo and motocross.

2. The 2-layer medium sports mouth guard medium

This mouth guard is recommended for adults practising sports with ‘flat strokes’, so it is suitable for the following sports: boxing, biking, basketball, football, judo, wrestling, horse riding, handball, water polo, motocross.

3. The 3-layer light-pro sports mouth guard

This mouth guard is ideal for sports that feature very hard, small-area blows when the mouth is cramped. The 3-layer light-pro sports mouth guard is suitable for sports like ice hockey, field hockey, squash, polo, rollerblading, kickboxing, karate and rugby.

4. The 3-layer heavy-pro sports mouth guard

The 3-layer heavy-pro mouth guard is recommended for adults practising sports with very hard, small-area hits. It is therefore suitable for ice hockey, field hockey, squash, polo, rollerblading, kickboxing, karate and rugby.

Individual design of the sports mouth guard

The acceptance of athletes of a sports mouth guard increases with comfort and appearance, therefore they will be happier with one that is individually designed for them as it will guarantee a higher degree of comfort. As regards appearance, the dentist will take the preferences of the wearer into account. A sports mouth guard can also be individualised as a wide range of colours is available.

So it is even possible to make a multicoloured design if the patient wants it!

Some of the best Boxing Mouth guards

Venum Challenger

This single piece mouth guard by Venum is made for boxing and martial arts. It is a “boil and bite” style, designed for you to heat the guard and form it to your mouth. This is one of the most popular mouthguards available and many say the best mouthguard for martial arts. More info here.

Sisu Aero

This Aero model Sisu mouth guard is one of the thinnest available on the market. You can talk, breathe and even drink with the mouthguard in place. It stays secure and won’t fall out, in fact some say it is too secure and find it a challenge to remove. The guard does not go so far back into the mouth that it causes gagging, which is nice. More info here.

Impact Custom Professional

This kit is for a truly made custom mouth guard. Once you order the kit, they send you what you need to make a mold of your teeth, you send the mold back on their dime and they mail you your custom mouthguard, all at a price much lower than the dentist. More info here.

Under Armour ArmourFit

This single piece boil and bite mouth guard is as easy as it gets, they can even be heated in a mug in the microwave. It has a low profile because it is just one piece, which makes breathing and talking easier when you are wearing it. More info here.

Everlast Evershield

This heavy duty double mouth guard is one of the top boxing mouth guards. It is soft and shock absorbing on the inside, firm and shock dispersing on the outside, plus in covers top and bottom teeth and is the boil and bite style so you can get a perfect fit. More info here.

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Patients often want to find out about metal-free removable restorations made of allergy-free materials. That is why we want introducing a special high potential plastic that professionals count on. It is a nylon-based thermoplastic material that is particularly suitable for partial and temporary dentures. This high-purity nylon resin is known under the product name Valplast. This material is:

• 100% monomer-free
• highly flexible
• unbreakable, and
• almost invisible

An overview of this allergy free material

Valplast is free from methyl methacrylate and benzoyl peroxide. It’s a thermoplastic polycondensate free from carboxylic acids and amines. Compared to a conventional PMMA, the water intake is significantly reduced. The material is resistant to most organic acids. Valplast is a thermoplastic which is moulded into shape by heating, and at no point do incompatible, allergenic substances manage to escape during the manufacturing process.

The slight transparency of the material allows the desired ‘chameleon effect’ of visually seeming to disappear in the mouth. This means that the restoration is integrated into the mouth with harmonious colours and becomes virtually invisible. Furthermore, Valplast is a CE certified medical device of class 2a (MPG).

An overview of the indications

• interim and immediate supply
• clasp-free provisional single tooth replacement, for example after implantation
• invisible interim prosthesis as a ‘spider’ partial, particularly in the anterior region of the mouth
• aligner rails can be used

Advantages and disadvantages of this allergy free material

In addition to biocompatibility and freedom from allergies, the dentures made of Valplast mimic an essential property of conventional plastic prostheses, namely elasticity. Valplast prostheses can be elastically deformed without breaking. That simplifies, for example, the incorporation and removal of the prosthesis, especially with patients with small mouths. A filigree and clip-free design is also possible, and any retaining clips that are incorporated, are barely visible.

However, the material does have a few limitations. Valplast is relatively difficult to reline, so subsequent expansion of the prosthesis is not possible. In the event of further tooth loss by the patient, a new prosthesis will have to be made for them.

After implant placements, Valplast prostheses offer a good solution for temporary restorations. The patient receives an aesthetically pleasing solution right from the time of the insertion of the implant, all the way up to when they receive their permanent denture. So patients need not fear having to wear unsightly temporary prostheses.

And patients like Valplast prostheses! Many patients confirm that Valplast prostheses are comfortable to wear. Due to the fact that they also look good, the patient’s quality of life is considerably enhanced compared to normal clamp prostheses. So patients not only get a new smile, but they also feel happier about their new denture.

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The temporomandibular (tem-puh-roe-man-DIB-u-lur) joint (TMJ) flexibly connects the lower jaw with the skull and acts like a sliding hinge. The joint consists of a joint socket on the base of the skull (temporal bone) and a joint head on the rear part of the bony lower jaw. In between, there is a complicated fibrous apparatus. The joint is not only complicated, but also manages to achieve top performance every day: the temporomandibular joint is involved in every movement of the mouth, no matter how small (chewing, speaking, laughing, etc.).

2. A TMJ never comes alone

Humans have two temporomandibular joints: one on the right and the other on the left of the skull. The two joints never move independently of each other. With every movement, both joints are stressed simultaneously.

3. The temporomandibular joint is part of a gear

The temporomandibular joint is part of an extensive control circuit made up of nerves, masticatory muscles of the jaw, face and neck muscles. The different areas of the human body are structurally and functionally related. A disorder in the area of the temporomandibular joints can affect the entire musculoskeletal system and dysfunction can lead to pain and discomfort.

4. The TMJ is incredibly flexible

In the true sense of the word, the temporomandibular joint is a hinge joint, which is unique in the human body. The TMJ allows movements in many spatial dimensions. Two fundamentally different movements are possible: the rotational and the sliding movement. In addition, the joint head can emerge from the joint pit (grinding movement), which is also atypical compared to other joints, causing damage when leaving the joint head from the joint pit (strain, sprain).

If you have a tooth or teeth missing, you are faced with the sometimes difficult choice of having to choose between conventional dentures, like a dental bridge or dental prosthesis, or modern dental implants. The right decision will depend on various factors, and we at Next Smile will guide you through the advantages and disadvantages of the different options. Every tooth has its function in the mouth. If a tooth or several teeth are missing, the gap should be closed. Missing teeth affect people in a variety of ways. First of all, it doesn’t look good, and people are often inhibited form laughing or smiling! Biting and chewing are also negatively affected, which can have an impact on the person’s eating habits. Existing neighbouring teeth can start to tip towards or grow into the gaps, or even loosen, with a risk of losing more teeth. The temporomandibular joints can also be negatively affected.

However, all these unfortunate scenarios can be avoided, because modern dentistry and dental technology offer a variety of dental solutions. We will help you chose the right one for you

A dental bridge, prosthesis or implant can be used to replace missing teeth

With a dental bridge, the remaining teeth are included, because a bridge fixes the dental prosthesis on ‘pillars’. If a tooth gap must be closed, the teeth on both side of the gap the gap become pillars on which the bridge is supported. The bridge body, called the pontic, is the new tooth.

• The dental bridge is permanetly anchored in the row of teeth and can’t be removed from the patient’s mouth. The materials used for dental bridges include all-ceramic, metal-ceramic, high-performance composite or metal alloys.
• A dental prosthesis, however, can be removed from the patient’s mouth to be cleaned for the purposes of oral hygiene. As a general rule, prostheses are used when many teeth are missing, or when the patient no longer has any teeth.
• The prosthesis is anchored to the remaining teeth with brackets, or other retaining elements. When the patient has no teeth, the prosthesis is held in place by the alveolar ridge. The materials used for dentures include plastic, high-performance composites, or metal alloys.
• Dental implants are becoming increasingly popular with patients. It is a modern, scientifically proven and convenient solution for replacing missing teeth. A dental implant functions like an artificial tooth root that is ‘implanted’ into the patient’s jawbone. Because biocompatible materials are used, the implant becomes firmly attached as the bone of the patient’s jaw bonds with it in a process called osseointegration. It then serves to anchor the dental prosthesis.
• Usually the implant consists of two parts – the implant body, which will be the new ‘root’ in the patient’s jaw, and the implant ‘abutment’, which is the new tooth. With dental implants, individual teeth or entire rows of teeth can be replaced. The materials for dental implants include implant body titanium or all-ceramic, all ceramic for the implant abutment, or high-performance composites.

Advantages and disadvantages of a dental bridge and dentures

Dental bridges and dentures have been used to replace missing teeth for many decades, so it is a proven solution. Highly skilled dentists and dental technicians can create long-term stable and functional dentures. The treatment generally is quite short. As a rule, the effort and costs for a dental bridge or dental prosthesis are less than for dental implants. However, dental prostheses can lose their fit for a variety of reasons, for example bone loss in the patient’s jaw. Ill-fitting dentures can cause pain from rubbing on the gums. Eating and speaking can also be negatively affected.

Many patients also find dentures uncomfortable. Dental bridges are more comfortable and fit firmly in the patient’s mouth. However, they have one major disadvantage – the two neighbouring teeth that will serve as anchors or pillars, have to be ground down. This means removing completely healthy tooth material. This flies in the face of modern dentistry because dentists always try to preserve the substance of healthy teeth.

Advantages and disadvantages of dental implants

Filling in a gap in a patient’s teeth with an implant means that the healthy neighbouring teeth do not have to be ground down. The implant fits simply fits into the row of teeth like another natural tooth. If the patient has only a few or no teeth, the patient can be given a fixed denture with the help of implants. So ugly, visible clamps or poorly fitting prostheses are a thing of the past, as is that often annoying palatal plate! An implant-supported denture also ensures that the patient can chew in comfort. The ‘new’ and highly functional teeth look completely natural, so the patient looks good as well.

In short, the possibilities of modern dentistry, with CAD/CAM and digital 3-D technology, is really impressive. Another very positive element is that modern dentistry nowadays tries to operate in a minimally invasive way.

Are white teeth healthier?

No, that is not a claim that can realistically be made. The tooth colour does not necessarily have anything to do with the health of the teeth. But the attractiveness of your smile will definitely be affected by the colour of your teeth. Studies say that bright, white teeth is very much part of a beauty ideal. Of course, ideals are relative, and the perception of beauty is subjective, but it is a fact that more and more patients are consulting their dentist not only for fixing their teeth, but for purely aesthetic reasons, so teeth aesthetics are obviously becoming increasingly important.

Which leads us to ask – what are the causes of teeth discolouration?
The causes of tooth discolouration can be intrinsic and/or extrinsic. Extrinsic discoloration is due to substances that are deposited on the tooth surface. It could be something as simple as tea, coffee or a glass of red wine. The tannins or polyphenols in these can cause discolouration. Mouth washes that contain chlorhexidine and cetylpyridinium chloride can also stain your teeth. Long-term smoking is notorious for causing nicotine discoloration of the teeth enamel that even professional cleaning may not be able to remove.

In the case of colour-changes happening in the tooth structure itself, we speak of intrinsic discolouration. These originate inside the tooth, for example blood breakdown products of necrotic pulp inside a diseased tooth, or structural malformation due to genetically determined factors like amelogenesis imperfecta. Certain medications like antihistamines, some antibiotics and various other drugs can also cause teeth discoloration. Dyes present in various substances that penetrate directly into the tooth enamel.

HOW CAN I GET THOSE RADIANT AND BEAUTIFULLY WHITE TEETH?

So how can I get those radiant and beautifully white teeth?
Teeth whitening through bleaching can help. Professional whitening, which is done by the dentist, is gentle on your teeth and gums, and completely pain free. The common active ingredient for whitening is carbamide peroxide, the effect of which was discovered purely coincidentally. The drug was initially just used as an antiseptic to treat gingivitis. Then it was noticed that it did not only result in helping with the inflammation, but also had a whitening effect on the teeth.

The process works by the whitening agent, which can be either hydrogen peroxide or carbamide peroxide, penetrating the tooth enamel to reach the discoloured molecules inside the enamel. The oxygen molecules from the whitening agent then reacts with the discoloured molecules and breaks the bonds that hold them together, thus whitening the teeth. It is quite a complex process but in short, the
bleaching agent causes an oxidation of the inorganic dye molecules that cause the discolouration.

Recently science and research have made great strides in adhesive technology. Many innovative materials have been clinically proven which gives dentists the confidence to use this technology in their practices.

CAN I BLEACH MY TEETH MYSELF?

There are four ways in which teeth bleaching is normally carried out:

• Chairside whitening that is done in the dental practice. First the gums are covered to protect them, then highly concentrated bleaching gel is applied to the teeth. Lasers or halogen lamps are then used for catalysis. After the therapy the teeth are polished and treated with fluoride. The patient remains in the dentist’s chair during treatment.

• Chairside whitening that is done in the dental practice. First the gums are covered to protect them, then highly concentrated bleaching gel is applied to the teeth. Lasers or halogen lamps are then used for catalysis. After the therapy the teeth are polished and treated with fluoride. The patient remains in the dentist’s chair during treatment.

• In-office whitening in the dental practice that is recommended for very severe discolouration. This professional bleaching method is carried out under dental observation and is indicated for severe discoloration. The bleaching agent is applied in a vacuum-formed splint, and takes about 30 – 60 minutes, during which time the patient stays in the dentist’s waiting room.

• Home whitening under the care of the dentist. The patient is instructed in the practice and independently puts the bleach into an individually made plastic rail that he or she wears during a given exposure time. The application can be repeated until the desired level of whitening has been achieved.

• Over-the-counter whitening products can be used without input from a dentist, and usually contain a hydrogen peroxide concentration below 0.1%. The process involves whitening strips or rails that are assembled.

SIDE EFFECTS OF TEETH BLEACHING

Whitening under dental care is usually gentle, but possible side effects can occur, such as tooth sensitivity or irritation of the mucous membrane. In this regard, the client’s medical history is important. Teeth with damaged tooth enamel carry a higher risk of being damaged. Bleaching agents can soften the surface of fillings in the teeth. Amalgam fillings should not be exposed to bleaching as there is a danger of an increased release of mercury.

THE COST OF TEETH BLEACHING

Unless you have supplementary dental insurance, teeth whitening is normally not covered by your health insurance, so you will have to pay for it yourself. The process will be thoroughly discussed with you and you’ll be given a full breakdown of the costs before you start the treatment. Remember our experts are always available to answer any questions that you may have!

ADDITIONAL READS

Dental Material Compendium – Zirconia