The Future of Dentistry

 

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Dr. Timothy Rose

Dentures hopefully won't be the treatment of choice in the future. Rather, I would hope that implant dentistry and the replacement of teeth will be the treatment of choice. Patients should understand that a denture does not last a lifetime, that it needs constant maintenance and will have to be replaced periodically. The advantage of implant dentistry, once the implants are in place and are integrated, they can be used for a lifetime.

Each patient should evaluate all of their treatment options based on factors to include cost, but not limited to cost alone. Some of the more costly proceedures last longer, and over a moderately extended period of time, are more cost effective than some of the initially less costly procedures that have to be re-done more frequently.

Moderator

Dr. Rose, can you tell us a little bit more about how implants work?

Dr. Timothy Rose

Implants have existed in dentistry for more than 50 years. They came into vogue in the early 1980s. The materials that are used today are a direct offshoot of the work that was done with artificial joint replacement. Most of the metal that is used in joint replacement is titanium, and titanium is the metal of choice of implants.

One of the common misconceptions that patients have is that when they have multiple teeth that have to be replaced, they believe that they have to have an implant for each of those teeth. That generally is not the case. Obviously, when one has a single tooth to replace, a single implant is needed. But when one is replacing 14 teeth, one does not need 14 implants.

Patients are going to prefer to have a stable, fixed appliance in their mouth versus a denture that in many cases is not stable and moves around. Over a period of time, under a conventional denture that rests on gum and bone, the bone continues to shrink, and the denture will become loose. The reason dentures become loose, is not because the dentures change, but because the bony support of the denture continues to change under pressure. And patients can eventually lose enough bone so their dentures cannot become stablized. The advantage to implant dentistry is that the denture does not sit on either gum or bone, rather it sits on the implants and the forces created in functioning with the appliance are transmitted to the implants, thus protecting the adjacent bone.

mike from ext.eastgw.xerox.com at 3:28pm ET

is there a treatment in the works for the problem of receeding gums?

Dr. Timothy Rose

Yes. Today we are able to regenerate the tissue that has receeded off a tooth by doing a surgical proceedure called a graft. The grafting procedure is meant to cover the exposed root surface with a piece of gum tissue that will eliminate not only the exposed surface of the tooth, but protect that exposed surface of the tooth in the future so that the patient does not have the potential for all of the problems that can occur when the root surface of the tooth is exposed to the oral cavitiy.

chris from del.nj.webspan.net at 3:30pm ET

Is re-mineralization of the enamel possible as suggested by the new toothpaste Enamelon

Dr. Timothy Rose

Yes, it appears to be. The technology used in Enamelon is a by-product of some technology that was developed by the American Dental Association in the use of calcuim phosphates. Those materials appear to stimulate the regeneration of hard tissues.