Sinus Grafting to Support Dental Implants

The preferred technique for tooth replacement, dental implants offer a number of advantages to patients. They look good, they’re long-lasting, and over the long-term, they’re more cost-effective than other alternatives.

Dental implants are titanium screws that are anchored to the jawbone, so patients are only candidates for the treatment if they have enough underlying bone to house the screws.  Some patients, such as those with periodontal disease, may not have enough bone structure for dental implants.  Additionally, if the tooth has been missing for some time, and the bone has receded, dental implant placement can be problematic.

Bone loss can be especially pronounced in the posterior section of the upper jaw as the jaw bone can be particularly thin in the area of the sinus cavity which lies just above the molars. This can be troublesome if the tooth that needs to be replaced is a molar. Fortunately, implant dentists can use sinus grafting to address this issue and add bone to support the dental implants.

In a sinus graft, the soft sinus floor is essentially raised, encouraging additional bone growth in the area.  An incision is made in the gums in the area below the sinus, and then cut through the bone to create a “window” into the sinus cavity.  Bone graft material, which ultimately encourages thicker bone growth, is then placed in the area, and the incision is then sutured.  A sinus graft can take place under local anesthesia.

Sinus grafting may extend the overall treatment as it takes time for the bone to mature after the initial sinus lift before the dental implants can be placed.  However, in some situations it may be possible to place the implants during the augmentation surgery and thus avoid the additional healing time and a second surgery. Each case is different.

 

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Fixed Permanent Bridges vs. Dental Implant

Monmouth Country NJ patients in need of a tooth replacement often struggle deciding whether to have a fixed permanent bridge or a dental implant. A fixed permanent bridge requires the replacement tooth to have a permanent crown placed on the tooth on either side. Dental implants allow for a single prosthetic replacement tooth to be anchored to the jawbone by a titanium screw (dental implant). Here is a discussion of several points of consideration that should help you make the choice between the two.

Durability
If you care for them properly, dental implants can last for decades if not a lifetime, and they are a better choice for preserving the natural bone and teeth in the rest of the mouth. Bridges compromise the structure of the nearby teeth, which must have healthy tooth structure shaved down before the abutment crowns can be placed. Because the implant actually replaces the original tooth’s root, dental implants help to preserve the jawbone, which can erode when a conventional tooth-supported bridge is used as a tooth replacement.

Appearance
Because they prevent bone and gum loss, dental implants do more to preserve aesthetics over the long run. Implants also look just like natural teeth, so no one will suspect that they’re actually replacements. Also, gums are more likely to recede in the vicinity of a bridge than in the area of an implant, and this can have an unsightly affect on your smile.

Cost
The cost of a single dental implant tooth replacement is typically about the same or less than the cost of a tooth-supported fixed bridge. When multiple implants are involved, the costs may be somewhat higher than that of the fixed bridge. However, it’s also important to consider the long-term costs. If tooth decay occurs in either of the remaining teeth surrounding the bridge, which sometimes happens, the crown may need to be replaced, or a more extensive treatment, such as a root canal might be necessary to preserve the tooth structure.

It is critically important to recognize that with either option, you will get the best outcome when under the care of an experienced and credentialed specialist.

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Am I a Candidate for Crowns or Bridge?

A crown, also known as a cap, is a type of restoration which covers a tooth or attaches to a dental implant. A crown is typically bonded to the tooth with a dental cement, and may be attached to a dental implant by a screw or by dental cement. Crowns restore the appearance and function of decayed, cracked, or broken teeth, as well as teeth that have had root canals. A bridge can be made to replace a missing tooth, which consists of two crowns attached to a fake tooth (a pontic).

How Are Crowns + Bridge Done?
Tooth structure is removed circumferentially (360 degrees) around the damaged tooth to allow space for the porcelain. An impression is then made of the prepared tooth, which our dental laboratory technicians use to custom build your crown.
While the technicians are perfecting your crown, you will wear a temporary crown made of acrylic to protect your tooth. The final crown is shaped to look and feel natural, then is attached with a special dental cement.
Dr. Courey’s goal is to make it appear as if it is a natural tooth emerging from
the gums.

Am I a Candidate for Crowns or Bridge?
Crowns may be a good option for you if you have teeth that are badly damaged or worn, require or desire major changes in size, shape, or alignment of teeth, and are committed to practicing good oral hygiene habits.

Maintaining Your Crowns + Bridge
Crowns can be treated like regular teeth. Like regular teeth, you can still get cavities underneath a crown so it is extra important to brush, floss and use fluoride. Since they are most frequently made of ceramic, crowns can fracture. Avoid chewing ice and biting your fingernails. A nightguard might be made to help protect your crowns from fracture, especially if you clench or grind your teeth.

Call New Jersey Monthly Top Dentist, Prosthodontist, Dr. James Courey to see how your dental health and appearance can be improved: 732-577-0555.

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What tooth number is this tooth?

Do you know the names and numbers of your teeth? Can you only say “The pointy one in the top right side!” Let’s get to know your teeth better here; it will make you a better communicator with your dental professional – you’ll even be able to pinpoint specific teeth over the phone!Tooth Chart

The universal numbering system, identifies each tooth in a person’s mouth with an individual number. This system references all the teeth that should be in your mouth, so if you have wisdom teeth (or other teeth) which have been removed, those numbers still exist. # 1 is your upper right wisdom tooth. Each tooth then progresses up one number all the way across to the 3rd molar (wisdom tooth) on the left side of the mouth (# 16). #17 will be the lower left wisdom tooth, and counting clockwise, the last tooth will be #32, the lower right wisdom tooth.

Because most people do not have 32 teeth, due to wisdom tooth extraction, congenitally missing them or extraction due to non-restorable dental conditions, we will skip over any missing numbers. It is also important to know the names of the teeth! Your front four teeth (7, 8, 9, 10) and your front lower four teeth (23, 24, 25, 26) are incisors. Incisors are mainly used for gripping, cutting and shearing food, and are the first thing a person sees when you flash your smile. Incisors also play a dominant role in speech.

Moving further back are the canines (or cuspids).On the upper jaw, canines are also named “eye teeth” because the long root almost points to the eye socket. They are #6 and 11 (upper jaw) and #22 and 27 (lower jaw). Canine teeth are relatively long and pointed, used primarily for holding food while it is being ripped in the mouth.They are an important guide for the bite of your teeth; usually they are the first to wear away. Once canines are worn, other teeth will wear away quickly.

Behind the canines lie the bicuspids (or premolars), #4, 5, 12, 13 (upper jaw) and #20, 21, 28, 29 (lower jaw). Bicuspids are a sort of “in between tooth,” with the properties of both the canine and molar teeth. These teeth transfer food from the canines to the molars for proper grinding.
Finally, the molars make up the rear-most teeth in your mouth. Depending on if you have your wisdom teeth or not, you will have 8 or 12 molars, which lie directly behind the two biscuspids in each quadrant of your mouth, #2, 3, 14, 15 (upper jaw) and #18, 19, 30, 31 (lower jaw). Molars are like a grinding table, carrying out the smashing and grinding of food for digestion.

Next time, try to communicate with your dental professional the name or number of your tooth that is being discussed. It would impress and earn great respect from your dental professional, and would also be the first step to knowing your teeth! Once you know your teeth better, you will likely find taking care of your dental health easier more interesting. If you learn these numbers, you will be one step ahead of most people regarding dental communication!

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The latest testimonial from one of Dr. Courey’s cosmetic dentistry patients

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Which health conditions are related to gum disease and mouth problems?

Bacteria Cause Gum Disease and Worse

The research isn’t conclusive, but red, swollen, and bleeding gums may point to health problems from heart disease to diabetes. Sometimes, bacteria from your mouth can travel to your bloodstream, setting off an inflammatory reaction elsewhere in your body. Left untreated, gum disease can increase your risk for a host of diseases linked to inflammation. Certain diseases and medications also may cause mouth problems.

Can Mouth Bacteria Affect the Heart?

Some studies show that people with gum disease are more likely to suffer from heart disease than those with healthy, pink gums. Researchers aren’t sure why this association exists. One theory is that oral bacteria travel into the bloodstream where it may attach to fatty plaques in the arteries, causing inflammation and setting the stage for a heart attack. Are you are at risk? Talk to your doctor.

Gum Disease and Diabetes

Diabetes can reduce the body’s resistance to infection. Elevated blood sugars increase the risk of developing gum disease. What’s more, gum disease can make it harder to keep blood sugar levels in check. Protect your gums by keeping blood sugar levels as close to normal as possible. Brush after each meal and floss daily.  Visit your hygienist and Dr. Courey at least twice a year.

Dry Mouth and Tongue Cause Tooth Decay

The 4 million Americans who have Sjögren’s syndrome are more prone to have oral health problems, too. With Sjögren’s, the body’s immune system mistakenly attacks tear ducts and saliva glands, leading to chronically dry eyes and dry mouth (called xerostomia). Saliva helps protect teeth and gums from bacteria that cause cavities and gingivitis. So a perpetually dry mouth is more susceptible to tooth decay and gum disease.

Medications That Cause Dry Mouth

Given that a chronically dry mouth raises risk of cavities and gum disease, you may want to check your medicine cabinet. Antihistamines, decongestants, painkillers, and antidepressants are among the drugs that can cause dry mouth. Talk to your doctor or Dr. Courey to find out if your medication regimen is affecting your oral health, and what you can do about it.

Stress and Teeth Grinding

If you are stressed, anxious, or depressed, you may be at higher risk for oral health problems. People under stress produce high levels of the hormone cortisol, which wreaks havoc on the gums and body. Stress also leads to poor oral care; more than 50% of people don’t brush or floss regularly when stressed. Other stress-related habits include smoking, drinking alcohol, and clenching and grinding teeth (called bruxism).

Osteoporosis and Tooth Loss
The brittle bone disease osteoporosis affects all the bones in your body — including your jaw bone — and can cause tooth loss. Bacteria from periodontitis, which is severe gum disease, can also break down the jaw bone. One kind of osteoporosis medication — bisphosphonates — may slightly increase the risk of a rare condition called osteonecrosis, which causes bone death of the jaw. Tell your Dr. Courey if you take bisphosphonates.

Pale Gums and Anemia
Your mouth may be sore and pale if you’re anemic, and your tongue can become swollen and smooth (glossitis). When you have anemia, your body doesn’t have enough red blood cells, or your red blood cells don’t contain enough hemoglobin. As a result, your body doesn’t get enough oxygen. There are different types of anemia, and treatment varies. Talk to your doctor to find out what type you have and how to treat it.

Eating Disorders Erode Tooth Enamel
A dentist may be the first to notice signs of an eating disorder such as bulimia. The stomach acid from repeated vomiting can severely erode tooth enamel. Purging can also trigger swelling in the mouth, throat, and salivary glands as well as bad breath. Anorexia, bulimia, and other eating disorders can also cause serious nutritional shortfalls that can affect the health of your teeth.

Thrush and HIV

People with HIV or AIDS may develop oral thrush, oral warts, fever blisters, canker sores, and hairy leukoplakia, which are white or gray patches on the tongue or the inside of the cheek. The body’s weakened immune system and its inability to stave off infections are to blame. People with HIV/AIDS may also experience dry mouth, which increases the risk of tooth decay and can make chewing, eating, swallowing, or talking difficult.

Treating Gum Disease May Help RA
People with rheumatoid arthritis (RA) are eight times more likely to have gum disease than people without this autoimmune disease. Inflammation may be the common denominator between the two. Making matters worse: people with RA can have trouble brushing and flossing because of damage to finger joints. The good news is that treating existing gum inflammation and infection can also reduce joint pain and inflammation.

Tooth Loss and Kidney Disease
Adults without teeth may be more likely to have chronic kidney disease than those who still have teeth. Exactly how kidney disease and periodontal disease are linked is not 100% clear yet. But researchers suggest that chronic inflammation may be the common thread. So taking care of your teeth and gums may reduce your risk of developing chronic kidney problems.

Gum Disease and Premature Birth

If you’re pregnant and have gum disease, you could be more likely to have a baby that is born too early and too small. Exactly how the two conditions are linked remains poorly understood. Underlying inflammation or infections may be to blame. Pregnancy and its related hormonal changes also appear to worsen gum disease. Talk to your obstetrician or Dr. Courey to find out how to protect yourself and your baby.

What Healthy Gums Look Like
Healthy gums should look pink and firm, not red and swollen. To keep gums healthy, practice good oral hygiene. Brush your teeth at least twice a day, floss at least once a day, see your dentist regularly, and avoid smoking or chewing tobacco.

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Dentures

Dentures, commonly referred to as false teeth, are removable dental prosthetics designed to replace missing teeth. If you are missing all your teeth in one or both jaws, complete dentures can be made that are supported by your gums or by dental implants.

If you are missing only some of your natural teeth, a partial denture can be made that is supported by your gums and teeth, and even dental implants. A prosthodontist, like Dr. James Courey, is a dental specialist who had three additional years of training, which included all steps of making esthetic customized dentures.

How Are Dentures Made?
Dr. Courey starts by taking dental impressions, as well as several measurements to get the bite and fit right for you. You can help choose the color and shape of your teeth, as well as any distinctive features you might want. Dr. Courey will then work hand-in-hand with an in-house expert dental technician to finalize the customized acrylic dentures.

Am I a Candidate for Dentures?
If you have lost or are losing all of your natural teeth, complete dentures are the traditional method of tooth replacement. If you are only missing some of your teeth, several types of partial dentures can be made to replace your missing teeth. In addition to conventional dentures, dental implants may be placed to stabilize and retain complete or partial dentures.

Maintaining Your Dentures
To properly maintain your dentures, wash them daily using a denture cleaner, hand soap, or liquid dish soap and cold or warm water. Soak your dentures in water or denture cleaner when they are not in your mouth to prevent them from drying out.

Remove your dentures at night, as wearing them can cause tissue irritation, fungal infection, and increased bone loss. If your dentures become loose or painful, it is time to see Manalapan prosthodontist, Dr. James Courey, to evaluate if they need an adjustment, a reline or replacement.

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I had an eating disorder, can you help me?

Dr. Courey, “I am scared! Am I going to loose my teeth?”
I looked at Jenny, from New Jersey, as I have with many similar pretty young ladies, and I really felt for her.

“Jenny, you will be fine – the good news is that you are recovering and you are here. I can help you have a healthy and beautiful smile again. It is challenging, but work with me – together we can get your mouth back in shape so you can look the way you feel, healthy.” And we did.

Jenny is not alone. Among the susceptible figure-conscious young female group, eating disorders are quite common, and teeth erosion is a side effect of the acidic oral environment resulting from either purging or a poor diet.

Eating disorders, including bulimia (binge eating followed by self-induced vomiting), anorexia and poor dieting habits carry side effects which are detrimental to your bodily and mental well being – they can also rot your teeth. Studies have shown that up to 2.1% of males and 7.3% of females purge (self-induced vomiting) at least once a week, and the numbers are even higher for adolescents.

Tooth surface loss from erosion caused by chemicals such as dietary, gastric or environmental acids typically wear away tooth enamel, which leads to sensitive teeth, cavities, or gum disease. If untreated, these effects can exacerbate leading to teeth grinding and gastric reflux disease. Soft tissue lesions, malnutrition, a suppressed immune system, low self-esteem, an addictive personality (smoking, drinking or drugs), peptic ulcers and esophagitis are common among people who suffer from bulimia and anorexia. Oral damage from such disorders can include a severe breakdown of the teeth or their supporting structures which can affect the facial muscular system, negatively affecting your daily quality of life; the effort to restore a damaged mouth can become extremely challenging and costly.

Treatment of the problem, besides education and being supportive to the person suffering from the disorder, involves precise dental management; controlling the oral environment, drinking water or healthier juice instead of diet soda, eating healthier (as opposed to binge eating and purging) are all part of the solution. Using prescription strength fluoride to harden and desensitize your teeth and maintaining your oral hygiene by brushing and flossing at least twice a day is also crucial. If you regurgitate or vomit, rinse your mouth out right away. Adding baking soda to your brushing can also neutralize the acidic environment.

Getting a custom-fitted night guard to prevent further loss of tooth structure from grinding and bruxism and perhaps veneers or crowns can be used to restore ideal health to your mouth. Of course, a consultation with Prosthodontist, Dr. Courey would be the first step of the process. The earlier you start treating the problem the better. A healthy mouth is essential for a healthy life.

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Wouldn’t you like a whiter smile?

Professional teeth whitening can create such a dramatic difference that millions of people worldwide will get their teeth whitened this year. Here are the answers to some common questions you may have about whitening.

What is whitening? It is a process that takes away stains and discoloration to brighten your teeth enamel. Safe, quick, and reliable teeth whitening can be done under the supervision of Dr. James Courey and his team of professionals – in the office or at home. What do patients report about their teeth whitening experiences?

*boosted self-confidence,

*improved looks,

*and they smile more!

Ask yourself, “Can I benefit?” Yes. After childhood, most people can benefit from whitening. As people age, their teeth tend to darken and yellow, particularly if they…

*drink coffee, tea, or red wine;

*use tobacco products;

*take certain medications.

Are you asking, “Why should I get supervised teeth whitening?” We make absolutely certain that the whitening ingredients in the system we prescribe for you suit your individual teeth and gums. Without supervision, ingredients found in some off-the-shelf kits could injure gums and other soft tissue in the mouth and throat, or make you ill if ingested.

How white can you expect your teeth to look? Teeth can be whitened up to an average of eight shades. The final result depends on the extent of staining. We can help you to determine your smile’s best whitening goal.

Dental specialist, Dr. James Courey has whitened many smiles of people from Manalapan, Freehold, East Brunswick, North Brunswick, Old Bridge, Colts Neck, Marlboro, Red Bank, Matawan, Monroe, Princeton, Spring Lake, and others towns in New Jersey, New York, and Philadelphia.

Courey_dental_whitening

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About New Jersey Prosthodontist, Dr. James Courey

Manlapan Dentist Dr. James CoureyDr. James Courey specializes in the restoration and replacement of teeth with implants, crowns, bridges, veneers, and dentures. The American Dental Association recognizes prosthodontists as the only genuine specialists in cosmetic or aesthetic dentistry, best able to restore optimum function and appearance to your teeth.

Their “extensive training and experience provide prosthodontists with a special understanding of the dynamics of a smile, the preservation of a healthy mouth and the creation of tooth replacements,” notes the American College of Prosthodontists.

Missing or imperfect teeth by traumatic accident, cancer, eating disorder, congenital conditions, or decay can be replaced with beautiful, long lasting, functional teeth. To produce dentistry’s best outcomes, Dr. Courey proudly partners with New Jersey’s finest dental specialists, general dentists and dental labs. “Working with top dentists & labs is the key to proving my patients with the best restorations available,” he says. “Together, we find the best possible solutions to complicated dental dilemmas.”

Dr. Courey received four years of advanced dental implant training at Department of Periodontal & Implant Dentistry at New York University, where he is also a postgraduate resident instructor of prosthodontics.  He earned his Prosthodontic specialty certificate at Albert Einstein College of Medicine/Montefiore Medical Center. “Ongoing study of a variety of medical & dental disciplines provides me with a wide range of diagnostic insight and diversified approaches to tooth replacement solutions.” This is his fourth time as a New Jersey Monthly Top Dentist.

Whether working in an advisory capacity with your general dentist or providing specialized care, Dr. Courey’s expertise yields natural looking, long lasting restorations.

James Courey, DDS, LLC

224 Taylors Mills Road, Suite 110

Manalapan, NJ 07726

732-577-0555

www.BuildingGreatSmiles.com

 

 

 

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