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Posts for: January, 2020

By J. Viana Paiva, Jr., D.D.S., P.A.
January 23, 2020
Category: Dental Procedures
DoYouHaveAdequateBonetoSupportanImplant

Besides their life-likeness, implants are also prized for their high success rate. More than ninety-five percent of implants continue to function effectively after ten years.

Implants’ advanced technology explains some of their reliability and longevity—they’re as close to natural teeth as we’re now able to achieve. But their impressive success rate also owes to the detailed protocols that dentists follow to install them. One critical part of these protocols is ensuring a patient has enough bone in their jaw to support and precisely situate the implant for the best functional and aesthetic outcome.

Unfortunately, there are situations where a patient doesn’t have enough bone to achieve a satisfactory result. This often happens if there’s been months or years between losing the tooth and considering an implant. The reason why relates to the nature of bone as living tissue.

Like other cellular tissues in the body, bone has a life cycle: Older, worn-out cells die and are absorbed by the body, and new cells form to replace them. The growth cycle in the jaw receives stimulation from the forces generated when we chew, which travel up through the teeth to the bone.

However, this stimulation stops after tooth loss for the related area of bone, which can slow new bone growth. Over time, the volume and density of the bone around a missing tooth gradually decreases, enough eventually to make an implant impractical.

Insufficient bone volume, though, doesn’t necessarily mean an implant is out of the question. We may be able to address the problem by attempting to regenerate the bone through grafting. This is a procedure in which we insert graft material into the affected area of the jawbone. The graft then becomes a scaffold upon which bone cells can grow.  After several months, we may have enough regenerated bone to support an implant.

If there’s been too much bone loss, we may still need to consider another form of restoration. But if we can successfully build up the bone around your missing tooth, this premier restoration for replacing lost teeth could become a reality for you.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation.


By J. Viana Paiva, Jr., D.D.S., P.A.
January 13, 2020
Category: Dental Procedures
YouMayNeedOrthodonticsBeforeReplacingaMissingTooth

Sometimes you need only a single solution to improve your smile: teeth whitening to brighten stained teeth; porcelain veneers or crowns to mask dental flaws; or a life-like dental implant to replace a missing tooth. But not all dental situations are that simple and sometimes require a combination of treatments.

A case in point: restoring a missing tooth within a poor bite. The absent tooth itself may be the cause of the bite problem if it’s been missing for some time: The nearby teeth tend to move or “drift” into the empty space, leaving no room for implant placement.

When this happens, you’ll first need orthodontic treatment to correct the bite problem. Not only will this open the space for the implant, it also comes with its own benefits. It obviously improves your smile appearance—but straighter teeth are also easier to keep clean of bacterial plaque, which reduces your disease risk. You may also experience better digestion after your teeth are properly aligned and able to function as they should during eating.

The traditional way to improve a bite is through metal braces. But there are some downsides: For one, braces can make it difficult to keep teeth adequately clean, making wearers more susceptible to tooth decay and gum disease. Braces are also quite visible and can detract from a person’s appearance (even more so if a missing tooth is involved).

Unless your situation requires braces, you can choose clear aligners as an alternative. These clear, computer-generated plastic trays are worn in sequence to gradually move teeth to their desired positions. Unlike braces, you can remove aligners for eating, cleaning or rare special occasions. And, they’re barely noticeable to others.

If you also have a missing tooth, you can have a temporary prosthetic (“false”) tooth built into your aligner trays. In this way you can still enhance your smile while undergoing aligner treatment.

Once your bite has been corrected, we can then proceed with restoring your missing tooth permanently with a dental implant. Although orthodontics adds to the time and expense of restoration, its often necessary to achieve the best result. Your future smile will be the better for it.

If you would like more information on dental solutions for improving your smile, please contact us or schedule an appointment for a consultation.


By J. Viana Paiva, Jr., D.D.S., P.A.
January 03, 2020
Category: Dental Procedures
Tags: gum recession  
4CommonCausesforGumRecession

Your gums play an important role in dental function and health. Not only do they help anchor teeth in the jaw, the gums also protect tooth roots from disease.

But you can lose that protective covering if your gums recede or shrink back from the teeth. An exposed tooth is more susceptible to decay, and more sensitive to temperature and pressure.

Here are 4 causes for gum recession and what you can do about them.

Gum disease. The most common cause for gum recession is a bacterial infection called periodontal (gum) disease that most often arises from plaque, a thin film of bacteria and food particles accumulating on teeth. Gum disease in turn weakens the gums causes them to recede. You can reduce your risk for a gum infection through daily brushing and flossing to remove disease-causing plaque.

Genetics. The thickness of your gum tissues is a genetic trait you inherit from your parents. People born with thinner gums tend to be more susceptible to recession through toothbrush abrasion, wear or injury. If you have thinner tissues, you’ll need to be diligent about oral hygiene and dental visits, and pay close attention to your gum health.

Tooth eruption. Teeth normally erupt from the center of a bony housing that protects the root. If a tooth erupts or moves outside of this housing, it can expose the root and cause little to no gum tissue around the tooth. Moving the tooth orthodontically to its proper position could help thicken gum tissue and make them more resistant to recession.

Aggressive hygiene. While hard scrubbing may work with other cleaning activities, it’s the wrong approach for cleaning teeth. Too much force applied while brushing can eventually result in gum damage that leads to recession and tooth wear. So, “Easy does it”: Let the gentle, mechanical action of the toothbrush bristles and toothpaste abrasives do the work of plaque removal.

While we can often repair gum recession through gum disease treatment or grafting surgery, it’s much better to prevent it from happening. So, be sure you practice daily brushing and flossing with the proper technique to remove disease-causing plaque. And see your dentist regularly for cleanings and checkups to make sure your gums stay healthy.

If you would like more information on proper gum care, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Gum Recession.”




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