Posts for: January, 2019

By Carlos Abreu, D.M.D. and Mahvassh Abreu, D.M.D.
January 29, 2019
Category: Dental Procedures
JohnnysTeethArentRottenAnyMore

Everyone has to face the music at some time — even John Lydon, former lead singer of The Sex Pistols, arguably England’s best known punk rock band. The 59-year old musician was once better known by his stage name, Johnny Rotten — a brash reference to the visibly degraded state of his teeth. But in the decades since his band broke up, Lydon’s lifelong deficiency in dental hygiene had begun to cause him serious problems.

In recent years, Lydon has had several dental surgeries — including one to resolve two serious abscesses in his mouth, which left him with stitches in his gums and a temporary speech impediment. Photos show that he also had missing teeth, which, sources say, he opted to replace with dental implants.

For Lydon (and many others in the same situation) that’s likely to be an excellent choice. Dental implants are the gold standard for tooth replacement today, for some very good reasons. The most natural-looking of all tooth replacements, implants also have a higher success rate than any other method: over 95 percent. They can be used to replace one tooth, several teeth, or an entire arch (top or bottom row) of teeth. And with only routine care, they can last for the rest of your life.

Like natural teeth, dental implants get support from the bone in your jaw. The implant itself — a screw-like titanium post — is inserted into the jaw in a minor surgical operation. The lifelike, visible part of the tooth — the crown — is attached to the implant by a sturdy connector called an abutment. In time, the titanium metal of the implant actually becomes fused with the living bone tissue. This not only provides a solid anchorage for the prosthetic, but it also prevents bone loss at the site of the missing tooth — which is something neither bridgework nor dentures can do.

It’s true that implants may have a higher initial cost than other tooth replacement methods; in the long run, however, they may prove more economical. Over time, the cost of repeated dental treatments and periodic replacement of shorter-lived tooth restorations (not to mention lost time and discomfort) can easily exceed the expense of implants.

That’s a lesson John Lydon has learned. “A lot of ill health came from neglecting my teeth,” he told a newspaper reporter. “I felt sick all the time, and I decided to do something about it… I’ve had all kinds of abscesses, jaw surgery. It costs money and is very painful. So Johnny says: ‘Get your brush!’”

We couldn’t agree more. But if brushing isn’t enough, it may be time to consider dental implants. If you would like more information about dental implants, please call our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implants” and “Save a Tooth or Get an Implant?


By Carlos Abreu, D.M.D. and Mahvassh Abreu, D.M.D.
January 19, 2019
Category: Dental Procedures
TimingisEverythingWhenReplacingaTeenagersMissingTooth

There are good reasons, for both health and appearance, to replace a missing tooth with a dental implant or similar restoration as soon as is practical. The bone around a tooth socket diminishes the longer it remains empty, up to 25% the first year. And, of course, your smile is less attractive, especially with a highly visible tooth.

If it’s your teenager, though, you may need to wait on a permanent restoration because their jaws are still developing. An implant placed before completion of jaw development could eventually appear out of alignment with neighboring teeth.

Our biggest concern is protecting bone health at the site of the missing tooth. We can do this and encourage growth by placing bone grafts (processed minerals from another donor) that serve as scaffolds on which surrounding bone can grow. Grafts usually dissolve (resorb) over time, but the rate of resorption can be slowed for a younger patient in need of long-term bone growth.

Planned orthodontic treatment can usually go on as scheduled. The orthodontist may accommodate the tooth loss by adding a temporary tooth within the braces or other device that matches the color and shape of the patient’s natural teeth. The orthodontist will also take care to maintain the empty space for a future implant or other restoration.

A dental implant is considered the best option for a missing tooth, not only for its life-like appearance and durability, but also its ability to encourage bone maintenance. Timing, though, is essential for teenagers. As it grows, the upper jaw will tend to move forward and down. Natural teeth move with this growth; implants, though, are attached differently and won’t move with the jawbone. While the other teeth around them move, the implants can appear to shrink back resulting in an unattractive smile appearance. So waiting until the jaw has finished growing is important.

For most people, jaw growth finishes by age twenty-one for men, women usually faster, but each person is different. The dentist’s expertise and experience, coupled with comparisons of adult family members’ facial appearances, will help determine the right time to undertake a permanent restoration for the best outcome both for health and a permanent, attractive smile.

If you would like more information on treating teenagers with missing teeth, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants for Teenagers.”


By Carlos Abreu, D.M.D. and Mahvassh Abreu, D.M.D.
January 09, 2019
Category: Dental Procedures
Tags: x-ray  
BitewingX-RaysSafelyRevealallAboutBackTeethtoPreventToothDecay

Modern dental care wouldn’t be the same without x-rays. Since dentists began capturing x-ray images a century ago to detect beginning tooth decay, billions of teeth have been preserved.

“Catching it early” is the key to staying ahead of this aggressive bacterial infection. Once it breaks through the protective defenses of tooth enamel, it can advance toward the center of the tooth, the pulp, damaging dentin as it goes. While we can effectively stop it at this point with a root canal treatment, it’s better for the tooth’s long-term health to detect and treat any decay early on with a less-invasive filling or other treatment method.

X-ray imaging helps make that possible, revealing decay much easier than we can see with the unaided eye. And while we can often detect decay in front teeth by visual examination or by using very bright lighting, that’s not as easy with the less accessible back teeth. For those teeth we use a special x-ray technique known as the bitewing.

The name comes from the small frame used to hold the film. It’s held in place in the mouth by the patient biting down on small tabs or “wings” extending from the frame. The x-ray beam travels through the outer cheek and teeth to the film being held in the frame on the back side of the teeth. When exposed, we’ll be able to view the interior of these back teeth: a set of four bitewings gives us a full view of all the upper and lower molars and pre-molars on each side of the jaws.

Like other forms of radiation energy, too much or too frequent exposures to x-rays can lead to serious health problems. But bitewing x-rays carry little risk to health. That’s because they fit well with the ALARA principle, meaning “As Low As Reasonably Achievable,” which helps guide our use of x-rays. Patients receive a fraction of the radiation exposure from routine bitewing x-rays than they receive annually from the natural environment.

Without bitewing x-rays and other diagnostic methods, the chances are high that tooth decay or other dental problems can go undetected in their early stages. Using this important tool can help us head off major damage before it occurs.

If you would like more information on the role of x-rays in dental 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 “Bitewing X-Rays: A Routine Part of Your Dental Exam.”




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Carlos Abreu, D.M.D. and Mahvassh Abreu, D.M.D.

1712 I St. NW , Suite 906 Washington, DC 20006