UAlberta SMILES ital to the health of our communities
Students ‘uplift the people’ Dental and dental hygiene students were ‘uplifting the people’ through their Sharing Smiles Day annual event in April 2017. Sharing Smiles Day events are a part of Oral Health, Total Health (OHTH) - a Federal Non-Profit Organization led by students and faculty from dentistry faculties across Canada with a mission to advocate, educate and improve the oral health care for persons with special needs. The event was the first one organized by the newly formed Alberta chapter. The day is meant to be informative and fun with opportunities for positive interactions where the attitudinal barriers between dental students and persons with special needs can be removed and positive relationships fostered. Photos courtesy of Adam Woods, Andrew Hoang, Kathleen Nguyen and Zach Teoh
A century of being vital to health of our communities The University of Alberta’s School of Dentistry is 100 years old. The School was founded when Canada was embroiled in the First World War. The Alberta school was the only one of its kind in Western Canada until the founding of the dental school at the University of Manitoba in 1957. The School has served Alberta communities through oral health education and programs like the Northern Satellite Clinics, Glenrose Rehabilitation Hospital Dental Clinic, Boyle McCauley Health Centre/SHINE Clinic, the Long Term Care Community Assessment and Treatment Program and finally, the main dentistry clinic on the U of A campus, which saw over 40,000 patients in 2016. As part of its centennial celebration, the School of Dentistry is releasing a trade paperback book in September titled: Roots—Extracted Tales from a Century of Dentistry at the University of Alberta. The century-long legacy of the School is vividly brought to life through a variety of stories. Alongside a history of dentistry, from tooth worms to virtual reality, other stories feature a former fruit farmer creating instructional dental models by hand; a determined woman battling institutional sexism to create the country’s second school of dental hygiene; and a desperate political fight against the school’s closure in the Ralph Klein era. Award-winning journalist Taylor Lambert is your historical tour guide for a witty journey that vividly brings the school’s history to life with surprising tales that even the most fervent dentophobe can sink their teeth into. All proceeds from the sale of the book go to Dentistry for Life Fund.
Table of contents How to help kiss cavities goodbye in babies Page 4-5
Meth: bad for your body and teeth
Why teeth can’t heal themselves
Addressing gum disease early critical for children
Taking the sting out of bad breath
Be smart and maintain wisdom tooth health through regular checkups Page 14-15
Grinding and clenching in your sleep is a wake-up call for treatment
Embracing your root canal. It’s not as bad as you think. Page 18-19
New and improved training tool aims to reduce radiation from dental x-rays
Going from face plant to tooth transplant Produced by School of Dentistry Design & Cover Tarwinder Rai Writers Tarwinder Rai Lesley Young Copy Editor Yuri Wuesnch
Edmonton Clinic Health Academy 5th Floor, 87 Avenue NW Edmonton, Alberta T6G 1C9 Kaye Edmonton Clinic 8th Floor, 11400 University Avenue Edmonton, Alberta T6G 1Z1 Katz Group for Pharmacy and Health Research Office: 7-020H Edmonton, Alberta T6G 2E1
Quit smoking for the sake of your smile
Keep that million-dollar smile with implants
How to help kiss cavities goodbye in babies Many of us have done it. Our baby drops their soother on the floor, we pick it up – lick it – and then put it back in their mouth. On the surface, this seems like an OK idea. But what many people fail to realize is that tooth decay is a transmissible disease. And if you have bacteria in your mouth – in the form of treated or untreated cavities – you may have passed that bacteria on to your child. “Most people aren’t aware that dental cavities are caused by bacteria and transmission is similar to any other infectious disease,” says pediatric professor and researcher Maryam Amin from the School of Dentistry. Carbohydrates alone cannot cause dental cavities in children, explained Amin. The cavity-causing bacteria must be present in order for cavities to occur. How are these bacteria passed on to a child? A simple kiss on the lips, blowing on their food to cool it down, licking the soother before placing it back into the child’s mouth, and even using the same utensil can pass the bacteria from your mouth to theirs. “Parents and caregivers are often surprised to learn this, but the majority of children can have this bacteria passed on to them until all their primary teeth erupt,” says Amin. While it can be challenging for parents to forego these culturally engrained displays of care and affection, there are steps parents can take to ensure they do not pass on cavity-causing bacteria. Keep in mind the most vulnerable time for bacteria to infest in a child’s mouth occurs from the eruption of their first tooth up to 31 months. This is also referred to as the “window of infectivity.” “Children who get the bacteria in their mouth at a young age have a higher chance of getting cavities later in life,” says Amin. “If you have cavities, treated or untreated, you still harbour the bacteria in your mouth.”
Meth: bad for your body and teeth While everyone benefits from the routine care provided by an oral health care professional, this expertise is even more critical for recreational drug users. “Substance abuse can substantially impact oral health,” says assistant clinical professor Arlynn Brodie from the School of Dentistry. “Methamphetamine users, for instance, often have poor oral health including severe tooth decay and gum disease.” Meth users also tend to have more plaque, calculus and gingival inflammation. The term ‘meth mouth’ is characterized by blackened, decaying teeth and a very dry mouth. For the most part, patients who use recreational drugs let their oral health slide and sometimes go days without brushing their teeth. Meth itself is acidic which contributes to increased dental decay. Combined with an increased intake of sugary drinks they often consume, tooth decay becomes an even bigger issue.
“Dental professionals are in a strong position to notice the effects of drug use on a person’s mouth,” Brodie explains. “Based on the patient’s dental history, we can determine whether they are a high risk caries patient or whether they experienced accelerated decay at any time. Drugs accelerate tooth decay. “So, when we see a patient, we can see why there is a decay pattern. If we’ve seen a patient since childhood who suddenly has dental carries, it may be a sign of drug use,” she says. Brodie recognizes that many people will not readily admit to drug use. However, she says dental hygienists and dentists have a duty to provide information and explain the impact of drug use on the oral cavity to their patients. “Asking a patient about drug use is a sensitive question. Even if they don’t answer, we will still provide them with accessible resources,” Brodie says. “Our goal is to educate patients whenever possible.”
School of Dentistry
Why teeth can’t heal themselves We know the human body can do many miraculous things. We get an injury, a broken bone or even give birth and it heals itself. Even after a heart attack, the heart muscle has the ability to heal. However, there is one part of our body that can’t heal itself –our teeth. “Teeth are the only part of your body that commonly become infected and remain in a state of constant infection and decay over a long period of time,” says Tom Stevenson, professor at the School of Dentistry. “Furthermore, unlike a cut finger, the body does not have the ability to heal or replace the lost parts of a tooth. In some parts of the world, tooth decay and gum disease are so prevalent that dental disease could be considered to be a pandemic.” Fractured bones have the ability to heal because they contain living tissues and cells whose function is to grow new cells and form new bone. By comparison, teeth, with the exception of the tooth nerve, do not have the ability to form new enamel or dentine. As a result, once tooth structure is lost to decay or injury, it cannot be replaced through normal healing. We are born with two sets of teeth: the primary dentition that erupts earlier in life and the secondary or adult dentition. The primary teeth are the first to erupt and they play an important role in the form and function of the developing jaws and in guiding the eruption of secondary teeth. Early loss of primary teeth can cause severe disruption in the eruption and
growth of secondary teeth. Dental decay and abscessed teeth are painful and can interfere with our eating, nutrition and wellbeing. In some cases, decay and abscessed teeth can progress to more serious infections or even death. A healthy dentition and oral cavity are important parts of total body health. The two most common oral diseases are tooth decay and gum disease. While there are a number of factors that can lead to gum disease and tooth decay, ingesting refined sugars and poor oral hygiene are at the top of the list. For the most part, this means that dental decay and gum disease are not only preventable but reversible. It means it’s never too late to take the path towards great oral health. “Repairing teeth can be costly and what we are able to repair or replace is never better than your own teeth,” says Stevenson. “The key to success is prevention. “Teeth are constantly exposed to the harsh environment of what we eat. This, coupled with poor oral hygiene, almost always leads to poor oral health. However, we can control both what we eat and how we care for our teeth.” Stevenson suggests following a balanced diet low in refined sugar, a consistent brushing and flossing routine, and regular visits to the dentist and dental hygienist will help “make your smile the best it could be.”
Addressing gum disease early critical for children While periodontal disease in children is rare, it does happen. In fact, if it isn’t addressed at an early stage, the effects of periodontal disease can be devastating.
“It’s very important that children have a periodontal exam as a part of their regular dental checkup,” she notes.
“Some children affected by this aggressive disease may lose all their teeth by the time they hit puberty,” says assistant professor Monica Gibson, a periodontist who specializes in periodontal research at the School of Dentistry. “The only way to properly diagnose periodontal disease is by visiting a dentist who can refer the patient to a periodontist for prompt treatment. That’s why visiting the dental office early in childhood is so important.”
Warning signs and what you can do:
Periodontitis, commonly referred to as “gum disease,” is mostly considered an adult condition. It typically occurs as the result of plaque accumulation due to a lack of proper oral hygiene. However, a particular type of gum disease known as aggressive periodontitis can also occur in the much younger population. Gingivitis and aggressive periodontitis have been documented in both children and adolescents.
Parents and dentists both should be on the lookout for warning signs of this condition. Early detection is often crucial. It can help prevent further destruction of tooth-supporting structures and tooth loss. “Periodontal disease in children is linked to a genetic condition and it is aggressive,” says Gibson. “It causes bone damage quickly and can rapidly spread to other teeth.” The good news, says Gibson, is that a few easy steps can help prevent periodontal diseases. Early diagnosis ensures the greatest chance for successful treatment.
Although a type of aggressive periodontitis does not exhibit clinical signs, bone damage may already be occurring – this makes routine exams necessary! If you or anyone in your family has gum disease or lost teeth at an early age for reasons other than trauma or caries, a hereditary factor involved could pass on to your child. In those cases, it is advisable to see a periodontist to help rule out aggressive periodontal disease. Children that do exhibit clinical symptoms – swollen, tender and red gums with sign of plaque and calculus accumulation – should be referred to a periodontal specialist for examination. Puberty marks significant hormonal changes in your child and can put them at risk for periodontal disease. Hormonal changes increase the gums’ sensitivity and lead to a greater reaction to any irritation, including food particles and plaque. During this time, the gums may become swollen, turn red and feel tender. It is important to follow a good dental hygiene regimen, including regular brushing and inter-dental cleaning, along with regular dental visits. In some cases, a dental professional may recommend periodontal therapy to help prevent damage to the tissues and bone surrounding the teeth.
Taking the sting out of bad breath Bad breath. Many of us worry about it on a daily basis.
secretions, which can produce an odour on your breath.
We may chew gum, use mouthwash and floss to mask the problem, but this solution is often only temporary. Why? Because not all bad breath is caused by food. In fact, many people don’t realize that bad breath is perfectly normal for some people.
“There are many underlying reasons for this problem. They include your metabolism, liver, lung infections, sinus infections and inflamed tonsils,” says Eggert, who adds that a health care professional can help diagnose the cause.
“Bad breath is caused mainly by volatile sulfur compounds in your mouth,” says dentistry professor Michael Eggert from the School of Dentistry. “Our noses are highly sensitive to these volatile sulfur compounds, which we smell and cause us to believe someone has bad breath. But bad breath can result from a variety of medical conditions, so its cause extends beyond what we eat.” Eggert says conditions like a hiatus hernia, which can release gases an odours from a person’s stomach, can also be a source of bad breath. “It doesn’t always relate to oral health.” Bad breath can even be caused by hunger. Skipping breakfast and being hungry can cause your stomach to increase
DID YOU KNOW?
Possible causes of bad breath • Uncontrolled periodontitis (gum disease) • Plaque on teeth • Biofilm buildup on tongue • Stomach gases • Inflamed tonsils • Poor hygiene with dentures or oral appliances Possible self-help • Brush your tongue • Practise good oral hygiene • Rinse with water after meals • Brush along your gum line • Floss regularly • Set a timer for two minutes when brushing • Using an electric toothbrush might help
People who are concerned about having bad breath but don’t actually have it suffer from halitophobia.
Be smart and maintain wisdom tooth Wisdom teeth, or third molars, appear in your mouth between the ages of 15 to 20. They are the last teeth to come in and can be the most irritating. If you don’t take proper care of your wisdom teeth, they can also be the most damaging to your mouth. Some of them will fully erupt, while others may not fully break through the gums because there isn’t enough room. If they’ve grown in completely and are functional, not all wisdom teeth need to be extracted. However, they do require regular dental checkups. “People assume if the tooth isn’t causing any pain, then they don’t have to worry about it,” says oral maxillofacial surgeon and clinical professor at the School of Dentistry Kevin Lung. “But they can damage nearby teeth and cause infections.”
The problem with wisdom teeth Looking back at history, wisdom teeth were probably once a necessity. Early humans had a full set of teeth and bigger jaws because of their diets at the time. Since then, evolution has made our jaws smaller and the use of wisdom teeth almost obsolete. “We didn’t eat processed foods before. Our diets consisted of more grains which required grinding,” says Lung. He notes that prior to the 1980s, many people only visited the dentist on a crisis-management basis. During that time, teeth tended to be extracted more to help make way for wisdom molars to grow in. However, times have changed. “Today, we try to save as many teeth as we can, and sometimes there isn’t enough room for the teeth.”
h health through regular checkups Complications from fully erupted or impacted wisdom teeth vary. They can cause infections, damage adjacent teeth, form cysts and cause gum disease. “If you chose to not have them extracted, you must follow up with your dentist on a regular basis,” says Lung. “Being pain free doesn’t necessarily mean you are problem free. These teeth are harder to clean and can cause cavities in adjacent teeth. Regular clinical follow-ups and radiographic imaging will help keep these teeth healthy.” Risks and Benefits Having your wisdom teeth removed when you are younger is beneficial. Because the root is not fully grown yet, it is easier to remove and heal.
School of Dentistry
The risks associated with not removing your wisdom teeth include: • Periodontal disease develops • Cyst or tumor may form around the base of an untreated wisdom tooth • Diseases and inflammation spreads to nearby teeth • Can cause cavities “Don’t wait until you have a major problem with your wisdom teeth to see a dentist. If you don’t want them out that is your choice, but it’s important to keep all your teeth healthy,” Lung adds. Source: www.aaoms.org
Grinding and clenching in your sleep is a wake-up call for treatment Have you ever woken up from a night’s sleep with sore teeth and jaws, or maybe even a headache? You could be grinding your teeth. Grinding your teeth, also known as bruxism, occurs during sleep. Most often, people are unaware they grind their teeth while asleep. Some individuals may also grind and/or clench their teeth during the day. The pathophysiology of nighttime and daytime bruxism are different but have basically the same effects. Bruxism is characterized by the grinding and clenching of the jaw that causes teeth to wear down and possibly break. It can lead to jaw disorders and headaches. While it is most often assumed to be caused by stress and anxiety, scientifically there is no evidence to back this claim according to Ivonne Hernández, clinical professor at the School of Dentistry. “There are many reasons someone might grind their teeth, but we don’t know what causes it exactly,” she says, adding that it’s been difficult to single out the gene or genes responsible for bruxism as environmental factors also play a large role. There are many risk factors associated with grinding, but as you age your chances of developing bruxism reduce significantly. Common risk factors include stress, anxiety and possessing a goal-oriented personality. Bruxism can be secondary to sleep apnea and or neurological disorders. People experience teeth grinding 14 to 20 per cent during childhood, six to 12 per cent as teenagers
and adults, and three per cent as seniors. “As you age, especially once you reach 50, your chances of teeth grinding drop dramatically. However, accurately diagnosing the problem is crucial,” Hernández says. “Naturally, when your mouth is in a resting position, your teeth should not be in contact with one another. Of course, your teeth make contact when chewing or swallowing, but this usually takes no more than 20 minutes in a 24-hour period.” So what can be done to treat teeth grinding? If you constantly wake up with headaches or your jaw is sore, Hernández says recognizing that you may be grinding your teeth in your sleep is an important first step. “Most often, a spouse may hear you or sometimes you can even catch yourself grinding,” she says. “It’s important to address the issue in a timely manner because in severe cases where tooth wear is excessive, your teeth may become extremely sensitive and even start to crack.” Others preventative tips: • Use custom night guards, which can be applied in adults and children with permanent dentition if needed. • Study and employ relaxation, meditation, biofeedback and stress management techniques. • Practise healthy sleep habits. • Avoid harmful oral habits, including frequent lip or fingernail biting, gum chewing or chewing of other objects. • Consciously remember to relax your jaw muscles.
Embracing your root canal. I
It’s not as bad as you think.
Root canal treatment is done to the inside of a tooth. It is necessary when the dental pulp in the tooth becomes inflamed or infected. During treatment, the inflamed or infected pulp is removed, and the inside of the tooth is carefully cleaned and disinfected. The tooth is then filled and sealed with a rubber-like material followed by a crown or filling for protection. “Saving the tooth is more beneficial than having it extracted. Your eating habits and quality of life remain unchanged. Your smile stays natural, whereas a prosthetic won’t function like a real tooth,” says Campbell. “With good oral care, a root canal treatment can last decades, even a lifetime.”
Truth Root canal treatment doesn’t cause pain. It relieves it. Most patients see their dentist or endodontist when they experience severe tooth ache, which can be caused by damaged tissues in the tooth. Root canal treatment removes this damaged tissue from the tooth thereby relieving the pain you feel.
Root canal treatment causes illness.
“A root canal is a quick and comfortable procedure that gets you out of pain and preserves your tooth,” says endodontist and professor Les Campbell with the School of Dentistry. “Most patients think root canals are going to hurt, but it actually gets you out of pain. There are a lot of myths and misunderstandings out there, but the treatment now is similar to having a routine filling.”
Root canal: two words everyone dreads hearing. Despite its stigma, it’s the most effective way to save your natural tooth.
Root canal treatment is painful.
Truth There is no valid scientific evidence that links root canal-treated teeth and disease elsewhere in the body. Root canal treatment is safe and designed to eliminate bacteria from the infected root, prevent re-infections and save the natural tooth.
A good alternative to root canal is extraction (pulling the tooth). Truth Saving your natural tooth is the best option. Nothing can replace what nature gave you! (source: aae.org)
New and improved training tool aims to reduce radiation from dental x-rays Every day patients ask dentists if the X-rays they’re taking are safe. And while dentists can reassure patients that digital X-rays use very low levels of radiation—even less radiation than their predecessor, conventional film—a careful placement technique to avoid re-exposures is still essential.
amount of radiation we are exposed to annually from the environment. That said, because there is no safe threshold of a radiation dose below which there is no risk, the goal is always to minimize exposure by only taking X-rays when absolutely needed and to make sure the dose is kept as low as possible, said Senior.
“There’s a learning curve with digital X-ray equipment,” says Anthea Senior, a clinical associate dentistry professor at the University of Alberta’s School of Dentistry. “Because the placement of the digital sensor is different from film, more images can be required to see the areas that you need, which could render the benefits of the lower radiation to make the image moot.”
The million-dollar question is, how much more radiation is the average Canadian exposed to when extra digital images are taken in the dentist’s chair? Senior said that although individual exposure is very low, overall the dose to the population as a whole accumulates.
After noticing the significant struggle dentistry students were having with the different techniques required to take digital X-rays, Senior developed an iBook training manual for classroom and clinic use in 2014. “I wrote the manual to improve the quality of the original images and thus reduce the amount of images that need to be repeated, with the impetus to reduce the doses of radiation we are getting,” she said. Senior’s original manual has been downloaded in institutions worldwide and her videos demonstrating digital techniques have had thousands of views. That’s why, with business advice and licensing assistance from TEC Edmonton, Senior recently partnered with Dentsply Sirona to extend the manuals’ use as a training resource for industry and practitioners. The updated manual with improved images and videos is expected to be released in the next few months. How much radiation is too much? So what is a safe amount of radiation? And how can we make sure we’re not getting too much? Generally, the total amount of radiation from conventional dental intraoral and extraoral imaging is less than one per cent of the overall 20
“Because millions of people get dental X-rays performed, the collective dose to the population is not insignificant,” she said. How many X-rays should I get? “It is not a case of ‘one size fits all’ when deciding how often and what kind of dental X-rays you should have done,” said Senior. Deciding whether to prescribe an X-ray to help with a diagnosis is done on a case-by-case basis. The practitioner and patient consider when the last set of X-rays was taken, what the patient’s disease rate and past dental history look like, and what is found during their dental examination, Senior said. Intraoral images such as bitewings allow dentists to identify very early decay between teeth that can’t be spotted any other way. Extraoral images, such as panoramic views, show less detail but allow larger areas of the teeth and jaws to be seen. Bottom line Dental X-rays are an incredibly useful tool that assist dentists in diagnosing and managing serious oral problems, said Senior. “Have a conversation with your dentist before you have any X-rays taken to find out why they are necessary, and once you’ve had them taken, ask about what they are showing,” Senior advised. Community Report
Going from face plant to tooth transplant If you sustain an injury to your face and happen to lose a permanent tooth, there are ways to save it. Assuming you can find the tooth. William Caines couldn’t find his after taking a bad spill and hurting his face while skateboarding. Covered in blood, the 13-year-old was rushed to the hospital by his mother. While their understandable panic prevented William and his mom from taking the time to find the tooth, periodontist and professor Liran Levin from the School of Dentistry says it’s always worth trying. “When you knock out a tooth, it’s an emergency dental situation,” says Levin. “Try to find the tooth and immediately push it back in. Hold it at the crown, gently wash off any dirt on the roots and just shove it back in.” People unable to do that should place the tooth in milk to preserve the cells and go to their nearest dental office as quickly as possible - preferably within half an hour. The sooner they get there, the better the tooth’s chances for survival.
Caines may not have had his broken tooth, but he was eligible for a tooth transplant. However, because of his age and growing mouth, a fixed tooth implant wasn’t viable and dentures would not be comfortable. Instead, Levin extracted a tooth from the back of Caines’ mouth and transplanted it to the front. “We took a premolar, reshaped it to look like an incisor and placed it in the front,” says Levin, noting that procedural advice was provided by an orthodontist who recommended which of Caines’ back teeth would work best. “This transplanted tooth could last many years. Even if it is lost several years later, by then he’ll be old enough to receive a dental implant.” For Caines, the transition took time but was well worth it. “The tooth didn’t feel normal at first. Once it was remodeled, it felt a lot better,” says Caines, adding that he was surprised by the transplant procedure. “I was OK with it, but it wasn’t anything I had heard of before.”
Quit smoking for the
sake of your smile While any use of tobacco is harmful to our health, smoking causes the most harm to our mouths. Smoking increases the risk of many oral diseases and conditions, ranging from cosmetic concerns to serious tissue change such as cancer. Tobacco use also reduces our body’s ability to fight infection. As such, it reduces the healing potential of the tissues in our mouth. “Gum disease is definitely more prevalent in smokers,” says dentistry professor Steve Patterson from the School of Dentistry. “We also see that smokers can have stained teeth, bad breath, sores in the mouth and they are more susceptible to cavities.” Patterson says most people don’t realize the impact smoking has on our oral health with the most significant potential change being oral cancer. Roughly 75 per cent of oral cancer is caused by tobacco use. “A big part of the work we do as dentists and dental hygienists is to help our patients identify risks,” says Patterson. “Being able to recognize the effects smoking has on teeth and the oral cavity is an important step in the process to quitting. As dentists, we are anti-tobacco because of its addictiveness. But we are not anti-tobacco user. We’re here to support and help anyone who wants to quit.” Patterson says when smokers attempt to quit on their own, success rates are low. But with even minimal assistance from health professionals, success rates can triple. If even more comprehensive support and assistance is received through counselling, behaviour modification and pharmacologic support for nicotine withdrawal, smokers have even better odds of quitting. “People can see the dental office as a part of their support system in being healthier,” Patterson says. “It often takes several attempts for patients to quit smoking. By addressing their challenge Community Report
during each dental visit, we can re-engage and re-motivate them to keep trying.” Patterson says dental offices often use the Five A’s approach to help patients quit tobacco use: • Ask – First, dental professionals need to know who uses tobacco, what type, how much and how often. • Advise – As health care professionals, dentists and dental hygienists advise patients of the risk associated with smoking and the importance of quitting. Signs of tobacco use’s impact in the mouth can be shown, identifying what’s happening inside the mouth and why quitting is a positive move. • Assess readiness to quit – This a key step. Not everyone is ready to quit at a given time. Dental professionals will work with individual patient timelines to help them prepare and ultimately quit using tobacco. • Assist – For those not ready to quit, information and counsel can be offered that helps patients prepare for a quit attempt one day. Patients can also receive referrals to other community resources to help them choose a quit day and prepare for the quit attempt. Dentists can also prescribe medications useful in helping patients quit. • Arrange follow-up – Follow-up with the patient to see if they are still smoke-free, provide support as required. Resources: Alberta has significant resources to help people quit. Visit albertaquits.ca You will find: • Discussion groups • Cessation classes • Help for quitting • How to prepare to quit • Information on the Smoker’s Helpline 25
Keep that million-dolla Missing teeth or loose dentures? Dental implants might be the solution. The Implant Clinic in the School of Dentistry offers patients a reduced-fee solution to helping them achieve that million-dollar smile. When long-time clinic patient Larry Mumby felt his dentures just didn’t fit quite right, he welcomed the School’s suggestion of having dental implants placed instead. Previously, Mumby’s lower denture was always loose and getting bits of food stuck under it. Today, he says he doesn’t regret having the procedure done. “It feels like I almost have my regular teeth back,” says Mumby, who has been a patient at the clinic for over four years. “Before, when I chewed on sticky foods, my dentures would come out. I have no complaints now. Coming to the clinic has been a good experience. The students take their time to explain everything carefully.” Working with leading-edge technology, for the past 10 years, the clinic has offered patients personalized one-on-one care, simultaneously connecting educational training and community care under one umbrella. Over the 2016-17 year, the clinic assessed 54 patients, accepted 28 and 14 patients needed to have other dental work completed prior to being reassessed. Clinical professor Bernard Linke is head of the implant program, while oral surgeon and clinical professor Kevin Lung is head of the surgical component for implants in the undergraduate program at the School of Dentistry. Prior to dental implants, missing or failing teeth were mostly fixed using either a bridge or partial denture. While these options are still available, Linke says dental implants are becoming a preferred option for replacing missing teeth.
“Dental implants have a long history of success,” says Linke. “The replacement can consist of replacing just one tooth or all of the teeth in patients who wear dentures. Our clinic is very busy because we are able to offer a unique program within the school and a service to our community.” For patients like Mumby who have lost all their teeth, dental implants provide significant benefits, says Linke. Patients are first screened with an examination, photos, diagnostic casts and radiographically using a Cone Beam Computed Tomography (CBCT) scan. The CBCT scan provides the most accurate and detailed information about the patient’s facial structure. The scan is then reviewed by a certified oral radiologist who creates a report detailing measurements for implant sites and any anomalies. Once the CBCT scan and imprint are taken, students use specialized software to digitally fuse the scan and imprint together. The examining students then develop a detailed treatment plan for the patient, including using software called Nobel Clinician to plan the implant sites. Linke and Lung then review and confirm the appropriate treatment plan for that patient. “The most current technology is used to ensure patients are provided with the best possible diagnosis and treatment outcome,” Linke says. “In this way, the clinic offers an educational model for teaching students and a service to the community.” However, if a patient is medically compromised or if their situation is determined to be too complicated, the School may be unable to accept them. In some cases, the patient may be referred to the General Practice Residency program for treatment. “The patient’s best interest is always our primary concern,” notes Linke.
ar smile with implants
School of Dentistry's annual community report.