"But my cousin had a lot of pain after her implant was placed and it ultimately failed."

I hear this from a patient occasionally, and it is very disheartening, because implant placement generally is not accompanied by severe pain. As a matter of fact, when a patient tells me that they experienced significant pain following implant placement, I suspect that something isn't right, and the implant may be infected. This is really a very rare occurrence. Implant success rates are in the 95-98% range. You would be hard pressed to find another procedure in medicine or dentistry that has that kind of predictability. Keep in mind that you likely have many friends and relatives who have implants that are doing well, and who had a good experience with their implant procedure. People are much more likely to voice their dissatisfaction when something doesn't go well than to brag about a procedure that they underwent in which everything went perfectly. That's just human nature. I tell my patients to expect some soreness following implant placement that may last 2-3 days. Anything worse than that, and I want to hear from them, because something isn't right. Fortunately, I rarely do have patients call to complain of unusual discomfort following implant procedures, and that's because implant placement really is a predictable and comfortable procedure in the vast majority of cases. 

Don't lose your benefits!

Most insurance plans start on January 1st and end on December 31st. If you've been delaying treatment, it's now or never to use your remaining benefits for this year. Even if you don't do all of your treatment this year, do what you can to lessen your out of pocket expenses next year. The Holidays are also a good time to recover from surgical treatment without having to use vacation or sick days. Time is growing short. 

What should gums look like?

Well, that really depends. In general, red is bad, but it's not that simple. There are many kinds of gum disease, and they all manifest themselves differently. You really can't tell how healthy gums are just by looking. Periodontists take many different measurements to determine gum health. They also note swelling, bleeding, puss, ulceration, and other factors to come up with a diagnosis. In some instances, a biopsy of the gum tissue is necessary to obtain an accurate diagnosis so that the prescribed treatment will be successful. A regular examination is the best way to know how healthy your gums are, and, like most other things, prevention is the best treatment. 

How long can I wait after losing a tooth to get a dental implant?

I get asked this question quite a bit, and the truth is that every situation is different. The one certainty is that sooner is better once the tooth socket has healed. In fact, often the best time to get an implant is the day that the tooth is removed. Implants and bone grafts tend to preserve the bone contours of your jaw. When you lose a tooth and the area is allowed to heal naturally, some of the bone is generally lost, and that can compromise the ability to replace the tooth with an implant or to place the implant in the best position possible to allow for a more natural look to the implant crown.  I generally recommend a bone graft at the time of the tooth extraction if the implant can't be immediately placed, and if there is no severe infection in the area. Research shows that these grafts cause more symmetrical healing, and prevent loss of bone height. In some cases, this is the difference between being able to eventually place an implant and having to do more bone grafting or give up on an implant altogether. Now, just because you lost a tooth 20+ years ago, it doesn't mean that an implant isn't possible. What it does mean is that some bone grafting may be necessary prior to implant placement, and you may have to wait 6-12 months to have the implant placed. Like I said earlier, every situation is different, so you won't know about your options unless you see a periodontist to allow him or her to evaluate you as an individual to determine the viability of implant placement in your mouth. 

Receding gums are not necessarily a part of the aging process

Many people assume that receding gums are a sign of aging. While older individuals do tend to have more root exposure, gum recession is often tied to other very specific issues unrelated to age. Things like grinding or clenching your teeth, brushing improperly, plaque, and thin gum tissue are the primary causes of recession. By addressing these issues, you can prevent and even correct receding gums. Some of these problems can even be identified in childhood, when intervention can prevent recession from even happening. If you notice that your gums are receding in yourself or a child, evaluation by a periodontist as soon as possible is the best way to prevent or correct this problem before it becomes a major issue that ruins your smile or leads to tooth loss. 

So, what is periodontal disease?

Periodontal disease is a chronic infection that is caused by bacteria found in plaque on the teeth adjacent to and under the gums. Not all bacteria in dental plaque cause periodontal disease. The "bugs" that cause bone and attachment loss around teeth generally favor a deep, non-oxygenated environment. This is why, as periodontists, we strive to reduce the depth of the pockets in the gums. The shallower the gum pockets, the fewer bad bacteria can inhabit the environment. Shallower pockets also allow better access for cleaning both at home and professionally. You can find out more about periodontal disease and its causes at www.perio.org

Painless periodontal surgery

The vast majority of our laser periodontal surgery patients (LANAP) experience little or no post-operative pain. We've really progressed from the days of flap surgery and bone grafts. Come see us and experience periodontal treatment in a much kinder, gentler way!

The office is fine, but Eriko wasn't so fortunate

I doubt that anyone in the Houston area wasn't effected in some way by Harvey. The scope of this disaster is mind-boggling. Our office is open and seeing patients with no access issues. Unfortunately Eriko and my parents both had their houses flood, and they remain flooded as of this time. It was heart warming to see how much the people of Houston and surrounding communities have pulled together to help one another, and that effort continues. It was good to see that the main lanes of the West Sam Houston Tollway were pumped out overnight, but it is still closed. My guess is that it will reopen by this coming Monday, which will provide a critical link between I-10 and Westheimer. As of now, water still covers most of the area from Memorial Drive to Westheimer, and, of course, many people in that area still have water in their homes. Our prayers go out to all of you effected by the flood. It will take time, but we will recover. 

Check credentials before choosing an implant provider

Did you know that some implant companies will sell their implants to a dentist with zero training and experience? That's right, you could be his or her very first attempt at placing a dental implant. Even a dentist with some training may not have taken any courses in advanced head and neck anatomy, a curriculum that should be a bare minimum for competency to place a medical device into a living patient's bone. How do you discern who you can or cannot trust to place an implant or to perform any other invasive procedure? You have to ask about their training. Periodontists, oral surgeons, and some other dental specialists receive training in anatomy and implant placement in an actual residency or post-graduate training program. They have plenty of experience even before they place an implant in private practice. The question that you should ask are as follows: How much training do you have with regard to dental implants? How many have you placed and for how long? What certifications do you have? What professional organizations do you belong to? How much continuing education in dental implants do you complete annually?  If something goes wrong, do you have the knowledge and skill to identify and correct the problem? What brand of implants do you place? If the answers are not satisfactory or evasive, you are better off finding someone else to place your implants. 

Laser periodontal surgery is comfortable. The old flap and graft procedures yielded considerable soreness, but LANAP (laser-assisted new attachment procedure) is vastly superior when it comes to post-operative pain. I've yet to have a patient who has had it done both ways prefer flap procedures. We want our treatment to be effective and pain free, which is why most of our periodontal treatment involves LANAP. No cutting, no suture, very little discomfort. Let us show you how effective periodontal treatment should be.

Implants are ordinary dentistry

There was a time, when I was first in practice, that dental implants were a rarity. People had little idea what they were and why they might need them. Times have changed and the average patient now wants an implant over any other method of tooth replacement. There's good reason for the popularity of dental implants. Across a myriad of studies, the success rate for dental implants is 95-98%. I can't think of another procedure in dentistry that even approaches that kind of success rate. Heck, orthopedic surgeons would be thrilled to have access to a hip replacement with that kind of effectiveness. Now, by state law, acceptable alternatives to any type of treatment have to be offered to patients who are seen in our office, and that includes doing nothing at all as an option. That being said, teeth play a huge part in our lives, from eating to smiling, so, why not get the very best replacement? In most cases, dental implants are the best alternative, and, in many cases, the least expensive when you take into account that most people will keep an implant for a lifetime. The same cannot be said for fixed bridges and conventional dentures.