Your teeth can take decades of daily biting and chewing and not miss a beat. But they do have a nemesis, dental disease, which can easily get the upper hand. As a result, millions of people lose teeth each year to tooth decay and periodontal (gum) disease.

But while both the living tissue that makes up teeth and gums are susceptible to bacterial attack, the non-living materials in a life-like dental implant are impervious to disease. That being the case, you would think your implants wouldn't need as much hygiene as your other teeth.

But they still do. True, implants in themselves aren't affected by infection, but the bone and other tissues that support them can become diseased. This often happens with advanced cases of gum disease.

There is, in fact, a particular form of gum infection associated with implants called peri-implantitis ("peri"—around; "it is"—inflammation), which occurs in the gums around an implant. Once it starts, peri-implantitis can advance at a rapid pace.

This is because implants don't have the gum attachment of real teeth, which can fight and slow the advance of a gum infection. Because an implant doesn't have this attachment, any infection around it continues virtually unimpeded. If the bone supporting an implant becomes infected, it can weaken to the point that the implant fails.

But this dire scenario can be avoided with continuing hygiene and maintenance of the gum tissues surrounding the implant. You should brush and floss every day around implants to remove dental plaque, the bacterial film most responsible for dental disease, just as you do with natural teeth.

It's also important to keep up regular dental visits for cleanings to remove lingering plaque and tartar (hardened plaque). Your dentist may also notice and clean away any residual cement from the restoration, which can also cause gum inflammation.

And, you should promptly see your dentist if you notice any telltale signs of a gum infection, such as swelling, redness or bleeding, especially around implants. The quicker we diagnose and treat a case of gum disease, particularly peri-implantitis, the less likely it will endanger your implant.

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

Getting dental implants is going to require surgery. But don't let that concern you—it's a relatively minor procedure.

Currently the “gold standard” for tooth replacement, an implant consists of a titanium post surgically imbedded in the jawbone. We can affix a life-like crown to a single implant or support a fixed bridge or removable denture using a series of them.

Because placement will determine the restoration's final appearance, we must carefully plan implant surgery beforehand. Our first priority is to verify that you have adequate jawbone available to support an implant.

Additionally, we want to identify any underlying structures like nerves or blood vessels that might obstruct placement. We may also develop a surgical guide, a retainer-like device placed in the mouth during surgery that identifies precisely where to create the holes or channels for the implants.

After numbing the area with local anesthesia, we begin the surgery by opening the gum tissue with a series of incisions to expose the underlying bone. If we've prepared a surgical guide, we'll place it in the mouth at this time.

We then create the channel for the insert through a series of drillings. We start with a small opening, then increase its size through subsequent drills until we've created a channel that fits the size of the intended implant.

After removing the implant from its sterile packaging, we'll directly insert it into the channel. Once in place, we may take an x-ray to verify that it's been properly placed, and adjust as needed. Unless we're attaching a temporary crown at the time of surgery (an alternate procedure called immediate loading), we suture the gums over the implant to protect it.

Similar to other dental procedures, discomfort after surgery is usually mild to moderate and manageable with pain relievers like acetaminophen or ibuprofen (if necessary, we can prescribe something stronger). We may also have you take antibiotics or use antibacterial mouthrinses for a while to prevent infection.

A few weeks later, after the bone has grown and adhered to the implant surface, you'll return to receive your new permanent crown or restoration. While the process can take a few months and a number of treatment visits, in the end you'll have new life-like teeth that could serve you well for decades.

If you would like more information on dental implants, 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 “Dental Implant Surgery.”

For nearly two decades, singer-songwriter Taylor Swift has dominated the pop and country charts. In December she launched her ninth studio album, called evermore, and in January she delighted fans by releasing two bonus tracks. And although her immense fame earns her plenty of celebrity gossip coverage, she's managed to avoid scandals that plague other superstars. She did, however, run into a bit of trouble a few years ago—and there's video to prove it. It seems Taylor once had a bad habit of losing her orthodontic retainer on the road.

She's not alone! Anyone who's had to wear a retainer knows how easy it is to misplace one. No, you won't need rehab—although you might get a mild scolding from your dentist like Taylor did in her tongue-in-cheek YouTube video. You do, though, face a bigger problem if you don't replace it: Not wearing a retainer could undo all the time and effort it took to acquire that straight, beautiful smile. That's because the same natural mechanism that makes moving teeth orthodontically possible can also work in reverse once the braces or clear aligners are removed and no longer exerting pressure on the teeth. Without that pressure, the ligaments that hold your teeth in place can “remember” where the teeth were originally and gradually move them back.

A retainer prevents this by applying just enough pressure to keep or “retain” the teeth in their new position. And it's really not the end of the world if you lose or break your retainer. You can have it replaced with a new one, but that's an unwelcome, added expense.

You do have another option other than the removable (and easily misplaced) kind: a bonded retainer, a thin wire bonded to the back of the teeth. You can't lose it because it's always with you—fixed in place until the orthodontist removes it. And because it's hidden behind the teeth, no one but you and your orthodontist need to know you're wearing it—something you can't always say about a removable one.

Bonded retainers do have a few disadvantages. The wire can feel odd to your tongue and may take a little time to get used to it. It can make flossing difficult, which can increase the risk of dental disease. However, interdental floss picks can help here.  And although you can't lose it, a bonded retainer can break if it encounters too much biting force—although that's rare.

Your choice of bonded or removable retainer depends mainly on your individual situation and what your orthodontist recommends. But, if losing a retainer is a concern, a bonded retainer may be the way to go. And take if from Taylor: It's better to keep your retainer than to lose it.

If you would like more information about protecting your smile after orthodontics, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Importance of Orthodontic Retainers.”

Though it sounds like an elite academic society, "The Freshman 15" is anything but. The phrase stands for the weight, pegged at 15 pounds, that many incoming students gain in their first few months at college—the result of poor dietary habits brought on by a hectic schedule and newfound freedoms.

These and other habits have consequences—and not just for unwanted pounds. Many can lead to dental problems, which could continue to overshadow a student's oral health long after college is over.

Here, then, are 5 tips to pass along to your newly minted college student (or anyone else, for that matter) to keep their teeth and gums as healthy as possible.

Brush and floss daily. While a hectic course load beckons, a student should still make time every day to brush and floss their teeth. Along with regular dental cleanings, these two tasks remove the daily buildup of plaque, a bacterial film that causes dental disease. Daily oral hygiene is good insurance against developing future tooth decay and gum disease.

Cut back on sugar. A student may rely on sugary snacks for a boost of energy throughout their day, but it could be setting them up for dental disease. That's because harmful oral bacteria also feed on sugar. Choose instead real, whole foods and snacks that are better for teeth—and for avoiding those dreaded freshman pounds.

Limit acidic beverages. Besides added sugar, sodas, sports and energy drinks also contain acid, another ingredient unfriendly to teeth. During prolonged contact, acid softens and erodes the mineral content in tooth enamel, opening the door to tooth decay. Those who drink these kinds of beverages should limit their consumption as much as possible.

Don't smoke. Smoking dries out the mouth, preventing saliva from buffering the acid that causes tooth decay. Its main ingredient nicotine restricts the mouth's blood vessels, further increasing the chances of dental disease. Tobacco use in general, including smoking, is also a key risk factor for oral cancer.

Avoid mouth "jewelry." It might be the bomb on campus, but lip rings, tongue bolts and other mouth jewelry can cause dental damage. Besides the possibility of chipped teeth, metal jewelry in or around the mouth is more likely to cause infection. Better to skip this fashion statement for healthier teeth.

If you would like more information on good oral practices, 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 “10 Health Tips for College Students.”

If you think there's not much difference between toothbrushes, a quick look on a retail oral care aisle might change your mind. About the only thing toothbrushes really have in common are a handle and bristled head.

Choosing the right toothbrush, therefore, might seem overwhelming. But choose you must: Your toothbrush is an essential tool in the fight against tooth decay and periodontal (gum) disease. Without it, your odds for developing dental disease skyrocket.

Along with flossing, brushing is the best way to remove daily plaque buildup, that bacterial film most responsible for dental disease. Brushing also minimizes the buildup of tartar, the hardened form of plaque that's just as harmful as softer plaque. And, brushing stimulates your gum tissues to help prevent or lessen inflammation.

But back to all those brushes—with so many options to weigh, how do you come up with your best choice? Actually, there are some basic tips that can help you narrow things down.

Bristle stiffness. Considering other cleaning chores, you might think you'll need a stiff brush. The opposite—a soft-bristled brush—is usually true. Your toothpaste's mild abrasives and the mechanical action of brushing perform most of the plaque removal. And stiffer brushes could irritate and damage your gums or tooth enamel, leading to bigger problems.

Size and shape. Through a little trial and error (and advice from your dentist), you may find a brush with an angled or tapered neck helps you get into difficult places, especially around the back teeth. If you have problems with grip, you may also opt for a brush with a large diameter handle. Bottom line: Choose a brush you feel comfortable handling.

ADA Seal of Acceptance. Common on dental product packaging, this seal indicates that after rigorous testing the item meets the high standards of the American Dental Association, and that it does what the packaging says it does. Even so, some quality brushes don't have this seal, so ask your dentist their opinion on a particular brand.

There's one more critical component—how well you use your toothbrush. For that, ask your dentist or hygienist for tips on better brushing. Combining the right brush and technique goes a long way toward avoiding dental disease.

If you would like more information on choosing the right toothbrush for you, 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 “Sizing Up Toothbrushes.”