Implant Crown Should Not Trap Food

Q:  I recently had my first bone graft and implant completed and am experienced that food gets trapped where the crown meets the gums.  I must floss after every single meal just to get all the food out. Is this normal? ...Mike, via e-mail

A: A crown over an implant should not be a place to store leftovers.

Possible causes to your problem:
• Open contacts: gaps between the crown and adjacent teeth.  Solution: Make a new crown.

• Implant abutment post too narrow.   Solution: Change out the abutment post to a larger diameter unit along with a new crown that will fill in the triangular voids (called embrasures).

• The implant itself is too narrow, resulting in a shelf like void around the crown, trapping debris.   Solution: Have your doctor take a look and sort things out

Flexible Dentures

Q:  I love your column and read it all the time without fail. Has there been any new technology in dentures? They still seem to be quite primitive...S.M. in Pasadena

A:  Thanks for the positive feedback.

An improvement in dentures would be “flexible” dentures such as Valplast dentures. Seldom taught in dental schools or in continuing education courses, this technique can fill a very useful niche of patients. Advantages are: fewer forces on the natural teeth they clip to, fracture resistant, no ugly metal clasps, available in various shades of pink and clear, no metallic taste, non-allergenic and lower cost. Flexible dentures can offer a comfortable and esthetic alternative for those who do not have the financial means for conventional or implant retained prostheses.

Dry Mouth

Q:  My dentist keeps finding cavities along the gum line around old crowns and bridges. He claims that it is due to this dry mouth problem that I have. What can I do about this?....H.J. in Hollywood

A:  Dry mouth is also known as Xerostomia.  Dry mouth is the most common side effects of prescription drugs (especially antidepressants and antianxiety drugs). Dehydration, smoking, cancer treatments, medications for blood pressure and allergies can cause dry mouth as well.

Dry mouth lead to frequent Candida infections, increased periodontal and peri-implant diseases, caries, and bacteria infection caused by the loss of protection from saliva.  Dry mouth also decreases the seal of soft tissue-borne removable prostheses and increases the risk of abrasions and sore spots.

Suggested management:
•  Saliva substitutes
•  Saliva stimulants – such as chewing gum
•  Frequent glasses of water throughout the day
•  Strict control of the diet to decrease cariogenicity
•  Avoidance of tobacco or alcohol products