Dr. Jeevan Kumar

Tobacco has many ill effects on the health and dental health is one of them. From dark stains to poor gum health to increased incidence of decay to the more severe oral cancer, tobacco has a very detrimental effect on your dental health. Read on know more about how harmful tobacco can be on the dental system.

1. Brown teeth and tongue: One of the tell-tale signs of a smoker are the brown teeth and stained tongue. A dentist need not even be told that the person smokes, it just shows!! What is interesting is that these stains do not go away with a scaling, they just continue to form as long as tobacco is being put into the system.
2. Gum disease: The oral health of a smoker is definitely not at its best. With the stains on the teeth, the gums are more prone for irritation and infection. This leads to grayish, unhealthy gums. The periodontal fibers are also affected, leading to bad breath, pocket formation and even tooth mobility in severe cases. The mouth is generally drier in comparison and so bacterial growth is more favored, further accelerating the process of gum disease and teeth decay.
3. Dental caries: The increased amount of bacteria leads to greater incidence of dental decay. Chances of cervical decay (around the gum line) and root decay are higher in smokers.
4. Bad breath: There are two reasons to it one is the tobacco per se and the second is the dry mouth, which leads to reduced saliva and increased bacterial growth.
5. Impaired taste: The tongue has a constant coating too, leaving the taste buds unable to completely taste food substances. Ask any smoker a couple of questions and you would realize how they never get to enjoy and taste the food as it should be.
6. Poor healing: Whether it is a gum disease, a tooth removal or a root canal therapy, smokers who go for dental treatment need a longer time to respond compared to nonsmokers. If smoking is continued at the same pace, then the chances of developing a dry socket with an extraction or a failed root canal therapy are quite high. There are more failures reported in success of implant in smokers as compared to non smokers.
7. Cancer: The most dangerous and the most severe of all, cancer of the cheek, gums, lips, tongue, roof of the mouth can all happen in smokers, twice more likely in comparison with non-smokers.

Now, if all these are not good enough to kick the habit, remember this list is only for the mouth and the teeth. The whole body goes through a lot more harmful effects, and that should be a good reason to quit tobacco use in any form. If you need professional help, do not be embarrassed to seek.

Tooth loss is a challenge for both the patient and the dentist. Patient has to deal with reduced chewing efficiency and altered appearance. The dentist, on the contrary, is faced with restoring the lost tooth to the maximum natural extent possible, functionally and structurally.

The fixed dentures came close with their ability to providing fixed teeth that were stable and aesthetically appealing. However, there was one big disadvantage, the adjacent teeth that were being used as abutment were reduced in size and therefore strength though they could be perfectly normal teeth.

In an effort to avoid this, the dental community started looking at options, the result of which was implant. Not just replacing the crown part of the tooth, even the root portion of the tooth is replaced here.
A biocompatible material, titanium, is put into the tooth to serve as the root. Titanium is strong, light, biocompatible (does not cause autoimmune reactions in the surrounding tissues) and most importantly osseointegrated (fuses to the surrounding bone). Once placed as the root, it gets absorbed into the bone after a period of about 2 to 6 months. Then, a crown or a denture is literally built on this root to simulate the natural appearance as close as possible. This provides not just the complete natural tooth structure but also provides support to the surrounding tissues like the gums and the cheeks.

Implant dentistry is a perfect example of teamwork including surgeons to operate and place the bone, prosthodontists to do the crown or the bridge, a periodontist to manage the gums health, and a lab technician who can do the finest job on the crowns or the bridges.

Types of implants:

1. Three common types include: Single tooth replacement: In cases where a single tooth is lost, the implant would be one root that is allowed to fuse to the bone and then a crown is placed over it.
2. Fixed multiple teeth replacements: If more than one tooth is lost, then bridges are fabricated by placing one or more implants and then custom-made crowns are placed over these implants.
3. Removable implant supported complete denture: If all the lower teeth are missing, implants could be placed at pre-identified locations and then a complete denture fabricated over it. This is commonly done in lower jaws as stability is always a cause for concern.

Contraindications:
The success of the implant requires good bone health. The most common contraindications would be patients with chronic diseases like poorly controlled diabetes, cancer in the line of jaws, chronic smoking, or poor periodontal health.

However, if managed well, even these patients can have implants after a detailed assessment by the dental team.