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Dental implants are a marvel! They look just like your natural teeth, and, even better, they function just like your natural teeth. So, when you’re planning on a dental implant after an extraction, you want to make sure that your implant has the best chance of success—and we do, too. That’s why we might recommend a socket preservation procedure, where socket grafting takes place immediately after your extraction.

What is a socket graft, and what does it “preserve”? Let’s take a closer look.

Socket Preservation—A Logical Choice After Extraction

You’ve decided on a dental implant for some excellent reasons.

• A missing tooth can change the appearance of your smile.
• Your remaining teeth might shift to fill the empty space, causing alignment and bite problems.
• A lost tooth affects the amount, shape, and health of the bone surrounding your teeth.

No one wants to lose a tooth, but sometimes, due to injury or decay, an extraction is the only choice for your oral health. After your tooth is extracted, if the socket bone holding the tooth is perfectly healthy and the extraction is a simple one, we might be able to place an implant post in the socket right away.

But often, bone needs time to heal before placing an implant post, and you risk losing the bone size and density you need to make a future implant possible. How can you lose bone? That’s an unfortunate consequence of losing teeth. Teeth are important not just because they let us eat comfortably—they also help maintain bone health.

Without the stimulation of biting and chewing, the bone beneath the teeth begins a process called resorption. As older cells are absorbed back into the body, new bone cells aren’t produced as quickly to replace them. The alveolar bone, the thick ridge of the jaw which holds our sockets, shrinks in size. As the bone gets smaller, gum tissue shrinks around it, causing a sunken spot where your tooth used to be.

For a dental implant to anchor successfully in the jawbone, you need healthy bone that is high enough, wide enough, and dense enough to hold the implant post securely as it fuses with the bone.

A socket graft at the time of extraction provides two important benefits: grafting material fills the empty socket immediately, preserving the bone and gum area around it, and the graft material acts as scaffolding for new bone growth, creating a firm, dense foundation for your implant.

Grafting materials are gradually and safely absorbed as your new, healthy bone tissue replaces them. The result, after several months of healing, is an alveolar ridge with normal height and width and with the density needed to anchor an implant successfully.

The Grafting Procedure

Grafting material comes in different forms, including allografts (made from donor bone), synthetic grafts (made from synthetic materials which function like bone tissue), and autografts (bone taken from your own body). Growth factors may also be included in the grafting material to encourage new cell growth. Dr. Dave Stinchfield and Dr. Tom Stinchfield will recommend the type of graft which will work best for you.

A socket preservation procedure will frequently involve the following steps:

• Local anesthesia to numb the area before your extraction. You might choose sedation options as well, which we’re happy to discuss with you in advance.
• Careful cleaning of the site after the tooth is extracted.
• Filling the empty socket with bone grafting material.
• Placing a barrier or membrane over the graft to protect it as it heals.
• Suturing the surrounding gum tissue.

Aftercare Treatment

Aftercare treatment for a socket graft is a lot like the treatment for a tooth extraction. You’ll need to be careful around the graft area for several days as it heals, and we’ll give you specific instructions for your recovery. Normally, these may include:

• Don’t disturb or touch the area. Even pulling on lips or mouth to look at the site can put stress on your sutures.
• Immediately after the procedure, we can give you suggestions for reducing swelling and managing any pain you might be feeling.
• We’ll let you know when and how to rinse your mouth clean and when you can return to brushing. And no spitting!
• Eat carefully. We might recommend a liquid diet for a few days before transitioning to bland and cool soft foods. We’ll let you know the best diet for the period after your surgery. Don’t use a straw for your liquid diet, because suction can interfere with the wound.
• Treat yourself carefully for a few days by avoiding strenuous activities, including workouts.
• Don’t smoke. Smoking interferes with the healing process, and the suction involved does your graft no favors either.
• Visit our Washougal, WA office for follow up appointments as recommended. We’ll monitor your healing, and give you a timeline for your future implant.

Preserving your socket now instead of repairing it later has many advantages. Immediate placement of a graft protects bone size and density, eliminates the need for a potential bone grafting procedure in the future, and makes it possible for you to enjoy the natural look and feel of a dental implant as soon as possible. If you have an extraction scheduled, let’s discuss why socket preservation might be your best path to an efficient, timely, and successful dental implant.

Creating good dental hygiene habits early in your child’s life is essential to the health of his or her teeth, even when your infant doesn’t have any. By starting now, you can set the foundation for your son or daughter’s oral health later on in life.

When do I start?

The best time to begin brushing your baby’s teeth is before that first tooth ever comes in. Wipe your little one’s gums gently with a soft washcloth soaked in warm water every day. Not only will this help to get rid of bacteria in the mouth, but it will also familiarize your child with a daily brushing routine.

What do I use?

When your child’s teeth begin to emerge, it’s time to switch to a baby toothbrush. Select one with a big grip for your hand and a small head that’s easy to maneuver in your baby’s mouth.

Your little one won’t need toothpaste until he or she is about a year old; and even then, only a small amount is necessary. Apply an amount the size of a grain of rice and move to a pea-sized amount when your infant is about two years old.

By around six years, your child will probably rinse and spit without your help. At this time, you may introduce a child-friendly fluoride mouthwash.

How do I do it?

Until about age five or six, it’s likely your child will still need your help with brushing teeth. Gently scrub over all the teeth and gums, even where teeth have yet to come in. It may be helpful to explain what you are doing and how you are doing it, so your toddler can learn to brush her or his teeth alone.

Paired with regular visits with Dr. Dave Stinchfield and Dr. Tom Stinchfield at our Washougal, WA office, proper hygiene habits instilled in your child early on will set up a good foundation for a healthy mouth in the future.

The best type of whitening for your smile depends on what you are hoping to accomplish.

Whitening Toothpastes

This is certainly the easiest method of whitening, but will brushing alone produce your whitest smile? Probably not. Whitening toothpastes use chemicals and abrasives to remove some surface stains caused by foods, beverages and smoking. They can also be used to maintain the appearance of your teeth after a professional whitening. However, toothpaste alone cannot change the natural color of your teeth or penetrate the surface of the tooth to remove deeper stains. A whitening toothpaste usually takes several weeks to produce results. Be sure to choose a product with a seal of approval from a reputable dental association and carefully follow the instructions for use.

Whitening Strips and Gel Trays

Whitening gels can be applied at home with strips or tray kits. These peroxide-based gels are stronger than the formulas used in toothpaste.

Strips come coated with the whitening gel and work when pressed to your teeth for a specified amount of time. One difficulty here is making sure each tooth is completely covered by the strip so that even whitening takes place. Tray and gel whitening systems provide a mouthguard-like appliance that is filled with whitening gel and applied to your teeth, again for a specific period of time. Because one size does not fit all, stock trays can be ill fitting and lead to problems with gums and soft tissue. You can talk to our team about a custom-fitted appliance and whether gel whitening is your best option.

Some users find gel products cause tooth and gum sensitivity and even enamel damage. These over-the-counter gel products will not work on caps, veneers, crowns, or bridges, and there might be underlying conditions in your natural teeth that will make the use of these products ineffective. Please talk to us at your next visit to our Washougal, WA office if you are interested in whitening at home, so we can advise you on how to achieve the best and safest outcome.

Office Treatment

Professional whitening makes use of a gel with a higher concentration of peroxide and should only be provided by Dr. Dave Stinchfield and Dr. Tom Stinchfield or a member of our team at our Washougal, WA office. This process is generally faster, more effective and longer lasting. We take care first to examine your teeth for pre-existing conditions such as cavities and gum disease that could cause problems. We protect your gums when the gel is applied in office and monitor the procedure. We can assess the progress of the whitening and suggest further treatment if needed. Custom mouthpieces can also be an option if you would like to use a whitening gel at home. A personally molded tray will fit your teeth perfectly and allow a more precise application of the peroxide gel.

Some teeth are not good candidates for normal whitening procedures at home or in office. If you have dark stains caused by trauma, drugs such as tetracycline, discoloration due to root canals, or darker dental bonding, crowns, or other prosthetics, please talk to us about other possible solutions. We want to help you achieve your brightest possible smile.

It’s a bit of a contradiction: you are justifiably proud of your beautiful dental work, but you don’t want it to be obvious when you smile. Dental prosthetics such as veneers and crowns should blend perfectly with your natural teeth. If you have noticed your veneers are a different shade than your other teeth, or have a crown that is visibly darker than the teeth surrounding it, you are probably wondering if there is any way to lighten and whiten an artificial tooth surface. There is no one right answer, but let’s examine a few common scenarios to find the best solution for you.

If You Haven’t Started Your Dental Work and Want a Whiter Smile

If you are planning on getting a veneer or a crown, it’s best to take advantage of teeth whitening before you have the work done. Choosing a shade of bright white for your veneers and then trying to whiten your natural teeth to match it afterward is almost impossible. It’s a good idea to talk to us about whitening beforehand, and, if this is the best way to achieve the look you want, Dr. Dave Stinchfield and Dr. Tom Stinchfield can match the color of your new prosthetic to your newly whitened smile. The goal is to make your new veneer or crown a perfect match to your natural teeth.

If You Have Existing Veneers, Crowns, or Other Artificial Surfaces

Porcelain veneers cannot be whitened, but the good news here is that they don’t stain the way natural teeth do. Unlike our teeth, porcelain is non-porous, so it is very difficult for typical culprits such as coffee, tea, or red wine to have as much effect. Any surface stains that appear can usually be gently removed with a professional cleaning and polishing, where we will take care not to scratch the delicate surface of the veneer. Porcelain crowns and implants, like veneers, can be brightened with a professional surface cleaning, but their original color cannot be changed.

Composite veneers and composites used in dental bonding are more porous and therefore more likely to stain. They are also immune to whitening, but might respond somewhat to a careful professional polishing at our Washougal, WA office.

Finally, if the color of your existing dental prosthetics is a concern, replacement is an option we can consider together.

Whether you have existing veneers and crowns or are planning future dental work, please talk with us about achieving a seamless blend of old and new for a beautiful, natural smile. It’s a bit of a contradiction: the best work is the work no one notices!