Geach Dental

3 Medical Conditions Associated With Periodontal Disease

Periodontal disease is a serious oral health concern and is a leading cause of tooth loss around the world. A number of medical conditions are associated with periodontal disease and this article will focus on 3 conditions: diabetes, atherosclerosis and hormone imbalance. This article explores each of these conditions and their implications for your oral health.

In this article, we will delve into three medical conditions that are closely linked to periodontal disease: diabetes, atherosclerosis, and hormone imbalance. Periodontal disease is a major cause of tooth loss and this can be a serious oral health concern, impacting not only your ability to chew and speak but also your overall quality of life. 

Understanding the connection between these medical conditions and periodontal disease is crucial for proactive prevention and effective management. Let’s explore each of these conditions and their implications for your oral health.

Diabetes and Periodontal Disease

The Relationship Between Diabetes and Periodontal Disease

Diabetes is a disease of disrupted glycemic control resulting from a lack of insulin production (type 1) or systemic insulin resistance (type 2). Prolonged elevation of  blood sugar (hyperglycemia) is the primary cause of the numerous complications created by diabetes. This includes negative effects on the heart, eyes, kidneys and peripheral nerves. Studies suggest that periodontal disease is a major complication of diabetes. Individuals with diabetes have at least a 3 times greater risk of periodontal disease than those without diabetes. 

How does diabetes cause periodontal disease? Prolonged hyperglycemia results in increased inflammation of the tissues surrounding the teeth. This can lead to severe gum inflammation and loss of bone around the teeth (periodontal disease). Loss of bone that supports the teeth is a leading cause of tooth loss. 

Moreover, diabetes-related inflammation and compromised immune function can hinder the body’s ability to combat oral infections. As a result, individuals with diabetes are more susceptible to dental issues, which can ultimately lead to tooth loss if left unaddressed.

A recent article from The American Dental Association concluded that US adults with uncontrolled diabetes and controlled diabetes were more likely to experience tooth loss than adults without diabetes. 

Prevention and Management

To prevent tooth loss in diabetic patients, maintaining optimal blood sugar control is paramount. Consistently monitoring and managing blood glucose levels through a well-balanced diet, regular exercise, and prescribed medications or insulin can significantly reduce the risk of oral complications.

Regular dental check-ups are equally vital in preventing gum disease and tooth loss. Dentists can closely monitor the oral health of diabetic patients and provide timely interventions when needed. Additionally, meticulous oral hygiene practices, such as brushing, flossing, and using an antiseptic mouthwash, are essential for managing the risk of gum disease.

Diabetic individuals should actively collaborate with their dentist to create a customized oral care plan that considers their specific needs. This tailored approach to oral health can help address the heightened risks associated with diabetes, ultimately safeguarding their teeth and promoting a healthier smile.

Atherosclerosis and Periodontal Disease

Atherosclerosis and Oral Health

Atherosclerosis is the pathologic narrowing of arteries due to the deposition of cholesterol in vessel walls. It is the primary cause of most cases of coronary heart disease and stroke. Many studies have shown that patients with a history of heart attack and stroke have worse oral health than healthy individuals. 

How does poor oral hygiene contribute to heart attack and stroke? Patients with periodontal disease and poor oral hygiene suffer from frequent severe gingival inflammation and circulation of bacteria in the bloodstream (bacteremia). This bacteremia activates the body’s inflammatory response leading to injury of the vascular walls of the arteries. Injury to the walls of the arteries leads to narrowing and plays a major role in causing heart attacks and strokes. 

Many studies have demonstrated that periodontal disease has a strong association with the risk of coronary artery disease and heart attack. There are also other studies that have not shown this link. Currently, there is insufficient evidence to prove a causal link between them. There is better evidence to support the relationship between periodontal disease and stroke. Can a patient’s risk of heart disease and stroke be reduced by treating periodontal disease and improving oral health? The results are not conclusive, however current research seems to trend in favor of the conclusion that improvement of oral health decreases the risk of atherosclerotic disease. 

Prevention and Management

For individuals with a family history of heart attack and stroke, it would be prudent to maintain excellent oral hygiene. Regular oral exams and thorough oral care practices, including brushing, flossing, and using an antiseptic mouthwash, are essential in reducing the risk of periodontal disease. 

During exams and recall visits to our office, our team will regularly recommend yearly check-ups with the patient’s physician to monitor cardiovascular health. We also take a blood pressure reading during our recall exams. Consistently monitoring can reduce the risk of heart attack and stroke. Regular dental check-ups and cleanings are vital in preventing periodontal disease and tooth loss. Dentists can closely monitor the oral health of patients and help prevent systemic disease from occurring. 

Hormone Imbalance and Periodontal Disease

Hormone Imbalance and Oral Health
Hormonal fluctuations, particularly in women, play a pivotal role in influencing the health of the gums and teeth. These hormonal imbalances can significantly impact oral health, and elevate the risk of developing gum disease. Hormone-related shifts can lead to an increased sensitivity in gum tissues and a greater propensity for inflammation.

Prevention and Management
For individuals experiencing hormone imbalances, maintaining good oral hygiene is of paramount importance. Regular and thorough oral care practices, including brushing, flossing, and using an antiseptic mouthwash, are essential in reducing the risk of gum disease associated with hormonal fluctuations.

Pregnant women, who often experience significant hormonal changes, should pay special attention to their oral health. Expectant mothers should consult their dentist to guide their oral health during this critical time. Dental professionals can provide tailored advice and recommendations to address the unique needs of pregnant women and minimize the risk of dental issues.

Menopausal women dealing with hormonal changes can explore hormone replacement therapy (HRT) options to help mitigate the impact of hormonal fluctuations on their oral health. HRT can assist in managing the oral health challenges that may arise during this life phase. 

A recent article from the Journal of Periodontal & Implant Science concluded that postmenopausal women had a significantly greater risk of periodontal disease than non-menopausal women. Additionally, the use of HRT in postmenopausal women could reduce the incidence of periodontal disease. 

Nevertheless, it is crucial for women to discuss the potential risks and benefits of HRT with their healthcare providers to make informed decisions regarding its usage.

Conclusion

Understanding the connection between these medical conditions and periodontal disease is important not only for improved oral health but also improved systemic health. 

Proper prevention and management can help individuals with these conditions maintain their oral health and overall quality of life. By addressing these concerns early and working closely with healthcare professionals, patients can reduce the risk of periodontal disease and associated tooth loss. 

At Geach Dental in Downtown Los Angeles and Laguna Niguel, Orange County our team has extensive experience in dealing with dental issues related to these conditions. If you are concerned about potential tooth loss, we encourage you to contact Geach Dental at (213) 622 3339, or click here to schedule a consultation. You deserve to face the world with a healthy, radiant smile! 

ABOUT THE AUTHOR: Meet Dr. Adam Geach, distinguished prosthodontics specialist and owner of Geach Dental. His dental education includes Harvard School of Dental Medicine and the University of Connecticut, where he earned a D.M.D. and an M.D.Sc. in Prosthodontics, respectively. Dr. Geach holds Diplomate status with the American Board of Prosthodontics, underscoring his exceptional expertise in dental care. 

At his clinics in Los Angeles and Laguna Niguel, Dr. Geach offers a wide range of services, from cosmetic treatments to full-mouth reconstructions, all delivered with a focus on personalized patient care.Take the first step toward your ideal smile and improved oral health by clicking here.

Further Reading:

Vu GT, et al. Tooth loss and uncontrolled diabetes among US adults. The Journal of the American Dental Association 2022; 153(6):542-551.

https://www.sciencedirect.com/science/article/abs/pii/S0002817721007145

Park KY, et al. Association of periodontitis with menopause and hormone replacement therapy: A hospital cohort study using a common data model. Journal of Periodontal & Implant Science 2023; 53(3):184–193. https://doi.org/10.5051/jpis.2202480124

Kane S. The effects of oral health on systemic health. Academy of General Dentistry 2017; 411:30-34.

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Meet Dr. Adam Geach, distinguished prosthodontics specialist and owner of  Geach Dental. 

His dental education includes Harvard School of Dental Medicine and the University of Connecticut, where he earned a D.M.D. and an M.D.Sc. in Prosthodontics, respectively. Dr. Geach holds Diplomate status with the American Board of Prosthodontics, underscoring his exceptional expertise in dental care. At his clinics in Los Angeles and Laguna Niguel, Dr. Geach offers a wide range of services, from cosmetic treatments to full-mouth reconstructions, all delivered with a focus on personalized patient care.Take the first step toward your ideal smile and improved oral health by clicking here.

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Are Dentures Comfortable? A Prosthodontist’s Guide for Seniors & Implant Patients in Los Angeles and Orange County

If you’re missing teeth and considering dentures, one of the most common questions seniors and implant candidates ask is: “Will dentures actually feel comfortable?” The good news is—yes, modern dentures can be very comfortable when they are custom-made, properly fitted, and supported by today’s advanced dental technology. For patients in Los Angeles and Orange County, especially seniors looking to restore their smile, chewing ability, and confidence, today’s denture and implant options offer far more comfort and stability than ever before. In this guide, you’ll learn: Types of Dentures Available in Los Angeles and Orange County Choosing the right type of denture plays a major role in comfort, function, and confidence. Below are the most common options recommended for seniors and patients that are missing teeth.  1. Complete Dentures Complete dentures replace all teeth in the upper or lower jaw. These removable appliances rest on the gums and rely on suction and fit for stability. Best for: Patients missing all teeth who want a less expensive, removable option.Comfort level: Good with proper fit, but may feel less stable over time due to natural bone loss. Material: Acrylic                                                                                                                    Adhesive use: Sometimes required 2. Removable Partial Dentures Partial dentures replace several missing teeth and attach to the remaining natural teeth using clasps. Best for: Patients who still have some healthy natural teeth.Comfort level: Good when properly designed, though clasps may take time to get used to. Material: Metal framework with acrylic. 3. Implant-Retained Dentures These dentures look similar to traditional removable dentures but are less bulky and snap onto dental implants for stability. Best for: Patients who struggle with loose dentures.Comfort level: Excellent – dramatically more stable than traditional dentures.                    Material: Metal framework is hidden for strength and wrapped with acrylic.                                                            Adhesive use: Not needed As few as two implants in the lower jaw and four in the upper jaw can significantly improve comfort and chewing efficiency. 4. Implant-Supported Dentures (All-on-4 / All-on-X) This is the most advanced tooth replacement solution available. A full arch of fixed teeth is supported by four or more implants and does not come out. Best for: Patients who want permanent, natural-feeling teeth.Comfort level: Highest – closest feel to natural teeth.Material: Zirconia ceramic for strength and esthetics. For many implant candidates, this option delivers the most life-changing results. What Makes Dentures Comfortable? Several key factors determine whether dentures feel comfortable or problematic. 1. Proper Fit Complete denture comfort begins with precise custom impressions and detailed shaping of the denture borders to match the movement of your lips, cheeks, and tongue. This technique is called border molding and helps prevent soreness, rubbing, and looseness. For partial dentures, proper planning and preparation of the supporting teeth ensures thinner appliances and more comfort for the tongue, cheeks and surrounding tissues. 2. Correct Bite Alignment (Occlusion) Occlusion refers to how your upper and lower teeth come together when you bite. If the bite is uneven, dentures can rock, rub the gums, and cause sore spots. A balanced bite greatly increases comfort and chewing ability. 3. Dental Implant Support For many patients, implants are the key to truly comfortable dentures. Implants: Lower dentures benefit the most from implant stabilization. The Adjustment Period: What Patients Should Expect When transitioning from natural teeth to dentures, an adjustment phase is completely normal and usually lasts a few weeks to a couple of months. During this time, you may experience: Tips for a Smoother Transition After extractions, your gums and bone continue healing for several months. Once fully healed, a final hard reline is performed to improve long-term comfort and fit. Denture Care & Maintenance for Long-Term Comfort Daily care is essential for both comfort and oral health.  1. Rinse after meals to remove food particles.2. Brush daily using a soft denture brush with mild soap (no toothpaste).3. Clean your gums and tongue with a damp cloth.4. Soak dentures overnight in water or a denture cleanser. 5. Never use hot water, bleach, or abrasive cleaners. 6. Visit your dentist yearly for fit checks and relines. Over time, jawbone changes can loosen dentures. Regular professional care prevents discomfort and instability. Common Denture Problems & Solutions Sore spots and irritationCause: Pressure or rubbing  Solution: Denture adjustment or reline Loose denturesCause: Bone shrinkage over timeSolution: Reline, remake, or add dental implants Difficulty chewingCause: New dentures or uneven biteSolution: Bite adjustment and dietary adaptation or remake dentures Difficulty speakingCause: Tongue adapting to new surfacesSolution: Speech practice and possible adjustment GaggingCause: Overextended denture baseSolution: Precision adjustment, add dental implants Unnatural appearanceCause: Poor tooth or gum contouringSolution: Remake and custom esthetic design Sunken facial appearanceCause: Bone loss without teethSolution: New dentures, add dental implants Are Implant Dentures Worth It for Seniors in Los Angeles and Orange County? For many seniors, implant-supported dentures are absolutely worth it because they: For patients seeking the most natural look and feel, All-on-4 or All-on-X solutions provide a permanent, fixed alternative to removable dentures. Frequently Asked Questions How long does it take to get used to dentures?Most patients adjust within a few weeks to a couple of months. Can dentures be worn at night?It is recommended to remove dentures at night to allow gums to rest and recover from daily use.  Are implant dentures permanent?Implant-supported bridges are fixed, while implant-retained dentures are removable but extremely stable. Do dentures hurt?Properly fitted dentures should not cause ongoing pain. Temporary soreness during adjustment is normal and treatable. How much do dentures cost in Los Angeles

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Zirconia Implants vs. Titanium: Health Benefits and Differences Explained

Dental implants have been a major advancement in replacing missing teeth. When placed correctly, titanium implants have incredibly high success rates and are the standard for tooth replacement. Dental implants can be used to replace a single tooth or can be strategically placed to support multiple missing teeth or a whole arch of teeth. The great benefit of dental implants is that they eliminate a removable denture and provide the function and appearance of natural teeth.  Over the past couple years, patients have become concerned about the idea of having metal titanium implants placed in their body. Some patients are not comfortable with the idea of having a “foreign metal object” placed into their jawbone. I can understand their concern especially if they are unsure of the science, materials used and potential risks. So much information is available on the internet and it is difficult to find answers to these questions. Because of this, some patients are more comfortable with the idea of non-metal zirconia implants as an alternative. So, are zirconia dental implants healthier than titanium dental implants?  Composition of titanium dental implants Titanium (Ti) is a metallic element with the atomic number 22 and has a silvery color. It is the ninth most abundant element in the earth’s crust. The alloy Ti-6Al-4V (Titanium, 6-aluminum, 4-vanadium), which was originally used for aerospace applications, is currently the most frequently used material for medical and dental implantation. Titanium alloys are widely used for orthopedic implantation (joint replacements) because of their lightweight, high biocompatibility and favorable strength/density ratios. Titanium alloys are superior to stainless steel and cobalt-chrome (Co-Cr) alloys with regard to biocompatibility and corrosion resistance.  Titanium plays a pivotal role for dental implants because the roughened surface of these implants attract bone cells to deposit bone and fill the space between the jawbone and the implant surface. This process is called osseointegration and is critical for implant stability. Titanium dental implants quickly form a layer of titanium dioxide on the surface and this layer forms a boundary between the metal surface and the body, preventing corrosion and deterioration of the material. This is the reason for the high biocompatibility.  Can titanium dental implants cause an allergic reaction?  Exposure to titanium from implants is common, but reports on clinical allergy are rare. Titanium dioxide on the surface of dental implants is more stable than pure titanium. It is possible that titanium ions could be released from the surface and sometimes into distant tissue. However, evidence for the possible toxic effects and risk of allergic reactions is weak (1). One study showed that titanium allergy can be detected in dental implant patients, even though its estimated prevalence is very low (0.6%) (2). It should be noted that no material, including any dental implant, can be considered universally biocompatible. As mentioned above, the Ti-6Al-4V alloy is the preferred choice for dental implants. Small amounts of other elements associated with titanium alloys can act as “impurities.” Titanium alloys can contain very small amounts of beryllium, cobalt, chromium, copper, iron, nickel and palladium. These impurities may be causative factors for different allergic reactions in patients with dental implants, but the likelihood is low.  It is therefore advisable to test for titanium allergy in patients with a history of multiple and/or severe allergies. These include allergy to jewelry, nickel and cobalt. Furthermore, patients with previous unexplained implant failure could be tested. In the rare situation that a patient is allergic to titanium, it is preferable to use alternative treatment options or to use an alternative dental implant material such as zirconia (3).  What are zirconia implants?  The idea of an alternative to titanium dental implants has been growing for years due to the questions regarding sensitivity to titanium that was discussed above. Another drawback of titanium is its grey color. When a titanium implant is placed in an area with very thin gingival tissue, there is a risk that a dark grey shadow may be visible.  Zirconium dioxide (zirconia) has been introduced as an alternative to titanium dioxide. Zirconia was first used for the fabrication of dental crowns and implant abutments. Currently, tetragonal zirconia poly-crystal is the ceramic of choice for dental implants. The white, opaque color of zirconia along with the good biocompatibility, favorable mechanical properties and low affinity for bacterial plaque, make it a good potential material for dental implants.  Are zirconia implants as successful as titanium implants?  Osseointegration is a major factor in the success of modern dental implants. Titanium remains the material of choice for obtaining and maintaining osseointegration. Early studies show that zirconia implants have similar 1 and 2 year survival rates when compared to titanium implants. More clinical long-term studies providing detailed information about implant failures, biological and technical complications, and prosthetic and esthetic outcomes are urgently needed (3). Potential implant abutment and crown complications Once a dental implant has integrated and healed with the jawbone, an implant abutment and crown are then made to complete the replacement of the tooth. The abutment and crown is held into the implant by a screw. These 3 components are shown in the picture below.   When titanium is used for the implant and abutment, this connection is incredibly strong and stable with very few mechanical complications from chewing. On the other hand, zirconia is a more brittle material compared to titanium. When zirconia is used for the implant and abutment, more mechanical complications (breakage of the abutment) have been reported, see picture below. This has been reported in studies and I have also experienced this in my practice. The challenge with zirconia is the strength and stability of the connection between the abutment and implant. So far, this connection is not as reliable as titanium. When implant abutments break, this expensive abutment and crown needs to be replaced and has the possibility of breaking again.   Conclusions References At Geach Dental in Downtown Los Angeles and Laguna Niguel, Orange County our team has extensive experience in dealing with dental implant issues. If you are

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Are Dentures Comfortable? A Prosthodontist’s Guide for Seniors & Implant Patients in Los Angeles and Orange County

If you’re missing teeth and considering dentures, one of the most common questions seniors and implant candidates ask is: “Will dentures actually feel comfortable?” The good news is—yes, modern dentures can be very comfortable when they are custom-made, properly fitted, and supported by today’s advanced dental technology. For patients in Los Angeles and Orange County, especially seniors looking to restore their smile, chewing ability, and confidence, today’s denture and implant options offer far more comfort and stability than ever before. In this guide, you’ll learn: Types of Dentures Available in Los Angeles and Orange County Choosing the right type of denture plays a major role in comfort, function, and confidence. Below are the most common options recommended for seniors and patients that are missing teeth.  1. Complete Dentures Complete dentures replace all teeth in the upper or lower jaw. These removable appliances rest on the gums and rely on suction and fit for stability. Best for: Patients missing all teeth who want a less expensive, removable option.Comfort level: Good with proper fit, but may feel less stable over time due to natural bone loss. Material: Acrylic                                                                                                                    Adhesive use: Sometimes required 2. Removable Partial Dentures Partial dentures replace several missing teeth and attach to the remaining natural teeth using clasps. Best for: Patients who still have some healthy natural teeth.Comfort level: Good when properly designed, though clasps may take time to get used to. Material: Metal framework with acrylic. 3. Implant-Retained Dentures These dentures look similar to traditional removable dentures but are less bulky and snap onto dental implants for stability. Best for: Patients who struggle with loose dentures.Comfort level: Excellent – dramatically more stable than traditional dentures.                    Material: Metal framework is hidden for strength and wrapped with acrylic.                                                            Adhesive use: Not needed As few as two implants in the lower jaw and four in the upper jaw can significantly improve comfort and chewing efficiency. 4. Implant-Supported Dentures (All-on-4 / All-on-X) This is the most advanced tooth replacement solution available. A full arch of fixed teeth is supported by four or more implants and does not come out. Best for: Patients who want permanent, natural-feeling teeth.Comfort level: Highest – closest feel to natural teeth.Material: Zirconia ceramic for strength and esthetics. For many implant candidates, this option delivers the most life-changing results. What Makes Dentures Comfortable? Several key factors determine whether dentures feel comfortable or problematic. 1. Proper Fit Complete denture comfort begins with precise custom impressions and detailed shaping of the denture borders to match the movement of your lips, cheeks, and tongue. This technique is called border molding and helps prevent soreness, rubbing, and looseness. For partial dentures, proper planning and preparation of the supporting teeth ensures thinner appliances and more comfort for the tongue, cheeks and surrounding tissues. 2. Correct Bite Alignment (Occlusion) Occlusion refers to how your upper and lower teeth come together when you bite. If the bite is uneven, dentures can rock, rub the gums, and cause sore spots. A balanced bite greatly increases comfort and chewing ability. 3. Dental Implant Support For many patients, implants are the key to truly comfortable dentures. Implants: Lower dentures benefit the most from implant stabilization. The Adjustment Period: What Patients Should Expect When transitioning from natural teeth to dentures, an adjustment phase is completely normal and usually lasts a few weeks to a couple of months. During this time, you may experience: Tips for a Smoother Transition After extractions, your gums and bone continue healing for several months. Once fully healed, a final hard reline is performed to improve long-term comfort and fit. Denture Care & Maintenance for Long-Term Comfort Daily care is essential for both comfort and oral health.  1. Rinse after meals to remove food particles.2. Brush daily using a soft denture brush with mild soap (no toothpaste).3. Clean your gums and tongue with a damp cloth.4. Soak dentures overnight in water or a denture cleanser. 5. Never use hot water, bleach, or abrasive cleaners. 6. Visit your dentist yearly for fit checks and relines. Over time, jawbone changes can loosen dentures. Regular professional care prevents discomfort and instability. Common Denture Problems & Solutions Sore spots and irritationCause: Pressure or rubbing  Solution: Denture adjustment or reline Loose denturesCause: Bone shrinkage over timeSolution: Reline, remake, or add dental implants Difficulty chewingCause: New dentures or uneven biteSolution: Bite adjustment and dietary adaptation or remake dentures Difficulty speakingCause: Tongue adapting to new surfacesSolution: Speech practice and possible adjustment GaggingCause: Overextended denture baseSolution: Precision adjustment, add dental implants Unnatural appearanceCause: Poor tooth or gum contouringSolution: Remake and custom esthetic design Sunken facial appearanceCause: Bone loss without teethSolution: New dentures, add dental implants Are Implant Dentures Worth It for Seniors in Los Angeles and Orange County? For many seniors, implant-supported dentures are absolutely worth it because they: For patients seeking the most natural look and feel, All-on-4 or All-on-X solutions provide a permanent, fixed alternative to removable dentures. Frequently Asked Questions How long does it take to get used to dentures?Most patients adjust within a few weeks to a couple of months. Can dentures be worn at night?It is recommended to remove dentures at night to allow gums to rest and recover from daily use.  Are implant dentures permanent?Implant-supported bridges are fixed, while implant-retained dentures are removable but extremely stable. Do dentures hurt?Properly fitted dentures should not cause ongoing pain. Temporary soreness during adjustment is normal and treatable. How much do dentures cost in Los Angeles

Read Up

Zirconia Implants vs. Titanium: Health Benefits and Differences Explained

Dental implants have been a major advancement in replacing missing teeth. When placed correctly, titanium implants have incredibly high success rates and are the standard for tooth replacement. Dental implants can be used to replace a single tooth or can be strategically placed to support multiple missing teeth or a whole arch of teeth. The great benefit of dental implants is that they eliminate a removable denture and provide the function and appearance of natural teeth.  Over the past couple years, patients have become concerned about the idea of having metal titanium implants placed in their body. Some patients are not comfortable with the idea of having a “foreign metal object” placed into their jawbone. I can understand their concern especially if they are unsure of the science, materials used and potential risks. So much information is available on the internet and it is difficult to find answers to these questions. Because of this, some patients are more comfortable with the idea of non-metal zirconia implants as an alternative. So, are zirconia dental implants healthier than titanium dental implants?  Composition of titanium dental implants Titanium (Ti) is a metallic element with the atomic number 22 and has a silvery color. It is the ninth most abundant element in the earth’s crust. The alloy Ti-6Al-4V (Titanium, 6-aluminum, 4-vanadium), which was originally used for aerospace applications, is currently the most frequently used material for medical and dental implantation. Titanium alloys are widely used for orthopedic implantation (joint replacements) because of their lightweight, high biocompatibility and favorable strength/density ratios. Titanium alloys are superior to stainless steel and cobalt-chrome (Co-Cr) alloys with regard to biocompatibility and corrosion resistance.  Titanium plays a pivotal role for dental implants because the roughened surface of these implants attract bone cells to deposit bone and fill the space between the jawbone and the implant surface. This process is called osseointegration and is critical for implant stability. Titanium dental implants quickly form a layer of titanium dioxide on the surface and this layer forms a boundary between the metal surface and the body, preventing corrosion and deterioration of the material. This is the reason for the high biocompatibility.  Can titanium dental implants cause an allergic reaction?  Exposure to titanium from implants is common, but reports on clinical allergy are rare. Titanium dioxide on the surface of dental implants is more stable than pure titanium. It is possible that titanium ions could be released from the surface and sometimes into distant tissue. However, evidence for the possible toxic effects and risk of allergic reactions is weak (1). One study showed that titanium allergy can be detected in dental implant patients, even though its estimated prevalence is very low (0.6%) (2). It should be noted that no material, including any dental implant, can be considered universally biocompatible. As mentioned above, the Ti-6Al-4V alloy is the preferred choice for dental implants. Small amounts of other elements associated with titanium alloys can act as “impurities.” Titanium alloys can contain very small amounts of beryllium, cobalt, chromium, copper, iron, nickel and palladium. These impurities may be causative factors for different allergic reactions in patients with dental implants, but the likelihood is low.  It is therefore advisable to test for titanium allergy in patients with a history of multiple and/or severe allergies. These include allergy to jewelry, nickel and cobalt. Furthermore, patients with previous unexplained implant failure could be tested. In the rare situation that a patient is allergic to titanium, it is preferable to use alternative treatment options or to use an alternative dental implant material such as zirconia (3).  What are zirconia implants?  The idea of an alternative to titanium dental implants has been growing for years due to the questions regarding sensitivity to titanium that was discussed above. Another drawback of titanium is its grey color. When a titanium implant is placed in an area with very thin gingival tissue, there is a risk that a dark grey shadow may be visible.  Zirconium dioxide (zirconia) has been introduced as an alternative to titanium dioxide. Zirconia was first used for the fabrication of dental crowns and implant abutments. Currently, tetragonal zirconia poly-crystal is the ceramic of choice for dental implants. The white, opaque color of zirconia along with the good biocompatibility, favorable mechanical properties and low affinity for bacterial plaque, make it a good potential material for dental implants.  Are zirconia implants as successful as titanium implants?  Osseointegration is a major factor in the success of modern dental implants. Titanium remains the material of choice for obtaining and maintaining osseointegration. Early studies show that zirconia implants have similar 1 and 2 year survival rates when compared to titanium implants. More clinical long-term studies providing detailed information about implant failures, biological and technical complications, and prosthetic and esthetic outcomes are urgently needed (3). Potential implant abutment and crown complications Once a dental implant has integrated and healed with the jawbone, an implant abutment and crown are then made to complete the replacement of the tooth. The abutment and crown is held into the implant by a screw. These 3 components are shown in the picture below.   When titanium is used for the implant and abutment, this connection is incredibly strong and stable with very few mechanical complications from chewing. On the other hand, zirconia is a more brittle material compared to titanium. When zirconia is used for the implant and abutment, more mechanical complications (breakage of the abutment) have been reported, see picture below. This has been reported in studies and I have also experienced this in my practice. The challenge with zirconia is the strength and stability of the connection between the abutment and implant. So far, this connection is not as reliable as titanium. When implant abutments break, this expensive abutment and crown needs to be replaced and has the possibility of breaking again.   Conclusions References At Geach Dental in Downtown Los Angeles and Laguna Niguel, Orange County our team has extensive experience in dealing with dental implant issues. If you are

Read Up
Related blog posts

Are Dentures Comfortable? A Prosthodontist’s Guide for Seniors & Implant Patients in Los Angeles and Orange County

If you’re missing teeth and considering dentures, one of the most common questions seniors and implant candidates ask is: “Will dentures actually feel comfortable?” The good news is—yes, modern dentures can be very comfortable when they are custom-made, properly fitted, and supported by today’s advanced dental technology. For patients in Los Angeles and Orange County, especially seniors looking to restore their smile, chewing ability, and confidence, today’s denture and implant options offer far more comfort and stability than ever before. In this guide, you’ll learn: Types of Dentures Available in Los Angeles and Orange County Choosing the right type of denture plays a major role in comfort, function, and confidence. Below are the most common options recommended for seniors and patients that are missing teeth.  1. Complete Dentures Complete dentures replace all teeth in the upper or lower jaw. These removable appliances rest on the gums and rely on suction and fit for stability. Best for: Patients missing all teeth who want a less expensive, removable option.Comfort level: Good with proper fit, but may feel less stable over time due to natural bone loss. Material: Acrylic                                                                                                                    Adhesive use: Sometimes required 2. Removable Partial Dentures Partial dentures replace several missing teeth and attach to the remaining natural teeth using clasps. Best for: Patients who still have some healthy natural teeth.Comfort level: Good when properly designed, though clasps may take time to get used to. Material: Metal framework with acrylic. 3. Implant-Retained Dentures These dentures look similar to traditional removable dentures but are less bulky and snap onto dental implants for stability. Best for: Patients who struggle with loose dentures.Comfort level: Excellent – dramatically more stable than traditional dentures.                    Material: Metal framework is hidden for strength and wrapped with acrylic.                                                            Adhesive use: Not needed As few as two implants in the lower jaw and four in the upper jaw can significantly improve comfort and chewing efficiency. 4. Implant-Supported Dentures (All-on-4 / All-on-X) This is the most advanced tooth replacement solution available. A full arch of fixed teeth is supported by four or more implants and does not come out. Best for: Patients who want permanent, natural-feeling teeth.Comfort level: Highest – closest feel to natural teeth.Material: Zirconia ceramic for strength and esthetics. For many implant candidates, this option delivers the most life-changing results. What Makes Dentures Comfortable? Several key factors determine whether dentures feel comfortable or problematic. 1. Proper Fit Complete denture comfort begins with precise custom impressions and detailed shaping of the denture borders to match the movement of your lips, cheeks, and tongue. This technique is called border molding and helps prevent soreness, rubbing, and looseness. For partial dentures, proper planning and preparation of the supporting teeth ensures thinner appliances and more comfort for the tongue, cheeks and surrounding tissues. 2. Correct Bite Alignment (Occlusion) Occlusion refers to how your upper and lower teeth come together when you bite. If the bite is uneven, dentures can rock, rub the gums, and cause sore spots. A balanced bite greatly increases comfort and chewing ability. 3. Dental Implant Support For many patients, implants are the key to truly comfortable dentures. Implants: Lower dentures benefit the most from implant stabilization. The Adjustment Period: What Patients Should Expect When transitioning from natural teeth to dentures, an adjustment phase is completely normal and usually lasts a few weeks to a couple of months. During this time, you may experience: Tips for a Smoother Transition After extractions, your gums and bone continue healing for several months. Once fully healed, a final hard reline is performed to improve long-term comfort and fit. Denture Care & Maintenance for Long-Term Comfort Daily care is essential for both comfort and oral health.  1. Rinse after meals to remove food particles.2. Brush daily using a soft denture brush with mild soap (no toothpaste).3. Clean your gums and tongue with a damp cloth.4. Soak dentures overnight in water or a denture cleanser. 5. Never use hot water, bleach, or abrasive cleaners. 6. Visit your dentist yearly for fit checks and relines. Over time, jawbone changes can loosen dentures. Regular professional care prevents discomfort and instability. Common Denture Problems & Solutions Sore spots and irritationCause: Pressure or rubbing  Solution: Denture adjustment or reline Loose denturesCause: Bone shrinkage over timeSolution: Reline, remake, or add dental implants Difficulty chewingCause: New dentures or uneven biteSolution: Bite adjustment and dietary adaptation or remake dentures Difficulty speakingCause: Tongue adapting to new surfacesSolution: Speech practice and possible adjustment GaggingCause: Overextended denture baseSolution: Precision adjustment, add dental implants Unnatural appearanceCause: Poor tooth or gum contouringSolution: Remake and custom esthetic design Sunken facial appearanceCause: Bone loss without teethSolution: New dentures, add dental implants Are Implant Dentures Worth It for Seniors in Los Angeles and Orange County? For many seniors, implant-supported dentures are absolutely worth it because they: For patients seeking the most natural look and feel, All-on-4 or All-on-X solutions provide a permanent, fixed alternative to removable dentures. Frequently Asked Questions How long does it take to get used to dentures?Most patients adjust within a few weeks to a couple of months. Can dentures be worn at night?It is recommended to remove dentures at night to allow gums to rest and recover from daily use.  Are implant dentures permanent?Implant-supported bridges are fixed, while implant-retained dentures are removable but extremely stable. Do dentures hurt?Properly fitted dentures should not cause ongoing pain. Temporary soreness during adjustment is normal and treatable. How much do dentures cost in Los Angeles

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Zirconia Implants vs. Titanium: Health Benefits and Differences Explained

Dental implants have been a major advancement in replacing missing teeth. When placed correctly, titanium implants have incredibly high success rates and are the standard for tooth replacement. Dental implants can be used to replace a single tooth or can be strategically placed to support multiple missing teeth or a whole arch of teeth. The great benefit of dental implants is that they eliminate a removable denture and provide the function and appearance of natural teeth.  Over the past couple years, patients have become concerned about the idea of having metal titanium implants placed in their body. Some patients are not comfortable with the idea of having a “foreign metal object” placed into their jawbone. I can understand their concern especially if they are unsure of the science, materials used and potential risks. So much information is available on the internet and it is difficult to find answers to these questions. Because of this, some patients are more comfortable with the idea of non-metal zirconia implants as an alternative. So, are zirconia dental implants healthier than titanium dental implants?  Composition of titanium dental implants Titanium (Ti) is a metallic element with the atomic number 22 and has a silvery color. It is the ninth most abundant element in the earth’s crust. The alloy Ti-6Al-4V (Titanium, 6-aluminum, 4-vanadium), which was originally used for aerospace applications, is currently the most frequently used material for medical and dental implantation. Titanium alloys are widely used for orthopedic implantation (joint replacements) because of their lightweight, high biocompatibility and favorable strength/density ratios. Titanium alloys are superior to stainless steel and cobalt-chrome (Co-Cr) alloys with regard to biocompatibility and corrosion resistance.  Titanium plays a pivotal role for dental implants because the roughened surface of these implants attract bone cells to deposit bone and fill the space between the jawbone and the implant surface. This process is called osseointegration and is critical for implant stability. Titanium dental implants quickly form a layer of titanium dioxide on the surface and this layer forms a boundary between the metal surface and the body, preventing corrosion and deterioration of the material. This is the reason for the high biocompatibility.  Can titanium dental implants cause an allergic reaction?  Exposure to titanium from implants is common, but reports on clinical allergy are rare. Titanium dioxide on the surface of dental implants is more stable than pure titanium. It is possible that titanium ions could be released from the surface and sometimes into distant tissue. However, evidence for the possible toxic effects and risk of allergic reactions is weak (1). One study showed that titanium allergy can be detected in dental implant patients, even though its estimated prevalence is very low (0.6%) (2). It should be noted that no material, including any dental implant, can be considered universally biocompatible. As mentioned above, the Ti-6Al-4V alloy is the preferred choice for dental implants. Small amounts of other elements associated with titanium alloys can act as “impurities.” Titanium alloys can contain very small amounts of beryllium, cobalt, chromium, copper, iron, nickel and palladium. These impurities may be causative factors for different allergic reactions in patients with dental implants, but the likelihood is low.  It is therefore advisable to test for titanium allergy in patients with a history of multiple and/or severe allergies. These include allergy to jewelry, nickel and cobalt. Furthermore, patients with previous unexplained implant failure could be tested. In the rare situation that a patient is allergic to titanium, it is preferable to use alternative treatment options or to use an alternative dental implant material such as zirconia (3).  What are zirconia implants?  The idea of an alternative to titanium dental implants has been growing for years due to the questions regarding sensitivity to titanium that was discussed above. Another drawback of titanium is its grey color. When a titanium implant is placed in an area with very thin gingival tissue, there is a risk that a dark grey shadow may be visible.  Zirconium dioxide (zirconia) has been introduced as an alternative to titanium dioxide. Zirconia was first used for the fabrication of dental crowns and implant abutments. Currently, tetragonal zirconia poly-crystal is the ceramic of choice for dental implants. The white, opaque color of zirconia along with the good biocompatibility, favorable mechanical properties and low affinity for bacterial plaque, make it a good potential material for dental implants.  Are zirconia implants as successful as titanium implants?  Osseointegration is a major factor in the success of modern dental implants. Titanium remains the material of choice for obtaining and maintaining osseointegration. Early studies show that zirconia implants have similar 1 and 2 year survival rates when compared to titanium implants. More clinical long-term studies providing detailed information about implant failures, biological and technical complications, and prosthetic and esthetic outcomes are urgently needed (3). Potential implant abutment and crown complications Once a dental implant has integrated and healed with the jawbone, an implant abutment and crown are then made to complete the replacement of the tooth. The abutment and crown is held into the implant by a screw. These 3 components are shown in the picture below.   When titanium is used for the implant and abutment, this connection is incredibly strong and stable with very few mechanical complications from chewing. On the other hand, zirconia is a more brittle material compared to titanium. When zirconia is used for the implant and abutment, more mechanical complications (breakage of the abutment) have been reported, see picture below. This has been reported in studies and I have also experienced this in my practice. The challenge with zirconia is the strength and stability of the connection between the abutment and implant. So far, this connection is not as reliable as titanium. When implant abutments break, this expensive abutment and crown needs to be replaced and has the possibility of breaking again.   Conclusions References At Geach Dental in Downtown Los Angeles and Laguna Niguel, Orange County our team has extensive experience in dealing with dental implant issues. If you are

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