Princeton's Ask The Doctor Jan-Feb 2019

QUESTION: I had an implant placed several months ago and it came out. Why did this happen? Dental implants are one of the best ways of restoring missing teeth. With advanced technology, such as 3-D imaging, and decades of research, the success of implants has never been better. Unfortunately not everything in medicine is 100% and implants are no different.

4432 Route 27, CN-201, Kingston, NJ 08528 Phone: 609.497.0808 www.David YoungDMD.com David P. Young, DMD, DICOI So what can cause an implant to fail (or loose integration). The first cause can be residual infection. If the natural tooth in that area or adjacent area had an infection that spread into the bone, that bacteria could have not allowed the implant to properly integrate (attach) to the bone. A patient that is diabetic has reduced healing abilities in some cases as well as immune compromised patients. A common cause for implant failure is smoking. The constriction of blood vessels secondary to smoking reduces the blood flow to the site thus diminishing the ability of the implant to properly attach to the bone. Excess biting forces can traumatize the implant resulting in failure. A patient that clenches or grinds their teeth is constantly applying a force to the implant and eventually failure can result. A mouth guard should be made to protect the teeth and implant. The last common cause of implant failure that I will mention is bone quality and quantity. The bone itself has to have certain characteristics and keep in mind, not every site in a patients mouth may qualify to receive an implant. Discussing your specific situation with your implant specialist will be the best way to understand the situation. As Implantologists, we strive for success every time. We too are disappointed whenever an implant does not heal well. If you have any questions or wish a consultation regarding dental implants, feel free to contact me at 609-497-0808 or kingstonimplantdentist@gmail.com. QUESTION: Why is it unwise to ignore symptoms of GERD? ANSWER: Gastroesophageal Reflux Disease (GERD) and acid reflux have been used interchangeably. GERD affects about 10 to 20% of adult population. It is a condition where stomach contents enter the esophagus due to a weak lower esophageal sphincter. Common symptoms include heartburn and a sense of acid or sour taste in the back of the mouth. Nausea and vomiting including blood may be seen. Trigger factors for GERD include acidic foods like tomato sauce and orange juice.Also chocolate, peppermint, coffee, carbonated beverages, alcohol, smoking, fried foods, large meals and lying down soon after eating can cause GERD. Hiatal hernia (a part of the stomach is pushed up above the diaphragm), results in a weak lower esophageal sphincter and leads to GERD. It is important to pay attention to symptoms of GERD and seek medical help before complications develop. Complications of GERD include: 1. Reflux esophagitis or inflammation of the esophagus leading to erosions or ulcers. 2. Difficulty with swallowing due to stenosis or narrowing of the esophagus. This is due to repeated inflammation with scar tissue formation. 3. Barrett’s esophagus where the lining of the esophagus changes to small intestinal lining. This can lead to a deadly form of esophageal cancer known as adenocarcinoma. 4. Atypical GERD which can cause hoarse voice, asthma attacks and esophageal spasm with chest pain. GERD can be effectively treated in a majority of the patients by lifestyle modifications and medications. This includes avoiding trigger foods, eating at least three hours before lying down and elevating head end of the bed. Medications include antacids, acid reducers such as H2 blockers and Proton pump inhibitors. Early diagnosis and treatment of GERD can avoid serious complications including cancer of the esophagus.

PREMIER GASTROENTEROLOGY OF PRINCETON • PUNITHA SHIVAPRASAD, DO 5 PLAINSBORO RD, MEDICAL ARTS PAVILION • SUITE #360, PLAINSBORO, NJ 08536 CALL (609) 917-9917 or VISIT PREMIERGASTROENTEROLOGYOFPRINCETON.COM If you have GERD symptoms, please call (609)-917-9917 OR visit premiergastroenterologyofprinceton.com

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