Category: featured

Single Tooth vs. Multiple Teeth Replacement Options

For those who suffer from one or more missing teeth, dental implants offer a permanent and natural feeling solution to restore dental appearance and function.

Dental implants can be paired with different types of restorations to replace a single tooth or multiple teeth. Dr. William Couvelis provides thorough examinations to determine which patients are suitable for single tooth versus multiple teeth replacement at his practice in Chicago, IL.

If you are missing one or more teeth and would like to find out which option is right for you, we welcome you to schedule a consultation with Dr. Couvelis.

Single Tooth Replacement

There are different options for replacing one or two teeth. The right option largely depends on the patient’s needs and treatment goals. The primary options for replacing individual missing teeth include dental implants and dental bridges.

Dental Implants for Single Tooth Replacement

For those who only have one or two missing teeth, single tooth replacement with a dental implant and crown restoration is often one of the best treatment options.

Replacing a single tooth with a dental implant provides the most natural feeling option for restoring missing teeth. Dental implants mimic the tooth’s natural root.

Dental implants feel so natural because the jawbone physically bonds to the implant after it’s surgically placed within the jaw, much like the jawbone bonds naturally to the tooth’s root.

In order to undergo dental implant treatment for single tooth replacement, patients must be healthy enough to undergo surgery. They should also have sufficient jawbone to support the dental implant. If the jawbone is insufficient, a bone graft may be performed to rebuild the jaw for dental implant treatment.

Dental Bridges for Single Tooth Replacement

Dental bridges are a non-invasive option for replacement of a single tooth, making them a good option for those who wish to avoid surgery or are unable to undergo surgery due to underlying health issues.

Dental bridges are made of two crowns joined by an artificial tooth. The crowns are then placed over the teeth adjacent to the missing tooth, effectively replacing the missing tooth.

Although dental bridges can restore dental function, there are several downsides. In order to place the bridge, healthy teeth must be filed and altered to accommodate the crowns used to attach the bridge.

Another downside is the bridge can leave a slight gap between the artificial tooth and the gums. This area needs to be cleaned with a bridge cleaner.

Multiple Teeth Replacement

As with single tooth replacement, there are several options for replacing multiple teeth. Dental implants are a popular option for replacing missing teeth and may be used to replace several teeth or a full set of missing teeth.

Dental Implants for Multiple Tooth Replacement

Dental implants may be paired with implant-supported bridges or implant-supported dentures to replace more than two teeth or a full arch of teeth.

When paired with dental bridges, the dental crowns used to attach the bridge within the mouth are attached to dental implants. This allows the replacement of three or more teeth using only two dental implants.

With implant-supported dentures, a set of dentures is attached within the mouth using as little as four or six dental implants. This makes it possible for denture wearers to enjoy a secure fit and improved dental function as their dentures stay firmly in place when eating and speaking.

Traditional Dentures

Of course, traditional dentures are still an option for replacing multiple teeth. Although traditional, removable dentures don’t provide the secure fit and improved function as implant-supported dentures, they may be the best option for patients who are not healthy enough to undergo surgery or who don’t want to undergo surgery.

Which Treatment Is Right for You?

To find out which treatment is right for your needs, request an appointment today with Dr. William J. Couvelis, an experienced cosmetic and restorative dentist at North Pier Dental Associates in Chicago’s Streeterville neighborhood.

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Relationship between diabetes and your oral health

* Periodontal (gum) disease.

Diabetes can lead to lowered immunity against infections and also impair wound healing. Brushing and cleaning between the teeth helps to remove bacteria and plaque which, if not removed, could lead to infection of the gums and eventually cause the gums to pull away from the teeth, resulting in periodontal disease. When plaque hardens into a rough porous deposit, it is called “calculus.” Calculus, also called tartar, are usually found along, above and below the gumline of the teeth.

If left untreated, periodontal disease can cause breakdown of the bony support of the teeth, eventually leading to tooth loss. Uncontrolled glose levels, as is the case in diabetes, increases the body’s susceptibility to bacterial infections and lowers the ability to fight germs that cause gum disease. This probably explains why periodontal disease is more severe in diabetics, especially those with poorly controlled blood glucose levels.

Calculus traps plaque and food particles, thereby predisposing to periodontal disease. Unless calculus is removed during a professional cleaning, it can trap plaque and food particles, increasing the risk of developing periodontal disease. In children, type 1 diabetes has been associated with increased gingival bleeding which decreased after improved control of blood sugar on initiation of insulin therapy.

* Tooth decay

When diabetes is not controlled properly, high glucose levels in saliva may help bacteria thrive. These bacteria, in the presence of refined sugars, produce acidic by-products which lead to softening of enamel and then cavity formation.


* Salivary gland dysfunction

Low saliva production and dry mouth increase the risk of demineralisation of enamel and make the teeth more prone to cavity formation.


* Fungal infections

The mouth normally contains fungi, viruses and bacteria but they are kept in check by the body’s natural defenses and good oral hygiene practices. However in some conditions, these may not be enough to keep them in check and so they may proliferate and defeat the body’s natural defenses. People with diabetes(because of elevated blood glucose) and those who wear dentures are more prone to having a fungal infection of the mouth called oral candidiasis. Other groups of persons prone to having fungal infections are smokers and people often on antibiotic treatment.

Antifungal medication may be prescribed by your dentist to treat this condition. It is also important to maintain good oral hygiene.


It’s important to have up-to-date medical records. Let your dentist be aware of the following: if you have been previously diagnosed with diabetes; if your diabetes is under control; if there has been any other change in your symptoms; the names of all prescription and over-the-counter drugs you are taking.

Good oral hygiene for diabetics

Keep very good daily oral hygiene by flossing at least once a day and brushing for at least two to three minutes with a fluoride-containing, anti-plaque toothpaste twice a day. You will also need regular dental screenings and periodontal evaluations for early diagnosis and treatment of any oral diseases and infections. Be on the look-out for any indications of oral disease and contact your dentist as soon as you notice any. Adhere strictly to the instructions of your physician pertaining to diet and medication and schedule regular dental appointments and follow-ups to maintain a healthy mouth.

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Pregnancy and Your Oral Health

There’s a bit of folk wisdom that calcium is lost from the teeth of pregnant women during pregnancy. Thankfully, this myth is just that — a myth. It is a useful warning to expectant mothers, however, that they may experience some changes in their oral health because of their pregnancy and the accompanying surge of hormones. In particular, gum tissues may respond differently to plaque, and women with gingivitis are likely to see their condition worsen during pregnancy.

Increases in the hormones estrogen and progesterone can lead to what’s known as “pregnancy gingivitis,” which begins to surface as early as the second month. In some ways, this is a blessing because it brings to the forefront the existing plaque stuck between the teeth, and it acts as a warning that worse hygiene problems, like periodontal disease, are on the horizon. Periodontal disease is the result of poor brushing and flossing habits, and it can cause tooth loss if hygiene is not improved or if it’s left untreated.

Pregnant women are also at risk for developing inflammatory, noncancerous tumors caused when swollen gums become irritated. The tumors are usually left untreated because they resolve on their own after the child’s birth, but if it interferes with a woman’s ability to eat or care for her teeth, the dentist may elect to remove it. Research suggests that good oral hygiene is also good for your baby; an association exists between preterm, low-birth-weight babies and mothers with gingivitis. Excessive bacteria from the gums can enter the bloodstream, negatively affecting the body’s labor reflexes.

Practicing good oral hygiene can help prevent any complications during pregnancy. Teeth cleanings and checkups every six months are important for keeping up with oral health. Regular brushing and flossing, along with use of a mouthwash, can help control plaque and gingivitis — two huge factors in keeping the gums free from irritation and preventing pregnancy tumors.

Consult your dentist and your physician about the safety of any non-emergency oral procedures that you’d scheduled prior to your pregnancy. The best time for a pregnant woman to receive a dental treatment procedure is between the fourth and sixth months, and x-rays should typically only be taken during pregnancy when needed for an emergency. Your dentist or physician may recommend postponing elective procedures until after your baby is born.

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Botox And Bruxism – When You Clench Your Jaw


Have you ever caught yourself clenching your jaw tightly or grinding your teeth? Or maybe you wake up with a sore jaw and wonder what was going on while you slept? It is possible that you have Bruxism – a condition in which you clench, gnash, or grind your teeth. It can occur while you’re awake and conscious or when you’re sleeping. Sleep bruxism is particularly concerning because it is associated with other sleep disorders such as snoring and sleep apnea (pauses in breathing). If your bruxism is severe enough, whether it be awake or sleep bruxism, it can cause discomfort, headaches, jaw disorders, and it can even damage your teeth. Regular dental care can help diagnose bruxism since it causes enamel wear and even broken teeth. Receding gums is an indication and that’s no joke. It puts you at risk for gingivitis which can lead to heart problems. Never thought grinding your teeth was such a big deal, did you?


Dentists are not certain what causes bruxism, although they suspect factors such as stress, personality type, and heredity are contributors. Awake bruxism seems to be related to anger, anxiety, or tension. It can also be a habit formed when you are concentrating. Sleep bruxism is a bit more of a mystery, but has been linked to fatigue, alcohol consumption, cigarette smoking, and sleep apnea.


When searching for ways to alleviate your grinding or clenching, it is sometimes enough that you have become aware of it. Though it can be difficult to shift behaviors like this one, it can be done. Stress and anxiety management, behavioral therapy, and biofeedback have been used to treat this condition. For some people, though – especially those who have sleep bruxism – different interventions are necessary. Dental approaches to treatment include splints or mouth guards, designed to separate the upper and lower jaw or keep a “cushion” between them. Although these tools won’t address the actual condition, they will protect your teeth and jaw from further damage.


Simply speaking, and in its traditional use, Botox smooths wrinkles on the face. It works by blocking the neurotransmitters that cause muscle contractions. It’s not a leap, then, to think that it might work for a muscular condition like Bruxism. Botox injections operate in essentially the same way to calm mandibular muscles that you use to clench your jaw and grind your teeth. Not so much that it interferes with speaking, eating, and other everyday activities, but just enough to reduce extreme movement and put a stop to clenching, gnashing and grinding.


Like all injectable treatments, Botox is administered in the office, using a local anesthetic. Appointments are short, and there is no downtime. To treat bruxism, Dr. Raval injects several tiny doses of Botox into the masseter muscle on each side of the jaw – near the joint, in front of each ear. You can see how it works in this short video.

Results take 3 or 4 days to kick in, about 10-14 days to reach their peak, and the injections last about 3 months. As with other Botox injections, treatment is renewable.


If you grind or clench your teeth – when you’re awake or asleep – this is something you should discuss with your dentist. But this condition cannot be cured, only treated. So if you’re tired of the pain and interrupted sleep, or worried about permanently damaging your teeth, why not schedule a consultation with Dr. Raval? It’s your chance to learn whether Botox injections could help you.

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Periodontal Disease and Diabetes

It is well documented that people who suffer from diabetes are more susceptible to developing infections than non-diabetes sufferers.  It is not widely known that periodontal disease is often considered the sixth complication of diabetes, particularly when the diabetes is not under proper control.

Periodontal disease (often called periodontitis and gum disease) is a progressive condition that often leads to tooth loss if treatment is not promptly sought.  Periodontal disease begins with a bacterial infection in the gingival tissue which surrounds the teeth.  As the bacteria colonize, the gum pockets become deeper, the gums recede as tissue is destroyed and the periodontitis eventually attacks the underlying bone tissue.

Diabetes is characterized by too much glucose (or sugar) in the blood.  Type II diabetics are unable to regulate insulin levels which means excess glucose stays in the blood.  Type I diabetics do not produce any insulin at all.  Diabetes is a serious condition which can lead to heart disease and stroke.

Reasons for the Connection

Experts suggest the relationship between diabetes and periodontal disease can worsen both conditions if either condition is not properly controlled.

Here are ways in which diabetes and periodontal disease are linked:

  • Increased blood sugar – Moderate and severe periodontal disease elevates sugar levels in the body, increasing the amount of time the body has to function with high blood sugar.  This is why diabetics with periodontitis have difficulty keeping control of their blood sugar.  In addition, the higher sugar levels found in the mouth of diabetics provide food for the very bacteria that worsen periodontal infections.
  • Blood vessel thickening – The thickening of the blood vessels is one of the other major concerns for diabetes sufferers.  The blood vessels normally serve a vital function for tissues by delivering nutrients and removing waste products.  With diabetes, the blood vessels become too thick for these exchanges to occur.  This means that harmful waste is left in the mouth and can weaken the resistance of gum tissue, which can lead to infection and gum disease.
  • Smoking – Tobacco use does a great deal of damage in the oral region.  Not only does tobacco use slow the healing process, it also vastly increases the chances of an individual developing periodontal disease.  For diabetics who smoke, the risk is exponentially greater.  In fact, diabetic smokers aged 45 and over are twenty times more likely to develop periodontal disease.
  • Poor oral hygiene – It is essential for diabetics to maintain excellent levels of oral health.  When daily brushing and flossing does not occur, the harmful oral bacteria can ingest the excess sugar between the teeth and colonize more freely below the gum line.  This exacerbates the metabolic problems that diabetes sufferers experience.

Diagnosis and Treatment

It is of paramount importance for people suffering from any type of diabetes to see the dentist at least twice yearly for checkups and professional cleanings.  Studies have shown that simple non-surgical periodontal treatments can lower the HbA1c (hemoglobin molecule blood test) count by as much as 20% in a six month period.

The dentist will use medical history, family history and dental X-rays to assess the risk factors for periodontal disease and determine the exact condition of the gums, teeth and underlying jawbone.  If necessary the dentist will work in conjunction with other doctors to ensure that both the diabetes and the gum disease are being managed and controlled as effectively as possible.

Non-surgical procedures performed by the dentist and dental hygienist include deep scaling, where calculus (tartar) will be removed from the teeth above and below the gumline, and root planing, where the root of the tooth is smoothed down to eliminate any remaining bacteria.  Antibiotics may be applied to the gum pockets to promote healing.

Before and after periodontal treatment, the dentist and hygienist will recommend proper home care and oral maintenance as well as prescribing prescription mouthwashes which serve to deter further bacteria colonization.

If you have questions or concerns about diabetes or periodontal disease, please contact our office.

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