Old Enough for a Dental Implant?

What is the minimum age for a dental implant?  

This is especially important for boys and girls who have congenitally missing teeth.  Dental implants should not be placed until after skeletal growth is complete.   Once placed, an implant and the bone which surrounds it do not change, so we don't want the jaws and teeth around the implants to continue to develop.  In general, boys mature skeletally between the ages of 17 and 19, girls between 16 and 18.  

How do you really tell?  

A "carpal index", or wrist film (X-ray), can be taken and evaluated by a radiologist.  The film will tell if the bones of the wrist (especially the adductor sesamoid) are completely formed (ossified), the growth (epiphyseal diaphyseal) centers of the fingers (proximal, middle and distal phalanges) are fused and the growth (epiphyseal diaphyseal) center of the radius is fused.  These factors suggest completion of skeletal growth.

Robert G. Tupac, DDS, FACP, Inc., 
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309 (map)

Denture Stomatitis and Fungal Infections

Denture stomatitis is a common disorder affecting denture wearers.  It is characterized as inflammation and redness of the tissues covered by the denture.  It is often asymptomatic; only a minority of sufferers experience pain, itching or burning.  It is primarily identified during a dental examination as the presence of inflammation and swelling under the denture.  It is associated with poor denture fit, increased age of the patient, increased age of the denture, continuous wearing of the denture and poor denture hygiene.  

Bacteria and fungi (primarily Candida Albicans) are likely included.  Patients can see it themselves when their tissues are fiery red under the denture and the redness follows the outline of their denture.  Not removing dentures at night while sleeping allows a biofilm of bacteria to colonize on the inside denture surface without being properly removed.  Treatment of the acute phase requires antifungal medications.  Rapid recurrence of the condition will occur unless the denture is properly disinfected and thereafter a daily denture hygiene regimen of removing the dentures and soaking them in a commercial disinfectant solution or diluted sodium hypochlorite.  Routine follow-up visits to assess that the denture maintains proper fit and function is important in reducing the risk for developing stomatitis.

Robert G. Tupac, DDS, FACP, Inc.,
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309 (map)

Alcohol-Free Chlorhexidine Mouthrinse

Chlorhexidine mouthrinse is a prescription rinse that specifically attacks the bacteria that cause gum inflammation, and is commonly used in patients with periodontal conditions.

A study by Todkar compared the efficacy of alcohol-free chlorhexidine mouthrinse, chlorhexidine containing alcohol and a placebo of water in terms of controlling gingival plaque and reduction of gingival inflammation in patients with gingivitis.

Measurements were made at the beginning, after 14 days and after 28 days.
The study concluded that the alcohol-free rinse was as effective as the one containing alcohol in controlling plaque and reducing gingival inflammation, and can be recommended for periodontal patients, especially those for whom the use of alcohol may lead to side effects.

Reported in: Dentistry Today, Feb., 2013, from Oral Health & Preventive Dentistry, Fall 2012, vol 10, issue 3, pp 291-296.


Robert G. Tupac, DDS, FACP, Inc.,
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309 (map)

Garlic VS Milk

How to prevent garlic breath with milk?

According to research noted by ScienceDaily, a study in the Journal of Food Science published by the Institute of Food Technologists (IFT) found that drinking milk while eating garlic-heavy food can reduce the bad breath associated with garlic consumption.

They found fat-free and whole milk lowered the concentration of odor-emitting compounds from garlic both in the nose and mouth.

For further details, go to:  www.sciencedaily.com/releases


Robert G. Tupac, DDS, FACP, Inc.,
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309 (map)

Osseointegration Study Club

Osseointegration Study Club of Japan meeting

www.facebook.com/OJOsseointegrationStudyClubOfJapan

Robert Tupac participated in the 25th anniversary meeting of the Osseointegration Study Club of Southern California and Osseointegration Study Club of Japan meeting. A selection of nationally and internationally known presenters focused on the parameters of minimally invasive to total arch regeneration and the latest research on implant surgery and loading. Selected topics included clinical practice of minimally invasive implant dentistry, minimally invasive sinus augmentation procedures, CAD/CAM zirconia abutments, three dimensional bone augmentation, long term clinical results of the All-on-Four concept, experimental determination of peri-implant mucosal stability and its interpretation, the benefits of reduced diameter abutments and implant/soft tissue connection, and the future of implant dentistry. 

With 25 years of experience with implant placement and prosthetics, Dr. Tupac has witnessed the evolution of implant design and surgical technique and prosthetic designs and restorative approaches. These issues affect the short and long term realities of implant restorations, their maintenance and the prevalence and management of complications support for a screw retained provisional fixed bridge placed at the same time the implants are placed. The technique may also be performed at the same time natural teeth are extracted.

Robert G. Tupac, DDS, FACP, Inc.,
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309 (map)

What Modern Dental Technology Can Do In a Single Visit

NobelBiocare and Procera Technology

We just checked a patient who had her remaining lower teeth extracted five days ago and four
implants placed and we converted her lower denture to a provisional fixed bridge. She had walked in with failing teeth and a partial and walked out with implants and a fixed bridge, in a single visit. This is a service called All-0n-4, as described on our website and done with NobelBiocare implants and Procera technology. 

Kim was born with a cleft palette and lip. Up until she was 38 years old, she suffered from repeat infections of the sinuses, gums and tissue. It took the right team of people orechetrated by her Prothodontist, to make all of the difference in Kim's dental health.

Kim's story is a good example of why patients go to a Prosthodontist. Prosthodontics is one of nine dental specialties recognized by the Dentist industry.

Robert G. Tupac, DDS, FACP, Inc.,
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309 (map)

Trained in emergency preparedness by the CDA

First Responder

Robert Tupac, DDS, FACP, was trained as a first responder for community disaster emergency preparedness at the annual California Dental Association Convention in Anaheim, California. As a health care provider, Dr. Tupac is one of several dentists prepared to offer his services in the event they are needed at the local level.

Robert G. Tupac, DDS, FACP, Inc.,
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309

How Treating a Tooth is like Building a House

Healthy Foundation Makes a Strong House

The goal of root canal therapy is to prevent and eliminate infection at the apex (tip) of the root
of the tooth. Then what? Treating a tooth is like building a house. A root canal ensures the foundation is healthy, but the structure on top must be properly constructed.

Many classical studies show that the restoration of the top of the tooth is essential to seal the tooth and prevent root canal re-infection. Greater success is observed in teeth restored with permanent restorations within 2 months of completion of the root canal treatment. Crowns are considered the restoration of choice for endodontically treated posterior teeth. In fact, statistics show root canal treated teeth not crowned are lost at a rate 6 times greater than teeth crowned after root canal therapy.

The thing to remember, then, is that even though the root canal therapy may get you out of pain, treatment isn't finished until the tooth is restored permanently.

Robert G. Tupac, DDS, FACP, Inc.,
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309 (map)

Cardiopulmonary Resuscitation Dentistry (CPR) Approved

CPR and AED Certified Staff

Robert Tupac and all of his office personnel 
have been trained in advanced CPR/AED (Cardiopulmonary Resuscitation/Automatic External Defibrillator) for the Professional Responder and Health Care Industry as certified by the American Red Cross. His office has an automatic defibrillator available for emergency use. His surgical suite features an array of vital signs monitoring equipment, as well as oxygen and nitrous oxide delivery systems. Dr. Tupac also offers the availability of a physician anesthesiologist for intravenous sedation during restorative dentistry or implant surgery.

Robert G. Tupac, DDS, FACP, Inc.,
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309 (map)

How Staying Trim Decreases Cancer Risk

Cancer's most common traits

The World Health Organization has stated that excess
weight is second only to tobacco as a known avoidable cause of cancer.

As reported here previously, rates (from Cancer, 2012, 118:2336-2356) of esophageal adenocarcinoma, colorectal cancer, pancreatic cancer, renal cell cancer, postmenopausal breast cancer and endometrial cancer are higher for overweight vs. normal individuals and even higher still for obese vs. normal individuals.  Data suggests that each 5-point increase in BMI results in an increased risk of developing cancer that ranges from 13% to 60% depending on cancer type. The exact mechanism has yet to be determined and research is ongoing.



Robert G. Tupac, DDS, FACP, Inc.,
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309 (map)

NobelBiocare Active implant system

Experience with the NobelBiocare System

Robert Tupac completed a series of five lectures to select groups of dentists in the Central Valley regarding the newly available NobelBiocare Active implant system. He related his experience with this newly released implant system. Dr. Tupac placed several of these implants prior to their commercial launch. The NobelActive implant has a back-tapered coronal design for maximum alveolar bone volume for improved soft tissue support. It has high initial stability even in compromised bone situations due to an expanding tapered implant body with double-lead threads designed to condense bone gradually. 


Experienced clinicians can adjust implant orientation during placement for optimal prosthetic connection and the implant is ideal for minimally prepared sites because it has an apex with drilling blades enabling a smaller osteotomy. It has a unique dual-function connection with hexagonal interlock and built-in platform shifting. It provides uniform load distribution with an extremely tight abutment fit. The implant-abutment interface allows for individual emergence profile design for improved soft tissue maintenance. Dr. Tupac has added this system to his available options for choosing the optimal implant for a patient's particular clinical requirements.

Robert G. Tupac, DDS, FACP, Inc.,
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309 (map)

Find out how Secondhand Smoke Plays into Children's Health! [influenza]

Secondhand Smoke Statistics

Children exposed to secondhand smoke who are hospitalized with influenza have more severe illness. compared children (exposed vs. not exposed) hospitalized between 2002 and 2009. Using intensive care, intubation and length of stay in the hospital as severity indicators, researchers found children with chronic conditions and secondhand smoke exposure required more intensive care and had a longer length of stay (10.0 vs. 3.5 hays) than children not exposed.

In addition, children with SHS exposure were 4.7 times more likely to be admitted to intensive care and had a 70% longer length of stay, even when factors including demographics and the presence of or chronic conditions were eliminated as factors. 

Read more here - http://www.ncbi.nlm.nih.gov/pubmed/22863259

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309