There’s a lot to like about replacing a missing tooth with a dental implant. This state-of-the-art restoration is by far the most durable and life-like option available. And unlike other replacement options implants stimulate bone growth, a major concern after tooth loss.
For that reason we encourage getting an implant as soon as possible — for adults, that is. We don’t recommend implants for younger patients because even a teenager’s jaws haven’t yet reached full maturity. Because it attaches to the jaw differently, an implant can’t move with the growing jaw as real teeth do. It would eventually look as if it were sinking into the jaw below the gum line or being left behind as the rest of the jaw grows.
It’s best, then, to postpone placing an implant until the jaw fully matures, usually in a patient’s early twenties. In the meantime, there are some things we can do to prepare for a future implant while also restoring the tooth with a temporary replacement.
As previously mentioned, our biggest concern is bone health. Like other living tissue, bone has a growth cycle of older cells dissolving and newer ones forming in their place. The teeth transmit the pressure produced when we chew to the bone to stimulate this growth. With the absence of a tooth, the adjacent bone no longer receives this stimulation — the growth cycle slows and may eventually lead to bone loss.
We can help this situation by placing a bone graft in the missing tooth socket at the time of extraction. The graft serves as a scaffold that’s eventually taken over and replaced by new bone growth. We can also try to control how fast the graft is replaced by using grafting material that’s slowly removed and lasts longer — often a preferable situation if an implant is years away.
As for appearance, we can create a custom partial denture or even a type of bridge that bonds a prosthetic tooth to neighboring teeth without significantly altering them. If the patient undergoes orthodontic treatment it’s also possible to add prosthetic teeth to an orthodontic appliance.
Eventually, we’ll be able to provide the permanent solution of a dental implant. With careful planning and measures to preserve bone health, there’s a good chance the outcome will be worth the wait.
If you would like more information on treatments for lost teeth in children and teenagers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants for Teenagers.”
If you’ve lost some teeth you may eventually want to replace them with dental implants. Implants by far are the restoration of choice due to their life-likeness and durability. But those advantages don’t come cheaply — implants can be expensive especially for multiple teeth.
If you’re forced to wait financially for implants, you still have other intermediary options like a removable partial denture (RPD). The conventional RPD has a rigid acrylic base colored to resemble gum tissue supported by a metal frame with attached prosthetic (false) teeth at the missing teeth locations. They’re held secure in the mouth through metal clasps that fit over the remaining teeth.
But these conventional RPDs can sometimes be uncomfortable to wear and don’t always cover the bottom of the gum completely. If this is a concern, you might consider an alternative: flexible RPDs. The base of this RPD is made of a form of flexible nylon rather than acrylic plastic. They’re much more lightweight but still fit securely in the mouth with thin plastic extensions rather than metal clasps. The base can also be more easily formed to cover areas where gum tissue may have receded.
While flexible RPDs hold up better to wear and tear than their conventional counterparts, they must still be maintained like any other appliance. They can accumulate plaque (bacterial biofilm) responsible for tooth decay and periodontal (gum) disease, so daily thorough cleaning is a must. And if there fit becomes loose they can be more difficult to reline or repair than other types of dentures.
They also share a common weakness with other dentures — they can’t prevent and may even stimulate bone loss. As bone ages, old cells dissolve and new ones form to take their place. As we eat and chew our teeth transmit the forces generated through the teeth to the bone to stimulate it to grow. RPDs and other dentures can’t transmit this stimulus, so the bone replaces much slower to the point that the bone volume can diminish.
That’s why it’s best to consider any RPD as a temporary solution until you can obtain an implant for a more permanent and bone-friendly option. In the meantime, though, an RPD can provide you with a great solution for both form and function for missing teeth.
If you would like more information on RPD choices, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Flexible Partial Dentures: An Aesthetic Way to Replace Teeth Temporarily.”
Porcelain crowns have been used to restore problem teeth since at least the early 20th Century. Crown technology has gradually progressed from the early use of precious metals like gold or silver to more life-like porcelain crowns, often with a metal interior for added strength. Today, most crowns are all-porcelain, made with newer materials that not only look attractive but can endure under the pressures of daily chewing or biting.
While crowns are often part of restorations for missing teeth, they’re also commonly used to cap or fit over a viable tooth with structural or appearance problems. Here are 4 situations where a crown could improve a tooth’s form and function.
Traumatized teeth. A significant blow to the face or mouth could generate enough force to chip away or fracture a significant amount of structure from a tooth. If the root remains healthy and firmly attached within the jaw, however, a crown can replace the missing structure and restore the tooth’s function and appearance.
Root canal treatments. Root canal treatments remove infected or dead tissue within a tooth’s pulp chamber, its inner core, and the root canals. The procedure rescues the tooth but can in the process significantly alter the tooth’s structure and appearance. A crown not only restores the tooth but also provides added protection against further decay or tooth fracture.
Teeth with multiple fillings. We can effectively treat cavities caused by tooth decay by filling them. But with each filling we must remove more of the decayed structure and shape the cavity to accommodate the filling. After a number of times, a tooth may not have enough structure left to support another filling. If the tooth is still viable, a crown could solve this dilemma.
Abnormally developed teeth. Teeth sometimes don’t erupt in the jaw as they should and may be only partly visible. The tooth not only looks out of place but it can’t fully function like a normal tooth. Capping an abnormally developed tooth with a crown will help normalize it and allow it to blend in with surrounding teeth.
If you would like more information on crown restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Crowns & Bridgework.”
You know the basics for a healthy mouth: daily oral hygiene and regular dental checkups. But there are other elements unique to you that also factor into your oral care: the mouth and facial structure you inherited from your parents (like a poor bite) and your past history with dental disease. Both of these help define your individual risk factors for potential dental problems.
That’s why you need a treatment strategy personalized to you to achieve the best health possible for your teeth and gums. We create this plan by using a detailed and thorough 4-step process.
Step 1: Identify your unique risk factors. To find your risk factors for dental disease, we carefully assess your history and other areas of oral function and health: the soundness of your supporting bone and gum structures; your teeth’s structural integrity and any effects from decay, enamel erosion or trauma; functional issues like a poor bite, a jaw joint disorder or a grinding habit; and problems with appearance like disproportional gums.
Step 2: Prioritize risk factors and form the treatment plan. Once we’ve identified your individual risk factors, we assess how each could impact you and whether any require immediate treatment. Any current dental disease should be treated immediately to minimize and prevent further damage. Depending on severity, other issues like bite problems or unattractive teeth may be scheduled for later treatment.
Step 3: Execute the treatment plan. With our priorities in place, we then proceed with treating your teeth and gums, the most pressing needs first. Throughout this step, our goal is to bring your oral health to the highest level possible for you.
Step 4: Monitoring and maintaining health. Once we’ve achieved an optimum level of health, we must remain vigilant about keeping it. So we monitor for any emerging problems and perform preventive treatments like clinical cleanings to help maintain that healthy state. This also means regularly repeating our 4-step process to identify and update any new, emerging risks and incorporate them into our treatment strategy.
While this process may seem overly methodical, it can actually result in more efficient and cost-effective treatment. It’s the best way to ensure good health for your teeth and gums throughout your lifetime.
If you would like more information on creating a long-term dental care plan, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Successful Dental Treatment: Getting the Best Possible Results.”
You’ve been embarrassed for a while now by your yellowed, dull teeth. You’re ready for a change.
There’s a simple and cost-effective way to make that change: you can temporarily brighten your smile with teeth whitening, possibly at home. But before you try it, you should first have a dental examination to find out if whitening is the right choice for you.
First off, healthy teeth with outer enamel staining are the best candidates for whitening. Teeth and gums with tooth decay or periodontal (gum) disease should be treated first before undergoing whitening. A dental exam will uncover any health issues you may have with your mouth.
In the same vein, you’ll want to consider whitening carefully if you have dental work like veneers, crowns or implants. Unlike natural teeth, these non-biological materials won’t be affected by the bleaching agent. We can discuss any potential for color mismatch between your whitened natural teeth and your dental work during your examination.
A dental exam can also uncover one other crucial fact — what kind of tooth staining you have. There are two basic types: extrinsic, staining on the outside enamel as we’ve mentioned earlier; and intrinsic, staining that originates from inside a tooth. The whitening kits you purchase from a store and even some of the whitening techniques we use in the office only diminish extrinsic, not intrinsic staining. To address an intrinsically-stained tooth requires a much more involved, invasive clinical technique only performed by dental professionals.
Finally, a dental examination is a good discussion forum for helping you decide between a home kit and a clinical procedure. While DIY kits are effective for the most part, you won’t be able to precisely control the degree of brightness like we can. This could be important if you want a specific shade of whiteness, from a more subtle and natural shade to dazzling “Hollywood” bright. Shade control could also help minimize color mismatch with dental work.
In the end, we want to help you make the best choice for teeth whitening. Even if you decide to pursue whitening at home, we can offer you valuable advice on what to look for when you buy a kit and how to use it. That alone could help ensure you get the new, bright smile you desire!
If you would like more information on teeth whitening, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Important Teeth Whitening Questions…Answered!”
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