Anyone at any age, including older children and teenagers, can lose or be born missing a permanent tooth. And while those missing teeth can be restored, replacing them in patients who haven’t yet reached adulthood can be tricky.
That’s because their dental and facial development isn’t finished. This is especially problematic for dental implants because as the jaws continue to grow, a “non-growing” implant could eventually appear out of alignment with the surrounding natural teeth. That’s why it’s often better to install a temporary restoration until the jaws fully mature in early adulthood. Two great choices are a removable partial denture (RPD) or a bonded (“Maryland”) bridge.
While “dentures” and “teens” don’t seem to go together, an RPD in fact can effectively restore a teen’s lost dental function and appearance. Of the various types of RPDs the one usually recommended for teens has a hard acrylic base colored to resemble the gums, to which we attach prosthetic (“false”) teeth at their appropriate positions on the jaw.
Besides effectiveness, RPDs are easy to clean and maintain. On the downside, though, an RPD can break and—as a removable appliance—become lost. They can also lose their fit due to changes in jaw structure.
The bonded bridge is similar to a traditional fixed bridge. But there’s one big difference: traditional bridges crown the natural teeth on either side of the missing teeth to secure them in place. The supporting teeth must be significantly (and permanently) altered to accommodate the life-like crowns on either end of the bridge.
Instead, a bonded bridge affixes “wings” of dental material extending from the back of the bridge to the back of the natural teeth on either side. While not quite as strong as a regular bridge, the bonded bridge avoids altering any natural teeth.
While a fixed bridge conveniently stays in place, they’re more difficult than an RPD to keep clean. And while less prone to breakage, they aren’t entirely immune to certain stresses from biting and chewing especially in the presence of some poor bites (how the upper and lower teeth come together).
Choosing between the two restorations will depend on these and other factors. But either choice can serve your teen well until they’re able to permanently replace their missing teeth.
You might think David Copperfield leads a charmed life:Â He can escape from ropes, chains, and prison cells, make a Learjet or a railroad car disappear, and even appear to fly above the stage. But the illustrious illusionist will be the first to admit that making all that magic takes a lot of hard work. And he recently told Dear Doctor magazine that his brilliant smile has benefitted from plenty of behind-the-scenes dental work as well.
“When I was a kid, I had every kind of [treatment]. I had braces, I had headgear, I had rubber bands, and a retainer afterward,” Copperfield said. And then, just when his orthodontic treatment was finally complete, disaster struck. “I was at a mall, running down this concrete alleyway, and there was a little ledge… and I went BOOM!”
Copperfield’s two front teeth were badly injured by the impact. “My front teeth became nice little points,” he said. Yet, although they had lost a great deal of their structure, his dentist was able to restore those damaged teeth in a very natural-looking way. What kind of “magic” did the dentist use?
In Copperfield’s case, the teeth were repaired using crown restorations. Crowns (also called caps) are suitable when a tooth has lost part of its visible structure, but still has healthy roots beneath the gum line. To perform a crown restoration, the first step is to make a precise model of your teeth, often called an impression. This allows a replacement for the visible part of the tooth to be fabricated, and ensures it will fit precisely into your smile. In its exact shape and shade, a well-made crown matches your natural teeth so well that it’s virtually impossible to tell them apart. Subsequently, the crown restoration is permanently attached to the damaged tooth.
There’s a blend of technology and art in making high quality crowns — just as there is in some stage-crafted illusions. But the difference is that the replacement tooth is not just an illusion: It looks, functions and “feels” like your natural teeth… and with proper care it can last for many years to come.Â Besides crowns, there are several other types of tooth restorations that are suitable in different situations. We can recommend the right kind of “magic” for you.
If you would like more information about crowns, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Crowns & Bridgework” and “Porcelain Crowns & Veneers.”
You have a winning smile except for one small flaw — one of your front teeth is chipped. In functional terms the defect is insignificant: your tooth is healthy and can still do its job. But with regard to your smile that chip is like a smudge on a masterpiece painting: it stands out — and not in a good way.
The good news is you have options to repair the chip and vastly improve your appearance. One option is to bond a custom porcelain veneer to the outside of the tooth to cover the chip. But that would also mean removing a slight bit of tooth enamel so the veneer won't appear too bulky. Although not as much as with a crown, the alteration still permanently affects the tooth — it will always require a restoration of some kind.
There's another choice that doesn't involve removing any of your enamel: composite resin. This treatment is a mixture of materials with a glass-like binder in liquid form that we apply to a tooth in successive coats. As we build up the layers we can match the tooth's shape, texture and various shades of its natural color. We're able to fill in the defect and make the tooth appear as natural as possible.
Unlike porcelain restorations, composite resins don't require a dental lab or a period of weeks to prepare. We can transform your simile in our office in as little as one visit.
Composite resin isn't the answer for every tooth defect. Teeth that have become worn, fractured or have undergone a root canal treatment are best treated with a porcelain restoration such as a veneer or crown. But where the defect is relatively minor, composite resin may be the answer.
To learn if you can benefit from a composite resin restoration, you'll need to undergo a dental exam. If we determine you're a candidate, we can use this state-of-the-art dental material to make your teeth look flawless.
If you would like more information on composite resins, 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 “Artistic Repair of Front Teeth with Composite Resin.”
Office cleanings and other minor procedures are a routine part of regular dental care. For some people, though, a routine visit could put them at slight risk for a serious illness.
The reason for this concern is a condition known as bacteremia. This occurs when bacteria, in this case from the mouth and conceivably during an office cleaning or other routine dental procedure, enters the bloodstream. Although for most people this isn’t a great issue, there’s been concern that bacteremia could further compromise the health of patients with or susceptible to other conditions like endocarditis (heart inflammation), prosthetic joints or compromised immune systems.
This concern grew out of a number of studies in the early 20th Century that seemed to show a link between dental bacteremia and infective endocarditis. At about mid-century it became a common practice to administer antibiotics before dental work (usually 2 grams of amoxicillin or an equivalent about an hour before) to high risk patients as a way of protecting them against infection. The practice later expanded to other health issues, including many heart conditions.
Beginning in 2007, however, guidelines developed jointly by the American Heart Association and the American Dental Association reduced the number of conditions recommended for antibiotic therapy. Based on these guidelines, we now recommend pre-procedure antibiotics if you have a history of infective endocarditis, artificial heart valves, certain repaired congenital heart defects, or heart transplant that develops a subsequent heart valve problem. Patients with prosthetic joints or immune system problems are no longer under the guidelines, but may still undergo antibiotic therapy if believed necessary by their individual physician.
If you have a condition that could qualify for antibiotic therapy, please be sure to discuss it with both your dentist and physician. We’ll work together to ensure any dental work you undergo won’t have an adverse effect on the rest of your health.
If you would like more information on antibiotic therapy and dental care, 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 “Antibiotics for Dental Visits.”
Just like other parts of your physical body, teeth naturally wear as we get older. Just the effect from chewing during hundreds of thousands of meals in a lifetime can take its toll.
But there are some factors that can make tooth wear worse. By addressing them promptly should they arise, you can keep age-related tooth wear to a minimum.
Here are 3 areas to watch for to avoid excessive tooth wear.
Dental disease. Tooth decay and periodontal (gum) disease are most responsible for not only the loss of teeth but for compromising tooth health overall. But the good news is they’re largely preventable through proper oral hygiene practices to remove bacterial plaque, the main trigger for these diseases. Prompt treatment when they do occur can also minimize any damage and help your teeth and gums stay strong and healthy.
Your bite. Also known as occlusion, the bite refers to how the upper and lower teeth align with each other when you bite down. When they don’t align properly, regular chewing and biting can create abnormally high forces in the teeth and cause them to wear unevenly and more rapidly. Correcting the bite through orthodontic treatment won’t just improve your smile, it can improve bite function and decrease accelerated tooth wear.
Bruxism. This is a general term describing habits like teeth clenching and grinding in which the teeth forcefully contact each other beyond normal parameters. There are a number of causes for bruxism, but for adults it’s typically related to stress. Over time, bruxism can accelerate tooth wear and cause other problems like TMD. There are a number of ways to stop or at least reduce the effects of bruxism like relaxation techniques or a night guard worn during sleep that prevents the teeth from making forceful contact.
If you suspect you’re experiencing any of these factors, see us for a full examination. We’ll then be able to discuss your condition, the potential impact on tooth wear, and what we can do to protect your teeth.
If you would like more information on protecting your teeth as you age, 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 “How and Why Teeth Wear.”
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