Posts for category: Dental Procedures
Durable as well as life-like, dental implants are by far the preferred method for replacing missing teeth. But they can be costly and, although not as much, so can traditional bridgework. Is there an effective but more affordable means to replace a few missing teeth?
There is: a removable partial denture (RPD). In fact, RPDs have always been the less expensive alternative to bridgework and implants. Today's RPDs are usually made of vitallium, a strong but lightweight metal alloy. Because of the metal's characteristics, we can create an appliance that precisely matches the contours of your gums, is thin and hardly noticeable. We anchor prosthetic (false) teeth made of porcelain, resins or plastics in acrylic or nylon that resembles gum tissue.
The most important aspect of an RPD is to design it to produce the least amount of movement in your mouth as you eat or speak. A good design will minimize pressure on both the underlying bone (which can accelerate bone loss) and on the remaining teeth that support the RPD. Although a little more costly, it may be advantageous to use a dental implant to stabilize a lower partial denture when no end tooth is available for support.
To get the most out of your RPD — and to prevent dental disease — it's important for you to practice diligent daily hygiene. RPD attachments can make remaining teeth more susceptible to plaque accumulation, a thin film of bacteria and food particles that can cause tooth decay and periodontal (gum) disease. To avoid this you should remove the RPD and thoroughly brush and floss your remaining teeth. You should clean the RPD every day with recommended cleansers. You should also take it out at night while you sleep to discourage further bacterial or fungal growth.
Besides daily care for your RPD and natural teeth, be sure to visit us for cleanings and checkups at least twice a year. Taking care of both your appliance and your mouth will help ensure your RPD serves you for many years to come.
If you would like more information on removable partial dentures or other restoration options, 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 “Removable Partial Dentures: Still a Viable Tooth-Replacement Alternative.”
Crowns are a mainstay of cosmetic dentistry used to improve your smile’s appearance in a variety of situations. Not all crowns are alike, though — and the differences could affect your cost.
Crowns or caps are needed to cover remaining tooth structure which was previously damaged. Tooth decay and trauma are the major reasons for damage or loss of tooth structure that make crowns necessary. After preparing the remaining healthy tooth to fit into the new crown, we then make an impression mold of the tooth for a dental technician to use to create the new crown. It’s at this point where the road to your new smile can take different paths, both in construction and how much artistry goes in to your crown’s formation.
Porcelain crown construction falls into two general categories. The first category involves life-like porcelain fused to an inner core of metal. Because many older types of porcelain tend to be brittle and subject to breaking under pressure, metals are used to strengthen the crown. A fused crown can thus provide both durability and a life-like appearance.
In recent years, though, new dental materials have made the second category — all porcelain crowns — a viable option. Either lithium disilicate or zirconium oxide account for nearly two-thirds of crowns made today. Although research on their durability is relatively new, initial results have been encouraging, showing advanced all-ceramic crowns can tolerate forces comparable to porcelain fused to metal (PFM) crowns used in bridges.
On the downside, these newer materials may be more expensive than PFM crowns. Costs for manufacturing may also increase depending on how life-like the matching of color with other teeth you desire your crown to be. For example, individual teeth aren’t a uniform color — there are gradations of color that can vary from the tip of the tooth to the root. To capture these gradations in an individual crown requires a high level of artistry and time by the dental technician, which increases the final cost.
If you’re in need of a crown, it’s best to first make an appointment for a consultation to review your options, and to consider both your expectations and financial ability. Together we can determine what it will take to create a new look for your teeth that fits your expectations and your budget.
Even though a child’s primary (“baby”) teeth eventually give way, it’s still important to treat them if they become decayed. Primary teeth serve as guides for the emerging permanent teeth — if they’re lost prematurely, the permanent tooth may come in misaligned.
If the decay, however, affects the tooth’s inner pulp, it poses complications. A similarly decayed adult tooth would be treated with a root canal in which all the pulp tissue, including nerve fibers and blood vessels, are removed before filling and sealing. Primary teeth, however, are more dependent on these nerves and blood vessels, and conventional filling materials can impede the tooth’s natural loss process. It’s better to use more conservative treatments with primary teeth depending on the degree of decay and how much of the pulp may be affected.
If the decay is near or just at the pulp, it’s possible to use an indirect pulp treatment to remove as much of the softer decay as possible while leaving harder remnants in place: this will help keep the pulp from exposure. This is then followed with an antibacterial agent and a filling to seal the tooth.
If the pulp is partially exposed but doesn’t appear infected, a technique called direct pulp capping could be used to cover or “cap” the exposed pulp with filling material, which creates a protective barrier against decay. If decay in a portion of the pulp is present, a pulpotomy can be performed to remove the infected pulp portion. It’s important with a pulpotomy to minimize the spread of further infection by appropriately dressing the wound and sealing the tooth during and after the procedure.
A pulpectomy to completely remove pulp tissue may be necessary if in the worst case scenario the pulp is completely infected. While this closely resembles a traditional root canal treatment, we must use sealant material that can be absorbed by the body. Using other sealants could inhibit the natural process when the primary tooth’s roots begin to dissolve (resorb) to allow it to eventually give way.
These all may seem like extraordinary efforts to save a tooth with such a short lifespan. But by giving primary teeth a second chance, their permanent successors will have a better chance of future good health.
If you would like more information on treating decay in primary teeth, 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 “Root Canal Treatment for Children’s Teeth.”
Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”
Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.
Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:
A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.
If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.
Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.
Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.
Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.
If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”
Due to financial circumstances, people often have a lost tooth restored with a removable partial denture, an effective appliance that restores function and a degree of aesthetic appearance. Later, though, they may want to improve both function and appearance with a dental implant.
If this describes you, you’re making a great choice. Dental implants are the closest technology we have to a natural tooth. But there may be a roadblock to your implant, especially if a long time has passed since your tooth loss—there may not be enough bone at the site to place an implant.
The heart of an implant is a titanium metal post surgically imbedded in the jawbone. The titanium naturally attracts bone cells, which grow and adhere to it to form a solid hold that can support a porcelain crown or other restorations like bridges or dentures. But to achieve a natural appearance it’s important that the implant is placed in the right location. To achieve that requires adequate bone.
But there may not be adequate bone if the tooth has been missing for a while. The forces generated when we chew travel through the teeth to the jawbone, which stimulates bone growth. If that stimulus is absent because of a missing tooth, new bone cells may not replace older ones at a healthy rate and the total bone volume begins to diminish. A denture can’t compensate and, in fact, accelerates bone loss.
But there may be a solution: bone grafting. With this procedure we place a donor bone graft into the area of bone deficiency some time before implant surgery. The graft serves as a scaffold for new bone cells to grow upon. Hopefully, this will produce enough healthy bone to support an implant. If the bone deficiency is minor, we may place the implant and the bone graft at the same time.
If you have experienced bone loss, we must first determine the amount of bone at the missing tooth site and whether grafting is a viable option. Bone grafting postpones your implant, but the delay will be worth the wait if we’re successful. With increased bone volume you’ll be able to obtain a new tooth that’s superior to your current restoration.