Posts for: June, 2019
We can do a great many things to preserve diseased teeth, from filling cavities to crowning damaged but still viable teeth to protect them and restore their attractiveness. But there may come a point where continued treatment just isn't worth it, and it may be time to remove and replace your troubled teeth.
Dental implants have become the premier restoration for missing teeth. But they have some anatomical limitations and may not work for some situations like excessive bone loss or close nerve proximity. And while a removable partial denture is a solid option, perhaps you'd rather have a fixed solution.
You might then want to consider a fixed bridge to replace one or more missing teeth. This tried and true option has been a mainstay in dentistry for several decades; and while implants may have surpassed them in popularity, they're still available and effective as a restorative option.
A traditional fixed bridge is composed of three or more life-like crowns that are fused together like pickets in a fence. The crown or crowns in the middle fill the empty tooth space; the outside crowns fit over and are bonded to the natural teeth on either side of the empty space to support the bridge. These natural teeth must be reduced in size to accommodate the crowns to fit over them.
Depending on how many teeth are missing, fixed bridges can be a more affordable alternative to dental implants and can achieve life-like results in both form and dental function. But the alterations required for the supporting teeth are permanent and can weaken them. The interface between the natural teeth and the bridge crowns has a higher risk of decay and periodontal disease, so you'll need to be extra vigilant with daily hygiene and regular dental cleanings and checkups.
And even though implants can be more expensive in the short-term, they typically have better durability and less maintenance costs than other restorations. Over the long-term, an implant restoration might actually incur less cost than a fixed bridge.
Still, a fixed bridge can be an effective way to replace missing teeth. Depending on your finances and your overall dental health, a bridge could help you regain an attractive smile.
If you would like more information on options for replacing missing 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 “Crowns & Bridgework.”
Fluoride is a critical weapon in the war against tooth decay. But this natural chemical proven to strengthen tooth enamel has also aroused suspicion over the years that it might cause health problems.
These suspicions have led to rigorous testing of fluoride's safety. And the verdict from decades of research? We've found only one verifiable side effect, a condition called enamel fluorosis. Caused by too much fluoride present in the body, enamel fluorosis produces white streaks and patches on teeth, and can develop into darker staining and pitting in extreme cases. But other than having an unattractive appearance, the teeth remain sound and healthy.
Fortunately, you can reduce the risk of fluorosis by limiting fluoride exposure to within recommended limits. Fluoride can show up in processed foods and other substances, but the two sources you should focus on most are oral hygiene products and fluoridated drinking water.
Dentists highly recommend using toothpaste with fluoride to fight tooth decay. But be careful how much your family uses, especially younger members. An infant only needs a slight smear of toothpaste on their brush for effective hygiene. At around age 2, you can increase the amount to about the size of a vegetable pea.
As to drinking water, most utilities add fluoride to their supply. If yours does, you can find out how much they add by calling them or visiting cdc.gov ("My Water's Fluoride"), where you can also learn more about recommended levels of fluoridation. If you think it's excessive, you can switch to water labeled "de-ionized," "purified," "demineralized," or "distilled," which contain little to no added fluoride.
Even if your fluoridated water is within recommended levels, you may wish to take extra precautions for infants nursing with formula. If possible, use "ready-to-feed" formula, which usually contains very low amounts of fluoride if any. If you're using the powdered form, use only water with the aforementioned labeling for mixing.
Before making any drastic changes that might affect your family's fluoride intake, consult with your dentist first. And be sure you're keeping up regular dental visits—your dentist may be able to detect any early signs of fluorosis before it becomes a bigger problem.
If you would like more information on maintaining the proper fluoride balance with your family, 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 “Tooth Development and Infant Formula.”
Unlike the natural tooth it replaces, a dental implant is impervious to decay. But don’t think that means you can relax your oral hygiene habits — even though the implant itself can’t be infected, the surrounding gum tissues and bone can. And if they’re not properly cared for you might eventually lose the implant.
In fact, implants may be more susceptible to problems from impacted food that becomes wedged between the gums and teeth than their natural counterparts. Natural teeth are connected to the jaw by way of a resilient, elastic tissue known as the periodontal ligament: the ligament resides in the space between the tooth root and the bone and attaches to both through tiny fibers. The bone and ligament are protected by an attachment of gum tissue that covers all of the surrounding bone and attaches to the root surface. The outer gum tissue surface is covered by a protein called keratin that makes it resistant to wear.
On the other hand, these periodontal ligament fibers don’t exist when implants are present as the implant is fastened directly to the bone. Because it doesn’t have this ligament attachment, and the gum tissues around can’t attach to the implant as with natural teeth, it may be more vulnerable to bacteria or trauma caused by food impaction. So, cleaning and caring for dental implants is just as important, if not more so than with natural teeth.
If the gums around an implant become infected and inflamed it could lead to peri-implantitis, a condition that can destroy the bone attachment between the implant and the bone. In other words, the loss of bone support can weaken the integration of the implant with the bone. As more and more attachment is lost, the implant can loosen and eventually be lost.
The best way to avoid this is with consistent daily hygiene and regular dental checkups. And, if you notice any signs of swelling or redness of the gums around an implant, contact us as soon as possible. The sooner we begin treatment to alleviate the infection, the less danger there will be of losing your implant.
If you would like more information on how to care for dental implants and other 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 “Infections around Implants.”