Posts for category: Dental Procedures
Roughly 75% of American adults are missing at least one tooth, mostly from disease, trauma or extraction for other dental reasons. A few missing teeth, though, never erupted in the first place.
It’s a rare occurrence, but sometimes people are born without certain teeth, usually back molars or premolars that may not be as visible. Occasionally, though, it’s the more visible upper lateral incisors positioned on either side of the central incisors (the two front teeth on either side of the midline of the face).
Missing incisors can lead to poor bites and create difficulties for speech development and nutrition. But these highly visible (or in this case, “invisible”) teeth can also detract from an otherwise attractive smile.
There are ways, however to correct a smile with missing lateral incisors. Here are 3 of those ways.
Canine substitution. We can fill the vacancy created by the missing incisors by orthodontically moving the canines (the “eyeteeth,” normally next to them) into the space. Braces can close the gap in a conservative way, while possibly correcting any existing bite problems. Because canines are larger than incisors, its often necessary to re-contour them and restore them with a crown, veneer or bonding material to look more natural.
Fixed bridge. A second way to fill the space is with a dental bridge. A bridge consists of a series of crowns fused together in a row. The middle crowns replace the missing teeth; the end crowns cap the natural teeth on either end of the gap, which establishes support for the bridge. Another variation is a cantilever bridge in which only one natural tooth is capped for support. With either type, though, the capped teeth will be permanently reduced in size to accommodate the crowns.
Dental implants. This popular restoration is also a favorite for correcting missing incisors. Implants provide a life-like and durable replacement for missing teeth, while not requiring any alterations to existing teeth as with a bridge. But they are more expensive than the other options, and they require adequate space between the adjacent teeth for insertion, as well as healthy bone for proper placement and anchorage. This is also an option that must wait until the jaw has fully matured in early adulthood.
If you would like more information on treating congenitally 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 “When Permanent Teeth Don't Grow: Treatment Options for Congenitally Missing Lateral Incisors.”
People improve their smiles for a lot of reasons: to better their career prospects, to put some juice in their social lives or just to do something special for themselves. But you may have an even stronger reason: a once-in-a-lifetime event—maybe your wedding day—is coming up soon.
You have several options for transforming your smile for the big day—and some are even quite economical. Here are 4 affordable ways to make your smile beautiful for that forever moment.
Cleanings. While dental cleanings should already be part of your regular dental care, scheduling one right before a big event can do wonders for your smile. Not only can your hygienist remove any lingering dull and dingy plaque and tartar, but they can polish your teeth for a brighter shine. Remember, though: dental cleanings support your own hygiene efforts, they don't replace them. Your own daily practice of brushing and flossing will also help you maintain a beautiful smile.
Teeth Whitening. You can also get an extra boost of brightness with a tooth whitening procedure. Using a professional bleaching solution and other techniques, your dentist can lighten your smile to your tastes, from a more natural hue to dazzling white. The whitening effect, though, is temporary, so plan to see your dentist no more than a few weeks before your big day.
Bonding. Perhaps a tiny chip is all that stands between you and a knockout smile. Your dentist may be able to repair that and other minor defects by bonding tooth-colored materials to the chip site. These composite resin materials have the shine of enamel and can be color-blended to match your tooth's natural shade. Composite resins are also fairly rugged, although you should avoid biting down on hard foods or objects.
Veneers. Although more expensive than the previous options mentioned, veneers are still affordable compared to crowns or bridgework. Usually made of thin layers of dental porcelain, dentists bond veneers to the front of teeth to mask mild to moderate problems like heavy staining, disfiguration and minor gaps. But because veneers are custom-fabricated by a dental lab, you'll need to plan them with your dentist at least six months before your event. The resulting change to your smile, though, may well be worth the wait.
If you would like more information on transforming your smile for a special event, 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 “Planning Your Wedding Day Smile.”
For generations, dentures have helped people avoid the dire consequences of total teeth loss. Now, implant technology is making them even better.
Composed of life-like prosthetic teeth fixed within a plastic or resin gum-colored base, dentures are manufactured to fit an individual patient’s mouth for maximum fit, comfort and performance. But dentures also have a critical drawback—they can’t stop bone loss in the jaw.
Bone is constantly regenerating as older cells dissolve and then are replaced by newer cells. In the jawbone, the forces generated when we chew travel through the teeth to the bone and help stimulate this new cell growth. When teeth are missing, though, the bone doesn’t receive this stimulus and may not regenerate at a healthy rate, resulting in gradual bone loss.
Dentures can’t transmit this chewing stimulus to the bone. In fact, the pressure they produce as they rest on top of the gums may actually accelerate bone loss. Over time then, a denture’s once secure and comfortable fit becomes loose.
In the past, most patients with loose dentures have had them relined with new dental material to improve fit, or have new dentures created to conform to the changed contours of the jaws. But implant technology now offers another alternative.
Implants are in essence a tooth root replacement. Dentists surgically implant a titanium metal post directly into the jawbone that naturally attracts bone cells to grow and adhere to it over time (a process called osseointegration). This not only creates a secure and lasting hold, it can also stop or even reverse bone loss.
Most people know implants as single tooth replacements with a porcelain crown attached to the titanium post. But a few strategically placed implants can also support either removable or fixed dentures. Removable dentures (also called overdentures) usually need only 3 or 4 implants on the top jaw and 2 on the bottom jaw for support through built-in connectors in the dentures that attach to the implants. A fixed bridge may require 4-6 implants to which they are permanently attached.
There are pros and cons for each of these options and they’re both more expensive than traditional dentures. In the long run, though, implant-supported dentures could be more beneficial for your bone health and hold their fit longer.
With the major changes in healthcare over the last few years, much of what we understand about insurance has been turned on its head. The term “Insurance” now often means something much different than how it’s traditionally understood.
Dental insurance is a prime example. Rather than a means to protect the insured from unforeseen costs, most dental policies work more like discount coupons. The vast majority are paid by employers as a salary benefit to reduce but rarely eliminate an employee’s treatment costs.
In fact, paying dental insurance premiums yourself may not be cost-effective. The average person spends $200 a year on basic care, while a typical policy costs $500 or more annually. Even if the plan fully paid for basic items like cleanings and checkups, the total cost with insurance can still be greater than paying out of pocket. Most plans also have deductibles — the fee portion the patient is responsible to pay — and annual maximum benefit limits of typically $1,200 or $1,500. With rising dental costs, these deductibles and limits may not be adequate.
There are also different types of plans, such as direct reimbursement or managed care. Under the former your employer is actually paying the claims from company funds — the insurance company acts as an administrator. The latter type packages services with select providers: the out-of-pocket costs are lower but your choices of provider are usually limited to those in their network — which on a new plan may not be the family dentist you’ve seen for years.
If you have a private plan, you should look carefully at your total costs, including premiums and out-of-pocket expenses, and compare those with projected costs without it. If you’re on an employer-paid plan, then be sure you understand it fully, especially any limits or restrictions. Also, speak with your dentist’s business staff to see how you can get the most out of the plan — dental offices work every day with insurance companies and know how to maximize your benefits.
Remember too that regular office visits for cleanings and checkups — as well as your own daily hygiene practices — are the best way to reduce long-term dental costs. Taking care of your teeth with preventive care will help ensure you’re not dipping into your own wallet — with or without insurance — more than you should.
If you would like more information on managing dental costs, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Insurance 101.”
You would love to replace your missing teeth with dental implants. And for good reason — they're the best way to restore life-like, functional teeth. But there's one problem — implants and fixed bridgework (the next, best option) are financially out of your reach.
There's another viable option, though, that might fit your budget — removable partial dentures (RPDs). Similar to full dentures, RPDs replace only the missing teeth in a dental arch. And they're much less expensive than implants or bridgework.
RPDs are custom made to fit an individual patient and their particular missing teeth locations. Their frameworks are usually made of vitallium, a strong but lightweight metal alloy. With vitallium, the frame can be made thin enough not to be noticeable but still conduct sensation.
A pink resin or plastic that mimics gum tissue covers the frame, to which we attach prosthetic (false) teeth made of porcelain, glass-filled resin or plastic to precisely match the missing teeth locations. The RPD is held in place with small metal clasps that fit around remaining natural teeth.
RPDs are designed to minimize movement and avoid undue pressure on the gum ridges, which could accelerate underlying bone loss. In certain situations, though, the location of some missing teeth could complicate matters. If you're missing a tooth in the back where the appliance coverage ends, the RPD may not be as stable.
The solution, ironically, could be a dental implant placed strategically at the end of the RPD, where it connects securely with the appliance. You would only need one or two implants, which won't dramatically increase costs.
One thing to remember with an RPD: they tend to accumulate bacterial plaque, the trigger for both tooth decay and periodontal (gum) disease. That's why it's important to practice daily effective hygiene by cleaning the RPD and your remaining teeth and gums, as well as taking the RPD out at night.
A well-maintained RPD could last for many years. With this appliance you can still have functional teeth and a winning smile, even without implants.
If you would like more information on removable dentures, 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.”