Lansing's Dental Discussion

Posts for: May, 2017

By Holly Scott-Hetchler DDS
May 23, 2017
Category: Dental Procedures
NewFrontTeethforaTeenagedDavidDuchovny

In real life he was a hard-charging basketball player through high school and college. In TV and the movies, he has gone head-to-head with serial killers, assorted bad guys… even mysterious paranormal forces. So would you believe that David Duchovny, who played Agent Fox Mulder in The X-Files and starred in countless other large and small-screen productions, lost his front teeth… in an elevator accident?

“I was running for the elevator at my high school when the door shut on my arm,” he explained. “The next thing I knew, I was waking up in the hospital. I had fainted, fallen on my face, and knocked out my two front teeth.” Looking at Duchovny now, you’d never know his front teeth weren’t natural. But that’s not “movie magic” — it’s the art and science of modern dentistry.

How do dentists go about replacing lost teeth with natural-looking prosthetics? Today, there are two widely used tooth replacement procedures: dental implants and bridgework. When a natural tooth can’t be saved — due to advanced decay, periodontal disease, or an accident like Duchovny’s — these methods offer good looking, fully functional replacements. So what’s the difference between the two? Essentially, it’s a matter of how the replacement teeth are supported.

With state-of-the-art dental implants, support for the replacement tooth (or teeth) comes from small titanium inserts, which are implanted directly into the bone of the jaw. In time these become fused with the bone itself, providing a solid anchorage. What’s more, they actually help prevent the bone loss that naturally occurs after tooth loss. The crowns — lifelike replacements for the visible part of the tooth — are securely attached to the implants via special connectors called abutments.

In traditional bridgework, the existing natural teeth on either side of a gap are used to support the replacement crowns that “bridge” the gap. Here’s how it works: A one-piece unit is custom-fabricated, consisting of prosthetic crowns to replace missing teeth, plus caps to cover the adjacent (abutment) teeth on each side. Those abutment teeth must be shaped so the caps can fit over them; this is done by carefully removing some of the outer tooth material. Then the whole bridge unit is securely cemented in place.

While both systems have been used successfully for decades, bridgework is now being gradually supplanted by implants. That’s because dental implants don’t have any negative impact on nearby healthy teeth, while bridgework requires that abutment teeth be shaped for crowns, and puts additional stresses on them. Dental implants also generally last far longer than bridges — the rest of your life, if given proper care. However, they are initially more expensive (though they may prove more economical in the long run), and not everyone is a candidate for the minor surgery they require.

Which method is best for you? Don’t try using paranormal powers to find out: Come in and talk to us. If you would like more information about tooth replacement, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Crowns & Bridgework,” and “Dental Implants.”


AnAffordableRPDCouldbetheAnswertoYourMissingTeethProblems

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.”




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Holly A. Scott-Hetchler DDS, PC 919 Chester RdLansing, MI 48912