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.
Everyone has to face the music at some time — even John Lydon, former lead singer of The Sex Pistols, arguably England’s best known punk rock band. The 59-year old musician was once better known by his stage name, Johnny Rotten — a brash reference to the visibly degraded state of his teeth. But in the decades since his band broke up, Lydon’s lifelong deficiency in dental hygiene had begun to cause him serious problems.
In recent years, Lydon has had several dental surgeries — including one to resolve two serious abscesses in his mouth, which left him with stitches in his gums and a temporary speech impediment. Photos show that he also had missing teeth, which, sources say, he opted to replace with dental implants.
For Lydon (and many others in the same situation) that’s likely to be an excellent choice. Dental implants are the gold standard for tooth replacement today, for some very good reasons. The most natural-looking of all tooth replacements, implants also have a higher success rate than any other method: over 95 percent. They can be used to replace one tooth, several teeth, or an entire arch (top or bottom row) of teeth. And with only routine care, they can last for the rest of your life.
Like natural teeth, dental implants get support from the bone in your jaw. The implant itself — a screw-like titanium post — is inserted into the jaw in a minor surgical operation. The lifelike, visible part of the tooth — the crown — is attached to the implant by a sturdy connector called an abutment. In time, the titanium metal of the implant actually becomes fused with the living bone tissue. This not only provides a solid anchorage for the prosthetic, but it also prevents bone loss at the site of the missing tooth — which is something neither bridgework nor dentures can do.
It’s true that implants may have a higher initial cost than other tooth replacement methods; in the long run, however, they may prove more economical. Over time, the cost of repeated dental treatments and periodic replacement of shorter-lived tooth restorations (not to mention lost time and discomfort) can easily exceed the expense of implants.
That’s a lesson John Lydon has learned. “A lot of ill health came from neglecting my teeth,” he told a newspaper reporter. “I felt sick all the time, and I decided to do something about it… I’ve had all kinds of abscesses, jaw surgery. It costs money and is very painful. So Johnny says: ‘Get your brush!’”
We couldn’t agree more. But if brushing isn’t enough, it may be time to consider dental implants. If you would like more information about dental implants, please call our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implants” and “Save a Tooth or Get an Implant?”
Maybe you don’t like to be without teeth — ever. Or maybe you get a little forgetful sometimes. Whatever the reason, if you’re wearing your dentures to bed at night, we have one message for you: Please stop!
Sleeping in dentures can have serious health consequences. A recent study published in the Journal of Dental Research found that nursing home residents who wore their dentures to sleep were 2.3 times more likely to be hospitalized or even die of pneumonia as those who did not sleep in dentures. But how can wearing dentures at night more than double your chances of getting a lung infection?
As the study noted, pneumonia-causing bacteria can readily be moved from the mouth to the lungs simply by breathing. And dentures that are not removed at night can become breeding grounds for all kind of bacteria and fungi (such as yeast). That’s what makes them potentially dangerous.
Another condition often seen in people who wear upper dentures continually is called denture stomatitis, which is characterized by a red, inflamed palate (roof of the mouth) that has been infected with yeast. The yeast microorganisms can also infect cracked corners of the mouth, a condition known as angular cheilitis. Moreover, it has also been shown that people who sleep in dentures have higher blood levels of a protein called interleukin 6, which indicates that the body is fighting an infection. Need we go on?
Wearing dentures is supposed to improve your quality of life, not reduce it. So promote good health by taking your dentures out at night, and sticking to a good daily oral hygiene routine:
- Remove and rinse your dentures after every meal.
- Brush your dentures at least once a day with a soft toothbrush or denture brush and dish soap, liquid antibacterial soap, or denture cleanser (but don’t use toothpaste — it is too abrasive).
- Store your dentures in water or a solution made for this purpose.
- Brush your gums and tongue every day with a soft toothbrush (not the same one you clean your dentures with).
- Rinse your dentures in clean water before you put them back in your mouth.
Other than the common cold, tooth decay is the most prevalent disease in the world. And while a cavity or two may seem like a minor matter, tooth decay’s full destructive potential is anything but trivial. Without proper prevention and treatment, tooth decay can cause pain, tooth loss and, in rare cases, even death.
This common disease begins with bacteria in the mouth. Though these microscopic organisms’ presence is completely normal and at times beneficial, certain strains cause problems: they consume left over carbohydrates in the mouth like sugar and produce acid as a byproduct. The higher the levels of bacteria the higher the amount of acid, which disrupts the mouth’s normal neutral pH.
This is a problem because acid is the primary enemy of enamel, the teeth’s hard protective outer shell. Acid causes enamel to lose its mineral content (de-mineralization), eventually producing cavities. Saliva neutralizes acid that arises normally after we eat, but if the levels are too high for too long this process can be overwhelmed. The longer the enamel is exposed to acid, the more it softens and dissolves.
While tooth decay is a global epidemic, dental advances of the last century have made it highly preventable. The foundation for prevention is fluoride in toothpaste and effective oral hygiene — daily brushing and flossing to removing plaque, a thin film of food remnant on teeth that’s a feeding ground for bacteria, along with regular dental visits for more thorough cleaning and examination. This regular regimen should begin in infancy when teeth first appear in the mouth. For children especially, further prevention measures in the form of sealants or topical fluoride applications performed in the dentist office can provide added protection for those at higher risk.
You can also help your preventive measures by limiting sugar or other carbohydrates in your family’s diet, and eating more fresh vegetables, fruit and dairy products, especially as snacks. Doing so reduces food sources for bacteria, which will lower their multiplication and subsequently the amount of acid produced.
In this day and age, tooth decay isn’t a given. Keeping it at bay, though, requires a personal commitment to effective hygiene, lifestyle choices and regular dental care. Doing these things will help ensure you and your family’s teeth remain free from this all too common disease.
If you would like more information on preventing and treating tooth decay, 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 Decay.”
Home whitening kits are a popular way to turn a dull smile into a dazzling one. But these self-applied products only work for teeth with outer enamel stains — if the discoloration originates inside a tooth, you’ll need professional treatment.
Known as “intrinsic staining,” this type of discoloration most often occurs within a tooth’s pulp or dentin layers. There are a number of causes like tooth trauma or tetracycline use at an early age. A root canal treatment used to remove infection from deep within a tooth can also cause discoloration: sometimes blood pigments left after tissue removal or the filling materials themselves can stain a tooth’s interior.
Intrinsic staining can often be treated by placing a bleaching agent, usually sodium perborate, into the tooth’s pulp chamber. But before undertaking this procedure on a tooth that’s undergone a root canal treatment,Â we want to first ensure the filling is intact and still adequately sealing the tooth from infection. We also want to make sure the supporting bone is also healthy.
If all’s well, we access the pulp in the same way as the root canal treatment, and preferably through the same access hole. We then clean out the pulp chamber of any stained matter and then ensure the root canals remain filled and sealed off from the pulp chamber.
We can then place the bleaching agent into the pulp, a process that will need to be repeated every three or four days to achieve the desired level of brightness. After each session we place a cotton pellet over the opening and held in place with a temporary adhesive; we can easily remove and re-apply this covering during subsequent sessions. Once we’ve achieved the desired color change, we seal the tooth with a permanent filling and restore the access cavity with a tooth-colored composite resin material bonded to the enamel and dentin.
There are other options for an intrinsically stained tooth like veneers or crowns that outwardly cover the discoloration. Internal bleaching, however, is a more conservative approach that causes less alteration of the tooth. If successful, it can restore a stained tooth to a brighter, more attractive shade.
If you would like more information on internal bleaching, 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 “Whitening Traumatized Teeth.”
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