Not long ago the dental bridge was the alternative treatment of choice to partial dentures for restoring lost teeth. Over the last few decades, however, dental implants have nudged bridgework out of this premier spot.
That doesn’t mean, though, that bridgework has gone the way of the horse and buggy. In fact, it may still be a solid restorative alternative to partial dentures for certain people.
A traditional bridge consists of a series of porcelain crowns affixed to each other like pickets in a fence. The end crowns are fitted onto the teeth on either side of the empty tooth space; known as abutment teeth, they support the bridge. The crowns in the middle, known as pontics (from the French for “bridge”), replace the teeth that have been lost.
Bridges have been an effective and cosmetically pleasing method for tooth replacement for nearly a century. To achieve those results, though, a good portion of the abutment teeth’s structure must be removed to accommodate the crowns. This permanently alters these teeth, so they’ll require a restoration from that point on.
Dental implants, on the other hand, can be installed in the missing space without impacting any neighboring teeth. What’s more, implants provide greater support to the underlying bone than can be achieved with bridgework.
But not everyone is a viable candidate for implants, and ironically the reason most often has to do with the bone. If a patient has suffered significant bone volume loss, either because of disease or the long-term absence of the natural teeth, there may not be enough bone to properly support an implant. Unless we can adequately restore this lost bone volume through grafting, we’ll need to consider another type of restoration.
That’s where bridgework could be a viable option for patients in this or similar situations. With continuing advances in materials and new applications, the traditional bridge still remains an effective and important means to restore a smile marred by missing teeth.
If you would like more information on dental 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 “Crowns & Bridgework.”
One of the key elements in a child’s development is their first set of teeth. Although primary (“baby”) teeth last only a few years, they’re critically important for enabling a child to eat solid foods, speak and smile.
But they also provide one more important benefit—they hold the space in the jaw reserved for the permanent teeth developing just under the gums until they erupt. But if a child loses a primary tooth prematurely because of disease or injury, other teeth may drift into the vacant space and crowd it out for the intended permanent tooth. It may then come in misaligned or remain stuck within the gums (impaction).
To avoid this, we try to treat and preserve a diseased primary tooth if at all practical. For a primary molar, one of the large teeth in the back of the mouth, this might include capping it with a stainless steel crown.
Why a metal crown? Primary molars normally don’t fall out until around ages 10-12, so it may be years for a younger child before their permanent molars erupt. All during that time these particular teeth will encounter heavier biting forces than teeth in the front.
A steel crown is often the best solution for a molar given their longer lifespans and encountered biting forces. The crown’s metal construction can stand up to these forces while still protecting the tooth from re-infection from decay. And because molars are typically outside of the “smile zone” occupied by more visible front teeth, the crown’s metal appearance isn’t usually an aesthetic issue.
Crowning a molar usually takes one visit, a dentist typically performing the procedure with local anesthesia and possibly a mild sedative like nitrous oxide gas (“laughing gas”). After removing any decayed structure from the tooth, the dentist will then fit a pre-formed crown over the remaining structure, sized and shaped to match the original tooth as close as possible.
A stainless steel crown is a cost-effective way to added needed years to a primary molar that could otherwise be lost prematurely. Preserving it may help a child avoid bite problems and expensive future treatments.
If you would like more information on dental care for 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 “Stainless Steel Crowns for Kids: A Safe and Effective Way to Restore Primary Molars.”
True or false: there’s no cause for concern about tooth decay until your child’s permanent teeth erupt.
False—decayed primary teeth can lead to potentially serious consequences later in life.
Although “baby” teeth last only a few years, they’re essential to future dental health because they act as placeholders and guides for the incoming permanent teeth. If they’re lost prematurely due to decay, other teeth may drift into the empty space intended for the emerging permanent tooth. Because of this, inadequate space will crowd the out of proper alignment.
And because they have thinner enamel than permanent teeth, primary teeth are more susceptible to decay. Once decay sets in, it can spread rapidly in a matter of months.
Fortunately, we may be able to prevent this from happening to your child’s primary teeth with a few simple guidelines. It all begins with understanding the underlying causes of tooth decay.
Tooth decay begins with bacteria: As a result of their digestion, these microorganisms secrete acid that at high levels can erode tooth enamel. The higher the population of bacteria in the mouth, the higher the acidity and potential threat to the teeth.
The first objective then in preventing decay is to remove dental plaque, the thin film of bacteria and food particles on tooth surfaces, through daily brushing and flossing. And because bacteria feed on sugar as a primary food source, you should reduce your child’s sugar consumption by restricting it to only meal times and not sending your child to bed with a bottle filled with a sugary liquid (including formula or breast milk).
To help boost your child’s protection, we can also apply sealants and fluoride to teeth to help protect and strengthen their enamel from acid attack. Because we’ll also monitor for signs of decay, it’s important to begin regular dental visits beginning around age one. If we do detect decay, we can then treat it and make every effort to preserve your child’s primary teeth until they’ve completed their normal life cycle.
By taking these steps, we can help make sure your child’s early teeth go the distance. Their current and future dental health will certainly benefit.
If you would like more information on prevention and treatment of 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 “Do Babies Get Tooth Decay?”
Pain is the body’s warning system: It tells us something is wrong. And depending on the location and intensity of the pain, it can give us vital clues about the problem.
Sometimes, though, it’s not so clear and direct—the pain could arise from any number of sources. Toothaches often fall into this category: Although it’s likely indicating a tooth or gum problem, it could be something else — or even somewhere else.
This is known as referred pain, in which you may feel pain in one location, like your mouth, but the actual source of the problem is somewhere else, like an infected and congested sinus passage. If we’re able to identify the true source and location of the pain, the better the chances of a successful treatment outcome.
Besides sinus infections, there are other conditions like trigeminal neuralgia that can refer pain to the mouth. This painful condition involves the trigeminal nerve, a large nerve running on either side of the face that can become inflamed. Depending on where the inflammation occurs, you might feel the pain at various points along the jaw, feeling much like a toothache.
There’s also the case of an earache mimicking a toothache, and vice-versa. Because of the proximity of the ears to the jaws, there is some nerve interconnectedness between them. For example, an infected or abscessed back tooth could feel a lot like an earache.
These and other possible problems (including jaw joint disorders or teeth grinding) can generate pain as if it were coming from the mouth or a single tooth. To be sure you’ll need to undergo a complete dental examination. If your dentist doesn’t find anything wrong with your mouth, he or she may refer you to a medical doctor to explore other possible causes.
Getting to the root cause of pain can help determine which treatment strategy to pursue to relieve it. Finding the actual source is the most efficient way to understand what a pain sensation is trying to tell us.
Be sure to mark August 6 on your calendars—and not just because it's the day in 1661 when the Dutch sold Brazil to Portugal, or when President Johnson signed the Voting Rights Act in 1965, or when the Ramones performed for the last time in 1996. August 6 also happens to be National Fresh Breath Day! But since fresh breath is important to us every day, we like to celebrate all month long.
Celebrating fresh breath might not seem as noteworthy as these other historical moments, but if you're a frequent halitosis (bad breath) sufferer, you know it can be downright embarrassing. More importantly, it could be a sign of a deeper health problem. It turns out there are a number of reasons why you might have bad breath. Here are the most common.
You're not adequately cleaning your mouth. Certain strains of bacteria are known for emitting volatile sulfur compounds, which give rise to that "rotten egg" smell and are a major component of bad breath. Because they feed on leftover sugars and proteins from food, you can keep them and their noxious odors at bay by brushing and flossing your teeth and brushing the broad surface of the tongue, a prime breeding ground for these bacteria.
You're not producing enough saliva. This unsung bodily fluid is a key part of good oral health. Besides helping to rinse the mouth of food particles after eating, saliva also fights odor-causing bacteria. If your mouth is dry because you're not producing enough saliva, bacteria can grow and create a number of oral health problems, including bad breath. You may be able to relieve chronic dry mouth and accompanying bad breath by using saliva-boosting agents or drinking more water. You should also talk to your doctor about any medications you're taking that might interfere with saliva production.
It could be caused by disease. Tooth decay or periodontal (gum) disease naturally give rise to bad breath—but so can other diseases like diabetes, cancer or respiratory infections. As you're dealing with these other conditions, you may also need to contend with bad breath as a side effect. You can help reduce any disease-based odors by keeping up your daily oral hygiene, especially if you're undergoing treatment for a systemic condition. Obtaining treatment, particularly if you have tooth decay or gum disease, will help reduce these embarrassing foul odors.
National Fresh Breath Day may not share the same pedestal with other momentous August dates, but if it reminds you to keep your mouth clean and see your dentist regularly, fresh breath certainly deserves its own day.
If you would like more information about the causes and remedies for bad breath, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Bad Breath: More Than Just Embarrassing” and “Dry Mouth.”
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