Tooth replacement at any age is a challenge, but especially for teenagers. Dental implants in particular may not be possible yet for teens or young adults whose jaws are still developing. Because it’s imbedded directly into bone, the implant will not move with the jaw as jaw growth occurs, making it look potentially unattractive.
The best solution could be a temporary replacement until their jaw reaches maturity. One such option is a removable partial denture (RPD), an artificial tooth set in an acrylic base that resembles gum tissue. Although we associate dentures with older adults, an RPD works well for teens as a temporary measure. Perhaps the best version for a younger person utilizes metal clips that fit over adjacent teeth and hold the RPD in place. Although quite resilient, the wearer needs to be careful when biting into something hard (like an apple or similar firm fruit) or the artificial tooth may break off.
Another option, a bonded bridge, is a fixed solution similar to a traditional bridge. Whereas a traditional bridge is supported by crowns affixed to the teeth on either side of the empty socket (and requiring extensive alteration of the teeth to accommodate them), a bonded bridge attaches to the supporting teeth with wing-like projections of dental material that attaches to the backs of the adjacent teeth, hidden from view. Although not as secure as a traditional bridge, they can conceivably endure until the teen’s jaw structure is ready for an implant or other permanent solution.
Choosing between an RPD and a bonded bridge will depend on a number of factors, including the teen’s individual bite, clenching or biting habits and the health and strength of supporting bone and gums. Regardless of the type of solution chosen, it’s important to maintain good oral hygiene, especially around a bridge. If bacterial plaque is allowed to build up on tooth surfaces, it could result in an infection that can damage both gums and bone, and reduce the chances of a successful implant in the future.
All these and other considerations should be discussed after a thorough examination. From there, we can advise you on the best course of action to restore both appearance and function until it’s time for a permanent restoration.
Everyone loves a concert where there's plenty of audience participation… until it starts to get out of hand.Â Recently, the platinum-selling band Fifth Harmony was playing to a packed house in Atlanta when things went awry for vocalist Camila Cabello. Fans were batting around a big plastic ball, and one unfortunate swing sent the ball hurtling toward the stage — and directly into Cabello's face. Pushing the microphone into her mouth, it left the “Worth It” singer with a chipped front tooth.
Ouch! Cabello finished the show nevertheless, and didn't seem too upset. “Atlanta… u wild… love u,” she tweeted later that night. “Gotta get it fixed now tho lol.” Fortunately, dentistry offers a number of ways to make that chipped tooth look as good as new.
A small chip at the edge of the tooth can sometimes be polished with dental instruments to remove the sharp edges. If it's a little bigger, a procedure called dental bonding may be recommended. Here, the missing part is filled in with a mixture of plastic resin and glass fillers, which are then cured (hardened) with a special light. The tooth-colored bonding material provides a tough, lifelike restoration that's hard to tell apart from your natural teeth. While bonding can be performed in just one office visit, the material can stain over time and may eventually need to be replaced.
Porcelain veneers are a more long-lasting solution. These wafer-thin coverings go over the entire front surface of the tooth, and can resolve a number of defects — including chips, discoloration, and even minor size or spacing irregularities. You can get a single veneer or have your whole smile redone, in shades ranging from a pearly luster to an ultra-bright white; that's why veneers are a favorite of Hollywood stars. Getting veneers is a procedure that takes several office visits, but the beautiful results can last for many years.
If a chip or crack extends into the inner part of a tooth, you'll probably need a crown (or cap) to restore the tooth's function and appearance. As long as the roots are healthy, the entire part of the tooth above the gum line can be replaced with a natural-looking restoration. You may also need a root canal to remove the damaged pulp material and prevent infection if the fracture went too far. While small chips or cracks aren't usually an emergency (unless accompanied by pain), damage to the tooth's pulp requires prompt attention.
If you have questions about smile restoration, please contact us and schedule an appointment. You can read more in the Dear Doctor magazine articles “Porcelain Veneers: Strength & Beauty As Never Before” and “Porcelain Crowns & Veneers.”
With a 95%-plus success rate, dental implants are an effective and durable replacement for lost teeth. But we can't place them and forget them: if you don't clean and maintain them they could fail as a result of disease.
The inorganic materials that make up the implant aren't in danger of infection. But the living gums and bone that surround and support the implant are at risk. In fact, there's a particular periodontal (gum) disease involving implants called peri-implantitis (“peri” – around; implant “itis” – inflammation).
Peri-implantitis begins when the gum tissues around the implant become infected and inflamed. This happens most commonly because plaque, a thin film of bacteria and food particles, builds up on implant surfaces. Another less frequent cause is a buildup of excess cement used to bond the crown to the implant. We need to remove the built-up plaque or the excess cement during your dental visit.
If the infection isn't treated or you don't keep up effective, daily hygiene practices, the infection can grow and extend deeper into the tissues and finally the bone. This can destroy the all-important integration of bone and metal titanium post that has created the implant's strong hold. When that support becomes compromised the implant can lose its attachment and, if untreated, eventually fail.
It's important to keep an eye out for any indications you may have a gum infection around an implant. Look for redness, swelling, bleeding or pus formation. If the implant feels loose, this may mean that extensive bone loss has already occurred. If you encounter any of these signs, see us immediately for an examination.
The best approach, though, is to prevent peri-implantitis in the first place. So, brush and floss daily around your implant as you do your natural teeth. And be sure you keep up regular dental cleanings and checkups.
With proper care and maintenance you can avoid problems with disease that could affect your implant. Healthy gums and bone will ensure your implant will last for many decades to come.
Your teeth’s hard, enamel coating protects them from environmental dangers or disease. But although it’s made of the hardest substance in the human body, enamel isn’t invincible — prolonged exposure to acid can cause dental erosion, a condition in which the enamel’s mineral content permanently dissolves, a process known as de-mineralization.
De-mineralization occurs anytime our mouth environment becomes too acidic due to eating or drinking items with high acid content. Saliva normally neutralizes mouth acid in thirty minutes to an hour after we eat, as well as restores mineral content to the enamel (re-mineralization). Danger arises, though, if the saliva’s buffering action is overwhelmed by chronic acidity, caused mainly by constant snacking or sipping on acidic foods and beverages throughout the day — in this situation, saliva can’t complete the process of buffering and re-mineralization.
As a result, the enamel may permanently lose its mineral content and strength over time. This permanent dental erosion leads to serious consequences: the teeth become more susceptible to decay; the dentin becomes exposed, which causes pain and sensitivity to pressure and temperature changes; and changes in the teeth’s size and color can negatively alter your appearance.
It’s important to take action then before dental erosion occurs. Along with daily oral hygiene, restrict your consumption of acidic foods and beverages to meal times and cut back on between-meal snacks. Rather than a sports drink after exercising, drink nature’s hydrator — water. You should also alter your brushing habits slightly — rather than brush right after you eat, wait thirty minutes to an hour. This gives saliva time to restore the mouth to its normal pH and re-mineralize the enamel. Brushing right after can remove even more of the minerals in softened enamel.
If significant erosion has occurred, there are a number of treatment options we can undertake to preserve remaining tooth structure and enhance your appearance. In moderate cases, we can reshape and cover damaged teeth using dental materials like composite resins or porcelain to fill decayed areas or cover teeth with veneers or crowns.
The key of course, is to identify dental erosion through clinical examination as soon as possible to minimize damage. Your enamel plays a critical role in protecting your teeth from disease — so take the right steps to protect your enamel.
If you would like more information on protecting your enamel, 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 “Dental Erosion.”
Most of us think of insurance as a means to protect us and our families from unforeseen loss. While that’s the general definition, some insurance plans — like dental — don’t quite work that way.
The typical dental plan actually works more like a discount coupon for dental services. Most are part of an employer-based benefit package and usually “fee-for-service”: the insurance company pays for part or sometimes the entire bill after your dental visit based on a fee schedule laid out in the policy.
A plan’s benefits depend on what the insurer offers to cover and what level of coverage your employer (or you) are willing to pay for. Typically, the more items covered under the policy, the higher the premium. Any deductibles (the amount you must pay out of pocket before receiving any plan benefits) can also affect the premium — the lower the deductible, the higher the premium.
The benefits may also be limited due to what a patient’s dentist charges for services. Most insurers pay benefits based on what they determine to be the “usual, customary and reasonable” (UCR) fee for a particular service. The dentist’s fees are most often higher, however, resulting in the patient paying a higher percentage of the bill.
Still, a dental plan can work to your financial advantage, especially if it’s employer-based with premiums paid by your employer. It may not be advantageous, however, if you’re paying the premiums. For example, a person without insurance might spend on average $200 a year for basic dental care (mostly preventative — checkups and cleanings), while a person with insurance may have those expenses covered, but are paying yearly premiums of $500 or more for the plan.
You should also consider one other factor: our first priority as dentists is to pursue the best course of treatment for your particular dental needs, which may not always align with what your policy covers. At the same time, we understand the limitations you may be under with your plan — we work in this world every day. We’ll certainly assist you in navigating the insurance waters to achieve the best care for what you can afford.
If you would like more information on dental insurance and other financial arrangements, 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 “Dental Insurance 101.”
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