Posts for: February, 2016
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.”
Your family uses fluoride toothpaste and your drinking water is fluoridated too. So with the fluoride your child already takes in, is it really necessary for topical fluoride treatments during their regular dental visits?
The answer is most definitely. Fluoride has a unique ability to strengthen enamel, your teeth’s protective cover against decay and other diseases. It does this by infusing itself in the enamel structure and making it that much more resistant to acid attack and decay.
This infusion occurs in two ways. First, growing teeth obtain it through the bloodstream as they incorporate other minerals that make up the enamel structure. The very small amount of fluoride added to drinking water — as low as one part per million (ppm) — imparts sufficient fluoride to developing teeth. In the absence of fluoridated water, dietary fluoride supplements can achieve the same effect.
The second way is just after the teeth have erupted and are still quite young. In this case, fluoride coming in direct contact with the enamel surface is absorbed, resulting in changes to the enamel’s crystalline structure that will create added strength. This can occur to a limited degree through fluoride toothpaste or other dental products. The concentration of fluoride in these products, though, is relatively low (850-1500 ppm) as mandated by the U.S. Food and Drug Administration for safety.
Professional applications, on the other hand, are much higher — 12,300 to 22,600 ppm depending on their form. They’re applied, of course, under strict clinical guidelines to cleaned tooth surfaces, usually as a gel, foam or varnish. The latter form will often continue leaching fluoride into the enamel for a month or more.
These topical applications can greatly strengthen the teeth of children who don’t have the benefit of fluoridated water or may be at higher risk for dental disease because of socio-economic conditions. But they can still be helpful for children with adequate fluoride exposure and low risk factors for disease. At the very least, fluoride treatments can give your child an added boost of protection as their teeth continue to develop.
If you would like more information on topical fluoride treatments for children, 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 “Topical Fluoride.”