Posts for: October, 2018
There are good reasons, for both health and appearance, to replace a missing tooth with a dental implant or similar restoration as soon as is practical. The bone around a tooth socket diminishes the longer it remains empty, up to 25% the first year. And, of course, your smile is less attractive, especially with a highly visible tooth.
If it’s your teenager, though, you may need to wait on a permanent restoration because their jaws are still developing. An implant placed before completion of jaw development could eventually appear out of alignment with neighboring teeth.
Our biggest concern is protecting bone health at the site of the missing tooth. We can do this and encourage growth by placing bone grafts (processed minerals from another donor) that serve as scaffolds on which surrounding bone can grow. Grafts usually dissolve (resorb) over time, but the rate of resorption can be slowed for a younger patient in need of long-term bone growth.
Planned orthodontic treatment can usually go on as scheduled. The orthodontist may accommodate the tooth loss by adding a temporary tooth within the braces or other device that matches the color and shape of the patient’s natural teeth. The orthodontist will also take care to maintain the empty space for a future implant or other restoration.
A dental implant is considered the best option for a missing tooth, not only for its life-like appearance and durability, but also its ability to encourage bone maintenance. Timing, though, is essential for teenagers. As it grows, the upper jaw will tend to move forward and down. Natural teeth move with this growth; implants, though, are attached differently and won’t move with the jawbone. While the other teeth around them move, the implants can appear to shrink back resulting in an unattractive smile appearance. So waiting until the jaw has finished growing is important.
For most people, jaw growth finishes by age twenty-one for men, women usually faster, but each person is different. The dentist’s expertise and experience, coupled with comparisons of adult family members’ facial appearances, will help determine the right time to undertake a permanent restoration for the best outcome both for health and a permanent, attractive smile.
If you would like more information on treating teenagers with missing teeth, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants for Teenagers.”
Before we discuss cosmetic options for transforming your smile, and before any preparations for treatment, there’s one question that needs to be answered: What do you want to be different about your smile?
There’s a common misconception that cosmetic changes to the teeth and gums — a “smile makeover” — is primarily a technical achievement based on rigid principles of beauty. Patients believe they must defer to their dentists for what will look best. But that’s not the entire picture: what’s often lost in the understanding is that it’s your smile — the smile at the end of the process you must be comfortable showing with confidence.
In this regard, there are two types of patients, with no right or wrong view — simply what a patient perceives as the smile they want. Some want the “perfect” smile — the greatest level of regularity between teeth shape, size and alignment and the maximum level of brightness. Others are more comfortable with a “natural” smile, a more subtle look with just enough change to create something new and different. The latter may even desire a less than perfect look that doesn’t “fix” all their imperfections — the ones they believe give their face “character.”
Knowing to which side you lean is important at the outset. It’s then important for you to communicate those expectations with us. While we’re focused on the technical aspects of treatment — tooth length, the lineup of teeth with other facial features or the gum-to-lip distance — only you can express what’s going to be a beautiful yet comfortable smile for you. By meshing the technical requirements with your personal desires, we’re able to formulate a makeover plan that fits you.
It all begins with a comprehensive examination to determine the exact health state of your mouth, and it may be necessary to first perform dental work to improve it. From there we can discuss what is and isn’t possible to change the appearance of your teeth and gums. In the end, we want the same result as you — a beautiful smile you’re happy and confident to show the world.
If you would like more information on smile makeovers, 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 “Great Expectations: Is what you get what you want?”
Dentures, removable restorations for missing teeth and gum tissue, can take a number of different forms, but are usually of two different types: complete and partial. A complete denture replaces all the teeth in a given arch. A removable partial denture (RPD), on the other hand, replaces several missing teeth while using the remaining teeth as support.
A common type of RPD formed of plastic is known as a “flipper” because it’s lightweight enough to be “flipped out” or moved around with the tongue. They serve an important purpose as a temporary appliance for use between periodontal treatment, implant placement and similar treatments before obtaining a more permanent restoration. In fact, they’re often referred to as “transitional” RPDs because they’re not designed for permanent tooth replacement.
Because of their low cost relative to other restorations, however, they often become the permanent choice for many people. While a well-constructed, properly fitting RPD in a healthy mouth can be an affordable alternative for people on modest budgets, their long-term use may increase the risk of dental disease and accelerated bone loss. Decades of research verify that people who permanently wear RPDs encounter more tooth decay and periodontal (gum) disease than non-wearers.
This is because the attachment points of a plastic RPD to remaining teeth increases bacterial growth, which can cause both tooth decay and gum disease. This doesn’t only endanger the survival of the remaining teeth, it can lead to bone loss that will affect the RPD’s fit.
While the better course is to consider RPDs as a stepping stone to dental implants or a fixed bridge, there’s an intermediary RPD constructed of cast vitallium or gold alloy that could be considered a permanent choice. These are even lighter weight than plastic and less obtrusive in their attachments in the mouth, which can reduce plaque stagnation and promote a better oral environment.
Regardless of your choice in dentures, it’s always important to maintain good consistent oral hygiene with daily brushing and flossing and semi-annual professional cleanings and checkups. Keeping a healthy mouth will help reduce your risk of dental disease and increase your satisfaction with your denture of choice.
If you would like more information on RPDs and other denture restorations, 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.”