While tooth loss can occur at any age, replacing one in a younger patient requires a different approach than for someone older. It’s actually better to hold off on a permanent restoration like a dental implant if the person is still in their teens.
This is because a teenager’s jaws won’t finish developing until after nineteen or in their early twenties. An implant set in the jawbone before then could end up out of alignment, making it appear out of place — and it also may not function properly. A temporary replacement improves form and function for now and leaves the door open for a permanent solution later.
The two most common choices for teens are a removable partial denture (RPD) or a bonded fixed bridge. RPDs consist of a plastic gum-colored base with an attached prosthetic (false) tooth matching the missing tooth’s type, shape and jaw position. Most dentists recommend an acrylic base for teens for its durability (although they should still be careful biting into something hard).
The fixed bridge option is not similar to one used commonly with adult teeth, as the adult version requires permanent alteration of the teeth on either side of the missing tooth to support the bridge. The version for teens, known as a “bonded” or “Maryland bridge,” uses tiny tabs of dental material bonded to the back of the false tooth with the extended portion then bonded to the back of the adjacent supporting teeth.
While bonded bridges don’t permanently alter healthy teeth, they also can’t withstand the same level of biting forces as a traditional bridge used for adults. The big drawback is if the bonding breaks free a new bonded bridge will likely be necessary with additional cost for the replacement.
The bridge option generally costs more than an RPD, but buys the most time and is most comfortable before installing a permanent restoration. Depending on your teen’s age and your financial ability, you may find it the most ideal — though not every teen is a good candidate. That will depend on how their bite, teeth-grinding habits or the health of surrounding gums might impact the bridge’s stability and durability.
A complete dental exam, then, is the first step toward determining which options are feasible. From there we can discuss the best choice that matches your teen’s long-term health, as well as your finances.
The long-running hit show Dancing with the Stars has had its share of memorable moments, including a wedding proposal, a wardrobe malfunction, and lots of sharp dance moves. But just recently, one DWTS contestant had the bad luck of taking an elbow to the mouth on two separate occasions—one of which resulted in some serious dental damage.
Nationally syndicated radio personality Bobby Bones received the accidental blows while practicing with his partner, professional dancer Sharna Burgess. “I got hit really hard,” he said. “There was blood and a tooth. [My partner] was doing what she was supposed to do, and my face was not doing what it was supposed to do.”
Accidents like this can happen at any time—especially when people take part in activities where there’s a risk of dental trauma. Fortunately, dentists have many ways to treat oral injuries and restore damaged teeth. How do we do it?
It all depends on how much of the tooth is missing, whether the damage extends to the soft tissue in the tooth’s pulp, and whether the tooth’s roots are intact. If the roots are broken or seriously damaged, the tooth may need to be extracted (removed). It can then generally be replaced with a dental bridge or a state-of-the-art dental implant.
If the roots are healthy but the pulp is exposed, the tooth may become infected—a painful and potentially serious condition. A root canal is needed. In this procedure, the infected pulp tissue is removed and the “canals” (hollow spaces deep inside the tooth) are disinfected and sealed up. The tooth is then restored: A crown (cap) is generally used to replace the visible part above the gum line. A timely root canal procedure can often save a tooth that would otherwise be lost.
For moderate cracks and chips, dental veneers may be an option. Veneers are wafer-thin shells made of translucent material that go over the front surfaces of teeth. Custom-made from a model of your smile, veneers are securely cemented on to give you a restoration that looks natural and lasts for a long time.
It’s often possible to fix minor chips with dental bonding—and this type of restoration can frequently be done in just one office visit. In this procedure, layers of tooth-colored resin are applied to fill in the parts of the tooth that are missing, and then hardened by a special light. While it may not be as long-lasting as some other restoration methods, bonding is a relatively simple and inexpensive technique that can produce good results.
If you would like more information about emergency dental treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor articles “The Field-Side Guide to Dental Injuries” and “Knocked Out Tooth.”
Like other aspects of our lives, aging can take a toll on our smile. Over a lifetime the effects of disease, teeth wearing and the foods we eat can cause our teeth and gums to look unattractive.
Here are 3 of the most common age-related dental problems and how we can help you "turn back the clock" on each one.
Discoloration. Teeth can dull and grow darker over time. And not just from what we eat or drink—age-related structural changes in the tooth can also cause discoloration. We can often alleviate external staining temporarily with teeth whitening. If the staining is heavy or it originates inside the tooth, then we can install life-like porcelain veneers or crowns to cover the discoloration. We can also use composite dental materials to alter the color of one darkened tooth so that it doesn't stand out from the rest of your teeth.
Wearing. Our teeth naturally wear down over time. If the wearing is excessive, though, teeth can look shorter and less youthful. Again, we can use veneers or crowns to change a tooth's outward appearance and make them look longer. We can also employ enamel contouring and reshaping that smoothes out sharper edges caused by wearing to give your teeth a softer, more youthful look.
Receding gums. On the other end of the spectrum, gums that have shrunk back or receded from the teeth can make them look much larger and unattractive. Our first step is to treat any gum disease present—the most common cause of recession—which often helps the tissues to regenerate. If your case is more advanced, though, you may also need grafting surgery to restore lost gum tissue. Using in-depth microsurgical techniques, surgeons attach grafted gum tissue at the recession site. Over time new tissue will grow, restoring adequate gum coverage.
You can also improve your appearance at any age with orthodontics. Besides a more attractive smile, properly aligned teeth tend to wear more slowly and evenly. This and proper daily oral hygiene and regular dental care can keep your teeth looking younger even in your later years.
If you would like more information on gaining a more youthful smile, 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 “How Your Dentist can help you Look Younger.”
The old stereotype with the words “pain” and “dental work” in the same sentence is no more. Using local or general anesthesia (or a combination of both) we can completely eliminate the vast majority of discomfort during dental procedures.
But how do you manage pain in the days after a procedure while your mouth is healing? The news is good here as well — most discomfort after dental work can be easily managed with a family of medications known as non-steroidal anti-inflammatory drugs (NSAIDs). In most cases, you won't even need prescription strength.
You're probably already familiar with aspirin, ibuprofen and similar pain relievers for the occasional headache or muscle pain. These types of drugs work by blocking prostaglandins, which are released by injured tissues and cause inflammation. By reducing the inflammation, you also relieve pain.
Most healthcare providers prefer NSAIDs over steroids or opiates (like morphine), and only prescribe the latter when absolutely necessary. Unlike opiates in particular, NSAIDs won't impair consciousness and they're not habit-forming. And as a milder pain reliever, they have less impact on the body overall.
That doesn't mean, however, you don't have to be careful with them. These drugs have a tendency to thin blood and reduce its clotting ability (low-dose aspirin, in fact, is often used as a mild blood thinner for cardiovascular patients). Their use can contribute to bleeding that's difficult to stop. Excessive use of ibuprofen can also damage the kidneys.
That's why it's necessary to control the dosage and avoid long-term use of NSAIDs, unless advised by a physician. Most adults shouldn't take more than 2,400 milligrams a day of a NSAID and only during the few days of recuperation. There's no need to overdo it: a single 400-milligram dose of ibuprofen is safe and sufficient to control moderate to severe post-procedural pain for about five hours.
Our aim is to help you manage any pain after a procedure with the least amount of pain reliever strength necessary. That will ensure you'll navigate the short discomfort period after dental work safely and effectively.
If you would like more information on pain management after dental care, 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 “Treating Pain with Ibuprofen.”
Before you consider cosmetic changes to your smile, ask yourself one question: how's your bite? How your teeth are positioned and aligned doesn't just affect their function — it also affects your appearance. A proper bite is foundational to a beautiful smile — and it deserves your attention first.
Here are 3 important steps for addressing your bite problem on your way to a more attractive smile.
Get an orthodontic evaluation. Only a dentist or orthodontist can determine if your teeth are properly aligned and working well with each other — and if not, why. With their knowledge and expertise they'll be able to tell you what specific bite problem (malocclusion) you have and the best treatment to correct it to support any future cosmetic enhancement.
Consider your tooth-movement options carefully. If you have a malocclusion, your dentist or orthodontist may recommend correction before undertaking other cosmetic work. In most cases, you'll have two choices. The first is traditional metal braces, which uses wires held in place and anchored by brackets cemented to the teeth. They're effective, but must be fixed in place and aren't considered attractive. The other choice is clear aligners, which use custom removable plastic trays worn in sequence to gradually move teeth. They're easier for oral hygiene and are hardly noticeable to others, but may not work in every bite situation.
Don't slack on the retainer phase of treatment. The day will come when the braces or aligners come out of your mouth for good. But your realignment project isn't over — you'll need to wear a retainer appliance for a while. Re-aligned teeth can relapse to their former positions, so it's essential you wear a retainer to keep them where they've been moved. Without a retainer, all the time and effort invested in your bite will have been to no avail.
In a nutshell: get the big picture about your bite, choose the treatment best for you and follow through on every phase. The end result will be a solid platform for the smile you've always dreamed about.
If you would like more information on orthodontic treatments, 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 “The Magic of Orthodontics: The Original Smile Makeover.”
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