Before implants, people often turned to a removable appliance to replace multiple missing teeth. Known as a removable partial denture (RPD), this appliance could restore both appearance and function at an affordable price.
But although implants may have diminished their use, RPDs haven't gone extinct. They're still a viable option for patients who can't afford implants or fixed bridgework, or who can't obtain implants due to the state of their dental health.
Although replacing only a few teeth rather than an entire arch, RPDs are similar in basic concept to full dentures. The prosthetic (artificial) teeth are anchored in a resin or plastic that's colored to resemble the gums, precisely placed to fit into the missing gaps. This assembly is further supported by a frame made of vitallium, a lightweight but strong metal alloy. The appliance fits upon the arch with the missing teeth, supported by vitallium clasps that grip adjacent natural teeth.
Each RPD must be custom designed for each patient to fit perfectly without excessive movement during chewing. Too much movement could warp the fit, reduce the RPD's durability or damage other teeth. To achieve this secure fit, dentists must take into account the number and location of missing teeth to be replaced, and then apply a specific construction pattern to balance the appliance.
There are RPDs that are meant to be used short-term, as with a teenager whose jaw isn't yet mature for dental implants. But the metal-framed RPDs we've described are designed for long-term use. There is, however, one primary downside: RPDs have a propensity to collect dental plaque, a thin biofilm most responsible for dental disease that could further deteriorate your dental health.
To avoid this, you'll need to keep both the RPD and the rest of your teeth and gums as clean as possible with daily brushing and flossing, and appliance care. And like dentures, it's best to remove the RPD when you go to bed at night to discourage the growth of harmful bacteria.
To see if an RPD to replace your missing teeth is an option for you, visit us for a complete dental exam. From there, we can advise you further as to whether an RPD could affordably restore your missing teeth and your smile.
If you would like more information on RPDs, 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.”
Waiting is part of life for a teenager: waiting to get a driver’s license, to graduate high school or to leave home and stretch their wings. A teenager with lost teeth may also need to wait until they’re older to obtain dental implants.
The reason arises from the differences in how implants and natural teeth attach to the jaw. Although natural teeth may seem rigidly set in the bone, they’re actually held in place by an elastic tissue between them and the bone known as the periodontal ligament. Tiny filaments that attach to the teeth on one side and the bone on the other hold the teeth in place, but also allow the teeth to move gradually in response to mouth changes.
A titanium implant post doesn’t have this relationship with the periodontal ligament — it’s attached directly to the jaw bone. Over time the bone, which has a special affinity with titanium, grows and adheres to it to form a durable bond without an attachment to the periodontal ligament. Because of this the implant can’t move like a natural tooth.
This is extremely important for implant placement because the jaws in particular won’t fully develop in most people until their late teens or early twenties: the upper jaw in particular will tend to grow out and down. Natural teeth accommodate to these changes, but the implant can’t — it will appear to retreat into the jaw. The gum tissues surrounding the implant also won’t conform to the continuing growth and may appear receded.
The best approach is to choose a temporary replacement option until the jaws and other facial bone structures have finished growing. One example is a bonded bridge in which we use a bonding agent to attach a bridge of artificial teeth to teeth on either side of a missing tooth — bonding won’t permanently alter them as with a traditional bridge. Once the jaws have finished growing, we can remove the bonded bridge and install the more permanent implant.
Ask any teenager: waiting can be hard. But with dental implants, waiting until the right time will help ensure the attractive result is a permanent one.
If you would like more information on dental restorations and teenagers, 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 “Teenagers & Dental Implants.”
What happens when you lose a tooth? In the short-run, it can certainly undermine your appearance and ability to efficiently chew and digest food. But a chain of events could also be set in motion that may cause the most harm to your appearance and health—and it all has to do with bone loss.
Our bones aren't just rigid structures providing a frame for our bodies. They're living tissue with other purposes like producing blood cells and regulating the endocrine system. Bone tissue is constantly replenishing itself as older cells die and newer ones take their place.
In the jawbone, the pressure generated by the teeth while biting and chewing travels through the roots to stimulate the growth of new bone. If a tooth goes missing, however, the bone around the tooth also loses this growth stimulus.
This can cause normal bone growth to slow so that dying bone cells aren't sufficiently replaced. The bone may then diminish at an alarming rate—a decrease in width of about 25% in the first year after a tooth loss and several millimeters in height after only a few years.
This bone loss can continue to advance, especially if multiple teeth are lost, until the jaw structure as a whole loses significant height. The bite may then collapse, forcing the front teeth to push forward. In this state, a person may not be able to adequately bite or chew food. It can also damage their appearance—their smile suffers, of course, but their entire face may also appear shrunken.
You may be able to avoid this scenario if you replace missing teeth with dental implants. In addition to their life-likeness and durability, implants can also stop or slow bone loss. This is because titanium, the principle metal used in an implant, has a strong affinity with bone: Bone cells readily grow and attach to the titanium surface and foster new growth.
But don't wait: Bone loss could eventually extend beyond what an implant can accommodate—you may then need grafting to build up the bone or consider a different type of restoration. So, speak with your dentist as soon as possible about an implant restoration for a lost tooth to help avoid significant bone loss.
If you would like more information on how tooth loss can affect your life, 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 Hidden Consequences of Losing Teeth.”
Instagram, America's humongous digital photo and video album, is chock-full of the silly, mundane, and poignant moments of people's everyday lives. That includes celebrities: Tom Hanks buying a used car; Ryan Reynolds sporting tiny sunglasses; Taylor Swift and Ed Sheeran taking a hike. And then there's former Olympic alpine skier, Lindsey Vonn—posting a video of her recent dental visit.
Winner of several World Cup competitions and the first woman to gain the gold for downhill racing at the 2010 Winter Olympics, Vonn broke her two front teeth during a—you guessed it—skiing competition a few years ago. This past September, she went to the dentist to update her restoration and gave her followers a fascinating firsthand look at dental bonding, a technique for repairing a chipped or broken tooth.
Although dental bonding has been around for decades, it's taken a leap forward in the last few years because of improvements in bonding material. A mixture of plastic and glass components, composite resins can produce a strong and durable result when bonded to teeth. To begin the technique, the tooth's surface is prepared so that the composite resin can better adhere. Along with an adhesive agent, the bonding material is applied as a paste, which makes it easier to shape and sculpt for the most realistic look. This is usually done layer by layer, with each individual layer hardened with a curing light.
The technique allows us not only to achieve the right tooth shape, but also to incorporate your natural tooth color. We can tint the composite resin as we work so that your restored tooth blends seamlessly with the rest of your natural teeth. The result: A “new” tooth that's both beautiful and natural-looking.
What's more, dental bonding is more affordable than veneers or crowns and can often be done in a single visit. You will, however, need to exercise care with your new restoration. Although highly durable, it can be damaged if you bite into something hard. You'll also need to watch foods and beverages like tea or coffee that can stain the dental material.
Even so, we can help you regain the smile you once had before you took your teeth skiing—Lindsey Vonn-style—or whatever you were doing that resulted in a “whoopsie.” All it takes is a call for an appointment to start you on the path to a more attractive smile.
If you would like more information about cosmetic dental enhancements, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Artistic Repair of Front Teeth With Composite Resin.”
After years battling disease, your troubled tooth reached its useful life's end. It's been extracted, and we've replaced it with a life-like dental implant. So now, as far as the implant goes, disease is no longer an issue…right?
Sorry, no—though not to the same degree as a natural tooth, an implant could be endangered by gum disease. Although the implant's materials can't be infected, the supporting gums and bone can.
In fact, there's a particular type of gum disease associated with implants known as peri-implantitis (“peri” around an implant; “itis” inflammation) that first affects the gums surrounding an implant. Although peri-implantitis can arise from an excess of dental cement used to affix the crown to the implant, it most commonly starts like other forms of gum disease with dental plaque.
Dental plaque, and its hardened form calculus (tartar), is a thin, bacterial biofilm that builds up on teeth surfaces. It can quickly accumulate if you don't remove it every day with proper brushing and flossing. The bacteria living in plaque can infect the outer gum tissues and trigger inflammation.
Gum disease around natural teeth can spread quickly, but even more so with implants. That's because the natural attachment of the gums helps supply antibodies that impede infection. Implants, relying solely on their connection with the bone, don't have those gum attachments. As a result, peri-implantitis can move rapidly into the supporting bone, weakening the implant to the point of failure.
The good news, though, is that peri-implantitis can be treated successfully through aggressive plaque removal and antibiotics. But the key to success is to catch it early before it progresses too far—which is why you should see your dentist at the first sign of gum swelling, redness or bleeding.
You can also prevent peri-implantitis by practicing daily brushing and flossing, including around your dental implant. You should also see your dentist twice a year (or more, if they advise) for cleanings and checkups.
Dental implants overall have a greater than 95% success rate, better than any other tooth restoration system. But they still need daily care and regular cleanings to ensure your implants are on the positive side of those statistics.
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