Posts for: September, 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.”
Removing a problem tooth (extraction) is a common dental procedure. But not all extractions are alike — depending on the type of tooth, its location and extenuating circumstances, you may need an oral surgeon to perform it.
Fortunately, that's not always the case. Teeth with straight or cone-shaped roots, like an upper front tooth, have a fairly straight removal path. A general dentist first carefully manipulates the tooth loose from the periodontal ligament fibers that help hold it in place (experienced dentists, in fact, develop a “feel” for this process). Once it's loosened from the fibers it's a simple motion to remove the tooth.
But as mentioned before, a “simple extraction” won't work with every tooth or situation. To find out if it can we'll first need to determine the true shape of the tooth and roots, as well as the condition of the supporting bone. We might find any number of issues during this examination that make a simple extraction problematic.
For example, teeth with multiple roots (especially in back) may have complicated removal paths. If the roots themselves are unhealthy and brittle from previous injury or a root canal treatment, they can fracture into smaller pieces during removal. A tooth could also be impacted — it hasn't fully erupted but remains below the gum surface. It's these types of situations that require surgery to remove the tooth.
During a surgical extraction, the oral surgeon will first numb the area with a local anesthetic, as well as a sedative if you have issues with anxiety. They then perform a surgical procedure appropriate for the situation to remove the tooth. More than likely they'll insert bone grafts before closing the site with stitches to deter bone loss (a common occurrence after losing a tooth).
Afterward, your provider may prescribe antibiotics and an antibacterial mouthrinse to ward off infection. You'll also be given care instructions for the extraction site to keep it clean. Any discomfort should subside in a few days and can be managed effectively with a mild anti-inflammatory drug like ibuprofen or aspirin.
It can be overwhelming having a tooth removed. In your dentist's capable hands, however, the experience will be uneventful.
If you would like more information on tooth extraction, 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 “Simple Tooth Extraction?”