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.”
Oral appliances run the gamut from night guards and retainers to full or partial dentures. Millions of people depend on them for restoring or maintaining dental health.
Today's user-friendly appliances reflect the latest advances in technology. But that doesn't mean you can simply "place them and forget them." Their longevity depends on taking care of them.
The most important aspect of appliance care is keeping them clean. Although bacteria have no effect on an appliance's materials, they can accumulate on its surfaces and raise the risk your natural teeth and gums will be infected. To reduce that risk you should clean your appliance every day.
The best way is with a countertop ultrasonic cleaner. These units emit high frequency sound vibrations that loosen plaque (a thin film of bacteria and food particles) from even the appliance's tiniest crevices. Most units cost between $40 and $60, and pose less of a scratching risk to the appliance's surfaces than manual cleaning.
If you'd prefer to use a brush, there are some dos and don'ts to follow. You can use a cleaner especially designed for your appliance, but less expensive mild dish detergent or hand soap (with an antibacterial agent) will work too. Don't use toothpaste — most contain an abrasive ingredient for removing plaque from enamel that could leave microscopic scratches on your appliance. Use a soft-bristle toothbrush (but not the one you use for your natural teeth) or one designed for your appliance.
While boiling kills bacteria, the high heat can soften and warp the plastic material in an appliance. This could alter how the appliance fits in your mouth, making them loose and uncomfortable to wear. You should also avoid bleach: it can whiten acrylic or nylon designed to mimic the red color of real gum tissue.
Unless we've advised you otherwise, don't wear the appliance around the clock, a practice that raises the chances of bacterial accumulation. And be sure you also brush and floss your natural teeth every day.
Keeping both your mouth and your appliance clean helps ensure the best oral health possible — and that your appliance will last longer.
Considering all the intensive conditioning, practice and training they do, most people would expect elite athletes to be… well… healthy. And that’s generally true — except when it comes to their oral health. A major study of Olympic contenders in the 2012 London games showed that the oral health of athletes is far worse than that of the general population.
Or to put it more succinctly: “They have bodies of Adonis and a garbage mouth.”
That comment, from Dr. Paul Piccininni, a practicing dentist and member of the International Olympic Committee’s medical commission, sums up the study’s findings. In terms of the numbers, the report estimates that about one in five athletes fared worse in competition because of poor oral health, and almost half had not seen a dentist in the past year. It also found that 55 percent had cavities, 45 percent suffered from dental erosion (excessive tooth wear), and about 15 percent had moderate to severe periodontal (gum) disease.
Yet, according to Professor Ian Needleman of University College, London, lead author of the study, “Oral health could be an easy win for athletes, as the oral conditions that can affect performance are all easily preventable.”
Many of the factors that had a negative impact on the athletes are the same ones that can degrade your own oral health. A follow-up paper recently published in the British Journal of Sports Medicine identified several of these issues. One is a poor diet: The consumption of excessive carbohydrates and acidic foods and beverages (including sports drinks) can cause tooth decay and erosion of the protective enamel. Another is dehydration: Not drinking enough water can reduce the flow of healthy saliva, which can add to the damage caused by carbohydrates and acids. The effects of eating disorders (which are more commonly seen in certain sports, such as gymnastics) can also dramatically worsen an individual’s oral health.
Sound familiar? Maybe it’s because this brings up some issues that dentists have been talking about all along. While we don’t mean to nag, this study does point out that even world-class competitors have room for improvement with their oral hygiene. How about you? Whether you’re a triathlete in training, a weekend warrior or an armchair aficionado, good oral health can have a major effect on your well-being.
If you have additional questions about oral health, please contact us or schedule an appointment for a consultation. For more information, see the Dear Doctor magazine article “Good Oral Health Leads to Better Health Overall.”
In an ideal situation, you would transition from a missing tooth to a permanent replacement with as little time in between as possible. Unfortunately, reality can intrude on the best of intentions.
For example, dental implants are one of the best ways to regain the form and function of a lost tooth. They are, however, initially expensive, especially if you’re replacing multiple teeth. Your financial ability may force you to wait — which means you need a solution now, if only temporarily.
Fortunately, a removable partial denture (RPD) could be the temporary solution you’re looking for. There are various kinds and all quite affordable; one of the more versatile is a flexible version made of a form of nylon. Due to its thermoplasticity, the nylon is quite pliable when heated and can be easily molded into a denture base with attaching prosthetic teeth. They’re comfortable to wear and attach to the remaining teeth at the gum line with flexible, finger-like clasps.
Â RPDs are designed as a transitional replacement between tooth loss and a permanent restoration such as implants, bridges or permanent dentures. Their light weight, comfort and affordability also make them tempting to consider as a permanent replacement.
They do, however, have some drawbacks that make them less desirable for long-term use. They weren’t designed for relining or repair, so such efforts can be difficult. The clasp holding them in place may also trap food and bacteria that increase the risk of dental disease to the gums and remaining teeth. You can minimize some of these weaknesses by properly cleaning and maintaining the RPD, and taking them out at night to inhibit the growth of bacteria while you sleep.
Mainly, though, you should primarily consider a RPD as a temporary bridge between lost teeth and a permanent restoration. To that end, we’ll work with you to develop a treatment and finance plan that will help you achieve a more permanent and satisfying restoration.
If you would like more information on teeth replacement options, 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 “Flexible Partial Dentures.”
Via a recent Instagram post, pop diva Ariana Grande became the latest young celebrity to publicly acknowledge a dental milestone: having her wisdom teeth removed. The singer of hits such as “Break Free” and “Problem” posted an after-surgery picture of herself (wearing her signature cat-eye eyeliner), with a caption addressed to her teeth: “Peace out, final three wisdom teeth. It’s been real.”
With the post, Grande joined several other celebs (including Lily Allen, Paris Hilton and Emile Hirsch) who have shared their dental surgery experience with fans. Will "wisdom teeth removal" become a new trending topic on social media? We aren’t sure — but we can explain a bit about the procedure, and why many younger adults may need it.
Technically called the “third molars,” wisdom teeth usually begin to emerge from the gums between the ages of 17 and 25 — presumably, around the same time that a certain amount of wisdom emerges. Most people have four of these big molars, which are located all the way in the back of the mouth, on the left and right sides of the upper and lower jaws.
But when wisdom teeth begin to appear, there’s often a problem: Many people don’t have enough space in their jaws to accommodate them. When these molars lack sufficient space to fully erupt (emerge), they are said to be “impacted.” Impacted teeth can cause a number of serious problems: These may include pain, an increased potential for bacterial infections, periodontal disease, and even the formation of cysts (pockets of infection below the gum line), which can eventually lead to tooth and bone loss.
In most cases, the best treatment for impacted wisdom teeth is extraction (removal) of the problem teeth. Wisdom tooth extraction is a routine, in-office procedure that is usually performed under local anesthesia or “conscious sedation,” a type of anesthesia where the patient remains conscious (able to breathe normally and respond to stimuli), but is free from any pain or distress. Anti-anxiety medications may also be given, especially for those who are apprehensive about dental procedures.
So if you find you need your wisdom teeth extracted, don’t be afraid to “Break Free” like Ariana Grande did; whether you post the results on social media is entirely up to you. If you would like more information about wisdom tooth extraction, please call our office to schedule a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
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