Let’s say you’re traveling to Italy to surprise your girlfriend, who is competing in an alpine ski race… and when you lower the scarf that’s covering your face, you reveal to the assembled paparazzi that one of your front teeth is missing. What will you do about this dental dilemma?
Sound far-fetched? It recently happened to one of the most recognized figures in sports — Tiger Woods. There’s still some uncertainty about exactly how this tooth was taken out: Was it a collision with a cameraman, as Woods’ agent reported… or did Woods already have some problems with the tooth, as others have speculated? We still don’t know for sure, but the big question is: What happens next?
Fortunately, contemporary dentistry offers several good solutions for the problem of missing teeth. Which one is best? It depends on each individual’s particular situation.
Let’s say that the visible part of the tooth (the crown) has been damaged by a dental trauma (such as a collision or a blow to the face), but the tooth still has healthy roots. In this case, it’s often possible to keep the roots and replace the tooth above the gum line with a crown restoration (also called a cap). Crowns are generally made to order in a dental lab, and are placed on a prepared tooth in a procedure that requires two office visits: one to prepare the tooth for restoration and to make a model of the mouth and the second to place the custom-manufactured crown and complete the restoration. However, in some cases, crowns can be made on special machinery right in the dental office, and placed during the same visit.
But what happens if the root isn’t viable — for example, if the tooth is deeply fractured, or completely knocked out and unable to be successfully re-implanted?
In that case, a dental implant is probably the best option for tooth replacement. An implant consists of a screw-like post of titanium metal that is inserted into the jawbone during a minor surgical procedure. Titanium has a unique property: It can fuse with living bone tissue, allowing it to act as a secure anchor for the replacement tooth system. The crown of the implant is similar to the one mentioned above, except that it’s made to attach to the titanium implant instead of the natural tooth.
Dental implants look, function and “feel” just like natural teeth — and with proper care, they can last a lifetime. Although they may be initially expensive, their quality and longevity makes them a good value over the long term. A less-costly alternative is traditional bridgework — but this method requires some dental work on the adjacent, healthy teeth; plus, it isn’t expected to last as long as an implant, and it may make the teeth more prone to problems down the road.
What will the acclaimed golfer do? No doubt Tiger’s dentist will help him make the right tooth-replacement decision.
If you have a gap in your grin — whatever the cause — contact us or schedule an appointment for a consultation, and find out which tooth-replacement system is right for you. You can learn more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Crowns & Bridgework.”
Protecting a child's primary (“baby”) teeth from tooth decay should be a top priority. If one is lost prematurely due to decay, it could cause the permanent tooth to misalign when it comes in.
The basic prevention strategy for every child is daily brushing and flossing and regular dental visits. But children at higher risk for decay may need more: Â additional fluoride applied to teeth enamel during office visits.
This natural mineral has been shown to strengthen enamel, teeth's protective layer against decay, especially during its early development. Enamel is composed of calcium and phosphate minerals interwoven to form a crystalline structure called hydroxyapatite. Fluoride joins with this structure and changes it to fluorapatite, which is more resistant to mouth acid than the original structure.
We mostly receive fluoride through fluoridated drinking water and dental care products like toothpaste. Topical fluoride takes it a step further with a stronger dose than found in either of these sources. It can be applied with a foam, varnish or gel using an isolation tray (foam or gel) or painted onto the enamel (varnish or gel).
But does topical fluoride effectively reduce the occurrence of decay? Research indicates yes: a recent review of 28 studies involving over 9,000 children found an average 28% reduction in decayed teeth in children who underwent topical fluoride treatments.
There is, though, one potential side effect: children who swallow the fluoride substance can become sick and experience headache, stomach pain or vomiting. This can be avoided with proper precautions when applying it; the American Dental Association also recommends using only varnish for children younger than 6 years. It's also recommended that children receiving gel or foam not eat or drink at least thirty minutes after the treatment (those who receive the varnish aren't restricted in this way).
Topical fluoride is most effective as part of an overall prevention strategy. Besides daily hygiene and regular dental visits, you can also help reduce your child's decay risk by limiting the amount of sugar in their diet. Sealants, which are applied to the nooks and grooves of teeth where plaque can build up, may also help.