Dental Bridges Pros and Cons

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Tooth under bridge snapped off at the gum line

A dental bridge is a common prothesis used to replace missing teeth. Typically the two teeth on the side of the space are crowned to anchor the false tooth or teeth in between them.
Bridges are effective to address both functional and esthetic needs until they have problems. If one side of the anchor teeth becomes detached from the bridge, the entire unit has to be removed and replaced. Decay and bite pressure can cause loosening of bridges.

This X-Ray shows a bridge that lasted over 12 years in the patient’s mouth until one side of the anchor teeth broke off at the gum line. Depending on how the tooth breaks, sometime it is impossible to replace with a new bridge.

A better alternative to bridges is to use dental implant to replace just the missing tooth if the space in between them is optimized. By treating teeth independently we can better manage the physical force of the bite on the teeth and the prosthesis.

The Importance of the Canine Tooth

In some cultures, the impacted canine is perceived as a charming character in the smile. It draws attention, and is considered a beauty mark.

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The clinical reality of the canines is that they are very important when properly positioned in the mouth.  Created with extremely long roots, the canine teeth provide support when the jaw grinds from side to side.  A properly aligned dentition is supported by the canines in the side way movements, so that none of the back teeth or teeth on the opposite sides should come into contact.  This important feature prevents wear facets and fractures to the back teeth.

With the advancement of clear aligner orthodontics, realigning the malpositioned canine can be achieved easily.  This patient spent fifteen months in clear aligner orthodontic to move her impacted canine back into proper position.  The treatment also straightened other misaligned teeth.

The end result is a pleasing smile with all functional guidance and stability established. 

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 Note only the canines are in contact during grinding movements.

Note only the canines are in contact during grinding movements.

 Note only the canines are in contact during grinding movements.

Note only the canines are in contact during grinding movements.

Which over the counter teeth whitening product is good?

I received this question yesterday.  From what I have seen, the one over the counter product that seems to show some good results is Crest White Strips.  However,  patients who use the product tell us that in order to keep up with the whitening - the costs eventually add up.  Also, the strips cannot adhere to the teeth well if the surfaces of the teeth are not straight.

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Professional whitening products are better because we fabricate custom fit trays that conform to the patient’s teeth.  Whitening gels then get injected into the trays to whiten the teeth over time.  Most patients do not use up all their gels, and the remaining gels can be stored and used for touch-up whitening occasionally as needed.

The upfront cost of professional whitening treatments beats the long term costs of over the counter product, and the concentration of the active whitening ingredients is much better. 

 

Alex Nguyen, DDS - Saratoga Dentist