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Can Dental Bridges or Dental Implants Replace a Single Missing Tooth?

There are many cosmetic dentistry options available today that dentists can use to replace missing teeth. The decision to use one instead of another depends on many factors. The best cosmetic dentistry treatment option can be different from person to person or from one area to another in the same mouth.

The purpose of this article is to list the major treatment choices and some of the key factors involved in the cosmetic dentistry treatment decision.

There are four major categories of restorations available for single tooth replacement:

• Bonded (Maryland) dental bridges
• Cantilevered dental bridges
• Conventional dental bridges
• Dental Implants

The goal in restoring a missing tooth is choosing the most conservative treatment that will provide you with a restoration that not only looks good but is functional and has long-term stability.

Bonded (Maryland) Dental Bridges

Bonded dental bridges use the teeth adjacent to the empty space to help support the missing tooth. To do this, a very thin piece of metal or tooth-colored material is overlaid and bonded onto the back of the adjacent teeth. Running between these two bonded pieces is a tooth that fills in the empty space.

The main advantage of bonded dental bridges is that it is the most conservative type of dental restoration that uses the adjacent teeth for support. So, if the teeth next to the empty space look good and are not in need of any other type of restorations (fillings), bonded dental bridges may be an option.

However, because this restoration mainly gets its strength from bonding only, the long-term success depends highly on how your teeth fit together, how hard your teeth come together (grinding), and if your teeth are loose or not.

So, how long can this type of dental bridge be expected to last? Looking at long-term research studies, the failure rate is about 25% at five years. This means that one out of every four dental bridges will come off within five years. Generally, they can be re-bonded when they come off, but once it is re-bonded, the chance of it coming off again increases.

Cantilevered Dental Bridges

A cantilevered type of restoration only uses one tooth next to the empty space to support the missing tooth. Designs for this type of dental bridge can range from only using the back of the tooth (more conservative) to using a full crown to help support the missing tooth (less conservative).

The choice of which is done again involves the amount of force (grinding) that is placed on the teeth and whether the tooth is in need of a full dental crown for any other reason. If used in the correct situation, with no history of grinding, this type of dental bridge has a higher success rate than bonded dental bridges. This type of design is particularly useful for replacing missing lateral incisors.

Conventional Dental Bridges

Conventional dental bridges are generally what people think of when they hear the word "dental bridges." This type of restoration uses crowns on the teeth next to the empty space that are hooked together to help support the missing tooth.

This type of bridge is also the treatment of choice if the two adjacent teeth need to have crowns for other reasons.

Conventional dental bridges are also one of the most predictable of all the options for replacing missing teeth. The failure rate of conventional dental bridges in the dental literature has a wide range of variation, ranging from 20% over 3 years to 3% over 23 years.

Dental Implants

A dental implant is a titanium metal "screw" that is placed directly into the bone in the area of the missing tooth. Once the dental implant is integrated into the bone, it will act as the root of the missing tooth. A dental crown can then be made to fit onto the implant.

By far, a dental implant is considered the most conservative of all the aforementioned procedures regarding the adjacent teeth. On the other hand, it may not seem conservative due to the surgical implant placement.

To be able to place a dental implant in the correct position, two main things need to be addressed. The first is whether there is enough bone to hold the dental implant and the second is whether the roots of the adjacent teeth are tilted and in the way of where the implant needs to go.

To overcome these concerns, you may require either bone grafting to increase the amount of bone or orthodontics (braces) to help move the roots of the adjacent teeth out of the way. Although this seems like a lot of work to do in order to place a dental implant, if the teeth next to the empty space look good and are healthy, a dental implant is the only way to replace the missing tooth predictably without altering your own teeth.

As with the other treatment options like dental bridges, the amount of force placed on your teeth (grinding) can have an effect on the long-term predictability of implants and should be evaluated. The failure rate of the dental implant in the front part of the mouth is currently around 5% at ten years.

By Greggory Kinzer, DDS, MSD

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

What's a Temporary Dental Crown?

When you decide to have crowns done, especially if they involve your front teeth, you will want to be able to give your input regarding how the final crowns will look. One way to do this is with temporary dental crowns. When your teeth are prepared for crowns, the dentist will place temporary dental crowns for you to wear while the final crowns are being made.

What Are the Main Purposes of Temporary Dental Crowns?

• Temporary dental crowns eliminate any tooth sensitivity by achieving a seal around the tooth.
• They also can keep your gum tissue healthy by recreating the contour of your real teeth. Keeping the gum tissue healthy is of prime importance when it comes time to place the final dental crowns. If the gum tissue is not healthy when the final crown is cemented, there may be contamination of the cement, which can result in a poor bond and/or sensitivity.
• They maintain the current position of your teeth by keeping contact with the opposing teeth when you bite and by contacting the adjacent teeth. This is important because all teeth can move and even a slight amount of movement can prevent your permanent tooth crowns from fitting correctly, requiring either a lot of adjustment or having it remade.
• Finally, the temporary dental crowns should act as blueprints for the final crowns. It is during this time that you can give the dentist your input regarding the position and shape of the teeth (for example, if the teeth are too long, too short, too square, etc.).

Care of Your Temporary Dental Crowns

There are some differences between temporary dental crowns and final crowns that you should be aware of. Temporary dental crowns are made of a different material, usually some sort of a plastic or acrylic. Since these materials are not as strong as your own teeth, you will have to be careful of what you eat. You should avoid hard foods such as nuts, and tough foods such as bagels or French bread.

Another difference is that temporary dental crowns are cemented on with a dental cement. The reason for this is that the cosmetic dentist will need to be able to remove the temporary dental crowns when it is time to cement the permanent ones. Since the cement is not as strong, sticky foods may cause them to come loose.

If your temporary dental crowns come off or are loose, you should call your dentist so that they can be re-cemented. It is important not to wait, as the tooth may be sensitive, it may move, or, if a long enough period of time passes, the tooth may get decay. As far as home care, your temporary dental crowns should be cleaned with a toothbrush, just like your own teeth. When flossing, though, it is important to floss towards the gums and then slide the floss out by one end rather than lifting it back up through the teeth. This will help ensure that your temporary dental crowns do not come off while flossing.

By Greggory Kinzer, DDS, MSD

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.