If you have a few missing teeth but can't afford dental implants or fixed bridgework, consider a removal partial denture (RPD). Although implants may be the superior choice aesthetically and functionally, an RPD can still effectively give you back your teeth.
RPDs are designed to replace one or more missing teeth but not a full arch like a full denture. Considered a permanent restoration, RPDs are also more durable than transitional "flippers," denture appliances that are flexible and light enough to be flipped out of the mouth with a flick of the tongue.
The key to both their affordability and durability is vitallium, a strong but lightweight metal alloy most often used in their frame construction. To it we attach artificial teeth usually made of porcelain or glass-filled resins that occupy the precise location of the missing teeth on the gum ridge. The artificial teeth and frame are surrounded by gum-colored plastic for a more natural look.
Each RPD is custom-made depending on the number and location of the missing teeth. Its construction will focus on minimizing any rocking movement of the RPD during chewing or biting. Too much of this movement could damage the adjacent teeth it's attaching to and cause the appliance to be uncomfortable to wear. We can stabilize the frame by precisely fitting it between teeth to buttress it. We also insert small rests or clasps made of vitallium at strategic points to grip teeth and minimize movement.
RPDs do have some downsides: their unique attachment with teeth encourages the accumulation of dental plaque, the thin bacterial film that's the leading cause of tooth decay and periodontal (gum) disease. These diseases can affect your remaining teeth's health and stability, which could in turn disrupt the fit of the RPD. Also, too much movement of the appliance can make the teeth to which it's attached become more mobile. It's important, then, if you wear a RPD to remove it daily for cleaning (and to thoroughly brush and floss your natural teeth), and to remove it at night to give the attaching teeth a rest.
A RPD can give you back the teeth you've lost for many years to come—if you take care of it. Maintaining both your RPD and the rest of your teeth and gums will help extend the life and use of this effective and affordable replacement 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 “Removable Partial Dentures: Still a Viable Tooth-Replacement Alternative.”
Whether performed in a dental office or using a home kit, teeth whitening applications are quite effective for bleaching exterior (extrinsic) stains on enamel surfaces. But what if your discoloration comes from inside the tooth? In this case, extrinsic teeth whitening won’t work — you’ll need to undergo an “internal bleaching” method, which can only be performed in a dentist's office.
There are a number of causes for “intrinsic” staining, including too much fluoride exposure or tetracycline use during childhood. One of the more common causes, though, occurs from root canal treatments used to remove the remnants of the pulp tissue inside a tooth’s pulp chamber and root canals. Certain cements used during the procedure to help seal in the filling material and leftover blood pigments can cause the tooth to darken over time.
To alleviate this discoloration, we use a bleaching agent, usually sodium perborate mixed with a diluted solution of hydrogen peroxide to achieve a safe, accelerated color change. After determining that the root canal filling is still intact and the bone is healthy, we create a small cavity in the back of the tooth to access the pulp chamber. The chamber is cleaned of any debris or stained material and then thoroughly irrigated. The original root canal filling is then sealed off to prevent leakage from the bleaching agent.
We then place the bleaching agent in the cleaned-out space with a cotton pellet and seal it in with a temporary adhesive. This step is repeated for several days until we achieve the desired shade of white. Once that occurs we then seal the dentin with a more permanent filling and then restore the cavity we created with a composite resin bonded to the enamel and dentin.
If we’re successful in achieving the desired color, intrinsic whitening could help you avoid more costly options like veneers or crowns for an otherwise healthy and attractive tooth. The end result would be the same — a beautiful smile without those unsightly stains.
If you would like more information on treating internal tooth stains, 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 “Whitening Traumatized Teeth.”
You may think an office cleaning is mainly cosmetic — giving your teeth that polished look and you that pleasant, “squeaky clean” feeling. But your dental hygienist is doing more than making your teeth look great during your cleaning session — they’re also providing a valuable service keeping your teeth and gums healthy.
Here, then, are 3 things your dental hygienist is doing during a cleaning session that protects your health.
Removing disease-causing plaque. An office cleaning produces more than a fresh and clean smile. Your hygienist is manually removing plaque and calculus (hardened plaque deposits) in hard to reach places or where it has built up despite your best efforts at brushing and flossing. This built-up plaque is a ready source of bacteria producing acids, which give rise to both tooth decay and gum disease. And for actual occurrences of the latter, plaque removal is an important part of the treatment to restore your gums to a healthy pink.
Checking for signs of dental disease. As your hygienist cleans your teeth, they’re also looking for abnormalities in the mouth’s soft tissue — lumps, bumps, sores, or swelling — that may indicate something more serious requiring further examination. They’re also assessing your overall gum health, probing any areas that might indicate gum disease. And, of course, they’re looking for cavities, softened enamel or other signs of tooth decay.
Helping you improve your oral hygiene.Â As proficient as they are, a dental hygienist can only do so much to help prevent dental disease; the rest — daily brushing and flossing — is on your shoulders. But you’re not completely on your own, because your hygienist is your best personal hygiene training partner: not only can they assess how well you’re doing in your daily regimen, but they can also give you expert advice and tips on improving your brushing and flossing performance.
If you would like more information on the role of your hygienist in your dental care, 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 “Dental Hygiene Visit.”
Fans of the primetime TV show The Middle were delighted to see that high school senior Sue, played by Eden Sher, finally got her braces off at the start of Season 6. But since this popular sitcom wouldn’t be complete without some slapstick comedy, this happy event is not without its trials and tribulations: The episode ends with Sue’s whole family diving into a dumpster in search of the teen’s lost retainer. Sue finds it in the garbage and immediately pops it in her mouth. But wait — it doesn’t fit, it’s not even hers!
If you think this scenario is far-fetched, guess again. OK, maybe the part about Sue not washing the retainer upon reclaiming it was just a gag (literally and figuratively), but lost retainers are all too common. Unfortunately, they’re also expensive to replace — so they need to be handled with care. What’s the best way to do that? Retainers should be brushed daily with a soft toothbrush and liquid soap (dish soap works well), and then placed immediately back in your mouth or into the case that came with the retainer. When you are eating a meal at a restaurant, do not wrap your retainer in a napkin and leave it on the table — this is a great way to lose it! Instead, take the case with you, and keep the retainer in it while you’re eating. When you get home, brush your teeth and then put the retainer back in your mouth.
If you do lose your retainer though, let us know right away. Retention is the last step of your orthodontic treatment, and it’s extremely important. You’ve worked hard to get a beautiful smile, and no one wants to see that effort wasted. Yet if you neglect to wear your retainer as instructed, your teeth are likely to shift out of position. Why does this happen?
As you’ve seen firsthand, teeth aren’t rigidly fixed in the jaw — they can be moved in response to light and continuous force. That’s what orthodontic appliances do: apply the right amount of force in a carefully controlled manner. But there are other forces at work on your teeth that can move them in less predictable ways. For example, normal biting and chewing can, over time, cause your teeth to shift position. To get teeth to stay where they’ve been moved orthodontically, new bone needs to form around them and anchor them where they are. That will happen over time, but only if they are held in place with a retainer. That’s why it is so important to wear yours as directed — and notify us immediately if it gets lost.
And if ever you do have to dig your retainer out of a dumpster… be sure to wash it before putting in in your mouth!
If you would like more information on retainers, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Why Orthodontic Retainers?”
Sleep — you'll spend a third of your life in its blissful embrace. But it isn't a luxury: you need it as much as nutrition and exercise. An occasional bad night's sleep leaves you irritable and drowsy; a bad night's sleep every night could endanger your health.
One of the most common causes for chronic poor sleep is obstructive sleep apnea. This occurs when the airway becomes blocked and you stop breathing temporarily. The blockage may be due to an oversized tongue, tonsils or uvula, an abnormal jaw or chin structure, or nasal polyps and congestion. When your brain notices you're not breathing, it rouses you just enough to relieve the blockage. These incidents can occur and end in seconds several times a night without you being aware of it.
This interrupts your normal sleep patterns, including the critical rapid eye movement (REM) of deep sleep that occurs at different times during the night. The results of not getting enough REM sleep are quite unhealthy: besides irritability and reduced concentration, poor REM sleep is linked to depression, headaches, decreased sex drive, acid reflux, high blood pressure or the onset of diabetes. Your night time experience — as well as your sleep partner's — won't be pleasant either as you may experience night time sweating and snoring.
Fortunately, sleep apnea can be treated. Our first considered treatment is a custom-fitted night guard you wear while you sleep that holds the tongue back from the airway. If your apnea is more severe, you may need to consider continuous positive airway pressure (CPAP) therapy, which uses a machine to pump pressurized air through a mask you wear while sleeping to force the airway open. You might also benefit from surgery to remove excess soft tissue obstructing the airway.
If you or your family has noticed any of these symptoms mentioned, make an appointment to see us — we're trained to look for oral signs in the mouth that may indicate sleep apnea. The sooner we can implement a treatment strategy, the sooner you'll begin experiencing a good night's sleep and better health.
If you would like more information on sleep apnea and what to do about it, 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 “Sleep Disorders & Dentistry.”
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