Posts for: March, 2016
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.”
As a regular part of your daily hygiene you may be using a mouthrinse — or “mouthwash” — mainly to keep your mouth feeling fresh and clean. Some mouthrinses, though, do more than give you fresher breath.
While there are countless mouthrinses available, we can place all of them into two broad categories: cosmetic and therapeutic. The first refresh your mouth and breath, usually with a mentholated or minty taste and smell that masks unpleasant odors. How well they work is mainly subjective: if you feel better after using them, they’ve done their job.
Therapeutic rinses have a different role, intended to improve oral health in some way. We can divide these into anti-cariogenic (decay prevention) or anti-bacterial rinses. You can find fluoride-based anti-cariogenic rinses over-the-counter in retail or drug stores, usually containing about .05% sodium fluoride per volume. Numerous studies have shown these rinses highly effective in preventing tooth decay when used with daily brushing and flossing.
Likewise, over-the-counter antibacterial rinses have proven somewhat effective in reducing bacteria that leads to dental disease. Formulated usually with triclosan, sanguinaria extract, zinc or essential oils, they can also help reduce the incidence of gingivitis (inflammation of the gums), but only if used in conjunction with brushing and flossing.
Perhaps, though, the most widely studied and substantiated therapeutic mouthrinse is chlorhexidine, a prescription-only rinse. Chlorhexidine inhibits the formation of bacterial plaque on tooth surfaces, the main trigger for both tooth decay and periodontal (gum) disease. It’s often used as a post-surgery rinse when brushing and flossing may not be possible, but dentists will often prescribe it for patients who have a high propensity for dental disease.
Using a mouthrinse depends on your current oral health and personal preferences. Therapeutically, most people gain some added tooth strength protection from using a fluoride rinse in their daily hygiene. If fresh breath and the way your mouth feels are important to you, you should consider such a rinse that also has a pleasant taste and effect for you. We can further discuss with you whether a different type of rinse, or a prescription-strength formula, might be best for your particular needs.
If you would like more information on mouthrinses, 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 “Mouthrinses.”