Not long ago the dental bridge was the alternative treatment of choice to partial dentures for restoring lost teeth. Over the last few decades, however, dental implants have nudged bridgework out of this premier spot.

That doesn’t mean, though, that bridgework has gone the way of the horse and buggy. In fact, it may still be a solid restorative alternative to partial dentures for certain people.

A traditional bridge consists of a series of porcelain crowns affixed to each other like pickets in a fence. The end crowns are fitted onto the teeth on either side of the empty tooth space; known as abutment teeth, they support the bridge. The crowns in the middle, known as pontics (from the French for “bridge”), replace the teeth that have been lost.

Bridges have been an effective and cosmetically pleasing method for tooth replacement for nearly a century. To achieve those results, though, a good portion of the abutment teeth’s structure must be removed to accommodate the crowns. This permanently alters these teeth, so they’ll require a restoration from that point on.

Dental implants, on the other hand, can be installed in the missing space without impacting any neighboring teeth. What’s more, implants provide greater support to the underlying bone than can be achieved with bridgework.

But not everyone is a viable candidate for implants, and ironically the reason most often has to do with the bone. If a patient has suffered significant bone volume loss, either because of disease or the long-term absence of the natural teeth, there may not be enough bone to properly support an implant. Unless we can adequately restore this lost bone volume through grafting, we’ll need to consider another type of restoration.

That’s where bridgework could be a viable option for patients in this or similar situations. With continuing advances in materials and new applications, the traditional bridge still remains an effective and important means to restore a smile marred by missing teeth.

If you would like more information on dental restoration 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 “Crowns & Bridgework.”

Your baby will grow into an adult so rapidly it will seem like they're changing right before your eyes. And some of the biggest changes will happen with their teeth, gums and jaw structure.

Unfortunately, disease or a traumatic accident could short-circuit this natural process and potentially create future dental problems. Here are 4 things you should be doing now to protect your baby's long-term dental health.

Start oral hygiene now. Even if your baby has no visible teeth, there may still be something else in their mouth—bacteria, which could trigger future tooth decay. To reduce bacteria clean their gums with a clean, wet cloth after each feeding. When teeth begin to appear switch to brushing with just a smear of toothpaste on the brush to minimize what they swallow.

Make your baby's first dental appointment. Beginning dental visits around your baby's first birthday will not only give us a head start on preventing or treating tooth decay, but could also give us a better chance of detecting other developing issues like a poor bite (malocclusion). Early dental visits also help get your child used to them as routine and increase the likelihood they'll continue the habit as adults.

Watch their sugar. Bacteria love sugar. So much so, they'll multiply—and more bacteria mean an increase in one of their by-products, mouth acid. Increased mouth acid can erode tooth enamel and open the way for decay. So, limit sugary snacks to only meal time and don't give them sugary drinks (including juices, breast milk or formula) in a bottle immediately before or while they sleep.

Childproof your home. A number of studies have shown that half of all accidents to teeth in children younger than 7 happen from falling on home furniture. So, take precautions by covering sharp edges or hard surfaces on chairs, tables or sofas, or situate your child's play areas away from furniture. And when they get older and wish to participate in sports activities purchase a custom mouthguard to protect their teeth from hard knocks—an investment well worth the cost.

If you would like more information on dental care for your child, 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 “Top 10 Oral Health Tips for Children.”

A lot of time and effort goes into straightening your smile. But there’s a possibility it might not stay that way—and all that hard work could be lost. The same natural mechanism that enables your teeth to move with braces could cause them to revert to their old, undesirable positions.

So for a little while (or longer for some people) you’ll need to wear a retainer, an appliance designed to keep or “retain” your teeth where they are now. And while the removable type is perhaps the best known, there’s at least one other choice you might want to consider: a bonded retainer.

Just as its name implies, this retainer consists of a thin metal wire bonded to the back of the teeth with a composite material. Unlike the removable appliance, a bonded retainer is fixed and can only be removed by an orthodontist.

Bonded retainers have several advantages. Perhaps the most important one is cosmetic—unlike the removable version, others can’t see a bonded retainer since it’s hidden behind the teeth. There’s also no keeping up with it—or losing it—since it’s fixed in place, which might be helpful with some younger patients who need reminding about keeping their retainer in their mouth.

There are, however, a few disadvantages. It’s much harder to floss with a bonded retainer, which could increase the risks of dental disease. It’s also possible for it to break, in which case it will need to be repaired by an orthodontist and as soon as possible. Without it in place for any length of time the teeth could move out of alignment.

If you or a family member is about to have braces removed, you’ll soon need to make a decision on which retainer to use. We’ll discuss these options with you and help you choose the one—removable or bonded—that’s right for you.

If you would like more information on bonded retainers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Bonded Retainers: What are the Pros and Cons?”

Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.

“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…

For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.

When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.

A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.

But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.

Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!

If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”

The month of February gets its name from the ancient spring cleansing ritual called “Februa.” So perhaps it’s appropriate that February is now celebrated as National Children’s Dental Health Month. Having a healthy mouth starts with good oral hygiene—a practice that’s important for everyone, but especially for kids, because the healthy habits they develop in childhood can keep their teeth and gums in good condition for life. How can you help your kids achieve the best oral health? We’re glad you asked. Here are five tips:

Brush and floss daily
Sure, you knew that already. But did you know that for effective cleaning, your kids should brush for two full minutes, twice a day? And despite reports you may have heard, the American Dental Association maintains that using an interdental cleaner (like floss) is essential part of good oral hygiene: It’s the best way to clean decay-causing bacteria from tooth surfaces that your brush just can’t reach.

Limit snacking to around mealtimes
If you allow kids to have sugary snacks, limit them to around mealtimes. That way, the teeth aren’t constantly bathed in substances that can feed harmful bacteria. It also gives the healthful saliva a chance to neutralize acids that can attack the tooth’s protective enamel coating.

Avoid soda and other sugary, acidic drinks
That includes so-called “sports” and “energy” drinks, which often contain extremely high levels of sugar. These beverages, along with diet sodas and some fruit juices, may also be highly acidic, and can damage teeth. What’s the best drink for your kids’ health? Plain old refreshing water!

Pay attention to baby teeth
Sure, in a few years, those teeth will be gone. But in the mean time, they have an important job to do: They not only contribute to proper speech, eating and appearance, but also hold a space for the permanent teeth that will follow them. If they are lost too early, problems with permanent teeth may follow.

Get regular checkups
Routine office visits are the best way to monitor your child’s dental health and development, prevent disease, and solve minor problems before they get bigger.  Plus, we can address any questions you may have about oral hygiene and a range of other topics. So if we haven’t seen your child lately, maybe February is a good time for a visit.

If you have questions about your child’s oral health, please contact our office or schedule a consultation. You can learn more in the Dear Doctor magazine articles “How to Help Your Child Develop the Best Habits for Oral Health” and “Importance of Baby Teeth.”