Posts for: June, 2016
While tooth loss can occur at any age, replacing one in a younger patient requires a different approach than for someone older. It’s actually better to hold off on a permanent restoration like a dental implant if the person is still in their teens.
This is because a teenager’s jaws won’t finish developing until after nineteen or in their early twenties. An implant set in the jawbone before then could end up out of alignment, making it appear out of place — and it also may not function properly. A temporary replacement improves form and function for now and leaves the door open for a permanent solution later.
The two most common choices for teens are a removable partial denture (RPD) or a bonded fixed bridge. RPDs consist of a plastic gum-colored base with an attached prosthetic (false) tooth matching the missing tooth’s type, shape and jaw position. Most dentists recommend an acrylic base for teens for its durability (although they should still be careful biting into something hard).
The fixed bridge option is not similar to one used commonly with adult teeth, as the adult version requires permanent alteration of the teeth on either side of the missing tooth to support the bridge. The version for teens, known as a “bonded” or “Maryland bridge,” uses tiny tabs of dental material bonded to the back of the false tooth with the extended portion then bonded to the back of the adjacent supporting teeth.
While bonded bridges don’t permanently alter healthy teeth, they also can’t withstand the same level of biting forces as a traditional bridge used for adults. The big drawback is if the bonding breaks free a new bonded bridge will likely be necessary with additional cost for the replacement.
The bridge option generally costs more than an RPD, but buys the most time and is most comfortable before installing a permanent restoration. Depending on your teen’s age and your financial ability, you may find it the most ideal — though not every teen is a good candidate. That will depend on how their bite, teeth-grinding habits or the health of surrounding gums might impact the bridge’s stability and durability.
A complete dental exam, then, is the first step toward determining which options are feasible. From there we can discuss the best choice that matches your teen’s long-term health, as well as your finances.
Tooth decay and periodontal (gum) disease pose the most common dangers to dental health. But there are some rare conditions that can also place teeth at risk to be on the lookout for during regular dental checkups.
One such condition is root resorption in an adult tooth, in which the root itself or its surface breaks down and is absorbed by the body. Resorption occurs naturally in a primary (“baby”) tooth so it can loosen and give way for an incoming permanent tooth. Â Resorption still occurs in a limited form with young permanent teeth but should eventually stop.
Sometimes, though, it doesn’t, either from the inside of the tooth out (internal resorption) or more often from the outside in, usually around the neck-like (or “cervical”) portion of the tooth. This more common occurrence, External Cervical Resorption (ECR), can first appear as pink spots on the enamel and then progress into cavity-like areas. If not found and treated promptly, damage can occur quickly and lead to tooth loss.
We don’t fully understand the exact nature and causes for ECR, but we have identified risk factors for its development. Excessive orthodontic force on the teeth or any other trauma can cause damage to the periodontal ligament (which holds teeth in place with the jaw bone). Teeth grinding habits and some dental procedures like internal tooth whitening can also be risk factors.That being said, though, the vast majority of people who experience these issues don’t develop ECR.
Although the causes aren’t fully understood, we can still treat it: the key to success is early detection. You probably won’t notice early signs of ECR, but we can often detect spots from routine x-rays. We can then remove the tissue cells within the lesions causing the damage and restore the area with a tooth-colored filling material. If ECR has extended near the tooth’s interior pulp layer, then a root canal treatment may be needed.
Needless to say, the more extensive ECR occurs in the roots, the less likely the tooth can be saved and may need to be extracted. It’s important, therefore, to maintain regular dental checkups (at least twice a year) to increase your chances of catching a developing problem early.
If you would like more information on root resorption in adult teeth, 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 “Root Resorption: An Unusual Phenomenon.”