Archives for June 2020

Is a Maryland Bridge a Good Temporary Restoration?

June 25, 2020 by Susan M. Dennis, D.D.S

We just completed my daughter’s orthodontics to open up a space where a congenitally missing tooth needs to be filled. The teeth had shifted over the years and there wasn’t going to be enough room, so when we were straightening her teeth we thought it best to plan ahead. We want to eventually get her a dental implant but are looking for a temporary tooth to place in there. My dentist is suggesting a Maryland Bridge because we won’t have to crown the adjacent teeth, like you would with a traditional dental bridge. I like that idea but I want to check out if it is our best idea so I’m writing a couple of other dentists to get their recommendations, including you.

Laura

Dear Laura,

Maryland Bridge

I’m actually very glad you wrote. First, your choice of a dental implant to place where her tooth is missing is a great one. That will last her a lifetime.

I don’t, however, think you should get a Maryland Bridge for your daughter. While it is true that you won’t have to crown the adjacent teeth, I wouldn’t consider it a temporary replacement option. This is because in order for it to fit properly, your dentist will need to cut notches into her teeth to help keep the wings in place. You can see an example of the type of notch I’m referring to on the left.

Once the bridge is removed, you will need to fill all that in. Anything that permanently changes the structure of the tooth cannot be considered temporary in my opinion.

A Great Temporary Tooth Replacement while Waiting on a Dental Implant

Dental Flipper

Instead, I am going to recommend you get her a dental flipper. This won’t require any structural changes to her tooth and will allow her to keep the space open until her jaw is developed and ready for the dental implant.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

Daughter Broke her Front Tooth

June 13, 2020 by Susan M. Dennis, D.D.S

I’m not sure what to do. My daughter was playing outside and fell and took off a chunk of her front tooth. I took her to the dentist and he said everything is fine. When I asked him to fix it he said he would need to wait six to eight weeks for the nerves to desensitize. Is that really necessary? By then she should be back in school. Though she’ll probably be in a mask most of the time, at lunchtime the kids will see her tooth. I don’t want her embarrassed.

Lisa

Dear Lisa,

child smiling in a dental chair

There is no dental reason to wait. He may be stalling to figure out the best fix. What she really needs is a cosmetic dentist familiar with this type of repair.

One thing you didn’t mention is whether it was an adult or baby tooth. If it is a baby tooth, you may just want to extract it. It’s not uncommon for young children to be missing teeth so it won’t be an issue at school. Front teeth don’t have to remain in place as long as their back molars.

If it is her permanent tooth, then the repair should go forward. Ideally, if you have the piece that broke off it could be repaired that way. Otherwise, you will need to find a dentist who does dental bonding. That will use a composite resin to build up the missing structure.

I don’t think most pediatric dentists will be familiar with these types of repairs. You will have more success with a general dentist who treats children.

It was smart of you to have the tooth checked out right away. Whenever there is trauma to a tooth, even if there is no visible challenge, there can be underlying damage to the root or developing adult tooth. Being proactive like you were can save her tooth.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

Do Adults Need Fluoride Treatments?

June 1, 2020 by Susan M. Dennis, D.D.S

I have some dental exam questions. First, how often are dental x-rays needed for an adult? My dentist insists on doing them every six months, even though my insurance only covers once per year. Second, do adults really need fluoride treatments? Is it safe or detrimental for them? Third, would I be better off with a biological dentist?

Casey

Dear Casey,

woman laying in a field of flowers

There are some general guidelines when it comes to x-rays for dental care:

Bitewing x-rays: Once a year
Panographic x-ray or full series of x-rays: Once every five years

Most dentists adhere to these guidelines. A reasonable exception would be if someone is prone to decay or really struggling with their oral health. If that is not you and your dentist is still insisting on every 6 months, I would at that point talk directly to the dentist, not the staff. Tell him or her your insurance only covers it once a year and it is a financial hardship for you. If they still insist, which some will, then it will be time to find a new dentist.

As for fluoride treatments, once the teeth are fully formed, the benefits of fluoride diminish. It is typically given to children up to 14 years of age. There are some cases where it would be of benefit to adults. Some of those would be if the patient is undergoing cancer treatments, which can be devastating to teeth, or (like the x-ray situation) this patient is more prone to decay.

Fluoride and Dental Work

As to your question as to whether it is harmful to you, fluoride isn’t detrimental to your health. It can, however, damage any dental work (such as dental crowns or porcelain veneers) depending on the type of fluoride given. The most common fluoride is acidulated fluoride. This will etch the dental work, causing permanent damage to the glazing. If you have dental work you want to make sure your hygienist doesn’t use this type of fluoride.

Biological Dentists

Your question about a biological dentist, also called a holistic dentist, was a good one as well. The benefit to a biological dentist is they are more likely to listen to your wishes, especially about things like x-rays and fluoride. They’re also mercury-free, which many patients prefer these days.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.