Archives for September 2024

Can a Maryland Bridge Bond to Implant Crowns?

Posted on September 29, 2024 by writeradmin.

I have two dental implants with dental crowns. Now the tooth between them is in need of replacement. Is it possible to just get a Maryland Bridge and attach it to the two implant crowns?

Edward

Dear Edward,

The ideal solution would have been if your dentist, knowing that you’ve lost the two adjacent teeth, would have anticipated the strong possibility of you losing the tooth between them. Then, he would have positioned the dental implants where the crowns could be removed and replaced with a dental dental bridge.

If he didn’t do that then, the next thing I would look at is if there is enough room for you to have a third implant placed in between the first two.

A Maryland Bridge

While technically you can place a Maryland Bridge on two dental crowns, I do not recommend it. It is harder to get the wings to bond to porcelain. Plus, there will need to be some tooth preparation done, such as the groove pictured in the tooth above. You also risk the preparation going straight through the porcelain. Getting to bond to metal would be even less secure.

I don’t know how long you’ve had these crowns, but I want you to consider something. This may not be an issue for you at all, but as we age our teeth pick up a lot of stains. If you are going to get your teeth whitened, then you need to do that before you have all of this work done. Then, you can get your new implant or bridge and have everything match the more updated color of your teeth. Once the work is done, the crowns will not whiten.

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

Upper Denture is Making Me Gag

Posted on September 16, 2024 by writeradmin.

Can you give me some advice? I have removable dentures. My lower denture feels fine, but every time I put my upper denture in, it causes me to gag. Is there anything that can help me with this?

Sheila

Dear Sheila,

Dentures come with a host of problems, one of which is what you are experiencing now. There are many patients who have trouble with an upper denture. There are a couple of solutions for you. First, the ideal solution is to get implant supported dentures, pictured above. This will completely eliminate the need for anything to go across your palate. While it will help your comfort and stop the gagging, it is more urgent for the lower arch to have the dental implants.

This is to prevent what is known in dental circles as facial collapse. When your teeth are first removed, your body kicks into preservation mode. It begins resorbing the minerals in your jawbone to use elsewhere in your body that it perceives as you no longer needing because you do not have teeth to support. This slowly shrinks your jawbone. This is not much of a problem for your upper dentures because those are held in by suction. However, the lower dentures rest on that jawbone. After about ten years or so, you no longer have enough jawbone left to retain your dentures.

The best thing you can do is have four or more dental implants placed in each arch and then anchor the dentures to them. This will both eliminate the problem of facial collapse as well as take care of the gagging problem you are having with the upper denture.

An Alternative Solution for Your Upper Denture

If getting them on both arches is impossible, there is another potential solution for the upper denture. Upper dentures typically go all the way over the hard palate to the vibrating line of the soft palate. This can be a cause for gagging.

A prosthodontist, Dr. Finlay Sutton (Lancashire, England), published his technique of cutting the denture in a way that preserves the suction, but helps prevent the gagging in some patients. You could try this and then get the implants on the lower dentures in order to preserve your bone structure.

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

Terrified of Getting My Wisdom Tooth Removed

Posted on September 9, 2024 by writeradmin.

I am 36 years old. I had a wisdom tooth that was partially exposed and partially under the gum and bone. It had a cavity that has now turned into an infection. My dentist says that taking this out is high risk because of the angle, the fact that it is next to a tooth with a root canal treatment, and I have risk of nerve damage. Now, I am absolutely terrified of extracting this and having something go wrong with the tooth or nerve. Because it is at the side of my cheek, I’m worried my face will look sunken in as well in that area. I’m attaching an x-ray. Can I just treat the infection with an antibiotic?

Thanks, Keri

I’m not seeing the infection, but if there is one, you do want to treat it. An antibiotic will not “cure” a tooth infection, only hold it at bay temporarily until you get the real treatment. There are two ways to treat a tooth infection. The first is with a root canal treatment. The second is with a tooth extraction.

For any tooth other than a wisdom tooth, I’d say get a root canal because this means you can save the tooth. A wisdom tooth you just want out. If the tooth is infected and you don’t extract it, you will not only end up with a dental emergency, but could end up with something that turns life threating. The infection will continue to spread to other parts of your body. Your jaw is close to your throat, heart, and lungs. If the infection spreads upward, it can even reach your brains.

Your lower left wisdom tooth does not appear to be impinging on a nerve at all. I would get your wisdom teeth out sooner rather than later. Don’t wait for all of them to develop a problem. The one exception to this is the tooth on the other side of the one bothering you now. That one looks like the roots are very close to the nerves.

I’m going to recommend that you get 3-dimensional scans of your mouth anyway. The dentist or oral surgeon will want to know exactly where all the nerves are in order to avoid them. Plus, he or she will need to be careful about the tooth with the root canal treatment.

I’m not too worried about the tooth that has the immediate problem being an issue. It would have been better if you had this done in your twenties before the roots are fully formed and the bone gets denser, but you’re still in a time where I don’t worry about complications. If you wait much longer, even just a few years, you will be in a danger zone for complications. That is a big reason why I do not want you to wait on the other teeth.

As for your face looking sunken in, that isn’t something to worry about. Your jawbone is more what determines the shape of your face in that area.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.
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Can I Whiten My Porcelain Veneers?

Posted on September 5, 2024 by writeradmin.

I have had porcelain veneers for about seven months. They started out very white, but have started picking up stains. I think it is because I drink a lot of coffee. That’s initially why I got porcelain veneers to begin with. That, and I have a chipped tooth. Is there a way for me to get these veneers back to how white they were when I first got them with something like teeth whitening?

Sara

Dear Sara,

For the benefit of others who may be reading this, I wanted to mention another option for improving your smile when it comes to the two things you mentioned: chips and discoloration. While you will find that porcelain veneers are the top of the line treatment for a smile makeover, you can find a suitable, less expensive option for those two things, if necessary. Another option is teeth whitening and dental bonding (for the chipped teeth). Dental bonding will not last as long as porcelain veneers, so you should expect to replace it periodically.

That being said, something has gone wrong with your porcelain veneers. The glazing on them should protect them from stains even better than your natural teeth would. Because of that, when they’re well cared for they will be white for quite some time, even if you drink coffee. You have only had yours for seven months so there should not be staining on them. If there is, the glazing has been damaged.

There are a few ways that this can happen. One of them is if you used something on the veneers which could damage them, such as over-the-counter whitening toothpastes. However, given the timing, this sounds more like your hygienist used something that damaged the glazing. It’s possible she used something like a power prophy jet or acidulated fluoride. This will scratch the glazing on your porcelain veneers, which in turn allows it to pick up stains.

While teeth whitening only works on natural tooth structure, they can polish them back up to their natural shine. This will take away the stains, but will not restore the glaze. If they were the ones to damage them, I think they should replace them.

If you are wanting to use a whitening toothpaste on your veneers, the only one I’d recommend is Supersmile Toothpaste. They use a protein pellicle, instead of an abrasive the way most whitening toothpastes do.

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