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Spruce Ridge Dental Blog

What are dental crowns used for?

March 31, 2018

Filed under: Uncategorized — Spruce Ridge Dental @ 4:16 am

Dental crowns are typically used to cover and protect a tooth that has cracked, broken, or is significantly damaged by decay. The tooth is shaped to allow the crown to fit over the top and then the crown is bonded into place. Crowns are created to look like your teeth, and most people will never know the difference

crowns

Crowns are also used to restore dental implants. In this case, instead of being affixed to your own tooth, the restoration is attached to an implant, which has been surgically placed in the space where a tooth used to be. This allows us to replace missing teeth with restorations that both look and function like your own teeth.

Restorations are also used in cosmetic dentistry to cover and conceal a tooth that is severely damaged, didn’t develop properly, or has significant discoloration that can be corrected with tooth whitening.

Today’s restorations are aesthetic and blend in flawlessly with your own natural teeth. This is a huge improvement from previous restoration technology, which often left an unpleasant gray line right at the gumline. Today, most people will never know your secret!

Why Are Dental Crowns Needed?

A restoration may be needed in the following situations:
1. To protect a weak tooth (for instance, from decay) from breaking or to hold together parts of a cracked tooth
2. To restore an already broken tooth or a tooth that has been severely worn down
3. To cover and support a tooth with a large filling when there isn’t a lot of tooth left
4. To hold a dental bridge in place
5. To cover mis-shapened or severely discolored teeth
6. To cover a dental implant
7. To make a cosmetic modification
For children, a crown may be used on primary (baby) teeth in order to:
• Save a tooth that has been so damaged by decay that it can’t support a filling.
• Protect the teeth of a child at high risk for tooth decay, especially when a child has difficulty keeping up with daily oral hygiene.
• Decrease the frequency of general anesthesia for children unable because of age, behavior, or medical history to fully cooperate with the requirements of proper dental care.
In such cases, a pediatric dentist is likely to recommend a stainless steel restoration.
What Types Are Available?
Permanent restorations can be made from stainless steel, all metal (such as gold or another alloy), porcelain-fused-to-metal, all resin, or all ceramic.
• Stainless steel restorations are prefabricated restorations that are used on permanent teeth primarily as a temporary measure. The restoration protects the tooth or filling while a permanent crown is made from another material. For children, a stainless steel crown is commonly used to fit over a primary tooth that’s been prepared to fit it. The restoration covers the entire tooth and protects it from further decay. When the primary tooth comes out to make room for the permanent tooth, the crown comes out naturally with it. In general, stainless steel restorations are used for children’s teeth because they don’t require multiple dental visits to put in place and so are more cost- effective than custom-made restorations and prophylactic dental care needed to protect a tooth without a crown.
• Metals used in restorations include gold alloy, other alloys (for example, palladium), or a base-metal alloy (for example, nickel or chromium). Compared with other crown types, less tooth structure needs to be removed with metal crowns, and tooth wear to opposing teeth is kept to a minimum. Metal crowns withstand biting and chewing forces well and probably last the longest in terms of wear down. Also, metal crowns rarely chip or break. The metallic color is the main drawback. Metal crowns are a good choice for out-of-sight molars.
• Porcelain-fused-to-metal dental crowns can be color matched to your adjacent teeth (unlike the metallic crowns). However, more wearing to the opposing teeth occurs with this crown type compared with metal or resin crowns. The crown’s porcelain portion can also chip or break off. Next to all-ceramic crowns, porcelain-fused-to-metal crowns look most like normal teeth. However, sometimes the metal underlying the crown’s porcelain can show through as a dark line, especially at the gum line and even more so if your gums recede. These crowns can be a good choice for front or back teeth.
• All-resin dental crowns are less expensive than other crown types. However, they wear down over time and are more prone to fractures than porcelain-fused-to-metal crowns.
• All-ceramic or all-porcelain dental crowns provide better natural color match than any other crown type and may be more suitable for people with metal allergies. However, they are not as strong as porcelain-fused-to-metal crowns and they wear down opposing teeth a little more than metal or resin crowns. All-ceramic crowns are a good choice for front teeth.
• Temporary versus permanent. Temporary crowns can be made in your dentist’s office, whereas permanent crowns are made in a dental laboratory. Temporary crowns are made of acrylic or stainless steel and can be used as a temporary restoration until a permanent crown is constructed by a lab.
• Zirconia or milled crown – which are digitally constructed either in an office that has the software and hardware to produce them or in a dental lab. Dental offices that have the software and hardware have the ability to produce a crown in one visit with no need for a temporary. These crowns require no impression.

Teeth Whitening

March 30, 2018

Filed under: Uncategorized — Spruce Ridge Dental @ 2:35 pm

 Advanced teeth whitening technology has enabled dentists to whiten teeth without adversely affecting the tooth structure.  These teeth whitening methods are 100% safe.  Teeth stains are inevitable due to our consumption of a variety of foods and drinks (soda, spicy food, coffee, etc.).  Our teeth have microscopic pores that allow pigmented food particles to accumulate and cause the stains.  Tooth brushing alone cannot remove these stains.  Tooth whitening treatment is effective in getting into these tiny pores to lift out the stains to achieve a beautiful  sparkling white smile.

teeth whitening

Almost all teeth whitening methods are similar in concept, but some are much more effective because of the way the whitening material is delivered to the teeth. Another contributing factor is the concentration of the material, which is why less potent over-the-counter whitening systems usually don’t give patients the results they are hoping for.

Two ways to whiten your teeth

The two main methods of professional whitening are tray whitening and in-office whitening. In tray whitening, an impression is taken and a custom tray is made for the patient. Then, a supply of whitening gel is given to the patient and he/she wears the tray for a few hours each day (techniques differ) for a period of time until an acceptable result is achieved. Sensitivity of the teeth is a normal side-effect of this whitening method and is almost always transitional.  At home whitening allows for a very convenient method of whitening right in the comforts of your own home.  You can whitening your teeth while watching TV or reading one of your favorite books.

On the other hand, in-office whitening is the most efficient means of whitening. There are a number of different types used, but the process is very similar for these methods; you can have your teeth whitened in one session and achieve significant results. The in office teeth whitening is stronger than the at home teeth whitening and therefore you achieve whiter teeth and more quickly.   Just like the home teeth whitening method, do expect some transient sensitivity.  If you use a sensitivity tooth paste, the sensitivity will go away much more quickly.

With both methods of teeth whitening, you should first book an appointment to asses if you are a candidate for teeth whitening.  An exam must be done to make sure you do not have any cavities since the whitening can make these decay worse.  In addition, if you have a professional cleaning, the plaque covering your teeth can be removed so that the whitening agent can get to your teeth pores and you will have a much whiter result.  Teeth whitening is an easy and fast way to improve the appearance of your smile.  Our dentists can give you more detailed information and help you decide which method is more suitable for you and your teeth.

Fluoride therapy

December 8, 2017

Filed under: Uncategorized — Spruce Ridge Dental @ 11:22 pm

Fluoride therapy is the delivery of fluoride to the teeth topically or systemically, which is designed to prevent tooth decay (dental caries) which results in cavities. Most commonly, fluoride is applied topically to the teeth using gels, varnishes, toothpaste/dentifrices or mouth rinse.

Systemic delivery involves fluoride supplementation using tablets or drops which are swallowed. This type of delivery is rarely used where public water supplies are fluoridated, but is common (along with salt fluoridation) in some European countries.

Benefits of fluoride therapy
Fluoride therapy is commonly practiced and generally agreed upon as being useful in the modern dental field. Fluoride combats the formation of tooth decay primarily in three ways:

Fluoride therapy promotes the remineralization of teeth, by enhancing the tooth remineralization process. Fluoride found in saliva will absorb into the surface of a tooth where demineralization has occurred. The presence of this fluoride in turn attracts other minerals (such as calcium), thus resulting in the formation of new tooth mineral.
Fluoride can make a tooth more resistant to the formation of tooth decay. The new tooth mineral that is created by the remineralization process in the presence of fluoride is actually a “harder” mineral compound than existed when the tooth initially formed. Teeth are generally composed of hydroxyapatite and carbonated hydroxyapatite. Fluorapatite is created during the remineralization process when fluoride is present and is more resistant to dissolution by acids (demineralization).

Fluoride therapy can inhibit oral bacteria’s ability to create acids. Fluoride decreases the rate at which the bacteria that live in dental plaque can produce acid by disrupting the bacteria and its ability to metabolize sugars. The less sugar the bacteria can consume, the less acidic waste which will be produced and participate in the demineralization process.
There are many different types of fluoride therapies, which include at home therapies and professionally applied topical fluorides (PATF). At home therapies can be further divided into over-the-counter (OTC) and prescription strengths. The fluoride therapies whether OTC or PATF are categorized by application – dentifrices, mouth rinses, gels/ foams, varnishes, dietary fluoridate supplements, and water fluoridation.

Fluoride therapy, while beneficial to adults, is more important in children whose teeth are developing. As teeth are developing within their jaw bones, enamel is being laid down. Systemic ingestion of fluoride results in a greater component of fluoroapatite in the mineral structure of the enamel.

Methods of delivery

Dentifrices
Most dentifrices today contain 0.1% (1000 ppm) fluoride, usually in the form of sodium monofluorophosphate (MFP); 100 g of toothpaste containing 0.76 g MFP (equivalent to 0.1 g fluoride). Toothpaste containing 1,500 ppm fluoride has been reported to be slightly more efficacious in reducing dental caries in the U.S. Toothpaste may cause or exacerbate perioral dermatitis most likely caused by sodium lauryl sulfate, an ingredient in toothpaste. It is suspected that SLS is linked to a number of skin issues such as dermatitis and it is commonly used in research laboratories as the standard skin irritant with which other substances are compared.

Prescription strength fluoride toothpaste generally contains 1.1% (4,950 ppm) sodium F toothpaste, e.g. PreviDent 5000 Plus or booster. This type of toothpaste is used in the same manner as regular toothpaste. It is well established that 1.1% sodium F is safe and effective as a caries preventive. This prescription dental cream is used once daily in place of regular toothpaste.

Mouth rinses
The most common fluoride compound used in mouth rinse is sodium fluoride. Over-the-counter solutions of 0.05% sodium fluoride (225 ppm fluoride) for daily rinsing are available for use. Fluoride at this concentration is not strong enough for people at high risk for caries.

Prescription mouth rinses are more effective for those at high risk for caries, but are usually counter indicated for children, especially in areas with fluoridated drinking water. However, in areas without fluoridated drinking water, these rinses are sometimes prescribed for children.

Gels/foams
Fluoride therapy gels and foams are used for patients who are at high risk for caries, orthodontic patients, patients undergoing head and neck radiation, patients with decreased salivary flow, and children whose permanent molars should, but cannot, be sealed.

GC Tooth Mousse, invented by Dr Eric Reynolds, Head of the School of Dental Science at Melbourne University, at the Royal Dental Hospital Melbourne is now considered an essential management solution for at risk patients.

The gel or foam is applied through the use of a mouth tray, which contains the product. The tray is held in the mouth by biting. Application generally takes about four minutes, and patients should not rinse, eat, smoke, or drink for at least 30 minutes after application.

Some gels are made for home application, and are used in a manner similar to toothpaste. The concentration of fluoride in these gels is much lower than professional products.

Varnish
Varnish Fluoride therapy has practical advantages over gels in ease of application, a non-offensive taste, and use of smaller amounts of fluoride than required for gel applications. Varnish is intended for the same group of patients as the gels and foams. There is also no published evidence as of yet that indicates that professionally applied fluoride varnish is a risk factor for enamel fluorosis. The varnish is applied with a brush and sets within seconds.

 

Dental Sealants

December 6, 2017

Filed under: Uncategorized — Spruce Ridge Dental @ 10:47 pm

Dental sealants are made of plastic material that is usually applied to the chewing surfaces of the back teeth: premolars and molars. This plastic resin bonds into the depressions and grooves (pits and fissures) of the chewing surfaces of back teeth. The sealant acts as a barrier, protecting enamel from plaque and acids.

Thorough brushing and flossing help remove food particles and plaque from smooth surfaces of teeth. But toothbrush bristles cannot reach all the way into the depressions and grooves to extract food and plaque. Sealants protect these vulnerable areas by “sealing out” plaque and food.

Sealants are easy for your dentist to apply, and it takes only a few minutes to seal each tooth. The teeth that will be sealed are cleaned. Then the chewing surfaces are roughened with an acid solution to help the sealant adhere to the tooth. The sealant is then ‘painted’ onto the tooth enamel, where it bonds directly to the tooth and hardens. Sometimes a special curing light is used to help the sealant harden.

As long as the sealant remains intact, the tooth surface will be protected from decay. Sealants hold up well under the force of normal chewing and usually last several years before a reapplication is needed. During your regular dental visits, your dentist will check the condition of the sealants and reapply them when necessary.

The likelihood of developing pit and fissure decay begins early in life, so children and teenagers are obvious candidates. But adults can benefit from sealants as well.

Key ingredients in preventing tooth decay and maintaining a healthy mouth are twice-daily brushing with an ADA-accepted fluoride toothpaste; cleaning between the teeth daily with floss or interdental cleaners; eating a balanced diet and limiting snacks; and visiting your dentist regularly. Ask your dentist about whether sealants can put extra power behind your prevention program.

Endodontics

December 5, 2017

Filed under: Uncategorized — Spruce Ridge Dental @ 12:42 am

Endodontics is a branch of dentistry that deals with the complex structures found inside the teeth. The Greek word “Endodontics” literally means “inside the tooth,” and relates to the tooth pulp, tissues, nerves and arterioles.

endodontics

Historically, a tooth with a diseased nerve would be removed immediately, but root canals are able to save the natural tooth in most cases. Generally, extracting the inner tooth structures, then sealing the resulting gap with a crown restores health and functionality to damaged teeth.

Signs and symptoms of endodontic problems:

  • Inflammation and tenderness in the gums.
  • Teeth that are sensitive to hot and cold foods.
  • Tenderness when chewing and biting.
  • Tooth discoloration.
  • Unexplained pain in the nearby lymph nodes.

Reasons for endodontic treatment

Endodontic treatment (or root canal therapy) is performed to save the natural tooth. In spite of the many advanced restorations available, most dentists agree that there is no substitute for healthy, natural teeth.

endodontics

Here are some of the main causes of inner tooth damage:

Bacterial infections – Oral bacteria is the most common cause of endodontic problems. Bacteria invade the tooth pulp through tiny fissures in the teeth caused by tooth decay or injury. The resulting inflammation and bacterial infection jeopardize the affected tooth and may cause an abscess to form.

Fractures and chips – When a large part of the surface or crown of the tooth has become completely detached, root canal therapy may be required. The removal of the crown portion leaves the pulp exposed, which can be debilitating painful and problematic.

Injuries – Injuries to the teeth can be caused by a direct or indirect blow to the mouth area. Some injuries cause a tooth to become luxated, or dislodged from its socket. Root canal therapy is often needed after the endodontist has successfully stabilized the injured tooth.

Removals – If a tooth has been knocked clean out of the socket, it is important to rinse it and place it back into the socket as quickly as possible. If this is impossible, place the tooth in special dental solution (available at pharmacies) or in milk. These steps will keep the inner mechanisms of the tooth moist and alive while emergency dental treatment is sought. The tooth will be affixed in its socket using a special splint, and the endodontist will then perform root canal therapy to save the tooth.

What does an endodontic procedure invlove?

Root canal therapy usually takes between one and three visits to complete. Complete X-rays of the teeth will be taken and examined before the treatment begins.

Initially, a local anesthetic will be administered, and a dental dam (protective sheet) will be placed to ensure that the surgical area remains free of saliva during the treatment. An opening will be created in the surface of the tooth, and the pulp will be completely removed using small handheld instruments.

The space will now be shaped, cleaned and filled with gutta-percha. Gutta-percha is a biocompatible material that is somewhat similar to rubber. Cement will be applied on top to ensure that the root canals are completely sealed off. Usually, a temporary filling will be placed to restore functionality to the tooth prior to the permanent restoration procedure. During the final visit, a permanent restoration or crown will be placed.

Digital X-Ray

December 4, 2017

Filed under: Uncategorized — Spruce Ridge Dental @ 1:46 am

Dentist Hinton, Edson, Grande Cache
How do digital x-rays work?
Similar to traditional x-rays, we place a sensor that is about the size and shape of a normal x-ray film inside your mouth. After a quick x-ray, a scanner sends signals to a computer that are translated into electronic pictures of your teeth, supporting bones, and gums.

Why do we use digital x-rays?

  • The patient receives approximately 50-90% less radiation than with traditional x-rays.
  • We get larger, more detailed images to help diagnose more accurately.
  • We can share the x-ray image with patients on our in room monitor to explain areas of concern or answer questions.
  • There is no developing involved, so no harmful chemicals are used.
  • The digital x-rays can be enlarged for clarification, and are stored in your file for future reference.
  • Immediate results from digital x-rays means less time developing x-rays and more time spent with the patient.
  • Digital x-rays can be submitted along with dental insurance claims to expedite the reimbursement process.

There are two main types of dental X-rays: intraoral (meaning the X-ray film is inside the mouth) and extraoral (meaning the X-ray film is outside the mouth).

  • Intraoral X-rays are the most common type of dental X-ray taken. These X-rays provide a lot of detail and allow your dentist to find cavities, check the health of the tooth root and bone surrounding the tooth, check the status of developing teeth, and monitor the general health of your teeth and jawbone.
  • Extraoral X-rays show teeth, but their main focus is the jaw and skull. These X-rays do not provide the detail found with intraoral X-rays and therefore are not used for detecting cavities or for identifying problems with individual teeth. Instead, extraoral X-rays are used to look for impacted teeth, monitor growth and development of the jaws in relation to the teeth, and to identify potential problems between teeth and jaws and the temporomandibular joint (TMJ) or other bones of the face.

Types of Intraoral X-Rays

There are several types of intraoral X-rays, each of which shows different aspects of teeth.

  • Bite-wing X-rays show details of the upper and lower teeth in one area of the mouth. Each bite-wing shows a tooth from its crown to about the level of the supporting bone. Bite-wing X-rays are used to detect decay between teeth and changes in bone density caused by gum disease. They are also useful in determining the proper fit of a crown (or cast restoration) and the marginal integrity of fillings.
  • Periapical X-rays show the whole tooth — from the crown to beyond the end of the root to where the tooth is anchored in the jaw. Each periapical X-ray shows this full tooth dimension and includes all the teeth in one portion of either the upper or lower jaw. Periapical X-rays are used to detect any abnormalities of the root structure and surrounding bone structure.
  • Occlusal X-rays are larger and show full tooth development and placement. Each X-ray reveals the entire arch of teeth in either the upper or lower jaw.

Gum Recession

December 3, 2017

Filed under: Uncategorized — Spruce Ridge Dental @ 3:47 am

Gingival recession (receding gums) refers to the progressive loss of gum tissue, which can eventually result in tooth root exposure if left untreated.  Gum recession is most common in adults over the age of 40, but the process can begin in the teenage years.

Gum Recession

Gum recession can be difficult to self-diagnose in its earlier stages because the changes often occur asymptomatically and gradually.  Regular dental check ups will help to prevent gum recession and assess risk factors.

The following symptoms may be indicative of gum recession:

  • Sensitive teeth – When the gums recede enough to expose the cementum protecting the tooth root, the dentin tubules beneath will become more susceptible to external stimuli.
  • Visible roots – This is one of the main characteristics of a more severe case of gum recession.
  • Longer-looking teeth – Individuals experiencing gingival recession often have a “toothy” smile.  The length of the teeth is perfectly normal, but the gum tissue has been lost, making the teeth appear longer.
  • Halitosis, inflammation and bleeding – These symptoms are characteristic of gingivitis or periodontal disease.  A bacterial infection causes the gums to recede from the teeth and may cause tooth loss if not treated promptly.

Causes of Gum Recession

Gum recession is an incredibly widespread problem that dentists diagnose and treat on a daily basis.  It is important to thoroughly examine the affected areas and make an accurate diagnosis of the actual underlying problem.  Once the cause of the gum recession has been determined, surgical and non surgical procedures can be performed to halt the progress of the recession, and prevent it from occurring in the future.

The most common causes of gingival recession are:

  • Overaggressive brushing – Over brushing can almost be as dangerous to the gums as too little.  Brushing too hard or brushing with a hard-bristled toothbrush can erode the tooth enamel at the gum line, and irritate or inflame gum tissue.
  • Poor oral hygiene – When brushing and flossing are performed improperly or not at all, a plaque build-up can begin to affect the teeth.  The plaque contains various bacterial toxins which can promote infection and erode the underlying jawbone.
  • Chewing tobacco – Any kind of tobacco use has devastating effects on the entire oral cavity.  Chewing tobacco in particular, aggravates the gingival lining of the mouth and causes gum recession if used continuously.
  • Periodontal disease – Periodontal disease can be a result of improper oral hygiene or caused by systemic diseases such as diabetes.  The excess sugars in the mouth and narrowed blood vessels experienced by diabetics create a perfect environment for oral bacteria.  The bacterium causes an infection which progresses deeper and deeper into the gum and bone tissue, eventually resulting in tooth loss.

Treatment of Gum Recession

Every case of gum recession is slightly different, and therefore many treatments are available.  The nature of the problem which caused the recession to begin with needs to be addressed first.

If overly aggressive brushing techniques are eroding the gums, a softer toothbrush and a gentler brushing technique should be used.  If poor oral hygiene is a problem, prophylaxis (professional dental cleaning) may be recommended to rid the gum pockets of debris and bacteria.  In the case of a severe calculus (tartar) build up, scaling and root planing will be performed to heal the gingival inflammation and clean the teeth.

Once the cause of the gingival recession has been addressed, surgery of a more cosmetic or restorative nature may be recommended.  Gum tissue regeneration and gum grafting are two excellent ways to restore natural symmetry to the gums and make the smile look more aesthetically pleasing.

 

A WHITER SMILE THE PROFESSIONAL WAY

December 2, 2017

Filed under: Uncategorized — Spruce Ridge Dental @ 5:00 am

Tooth Smile Whitening

Edson, Jasper, Grande Cache Tooth Whitening

Have you ever wondered why your smile is not as white as it used to be? Well, there may be a few different reasons that your teeth have become discolored over the years. The change in color may simply be due to wear and tear from aging. It may also be a result of dietary factors, because foods containing tannins, such as red wine, coffee and tea are known to discolor teeth. Tobacco use, whether smoking or chewing, is another common cause of stains on your teeth.

So, what should you do if you decide you would like a whiter smile? You should first make an appointment with our office, so that we can assess the root cause of the discoloration. We may recommend a quick and easy solution with in-office whitening, sometimes known as power bleaching.

An in-office whitening treatment can lighten your teeth three to eight shades in just one office visit! During your whitening treatment, we will first protect your lips, gums and cheeks, leaving only your teeth exposed. Then, we will apply a professional strength bleaching gel to your teeth. We may use a special light to make the bleach work faster. The great advantage of this treatment is that your smile will become noticeably whiter in just an hour!

If you would prefer to whiten in the comfort of your home, we can give you a take-home whitening kit. First, we will make molds of your mouth, from which we will create thin plastic mouth trays that fit your teeth exactly. You’ll apply the whitening gel to the trays and wear them on your teeth 30 minutes a day, twice a week, for about six weeks. While your teeth may not whiten as fast as in our office, if you wear them as directed, you’ll still see great results.

Though you may always be able to find a whitening solution in the aisle of your grocery store, remember that the best way to ensure the results you want is to get a professional treatment.

If you would like more information about teeth whitening, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Teeth Whitening.”

sealants

December 1, 2017

Filed under: Uncategorized — Spruce Ridge Dental @ 9:45 pm

Sealants are thin layers of resin that are placed on the pits, fissures, and grooves of molars to prevent decay on these surfaces.

sealants

 

The majority of decay on back teeth starts in the grooves and pits of chewing surfaces, especially during the first few years after their eruption. Sealing these surfaces with composite resins prevents this kind of decay.

More than 75% of dental decay begins in these deep grooves and pits.  Teeth with these deep grooves and pits are hard to clean and are very susceptible to decay.  A sealant protects the tooth by sealing deep grooves and pits, creating a smooth, easy to clean surface.

Sealants can protect teeth from decay for many years, but need to be checked for wear and chipping at regular dental visits.  Once a sealant leaks, they can no longer seal bacteria out and need to be replaced.

Sealants are one of the most effective methods of preventing decay on the surfaces where they are placed. Although it is still a possibility that decay may develop on surfaces in between teeth, sealants significantly reduce the overall chance of having cavities.  Keep in mind that sealants do not 100% prevent caries and that is why they work most effectively when combined with regular flossing and brushing at home, and regular visits to the dentist’s office for cleaning, fluoride treatment and regular check ups to monitor the sealants and catch decay early.

We are a full service dental office for children and adults.

Dental bridges

November 30, 2017

Filed under: Uncategorized — Spruce Ridge Dental @ 3:34 pm

A dental bridge, otherwise known as a fixed partial denture, is a prosthesis used to replace missing teeth and is not removable by the patient. A prosthesis that is removable by the patient is called a removable partial denture.

Dental bridges

A dental bridge is fabricated by reducing the teeth on either side of the missing tooth or teeth by a preparation pattern determined by the location of the teeth and by the material from which the bridge is fabricated. In other words the abutment teeth are reduced in size to accommodate the material to be used to restore the size and shape of the original teeth in a correct alignment and contact with the opposing teeth.

The materials used for the bridge include gold, porcelain fused to metal, or in the correct situation porcelain alone. The amount and type of reduction done to the abutment teeth varies slightly with the different materials used. The recipient of such a bridge must be careful to clean well under this prosthesis.

When restoring an edentulous space with a fixed partial denture that will crown the teeth adjacent to the space and bridge the gap with a pontic, or “dummy tooth”, the restoration is referred to as a bridge. Besides all of the preceding information that concerns single-unit crowns, bridges possess a few additional considerations when it comes to case selection and treatment planning, tooth preparation and restoration fabrication.

Case selection and treatment planning

When a single tooth requires a crown, the prosthetic crown will in most instances rest upon whatever tooth structure was originally supporting the crown of the natural tooth. However, when restoring an edentulous area with a bridge, the bridge is almost always restoring more teeth than there are root structures to support. For instance, in the photo at right, the 5-unit bridge will only be supported on three abutment teeth. In order to determine whether or not the abutment teeth will be able to support a bridge without a virtually guaranteed failure due to lack of proper support from the remaining root structures, the dentist should employ Ante’s rule, which states that the roots of the remaining abutment teeth must possess a combined total surface area in three dimensions more than that of the missing root structures that are to be restored with the bridge. When the situation yields a poor prognosis for proper support, double abutments may be required to properly conform to Ante’s rule.

When a posterior tooth that is intended to become an abutment tooth already possesses an intracoronal restoration, it might be in order to make that bridge abutment into an inlay or an onlay, instead of a crown. However, this may concentrate the torque of the masticatory forces onto a less enveloping restoration, thus making the bridge more prone to failure.

In some situations, a cantilever bridge may be constructed to restore an edentulous area that only has adequate teeth for abutments either mesially or distally. This must also conform to Ante’s rule but, because there are only abutments on one side, a modification to the rule must be applied, and these bridges possess double abutments in the majority of cases, and the occlusal surface area of the pontic is generally decreased by making the pontic smaller than the original tooth.

Tooth preparation

As with preparations for single-unit crowns, the preparations for multiple-unit bridges must also possess proper taper to facilitate the insertion of the prosthesis onto the teeth. However, there is an added dimension when it comes to bridges, because the bridge must be able to fit onto the abutment teeth simultaneously. Thus, the taper of the abutment teeth must match in order to properly seat the bridge; this is known as requiring parallelism among the abutments. When this is not possible, due to severe tipping of one of more of the abutments, for example, an attachment may be useful, as in the photo at right, so that one of the abutments may be cemented first, and the other abutment, attached to the pontic, can then be inserted, with an arm on the pontic slipping into a groove on the cemented crown to achieve a span across the edentulous area.

Restoration fabrication

As with single-unit crowns, bridges may be fabricated using the lost-wax technique if the restoration is to be either a multiple-unit FGC or PFM. As mentioned in the paragraph above, there are special considerations when preparing for a multiple-unit restoration in that the relationship between the two or more abutments must be maintained in the restoration; that is, there must be proper parallelism in order for the bridge to be able to seat properly on the margins. Sometimes, the bridge does not seat, but the dentist is unsure whether or not it is only because the spacial relationship of the two or more abutments is incorrect, or whether the abutments do not actually fit the preparations. The only way to determine this would be to section the bridge and try in each abutment by itself. If they all fit individually, it must have simply been that the spacial relationship was incorrect, and the abutment that was sectioned from the pontic must now be reattached to the pontic according to the newly confirmed spacial relationship. This is accomplished with a solder index.

The proximal surfaces of the sectioned units (that is, the adjacent surfaces of the metal at the cut) are roughened and the relationship is preserved with a material that will hold onto both sides, such as GC pattern resin. With the two bridge abutments individually seated on their prepared abutment teeth, the resin is applied to the location of the sectioning to re-establish a proper spacial relationship between the two pieces. This can then be sent to the lab where the two pieces will be soldered and returned for another try-in or final cementation.

 

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#20 - 4 Spruce Ridge Drive, Spruce Grove, AB T7X 4S3 CA
Dr. Mark Southwood Spruce Grove, AB dentist. (780) 962-5538 (780) 962-4485 spruceridgedental@hotmail.ca