Restoring and Replacing Your Teeth

 

Dentists believe that the best teeth are your own teeth.  They will do all they can to make sure you keep your teeth.  But sometimes, a tooth is badly damaged or lost.  The good news is, there are a number of ways to restore a badly damaged tooth and replace a lost tooth.  This section is about restoring and replacing your teeth.  If you need to have a tooth (or teeth) replaced, your dentist may do it, or refer you to a prosthodontist.  A prosthodontist is a dental specialist with at least 2 years extra training in this area.  If you are having an implant, your dentist or prosthodontist may refer you to an oral surgeon (also called an oral and maxillofacial surgeon) for surgery.

Crowns

If your tooth is damaged but not lost, a crown (also called a cap) can be used to cover the damaged part of your tooth.  A crown protects your tooth from further damage.  You may need a crown if:

 - you have a root canal,

 - you have a large filling in a tooth,

 - you have a broken tooth,

 - your tooth is badly stained, not the right shape, or out of line.

Crowns can be made of different kinds of metals, porcelain, or porcelain fused to metal.  They are strong and last for about ten years if you take good care of them. 

Brush and floss your crown, just like you clean your natural teeth.

But crowns and replacement teeth may not be as strong as your natural teeth, so:

- do not bite down on hard objects,

- do not use your teeth to open or cut things,

- do not do these things with your natural teeth either.

Here's how a crown is made:

- Your dentist may make a mold (or an impression) of your tooth to fit a temporary crown.  A temporary crown protects your tooth until the final, permanent crown is ready.  Temporary crowns may not have the same shape and colour as permanent ones.

- Your dentist gives you freezing (called a local anesthetic).  He or she then files down your tooth to make room for the crown.

- Another mold (or impression) of the filed-down tooth and nearby teeth is taken.  Then the temporary crown is placed over your tooth and you are sent on your way.

- This mold is sent to a dental lab where your permanent crown is custom made.  The mold of your tooth is used to make a model.  A filling (or restoration) that is the same size and shape as your tooth is built based on the model.

- On your next visit, your dentist takes off the temporary crown and puts on the permanent one.  Your dentist checks to make sure the crown is the right fit, shape and colour.  If it is, your dentist cements the crown into place.  Your tooth will look and work very much like a natural tooth. 

These are the steps dentists most often follow in making a crown, but your tooth may need special care.  You may need orthodontic treatment or gum treatment.  It may take more than 2 visits to your dentist, or your visits may last longer.

Bridges

If a tooth is lost, it is important to replace it with a false (or artificial) tooth as soon as possible.  This will prevent the teeth that are left from drifting out of line and causing other problems. 

A bridge is also called a "fixed bridge" or a "fixed partial denture".  It can replace one or more missing teeth.  It is held firmly in place by healthy teeth on each side of the missing one(s).  You cannot take a bridge out.  It is permanent.

Here's how a bridge is made:

- The teeth on each side of the missing one(s) are prepared for crowns.

- The false tooth (or teeth) and 2 crowns are custom made in a dental lab as one piece.

- The unit is placed in your mouth.  The crowns are cemented to your 2 healthy teeth on each side of the missing one(s).

A bridge should last for about 10 years, if you take good care of it.  Your dentist will show you how to use a floss threader to floss under and around the false tooth (or teeth) in the middle of the bridge.

Dentures

There are two types of dentures: partial dentures and full dentures.  Both are made in a dental lab, based on a mold (or impression) or your mouth. 

A partial denture is also called a "removable partial denture" or a "partial".  It is made up of one or more false teeth, and held in place by clasps that fit onto nearby teeth.  You can take the partial denture out yourself, for cleaning and at night.  A partial denture may be used when nearby teeth are not strong enough to hold a bridge, or when more than just a few teeth are missing.

You need to care for a denture as carefully as you would look after your natural teeth. Here's how:

- Keep your denture clean.  Plaque builds up on a denture just like it does on natural teeth.  Unless plaque is removed from your denture, it can spread to your natural teeth and gums, causing gum disease and cavities.

- Remove your denture every night.  Brush your natural teeth and your gums carefully with a soft toothbrush.  If your tooth brush hurts you, run it under warm water to make it softer, or try using a finger wrapped in a clean, damp cloth.

- Soak your denture overnight.  It can be soaked in a special cleaner (called denture cleanser), in warm water, or in a mix of warm water and vinegar (half and half).  If your denture has metal clasps, soak it in warm water only.  Soaking will loosen plaque and tartar, so they will come off more easily when you brush.  Brush and rinse your denture before you put it back in.

- See your dentist on a regular basis.  Your mouth is always changing, so your denture will need adjusting from time to time to make sure it fits well.  If you have a partial denture, regular check-ups are important to make sure that your natural teeth and gums get the care they need.

Dental Implants

Dental implants are used to replace missing roots and support replacement teeth.  The replacement teeth may be fixed to the implant(s), or you may be able to take them out yourself. 

 Here's how an implant is done:

- Your dentist (or oral surgeon) will put a small metal post into your jawbone.

- Over time, the post will bond with the bone around it.

- The post (or implant) will act like an anchor to hold one or more false teeth in place.

Because implants stick to the bone, false teeth attached to implants look and act much like natural teeth.  But implants are NOT as strong as natural teeth.  You must brush and floss your implant(s) very carefully.  Be gentle, but make sure you brush all sides of your implant(s).  A toothbrush that has longer bristles at the tip may help clean behind your implant(s).  At least once a day, floss very carefully.  You will need to be gentle with the floss where the implant meets the gum (called the gumline).  You may find a floss threader useful to clean this area.

Implants are not for everyone.  You must:

- be in good general health,

- have healthy gums,

- have enough bone in your jaw to support the implant(s).

It's normal for bone to shrink if it no longer has teeth to support.  Because an implant sticks to the bone, the bone is less likely to shrink.  But if you have been missing teeth for some time, you may have lost bone.  A bone graft can build the bone so it can support an implant.  When a bone graft is done, bone is added to the area where your jaw bone has shrunk.  Your dentist or dental specialist will tell you if this can be done in your case.

You must also be willing to:

 - see your dentist or dental specialist several times until the work is done and

 - take very good care of your implant(s).

In addition, implants can cost more than other kinds of replacement teeth.