Posts for: September, 2015
In real life he was a hard-charging basketball player through high school and college. In TV and the movies, he has gone head-to-head with serial killers, assorted bad guys… even mysterious paranormal forces. So would you believe that David Duchovny, who played Agent Fox Mulder in The X-Files and starred in countless other large and small-screen productions, lost his front teeth… in an elevator accident?
“I was running for the elevator at my high school when the door shut on my arm,” he explained. “The next thing I knew, I was waking up in the hospital. I had fainted, fallen on my face, and knocked out my two front teeth.” Looking at Duchovny now, you’d never know his front teeth weren’t natural. But that’s not “movie magic” — it’s the art and science of modern dentistry.
How do dentists go about replacing lost teeth with natural-looking prosthetics? Today, there are two widely used tooth replacement procedures: dental implants and bridgework. When a natural tooth can’t be saved — due to advanced decay, periodontal disease, or an accident like Duchovny’s — these methods offer good looking, fully functional replacements. So what’s the difference between the two? Essentially, it’s a matter of how the replacement teeth are supported.
With state-of-the-art dental implants, support for the replacement tooth (or teeth) comes from small titanium inserts, which are implanted directly into the bone of the jaw. In time these become fused with the bone itself, providing a solid anchorage. What’s more, they actually help prevent the bone loss that naturally occurs after tooth loss. The crowns — lifelike replacements for the visible part of the tooth — are securely attached to the implants via special connectors called abutments.
In traditional bridgework, the existing natural teeth on either side of a gap are used to support the replacement crowns that “bridge” the gap. Here’s how it works: A one-piece unit is custom-fabricated, consisting of prosthetic crowns to replace missing teeth, plus caps to cover the adjacent (abutment) teeth on each side. Those abutment teeth must be shaped so the caps can fit over them; this is done by carefully removing some of the outer tooth material. Then the whole bridge unit is securely cemented in place.
While both systems have been used successfully for decades, bridgework is now being gradually supplanted by implants. That’s because dental implants don’t have any negative impact on nearby healthy teeth, while bridgework requires that abutment teeth be shaped for crowns, and puts additional stresses on them. Dental implants also generally last far longer than bridges — the rest of your life, if given proper care. However, they are initially more expensive (though they may prove more economical in the long run), and not everyone is a candidate for the minor surgery they require.
Which method is best for you? Don’t try using paranormal powers to find out: Come in and talk to us. If you would like more information about tooth replacement, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Crowns & Bridgework,” and “Dental Implants.”
If you’ve suffered from problems with your jaw joints, known collectively as temporomandibular disorders (TMDs), then you know how uncomfortable and painful they can be. You may also have heard about the use of Botox injections to ease TMD discomfort.
Before you seek out Botox treatment for TMD, though, you should consider the current research on the matter. Far from a “miracle” treatment, the dental profession is still undecided on the effects of Botox to relieve TMD pain symptoms — and there are other risks to weigh as well.
Botox is an injectable drug with a poisonous substance called botulinum toxin type A derived from clostridium botulinum, a bacterium that causes muscle paralysis. The Food and Drug Administration (FDA) has approved small dose use for some medical and cosmetic procedures, like wrinkle augmentation. The idea behind its use for TMD is to relax the muscles connected to the joint by paralyzing them and thus relieve pain.
The FDA hasn’t yet approved Botox for TMD treatment, although there’s been some use for this purpose. There remain concerns about its effectiveness and possible complications. In the first place, Botox only relieves symptoms — it doesn’t address the underlying cause of the discomfort. Even in this regard, a number of research studies seem to indicate Botox has no appreciable effect on pain relief.
As to side effects or other complications, Botox injections have been known to cause pain in some cases rather than relieve it, as with some patients developing chronic headaches after treatment. A few may build up resistance to the toxin, so that increasingly higher dosages are needed to achieve the same effect from lower dosages. And, yes, Botox is a temporary measure that must be repeated to continue its effect, which could lead to permanent paralyzing effects on the facial muscles and cause muscle atrophy (wasting away) and even deformity.
It may be more prudent to stick with conventional approaches that have well-documented benefits: a diet of easier to chew foods; cold and heat applications; physical therapy and exercises; pain-relief medications and muscle relaxers; and appliances to help control grinding habits. Although these can take time to produce significant relief, the relief may be longer lasting without undesirable side effects.