When one or more teeth are damaged or missing from your smile, you face more than just aesthetic problems.
Decades of studies have linked tooth loss and decay to a wide variety of health and wellness issues, including:
- Cardiovascular disease
- Respiratory diseases
- Vascular disease
- Stomach Ulcers
- Oral Cancers
Luckily, when it comes to your health and smile, prosthodontists are here to help!
Prosthodontics is the specialized field of dentistry concerned with diagnosing, planning and executing restorations to lost or damaged teeth.
Depending on whether your teeth are cracked, chipped, fractured, decayed, or completely missing, there are a number of tooth restorations a prosthodontic dentist can use to help.
The most common restorations include:
- Tooth Fillings
- Porcelain Veneers/Dental Crowns
- Dental Bridges
- Dental Implants
In this post, we’ll help you understand the what these dental restorations are, when you might need them, and how much they cost.
Fillings are a way to restore teeth damaged by decay back to their normal function and shape.
When a dentist fills your tooth, he or she will first remove the decayed tooth material and clean the affected area.
They’ll then fill this cleaned cavity with special material to prevent further damage and decay.
Depending on the extent of damage, where the filling is located, any allergies you have, and your budget, fillings can be made from a variety of material including:
Gold fillings are well tolerated and may last for 20 years, making them a commonly recommended choice.
However, they need to be made in a laboratory and require multiple visits, making them the most expensive choice.
Amalgam or silver fillings are resistant to wear and relatively inexpensive, however their dark color makes them more noticeable so they’re not usually used in highly visible areas of the mouth.
Composite or plastic resin fillings are matched to the color of your teeth, making them ideal for places where a natural appearance is desired; they can also be mixed and placed directly into a cavity, making them a convenient choice.
However, composite fillings can chip, wear over, and become stained over time, typically lasting three to 10 years.
Like gold, porcelain fillings are made to order by a lab then bonded to the decayed tooth (after cleaning).
Unlike gold fillings, they’re made to match the color of the tooth and are resistant to staining but cost about the same.
Do I need dental fillings?
Your family dentist will usually check for cavities during your regular visits and let you know if there are any that need to be filled.
Normally this is done with a small mirror to examine the surfaces of each tooth, however they may use special instruments or if you are due for X-rays, abnormalities can be spotted here as well.
If your dentist finds a large fracture or extensive decay , they may recommend other prosthodontic procedures like crowns, dental implants, or bridges instead.
Porcelain Veneers and Dental Crowns
Dental Veneers are a thin layer of tooth-colored ceramic or composite material that’s applied over a tooth to improve its color and shape.
They’re designed to correct common problems that compromise the look and health of your smile, including discoloration, chipped or broken teeth, misalignments, and gaps.
Tooth veneers come in two types:
- Indirect: This type of veneer is made in a laboratory out of either porcelain or resin. Resin veneers are easier to apply, less invasive, and less costly, but porcelain veneers are better at resisting stains. Both options will require two visits to the dentist’s office.
- Direct: These veneers are made of composite resin applied by hand directly to your teeth. They may only require one visit and are less expensive, however they’re more time intensive and may not be as uniform as indirect veneers.
For either type, your prosthodontist will remove a small amount of enamel from your teeth to improve the bond, otherwise these procedures are minimally invasive.
Much like veneers, Dental Crowns are coverings to fix damaged or otherwise unsightly teeth.
The main difference between the two is size and thickness: whereas veneers are relatively thin (up to one millimeter), crowns are 2 millimeters or more.
Because of this, crowns are used in cases where damage is more extensive and can’t be restored with a veneer or filling.
Dental crowns are typically made of one of three materials:
- Porcelain (to match the color of your teeth)
- Gold (which is especially strong and durable)
- Porcelain-Fused-to-Metal (offers the look of porcelain with the strength of metal).
A bridge is a permanent prosthodontic structure made of two or more crowns on either side of a gap in your teeth. These “abutment teeth” anchor a false tooth (or teeth) called “pontics” that then fill the gap; these can be made from gold, alloy, porcelain, or a combination of these, while crowns are made of the materials we mentioned above.
And in some cases, dental implants are used to support the bridge instead of natural teeth; usually this is done for more extensive gaps involving 3 or more missing teeth, or in cases where abutment teeth are particularly weak.
On top of the cosmetic benefits of filling a gap in your teeth, bridges are also helpful for:
- Restoring your ability to properly chew and speak.
- Distributing the force of your bite to prevent further damage.
- Keep remaining teeth from drifting out of position.
Dental bridges come in three main types:
As we described above, these involve creating a crown for abutment teeth (or implants) on either side of a gap with one or more pontics in between. Traditional bridges are the most common and are typically made of either porcelain-fused-to-metal or ceramics.
These bridges involve the use of abutment teeth on only one side of a gap instead of two with the pontic located on the outside.
Situations where these might be used include:
- When it’s undesirable to prepare abutment teeth on both sides of the gap for aesthetic reasons.
- When no teeth exist on one side of the gap.
- When potential abutment teeth on one side of the gap are already supporting another dental prosthetic.
Because cantilever bridges increase the amount of strain on abutment teeth, they’re not very common due to the increased risk of damage – especially in the back of the mouth.
Maryland Bonded Bridges
Also known as a “Resin-bonded bridge” or simply a “Maryland bridge,” these bridges are made with porcelain, porcelain-fused-to-metal, or composite pontics supported by metal or porcelain “wings” on either side.
These wings are bonded to your existing teeth. Unlike other types of dental bridge, they don’t require any trimming down and crowning of otherwise healthy abutment teeth.
Getting dental bridges will typically require two trips to your prosthodontic dentist.
On the first trip, he or she will prepare the abutment teeth by removing a portion of the enamel to create room for a crown before taking impressions of these teeth and your tooth gap.
They’ll then send you home with a temporary bridge to protect your teeth and gums while your bridge is made in a dental laboratory.
On your second visit, the temporary bridge will be removed and your new bridge will be fitted.
Your dentist may have you come back for one or more visits a few weeks later to ensure the bridge fits properly, after which your bridge should last 5 to 15 years (4 to 8 years for Maryland bridges).
Dental or tooth implants serve as an artificial root for other tooth restoration techniques, either to fill a gap with a crown or bridge, or to replace a loose or severely decayed or damaged tooth.
The implant is a small titanium post that’s surgically inserted into the jawbone and becomes bonded to it as part of the healing process.
A metal abutment is attached to this implant post, on top of which a crown, bridge, or denture is placed.
Dental implant work is typically done in stages, with separate visits and costs for the implant surgery, abutment placement, and the final prosthodontic (crown, bridge, or denture).
Why get a tooth implant in addition to one of those?
The primary benefit of dental implants is their stability; dentures and bridges mounted to implants won’t slip or shift in your mouth, which is especially important for eating and speaking.
The secure fit they provide also feels more natural than conventional bridges and dentures.
The key advantages of dental implants include:
- Improved appearance
- Improved speech
- Improved comfort
- Easier eating
- Easier cleaning and improved oral health
- Increased durability
- More convenient
To receive implants, you’ll need to have healthy gums and enough bone for support.
When your dentist confirms implants an option for you, they’ll create a plan to meet your specific needs.
Next, your prosthodontist will implant one of two American Dental Association approved types of implant:
- Endosteal implants are surgically implanted directly into the jawbone. Once the surrounding gum tissue has healed, a second surgery is needed to connect a post to the original implant. Then on a third visit, the artificial teeth are attached to this post.
- Subperiosteal implants consist of a metal frame fitted to the jawbone before posts are attached to this frame, followed by the artificial tooth or teeth.
With either type of implant, the new implant healing process takes about 6 to 12 weeks before the post is added.
Once the post or posts are in place, your dentist will make an impression of your teeth from which your crown, bridge, or denture is created in a dental lab.
Dental Bridges vs. Implants
In the past, bridges were the only choice for more permanently filling gaps in teeth.
Now, a single tooth gap may be filled with a single implant and crown, which removes the need to prepare and alter otherwise healthy teeth for a bridge.
If, however, teeth adjacent to the gap will need fillings or crowns themselves a bridge might be a better choice to restore these teeth at the same time.
And if the missing tooth has been gone for a while, the gum and bone will have receded which will require additional preparation to make that area viable for an implant.
Implants also make maintaining good oral hygiene easier, as the wings that attach bridges to abutment teeth make flossing more difficult, and dentures may move while brushing, while implants can be cleaned just like normal teeth.
Dental implants are also more durable than bridges, lasting a lifetime if well maintained compared to an average of 10 years for a dental bridge.
However, implants do cost more for the initial surgery and placement – though their durability may make them more effective in the long run.
Made from porcelain, resin, acrylic and/or metal, dentures are removable plates used when most or all of your teeth are missing.
Conventional dentures are held in place by suction and/or dental adhesive, though they can also be supported by implants as we mentioned above; dentures secured by dental implants are still removable (compared to crowns or bridges, which are not).
As the name suggests, these are used when all teeth are missing, or when your prosthodontist will remove any remaining teeth due to extensive damage, decay, or weakness.
Complete dentures can either be “conventional” or “immediate.”
Conventional dentures are made after all teeth are removed and your gum tissue has begun to heal; they’re ready for placement about 8 – 12 weeks after this initial surgery.
Immediate dentures are made in advance of any tooth removal surgery and can be placed right away, allowing you to have teeth during the healing period.
However, your bones and gums will shrink during the healing process, which means immediate dentures require more adjustments than conventional ones to ensure a proper fit.
These also fill a smaller gap in your teeth, much like a dental bridge, the difference being partial dentures are removable, whereas bridges are attached and remain in place.
Which Tooth Restoration is right for me?
Now that we’ve covered the most common prosthodontic procedures used to restore teeth, which one is best for your needs?
Here are some general guidelines:
- If most of your tooth or teeth are intact but require some minor fixing, fillings are ideal.
- For lighter external damage, porcelain veneers can restore normal function and look.
- For more extensive damage to a single tooth, dental crowns are best.
- For filling a single gap in your teeth, bridges offer a cost-effective, while implants offer a more secure and permanent solution that preserves surrounding healthy teeth.
- For larger gaps, bridges and implants offer a more permanent solution, while removable partial dentures are lower in up-front cost.
- If all your teeth need to be replaced, full dentures are the most common option, though implant-secured dentures offer a better fit for a premium.
Need a Prosthodontic procedure?
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If you are in need of dental implants in Rockville Maryland, our wonderful staff will take your call, schedule an appointment, and warmly greet your during every appointment with us. We look forward to hearing from you!
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