Posts for: March, 2016
One of the most common and anguish-filled birth defects is a cleft lip or palate (roof of the mouth). Not only do clefts disrupt the normality of a child’s facial appearance, they can also lead to problems with chewing, speech and the long-term health of teeth and gums.
A cleft is a tissue gap that occurs during fetal development, usually in the first trimester, in which parts of the baby’s face fail to unite. Why this occurs is not fully understood, but vitamin imbalances in the mother, exposure to radiation or other toxic environments, or infections are all believed to play a role.
Facial clefts are classified as either incomplete, in which there is some but not full tissue fusion, or complete, with no fusion at all. A cleft can be unilateral, affecting only one side of the face, or bi-lateral, affecting both sides. During infancy a cleft can adversely affect a child’s ability to nurse, and it sometimes disrupts breathing. As the child grows, speech patterns may be severely disrupted and their teeth and bite may not develop properly.
Fortunately, there have been dramatic advances in cleft repair over the past sixty years. It’s actually a process that can span a child’s entire developmental years and involve the expertise of a number of surgical and dental specialists. For a cleft lip, the initial surgical repair to realign and join the separated tissues usually occurs around three to six months of age; repair of a cleft palate (where the gap extends into the roof of the mouth) between 6 and 12 months.
Subsequent procedures may be needed in later years to refine earlier results and to accommodate the mouth’s continuing growth. At some point the treatment focus shifts to cosmetic enhancement (which can include implants, crown or bridgework) and periodontal health, to ensure gum tissues that support teeth and gums aren’t compromised by the effects of the cleft or its treatment.
At the end of this long process, something of a miracle may seem to occur: a young person’s once disfigured mouth transforms into a beautiful smile. It’s a chance for them to gain a normal life — and a new lease on physical, emotional and oral health.
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.”