This is a common question my patients ask me at my Sydney CBD practice on a daily basis.  Or patients approach me, wanting to know how they can replace a denture, which they have worn for many years, with permanent and natural looking teeth.

There are two main options to fill gaps in the mouth here at MLC Centre Dental. These two options are Bridges and Dental Implant supported crowns.

A Bridge is literally like a bridge across a river.  It uses two pylons (the teeth either side of the gap) and then a false tooth joins the two pylons together. The Bridge looks and feels the same as natural teeth and functionally is as good as natural teeth.  Before the age of Dental Implants, a Bridge was the only option to fill a gap permanently.

A dental implant is a titanium fixture which is surgically placed into the bone by a specialist; this is completed at our specialist referral practice in the Sydney CBD.  The surrounding bone then bonds to the implant fixture, so in essence, the implant becomes like a new tooth root.  A new, artificially created tooth is then attached to the dental implant with a titanium screw here at MLC Centre Dental, Sydney CBD.  Dental Implants look and feel like natural teeth.  They are more solid than a bridge, and act as an independent “stand alone” tooth, which means you do not need to work on teeth either side of the dental implant for support, like the bridge alternative.

Both methods are highly successful treatment options, when carried out by a well trained and experienced Sydney CBD dentist.  There are advantages and disadvantages for either treatment modality, which should be fully discussed and understood by the patient prior to making a decision.

20 plus years ago, bridges and dentures were the only option to replace missing teeth. Bridges have the advantage of being completed within 2-3 appointments.  If the teeth either side of the gap are heavily broken down or filled then these teeth are stabilised as well by using a bridge.  If the preparation of a bridge involves teeth which are not heavily filled or broken down, you are essentially treating teeth, which ordinarily would not require treatment. In the future, if the bridge was to fail, you would then need to consider the replacement of 3 teeth, instead of 1.

The advantage single tooth dental implant replacements have over bridges is that it is a single unit, unlike a bridge, where the teeth either side need to be treated. Unfortunately implants do take longer and there is a surgical phase involved and a healing period of 3-6 months in most cases.  The surgery with modern techniques is now very straight forward and discomfort levels are quite minimal post surgery, most of my patients feel comfortable to return to work the next day after treatment.

Not every patient is suitable for implants though, if for example, you have gum disease, this needs to be controlled prior to implants.  Also immune compromised patients e.g. diabetics, smokers and patients on bisphosphonate medication need special care and consideration.

We are seeing here at MLC Centre Dental population groups are keeping teeth for longer than previous generations. This also means in some cases, existing teeth have been heavily restored and eventually, even with the best efforts of dentists, the teeth just become structurally compromised to the point where the tooth fractures in a way that can’t be restored. This can happen under existing bridges and crowns. It is important when deciding on treatment options, to consider the long term outcomes which could involve further expense and treatment in the future.

Dental Implants are a better option than a Bridge if :

·        The gap is more than two teeth.  This usually means that the supporting “pylon” teeth are subjected to too much force and the bridge fails.

·        If the gap does not have teeth either side to use as pylons or support teeth for a bridge;

·        If the teeth either side of the gap have not been treated or minimally treated in the past.  Teeth are there strongest long term if left untreated; or

·        If there are potentially any future issues that may arise from the other teeth.  Bridges are a connected unit between three or four teeth, so if something goes wrong with one, everything then needs to be replaced.  It is always a lot simpler and cheaper in the future if you are only dealing with one tooth instead of multiple teeth.

The benefits of a Bridge are:

·        Treatment can usually be finalised within 2-3 appointments;

·        There is no surgery required;

·        If the teeth either side of the gap are heavily filled then crowning these teeth can actually improve the long term prognosis for them.  Thus, multiple issues are solved at once; and

·        If the teeth have been lost for a long period of time, then there will have been some bone and tissue loss.  Bridges can solve these issues much more easily than Dental Implants, without the need for bone or tissue grafting procedures.

Not all dentists will explore all treatment options with the patient.  If a dentist does not feel comfortable or experienced in either Bridges or Dental Implants, then there will be a natural bias in treatment recommendations towards the treatment option which the dentist is most comfortable carrying out.  Most dentists will do Bridges, but not all dentists will discuss the option of Implants with a patient.  Conversely, a dentist who places Implants will discuss all the negatives about bridges and only really recommend Implants.  It is important to find a dentist who gives the patient all options, explaining them thoroughly without any bias.  Ultimately, it is the patient who needs to be able to make the decision.

Dr Adam Alford graduated from the University of Sydney, Australia, in 2000 with honors. Dr Alford has worked extensively in Cosmetic and Implant practices in Australia and the UK. He has a special interest in cosmetics and tooth whitening. Dr Alford is the author of the article and he maintains a General Dental, Cosmetic and Implant Dental Surgery in Sydney CBD http://www.mlccentredental.com.au Webmasters are free to reprint this article provided that it is not edited, the author’s information is included, and the links are included as live links. To find out more about cosmetic dentistry please view http://www.mlccentredental.com.au/cosmetic-dentistry.php . To find out more about Tooth Whitening please view http://www.mlccentredental.com.au/tooth-whitening.php

Every dental advertisement you see mentions Cosmetic Dentistry. It is the new catch cry of the dental professional in the 21st century, but what does it really mean?

Cosmetic Dentistry or Aesthetic dentistry is a rather broad description for dental procedures that improve or enhance a patients smile and so therefore their dental appearance. Remember though, not all cosmetic dentistry needs to be expensive, or it does not mean complete ‘Dental makeovers’. A true cosmetic dentist is one that just carries out all of their treatment not only to a high functional level but also to a high cosmetic level. If you have a dentist who has cosmetic prowess then by the time you see them year in year out, and you replace fillings etc as they fail, then in the end you will have a beautiful long lasting cosmetically pleasing smile.

It is important that your dentist or any ‘Cosmetic Dentist’ asks their patients “What do you not like about the appearance of your teeth?” The reason for this is sometimes to improve or enhance a patients smile is merely a means of smoothing the chips off the front teeth and reshaping them a little whilst smoothing, this can make a dramatic effect to the appearance with out costing anything. It may be that the patient is happy with the color and shape, but just does not like one particular metal filling, once again an easy fix by just replacing the filling to a more cosmetic material, and therefore not expensive. What about if the patient does not mind the shape and position but just wants whiter teeth, another easy fix, just whiten the teeth.

Treatment plans for cosmetics should be based on what the patient has issues with not what the Dentist feels is the most ideal treatment plan, with maximum profits.

If you are looking for the ‘Cosmetic Makeover,’ which includes reshaping the smile, maybe repositioning crooked teeth, or replacing lost teeth, be careful who you pick. Explore all your options with the dentist. Remember when picking a ‘Cosmetic Dentist’ to carry the work out, cosmetic treatment is like an art form, you should always be shown a model of your teeth as they could look like, so you have control from the start. Not all ‘Cosmetic Dentists’ are good at what they do, try and see some before and after photo’s of their work. Good ‘Cosmetic Dentists’ keep copies of their work because they are proud of it, they get a kick out of transforming smiles, just like a sculptor or a painter.

When it comes to the ‘cosmetic makeover’ spending a little more on better quality materials and a better practitioner, ends up costing you less money in repairs and redoing the work later on. Be careful of dentists that want to replace all your old amalgams because they are ugly or leaking mercury into your system, its not really true, these dentists will often place ‘tooth coloured fillings’ which as just a plastic and don’t last as long as other materials available and no where near as long as the amalgams. Be guided by what you want, and what you dislike.

Dr Adam Alford graduated form the University of Sydney, Australia, in 2000 with honors. Dr Alford has worked extensively in Cosmetic and Implant practices in Australia and the UK. He has a special interest in cosmetics and tooth whitening. Dr Alford is the author of the article and he maintains a General Dental, Cosmetic and Implant Dental Surgery in Sydney http://www.mlccentredental.com.au Webmasters are free to reprint this article provided that it is not edited, the authors information is included, and the links are included as live links. To find out more about cosmetic dentistry please view http://www.mlccentredental.com.au/cosmetic-dentistry.php