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Replace a Missing Tooth: Restorative Dentistry

We've come a long way from the "yank 'em" philosophy of early dentistry, before techniques and materials gave us the wherewithal to save teeth. These days, there's rarely a case we can't salvage. It's a good time for dentists - saving teeth is why we get up in the morning.

The way we see it, a missing tooth is more than just a hindrance to normal chewing, more than a cosmetic bother. It's a threat to the entire architecture of your mouth.

The mouth is dynamic. Where there is a missing tooth, neighboring teeth drift, gum disease may crop up, even the unprotected bone ridge is susceptible to damage.

So we replace the missing tooth with a dental bridge, or rescue a broken down tooth with a dental crown.

Bridges are partnered with crowns to resolve gaps left by missing teeth. The idea is to replace teeth with false, or "pontic" teeth, anchored to crowns at either end, and fixed in place. Quality bridgework looks and feels very natural, one of dentistry's mainstays and our first restoration choice whenever possible.

Partial dentures, too, are dependent on your remaining teeth for support, but are attached by clasps or "precision attachments." Complicated partials can be engineering marvels, filling in for missing teeth on both sides of the dental arch. The success of partials depends in part on the strength of attachment teeth.

Complete dentures are not the end of the line, dentally speaking. A good, well-fitting denture can come close to a full complement of teeth, and contribute to a youthful aspect, as well.

Dental implants are the newest remedy for missing teeth, to replace a single tooth, or to support an overdenture. People who have implants all agree: why didn't I do this sooner?

Replace missing teeth with cosmetic dental work? Do it. Restorative dentistry has a way.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

Types of Tooth Crowns

Most dentists will agree that the tooth crown is at the heart of general dentistry. They've all studied dental crowns in dental school, and some have done their best work replacing a missing tooth and saving the rest.

Research has given them the wherewithal to achieve virtually ideal restorations. They are natural looking, comfortable and stable in the moist environment of the mouth. Cosmetic dentistry professionals are better equipped now more than ever to build strong, long-lasting and cosmetically superior dental crowns.

What is a dental crown?

A crown (or cap) is a restoration placed over broken teeth or a cracked tooth that cannot sustain a conventional filling. By covering the biting surfaces and sides of the tooth, a dental crown strengthens the damaged tooth by binding together the remaining structures. There are basically three kinds of full-crown restorations that can be placed by your cosmetic dentist, each with pros and cons, depending on your situation.

A gold crown or metal alloy crowns have the longest track record for durability, but some people object to the look of metal.

A full porcelain crown - and its new ceramic cousin - looks wonderful and fits well; however, porcelain crowns are usually best on front teeth where stress is not so great.

Porcelain-fused-to-metal dental crowns are our loyal work-horses for single-tooth restoration - they're very strong.

There are elements of finesse in the creation of any crown. The fit is the thing. The teeth must be prepared with opposing teeth in mind so a good bite won't go bad after the crown is placed. The fit must accommodate adjacent teeth, too. And the "margin," the part of the crown nearest the gum, must fit smoothly to protect the health of gum tissue.

And all this effort is to one end: to save a tooth.

When is a dental crown called for?

• A tooth that has been filled more than once cracks, breaks off, or falls victim to secondary caries - a cavity under or around a filling.
• You've had root canal treatment on a molar, and it's prone to brittleness.
• A tooth has suffered severe enamel wear.
• The high school hockey star takes a blow in the mouth, and an otherwise sound tooth is broken.
• You need an anchor for your new dental bridge.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.