Posts for: May, 2013
The lengths that some comedians will go to for a laugh! Actor Ed Helms, as dentist Stu Price, pulled out his own tooth in the movie The Hangover. Or did he? Turns out Helms really is missing a tooth, which never grew in. When he was in his late teens, he received a dental implant to make his smile look completely natural.
Helms told People magazine he wasn't exactly eager to remove the implant crown that had served him so well for almost 20 years, but there was no better way to do the famous tooth-pulling scene.
“We started to do different tests with prosthetics and blacking it out and nothing worked,” Helms told the magazine. Helms' dentist said it would be okay to take the implant crown out. “My dentist was really into it,” Helms said. The rest is movie history!
Congenitally missing (“con” – together with; “genital” – relating to birth) teeth are inherited and actually quite common. More than 20% of people lack one or more wisdom teeth, for example. These would not usually be replaced if missing (in fact, wisdom teeth are often removed) but it's a more serious issue when the missing tooth is in the front of the mouth — and not just for aesthetic reasons.
When a particular type of tooth is missing, it disrupts the pattern and function of the teeth. If left alone, sometimes the existing teeth will shift to close the gap. It's like removing a brick from an arch — the rest of the bricks would fall together in a different formation (or collapse entirely). And when upper and lower teeth don't come together properly, they can't function well.
The best treatment for this type of situation is the one Ed Helms had: a dental implant. They look and function like real teeth and do not attach to or damage adjacent teeth as other tooth-replacement options might.
It is important that a child with a congenitally missing tooth wait until jaw growth is complete — different for every person but usually in the late teens — before getting an implant. Otherwise, the artificial tooth might eventually appear too short when the person has stopped growing. In the meantime, there are temporary tooth replacements that can be made.
If you would like more information about options for congenitally missing teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “When Permanent Teeth Don't Grow.” Dear Doctor also has more on “Teenagers & Dental Implants.”
A “crown” or a “cap” is the term used to restore a decayed or broken tooth that needs to be completely encased to protect the tooth beneath it. A crown's dual purpose is to restore the tooth's form and function. Decades ago gold was the material of choice for a crown. What we ultimately choose depends on a particular crown's requirements with regard to the tooth's appearance and function, and to some extent what you want.
Gold: Gold crowns last the longest and wear the best (at about the same rate as natural teeth), but they are not used as frequently today, especially if they are visible in a person's smile. Gold crowns are made of cast gold, a technique that has been in use for over a hundred years. They can last for decades, and have been known to last 50 years or more. They tend to cost less per tooth than porcelain or other materials.
All-Porcelain: “All porcelain” crowns have a natural appearance and as technology improves they are gaining popularity. Dental porcelains are composed of ceramic substances that are variations of glass. This gives them their translucent, lifelike appearance — but it makes them brittle and subject to fracture. Therefore all-porcelain crowns may not be a good choice for back teeth because they frequently fail under the biting forces applied during chewing and especially adverse habits like tooth clenching or grinding. Porcelain crowns are made of material that doesn't wear. Consequently, it can cause excessive wear to the teeth they bite against.
Porcelain-Fused-to-Metal (PFM): PFM crowns have been in use for more than 40 years. They combine a substructure of gold or platinum for strength and have porcelain “facings” for the visible surfaces. In some ways they combine the best of both worlds, but they do have some problems; the metal can show through the porcelain, detracting from its life-like appearance. These crowns can have a functional lifespan of about 20 years or more.
New and Future Materials: Newer “pressed-ceramic” restorations and computer-milled ceramics have received good reviews for aesthetics and service. These new materials are being intensively researched. Initial results look good, but we'll have to see how they last over time.
Contact us today to schedule an appointment or to discuss your questions about crowns and other dental restorations. You can also learn more by reading the Dear Doctor magazine article “Gold or Porcelain Crowns?”