Durable as well as life-like, dental implants are by far the preferred method for replacing missing teeth. But they can be costly and, although not as much, so can traditional bridgework. Is there an effective but more affordable means to replace a few missing teeth?

There is: a removable partial denture (RPD). In fact, RPDs have always been the less expensive alternative to bridgework and implants. Today's RPDs are usually made of vitallium, a strong but lightweight metal alloy. Because of the metal's characteristics, we can create an appliance that precisely matches the contours of your gums, is thin and hardly noticeable. We anchor prosthetic (false) teeth made of porcelain, resins or plastics in acrylic or nylon that resembles gum tissue.

The most important aspect of an RPD is to design it to produce the least amount of movement in your mouth as you eat or speak. A good design will minimize pressure on both the underlying bone (which can accelerate bone loss) and on the remaining teeth that support the RPD. Although a little more costly, it may be advantageous to use a dental implant to stabilize a lower partial denture when no end tooth is available for support.

To get the most out of your RPD — and to prevent dental disease — it's important for you to practice diligent daily hygiene. RPD attachments can make remaining teeth more susceptible to plaque accumulation, a thin film of bacteria and food particles that can cause tooth decay and periodontal (gum) disease. To avoid this you should remove the RPD and thoroughly brush and floss your remaining teeth. You should clean the RPD every day with recommended cleansers. You should also take it out at night while you sleep to discourage further bacterial or fungal growth.

Besides daily care for your RPD and natural teeth, be sure to visit us for cleanings and checkups at least twice a year. Taking care of both your appliance and your mouth will help ensure your RPD serves you for many years to come.

If you would like more information on removable partial dentures or other restoration options, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Removable Partial Dentures: Still a Viable Tooth-Replacement Alternative.”

Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.

“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…

For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.

When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.

A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.

But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.

Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!

If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”