Archive for August, 2008

What can be done with canine tooth way out of line?

Wednesday, August 20th, 2008

Thank you for your web site. I have read a lot of it and you have some tremendous information here for visitors!

I have a complicated situation. I’m 34, and my upper left canine never came in right. It’s in between the two bicuspids and in front of them. The baby canine is decaying and doesn’t have much root left, so it needs to come out, which will leave a space there. But the orthodontist says that because of the structure and positions of the roots of the other teeth, the permanent canine can’t be moved into that space.

What are my options? Do I have them extract the baby canine and the permanent one and then get braces to widen the space where the baby was so a full-sized canine implant can be put in? How about a bridge there? Or can something else be done with a smaller implant plus veneers or something to create the illusion of normal teeth?
- Diana in California

Diana,
It sounds like a very interesting case. It’s tough to give an answer of what’s best for you without seeing it and a full clinical exam, but I can give you some ideas.

I would not do a mini implant. Having anything other than canine teeth where the canines are supposed to be almost always ends up looking funny. There’s a  bony prominence that’s supposed to be there, and the canines also frame the smile.

It sounds like you are going to have to have the baby canine and the permanent canine extracted. From the picture you’re giving me, it looks like any effort to move the permanent canine may move it completely out of the bone.

I would definitely lean toward an implant, based on what you’ve told me. A full-sized canine implant. If you have to move some teeth to get that done, then I’d do that, too. If you have a bridge to replace the canine, the bone will shrink in that place and you’ll lose the “canine eminence” on that side of your face.

But realize that I don’t have all the information. This is a case where you need a dentist who is expert in both cosmetic dentistry and implant dentistry to give you a thorough exam and explain your options. We’d be happy to see you here. But if you want to find someone close to home, since this treatment is going to span months, I’d look for a dentist who is accredited in cosmetic dentistry by the American Academy of Cosmetic Dentistry. I’ve been an accreditation examiner for the AACD for many years, and I have great respect for the dentists that successfully make it through that accreditation process.

Good luck.

Related links:
Teeth in an hour
Dental bridge vs implant - the pros and cons of each treatment
Tooth replacement options
Dental implant insurance

Can I get a denture with a gold crown on a tooth?

Tuesday, August 5th, 2008

I am a 50 year old denture wearer in need of new dentures. I have seen dentures that have gold crowns or other dental appliances affixed to them. I thought they made the dentures look more realistic. is this a normal practice, and where can i have dentures like this made?
- Michael in Ohio

Michael,
This is certainly doable. We can put a gold crown on one of the teeth in your denture, and any dental office with a desire to please should also be able to handle this for you. But there are a couple of points you may want to consider:

1. There are materials and methods that make the teeth in a denture look beautiful, natural, and realistic at the same time. Often what makes dentures look fake is the lower quality of teeth that are put in them, or the poor quality of pink acrylic that stains or discolors over time. And upgrading to the nicer materials could be considerably less expensive than adding a gold crown.

2. Twenty or thirty years ago, gold work and dark amalgam fillings were more common. These days, many people have ceramic crowns and white fillings, so that their dental work doesn’t show.

And, as an aside, I hope you will consider having your denture to be implant supported. Do you realize that while your denture may last twenty years, the lifespan of your jawbone may be considerably shorter? With no teeth, your body is constantly dissolving away the bone of your jaw to use those minerals elsewhere in your body. The presence of dental implants prevents this dissolving, because of what is called the piezoelectric effect. Have your dentist go over these options with you. A snap-on denture, with only two dental implants holding it in, is an economical option that will accomplish this. Otherwise, in ten or twenty years you will likely end up a dental cripple, unable to retain a denture, to eat, or to appear in public without embarrassment.

Related links:
Cost of dental implants
Teeth in an hour
How long do dental implants last?