Dental Appliances

Losses of teeth can be due to a number of conditions, including caries, periodontal disease, or trauma, or they can be extracted if treatment fails. Missing teeth can cause cosmetic and speech problems and tooth alignment problems in the upper and lower jaws. They can also allow the remaining adjacent teeth to move.

They can be replaced by several types of dental appliances. These appliances include bridges, crowns, implants, and dentures.

Bridges, crowns, and implants

An extracted tooth can be replaced by a bridge or an implant. A crown can be placed on a badly damaged tooth.

A bridge is a partial prosthesis fixed on crowned teeth on each side of the missing tooth. It is made of false teeth fused together and then fixed on a crown placed on natural teeth. It is permanently attached and cannot be removed. Missing teeth can be replaced by more than one bridge.

A crown is a reconstruction that covers the tooth. Two sessions with the dentist are usually necessary to obtain a well-adapted crown, but sometimes more. During the first consultation, the dentist prepares the tooth by cutting it slightly, taking an impression of the tooth thus prepared, and placing a temporary crown. The final crown is then made, from the impression, in a dental prosthesis laboratory. During the next session, the temporary crown is removed and the final crown is cemented on the prepared tooth. Many dentists today use digital scanners and crown drills to allow them to design and place a crown on the same day.

Generally, crowns are made of gold, ceramic, or porcelain, fused to a metal framework. A porcelain coating can be used to mask the color of the metal. Although porcelain is harder and more abrasive than tooth enamel and can cause wear on opposing teeth, newer ceramics are less likely to cause these inconveniences. All-porcelain or comparable crowns are slightly more prone to breakage than all-metal crowns.

You can also replace missing teeth with implants... If the person does not have enough healthy bone in the jawbone, bone grafts may be performed to create adequate support for the implants. Implants are metal pieces inserted into the jawbone. Metal is a special alloy to which bone cells can attach themselves. After some time, usually 2 to 6 months, the implant fuses to the bone, and a piece is attached to it. Then an artificial tooth (a crown) is attached to this piece. The resulting tooth can handle the force of normal chewing. Implants are currently favored because they do not decay and offer a permanent solution to removable dentures. People should keep the area around the implant very clean to avoid infection.

Dental Appliances

Dental prosthesis

Full or partial dentures are useful for people who have lost all or most of their teeth. Full dentures are removable and worn by people who don't have teeth. Partial dentures are also removable and are worn by people who need to have several teeth replaced but do not have bridges or implants or do not have the financial means to do so.

Dentists make dentures with care so that they fit well and look natural. Typically, making dentures takes several months and involves a sequence of carefully timed steps. Once the dentures are fitted, people will need to see their dentist at least once a year. The shape of the mouth and jaws may change over time or as the person gains or loses weight, in which case dentures may need to be adjusted or replaced.

Dentures can improve a person's appearance and speech, but they are far from a perfect solution. They do not replace the feeling of natural teeth and restore less than 20% of the chewing ability that natural teeth provide. Dentures can also cause discomfort and affect the taste.

They must be kept in a good state of cleanliness. They should be removed after each meal and cleaned with non-whitening, non-abrasive toothpaste or baking soda, using a soft toothbrush or denture brush. The mouth must also be cleaned to remove all residues. The dental prosthesis must be removed for the night before going to bed, carefully cleaned, and put in a safe place. The denture can be soaked overnight in a rinsing solution, which is not necessary if it has been cleaned well with a toothbrush.

Problems with dentures

Sometimes the gums under dentures become red and inflamed with a fluffy appearance (ulcers under dentures). The inflammation may not be painful. People with infections caused by the Candida fungus may have ill-fitting dentures, poor oral hygiene, and excessively moving dentures, and most of the time, people who wear their dentures 24 hours a day are at increased risk of inflammation. People with fungal overgrowth have cottony spots or ulcerative sores on their gums, which can often be treated easily with medication. If the inflammation persists, the dentist may order a biopsy to screen for oral cancer and other tests to look for systemic pathologies, such as diabetes.

Correctly made, readjusted or new dentures almost always improve the situation. Better oral hygiene and more effective cleaning of dentures can also reduce tissue inflammation. For some people, it may be necessary to remove their dentures for long periods of time and use antifungal mouthwashes and denture soaks overnight. The dentist may prescribe various topical antifungals to treat yeast infection (Candida) that contributes to an inflammation under dentures.

Braces and surgery

Typically, all removable dental appliances are removed before any general anesthesia or throat surgery to prevent them from breaking or being swallowed, or inhaled into the lungs. During surgery, braces are kept in water to prevent them from changing shape. However, anesthetists (doctors who apply anesthesia during surgery) sometimes ask people not to remove their dentures in order to get an airway through better. Keeping dentures in place during a procedure also allows the face to maintain a more normal shape so that the anesthesia mask fits better and avoids any trauma to the gums inflicted by natural teeth in toothless areas.

Additional Information

This is an English resource that may be helpful. Please note that LE MANUEL is not responsible for the content of this resource.

• Mouth Healthy: This general resource provides oral health information, including nutrition and recommendations for choosing products with the American Dental Association's Seal of Approval. There are also tips for finding a dentist, and tips on how and when to see a dentist.