Your leading source for cosmetic dentistry
information and referrals.

Hockey Players and Dental Implants

Posted on by .


We thank our advertisers who help fund this site.

Hi Dr Hall

My son in college is a hockey player who just lost his front tooth due to a direct hit from a hockey puck. He started the process for an implant, meaning they removed the tooth and added a plug. He was recently told by other teammates that an implant is not a good option until he finishes playing the sport because a second trauma is possible. Is an Encore Bridge or a Zirconia Maryland Bridge a good option? He wants it also for cosmetic reasons as he will be getting married later this year. He Lives in CA and would be willing to come to see you if needed.

Thanks
Geoff from California

Geoff,
Thanks for your question! I had never heard about this concern before – placing a dental implant in a hockey player, but your son’s teammates make sense. I went to the University of Minnesota Dental School. One of our oral surgery professors was official team dentist for I think it was the Minnesota North Stars hockey team at the time, and we heard a lot about hockey dental injuries. I would listen to those teammates. Getting a tooth knocked out is one thing. With that tooth anchored on a dental implant, the implant would be ripped out of the bone damaging who knows what else and requiring bone grafting on top of everything else.

There’s no harm in having the root fixture placed, but I would hold off on putting a crown on the tooth until after his hockey career is over. Meanwhile, no, a bridge is not a temporary restoration – whether it is an Encore bridge or a zirconia Maryland Bridge. A bridge requires tooth preparation on the adjacent teeth if it is placed properly. Besides, now you’re hooking three teeth together and that is going to magnify the risk to all those teeth should he have another accident.

What he needs is a removable flipper partial to tide him over. I would go to one of our recommended cosmetic dentists to get a great match of the false tooth to his other front tooth, which might require spending a little more money. Done well, no one will know it’s a false tooth.

– Dr. Hall

Do you have a comment or a question or anything else to add? We’d love to hear from you. Enter your comment below.

Click here to ask Dr. Hall a question of your own.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

An update on the Encore Bridge

Posted on by .

Dr. Hall,
I can’t find anyone in the Dallas area that knows about an Encore Bridge. Do you know anyone who does this procedure or is it outdated?
Thank you,
Nikki from Dallas


We thank our advertisers who help fund this site.

Nikki,
The Encore Bridge was never widely popular. It is very technique sensitive, meaning that many dentists weren’t doing it right, resulting in a weak bridge that might either de-bond or break. Furthermore, it was developed by master dental ceramist Uri Yarovesky of Opus One Laboratories in California, and he has been the only lab doing this procedure, to my knowledge. He may even have a patent on it.

Recently, another aesthetic alternative to the Maryland bridge has developed—the zirconia Maryland Bridge.

Zirconia is an extremely strong ceramic that has excellent optical properties. This is easier to place than an Encore Bridge. Here is a photograph of a zirconia Maryland Bridge, courtesy of Dental Arts Laboratories of Peoria, IL.
A zirconia Maryland Bridge

Some caution is still needed, however. While not as technique sensitive as the Encore Bridge, it is still technique sensitive, and unless a dentist has done several of these successfully, I wouldn’t ask him or her to do one on you. Dentists who haven’t done many tend to think that it can be placed with little or no tooth preparation, but if that is done, there is a strong tendency for the bridge to come loose. An expert cosmetic dentist who does a lot of porcelain bonding work should understand how to do this well. The best approach would probably be to ask a dentist if they have done any of these. If you can’t find an experienced dentist to do this, then I would ask for an understanding up front that if it fails that you will get your money back, or some such guarantee that will be satisfactory to you.

Uri Yarovesky, the inventor of the Encore Bridge, tells me that he has research data showing that the Encore Bridge is stronger than the zirconia Maryland Bridge because it has a greater ability to flex with tooth movement.

– Dr. Hall

Do you have a comment or a question or anything else to add? We’d love to hear from you. Enter your comment below.

Click here to ask Dr. Hall a question of your own.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

How to repair an Encore bridge

Posted on by .

Dr. Hall,

I had an Encore bridge done in 2012 and the tooth has now come off the bridge, but the back of the bridge is still attached to the gum and the other two teeth. Can the tooth be re-attached to the bridge and where can I go in CA ,or a nearby state, to have it done and at what cost since my insurance has been used already this year? It is a top tooth next to the front teeth.
– Dori from California

Dori,

The Encore bridge is tricky to do in the first place, and repairing it is even trickier. You can’t just do the bonding over again. The dentist has to thoroughly clean off all the old bonding material. Then the surface of the porcelain tooth has to be re-etched so that it will bond to the luting composite. This requires either having hydrofluoric acid, or what is called a micro-etcher, which is a mini sand blaster to treat the surface of the porcelain, or both. Cleaning off the surface of the resin framework is not as critical and that could just be scraped clean. If the porcelain is properly prepared, it should adhere to the framework. Though I wouldn’t expect it to last as long as the original. You got three years out of the first installation–I would expect less than that this time. So I’d start saving up to have a dental implant placed as a long-term solution.

(I then recommended an expert cosmetic dentist in her area. I’m not going to mention the dentist here, as it would make Dori personally identifiable. But I’m confident that the dentists I list here would have the expertise needed to do this repair.)

Dr. Hall

Note – I wrote a post about 3 1/2 years ago about the lifespan of a Maryland bridge where I included some comments about the lifespan of an Encore bridge.

Click here to ask Dr. Hall a question of your own.

We thank our advertisers who help fund this site.
.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

The lifespan of a Maryland Bridge

Posted on by .

Dr. Hall,
I am having a Maryland Bridge put in tomorrow. I keep forgetting to ask my dentist a question about it. He said it would have a lifespan of about 10 years. What happens after that 10 years? It is fixed. Does it loosen after that period of time? If it reaches it’s life span, then what happens? Thank you so much for any information that you can provide to me. I’m hoping that I’ve made the right choice, but have already been fitted and the bridge made, so there’s no turning back now.
– Theresa from New York

Theresa,

It’s confusing to people when dentists put a lifespan on dental work. The lifespan will vary so much from patient to patient, it’s hard to really say how long it will last. And it’s not entirely a question of something “wearing out,” it’s more a question of how long it will be until something goes wrong with it.

A tire has a pretty definable lifespan – the rubber wears away on the road at a certain rate, and with average driving conditions you can predict pretty closely how long it will be before the tread wears away and you need a new tire. Dental work is different. I like to compare it to a bookcase. If you have no children in the house and you just put books on it, it doesn’t get any water stains, and you use a wood polish on it periodically, a nice wooden bookcase may last 40 or 50 years and still look pretty good. But if you’re a young family with children and they are putting their drinks on it and their toys and maybe some really heavy things, it’s going to get scratched and stained and maybe in five years it will look pretty bad and be ready for replacement. That’s more like the way dental work is rather than like a tire.

A Maryland bridge is susceptible to loosening, but it depends on the stresses present in your mouth. If you have a stressful bite that tends to flex your teeth, a 10-year lifespan may be optimistic. If you don’t, it could last much longer than that. You could also get decay around the attachments, but that is going to depend a lot on your eating habits, particularly how often you snack. And then the other factor in the lifespan is the rate of staining of your natural teeth. The false tooth in a Maryland bridge is made out of porcelain, which doesn’t absorb stain like your natural teeth do. If you consume a lot of highly pigmented foods like certain berries, coffee, tea, etc., and you don’t do any bleaching of your teeth, the color mismatch could become bothersome, if this is a tooth that shows in your smile, after ten years or so.

I hope this is helpful.
Dr. Hall

(Note: What I say here about the lifespan of the Maryland bridge would apply also somewhat to the lifespan of an Encore bridge, though I would expect less lifespan out of an Encore bridge. The technique is similar – the Encore bridge is just made out of tooth-colored materials which are more flexible and thus more susceptible to de-bonding.)

We thank our advertisers who help fund this site.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

Why wasn’t I given Maryland Bridge as an option?

Posted on by .

Why didn’t my dentist mention the option of a Maryland Bridge? I only found it by an internet search.
– Deborah in Kansas

Deborah,
A Maryland Bridge doesn’t work for most cases where you have a missing tooth. Plus, some dentists don’t know how to do them, and there are technical problems with their use in that they aren’t as strong or reliable as a conventional bridge.

If you have a missing tooth, in my opinion the dentist should give you the option of either replacing it with a conventional dental bridge or with a dental implant. In some cases, a removable partial denture may be an appropriate option. Only in special circumstances would a Maryland Bridge or an Encore Bridge be an appropriate option.
– Dr. Hall

We thank our advertisers who help fund this site.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

How best to replace a front tooth – taking Fosamax

Posted on by .

I had a next to the front tooth extracted. My surgeon cautioned about an implant as I have been on fosamax for about 10 years. I am now wearing a flipper which annoys me and has a sour taste in my mouth. I read about the Encore Bridge or Maryland Bridge. The tooth next to the one pulled has a cap on it. Am I eligible for an Encore Bridge? My dentist hesitates to give a regular bridge as he would have to file down a front large tooth. Any advice?
– Susan in Massachusetts

Susan,
I have a couple of points that may be helpful.

First, taking Fosamax doesn’t mean you can’t have a dental implant. There is a slightly increased risk of serious local bone problems when you are taking Fosamax and you have oral surgery that involves the bone, which placing dental implants does. The risk is small, but the potential consequences are serious, so I wouldn’t ignore the risk. However, you can temporarily suspend taking the Fosamax and work around it, if your oral surgeon coordinates this with your physician.

If you don’t want to deal with that, then some type of dental bridge would be best. But I would leave it up to your dentist to choose the type of bridge. An Encore Bridge is a nice service and is esthetic and conservative. But I wouldn’t want you to be the first patient your dentist had ever done an Encore Bridge on. The procedure is very tricky and has some strength limitations. Stick to the types of bridges your dentist suggests, because then you can be fairly certain your dentist is comfortable doing that type of bridge.

If your dentist is a typical general dentist, I would recommend doing the conventional, tried-and-true regular bridge, filing down the front teeth like has been done millions of times before for other patients, and it works.

There is no perfect solution for you. Given the assumptions I have made in this answer, I think the conventional bridge has the smallest downside and the least risk for you.
– Dr. Hall

We thank our advertisers who help fund this site.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

Categories

Follow this blog

Get every new post delivered right to your inbox.