In real life he was a hard-charging basketball player through high school and college. In TV and the movies, he has gone head-to-head with serial killers, assorted bad guys… even mysterious paranormal forces. So would you believe that David Duchovny, who played Agent Fox Mulder in The X-Files and starred in countless other large and small-screen productions, lost his front teeth… in an elevator accident?

“I was running for the elevator at my high school when the door shut on my arm,” he explained. “The next thing I knew, I was waking up in the hospital. I had fainted, fallen on my face, and knocked out my two front teeth.” Looking at Duchovny now, you’d never know his front teeth weren’t natural. But that’s not “movie magic” — it’s the art and science of modern dentistry.

How do dentists go about replacing lost teeth with natural-looking prosthetics? Today, there are two widely used tooth replacement procedures: dental implants and bridgework. When a natural tooth can’t be saved — due to advanced decay, periodontal disease, or an accident like Duchovny’s — these methods offer good looking, fully functional replacements. So what’s the difference between the two? Essentially, it’s a matter of how the replacement teeth are supported.

With state-of-the-art dental implants, support for the replacement tooth (or teeth) comes from small titanium inserts, which are implanted directly into the bone of the jaw. In time these become fused with the bone itself, providing a solid anchorage. What’s more, they actually help prevent the bone loss that naturally occurs after tooth loss. The crowns — lifelike replacements for the visible part of the tooth — are securely attached to the implants via special connectors called abutments.

In traditional bridgework, the existing natural teeth on either side of a gap are used to support the replacement crowns that “bridge” the gap. Here’s how it works: A one-piece unit is custom-fabricated, consisting of prosthetic crowns to replace missing teeth, plus caps to cover the adjacent (abutment) teeth on each side. Those abutment teeth must be shaped so the caps can fit over them; this is done by carefully removing some of the outer tooth material. Then the whole bridge unit is securely cemented in place.

While both systems have been used successfully for decades, bridgework is now being gradually supplanted by implants. That’s because dental implants don’t have any negative impact on nearby healthy teeth, while bridgework requires that abutment teeth be shaped for crowns, and puts additional stresses on them. Dental implants also generally last far longer than bridges — the rest of your life, if given proper care. However, they are initially more expensive (though they may prove more economical in the long run), and not everyone is a candidate for the minor surgery they require.

Which method is best for you? Don’t try using paranormal powers to find out: Come in and talk to us. If you would like more information about tooth replacement, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Crowns & Bridgework,” and “Dental Implants.”

If there was an “Unsung Hero” award for dental procedures, the root canal treatment would win hands-down. Much aligned in popular culture, today’s root canal treatment is actually a valuable tool for saving teeth that would otherwise be lost. And contrary to popular belief, root canal treatments don’t cause pain — they relieve it.

To help you understand its true worth, here are some common questions and answers about the root canal treatment.

What problem does a root canal treatment fix?
A root canal treatment stops a bacterial infection that has invaded the innermost part of a tooth — the pulp — and is advancing toward the end of the root through small passageways known as root canals. Most people first notice the problem as a sharp pain in the affected tooth that may suddenly dissipate in a few days. The infection has attacked the inner pulp tissue, rich in nerve fibers; when the nerve fibers die they stop sending pain signals. The infection, however, hasn’t died: as it advances, you may then begin to experience pain when you bite down or when you encounter hot foods. You may also notice tenderness and swelling in nearby gums.

How does the procedure stop the infection?
A root canal treatment removes all the infected or dead tissue and cleanses the pulp chamber. We enter the pulp chamber through a small access hole created in the tooth’s biting surface. After tissue removal, we then “shape” and prepare the empty chamber and root canals (often with the aid of microscopic equipment) to be filled with a special filling. After filling, the tooth is then sealed to prevent re-infection (most often, we need to install a permanent crown at a subsequent visit for maximum protection).

How much pain can I expect during and after the procedure?
During the procedure, none — the tooth and surrounding gums are fully anesthetized before we begin the procedure. Afterward, you may experience mild discomfort for a few days that can be relieved with over-the-counter medications like aspirin or ibuprofen.

What’s the ultimate value for a root canal treatment?
The procedure can save a tooth severely damaged by the infection. Even covered by an artificial crown, a living tooth continuing to exist and function normally within the mouth is usually more conducive for optimum oral health than an artificial tooth replacement.

If you would like more information on root canal treatments, 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 “Common Concerns About Root Canal Treatment.”