From Wood to Titanium: Dental Professionals’ Opinions on Tooth Replacement

As in a previous post, this week I decided to venture into the Blogosphere to see what the professionals in the dental world were discussing. A lack of “hot topics” made my search quite uneventful however I was able to find some very interesting information concerning tooth replacement. While the majority of the population will eventually lose a permanent tooth, modern dentists have come up with numerous, effective ways to replace dentition. That being said, professionals must decide what method to perform in order to restore functionality in the mouth. Common knowledge dictates that when enough teeth are missing, typically in elderly citizens, dentures (image to the right) will be used to help chew and speak. But, this begs the question as to what dentists do when the patient needing to restore their teeth is not aged, and perhaps does not need the majority of their teeth substituted. As covered previously, a common alternative is a dental implant. Conversely in the instance that a tooth is knocked out (bottom left image shows dramatization of this), and the individual was able to recover it, most experts suggest reimplantation. My interest in both dentures and reimplantation spurred a blog search for the topics, and I was able to find two current posts discussing each of the issues. The first post was entitled “Removable Partial Dentures and Complete Dentures” featured on the blog DMDstudent.com. The author is a dental student at Temple University in Arizona. The post discusses a project he is making for dental school as well as some tips on making dentures. His knowledge on the subject will give me great insight with any questions I have. The second post I discovered is called, “Intentional Reimplantation” written by Doctor Jason Hales. He discusses a real-life experience with a patient losing a tooth, and the reasoning, and success from reimplanting it. I posted insightful comments on both blogs, and have included them below for convenience.

“Removable Partial Dentures and Complete Dentures”
Comment:

First off, let me congratulate you on a wonderful blog and post. I find the information I read on your page to be incredibly helpful and valuable. As a future dental student, I am learning a lot about what it truly takes to succeed in dental school, as well as what is expected of you. In this post when you talk about how much the project you are working on will affect your grade, it gives me more insight concerning the importance of lab assignments, and what a good finished product looks like. In summary, personal articles such as this are what make me visit your blog frequently. I chose to comment on this specific post however because it brought up numerous questions which I believe you could answer. You mention when creating dentures for a patient who has several missing teeth, the keys are retention, stability, and support. Obviously, partials that meet these requirements will be successful and will help a patient thrive. I wonder though, if dentures are always the most viable option. As there is so much advancement in implant technology, will dentists make a movement towards more implants and away from dentures, or is it not worth the expense, especially for older people to substitute missing teeth with implants? If so, what are the keys to successful implants and are they similar to those of dentures? Although I do have a fair amount of dental knowledge, I still consider myself a layman in terms of this subject, and the practicality of implants over dentures. While I know that income is something that greatly effects a patient’s decision on what type of procedure they would like (for instance amalgam versus composite fillings), I am curious as to what you believe are key factors when deciding what technique to use. I find the choices that dentists and patients have to make together a very interesting subject, and was curious as to whether there is a debate on what ways teeth should be replaced. While it depends largely on age and income, what other factors can influence the decision?

“Intentional Reimplantation”
Comment:

Thank you for writing this post on a most interesting and engaging topic. While I am in no way an endodontist or even a dentist, I am hoping to become one, and this blog as well as posts similar to this one inspire me even more to succeed at my goal. As a very athletic person and a college student, I have seen young people lose or chip teeth all too often. As many of my friends know I am interested in dentistry, in turn I am constantly barraged with questions about why teeth cannot simply be “shoved back in” when they fall out. After reading the article, I can explain that factors such as the amount of time the tooth is out of the mouth, damage to the periodontal ligament, and contamination by bacteria can all affect the ability of a dentist to reimplant a tooth. As a layman I was curious about what traditional endodontic surgeries and conditions must be avoided or present in order for a professional to support intentional reimplantation. The specific incident that you address covered this in addition to being very exciting to read. It showed me that dentists are truly required to think on their feet, and that when the unexpected happens one must act quickly and calmly. The idea of being quick on your feet makes me wonder how modern the idea of intentional reimplantation is. While it seems that the process could be very old-fashioned, even back to the times where doctors worked in unclean environments, it also seems very progressive and new. This then creates a new question, whether or not the method is a viable alternative to tooth replacement by implant or bridge. Obviously, as previously mentioned, there are certain criteria for the process to take place, but are these criteria easily met? And if so, are they less specific or more specific than choosing to get an implant? Moreover, are there other factors that can affect the situation such as income and age? I seem to find that the world of dentistry has numerous ways to accomplish the same task, and I am curious in this instance which is generally superior.