In addition to pediatric and senior dental care, many of our doctors focus on different types of dental procedures. That means you and your family can receive major restorative and prosthetic treatment - including oral surgery - without being referred to outside specialists. The need for such treatment can be stressful enough without having to deal with new people, new surroundings and new policies.

If you have lost all of your natural teeth, whether from periodontal disease, tooth decay, or injury, complete dentures can replace your missing teeth - and your smile. Replacing missing teeth will benefit not only your appearance but also your health. You will be able to eat and speak - two things that most people take for granted until their natural teeth are prematurely lost.

A complete denture replaces natural teeth and provides support for your cheeks and lips. Without support from the denture, facial muscles sag, making a person appear older.

Types of Complete Dentures
There are various types of complete dentures. A conventional full denture is made and placed in the patient's mouth after the remaining teeth are removed and the gum tissues have healed. Healing may take several weeks. This method is best for making a denture that looks natural and fits well.

An immediate full denture is inserted as soon as the remaining teeth are removed. The dentist takes measurements and makes models of the patient's jaws during a preliminary visit. With an immediate denture, the denture wearer does not have to be without teeth during the healing period. However, the results are not as predictable as with a conventional full denture, and getting used to the new denture is usually more difficult.

The framework of the complete denture, called the base, is made of acrylic materials that duplicate the shade and texture of your gums. The base of the upper denture covers the palate (roof of the mouth) while that of the lower is shaped like a horseshoe to allow room for the tongue. The gum and bone tissues of the dental ridge support the denture. The base, which conforms closely to the ridge, is held in place with a thin film of saliva. In addition, the base of the upper denture creates a seal with the gums and palate and the resulting suction helps hold the denture in place. The lower denture is dependent on the cheek muscles and the tongue to help hold the denture in place. No suction can be created with a lower denture.

An implant-supported complete denture is a complete denture that is attached to several implants (artificial roots that attach directly to the jaw). This allows a more secure fit - especially for lower complete dentures. Because the denture is supported primarily by the implants, less stress is placed on the dental ridges reducing the amount of bone and gum shrinkage as time passes.

If you have a few sound individual teeth, the tooth roots may be used to support a complete denture called an overdenture once root canal therapy is performed on the teeth. Your dentist reduces the remaining teeth to just above the gumline. He will make a denture that is inserted over the roots and the gums. The roots help support the denture and preserve the ridge and gums.

What are crowns and why are they used?
A crown is a restoration that covers, or caps, a tooth to restore it to its normal shape and size. In essence, it "resurfaces" and rebuilds the tooth. Its purpose is to strengthen and/or improve the appearance of the tooth. Crowns are placed for a variety of reasons.

Crowns can:
• Restore teeth when there isn't enough tooth remaining to provide support for large fillings
• Attach bridges
• Protect weak teeth from fracturing
• Restore fractured teeth
• Cover badly shaped or discolored teeth
• Cover dental implants

Which material is the best?
Cincinnati Dental Services offers crowns made of several different materials. Both the "look" and function of a crown are considered when choosing the materials most suitable for you. Your CDS dentist will consider the tooth location, the position of the gum tissue, the amount of tooth that shows when you smile, the color or shade of the tooth, and the function of the tooth. Based on his analysis, he will recommend the type of crown that is best for you.

Crowns offered by Cincinnati Dental Services include those made of gold alloys, non-precious alloys, porcelain and other ceramic materials, resin, and combinations of these materials. Full metal crowns are stronger but not as esthetically pleasing. Porcelain and other ceramic crowns duplicate the shade and characteristics of natural tooth enamel beautifully but do not have the strength of the full metal crowns. Crowns that are made of a metal base coated with porcelain provide a good compromise of strength and appearance.

How is a crown placed?
The placement of a crown is a precision procedure. Several steps are involved, and at least two visits are usually necessary for completion. Your dentist will prepare the tooth by removing its outer portion to accommodate the thickness of the crown. If the tooth has a filling, part of the material may be left in place to serve as a foundation for the crown. If the tooth is severely broken down, a material may be bonded to the remaining natural tooth structure to serve as a foundation for the crown. After the tooth is prepared, an impression (mold) is made of the tooth. From this impression the dental laboratory technician makes an exact model of the prepared tooth, and the crown is fabricated on the model. Your dentist will place a "temporary" crown on the tooth to cover and protect it while the laboratory technician is making the "permanent" crown.

When the finished crown is ready, your dentist will remove the temporary crown and place the permanent crown after making any necessary adjustments to its shape. When the crown is in an area of the mouth that can be seen when you smile, you will be given an opportunity to view and approve of the appearance of the crown prior to permanent cementation of the crown. It is very important that you look carefully before giving your approval. Once the crown is cemented, significant changes can be made only by removing the crown and making a new one. This involves significant additional time and creates additional expense for you. Crowns are cemented with strong cements that create a chemical bond between the natural tooth and the crown.

How do I care for my crowns?
The care of a crown is the same as the care of any natural tooth. It is very important that you brush at least twice a day and floss at least once a day to remove the sticky film of bacteria known as plaque. Be sure to give extra attention to removing plaque from the area where the gum meets the tooth. If plaque accumulates along the gumline, it can cause dental decay or gum disease. It is also important to return to Cincinnati Dental Services for regular professional cleanings and examinations.

To prevent damaging or fracturing the crowns, avoid chewing hard foods, ice, or other hard objects. This is very important when crowns are made entirely of porcelain or other ceramic materials. Of course, these same precautions should be taken for your natural teeth.

What will the finished crown look and feel like?
Your CDS dentist's main goal is to create crowns that look like natural teeth and feel comfortable. To achieve this, a number of factors are considered. These include the color, occlusion or "bite," and the shape and length of both your natural teeth and artificial crown. Although your dentist may be able to accommodate your request for a particular esthetic effect, your first choice may not be possible due to technical limitations or oral health concerns. If you have a certain look in mind for your crown, please discuss it with you dentist at your initial visit.

A dental filling is a repair of the crown of a natural tooth. It replaces a portion of the tooth that is missing or unstable due to tooth decay or fracture. Teeth can be filled only when there is sufficient remaining tooth structure to surround the filling. If a cusp (point) of a back tooth or the biting edge of a front tooth is missing or if the remaining natural tooth structure is thin and weak, a crown is a better alternative for restoring the tooth to its original size, appearance, and strength.

Types of fillings
Dental fillings offered by Cincinnati Dental Services come in two basic types. Silver amalgam (metal) fillings have been used since the nineteenth century, and they remain the material of choice in some instances. Composite resin (white) materials have gained popularity during the last thirty years due improvements in their durability and appearance. These resin materials were developed for use in low stress areas of front teeth, but they are now used routinely in both front and back teeth due their increased durability.

Which type of filling is better?
It depends on the situation and your priorities. If appearance is the overriding concern, the composite resin filling material is the obvious choice. The latest resin filling materials provide beautiful results that blend with the remaining natural tooth structure and are nearly indistinguishable. Tooth colored resin fillings have been used in front teeth for years, and their use in back teeth has increased greatly in the past twenty years due to improvements in the durability of the material. Although much improved, resin fillings still do not have as much strength and resistance to wear as the silver amalgam fillings when used in back teeth. If strength and durability is more important than appearance, silver amalgam is the better choice for back teeth.

If cost is a consideration, silver amalgam fillings cost less than resin fillings. There are more steps and more time involved in placing resin fillings than similar sized amalgam fillings. The resin materials themselves are more costly and placing them is a more technique sensitive process requiring more time. If dental insurance is involved, co-payments are usually more when resin is used to fill back teeth versus when silver amalgam is used.

Another factor to consider in making the choice of materials is that some people experience a hypersensitivity to the resin materials especially when it is used in back teeth. Although your dentist will place lining materials under these resin fillings to minimize sensitivity, some people experience ongoing aching and temperature sensitivity in teeth filled with the resins. When this sensitivity occurs and when it is extreme, the only solution is removal of the resin and replacement with silver amalgam. This causes additional cost and inconvenience for the patient.

In the past decade there has been concern voiced about the safety of silver amalgam filling materials. Studies conducted by the Food and Drug Administration, the National Institute of Health, and the American Dental Association have shown this concern to be unfounded. The doctors of Cincinnati Dental Services believe that, based on the findings of these scientifically conducted professional studies, this should not be a factor when considering which filling material to use.

Other important information about fillings.
No filling material is unbreakable. Avoid chewing ice and hard foods. Avoid habits like chewing on pens, fingernails, etc.

Filling materials cannot decay, but the natural tooth structure surrounding them can. Good oral hygiene and regular professional cleanings are important in maintaining dental fillings.

If you receive a local anesthetic to make you comfortable while a tooth is being filled, do not chew or drink anything until the numbness is gone. It is very easy to accidentally bite or burn your numb tongue, cheek, or lip without realizing it.

Avoid chewing on silver amalgam fillings during the first twenty-four hours after they are placed. This filling material does not reach full strength until it sets for twenty-four hours. Resin filling materials reach one hundred percent strength immediately so there is no need to wait to chew on them.

You may notice that a tooth with a new filling is sensitive to heat and/or cold ---especially if the filling is large or deep and close to the pulp of the tooth. This sensitivity usually subsides as time passes. Over the counter pain medications that have antiinflammatory properties (ibuprofen, aspirin) will provide relief until the sensitivity subsides.

If sensitivity and aching remains or increases in intensity, this means that the bacteria in the decay may have already injured the pulp to the extent that it is unable to repair itself. This injury causes the pulp to die. If you experience this, contact our office for follow-up care.

Have you taken a look at your smile lately? Do you like what you see? Would you like to see a whiter, straighter, or more attractive smile? Cincinnati Dental Services offers a number of treatment choices to help you improve your smile.

Before you see a CDS dentist, there are some questions you should ask yourself. The answers to these questions will help you and your dentist identify elements of your smile that you do not like. They will also help clarify what you would like to see at the completion of treatment.

• When you look in a mirror, do you like the way your teeth look?
• What don't you like?
• Do you dislike the color of your teeth?
• Are there spaces between your teeth?
• Do you have any cracks or chips on your teeth?
• Are you missing any teeth?
• Do you have any crooked teeth?
• Do you feel your teeth are too long or too short?
• Are your pleased with the shapes and positions of your teeth?

Treatment Choices for a New Smile
Due to advances in materials and techniques during the past 25 years, cosmetic dentistry has made great gains. Today, there are many options for solving cosmetic dental problems. Because of these new procedures and materials, you can have more natural-looking and attractive teeth.

If you don't like the shape of your teeth, their contours can be changed for a more pleasing appearance. If the color is too dark, you can try Rembrandt Professional Whitening. Chips, cracks, or fractures can be repaired with bonding, and veneers can cover a multitude of problems like gaps, stains, poor shape, or teeth that are out of alignment. Tooth-colored materials are used to repair decay, and sealants help protect the teeth.

Less visible and "invisible" braces help improve smiles with crooked or misaligned teeth. In some cases teeth can be straightened without using braces at all. The new Invisalign system offered by CDS uses a series of clear plastic removable mouthpiece-like aligners.

Conservative options include:
Veneers - thin custom-made shells that are designed to cover the front side of teeth. Made of tooth colored materials, veneers are used to treat spaces between teeth and teeth that are permanently stained, poorly shaped or slightly crooked. They may also cover teeth that are chipped or worn.

Tooth Whitening - also called bleaching - is a procedure that brightens teeth that are discolored, stained, or have been darkened because of injury. It can be performed on living teeth or teeth that have had root canal treatment. CDS doctors provide the Rembrandt Home Whitening System that allows you to whiten your teeth in a safe, proven, and predictable manner.

Bonding - a cosmetic procedure that can improve the appearance of teeth that are chipped, broken, cracked, stained, or have spaces between them. With bonding, tooth colored materials are attached, or bonded, to a tooth surface. The process can improve unsightly stains from coffee, tea, tobacco or certain childhood medications; front-tooth spaces; and accident-induced cracks or chips. Bonding is also used to fill small cavities. It usually lasts from three to five years.

Enamel Shaping - a process of shaping, or contouring natural teeth to improve their overall appearance. When teeth are slightly crowded or uneven, or when eye teeth appear too long, enamel shaping may be used to correct the flaw.

Invisalign Orthodontics - a new orthodontic technique that moves and straightens teeth with a series of clear, plastic, removable aligners. Please see our section on "Invisalign."

Other options:
Crowns as well as tooth replacement with implants, fixed bridges, or removable bridges (removable partial dentures) can be used to improve your smile when the conservative options are not adequate to achieve the result you desire. Please see our sections on "Crowns" and "Tooth Replacement."

What is Periodontal Disease?
The word "periodontal" literally means "around the tooth." Healthy gum tissue fits like a cuff around each tooth. Where the gum line meets the tooth, it forms a slight v-shaped crevice called a sulcus. In healthy teeth, this space is usually three millimeters or less.

Periodontal disease is an infection that affects the tissues and bone that support the teeth. As the tissues are damaged, the sulcus deepens into a pocket that is greater than three millimeters. In general, the more severe the disease, the greater the pocket depth and loss of bone. The deeper pockets allow harmful bacteria to grow and make it difficult to practice effective oral hygiene. Left untreated, periodontal diseases may eventually lead to tooth loss.

What Causes Periodontal Disease?
The mouth is filled with countless bacteria. Periodontal disease begins when certain bacteria in plaque (the sticky colorless film that constantly forms on the teeth and the surfaces lining the mouth) produce toxins and enzymes that irritate the gums and cause inflammation. The resulting inflammation, which may be painless, can damage the attachment of the gums and bone to the tooth.

Good oral hygiene - brushing twice per day and flossing - helps reduce the plaque film. Plaque that is not removed regularly can harden into rough porous deposits called calculus or tartar. Tartar is not the main cause of periodontal disease, but the pores in the tartar hold bacteria and toxins, which are impossible to remove even with regular brushing. Once the hardened tartar forms, it can only be removed when teeth are cleaned professionally at the dental office.

Are There Factors That Increase the Risk of Periodontal Disease?
Yes, there are several including:
• Smoking and chewing tobacco use

• Systemic diseases such as diabetes, blood cell disorders, HIV infections, and AIDS that lower the body's resistance to infection

• Medications such as steroids, some types of anti-epilepsy drugs, cancer therapy drugs, blood pressure drugs, and oral contraceptives

• Bridges that no longer fit properly

• Defective fillings or crowns that collect plaque and bacteria

• Crowded teeth that are difficult to clean

• Puberty, pregnancy, and oral contraceptives that change the body's hormonal levels can cause the gum tissue to become more sensitive to toxin and enzymes

• Genetics may play a role in making some people predisposed to a more aggressive , severe type of periodontal disease

• Some studies have shown that periodontal disease may be passed from parents to children and between couples. Research suggests that bacteria causing periodontal diseases are passed through saliva.

How Would I Know If I Have Periodontal Disease?
Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms. That is why regular dental checkups and periodontal examinations are very important.

Several warning signs can signal a problem. While periodontal disease may begin slowly for some patients, others may develop a rapidly progressive form of the disease. If you notice any of the following, please come see us:

• Gums that bleed easily
• Red, swollen, or tender gums
• Gums that have pulled away from your teeth
• Persistent bad breath
• Pus between the teeth and gums
• Loose or separating teeth
• A change in the way your teeth fit together when you bite
• A change in the fit of partial dentures

How Can I Prevent Periodontal Disease?
A good oral hygiene routine practiced for a few minutes twice a day can help reduce the risk of developing periodontal disease and tooth decay:

Brush your teeth twice daily with a fluoride toothpaste. With thorough brushing, you can remove plaque from the inner, outer and chewing surfaces of each tooth. You CDS dentist or dental hygienist can show you a proper brushing technique.

Clean between the teeth once a day with dental floss or other interdental cleaners to remove plaque and debris from areas your toothbrush cannot reach.

If you need extra help in controlling plaque that forms above the gumline, you dentist may recommend an antimicrobial mouthrinse as an effective addition to your daily routine.

Eat a balanced diet for good general health and limit snacks.

Visit Cincinnati Dental Services regularly. Professional cleanings are the only way to remove tartar above and below the gum line.

How is Periodontal Disease Treated?
The doctors and dental hygienists at Cincinnati Dental Services take a conservative approach in treating periodontal disease. The first step is normally the cleaning of plaque and tartar from your teeth. If your gums are badly infected and/or bleed easily, your dental hygienist may do this in two steps. The first step is to remove the larger deposits from you teeth and allow you gums at least one week to begin the healing process. You will return for a second visit during which the smaller deposits will be removed and your teeth will be polished. The advantage of this approach is that it makes the process more comfortable for you because your gums are allowed to partially heal before cleaning the more sensitive areas. At the second visit, your gums will no longer bleed as easily and interfere with the dental hygienist's ability to detect and remove the smaller, less visible deposits.

If periodontal disease has progressed into the more advanced stages, and tartar deposits have extended to the areas on the root surfaces under the gums, it is necessary to give a local anesthetic to make you more comfortable while the root surfaces are cleaned. This ensures your comfort while the dental hygienist does a thorough job of removing the tartar and smoothing the root surfaces. This is generally accomplished by treating one fourth of your mouth per visit (one side of the upper or lower jaw). After all areas are treated and time has been allowed for healing, your dentist will reexamine you to check your progress. If he determines that your teeth and gums have not returned to good health, he will arrange for additional treatment such as gum surgery to help you achieve this goal.

You may be aware that if one of your teeth becomes injured or diseased, it can be saved through a specialized procedure known as root canal (endodontic) treatment. What you might not realize, however, is the very important role that you play in helping ensure that this process is completed successfully. To help you understand the steps involved in endodontic treatment, we have answered some of the most frequently asked questions about root canal treatment.

Who Performs Root Canal Treatment?
Many of the general dentists on the CDS staff perform root canal treatment. For more difficult cases, we are also fortunate to have a root canal specialist (endodontist) on our staff. His name is Dr. Harish Malyala. Dr. Malyala received both his Doctor of Dental Surgery Degree and his endodontic training at the New York University College of Dentistry. His specialty training consisted of two years of advanced study in endodontics at NYU.

What is Root Canal Treatment?
Root canal treatment involves the removal of the tooth's pulp, a small thread-like tissue that was important for tooth development. The pulp is the soft tissue that contains the blood vessels, nerves, and connective tissue of a tooth. It lies in a canal that runs through the center of the dentin---the hard tissue on the inside of the tooth that supports the outer layer of tooth enamel. The crown (the portion of the tooth visible above the gums) contains the pulp chamber. The pulp extends from this chamber down through the root canal to the tip of the root that lies in the jawbone. Teeth have only one pulp chamber but may have more than one root and several canals.

Why Might The Dental Pulp Need To Be Removed?
If the pulp is diseased or injured and unable to repair itself, it loses its vitality. The most common causes of pulp death are a deep cavity, a crack, or traumatic injury to the tooth. All of these can allow bacteria and their products to leak into the pulp. If the injured or diseased pulp is not removed, the tissues surrounding the root of the tooth can become infected and an abscess can form. This usually results in pain and sometimes swelling. Even if there is no pain, certain substances released by the bacteria can damage the bone that anchors the tooth in the jaw. Without treatment, the tooth may have to be removed.

What Does The Treatment Involve?
Treatment involves one or more visits. There are several steps in the process of root canal treatment that your general dentist or endodontist (root canal specialist) will perform. At various stages, your follow-up will be needed to help ensure a successful outcome.

What Are The Steps In The Process of Saving The Tooth?
First, local anesthesia is given so that you will be comfortable during treatment. After you feel numb, an opening is made through the crown into the pulp chamber.

The pulp and its remnants are then removed carefully from both the pulp chamber and the root canal(s). The root canal(s) is cleaned and shaped to a form that can be filled and sealed.

In some cases, the root canal treatment is completed in one visit. In theses cases, the root canal(s) is filled with a biocompatible material, usually gutta percha, and then sealed. In other cases, however, a temporary filling will be placed in the crown opening to prevent saliva from getting into the chamber and root canals, and the root canal(s) will be filled at the next visit.

You might be given antibiotics if infection is present and has spread beyond the end of the root(s). Your doctor may also recommend or prescribe medication to alleviate discomfort if he predicts it will take some time for the tooth to become comfortable. If your dentist has prescribed medication, use it only as directed. If you have any difficulties with the medication, call our office. It is also important to follow your dentist's directions regarding scheduling your next dental appointment.

In the final step, a crown (see section on "Crowns") is usually placed over the tooth. The crown covers the tooth to restore it to its normal shape and size. Its purpose is to strengthen the tooth and improve its appearance. If an endodontist performs the root canal treatment, he will recommend that you return to your general dentist for the crown. Be sure to follow the recommendation from your general dentist or endodontist and schedule this final step as soon as possible.

How Long Will The Restored Tooth Last?
As long as the root(s) of a treated tooth is nourished by the tissues around it, your tooth can remain healthy. However, the tooth could still become decayed, so good oral hygiene at home and regular dental exams are necessary to help prevent both tooth decay and gum disease.

If you are missing one or more teeth (but have some natural teeth remaining) and you wish to eat your favorite foods, increase your ability to chew, and improve your appearance, speech, and self-esteem, Cincinnati Dental Services offers several solutions. All of your teeth work together to help you chew, speak, and smile. When teeth are missing, these things become more difficult. Even the loss of a back tooth may cause your mouth to shift and your face to look older. Teeth adjacent to the missing tooth space can drift and cause your remaining teeth to come together without intermeshing correctly. This may lead to joint and muscle problems and headaches. A person who has missing teeth puts unnatural wear and stress on his remaining teeth when they are forced to do the added work of the teeth that are missing.

Fortunately, missing teeth can be replaced. The technology and the materials available for tooth replacement have evolved rapidly in the past decade. Implants, an option that was in its infancy twenty-five years ago, have moved into mainstream as dependable, natural, comfortable replacements for lost teeth.

Choosing the correct treatment is very important. The doctors of Cincinnati Dental Services can provide any of three options for tooth replacement---depending on your needs and the best way to meet them.

Implants
A dental implant is much like a natural tooth and is the current state of the art method for replacing teeth. A natural tooth has a root portion that is anchored in your jawbone. It is topped by a crown (the part of the tooth that you can see). When you need an implant, your dentist inserts a metal post beneath your gum and into the bone. It fuses to the bone in your jaw and acts like the root of the tooth. Your dentist attaches a replacement crown to the metal post. This crown is designed to blend with the way your natural teeth look and feel. Implants can also be fitted with special posts that can be used as anchors for dentures.

Most of our patients find that an implant is secure and stable and closely replicates the look and feel of a natural tooth. Implants, however, are not an option for everyone. Because implants require minor surgery, patients should be in good health and have healthy gums. Smoking makes the likelihood that an implant will fail much greater. In addition, patients who choose implants must either have adequate bone to support the implant or be good candidates for surgery to build up the area needing the implant. Patients who have implants must be committed to maintain very good oral hygiene and having regular dental check-ups.

How are implants placed?
First, minor surgery is performed to place the root portion of the implant in your jaw bone. Following this placement, up to six months of healing time may be required for the bone to grow around the implant and hold it firmly in place. In some cases your dentist may use a technique that allows immediate use of the implant. Some implants require a second step in which a post is attached to connect the replacement crown. With some implants, the implant and post are one unit placed in the mouth during the initial surgery.

After healing and stabilizing of the root portion, the replacement crown is made and fitted to the post portion of the implant.

At Cincinnati Dental Services, the placement of the root portion of the implant is done by our oral surgeon at our Mt. Auburn location. A local or general anesthetic may be used. Discomfort following the procedure is usually minimal and will be managed with oral pain medications. You will be given instructions on diet and home care. When the root portion of the implant stabilizes, the replacement crown will be placed by the Cincinnati Dental Services general dentist you normally see.

Advantages of implants
An implant is most similar to a natural tooth
Adjacent teeth do not have to be involved in the placement procedure
Implants may decrease or help prevent shrinkage of the jawbone from tooth loss

Disadvantages of implants
Not every person with missing teeth is a good candidate for implants
Implant placement takes longer and may require more dental visits than alternative procedures

Fixed Bridges
Another alternative is a fixed bridge (sometimes called a fixed partial denture). This is a restoration that replaces or spans the space where one or more teeth have been lost. A fixed bridge is bonded or cemented into place. Only a dentist can remove a fixed bridge.

Your appearance, dental health and proper functioning of your mouth all are important reasons for wearing a fixed bridge. It helps maintain the natural shape of your face and may help support your lips and cheeks.

How is a fixed bridge attached?
A fixed bridge is commonly cemented or bonded to the natural teeth next to the space left by the missing teeth. An artificial tooth (called a pontic) replaces the lost natural tooth, and restores its function. A pontic is attached to a crown (restoration that covers a natural tooth). Crowns, which are cemented on adjacent prepared natural teeth, serve as retainers that support the fixed bridge.

Different types of fixed bridges
A fixed bridge can be attached to your natural teeth. Different types of artificial teeth may be used in fixed bridges. These include gold alloys, porcelain fused to metal, and all- porcelain.

Advantages of fixed bridges
Look, feel, and function like natural teeth
No need to remove from mouth for cleaning
Strengthen adjacent teeth if these teeth are in poor condition

Disadvantages of fixed bridges
Likely to cost more than removable bridges
Attach to adjacent teeth making preparation of these teeth a requirement

Removable Bridges
As the name implies, a removable bridge (sometimes called a removable partial denture) can easily be taken out of the mouth for cleaning. Although removable bridges generally cost less, fixed bridges may feel more stable and comfortable.

Depending on the situation, a removable bridge may be for you. Removable bridges usually have replacement teeth attached to gum-colored plastic bases connected by metal framework. They may attach to your natural teeth with metal clasps or devices called precision attachments. A claspless removable bridge, when indicated, may provide better support and appearance.

Growing accustomed to a removable bridge
Inserting and removing the new removable bridge takes some practice. Your dentist will show you the best way to do this. The removable bridge may feel awkward for the first few weeks until you become accustomed to it. Your dentist will explain how long the removable bridge should be worn and when it should be removed. He will also recommend the best methods of cleaning the removable bridge.

Removable bridges usually need adjustments by your dentist during the first weeks of wearing them. This is due to fluctuations in the contour of the ridges and gums that support it. If the bridge puts too much pressure on an area, that area will become sore, and your dentist will adjust the removable bridge so it will fit more comfortably.

Once your missing teeth are replaced, eating should be a much more pleasant experience. Since missing teeth can make it difficult to speak clearly, wearing a removable bridge can help with that, too.

Over time, as you age and your mouth changes, your removable bridge may no longer fit well. It also could break, crack, chip, or one of the teeth could loosen. Cincinnati Dental Services has our own dental laboratory. Our laboratory technicians can often make repairs or reline the removable bridge and return it to you the same day. More complicated repairs may take longer.

Advantages of a removable bridge over a fixed bridge
Usually easier to repair
Usually less expensive

Disadvantages
Removable bridges can be less stable than alternative choices
They can break or be lost
They must be removed to clean them and your remaining teeth every time you eat
Some people find removable bridges uncomfortable and do not tolerate them well
Some people are embarrassed to take out their teeth for cleaning

Explore all your options
Your Cincinnati Dental Services dentist will be happy to discuss your options for tooth replacement with you and answer any questions you may have. Your dentist can recommend the best option for you and show you examples of each alternative.