Replacement of a dental bridge


I just got a chip on my porcelain bridge. I actually have an eight-teeth porcelain bridge on top and I was wondering if the one that has been damaged can be repaired?

– Linda in Oregon


Based on what you have described, your porcelain dental bridge can be repaired. Although, it does require a certain level of expertise and special training to do a nice job. It will be a similar process as placing a porcelain crown. You may want to consider meeting with a cosmetic dentist. This is because there are many techniques that are not taught in dental school that a cosmetic dentist utilizes.

Here is what you can expect. First, the area will be cleaned, rinsed, and etched to prepare it for dental bonding. If your bridge is fused to metal, than the metal will also need to be prepared. Hydrofluoric acid is one method used for etching, another method uses a microetcher. The latter uses fine aluminum oxide particles to perform the etching. This will all be localized as to not etch the surrounding areas so the glaze on the existing teeth isn’t ruined.

Next, the porcelain will need to be primed using a special agent and then it is used to coat the repair area with resin. Again if your bridge is fused to metal, it will need to be etched with a metal bonding agent. When this work is done by an expert cosmetic dentist it is very natural and life-like and the chip will not be noticeable at all.

Composite bonding resins will be the next step and they are layered to match the exact color of the other porcelain. This composite will be polished so it mimics the luster of your natural teeth.

Once it is all said and done, it would be wise to avoid smoking and excessive coffee intake so the bonding doesn’t pick up stain. Alcohol consumption will affect the lasting color as well.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Symptoms of a dental abscess

I think I may have a dental abscess. The tooth and gum have pain only when I put pressure on the tooth or press on the gum above the tooth. Is this the start of an abscess?

Thanks, Dan in Arizona

Dear Dan,

The best way to determine if you actually have an abscess forming is to have dental x-rays taken of the area. A true abscess will show up on an x-ray and your dentist will be able to properly recommend treatment for the tooth. Some abscesses start out with being pressure sensitive either by the touch of your finger or while chewing foods. As the infection progresses it becomes sensitive to temperature, more to hot then cold, however can be both. Many people complain of a dull ache throughout the day or an aching tooth that wakes them up in the middle of the night. Dental abscesses can irritate the gum causing swelling and redness. You should contact your dentist right away before you it turns into a dental emergency situation.

Sometimes patients don’t realize they have an infected tooth because the tooth infection is draining out into the mouth, eliminating many symptoms. If this is the case, a pimple-like formation will develop on the gum above or below the tooth. Even if the infection is draining in the mouth it would still have to be treated. An infected tooth left untreated over time can cause nausea, vomiting, loss of the tooth, and sometimes death.

If you have an infection your dentist will most likely put you on antibiotics to clear up the infection. Teeth become infected because the nerve in the tooth is dying. When this happens a root canal and dental crown are recommended to preserve the tooth. If patients opt out of root canal treatment the only other option would be to extract the tooth to alleviate further symptoms. Replacement options for missing one tooth include a dental implant or a dental bridge.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Broken tooth in a child.

My son is twelve years old and fell while he was riding his bike and his front tooth broke off. It was broken at the gum line. We went into an emergency dentist and they removed the root tip. I plan on seeing our regular family dentist very soon, but I was wondering if you could give me an idea of what my options are to replace my son’s missing tooth?

– Shelly in California,


Since the remaining root was removed at the emergency dentist, a removable flipper could work or your son could wear a  retainer with a tooth affixed to it. Since your son is still young, his mouth is still developing. The mouth and teeth will continue to change so a dental implant or dental bridge probably isn’t the best choice for a child. It is important to have some kind of appliance placed in the space where the tooth was. This is because you don’t want the teeth to shift around or move into that open area. Otherwise you will be dealing with more crowding and misaligned teeth, as well as the potential for other problems.

Here are some choices for you to consider:

  • Hawley Retainer – An acrylic appliance that is suctioned to the roof of the mouth. A fake tooth is attached to the wire retainer. It is removable and is probably the most economical.
  • Delineator – Many dentists may not have heard of this option, because it is relatively new to the market. If you think you may want to get a dental implant once your son gets older, this could be an excellent option. It is comprised of acrylic and plastic and actually is kept in place with the surrounding teeth. It will look natural and will be very sturdy and best of all it helps to ensure successful dental implant placement in the future.
  • Essix Style Retainer – This is an appliance that kind of looks like a teeth bleaching tray or an Invisalign tray. It is clear and the tooth is attached directly to it. It is not noticeable when it is worn.

As your son matures, a dental implant will be the best way to replace his tooth permanently. It will look, feel, and function just like a natural tooth. So you may want to do talk with your regular dentist about the appropriate timing for your son.

Hopefully this provided you with some information that you will be helpful when you meet with your family dentist.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Related link: dental implant vs bridge

My mouth keeps cracking

I seem to keep getting cracks in the corner of my mouth. They hurt! I’m 76 and don’t feel like dealing with this annoyance. I have also been a denture wearer for over seven years. Do you know what is happening?

– Violet in Virginia


Cracking or lesions in the corners of your lips is called Angular Chelitis. For many, the condition remedies itself. But for some, it is very painful and has been known to bleed. There are many causes. Although the dentures may not be causing the problem, it could be due to an issue before your dentures were placed. When one is missing teeth or when your teeth were removed, specifically in the front of the mouth, the mouth can over close. Without the teeth, this area of the mouth lacks support. The denture may be contributing to the irritation if it is not fitting correctly. You probably want to get into your dentist to see if it needs to be remade.

Others develop Angular Chelitis from:

  • Iron deficiency
  • Eating disorder
  • Habitual biting or licking lips
  • Excessive dry skin
  • Protein deficiency (typically occurs in elderly)
  • Infection from bacteria or fungus

A topical antibiotic will take care of infections on the skin, but you may want to meet with your doctor to ensure any vitamin deficiencies are not present. It is important to pinpoint the cause so you can be properly treated and find relief once and for all.

This post is sponsored by Cleveland dentist Hylan Dental Care.

I am terrified of dental treatment. Help!

I am terrified of going to the dentist and truly want to overcome this fear.  Any suggestions?


Carl in New Jersey

Dear Carl,

You are not alone.  Thousands of people fear the dentists for many reasons.  I applaud that you are attempting to face this fear and overcome it.  The best thing that you can do is to go to the dentist when you are not in pain.  A lot of our dental fear is rooted in past experiences.  Look for a dentist that specializes in dental anxiety.  These offices understand the fears associated with dental treatment and are ready and willing to help you. They cater to cowards and often allow extra time with patients so that you will not feel rushed and anxious.  You are going to need a few gentle dentist appointments with the right dentist to rebuild your confidence. You will need to build a relationship of trust between you and the dentist or hygienist and this will take time.

Before treatment, ask them to “Show and Tell” by explaining what they will be doing and what instruments they will be using. This is to ensure that there are no surprises and helps you feel more in control. If the sounds of the office trouble you, you can bring headphones and music to listen to if you think that might help.  Also bring a friend with you to the appointment for support. It is comforting to know that someone who cares is waiting for you after your appointment.  If things are still too overwhelming, your dentist may suggest a mild sedative before your appointment or even nitrous oxide sedation during treatment.  Nitrous oxide is sedation dentistry in the form of a gas that relaxes you while you are in the dental chair.  It may be something that will help you until you get a few appointments completed and begin to feel more comfortable.  With some perseverance and the right dental office you can overcome or at the very least, manage your dental fears.

This post is sponsored by Cleveland dentist Hylan Dental Care.

My crown keeps coming off.

I have had to get my dental crown re-cemented three times. It keeps coming off after about a week. My dentist has decided there is really nothing left to do to fix it. He asked me to think about getting a dental implant. But will I just have the same problem with the implant crown falling off? Do you know if there is a different kind of crown that will do the trick?

– Gordon in Iowa


What you have described is very rare. If a dental crown is properly placed it will not fall off. It may be time to begin seeking another opinion from a different dentist. And if you decide to go that route, than it may be in your best interest to research and find an experienced cosmetic dentist. As far as your question about the dental implant, I would again seek another opinion. If this current dentist can’t place a crown properly, you really don’t want to take your chances with a dental implant. Dental implant failure is all too common from dentists that attempt to cut corners or save on costs.

A well placed crown is highly dependent on quality tooth preparation. If the shape of the tooth is too tapered than the crown will have difficulty staying in place. So that could be what happened in your situation. Again, a cosmetic dentist will be familiar with the technology required to properly bond the crown to the tooth, whether it is metal, porcelain, or some other material.

Good  luck!

This post is sponsored by Cleveland dentist Hylan Dental Care.