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.”

Your smile may look healthy, but something quite unhealthy may be going on behind it. Unbeknownst to you, periodontal (gum) disease could even now be damaging tissues and bone that could lead to tooth loss. Caused by plaque, a thin film of food remnant and bacteria built up on the teeth due to poor oral hygiene, gum disease can aggressively spread deep into gum tissues without you even realizing it.

If you pay close attention to your gums, however, it’s still possible to pick up signs of the disease, even during its early “silent” stage. As the infection progresses, the signs will become more frequent — and consequential.

Here are 4 signs of gum disease you should definitely keep on your radar.

Bleeding. Unless you’re doing it too hard, healthy gums won’t normally bleed when you’re brushing or flossing. If they do bleed with just light to moderate pressure, it’s a sign the tissues have been inflamed and weakened by the infection.

Inflammation and redness. If you notice your gums seem swollen or reddened, it could mean they’re inflamed. Inflammation is the body’s response for fighting infection — however, if the inflammation becomes chronic it can actually damage the tissue it’s trying to protect.

Abscesses. These are localized areas in the gums where the infection has become isolated. They’ll typically be more swollen than surrounding gum tissues and are often filled with pus. They can also be sensitive to the touch and painful. Any sore spot like this that lasts for more than a few days should be examined.

Loose or moving teeth. Teeth that can move in the socket or appear to have shifted their position are signs of an advanced stage of gum disease. It’s an indication the gum and bone tissue that hold teeth in place have been weakened and are losing their attachment. Without immediate treatment, it’s just a matter of time before the teeth are lost altogether.

If you notice any of these signs, you should see us as soon as possible for a complete exam. The sooner we’re able to diagnose gum disease and begin treatment, the less likely it will permanently harm your teeth and gums.

If you would like more information on treating gum disease, 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 “When to See a Periodontist.”