Before implants, people often turned to a removable appliance to replace multiple missing teeth. Known as a removable partial denture (RPD), this appliance could restore both appearance and function at an affordable price.

But although implants may have diminished their use, RPDs haven't gone extinct. They're still a viable option for patients who can't afford implants or fixed bridgework, or who can't obtain implants due to the state of their dental health.

Although replacing only a few teeth rather than an entire arch, RPDs are similar in basic concept to full dentures. The prosthetic (artificial) teeth are anchored in a resin or plastic that's colored to resemble the gums, precisely placed to fit into the missing gaps. This assembly is further supported by a frame made of vitallium, a lightweight but strong metal alloy. The appliance fits upon the arch with the missing teeth, supported by vitallium clasps that grip adjacent natural teeth.

Each RPD must be custom designed for each patient to fit perfectly without excessive movement during chewing. Too much movement could warp the fit, reduce the RPD's durability or damage other teeth. To achieve this secure fit, dentists must take into account the number and location of missing teeth to be replaced, and then apply a specific construction pattern to balance the appliance.

There are RPDs that are meant to be used short-term, as with a teenager whose jaw isn't yet mature for dental implants. But the metal-framed RPDs we've described are designed for long-term use. There is, however, one primary downside: RPDs have a propensity to collect dental plaque, a thin biofilm most responsible for dental disease that could further deteriorate your dental health.

To avoid this, you'll need to keep both the RPD and the rest of your teeth and gums as clean as possible with daily brushing and flossing, and appliance care. And like dentures, it's best to remove the RPD when you go to bed at night to discourage the growth of harmful bacteria.

To see if an RPD to replace your missing teeth is an option for you, visit us for a complete dental exam. From there, we can advise you further as to whether an RPD could affordably restore your missing teeth and your smile.

If you would like more information on RPDs, 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 “Removable Partial Dentures.”

Heartburn is a big problem: Each year we Americans spend around $10 billion on antacid products, twice as much as for over-the-counter pain relievers. It's an even bigger problem because many indigestion sufferers actually have acid reflux or GERD (gastroesophageal reflux disease), a chronic disease that can cause physical harm—including to teeth.

That's why we've joined with other healthcare providers for GERD Awareness Week, November 17-23, to call attention to the causes and consequences of this disease. In addition to the harm it poses to the esophagus (the “tube” leading from the mouth to the stomach through which food passes), GERD could also damage your teeth to the point of losing them.

GERD is usually caused by the weakening of the lower esophageal sphincter, a ringed muscle located at the junction between the esophagus and the stomach. It acts as a “one-way valve” allowing food into the stomach, but not back into the esophagus. If it weakens, powerful stomach acid can come back into the esophagus and possibly even the mouth. The latter scenario poses a danger to teeth's protective layer of enamel.

Although tough and durable, enamel softens after prolonged contact with acid. Oral acid isn't all that unusual—acid levels typically rise right after eating, causing a temporary softening of enamel. Our saliva, however, goes to work to bring down those acid levels and stabilize enamel.

But if stomach acid enters the mouth because of GERD, the increased acidity can overwhelm saliva's ability to neutralize it. This can lead to enamel erosion, tooth decay and ultimately tooth loss. The enamel damage can be so pronounced that dentists are often the first to suspect GERD.

If you're diagnosed with GERD, here's what you can do to protect your teeth.

• Manage your GERD symptoms through medication, avoidance of spicy/acidic foods, alcohol, caffeine or tobacco products, and maintaining an optimum weight;
• Stimulate saliva by drinking more water, using saliva boosters, or (with your doctor's consent) changing from medications that may be restricting saliva flow;
• Speak with your dentist about strengthening your enamel with special toothpastes or mouthrinses containing extra fluoride or amorphous calcium phosphate (ACP).

You should also brush and floss daily to lower your risk of dental disease, but with one caveat: Don't brush your teeth during or immediately after a reflux episode, as you might remove microscopic bits of softened enamel. Instead, rinse your mouth with water mixed with a half-teaspoon of baking soda (an acid neutralizer) and wait about an hour to brush. The extra time also gives saliva time to further neutralize any remaining acid.

GERD can be unpleasant at best and highly destructive at worst. Don't let it ruin your teeth or your smile.

If you would like more information about GERD and dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “GERD and Oral Health” and “Dry Mouth.”

The fast-paced world of sports and entertainment isn’t all glitz and glamour. These high-profile industries create a unique kind of emotional and mental stress on celebrities. For many of them, a way to “let off steam” is an oral habit known as teeth grinding.

Teeth grinding is an involuntary habit in which a person bites and grinds their teeth outside of normal activities like eating or speaking. It’s common among young children, who usually grow out of it, but it can also affect adults, especially those who deal with chronic stress. If not addressed, teeth grinding can eventually wear down teeth, damage gum attachments or fracture weaker teeth. It can even contribute to tooth loss.

A number of well-known personalities in the spotlight struggle with teeth grinding, including actress Vivica Fox, model and TV host Chrissy Teigen, and star athletes Tara Lipinski and Milos Raonic of ice skating and tennis fame, respectively. The habit represents not only a threat to their dental health, but also to one of their most important career assets: an attractive and inviting smile. Fortunately, though, they each use a similar device to manage their teeth grinding.

Besides seeking ways to better manage life stress, individuals with a teeth-grinding habit can protect their teeth with a custom mouthguard from their dentist. Made of slick plastic, this device is worn over the teeth, usually while sleeping, to minimize dental damage. During a grinding episode, the teeth can’t make contact with each other due to the guard’s glossy surface—they simply slide away from each other. This reduces the biting forces and eliminates the potential for wear, the main sources of dental damage.

Chrissy Teigen, co-host with LL Cool J on the game show Lip Sync Battle, wears her custom-made guard regularly at night. She even showed off her guard to her fans once during a selfie-video posted on Snapchat and Twitter. Vivica Fox, best known for her role in Independence Day, also wears her guard at night, and for an additional reason: The guard helps protect her porcelain veneers, which could be damaged if they encounter too much biting force.

Mouthguards are a prominent part of sports, usually to protect the teeth and gums from injury. Some athletes, though, wear them because of their teeth grinding habit. Tara Lipinski, world renowned figure skater and media personality, keeps hers on hand to wear at night even when she travels. And Milos Raonic, one of the world’s top professional tennis players, wears his during matches—the heat of competition tends to trigger his own teeth-grinding habit.

These kinds of mouthguards aren’t exclusive to celebrities. If you or a family member contends with this bothersome habit, we may be able to create a custom mouthguard for you. It won’t stop teeth grinding, but it could help protect your teeth—and your smile.

If you would like more information about protecting your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Grinding” and “When Children Grind Their Teeth.”