Crowns, Bridges and Onlays

Crowns vs. Onlays: Biomimetic Dentistry

One of the main tenets of biological dentistry is maintaining and conserving natural tooth structure. Naturally occuring, precious enamel is your body’s very best defense, and is better than any lab-created restoration.  However, when decay takes its toll and enamel has already been lost, a crown or an onlay may be needed to maintain your tooth’s function.  This is where the intersection between a conventional and biological dentist lies.  Whereas a conventional dentist is likely to crown a tooth with a compromised cusp, for example, Dr. Ulm’s training in biomimetic dentistry (“mimicking” the body’s natural function) gives you more options, including onlays.  Onlays are superior to crowns in some cases because they enable you to keep all the healthy enamel on your tooth intact and remove only what is decayed or compromised.  The result: a far superior restoration that maintains your natural tooth, looks beautiful, AND keeps your tooth healthier longer. 

Bridges vs. Implants

In nearly every case, Dr. Ulm recommends a dental implant rather than a bridge to replace a missing tooth.  He has extensive continuing education and experience in implant placement, and takes the utmost care to ensure only the highest grade materials and techniques are used.  The benefits of an implant over a bridge are many, but include:

  • Unless the teeth adjacent to the missing tooth are already crowned, replacing the missing tooth with a bridge requires removing healthy enamel and crowning those teeth.  This is contrary to the philosophy of maintaining as much natural enamel as possible, and unnecessarily puts those teeth at risk for further problems.
  • With a bridge, there are a minimum of 2 to 3 “units” to be concerned about, and like the Three Musketeers, it’s “all for one and one for all”.  If one unit has a problem, they ALL have a problem.  Therefore fixing a problem with one tooth likely means removing the entire bridge and replacing it.  When the missing tooth is replaced with an implant rather than a bridge, each tooth remains separate and can be treated accordingly.
  • When a tooth is missing, the bone in the area is unstimulated and therefore receeds at an accellerated rate.  A bridge does nothing to remedy this problem, but a dental implant stimulates the bone much as the natural tooth would, which prevents bone recession.
  • Good dental hygiene is much easier with an implant rather than a bridge.  An implant allows the teeth to be flossed normally.  The difficulty of threading floss underneath a bridge often leads to lack of flossing, which then leads to decay in inaccessible areas.  This can eventually result in the failure of the bridge, which is not only expensive, but can ultimately cause loss of the supporting teeth.

In some cases, a bridge is an acceptable solution, for example, if an existing bridge needs to be replaced, or excessive bone loss in the area reduces the possibility of a successful implant.  In those cases, Dr. Ulm works with the best local labs to ensure that you get the very best bridge for your investment.  He carefully selects the materials used to ensure they are nontoxic, and encourages materials reactivity testing to ensure individual biocompatibility.  These efforts significantly increase the longevity of your bridge, the health and function of your teeth, and therefore your overall health.

Whether you need an onlay, a crown, a bridge, or an implant, choose a dentist who will take a Biological approach.

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