Peter Mann, DDS

There are 3 dental options for replacing a missing tooth.  In no particular order 1. Bridge 2. Dental implant 3. partial denture.  The disadvantage of a dental bridge is that you have to shave down the adjacent teeth.  It's also hard to floss a bridge since all the teeth involved are splinted together. The major advantage of an implant is that we don't have to drill any other teeth.  A partial denture is not as stable and comes in and out of the mouth, it's the least comfortable option.

Dear Sarah,

It sounds like your teeth used to be whiter, but may have turned darker for some reason.  Maybe your teeth got stained from coffee, tea, smoking, or another reason.  My first option would always be to try the most conservative method.  Zoom in-office teeth whitening is a safe way to whiten your teeth.  If teeth turned darker due to stains then the in-office whitening should remove those stains.  If that doesn't work the only option left would be to veneer your teeth to a whiter color. Good Luck!

The trays for take home whitening have to be custom made. The dentist will take impressions of your mouth and use those to create custom fitted trays for you. You then add a small drop of whitening gel to each tooth in the tray and place it in your mouth for about an hour. Without the trays you would not be able to use the home whitening kit.

Unfortunately root canal treated teeth tend to turn darker. This becomes a cosmetic concern with anterior teeth. I usually recommend the tooth gets a crown to match the adjacent teeth. Since the new crown will never change color, whitening all the teeth before hand is a good idea.

To match up the shade of one tooth exactly with the rest of your teeth is very challenging. Make sure you find a dentist who does this routinely, who uses a top of the line dental lab and the crown has to be metal free for proper appearance. A cheap crown will never look right because to match up the color exactly requires a dental lab that treats crowns like a work of art.

Good Luck!

I understand your dilemma, but it's extremely important that the extraction is done atraumatically conserving as much bone as possible.  Ideally the same surgeon placing the implant should be the one who will carefully extract the tooth without damaging the surrounding bone.  If the dentist is not familiar with implants, he may damage the bone when attempting to get the tooth out.  If there's not enough bone when it comes time to place the implant you may require additional bone grafting procedures which will cost time and money.  Sometimes the dentist will immediately notice after the extraction that there's a large bone defect that requires a bone graft and perform it that same visit..