Exploring Innovative Alternatives to Dental Flippers for Optimal Patient Smiles!
By: Dr. David Rice
Trauma, emergency extraction(s) due to pain or infection, future dental implant, or simply missing a tooth, patients present in a variety of ways, for a variety of reasons.
Dentistry has a variety of ways to fill the gap.
Once upon a time, the best we had in dentistry was an interim partial denture, known as the very aptly named, flipper.
In short, dental flippers are removable retainers with one or more teeth attached and help a patient smile, in the short run.
If you’re working in the analog world, it’s physical impressions plus bite registration plus taking a shade.
If you have access to a little dental technology, it’s scan plus shade, plus send to your favorite lab.
Or if you have access to all the toys, it’s scan plus shade plus virtual design and either mill or 3D print, potentially all on the same day.
👍 Cost: Flippers are cost-effective for you and your patients. More or less so based on the technology you access to.
👍 Speed: Whether you have all the tech bells and whistles – or you’re working with your favorite lab – turnaround time is typically one day or less.
👍 Simplicity: The one way in and out of your patient’s mouth – the removability for easy cleaning – and the material choice of most flippers means chair time is minimal.
👍 Stability: Not in the sense that they don’t move around, they’re not called flippers for nothing. Stability in the sense of maintaining the position of the teeth forward and behind, as well as above or below.
👎 Weak: Because flippers are typically designed to save cost – the materials used are less durable and can crack relatively easily.
👎 Movement: It’s in the name – so – yes – flippers are more for smiling than they are eating and enjoying.
👎 Longevity: In addition to breakage – a challenge with most flippers today is they loosen over time.
Here are the top three alternatives to dental flippers:
Let’s start with what we really want when we can have it when figuring out which alternative to proceed with:
- Strength. Ever heard the phrase – never enough time to do the job well; plenty of time to do it again? That shouldn’t apply here – let’s go strong enough to not break and need new and/or repairs from the start.
- Beauty. Temporary or not – we have materials today that mimic mother nature in an extraordinary fashion.
- Fixed. In an ideal world for everyone – let’s fabricate a temporary replacement tooth that stays in the mouth unless we remove it.
- Cost. If we’re making a wish list – why not have it all and low cost to our patient and practice?
Given our wish list, let’s look at some of our best alternatives and which list items we need to sacrifice when we use them.
1. Essex Retainers
When talking about Essex retainers, think clear aligner in concept with a missing tooth or teeth where we need it (and we’re not going to move any teeth).
- Strength → Low: however we eliminate the movement issue flippers bring.
- Beauty → Medium: based on the lab or dental team member fabricating the appliance.
- Fixed → Removable by the Patients: Though they do stay in place very well.
- Cost → Low: This is a fast and inexpensive treatment modality.
2. Maryland or Fiber Reinforced Bridges
Maryland or Fiberreinforced bridges are another alternative to Dental Flippers.
- Strength → High: When we take a patient’s bite into account – we can build a very long-lasting, temporary restoration.
- Beauty → High: We have material options in this category and thus we can build very natural beauty.
- Fixed → Yes: This is a major win for our patients. They can smile and eat confidently, knowing their temporary isn’t going anywhere.
- Cost → High: As they say, we get what we pay for. With the improved materials of a Maryland bridge and more time invested, our patients will need to invest more to have this option.
3. Fixed Bridge
Yet another alternative to Dental Flippers is a Fixed Bridge.
- Strength → High: When preparation design is appropriate this can be more than a temporary solution for our patients.
- Beauty → High: Today’s ceramics are outstanding. We can create harmony in almost any circumstance.
- Fixed → Yes: Based on our temporary cement selection – we can control how fixed this option is.
- Cost → High: Per materials, time, and most often – lab involvement – patients should expect to invest more for this solution.
I have one caveat I would like to mention about the fixed bridge alternative.
The need to prepare the adjacent teeth for a fixed bridge makes it a very distant last place for me, except, when those teeth have been prepared in the past and I can remove the old crowns, use those two adjacent teeth, and not need to prepare them for this alternative.
Dental Flippers are not patient favorites. Having multiple viable alternatives enables you and I to have open, honest discussions with our patients to explain the wins and losses of each.
Before you assume an option because that’s what dental school taught you – ask your patient what matters most to them.
- If they’re okay with something removable – review the options.
- If they prefer something that stays in place – review the options.
And as always, when you want a deeper dive, we’re here to help.
Just reach out to us here, or DM us @igniteDDS on Instagram.
Photo by Cedric Fauntleroy