Your teeth are one of the most important functional features we have. As we age, even with consistent good dental hygiene practices and routine visits to the dentist’s office, it is probable that everyone will experience a dental issue that requires repairing a damaged, fractured, or otherwise missing tooth. Since we’re the premier Missoula dentist, Dr. David B. Duke can utilize bridges, crowns, partial implants, and other dental fillings to repair or replace your damaged or missing teeth.

Get Your Smile Back

Whether you managed to damage a tooth on accident or were dealt a bad dental hygiene hand by your genetics, Bitterroot Dental can help you regain your natural smile. From porcelain crowns that match your existing tooth shade to completely replacing your existing teeth with dentures, Dr. Duke can help give you a reason to smile.


Dental bridges are a great way to replace missing teeth. When you invest in a bridge, your Missoula dentist uses your existing teeth to create a bridge to cross the area where your tooth is missing.  You can have your bridge made from gold, metal, alloys, or porcelain to ensure that they are strong and durable.

bridges_photoThe dental bridge consists of one crown on either end of a missing tooth, or “the abutment teeth” being fused and supporting a new tooth, “the pontic,” to replace the missing tooth. The process of creating a bridge begins by creating abutments out of your existing teeth where the bridge will be attached. The existing teeth are recontoured to provide a base for the bridge. After the abutments have been created, a mold is taken of the area and sent to a dental lab. The lab is able to use the mold to create a bridge that will fit properly and feel as close to your natural teeth as possible. The bridge will be cemented, so it is not removable.

We will fit you with a temporary bridge while we wait for the lab to artistically design and craft your final bridge. This will protect the abutments and the exposed gum areas and look more appealing than having a gap where your teeth should be. When the permanent bridge has been created, you will have a follow up visit to set the bridge. It will be placed on the abutments and the dentist will then use an adhesive to make sure that the bridge is set.

Since bridges fasten to your natural teeth, they must be routinely cleaned and cared for, just like a regular tooth. Bridges are susceptible to the same tooth problems and neglect as natural teeth.

If you are missing a tooth you should strongly consider having it replaced. Besides the aesthetic disadvantage of missing teeth, it could also cause structural changes to your mouth and jaw or alter your bite as the adjacent teeth shift into the open area. It also makes it difficult to eat or speak properly. Set up an appointment today to restore your smile by replacing your missing teeth.

Inlays and Onlays

Inlay_Onlay_Crown“Inlays” and “onlays” are often referred to as partial crowns. They use the existing tooth as a base and fit the inlay or onlay onto the tooth. This is done to strengthen the tooth, restore its shape, and prevent further damage. An inlay is done when there is no damage to the cusps of the tooth and the inlay can be placed right on the tooth. An onlay is used when the damage is a little more extensive or if the cusp of a tooth is damaged.

The decayed/fractured area of the tooth is first removed. A mold of the tooth is then taken and sent to a dental lab. They create a restoration made from porcelain, gold, or a composite resin. The restoration takes three weeks to make, so a temporary inlay or onlay will be placed on the tooth during that time. On your next visit the inlay or onlay will be cemented or bonded into place. Your new tooth will look so natural, no one will be able to tell the difference.


Dentures are a replacement for missing teeth that can be removed and put back into your mouth as you please. Depending on each individual patient case, they may receive full or partial dentures. Full dentures are used when all of the natural teeth are removed from the mouth and replaced with a full set of dentures. There are two types of full dentures.denture3

  • Conventional Full Dentures – If you need to replace your old or broken denture, we can help you. During just a few appointments we will take a series of impressions of your jaws, get your accurate bite, and select the tooth shape and color you desire. After you get your new denture we will make any necessary adjustments to ensure the fit is as comfortable as possible.
  • Immediate Full Dentures – Immediate dentures are for individuals who have teeth that cannot be saved and do not want to go without teeth. Prior to having your teeth removed, Dr. Duke takes measurements and impressions for your new denture and has dentures fitted for your mouth. After removing all remaining teeth, the dentures are immediately placed in your mouth. We will select the shape and color of the teeth you desire. Once the denture is made, we will remove all remaining teeth and make any necessary adjustments for a good fit the same day. You will never be without teeth, and in most cases, you will leave with more teeth than you had when you arrived. You will need to have several follow up visits to adjust sore spots while the bone and gums heal over the areas where teeth were removed. Because the jaw bone and gums will change shape as your mouth heals, this will be an ongoing process. Some people need only a few adjustments, while others need many over the first six months. The dentures will need to be realigned after the jaw bone has healed.

Partial dentures are another option when not all of your teeth need to be removed. This is similar to a bridge, but it is not a permanent fixture in your mouth. Partial dentures use remaining teeth for stability but the partial denture will still move slightly. Usually they have a metal base for durability and support but they can also be made with a flexible resin base.

Your dentures or partial dentures may take some time to get used to. After all, they aren’t fastened in the mouth. They may also feel bulky or constrict the space for your tongue. Depending on the amount of bone you have your dentures may feel loose, especially bottom dentures. These feelings will affect the way you eat and talk for a little while. They may tip when you eat or talk and you may have trouble biting into things. Over time, your mouth becomes trained to eat and speak with your dentures and they begin to feel more and more like your natural teeth. They will never feel like your natural teeth, but they are much better than the alternative of not having teeth. To avoid the problem of tipping and movement, you can have implants placed under the denture to stabilize it. This can either be done when the teeth are removed or even years later. If you have a tipping or rocking denture with little or no suction, talk to Dr. Duke about how implants can improve your lifestyle.

Even though dentures are not real teeth, you should care for them like they are. You should brush them to remove plaque and food particles before removing your dentures. After they have been removed you should place them directly into room temperature water—or a denture cleaning solution periodically. Never use hot water or leave them in hot places, like cars in the summer, because it could warp the dentures. Your dentures are delicate, so make sure you are careful when handling them so you don’t drop them. Also, never try to adjust your dentures yourself. You could ruin them, so you should always seek assistance from Dr. Duke if they feel uncomfortable, loose or you develop sore spots.


crownsOver time our teeth begin to weaken and become more susceptible to problems such as decay, cracks, discoloration and others. If you feel your smile isn’t what it once was, crowns can help you recover your smile. If we notice that a tooth is severely decayed, the decay is below the gum line, or the tooth is weakened or cracked, a crown may be necessary to ensure there are no additional problems with the tooth. In cases like this a filling or bonding will not be sufficient.