Restorative Dental Services
Restorative Dentistry includes dentures, bridges, implants, fillings and root canal therapy. Each of these restorative services helps restore a lost or damaged tooth due to dental disease or injury. Restoring the function of the teeth allows speech, swallowing and chewing to be restored.
Sealants are used to fill narrow grooves in a tooth that cannot be adequately cleaned by brushing. In some cases, the tooth structure has fine grooves or pits which accumulate plaque, not because the person doesn’t brush, but because they’re too narrow to allow even one bristle into them. To avoid cavities developing over time, the dentist will brush on a coating that seals the grooves and pits, making it possible to brush off all the plaque and keep your teeth healthy.
Bonding involves adhering composite resin material that is matched to the color of the tooth, to the front of the tooth. This is performed to repair damage caused by decay, to alter the alignment of the tooth, close gaps between the teeth, or for other cosmetic purposes.
First the surface of the tooth is roughened in order to accept the bonding. A gel is applied so the resin will adhere to the surface of the tooth. The composite is then placed on the tooth and the bonding agent hardens with intense light. The last step is shaping and polishing to give a lustrous finish.
A filling is a way to restore a tooth damaged by decay back to its normal function and shape. If you have a tooth that requires a filling, the dentist will first remove the decayed tooth material, clean the affected area, and then fill the cleaned out cavity with a filling material. A filling helps prevent further decay by closing off any cracks or spaces where bacteria can enter.
- Composite (plastic) resins are custom made to the exact color of your natural teeth, creating a more natural appearance. While white fillings may be less noticeable than other materials, they usually only last between 3 and 10 years and may not be ideal for large fillings as they may chip or wear over time. They can also become stained from coffee, tea or tobacco.
If decay or a fracture has damaged a large portion of the tooth, a crown (or “cap”) may be recommended. Decay that has reached the nerve may be treated through root canal therapy or through a procedure called pulp capping.
SEDATION DENTISTRY/DENTAL ANXIETY
Dental sedation is a technique that can be used when a patient suffers from dental anxiety or dental phobia. We are happy to offer a number of solutions for our patients to make their dental visit as comfortable as possible. Sedation dentistry techniques enable patients who might otherwise avoid the dentist, to receive dental treatment necessary for a healthy smile. Depending on the extent of the anxiety or phobia, varying degrees of dental sedation can be utilized as described below.
Nitrous Oxide Sedation
Nitrous Oxide sedation, also known as “laughing gas” is commonly used to make treatment more comfortable. This sedation is inhaled through a mask that allows you to breathe in the medication and induces a state of relaxation. Local anesthetic will be administered in conjunction with nitrous oxide to eliminate pain.
This medication can be given to a patient the night before a dentistry procedure as well as an hour prior to the dental appointment, depending on the severity of the anxiety. Oral sedatives do not provide pain relief, so an injection of local anesthetic will also be administered.
CROWNS AND BRIDGES
Crowns and bridges are used to restore and enhance teeth that are damaged or to take the place of missing teeth. A crown (also referred to as a cap) is used to entirely cover a damaged tooth. A crown not only strengthens a tooth, but it can dramatically improve a tooth’s appearance, shape and alignment.
Crowns may be used to:
- Replace a large filling when there is little tooth structure remaining
- Protect a weak tooth from fracturing
- Restore a fractured tooth
- Attach a bridge
- Cover a dental implant
- Cover a discolored or poorly shaped tooth
- Cover a tooth that has had root canal treatment
A bridge is an ideal method to fill the space created by missing teeth. A bridge is one or more artificial teeth cemented into place using the teeth on either side for support. This is an option for filling the space created by a missing tooth. Bridge work is as much an art as it is an exact science since it replaces a missing tooth both functionally and cosmetically. The materials used may be gold alloys, porcelain bonded to metal alloy, or all ceramic material made to match your natural tooth color. The choice of material depends on requirements for strength, wear, and aesthetics.
It is important that a missing tooth be replaced as soon as possible. If not treated, the teeth surrounding the gap begin to shift inward. Since teeth use their neighbors for support, if one is missing they begin to “fall” and shift into the open spaces. This may worsen the bite because of the changes in pressure and can eventually result in problems with the jaw such as TMJ.
Bridges and crowns are made by first taking an impression of your mouth. The impression is sent to a dental lab where your crown or bridge will be custom made to fit your mouth and match your natural tooth color. A temporary crown or bridge will be placed into your mouth until your permanent crown or bridge is ready and cemented into place.
Bridges and crowns are very durable and can last a lifetime with extra care and good oral hygiene.
Good oral hygiene should always be practiced since the loss of a single tooth can have major impact upon your oral health and appearance. Although dentists will use every measure to prevent tooth loss, there still sometimes necessary occasions when a tooth may need to be extracted. A tooth may need to be extracted for the following reasons:
- Severe decay
- Advanced periodontal disease
- Infection or abscess
- Orthodontic correction
- Malpositioned teeth
- Fractured teeth or roots
- Impacted teeth
After careful examination and treatment, the dentist may advise to have a tooth extracted. Before a tooth is removed, the dentist will take an x-ray in order to understand the shape and position of the tooth and surrounding bone. Based on the degree of difficulty, we may refer you to a specialized or al surgeon.
For a simple extraction, we will first apply a local anesthetic to prevent pain and discomfort. The tooth will be loosened with a tool called an elevator and then removed with dental forceps. Once the procedure is complete, the area may be closed with one or two stitches. We will then provide you with care instructions to alleviate discomfort and ensure proper healing.
WISDOM TOOTH EXTRACTIONS
Wisdom teeth are the last molars or “third molars” that develop on each side of the jaws. Wisdom teeth usually emerge in the back of the mouth between the ages of 16-20.
Wisdom teeth are a valuable asset to the mouth when they are healthy and properly positioned. Often, however, problems develop that require their removal. When the jaw isn’t large enough to accommodate wisdom teeth, they can become impacted (unable to come in or misaligned). Wisdom teeth may also grow in sideways, emerge only part way through the gum or remain trapped beneath the gum and bone.
A wisdom tooth extraction is a relatively routine procedure. The dentist will numb the area in your mouth with a local anesthesia conscious sedation to help relax you during the procedure.
After the tooth is removed, we will provide care instructions to ensure proper healing. Some pain and swelling may occur but will normally subside after a few days. You should call your dentist if you have prolonged or severe pain, swelling, bleeding or fever.
ROOT CANAL TREATMENT
Root canal treatment (also referred to as root canal therapy or endodontic therapy) is made necessary when an untreated cavity reaches all the way to this pulp. Treatment may also be needed when deep restorations or trauma to a tooth cause nerve damage. Once the pulp becomes infected, and can begin to eat away at the surrounding bone (this is known as an abscess). If the pulp is infected, not only is it painful but it will require treatment as it cannot heal on its own. Symptoms that indicate the pulp has become infected may include sensitivity to hot/cold or sweets, pain, swelling, pain to biting or pressure, and a bad taste in the mouth. However, sometimes no symptoms are apparent and you may be unaware of any problem until a checkup.
A root canal is performed to clean out the infected tooth pulp and disinfect the canals of the tooth. Alternate treatment would be to extract the tooth. Once the infection is resolved, the canal is filled in to prevent any further infection. Usually a core build-up and crown is recommended for restoring a tooth that has undergone root canal therapy.
A dental implant is an ideal tooth restoration for people who are missing one or more teeth as a result of injury, periodontal disease, or any other reason. A dental implant is a metal post that a periodontist or oral surgeon surgically positions into the jaw. Once in place and bone surrounding the implant has had time to heal, a replacement tooth is attached to the post. While implants are typically more expensive than other methods of tooth replacement, they provide superior benefits. Implants are stronger than natural teeth and generally last 10-20 years. They are also a more favorable approach than bridgework since they do not depend on neighboring teeth for support.
To receive implants, you need to have healthy gums and adequate bone to support the implant. You must also be committed to excellent oral hygiene and regular dental visits as these are critical to the long-term success of dental implants.
A denture is a removable replacement for missing teeth and surrounding tissues. There are two types of dentures available, including partial and complete dentures. Partial dentures are used when some natural teeth remain, while complete dentures are used to completely replace all teeth. Dentures are made to resemble your natural teeth so there should be no noticeable change to your appearance. In fact, dentures may even improve your smile!
This restoration method is used to restore your smile and mouth function if all your teeth have been lost. The dentures are custom created to resemble natural teeth and are positioned to take the place of natural teeth. Complete dentures are removable and may require adjustments in order to create a proper fit with the gums and mouth.
A removable partial denture is a device used when one or more natural teeth still remain in the upper or lower jaw. They usually consist of replacement teeth attached go a gum-colored plastic base which is held in place in the mouth. A fixed partial denture acts the same as a removable denture, but it is cemented into place using adjacent teeth for support.
New dentures may feel awkward or loose for the first few weeks until the muscles of your cheek and tongue learn to keep them in place and you are comfortable eating and speaking. Although this may require some practice you will adjust and enjoy the benefits a full mouth of teeth can provide.
NIGHTGUARDS AND MOUTHGUARDS
Custom designed mouth guards and night guards are made of flexible plastic and molded to fit the shape of your teeth. Mouth guards are recommended to protect the jaw and teeth during physical activity and sports such as boxing, football, basketball, or other activities where your mouth may be hit. Guards also protect the soft tissues of your tongue, lips and cheek lining. Night guards are recommended for patients who clench or grind their teeth at night as a way to protect their teeth and bite.
If you have decided a guard is right for you, we will take an impression of your teeth which will then be sent to a lab to make a custom fit guard. In most cases you can choose from a variety of colors and styles. On average, guards last between 3 and 10 years.
TMJ stands for temporal-mandibular joint. Temporal, as in temple area of skull; mandibular as in mandible, or lower jaw; joint as in where the head and jaw meet. Problems in this joint may be caused by a misalignment of the teeth, trauma, or excess muscle tension. Cartilage buffers the two bones and five muscles that meet in this area, but any problems in this area can create quite a bit of pain and biting difficulties.
Symptoms of TMJ include:
- Trouble/soreness in opening and closing the mouth
- Clicking or popping of the jaw
- Pain in the jaw muscles
- Soreness in the area, sometimes extending to the face
Dental treatments for the condition can include replacing missing teeth, moving teeth, adjusting the bite and filling gaps between teeth. There is no one solution that is right for all cases. Occasionally a plastic mouthpiece is used to prevent clenching or grinding that is contributing to the problem. If untreated and in severe cases, surgery may be required to repair a badly damaged joint.
Veneers are a dental procedure in which a covering is placed over the outside (visible area) of the tooth. Veneers are usually only applied to the part of the tooth that is visible when talking or smiling. The procedure can be direct or indirect.
The direct technique usually involves placing composite resin on the outside of the tooth using bonding. This method is usually referred to as bonding.
The indirect technique usually involves two appointments because the veneers will be fabricated at a dental laboratory. At the first appointment the teeth are prepared, impressions taken, and the teeth are given a temporary covering. In two to three weeks the veneers are back from the laboratory, the temporaries are removed and the veneers are bonded to the teeth. The laboratory fabricated veneers are usually made using porcelain or pressed ceramic and are very aesthetic.
The advantage of veneers versus crowns is that much less tooth material is removed, and the procedure is generally less uncomfortable. Veneers are recommended for teeth that have large fillings or little tooth structure.