Restorative Dentistry

CROWNS

Crowns are used to restore a tooth that is cracked, decayed or damaged to its natural form, beauty and function. A crown is a permanent covering that fits over the tooth like a thimble, replacing the enamel of the tooth. A crown strengthens weakened tooth structure, is compatible with tooth structure restoring teeth disfigured by decay, breakage, abrasion and imperfect development. Porcelain crowns typically have the most realistic appearance.



COMPOSITE FILLINGS

In the past dentists filled and sealed cavities with a silver and mercury amalgam. Unfortunately these fillings often weaken the tooth due to the large amount of the original tooth that has to be removed. Modern dentistry has turned to composite fillings as a strong, safe and natural looking alternative. Composite fillings use a soft white plastic substance that can be tinted to match your natural tooth color. Composite material can also be used to cover stain and to rebuild or change a tooth’s shape. Composite fillings are about 1 ½ to 2 times more expensive than the amalgam restorations. Dental insurance typically covers the cost of composite fillings up to the price of amalgam fillings. This office does not place amalgam fillings and hasn’t done so in many years.

BRIDGES

A bridge is an appliance used to fill the space where a tooth has fallen out or been removed. A typical bridge consists of a pontic tooth (filler tooth) that is attached to two surrounding crowns (abutments). Without the use of a bridge, spaces in the mouth from missing teeth can cause multiple teeth to shift, cause jaw problems, bite problems and possible speech problems. Bridges, which can remain in place indefinitely with proper care, help eliminate strain when biting down, correct speech impaired by missing teeth, and make chewing much easier.

PERIODONTAL TREATMENT

Approximately 75% of the population has some form of periodontal (gum) disease, and the majority are not aware of it. Gum disease starts in between the teeth where toothbrushes do not reach, and most people cannot floss effectively. Gingivitis is a bacterial infection of the gums that is reversible. The gum tissue is inflamed and bleeds when probed, but there is no bone loss involved. Once the infection has spread into the bone, permanent damage has been done and treatment becomes a necessity if one wants to keep their teeth. Early detection is the key to successful treatment. Our hygienist will perform a gum screening exam and measure your gum pocket depth. The result of this exam can determine your status and a course of treatment may be recommended. A routine cleaning is not enough by itself to treat periodontal disease. There are several causes of periodontal disease. They are:

• Physical and chemical irritants—Impacted food, tobacco products, alcohol, and the improper use of toothpicks or dental floss may irritate the gum tissue.
• Abnormal oral conditions or habits—Badly aligned teeth, poorly fitted bridges or partial dentures, defective fillings, grinding the teeth or chewing ice can also cause problems.
• Unbalanced diet.
• Pregnancy—due to fluctuations in hormone levels, a temporary condition called “pregnancy gingivitis” may occur.
• Certain medications.
• Certain diseases.

In addition, evidence now links gum disease to a number of health concerns including heart disease in men and women, stroke, diabetes, premature births and low birth weight babies. Periodontal disease can be disfiguring as well. The gums become inflamed and bleed easily. Your teeth may shift and need to be removed.

The type of treatment you receive depends on how advanced your case is. We may recommend the following treatments:

• More frequent cleanings.
• Scaling and root planning. Scaling is the removal of calculus deposits from your teeth. Root planning is the smoothing of the root surfaces so that the gum can reach to the tooth.
• Curettage. This removes the soft tissue lining the periodontal pockets. This helps the gum to heal.
• Gingivectomy. This is the surgical removal of the periodontal pocket to allow easier access for cleaning.
• Flap surgery. This allows us to gain access to the root of the tooth for the removal of calculus, plaque and diseased tissue. The gum is then secured back into place.

Once your periodontal treatment ids completed your dentist will need to see you at regular intervals. You may need to come in twice as often as usual to insure the disease is under control. If you use tobacco, you should know that tobacco contains chemicals that can slow the healing process and cause gum disease to become more severe. Good oral hygiene at home is essential to help keep periodontal from becoming more serious or recurring. In this office we believe in treating the disease BEFORE the pocket depth reaches dangerous proportions. We offer a comprehensive treatment protocol. Insurance covers a portion, but the out of pocket cost should not prevent the patient from seeking treatment. As with many things in healthcare, early detection and early treatment can save a patient time, money and pain. Our hygienists have trained in periodontal offices and are very aggressive in the fight against gum disease.

DENTAL IMPLANTS

Implants are metal posts or frames that are surgically placed beneath your gums. These implants fuse to your jaw bone and act as artificial roots. Replacement teeth are attached to the implant. The implant remains below the gum and the bone grows and holds the implants firmly in place, providing a stable base for a new crown. The crowns are made of porcelain or porcelain fused to metal. Not everyone is a candidate for implants—the gum and bone must be in optimum health for the process to be successful.

ENDODONTICS

Everyone has heard of a root canal, usually horror stories from friends or relatives. Thanks to advances in dentistry this procedure has become less uncomfortable, and can often times be done in one visit . it is often a necessary treatment in saving a valuable tooth from being lost. Root canal therapy treats disorders of the nerve of the tooth. In the past often times the tooth was simply removed. Today 95% of the cases can be successfully treated by a root canal. Modern dentists believe in saving teeth and make every effort to help you keep your natural teeth for a lifetime.

There are several reasons that would indicate the need for a root canal.

• Physical irritation caused by deep decay or a very large filling.
• Severe gum disease.
• Trauma, such as a physical blow to a tooth, or the constant striking of a tooth in the opposite jaw that traumatizes the tooth.

The tooth pulp, (nerve) becomes irritated and infected. Bacteria grow within the pulp causing pressure and pain which can sometimes be accompanied by swelling. Sometimes this happens gradually and little pain is felt. Eventually the bacteria can destroy the pulp and in turn the bone surrounding the tooth may also become infected and so destroyed. This is why when a dentist sees an abscess on an x-ray, root canal therapy is often recommended, even though the patient may not be in pain.

During the treatment the tooth and surrounding area are numbed with local anesthetic. The tooth is isolated by a rubber dam and an opening is made through the tooth to the pulp. The diseased pulp is then removed and the root canal area is carefully cleaned, enlarged and shaped. In some cases a medication is placed to control bacterial growth and reduce infection. Sometimes the tooth may be left open in order to allow the infection to drain. The inside of the tooth is sterilized to remove bacteria. The root canals and pulp chambers are filled and sealed. It is important that a patient follow through with all of the visits involved in this procedure. Many patients come for the initial visit because they are in pain and once out of pain feel that they don’t need to return to have the procedure completed. If the root canal is not completed a patient opens themselves up to further infection, with the loss of tooth function a real possibility.

Once the root canal is finished you should consider the following:

• Brittleness — a non-vital tooth is more brittle and is more susceptible to fracture. This is why your dentist will recommend that a crown be placed shortly after the root canal.
• Discoloration — an endodontically treated tooth will discolor.

Again, we believe in prevention. As soon as the doctor identifies an abscess or sees a tooth with severe decay around a large filling, he will recommend root canal therapy. Although you may not be experiencing pain in the tooth it does not mean that the tooth is problem free. We want to treat the tooth before it becomes a painful or dangerous problem.

TMJ

OCCLUSAL GUARDS

Occlusal guards, sometimes called night guards, are used for several reasons. One is to protect the mouth from injury during contact sports. Another is to protect the teeth from the grinding action found in patients with bruxism. Many patients are unaware that they grind their teeth since they do so while sleeping. A patient may wake up with pain in the jaw, headache, toothache or a sore face. Grinding can fracture tooth enamel and will eventually loosen teeth. A night guard fits over the upper or lower teeth and prevents contact between them. It provides cushioning and relieves some of the pressure of grinding and clenching which can damage delicate jaw joints.