Before development of dental implants, dentures were the only alternative to replacing a missing tooth or teeth.
Implants are synthetic structures that are placed in the area of the tooth normally occupied by the root. Implants are anchored to the jawbone or metal framework on the bone and act as a foundation for an artificial tooth or permanent bridge. In some cases, implants can be used to attach dentures.
Not everyone is a candidate for a dental implant, however. For a successful implant to take hold, a candidate must have proper bone density and have a strong immune system. In all cases, dental implants require strict oral hygiene.
Implants are so well designed that they mimic the look and feel of natural teeth. Implants are usually made of a synthetic yet biocompatible material like metal or ceramic.
Surgery is necessary to prepare the area for an implant and place the implant in the mouth. Following the procedure, a period of time is required for the implant to take hold and for bone tissue to build up and anchor the device. In some cases, metal posts are inserted into the implant during a follow-up procedure to connect the tooth.
Because implants require surgery, patients are administered anesthesia and, if necessary, antibiotics to stave off infection following the procedure.
Like any restoration, implants require diligent oral hygiene and proper care to ensure they last a long time.
Teeth that are badly stained, shaped or crooked may be improved by a veneer placed on the surface of the affected teeth.
Veneers are thin pieces of porcelain or plastic cemented over the front of your teeth to change their color or shape. Veneers are used on teeth with uneven surfaces or are chipped, discolored, oddly shaped, unevenly spaced or crooked. Little or no anesthesia is needed. Veneers have a longer life expectancy and color stability than bonding, and highly resist permanent staining from coffee, tea, or even cigarette smoking.
Veneers are usually made by a dental lab technician working from a model provided by your dentist. Veneers are usually irreversible because it`s necessary to remove a small amount of enamel from your teeth to accommodate the shell.
Porcelain veneers can mask undesirable defects, such as teeth stained by tetracycline, by an injury, or as a result of a root-canal procedure, and are ideal for masking discolored fillings in front teeth. Patients with gaps between their front teeth or teeth that are chipped or worn may consider porcelain veneers.
Typically, veneers entail at least three appointments: diagnosis and treatment planning, preparation, and bonding.
During the tooth preparation visit, usually lasting one to two hours, the teeth are lightly buffed to allow for the small added thickness of the veneer. Usually, about a half a millimeter of the tooth is removed, which may require a local anesthetic. During the same visit, a mold is taken of the teeth, and sent to the laboratory for the fabrication of the veneers.
During the final "bonding" visit, also about one or two hours, the veneers are placed on the tooth surface with water or glycerin on the teeth to check their fit and get a sense of the shade or color. While the veneers are resting on your teeth, they can be adjusted with various shades of cement to match the color of your teeth. To apply the veneer, the tooth is cleansed with specific chemicals to achieve a bond. Once a special cement is sandwiched between the veneer and tooth, a visible light beam, or laser, causes a catalyst to be released, hardening the cement.
During a two-week period of adjustment that follows, you may notice the change of size and shape in your teeth. It is important to brush and floss daily. After one or two weeks, you`ll return for a follow-up appointment. Porcelain veneers are reasonable facsimiles of natural teeth, not perfect replacements. It`s not uncommon to see slight variations in the color of porcelain veneers upon close inspection, as this occurs even in natural teeth.
For certain patients no preparation of the teeth may be necessary. Please see our specialties page for more information.
Bridges are natural-looking dental appliances that can replace a section of missing teeth. Because they are custom-made, bridges are barely noticeable and can restore the natural contour of teeth as well as the proper bite relationship between upper and lower teeth.
Bridges are sometimes referred to as fixed partial dentures, because they are semi-permanent and are bonded to existing teeth or implants. There are several types of fixed dental bridges (cannot be removed), including conventional fixed bridges, cantilever bridges and resin-bonded bridges. Unlike a removable bridge, which you can take out and clean, your dentist can only remove a fixed bridge. .
Porcelain, gold alloys or combinations of materials are usually used to make bridge appliances.
Appliances called implant bridges are attached to an area below the gum tissue, or the bone.
Crowns are synthetic caps, usually made of a material like porcelain, placed on the top of a tooth.
Crowns are typically used to restore a tooth's function and appearance following a restorative procedure such as a root canal. When decay in a tooth has become so advanced that large portions of the tooth must be removed, crowns are often used to restore the tooth.
Crowns are also used to attach bridges, cover implants, prevent a cracked tooth from becoming worse, or an existing filling is in jeopardy of becoming loose or dislocated. Crowns also serve an aesthetic use, and are applied when a discolored or stained tooth needs to be restored to its natural appearance.
A tooth must usually be reduced in size to accommodate a crown. An impression is then made from the existing tooth to create a custom-designed crown. The impression is sent to a special lab, which manufactures a custom-designed crown. In some cases, a temporary crown is applied until the permanent crown is ready. Permanent crowns are cemented in place.
Crowns are sometimes confused with veneers, but they are quite different. Veneers are typically applied only to relatively small areas.
Caring For Your Crowns
With proper care, a good quality crown could last up to eight years or longer. It is very important to floss in the area of the crown to avoid excess plaque or collection of debris around the restoration.
Certain behaviors such as jaw clenching or bruxism (teeth grinding) significantly shorten the life of a crown. Moreover, eating brittle foods, ice or hard candy can compromise the adhesion of the crown, or even damage the crown.
Whitening procedures have effectively restored the smile of people with stained, dull, or discolored teeth.
The darker tissue of your teeth, the dentin, can become exposed as the outer layer of enamel is worn away by the effects of aging or things like caffeine and tobacco.
Food particles are naturally attracted to a tooth's enamel by a certain protein. Products like coffee and tea, berries and soy sauce are notorious for staining teeth. Over time, teeth actually become more absorbent and vulnerable to staining from food and other substances.
One type of stain—caused by traumatic injuries, medications and fluorosis—actually begins inside the tooth; brushing and flossing don’t help. Another type of stain—one that can be more easily attacked by brushing, flossing and rinsing—is caused by external factors such as foods.
More and more people today are choosing tooth-whitening procedures to reverse the effects of aging and abuse from food and tobacco stains.
Some commercially available "whitening toothpastes" can be somewhat effective at removing stains and making teeth a few shades brighter. However, many of these products have abrasive substances that can actually wear away your tooth's enamel.
Whitening agents actually change the color of your teeth, but only are effective on certain types of stains. For example, bleaching agents have a difficult time removing brownish or grayish stains. These products also are not as effective on pitted or badly discolored teeth, or on restorations such as crowns, bridges, bonding and tooth-colored fillings (porcelain veneers or dental bonding may be more appropriate in this case).
The professional whitening solution offered by our office is considered to be the most effective and safest method available; done properly, tooth whitening can last as long as five years.
Root canals are tiny passageways that branch off from beneath the top of the tooth, coursing their way vertically downward, until they reach the tip of the root.
All teeth have between one and four root canals.
Many tooth problems involve infections that spread to the pulp, which is the inner chamber of the tooth containing blood vessels, nerves and other tissues. When the infection becomes worse, it can begin affecting the roots. A traumatic injury to a tooth can also compromise the pulp, leading to similar problems.
A diseased inner tooth brings a host of problems including pain and sensitivity as the first indications of a problem. However, inside a spreading infection can cause small pockets of pus to develop, which can lead to an abscess.
Root canal therapy is a remarkable treatment with a very high rate of success, and involves removing the diseased tissue, halting the spread of infection and restoring the healthy portion of the tooth. In fact, root canal therapy is designed to save a problem tooth; before the procedure was developed and gained acceptance, the only alternative for treating a diseased tooth was extraction.
Root canal therapy usually entails one to three visits. During the first visit, a small hole is drilled through the top of the tooth and into the inner chamber. Diseased tissue is removed, the inner chamber cleansed and disinfected, and the tiny canals reshaped. The cleansed chamber and canals are filled with an elastic material and medication designed to prevent infection. If necessary, the drilled hole is temporarily filled until a permanent seal is made with a crown.
Most patients who have root canal experience little or no discomfort or pain, and enjoy a restored tooth that can last almost as long as its healthy original.
Simple toothaches can often be relieved by rinsing the mouth to clear it of debris and other matter. Sometimes, a toothache can be caused or aggravated by a piece of debris lodged between the tooth and another tooth. Avoid placing an aspirin between your tooth and gum to relieve pain, because the dissolving aspirin can actually harm your gum tissue.
Broken, Fractured, or Displaced Tooth
A broken, fractured or displaced tooth is usually not a cause for alarm, as long as decisive, quick action is taken.
If the tooth has been knocked out, try to place the tooth back in its socket while waiting to see your dentist.
First, rinse the mouth of any blood or other debris and place a cold cloth or compress on the cheek near the injury. This will keep down swelling.
If you cannot locate the tooth back in its socket, hold the dislocated tooth by the crown - not the root. Next, place it in a container of warm milk, saline or the victim's own saliva and keep it in the solution until you arrive at the emergency room or dentist's office.
For a fractured tooth, it is best to rinse with warm water and again, apply a cold pack or compress. Ibuprofen may be used to help keep down swelling.
If the tooth fracture is minor, the tooth can be sanded or if necessary, restored by the dentist if the pulp is not severely damaged.
If a child's primary tooth has been loosened by an injury or an emerging permanent tooth, try getting the child to gently bite down on an apple or piece of caramel; in some cases, the tooth will easily separate from the gum.
A knocked out tooth or bitten tongue can cause panic in any parent, but quick thinking and staying calm are the best ways to approach such common dental emergencies and prevent additional unnecessary damage and costly dental restoration. This includes taking measures such as application of cold compresses to reduce swelling, and of course, contacting our office as soon as possible.