Dental Care Associates

Fillings

Before

After

Fillings are done to restore teeth that have cavities, broken teeth, and old fillings. It is called a filling because a new material fills a hole that decay left. Now days most teeth are treated with bonded tooth colored composite resin fillings. Caught early enough, cavities can be treated easily and painlessly. If not treated decay can lead to a toothache and/or infection, which could lead to the tooth needing root canal treatment or extraction.

Crowns

Before During treatment Finished

Crowns are full coverage restorations that are used to cover a tooth that is likely to break, or is too broken down to be restored with a filling, and they are commonly done after root canal treatment. Teeth are subjected to tremendous pressures. Crowns cover the weakened tooth, providing strength and protecting the tooth against breakage. A broken or cracked tooth is a far more serious matter and much more difficult to treat. Crowns prevent this, as well as making for a nice smile.

It takes two appointments to restore a tooth with a crown. In the first any decay is removed from the tooth and it is shaped to accept the crown. Then an impression is made of the tooth for use in fabricating a crown. Between the two visits the crown is made, usually of high-strength porcelain over gold alloy, all ceramic material, or gold. During this time a temporary crown is worn. In the second visit this temporary is removed. Then the permanent crown is adjusted as needed and then cemented in place.

Implants

                                       Before                                                                 After
           Patient missing four teeth on left side of lower jaw.                      All implants restored with teeth with a very natural appearance!

Before After
Patient missing front tooth Tooth replaced with and implant and crown!

A dental implant is an option to replace missing teeth or to support dentures. In this procedure, a small titanium post is placed into the bone and allowed to set. The bone grows around it forming a tight connection, which additionally prevents the bone loss that occurs when the root of a natural tooth is missing. Once the implant is firmly set in the mouth, we fabricate a replacement tooth onto the top of the post. This permanent solution has the advantages over bridge work that it does not stress the surrounding teeth for support, and, should the tooth wear out, another can simply be replaced on the post.

Implants can also be used as support as part of an implant bridge. This is an alternative to partial dentures, and has several advantages. First, there is no adjustment period to acclimatize the patient who, once the work is done, only feels teeth, not metal supports intruding into the mouth. Second, this slows the bone loss occasioned by missing teeth. Third, there is no discomfort or difficulty in eating. And, best of all, of course, they don't have to be taken out all the time.

Bridges

                           Before                                                                                               After
Patient missing two teeth and front teeth chipped and poor                Great results, pt is learning to smile again!!!!
appearance, patient told us he never smiles, and hasn't
for thirty years.

This is an option for filling the space created by a missing tooth. It is formed to look like the missing tooth, and it takes its place in the mouth. The sides of a bridge use the two surrounding teeth for support, hence the name. A bridge replaces the missing tooth, both functionally and cosmetically. Bridge work is as much an art as it is an exact science. The materials used may be gold alloys, porcelain bonded to metal alloy, or all ceramic material. The choice of material depends on requirements for strength, wear, and/or esthetics.

It is important that a missing tooth be replaced as soon as possible for several reasons. If not treated the teeth surrounding the gap begin to shift inward, creating a whole chain reaction of bad things. Teeth use their neighbors for support, and, with one missing, they start to "fall." As this worsens, the bite changes in response to the pressure.

Root Canal Treatment

Root canal treatment (also referred to as root canal therapy or endodontic therapy) is made necessary when a cavity is allowed to reach all the way to this pulp. (Regular cleanings and checkups prevent and detect problems early) Sometimes deep restorations or trauma to a tooth may cause the nerve to be damaged to the point it needs root canal therapy, also. Once this occurs the pulp becomes infected, and can even extend through the root tip and begin to eat away at the surrounding bone (this is an abscess). By the time the pulp is infected it must be treated, and cannot heal on its own. This is dangerous, not to mention very painful. Symptoms that 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. Sometimes, however, no symptoms are apparent and the person is 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. Once the infection is resolved, the canal(s) are filled in to prevent any further infection. A core build-up and crown is usually recommended for restoring a tooth that has had root canal therapy.

Extractions

Sometimes when a tooth is determined un-restorable due to excessive loss of tooth structure or bone supporting the tooth, removing the tooth is the only option. In the short term extracting a tooth may seem like the least expensive, but the cost of replacing the missing tooth as well as treating the difficulties extending from a missing tooth it causes is much more expensive. For these reasons extracting a tooth should be the last option. Wisdom teeth are best extracted to prevent the problems associated with retaining them. A wisdom tooth is the hardest tooth to clean as well as restore, and in order to prevent these problems we may recommend extracting these even if you don't have problems with them yet.

Dentures

There are different types of dentures, but they share their common function. They replace teeth that have been lost due to cavities or bone loss. The entire mouth is examined and a determination is made as to which teeth will have to be removed, and which will remain. Dentures are fitted to go over or around whatever teeth remain in the mouth, depending on the type. There is an adjustment period after dentures are placed in the mouth, and it can take some getting used to. Often we use utilize implants to both stabilize and prevent further bone loss with lower dentures when closer to normal function is needed.

Digital X-Rays
This is a focused beam of X-Ray particles through bone which produces an image on special film, showing the structure through which it passed. This gives the familiar black and white images that doctors and dentists use to diagnose problems. X-rays are a necessary part of the diagnostic process, and not to use them could lead to undiagnosed disease. Without an X-ray of the whole tooth, and supporting bone and gum tissues, there is no real way to detect infection or pathology that requires attention.

In our office we use digital radiography which allows us to take X-rays using up to 70% less radiation versus conventional X-rays. Coupled with computer monitoring, digital x-ray technology allows us to enhance the images for better diagnosis of any dental concerns.

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Frequently Asked Questions

Q: Which type of toothbrush should I use?
A: The brand of the toothbrush is not as critical as the type of bristle and the size of the head. A soft toothbrush with a small head is recommended because medium and hard brushes tend to cause irritation and contribute to recession of the gums, and a small head allows you to get around each tooth more completely and is less likely to injure your gums. It's unnecessary to "scrub" the teeth as long as you are brushing at least twice a day and visiting your dentist at least twice a year for cleanings.

Q: Is one toothpaste better than others?
A: Generally, no. However, it's advisable to use a fluoride containing toothpaste to decrease the incidence of dental decay. We recommend our patients use what tastes good to them as long as it contains fluoride.

Q: How often should I floss?
A: Flossing of the teeth once per day helps to prevent cavities from forming between the teeth where your toothbrush can't reach. Flossing also helps to keep your gums healthy.

Q: What's the difference between a "crown" and a "cap"?
A: These are restorations to repair a severely broken tooth by covering all or most of the tooth after removing old fillings, fractured tooth structure, and all decay. The restoration material is made of gold, porcelain, composites, or even stainless steel. Dentists refer to all of these restorations as "crowns". However, patients often refer to the tooth-colored ones as "caps" and the gold or stainless steel ones as "crowns".

Q: What's the difference between a "bridge" and a "partial denture"?
A: Both bridges and partial dentures replace missing teeth. A bridge is permanently attached to abutment teeth or, in some cases, implants. A partial denture is attached by clasps to the teeth and is easily removed by the patient. Patients are usually more satisfied with bridges than with partial dentures.

Q: What about "silver" fillings versus "white" fillings?
A: Although the U.S. Public Health Service issued a report in 1993 stating there is no health reason not to use amalgam (silver fillings), more patients today are requesting "white" or tooth-colored composite fillings. We also prefer tooth-colored fillings because they "bond" to the tooth structure and therefore help strengthen a tooth weakened by decay. While fillings are also usually less sensitive to temperature, and they also look better. However, "white" fillings cannot be used in every situation, and if a tooth is very badly broken-down, a crown will usually be necessary and provide better overall satisfaction for the patient.

Q: Do I need to have a root canal just because I have to have a crown?
A: No. While most teeth which have had root canal treatments do need crowns to strengthen the teeth and to return the teeth to normal form and function, not every tooth needing a crown also needs to have a root canal.