Our practice can provide a wide range of dental services. We can typically provide every type of dental service without having to refer you to other specialties. This flexibility saves you time and keeps your total dental care within one practice. Our emphasis is on total preventive care for our patients.
We will thoroughly examine your teeth and gums, specifically looking for any potential problems. Depending on the patient, X-rays may be taken. If there are any signs of decay or other problems, we will recommend treatment options and make notes of any conditions that may need future observation. Oral hygiene instructions will also be provided along with suggestions to help you care for your teeth.
Routine Teeth Cleanings
Twice a year, you should schedule a routine dental cleaning. During this visit, one of our dental hygienists will remove plaque from your teeth, especially from places where your brush can’t reach, such as underneath the gum line and between teeth. We will then clean your teeth and apply fluoride to help protect your teeth once you leave the office.
Fillings replace damaged or decayed tooth structure with a restorative material. There are several different types of filling materials, including:
- Silver amalgam: Silver was once the most commonly used material when it came to dental restorations, such as fillings. However, silver fillings do not have much aesthetic appeal to patients.
- Gold fillings: Gold fillings are very durable, able to last approximately 10 to 15 years. The main drawback to gold fillings is the cost of the restoration, since gold is a precious metal.
- White fillings: After much research, some new tooth-colored materials have been developed that are stronger, longer-lasting and more aesthetically pleasing to our patients. These new tooth-colored fillings bond directly to the tooth, strengthening it by restoring most of its original shape. The fillings can even be custom-colored to match your teeth to help give you the most natural-looking smile possible.
A crown is a custom-made covering that fits over an original tooth that is either decayed, damaged or cracked. Crowns are made of a variety of different materials such as porcelain, gold, acrylic resin or a mix of these materials.
The treatment plan for a patient receiving a crown usually involves:
- Numbing the tooth to remove the decay in or around it
- Re-sculpturing the tooth to provide an ideal fit for the crown
- Making a physical or digital impression of your teeth in order to create the custom crown
- Making a temporary crown out of acrylic resin and fitting it to the tooth while the custom crown is being made
- Removing the temporary crown and fitting the custom-made one onto the tooth
- Ensuring that the crown has the proper look and fit, and cementing it into place
New technologies have greatly reduced the time needed to make strong, natural-looking crowns. Once the procedure is completed, proper care should be taken to ensure the crown remains in good condition and the teeth and gums are healthy. Given proper care, your crowns can last a lifetime!
A bridge is a dental device that fills a space that a tooth previously occupied. A bridge may be necessary to prevent the shifting of teeth, to fix bite problems or to ensure the strength and integrity of the surrounding teeth.
Fixed bridges are the most popular, and consist of a filler tooth attached to two crowns in order to hold the bridge in place. “Maryland” bridges, commonly used to replace missing front teeth, use tooth-colored metal bands bonded to surrounding teeth. And cantilever bridges use two crowned teeth positioned next to each other on the same side of the missing tooth.
Regardless of your needs, we have a bridge solution that will work best!
A root canal is a procedure that extracts decayed tissue from inside a tooth, reshapes the canal and replaces it with strengthened filler. There are a number of reasons a root canal may be necessary, including dental injuries, severe decay and infection or inflammation in the tooth pulp. When left untreated, these problems can cause extensive damage to the tooth structure.
Root canals can typically be completed in one visit, although more extensive cases may require another appointment. You will also be able to drive yourself home after the appointment.
An extraction is the complete removal of a tooth. Extractions are sometimes necessary if:
- A primary tooth is preventing the normal eruption of a permanent tooth
- The tooth has suffered extensive tooth decay or trauma that cannot be repaired
- The patient has gum disease
- The tooth is impacted – this is usually the case with the third molars, or “wisdom teeth,” as they erupt years after the other teeth and often have insufficient room in the jaw
Depending on the complexity of the case, an extraction can be performed surgically or non-surgically. A mild anesthesia is used to ensure the patient is as comfortable as possible throughout the procedure.
Dentistry is an art as well as a science; dental crowns offer a perfect example of this. A dental crown or “cap” is a covering that fits over a damaged, decayed or unattractive tooth. It can even replace a tooth entirely as part of dental bridgework.
A crown completely covers a tooth above the gum line. This is in contrast to a dental veneer, which only covers a tooth’s front surface and needs natural tooth structure to support it. Therefore, if a tooth is missing a significant amount of structure above the gum line, a crown would be the restoration of choice.
Crowns strengthen damaged teeth, allowing them to function normally again. When crafted from today’s high-tech porcelains (dental ceramics), crowns are virtually indistinguishable from natural teeth. They can even be designed to improve upon a tooth’s original appearance.
There are other materials besides porcelain that we can use to make dental crowns, depending on what qualities are most important. For durability, cast gold can’t be beat. However, this is not always the most aesthetic choice — especially towards the front of the mouth. Other possibilities include porcelain-fused-to-metal crowns (PFM), which have a metal interior for strength and a porcelain exterior for a more natural appearance, and all-porcelain crowns with zirconia, representing the strongest ceramic. We would be happy to discuss the pros and cons of these various options with you.
Crowning or Capping a Tooth
Crowning or capping a tooth will usually take two to three visits. At the first visit, we will prepare your tooth to receive its new crown. First we will shape it to fit inside the new covering. This will involve some drilling to give the tooth a uniform shape. We will numb the tooth and the surrounding area beforehand. If there is very little tooth structure left to begin with, we may have to build up the tooth with filling material, rather than remove tooth structure, to support the crown.
After the tooth is prepared, we will take impressions of your teeth, either digitally or with reliable, putty-like impression materials, and send them to the dental laboratory. There, the impressions will be used to make models of your teeth for the creation of a crown. The models will serve as guides to the highly skilled lab technicians, who will ensure that your new crown is designed to enhance your smile and function well within your bite.
Before you leave the office, we will attach a temporary crown to your tooth to protect it until the permanent crown is ready. At the second visit, your permanent crown will be attached to your tooth with either a resin that hardens when exposed to a special light source, or a type of permanent cement.
Creating a Bridge
Crowns can also be used to create a lifelike replacement for a missing tooth. This is done with bridgework, which spans the space of the missing tooth and requires at least three crowns. Two of those crowns will be placed over healthy teeth on either side of the missing tooth; these healthy teeth are referred to as abutment teeth. The two crowned abutment teeth become supports for a third crown placed in between them; that third crown is referred to as a pontic. If more than one tooth is missing, more crowns will be needed to bridge the gap in between the abutment teeth.
The number of abutment teeth necessary to replace missing teeth is influenced by the number of missing teeth, the size and length of the abutment tooth roots, the amount of bone support each abutment tooth has, as well as where in the mouth the missing tooth is located. For example, if you have three missing teeth, four abutment teeth may be necessary, thereby creating a seven-tooth bridge. Engineering and designing of the bridge requires an understanding of how to replace teeth, as well as the biology of the supporting gum and bone tissue.
Caring for Your Crowns & Bridgework
Crowns and bridgework require the same conscientious care as your natural teeth. Be sure to brush and floss between all of your teeth — restored and natural — every day to reduce the buildup of dental plaque. When you have crowns, it is even more important to maintain your regular schedule of cleanings here at the dental office. Avoid using your teeth as tools (to open packages, for example). If you have a grinding habit, wearing a nightguard would be a good idea to protect your teeth and your investment.
If you have never had a cavity, congratulations! If you have had one, you are not alone. About 78% of us have had at least one cavity by the time we reach age 17, according to a 2000 report by the U.S. Surgeon General. Fortunately there’s a time-tested treatment for cavities: the dental filling.
Fillings do just what the name implies — seal a small hole in your tooth, i.e., a cavity, caused by decay. This prevents the decay (a bacteria-induced infection) from spreading further into your tooth and, if untreated, continue on to the sensitive inner pulp (nerve) tissue located in the root canal. Should that happen, you would need root canal treatment.
There are a variety of materials we use to fill teeth these days, but the process of filling a tooth is similar regardless. First, we do a clinical exam of the tooth and, with x-rays, determine the extent of the decay. Then we need to remove the decayed area of the tooth, usually with a dental drill or another handheld instrument. Your tooth will be anesthetized first, so you won’t feel any discomfort. If numbing injections normally provoke anxiety for you, please let us know; we can discuss medication or the use of nitrous oxide, to help with this. After we remove the decay, all debris is cleaned from the tooth, and then the filling material is applied.
Types of Fillings
Fillings can be divided into two broad categories: metal and tooth-colored. Both have advantages and disadvantages, which we would be happy to discuss in detail with you.
Amalgam — The classic “silver” filling in use for more than a century, dental amalgam is actually an alloy made up of mercury, silver, tin, and copper. The mercury combines with the other metals in the amalgam to make it stable and safe. These fillings are strong and inexpensive, but also quite noticeable. They also require relatively more tooth preparation (drilling) than other types.
Cast Gold — Among the most expensive restorative dental materials, cast gold combines gold with other metals for a very strong, long-lasting filling. It is also highly noticeable, which can be considered a plus or minus.
Composite — A popular choice for those who don’t want their fillings to show, composite is a mixture of plastic and glass, which actually bonds to the rest of the tooth. Composites are more expensive than amalgam fillings, and the newer materials can hold up almost as long. Less drilling of the tooth is necessary when placing composite as compared to amalgam.
Porcelain — These high-tech dental ceramics are strong, lifelike, and don’t stain as composites can. They are sometimes more expensive than composites because they can require the use of a dental laboratory or specialized computer-generated technology. While considered the most aesthetic filling, they can also, because of their relatively high glass content, be brittle.
Glass Ionomer — Made of acrylic and glass powders, these inexpensive, translucent fillings have the advantages of blending in pretty well with natural tooth color and releasing small amounts of fluoride to help prevent decay. They don’t last as long as other restorative materials.
What to Expect After Getting a Filling
The numbness caused by your local anesthesia should wear off within a couple of hours. Until then, it’s best to avoid drinking hot or cold liquids, and eating on the side of your mouth with the new filling. Some sensitivity to hot and cold is normal in the first couple of weeks after getting a tooth filled. If it persists beyond that, or you have any actual pain when biting, please let us know. This could signal that a bite adjustment to your filling needs to be made. Continue to brush and floss as normal every day, and come in to the dental office at least twice per year for your regular checkups and cleanings. Tooth decay is a very preventable disease; with good oral hygiene and professional care, you can make your most recent cavity your last!