Crowns & Bridges | Fillings | Root Canal | Dentures | Conservative Periodontics
Extractions | Bruxing Night Guard Appliances | Sports Mouthguards
Crowns and Bridges
A crown is a permanent 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. Porcelain generally has the most natural appearance, although it is often less durable.
The treatment plan for a patient receiving a crown 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 an impression of your teeth in order to create a custom-made crown (usually takes one to two weeks).
- Making a temporary crown out of acrylic resin and fitting it onto the tooth during the interim period when the permanent custom-made crown is being created.
- Applying the permanent crown (when received from the lab) by removing the temporary crown and fitting the permanent one onto the tooth.
- After ensuring that the crown has the proper look and fit, the dentist cements it into place.
This process generally consists of a minimum of 2-3 visits over a three to four week period.
Once the procedure is completed, proper dental hygiene, including daily brushing and flossing, is required to maintain healthy, bacteria-free teeth, gums and crowns. This helps in the prevention of gum disease. 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:
- Shifting of the teeth that can lead to bite problems (occlusion) and/or jaw problems and resultant periodontal disease.
- Bridges safeguard the integrity of existing teeth and help maintain a healthy, vibrant smile.
There are three main types of bridges, namely:
- Fixed bridge- this is the most popular and consists of a filler tooth that is attached to two crowns, which fit over the existing teeth and hold the bridge in place.
- The "Maryland" bridge is commonly used to replace missing front teeth and consists of a filler that is attached to metal bands that are bonded to the abutment teeth. The metal bands consist of a white-colored composite resin that matches existing tooth color.
- The Cantilever bridge is often used when there are teeth on only one side of the span. A typical three-unit cantilever bridge consists of two crowned teeth positioned next to each other on the same side of the missing tooth space. The filler tooth is then connected to the two crowned teeth, which extend into the missing tooth space or end.
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The concept of a "filling" is replacing and restoring your tooth structure that is damaged due to decay or fracture with a material. We will replace old, broken-down amalgam/metal fillings that contain traces of mercury with white fillings (composites) to restore your smile and teeth to a more natural look and feel.
With today’s advancements, no longer will you have to suffer the embarrassment of unsightly and unhealthy silver/mercury fillings or metal margins of the past. Eliminate the dark, black appearance in your teeth with new-age, state-of-the-art, tooth-colored resin or porcelain materials.
Comparing White Fillings Versus Silver Amalgam Fillings:
- White fillings bond to the tooth; they strengthen the tooth by restoring most of its original shape. Silver amalgams, on the other hand, weaken the teeth and make them more susceptible to breaking. Broken teeth can be very expensive to replace; white amalgam can actually save time and money in the long run.
- White filling composites are preferred by most patients. This is due to the natural color, strength and overall appearance and feel. Composites are naturally more comfortable.
- Hot and cold sensitivity is greatly reduced with composite material compared to the silver/mercury amalgams.
- Restorations with composites require less removal of tooth, less structure to place than those with amalgams and especially with new cavities. Dramatically smaller holes are needed with a composite.
- White fillings are healthier because no traces of mercury are used, unlike silver amalgams.
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A root canal is a procedure that extracts decayed pulp from the central part of the tooth, reshapes the canal and replaces it with strengthening filler.
A cavity is the result of superficial decay of the enamel of the tooth. Left long enough, this decay can burrow into the deeper reaches of the tooth, causing extensive damage to tooth structure. When the damage goes beyond what can be treated with a filling, dentists can perform a root canal (or endodontics), preserving the tooth and retaining its original integrity; thereby, saving a tooth that in the past would have to have been pulled.
- The patient undergoes anesthesia.
- A dental dam is used to isolate the tooth.
- The tooth is opened to allow for removal of infected or dead dental pulp.
- The tooth is comprehensively cleaned, including any cracks and canals.
- With special tools, the doctor reshapes the canals.
- The tooth is filled again with cutting edge biocompatible filling material.
- A temporary covering is used to cover the access opening.
- Patients MUST see their regular dentist quickly for a permanent restoration of the tooth.
Also known as a root-end resection, an apicoectomy literally means the removal of the apex of the root of the tooth. This procedure, done following a root canal, treats the bony area surrounding the end of your tooth, which has become inflamed or infected. By folding back the gum near the tooth, the doctor can access the underlying bone and extract the inflamed tissue. At the same time, the very tip of the root is removed and usually replaced with a small plug or filling. At this time, the doctor may treat the area with antibiotics and will then close the area with a small suture. Eventually, the jaw surrounding the tooth will fill in with bone, supporting the tooth as before. This procedure helps ensure the lasting result of your endodontic treatment.
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Replacing your missing or damaged teeth will benefit not only your appearance but your overall health. Using state-of-the-art technology and updated materials, dentures can now be custom designed to look more natural and feel more comfortable.
It may take some time to adjust to your dentures. Speaking and eating may feel different at first, but these regular activities will resume normally once you are accustomed to your dentures.
Complete dentures are artificial, removable replacements for the natural teeth of the upper or lower jaw or both.
- Upper dentures
Upper dentures are held in place by a vacuum created between your appliance and the palate of your mouth.
- Lower dentures
Lower dentures are horseshoe-shaped to accommodate the tongue, and, due to lack of suction, are often held in place by implants placed in the jaw for support.
Partial dentures are removable appliances that replace missing teeth by attaching via a metal framework to your natural teeth.
Caring for your removable appliances:
Proper denture care is essential to the durability of your dentures and the overall health of your mouth.
- Brush your dentures daily with a soft-bristled tooth brush. (Don’t forget to brush your gums and tongue as well.)
- While not being worn, keep your dentures in denture solution and/or water (not hot) to prevent warping.
- Handle with care and keep out of the reach of children and pets
- If your dentures become loose, chip, break or crack, see your dentist.
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Even when periodontal disease is in a fairly advanced stage, it is possible to improve or even reverse the condition with non-surgical procedures. Depending on the type of disease and its severity, one of these approaches may be suggested by your doctor.
This process can be done above or below the gum line and involves the scraping and removal of plaque and calculus (tartar) from the tooth. Scaling done at regular teeth cleanings usually involves the crown of the tooth. However, in more extreme circumstances, it is necessary to go further below the gum line to thoroughly remove disease-causing bacteria and its by-products on the root surface. In very advanced cases, flap surgery or gingivectomy may be necessary to allow the doctor free access to the infected tooth root.
After the thorough cleaning of the tooth surface has been completed above and below the gum line, the root of the tooth undergoes a process called planing. This is a process of smoothing the root of the tooth so that any remaining tartar is removed. This also serves two other purposes: it clears away any rough areas that bacteria below the gum line thrive in, and it makes it much easier for the gingival (gum) tissue to re-attach itself to the tooth, effectively reducing the size of the pockets that the plaque and bacteria hide in. This re-growth of tissue is key in stopping a recurrence of gum disease and happens very quickly once the calculus has been removed.
With either of these procedures, your periodontist may prescribe you either local or systemic antibiotics and a specially indicated mouth rinse.
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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, if the tooth has suffered extensive tooth decay or trauma that cannot be repaired, if the patient has gum disease, or if the tooth is impacted (usually the wisdom teeth). Depending on the complexity of the case, an extraction can be performed surgically or non-surgically. A mild anesthesia is used to ensure your child is as comfortable as possible throughout the procedure.
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Bruxing Night Guard Appliances
A bruxing night guard appliance is a hard plastic retainer placed over either the top or bottom row of your teeth. It is designed to help prevent or slow the damage done to teeth by grinding or clenching. Nighttime grinding and clenching can wear down the tooth enamel, eventually leading to major dental procedures such as root canals, tooth extractions, crown placements and oral surgery. With a properly designed night guard splint, the wear on this enamel is decreased, therefore slowing the damage to the teeth.
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We are pleased to offer our patients custom-fabricated mouthguards for sports activities. Unlike stock mouthguards, which fit loosely because they are designed to accommodate many possible wearers, our sports mouthguards are tailored to fit your exact dental profile, providing the highest attainable level of comfort and security in a mouthguard.
The first step in fabricating these mouthguards is to take an impression of your teeth. We then use that impression and fabricate the mouthguard using special professional-grade materials. The perfect fit of these custom-fabricated mouthguards ensures that not only will your mouthguards fit comfortably, they will also offer the most protection and will interfere the least with speech or breathing.
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