BondingBonding uses composite resin material to change the color and shape of the tooth.
The purposes for bonding include: repairing tooth damage from decay, altering tooth alignment, closing gaps between teeth, and making cosmetic improvements. These are the steps:
- The surface of the tooth is roughened in order to accept and hold the bonding.
- The tooth surface is etched with a gel and a primer/bond agent is then applied.
- The material itself is placed on the tooth and hardened with a curing light.
- The composite resin material is shaped and polished to a natural-looking finish.
A bridge replaces a missing tooth both functionally and cosmetically by filling the space. The sides of a bridge use the two surrounding teeth for support, hence the name.
Bridge work is as much an art as it is an exact science.
The materials may be all porcelain, porcelain fused to metal, or all gold, depending on requirements for strength, wear or esthetics.
Replacing a missing tooth as soon as possible is important because the teeth surrounding the gap begin to shift inward, creating a chain reaction of problems:
- The bite changes in response to the pressure.
- The change in bite can eventually cause problems with the entire jaw (for example, TMJ).
- The surrounding teeth deteriorate and may eventually need to be extracted. If a lower tooth is missing, the opposing upper tooth may move out of alignment to fill that gap.
Cosmetic Dentistry
This treatment corrects the appearance of the mouth.
Because the upper teeth show when smiling and the lower teeth show when talking, both arches are important.
The color, alignment spacing and regularity of the teeth can all be repaired to give a more confident smile.
A wide variety of cosmetic options are available including smile design, whitening, teeth recontouring, bonding, veneers, ceramic crowns and full-mouth reconstruction.
Crowns
Crowns are full-coverage restorations for teeth that are
- Likely to break.
- Too broken down to be restored with a filling.
They are most commonly recommended after root canal treatment or when a large filling wears out.
The larger the cavity, the more likely a crown is needed to ride over the weakened tooth, thereby providing strength and protecting the tooth against breakage.
A broken or cracked tooth is far more serious and much more difficult to treat.
Crowns also contribute to a nicer smile.
Two appointments are necessary to restore a tooth with a crown.
At the first appointment, the decay or existing filling is removed from the tooth and the tooth is shaped to accept the crown. Then an impression is made for fabricating a crown (usually made of all porcelain, porcelain fused to metal, or all gold).
The patient wears a temporary crown until the second appointment. At that time the permanent crown is adjusted as needed and then cemented in place.
Dentures (Complete or Partial)
Although dentures differ in their appearance, they share a common function: to replace loose or decayed teeth.
In preparation for dentures, the entire mouth is examined and the dentist determines which teeth must be removed. The loose teeth are then extracted.
Dentures cover the entire arch or fit around the remaining teeth.
Patients usually need an adjustment period after dentures are placed in the mouth, but in general, acceptable functionality and appearance do return. Implants may be used to further stabilize the dentures.
Fillings
Fillings replace tooth structures affected by decay. If not treated, decay can lead to toothaches or infection and eventually to root canal treatment or extraction.
Caught early enough, cavities can be treated easily and painlessly. Today most teeth are treated with bonded tooth-colored composite resin fillings.
Implants
Dental implants replace missing teeth. They can also support an implant bridge or denture. In this procedure, a small titanium post is surgically positioned in the bone; the bone grows around the post, forming a tight connection.
Once the implant is firmly integrated (approximately 2 months), the dentist attaches the replacement to the top of the post.
Implants have the following advantages over bridge work:
- Most importantly, the implant preserves the jaw bone.
- It does not require the adjacent teeth for support.
- It offers the most natural appearance and function.
Laser Decay Detection
Laser decay detection uses a diode laser to scan the tooth surfaces. Because healthy tooth material does not fluoresce (glow) under the laser, only areas of decay show up.
This process allows us to see new cavities months or years before they show up on X-rays, long before they become serious problems.
Nitrous Oxide (Laughing Gas)
The use of nitrous oxide makes treatment more comfortable. It's safe, effective and pleasant.
The patient wears a mask and breathes in through the nose, out through the mouth. Within 4 minutes, the patient becomes more sedate; the cheeks and gums may go numb. At this point, local anesthetic is applied and treatment can begin.
When the treatment is complete, the patient breathes pure oxygen for about five minutes to dissipate the effects of the nitrous.
Non-Surgical Gum Treatments
The gums, ligaments and bone form the teeth’s foundation (periodontium), so an unhealthy periodontium jeopardizes the stability of the teeth.
Signs of periodontium (gum) disease may include:
- Red gums that bleed easily
- Persistent bad breath
- Gums pulled away from the teeth
- Loose teeth
- Changes in the position or bite of the teeth
The treatment usually involves a deep cleaning or root planing and application of local antibiotics .
Because severe gum disease may require surgery or extraction, we strongly advise early treatment.
Root Canal Treatment
Root canal treatment (endodontic therapy) is necessary when a cavity reaches the tooth’s pulp (the nerve and its bundle of blood vessels).
Although regular cleanings and checkups can prevent and detect early problems, other causes (such as deep restorations, crown preparation or trauma to a tooth) may damage the nerve.When the pulp becomes infected, the infection can extend through the root tip to the surrounding bone, creating an abscess. If the infection is not treated, it can weaken the body’s entire immune system – a dangerous situation!
Symptoms that the pulp has become infected may include:
- Sensitivity to hot/cold or sweets
- Pain
- Swelling
- Pain to biting or pressure
- A bad taste in the mouth
During root canal treatment, the dentist cleans out the infected tooth pulp and disinfects the canals.
The only other possible treatment is extraction of the tooth.
After the infection is resolved, the canal(s) are filled with material to prevent further infection. The final step is a post, core buildup and crown.
Sealants
The tooth structure has fine grooves or pits that cannot be adequately cleaned by brushing. Over time, plaque may accumulate in these areas and cause cavities.
The dentist seals the grooves and pits by brushing on a coating. This treatment allows you to brush off the plaque and keep your teeth healthy.
TMJ Treatments
The temporal-mandibular joint joins the head to the lower jaw. Problems in this joint may be caused by:
- Misaligned teeth
- Trauma
- Excess muscle tension
- Excess of grinding and clenching
- Headaches
- Neck pain
- Earaches
- Trouble/soreness in opening and closing the mouth
- Clicking or popping of the jaw
- Pain in the jaw muscles
- Soreness in the area, sometimes extending to the face
Dental treatments for the condition may include:
- Wearing a plastic mouthpiece to prevent clenching or grinding
- Taking muscle relaxing medication
- Seeking physical therapy
- Adjusting the bite
- Replacing missing teeth
- Moving teeth
Whitening - Including Zoom2!
This procedure makes teeth whiter and, therefore, more attractive.
We use Zoom2!, in the office and offer passive tray whitening for you to use at home.
Zoom2! is a safe, effective and fast whitening procedure. The clinician applies the whitening gel that is then activated by a special light. A fluoride treatment completes the procedure. Most patients see an immediate improvement. Over the next few days, the color stablizes. We recommend the patient uses trays with gel afterward for maximum whitening and maintenance.
With the tray method, the patient wears custom vinyl trays at night or twice a day for 30 minutes for approximately 2 weeks. The trays are filled with a carbamide peroxide or a hydrogen peroxide gel, which comes in different strengths. (The higher the strength, the greater the likelihood of reactions or tooth sensitivity.) Sometimes we recommend this method for: mildly stained tetracycline teeth. The patient may need to continue the process for several months to see significant color improvement.
For maintenance of whitened teeth, the patient should use the trays for one week every several months.
Trays and Zoom2! have the same results, but the tray method is about half the cost of Zoom2!, and the tray method usually causes less post-treatment sensitivity. However, the tray method takes much longer for results.
X-Rays
X-rays are a necessary part of the diagnostic process. With an X-ray of the whole tooth and its supporting bone and gum tissues, the dentist is able to detect infection, diseases and pathological concerns.
Veneers
We recommend veneers for teeth that need a change in their appearance such as:
- A chipped tooth
- Diastema (teeth widely spaced)
- Tetracycline teeth
- Worn teeth
- Badly stained teeth (tobacco, coffee, soda, etc.)
- Teeth with congenital abnormalities
The direct technique bonds composite resin onto the tooth (see the earlier section Bonding).
The indirect technique requires two appointments:
- The dentist prepares the teeth, takes impressions and gives the teeth a temporary covering. Impressions are sent to a dental laboratory, which then fabricates the veneers.
- Two to three weeks later, the dentist removes the temporaries and bonds the veneers to the teeth.
Compared to crowns:
- Less tooth material is removed with veneers.
- The veneer procedure requires minimal (if any) anesthesia.