Composite Resins are tooth colored restorations that are bonded into place. They generally require less tooth structure to be removed than amalgam (silver) restorations. They are an excellent option to restore form and function given their ability to be shaped and color-matched to the patient’s dentition.
Amalgam Restorations are commonly known as “silver” fillings. Amalgams are an alloy composed of five metals: Silver, Mercury, Tin, Cooper and Zinc. Given the advancements in composite resin technology, amalgam (silver) restorations are used less frequently. When the existing amalgam restorations have met their ideal life expectancy, they are now generally replaced with a different restorative material.
Inlays and Onlays are restorations fabricated by the dental lab and require a minimum of two office visits. They are usually placed in cases that require more tooth structure to be removed and would require a stronger and more durable restorative material in comparison to the typical composite resin or amalgam restoration. There are 3 materials available:
Gold: Still considered to be the best material because of the exceptional fit, longevity, and biocompatibility. However, due to its aesthetic perception, gold is not used as often.
Porcelain has increasingly become more popular due to its higher aesthetic value; however, it is more abrasive than gold and may need to br replace more frequently.
Lab-processed composite resin is a less utilized alternative. It is similar to the composite resin material placed directly by the dentist chair side. However, it is stronger because the material is more thoroughly cured in the dental lab. In comparison to porcelain, it is less abrasive, but not as strong and stains more easily.
Crowns are prosthetic restorations that replace and replicate the entire portion of the tooth and are commonly known as “caps.” They are usually placed to protect the tooth as a whole, restore a significant amount of missing or damaged tooth structure, or improve the shape and position of the original tooth. There are 3 general categories of materials from which crowns can be made from.
Porcelain Fused to Metal (PFM): Alloy of metals are covered by porcelain to replicate the look of natural teeth. The types of metals used may vary. We use only High Noble metals, which is the highest quality, because of their intrinsic ability to resist corrosion.
Gold: Still considered to be the best material because of the exceptional fit, longevity, and biocompatibility. However, it is not used as often now because of esthetic perception.
Full Porcelain: Seen as the most aesthetically pleasing option. Recent advances have made full porcelain crowns stronger and thus more widely used, even in areas that have traditionally been reserved for PFM's.
Veneers are prosthetic restorations used for enhancing the aesthetics of teeth. They are typically made of porcelain, but can be made of composite resin. They are chemically bonded on to the facial surface of natural teeth.
Teeth Whitening (bleaching) is used to enhance the aesthetics of teeth by whitening the intrinsic color of the dentin layer of the teeth. The dentin layer lies under the enamel, which is the outermost layer of the tooth and is semi-transparent. That is why stain removers such as some whitening toothpastes will have no affect on changing the color of teeth since the color is provided by the dentin. Whitening teeth tends to cause some temporary sensitivity, but each individual results may vary. The color end result will vary for each individual as well. There are three general methods of teeth whitening:
Over the Counter (OTC) teeth whitening products tend to be the cheapest route. The concentration of the whitening ingredient is less than that provided by dental professionals.
Take-Home Bleaching Trays consist of placing professional strength whitening gel into individually fabricated customized trays. The trays are generally worn for 2 to 3 hours a day for about two weeks or until the desired shade is reached.
Zoom In-Office Whitening is a one visit procedure. A special light activated bleaching gel is placed on the upper and lower front 8 to 10 teeth (depending on each person's width of smile), and the Zoom light is placed directly over the teeth to activate the gel. The appointment takes approximately 2 hours. This product was used in the popular show "Extreme Makeovers."
Depending on each individual’s diet (e.g. wine, soda, etc.) and oral habits (e.g. smoking), touch ups are often needed every 6 months.
Prophylactic Cleaning is commonly referred to as a regular cleaning. It should be done at least once every 6 months for patients with healthy gums. For those who have trouble maintaining their hygiene but do not have the disease, periodontitis, a more frequent prophylactic cleaning may be ideal. The cleaning procedure involves removing plaque and other debris around the teeth and below the gum line by about 1-2mm, depending on the patient's comfort.
Scaling and Root Planing is commonly known as a deep cleaning. It is reserved for situations in which patient have periodontitist. Periodontitist is an infection of the gums and bones around the teeth. The effects of the disease are inflamed (red and swollen) gums, and bone loss around the teeth, which can be clinically detected by gum pocket measurements of 4mm or greater. With enough bone loss the teeth will become loose or may have to be taken out. The deep cleaning procedure consists of being anesthetized and using special dental instruments to go down to the base of the gum pocket and clean the root surfaces. In addition, one recommended option is to place the product Arestin in the deeper pockets at the time of the deep cleaning appointment. Arestin is an antibiotic, minocyclin, that has been shown to be a wonderful treatment adjunct, but may require multiple dosings.
Root Canal Treatment (RCT) is a procedure in which the pulpal tissue (nerves and blood vessels) are removed from within the tooth. The reasons for RCT are: to remove bacteria infected tissue; to alleviate pain; and to make it possible to restore a tooth with a dental prosthesis (i.e. crown). Root Canal Treatment has the stigma of being painful, but with present day advancements in anesthetics and techniques, the pain experienced in the past no longer holds true, or at least to a lesser degree.
Removable Partial Dentures are a treatment option to replace missing teeth. They are held in place by using either metal or acrylic clasps to hook on to the remaining teeth. They are to be taken out every night prior to going to bed and must be cleaned. The recommended replacement time is once every 5 years.
Complete Dentures are a treatment option to replace an entire set of teeth in either or both the upper and lower jaw. They do tend need to be relined approximately once every year and the recommended replacement time is once every 5 years. Implants can be used in combination with the dentures to improve retention and stability.
Implants are titanium prosthetic devices that are placed into the bone used to replace missing teeth. They are considered to be the best option for replacing missing teeth since they replace the entire tooth structure from root to crown and help to preserve bone. There is a waiting period of 4-6 months for the implant to osseointegrate, meaning the implant to fuse with the bone. After which, a custom fitting abutment and crown will be placed.
Extraction is the permanent removal of a tooth. Extractions are done under local anesthesia, but in complex cases of wisdom teeth extractions, patients may elect to be placed under general anesthesia. During routine extractions, the patient should not feel any pain, just pressure. There are multiple reasons for extracting a tooth, but the main reason is that the tooth is nonrestorable, which could be due to severe bone loss, fracture, decay, etc. Great care must be taken post-operatively so as to avoid a dry socket. A dry socket is when the blood clot is dislodged from the extraction site and the bone remains exposed. If a dry socket does occur, please call immediately so that we may treat your pain right away.
Oral Anti-Snoring and Sleep Apnea Devices are used to help alleviate the symptoms and the problem of sleep apnea and snoring. Snoring is the noise generated from the vibration of the soft palate and/or the partial airway obstruction from the tongue falling back into the throat area. Sleep apnea is the total obstruction of the airway when the tongue falls back into the throat. Snoring may disrupt the sleeping pattern of their bed partner, which may in turn cause them to be more irritable and less focused the next day. Sleep apnea has been shown to cause cardiovascular problems, next day fatigue, low mental acuity, and more seriously, premature death. Prior to obtaining an oral anti-snoring device, patients should see a physician specializing in sleep medicine so that the necessary tests may be performed to determine the proper diagnosis and treatment.
Night Guards are oral appliances that protect the patient's teeth when they clench or grind. People do it out of habit usually under stress during sleep. Signs and symptoms are flattened top surfaces of teeth, sore jaw muscles in the morning, and hyper-sensitive teeth.