Restorative Dentistry

DENTAL BRIDGE

A bridge is made up of two crowns for the teeth on either side of the gap – these two anchoring teeth are called abutment teeth – and a false tooth/teeth in between. These false teeth are called pontics and can be made from gold, alloys, porcelain or a combination of these materials. Dental bridges are supported by natural teeth or implants.

What Are the Benefits of Dental Bridges?

  • Restore your smile
  • Restore your ability to properly chew and speak
  • Maintain the shape of your face
  • Distribute the forces in your bite properly by replacing missing teeth
  • Prevent remaining teeth from drifting out of position

What Types of Dental Bridges Are Available?

There are three main types of bridges:

  • Traditional bridges involve creating a crown for the tooth or implant on either side of the missing tooth, with a pontic in between. Traditional bridges are the most common type of bridge and are made of either porcelain fused to metal or ceramics.
  • Cantilever bridges are used when there are adjacent teeth on only one side of the missing tooth or teeth.
  • Maryland bonded bridges (also called a resin-bonded bridge or a Maryland bridge) are made of plastic teeth and gums supported by a metal framework. Metal wings on each side of the bridge are bonded to your existing teeth.

What Is the Process for Obtaining a Dental Bridge?

During the first visit, the abutment teeth are prepared. Preparation involves recontouring these teeth by removing a portion of enamel to allow room for a crown to be placed over them. Next, impressions of your teeth are made, which serve as a model from which the bridge, pontic, and crowns will be made by a dental laboratory. Your dentist will make a temporary bridge for you to wear to protect the exposed teeth and gums while your bridge is being made.

During the second visit, your temporary bridge will be removed and the new permanent bridge will be checked and adjusted, as necessary, to achieve a proper fit. Multiple visits may be required to check the fit of the metal framework and bite. This is dependent on each individual’s case. If the dental bridge is a fixed (permanent) bridge, your dentist may temporarily cement it in place for a couple of weeks to make sure it is fitting properly. After a couple weeks, the bridge is permanently cemented into place.

How Long Do Dental Bridges Last?

Dental bridges can last 5 to 15 years and even longer. With good oral hygiene and regular prophylaxis, it is not unusual for the life span of a fixed bridge to be over 10 years.

Will It Be Difficult to Eat With a Dental Bridge?

Replacing missing teeth should actually make eating easier. Until you become accustomed to the bridge, eat soft foods that have been cut into small pieces.

How Do I Care for My Bridges?

It is important to keep your remaining teeth healthy and strong as the success of the bridge (depending on the type selected) depends on the solid foundation offered by the surrounding teeth. Brushing twice a day and flossing daily helps prevent tooth decay and gum disease that can lead to tooth loss. Your dentist or dental hygienist can demonstrate how to properly brush and floss your teeth. Keeping a regular cleaning schedule will help diagnose problems at an early stage when treatment has a better prognosis. Selecting a balanced diet for proper nutrition is also important.

DENTAL CROWN

A dental crown is a tooth-shaped “cap” that is placed over a tooth – covering the tooth to restore its shape and size, strength, and/or to improve its appearance.

The crowns, when cemented into place, fully encase the entire visible portion of a tooth that lies at and above the gum line.

Why Is a Dental Crown Needed?

A dental crown may be needed in the following situations:

  • To protect a weak tooth (for instance, from decay) from breaking or to hold together parts of a cracked tooth
  • To restore an already broken tooth or a tooth that has been severely worn down
  • To cover and support a tooth with a large filling when there isn’t a lot of tooth left
  • To hold a dental bridge in place
  • To cover misshaped or severely discolored teeth
  • To cover a dental implant

What Types of Crown Materials Are Available?

Permanent crowns can be made from all metal, porcelain-fused-to-metal, all resin, or all ceramic.

How Long Do Dental Crowns Last?

On average, dental crowns last between 5 and 15 years. The life span of a crown depends on the amount of “wear and tear” the crown is exposed to, how well you follow good oral hygiene practices, and your personal mouth-related habits (you should avoid such habits as grinding or clenching your teeth, chewing ice, biting your fingernails and using your teeth to open packaging).

Does a Crowned Tooth Require any Special Care?

While a crowned tooth does not require any special care, remember that simply because a tooth is crowned does not mean the underlying tooth is protected from decay or gum disease. Therefore, continue to follow good oral hygiene practices, including brushing your teeth at least twice a day and flossing once a day-especially around the crown area where the gum meets the tooth.

DENTURE

A denture is a removable replacement for missing teeth and surrounding tissues. Two types of dentures are available – complete and partial dentures. Complete dentures are used when all the teeth are missing, while partial dentures are used when some natural teeth remain.

Complete Dentures

Complete dentures can be either “conventional” or “immediate.” Made after the teeth have been removed and the gum tissue has begun to heal, a conventional denture is ready for placement in the mouth about 8 to 12 weeks after the teeth have been removed.

Unlike conventional dentures, immediate dentures are made in advance and can be positioned as soon as the teeth are removed. As a result, the wearer does not have to be without teeth during the healing period. However, bones and gums shrink over time, especially during the healing period following tooth removal. Therefore a disadvantage of immediate dentures compared with conventional dentures is that they require more adjustments to fit properly during the healing process and generally should only be considered a temporary solution until conventional dentures can be made.

Partial Dentures

A removable partial denture or bridge usually consists of replacement teeth attached to a pink or gum-colored plastic base, which is connected by metal framework that holds the denture in place in the mouth. Partial dentures are used when one or more natural teeth remain in the upper or lower jaw. A fixed (permanent) bridge replaces one or more teeth by placing crowns on the teeth on either side of the space and attaching artificial teeth to them. This “bridge” is then cemented into place. Not only does a partial denture fill in the spaces created by missing teeth, it prevents other teeth from changing position. A precision partial denture is removable and has internal attachments rather than clasps that attach to the adjacent crowns. This is a more natural-looking appliance.

Are There Alternatives to Dentures?

Yes, dental implants can be used to support permanently cemented bridges, eliminating the need for a denture. The cost is usually greater, but the implants and bridges more closely resemble the feel of real teeth. Dental implants are becoming the alternative to dentures but not everyone is a candidate for implants. Consult your dentist for advice.

Does Insurance Cover the Cost of Dentures?

Most dental insurance providers cover some or all of the cost of dentures. However, contact your company to find out the specifics of what they will cover.

DENTAL FILLINGS

To treat a cavity your dentist will remove the decayed portion of the tooth and then “fill” the area on the tooth where the decayed material once lived.

Fillings are also used to repair cracked or broken teeth and teeth that have been worn down from misuse (such as from nail-biting or tooth grinding).

What Types of Filling Materials Are Available?

Today, several dental filling materials are available. Teeth can be filled with gold; porcelain; silver amalgam (which consists of mercury mixed with silver, tin, zinc, and copper); or tooth-colored, plastic and glass materials called composite resin fillings. The location and extent of the decay, cost of filling material, patients’ insurance coverage and your dentist’s recommendation assist in determining the type of filling that will best address your needs.

How Should I Care for My Teeth With Fillings?

To maintain your fillings, you should follow good oral hygiene practices – visiting your dentist regularly for cleanings, brushing with a fluoride-containing toothpaste, and flossing at least once daily. If your dentist suspects that a filling might be cracked or is “leaking” (when the sides of the filling don’t fit tightly against the tooth, this allows debris and saliva to seep down between the filling and the tooth, which can lead to decay), he or she will take X-rays to assess the situation. If your tooth is extremely sensitive, if you feel a sharp edge, if you notice a crack in the filling, or if a piece of the filling is missing, call your dentist for an appointment.

What’s a Temporary Filling and Why Would I Need One?

Temporary fillings are used under the following circumstances:

  • For fillings that require more than one appointment – for example, before placement of gold fillings and for certain filling procedures (called indirect fillings) that use composite materials
  • Following a root canal
  • To allow a tooth’s nerve to “settle down” if the pulp became irritated
  • If emergency dental treatment is needed (such as to address a toothache)

Temporary fillings are just that; they are not meant to last. They usually fall out, fracture, or wear out within 1 month. Be sure to contact your dentist to have your temporary filling replaced with a permanent one. If you don’t, your tooth could become infected or you could have other complications.

ROOT CANAL

A root canal is a treatment used to repair and save a tooth that is badly decayed or becomes infected.

Root canal procedures are performed when the nerve of the tooth becomes infected or the pulp becomes damaged. During a root canal procedure, the nerve and pulp is removed and the inside of the tooth is cleaned and sealed.

Root canal procedures have the reputation of being painful. Actually, most people report that the procedure itself is no more painful than having a filling placed. The discomfort experienced in the period leading up to a seeking of dental care is truly the painful period of time, not the root canal procedure itself.

What Damages a Tooth’s Nerve and Pulp in the First Place?

Nerve and pulp can become irritated, inflamed and infected due to deep decay, repeated dental procedures on a tooth and/or large fillings, a crack or chip in the tooth, or trauma to the face.

What Are the Signs that a Root Canal Is Needed?

Signs to look for include:

  • Severe toothache pain upon chewing or application of pressure
  • Prolonged sensitivity/pain to heat or cold temperatures (after the hot or cold has been removed)
  • Discoloration (a darkening) of the tooth
  • Swelling and tenderness in the nearby gums
  • A persistent or recurring pimple on the gums
  • Sometimes no symptoms are present

Alternatives to a Root Canal

Saving your natural teeth is the very best option, if possible. Your natural teeth allow you to eat a wide variety of foods necessary to maintain proper nutrition. The root canal procedure is the treatment of choice.

The only alternative to a root canal procedure is having the tooth extracted and replaced with a bridge, implant, or removable partial denture to restore chewing function and prevent adjacent teeth from shifting. These alternatives not only are more expensive than a root canal procedure but require more treatment time and additional procedures to adjacent teeth and supporting tissues.

Since some of the reasons why the nerve of a tooth and its pulp become inflamed and infected are due to deep decay, repeated dental procedures on a tooth and/or large fillings, following good oral hygiene practices (brushing twice a day, flossing at least once a day, and scheduling regular dental visits) may reduce the need for a root canal procedure.

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WISDOM TEETH EXTRACTION

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