Restorative Dentistry

A person's smile can be their best feature. But chipped, stained, misshapen, or missing teeth can mar that smile, and cause a person to feel self-conscious. Fortunately today's dentistry offers patients a wide range of choices to correct these problems and help restore confidence to their smiles.

Replacing Missing Teeth

A missing tooth can cause problems with your bite. The teeth on either side of the missing tooth or the tooth that would occlude (bite) against the missing tooth can shift into the open space. When teeth tip or drift, it may become difficult to keep them clean. This can eventually lead to decay, gum disease, and the loss of additional teeth. There are several options available to replace missing teeth.

Fixed Bridgework

A bridge is a lab fabricated restoration that literally bridges the "gap" left by the missing tooth or teeth. The restoration is bonded permanently into place. Materials used to create this type of restoration include gold or porcelain. "Fixed" bridgework is easy to maintain with good brushing and flossing.

Implants

Implants are metal posts and are inserted directly into the bone in the area of the missing tooth. After placement of an implant, the post will need to remain undisturbed for several months while the implant and the bone fuse together. A final restoration can then be placed onto the exposed metal post. The metal posts can be placed by oral surgeons, periodontists, and some general dentists. Dr. McGary will place them, on a case-by-case basis. These implant posts can also be used to retain dentures for more stability. Dr. McGary, after sufficient healing time, can place the final restoration (crown or bridge). In order for implants to be a viable option, there must be sufficient, good quality bone in the area of the missing tooth or teeth.

Removable appliances

If there are several missing teeth which we need to replace, and adequate bone support is not present for implant or fixed bridge treatment, a removable bridge or partial denture may be the treatment option for you. A removable appliance can help with chewing, aid in speech, and give facial support. The appliance usually requires metal clasps that attach to existing teeth.

The success of any bridge, implant, or removable dental appliance depends on the health of the teeth, gums, or bone to which it is attached. It is important to maintain the health of your teeth and gums.

Cracked Teeth

Teeth may crack due to:

It can be difficult to tell which tooth hurts or whether the pain is from an upper or lower tooth. A crack may appear as a hairline fracture, running vertically along the tooth. It often is invisible to the eye and usually will not show on an x-ray. A cracked tooth may cause discomfort because the pressure of biting causes the crack to open. When you stop biting, the pressure is released and a sharp pain results as the crack quickly closes. Even thought the crack may be microscopic, when it opens, the nerve chamber inside the tooth may become irritated. If this nerve chamber becomes damaged or diseased as a result of the crack, root canal treatment may be necessary to save the tooth. A severely cracked tooth may need to be extracted if the tooth cannot be saved. Recommended treatment for a cracked tooth is a full coverage crown. This type of restoration is needed to cover the tooth to keep the crack from opening when biting. Regular dental check-ups are important. They allow diagnosis and treatment of problems in their early stages.

Repairing Teeth

Even without missing teeth there are a host of problems that you can encounter that can make you less than confident about your smile. Common restorations used by dentist to repair damaged teeth include crowns, extractions, fillings, and root canals

Crowns

A crown (or a cap) is a porcelain or gold cover that fits precisely over the affected tooth. You may need a crown when a tooth has new decay around an existing filling and no longer has enough tooth structure to accommodate another filling. A crown is also recommended treatment for a tooth that has a microscopic crack and needs the support of a crown to hold the tooth together. Teeth that have had root canal treatment are more likely to require full coverage to protect the tooth from fracture.

Extractions

Sometimes the only way to deal with a damaged or misshapen tooth is to remove it. An extraction may be necessary for a number of reasons, ranging from a tooth that is simply too decayed to be saved, to a baby tooth reluctant to fall out naturally, or a wisdom tooth that has become impacted. When the dentist determines that a tooth needs to be removed, the extraction may take place during that visit, or you may be required to schedule a separate appointment for the procedure. Tooth extraction does not take much time, but if you have concerns or wish to be sedated for the procedure, it is crucial that you share that information with the dentist.

Fillings

Damage to teeth caused by cavities is frequently addressed with fillings, also known as direct restorations. Traditional filling materials include amalgam fillings (silver) or gold filling restorations. Some older amalgam fillings contained mercury. While the strength and durability of these materials still make them useful for situations where restored teeth must withstand extreme forces that result from chewing, such as in the back of the mouth, they are conspicuous and tend to blacken in color over time. Newer dental filling materials include ceramic and plastic compounds that more closely mimic the appearance of natural teeth. These compounds, often called composite resins, are used most frequently in front teeth where a natural appearance is important, although they can be used on the back teeth in some circumstances. Composite resins tend to cost more than fillings made from the older materials.

Root Canal (Endodontic) Treatment

Root canal procedures are used to help save a diseased tooth. There are tiny canals within your tooth that may become infected, particularly if your tooth has a deep crack or cavity. This infection causes the pulp inside your tooth to become diseased. Left without treatment an abscess can form in the pulp tissue, causing the tissue to die and threatening your tooth, as well as the surrounding teeth and jaw. During a root canal procedure the dentist or endodontist specialist will drill into the tooth, remove all the diseased pulp and clean out all the tooth's canals. Then the cleaned out areas are sealed and a temporary filling will be placed on the tooth. A crown or permanent filling will be used after it's been determined that the infection is truly gone. Treatment often involves one to three visits, and contrary to popular belief is relatively simple and inflicts relatively minimal pain. A tooth that has been restored with a root canal can last a lifetime, provided you are diligent with your oral hygiene.

Which Option is Right for You?

There are a number of factors that help determine which procedure and material is best for you, and how much you can expect to spend for that procedure. These factors include: the components used, the amount of tooth structure remaining, the chewing load that the tooth will have to bear, and the length and number of visits needed to prepare and adjust the restored or replaced tooth.

The ultimate decision is best determined by the patient in consultation with the dentist. Before your treatment begins, discuss the options with the dentist. So talk to the dentist about the options most suitable for you.