Restorative Dentistry

FILLINGS:
A filling is placed when a tooth has an amount of decay that has not affected the tooth nerve or the structural integrity of the tooth. Dr. B uses a traditional handpiece or a laser to prepare a tooth to receive a filling. When appropriate, laser technology eliminates the noise and vibration associated with dental work. Our patients find fillings painless and quick.

Filling materials may be amalgam (metal) or composite (tooth-colored). Decay is removed from the affected tooth, and is cleaned and made ready to accept the material of choice. The materials used for fillings are at first moldable which allows Dr. B to carve the anatomy of your tooth. It’s important that a filling is designed to fit within a patient’s bite pattern. Once the bite has been checked, Dr. B completes the restoration.

ROOT CANALS:
Root canal treatment is indicated when a tooth is broken or severely decayed that the tooth nerve (the pulp) has been affected. Underneath the exterior enamel layer is the layer called dentin. Dentin is more organic and softer than enamel. Under the dentin is the pulp which contains blood vessels, nerves, and connective tissue.

In addition to removing the decay, the damaged or infected pulp is removed and the canal system is sterilized using the laser. The canal space is then sealed with special cement and gutta-percha (a pink rubbery material). A crown is usually needed after root canal treatments since a significant portion of the tooth’s structure will have been lost to decay or breakage.

Though many filling materials are durable, enough tooth structure needs to remain to confine the filling correctly. Without the tooth structural walls, a filling is subject to breakage; therefore, it’s the reason for the crown restoration.

CROWNS:
A crown, also sometimes called a “cap,” is usually made of gold or semi-precious metal (silver, platinum, palladium alloy). More recently, crowns are designed on a computer and are fabricated using zirconia oxide, a highly durable ceramic material comparable to metal. Crowns are made to replace large portions of a tooth that has been compromised by breakage or decay. Crowns involve preparing the damaged tooth, taking impressions or scanning the mouth with a computer camera, pouring models, and constructing a replica of your tooth. The dental laboratory can then fabricate the crown restoration. In cosmetic dentistry, we will improve upon the original configuration of the teeth.

FIXED BRIDGES:
Fixed bridges have been the classic way to replace strategically missing teeth. A fixed (or cemented) bridge involves preparing the 1 or more teeth on either side of the missing tooth or teeth and fabricating a single-piece restoration that looks like multiple crowns. It replaces the structure of the surrounding anchor teeth and suspends the missing tooth or teeth in the middle. These are not removable by the patient unless an anchor tooth becomes loose for some reason. A fixed bridge functions like natural teeth.

IMPLANTS:
Implants are titanium or ceramic cylinders that, when embedded in the jaw bone, simulate the root of a missing tooth. Implants are used to replace 1 or more missing teeth or to anchor a removable partial denture or full denture. Restored implants are more secure and function more like natural teeth than removable appliances, although a removable appliance secured by implants can function more like natural teeth.

If possible, it is preferable to replace teeth with implants instead of fixed bridges since we do not need to reshape the surrounding teeth next to the missing location. Therefore, it is less invasive.

FULL DENTURES OR PARTIAL DENTURES:
These are removable oral appliances to replace missing teeth that a patient can take in and out of the mouth. Partial dentures replace some missing teeth and are anchored by clasps or precision attachments cast into crowns. Full dentures replace all teeth in either the upper or lower jaw and depend on the anatomy, saliva, and suction ability for retention of the appliance.

TEETH XPRESS:
If a patient is missing all the upper and/or lower teeth, or if one needs removal of all upper and/or lower teeth and wants a more secure option for their replacement, Teeth Xpress may work for you. The dental prosthesis is attached to 4–6 implants placed by an oral surgeon in 1 visit. The restorative dentist will fabricate a temporary appliance that is placed the day of implant surgery.

Healing time is 3–6 months depending on upper or lower jaw surgery and the quality of the remaining boney ridge. After the recommended healing time, the final appliance is fabricated and replaces the temporary.

`DENTAL LASER (continued):
The dental laser can also be used in periodontal therapy to sterilize deeper gum pockets and recontour the gum tissue. We can remove certain growths in the mouth and for biopsies. We can place a “laser bandaid” over wounds in the mouth to decrease pain and facilitate healing. We can also tighten the skin around the mouth to reduce wrinkles and sagging to a point. We are always finding new applications for use of the dental laser.

INVISALIGN:
Instead of traditional braces using metal brackets and wires, Invisalign uses a series of clear aligners (plastic mouth pieces) to move and straighten your misaligned teeth. Impressions or computer scans are performed and your case is designed digitally. Each aligner is fabricated to move the teeth in small increments until the final alignment is achieved. Each case is evaluated to determine if the Invisalign technique is appropriate for the result to be achieved. There are times when traditional braces will achieve a better result.

NIGHTLASE:
Nightlase is a procedure performed by a dental laser to tighten the tissues of the mouth and soft palate. This procedure opens up the airway and tissues of the mouth and soft palate. Nightlase opens up the airway and allows breathing to proceed more easily through the nose and mouth.

The procedure usually requires no anesthesia, and is performed at least 3 sessions. Nightlase will reduce snoring, allowing for better sleep and less chance of medical issues related to snoring and a compromised airway.

PERIODONTAL THERAPY:
Healthy teeth and gums are pink, firm, exhibit no bleeding on probing, and exhibit little plaque or tartar deposits and cover the roots of the teeth. When a patient displays gum recession, bone loss around the teeth, inflamed or bleeding gums, or bleeding on measuring the depth of gum pockets (where the gum attaches to the root of the tooth), then periodontal treatment is indicated.

There are different levels of therapy depending on the findings. If a patient has advanced disease, then we refer to a periodontist, a specialist in the gums, supporting bone and implants. If there is early disease, we can perform a gross debridement where we use ultrasonic and hand scalers to clean the mild to moderately deep pockets and root surfaces of the teeth.

We can then do a routine prophylaxis on a routine basis if the oral health stabilizes. If the pockets are deeper, then we will anesthetize and perform a deeper debridement and use the laser to help decontaminate the pockets. This is called scaling and root planing. Maintenance is then performed on a routine basis every 3 months. The justification of this is because the dental plaque matures and becomes disease-producing every 90 days.