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Restorative
Dentistry
Damaged, decayed and/or broken teeth can be restored to their
original function, shape and appearance with restorative dentistry, such
as fillings and crowns. These restorations may last years to decades,
and their success is dependent upon the patient always maintaining a
healthy mouth through regular daily brushing and flossing, and by visiting
the dentist at least twice a year. Today’s dentistry offers many options
for restoring teeth, and here are some descriptions of the most common
kinds of restorations.
Fillings
Fillings can directly replace the part of a tooth that is
lost to a smaller amount of decay or fracture. Fillings may last
many years, depending upon the patients chewing habits and their
long-term oral health care.
To keep you comfortable when a filling is done, we use a small amount
of local anesthetic to numb the tooth and the surrounding lip, gums,
or tongue. The numbness typically lasts from one to three hours. Then,
we will remove old filling material and the decayed, weakened tooth
structure. The tooth is then carefully inspected to make sure that
only healthy, non-decayed tooth structure remains.
There are two filling materials that we can use to fill cavities
- composite resin and amalgam.
Tooth-colored composite resin
Tooth-colored composite resin fillings have been available for over
30 years. The technology has been greatly improving over the years. Composites
are now an ideal option for restoring a tooth to its original shape, function,
and color. Additionally, more of the healthy tooth structure may to be saved
while placing the filling, and composite resin fillings are bonded to the tooth,
reducing the possibility of tooth fracture in some cases.
The disadvantages of using composite resin are: • It is a more expensive material to use than silver colored
amalgam. • There are some limitations to where in the mouth it can be
used effectively.
Silver-colored amalgam
Silver amalgam has been a standard filling material for the last
150 years. It is a strong, long-lasting material that is less expensive
than tooth-colored composite resin fillings.
The disadvantages of amalgam fillings are: • It is dark in color. • Often, more of the healthy tooth structure must be removed in order
to place the silver colored filling properly (compared to the tooth-colored
composite resins).
• Silver amalgam fillings contain mercury, which, on its own, is toxic. When mercury is combined with the silver, there is a negligible amount of mercury exposure, but we still do not know level of mercury exposure is completely safe. The Food and Drug Administration now suggests that silver amalgam fillings may be harmful to children, unborn children, pregnant mothers, and people with immune system sensitivities to mercury. The FDA is scheduled to create a more specific policy on silver amalgam fillings in 2009. It is important to note that removal of existing amalgam fillings may also pose a slight threat of mercury exposure, and that removal of silver amalgam fillings should not be performed to a pregnant mother.
Crowns
Crowns are a great option to repair and restore a tooth
that has larger amounts of decay, larger fillings that are breaking
down or if the tooth is significantly fractured. Crowns, sometimes
called "caps", are indicated
on teeth that need extra structural support. If a tooth is weakened due to
severe decay or very large fillings, it is prone to fracture under normal
biting forces. A crown helps to support and stabilize the tooth to ensure its
long-term health and reduce its risk for fracture.
Crowns are available in three materials: porcelain, porcelain fused
to metal, and gold.
Porcelain crowns have superior esthetics and are great for anterior
teeth. They may have some risk of fracture in posterior teeth.
Porcelain-fused-to-metal crowns have great esthetics and are very
strong. There are a few circumstances where they fracture or wear
the opposing teeth, and the dentist will review the advantages or
disadvantages for each individual tooth.
Gold crowns are an excellent choice for molars, as they require
the smallest amount of tooth structure to be removed. They do wear
down the opposing teeth that they chew against.
In all circumstances, the dentist will give the patient all the appropriate
options from which to choose. Our goal is for you to have the restorations
and the mouth that you want.
Bridges
Dental Bridges are strong, permanent, fixed restorations to replace a missing tooth. They consist of two crowns on either side of the missing tooth space, with a false tooth, called a pontic, in between. They are fabricated similar to crowns, and can be made of porcelain fused to metal, or full gold. They are a very durable, life-like replacement for a missing tooth. We engineer the bridge for strength as well as beauty. The care of bridges is similar to natural teeth, with brushing and flossing being critical to maintain the healthy bridge and underlying teeth. Flossing a bridge requires that the floss be threaded around the pontic to ensure the health of the gums around the bridge.
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