Restoring & Preserving Teeth
Fillings
Tooth decay can occur even with healthy eating habits, good oral hygiene and regular dental care. When small areas of decay are present, a filling can be used as a minor, minimally invasive treatment. This replaces the decayed area and protects the tooth from further damage.
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Composite resin, a tooth-colored material made of glass and plastic, can be used for a discreet restoration option that matches the color of natural teeth. This type of filling won't affect the appearance of your smile.
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During the filling procedure, your dentist will first remove the decayed material and clean the tooth. Next, the filling material will be placed in the cleaned area and shaped to match the contour of your tooth.
From there, the material is set using a special curing light. After the filling has been hardened, your dentist will polish it to a smooth finish that feels natural in the mouth.
Crowns
Dental crowns are necessary when multiple surfaces of the tooth have been compromised by decay, cracks, or a previous filling. They may also be used to prevent the breakage of teeth. They cover the entire tooth above the gum line, acting as a tooth-shaped cap that is cemented onto the natural tooth to protect it, prevent further damage and restore its size and shape.
Crowns not only have restorative benefits but can also improve the appearance of your smile. For example, patients with misshapen or severely damaged teeth can receive multiple crowns to enhance their smile's appearance.
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Dental crowns can be made of a few different materials. The most common are full gold, porcelain fused to metal (PFM) and all-ceramic.
Full Gold Crown
Full gold crowns are less likely to chip or break, require less reduction of natural tooth structure, but they're the most expensive option. They're made of high noble alloys (precious metals) with at least 40% gold content. Due to the color, these crowns aren't as aesthetically pleasing as PFM or all-ceramic solutions. But, they're best suited for back teeth.
Porcelain Fused to Metal (PFM) Crown
Porcelain fused to metal (PFM) dental crowns are the most common type of crown restoration. They have a base layer of noble alloy and are covered with porcelain (tooth-colored material). They have the benefits of a metal base but are more aesthetically pleasing. However, they can be prone to cracking, especially in people who grind their teeth (bruxism).
All-Ceramic Crowns
All-ceramic dental crowns are strong restorations and can be matched to the natural color of your surrounding teeth, which makes them an excellent option for front teeth. The most common materials used to make all-ceramic crowns include zirconia and lithium disilicate.
Zirconia Crowns
Zirconia dental crowns are a strong restoration option for people with bruxism or who have cracked or broken teeth. They're tooth-colored but not as visually pleasing as lithium disilicate crowns. They're typically recommended for use on back teeth.
Lithium Disilicate Crowns
Lithium disilicate (e.max®) crowns are strong restorations that match well with natural teeth color. This makes them great for all areas of the mouth, but they're particularly recommended for front teeth.
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Initial consultation: Your dentist will examine your teeth and discuss your treatment options with you. Crowns usually take two appointments.
First appointment: Your dentist will remove any damaged or decayed tooth structure and shape the remaining tooth to make room for the crown. Then, they'll take impressions (molds) of your teeth to send to a dental lab that'll create your custom crown. Lastly, a temporary crown will be placed over the prepared tooth to protect it while your permanent crown is being made at the lab.
Delivering the permanent crown: Once your permanent crown is ready, you'll return to the dentist for a follow-up appointment. The temporary crown will be removed and the permanent crown will be checked for fit and color-matched to your other teeth. If everything looks good, the permanent crown will be cemented in place.
Follow-up care: Dental crowns can be brushed and flossed just like your natural teeth. Your dentist will evaluate your crown and all other teeth at your next exam.
Root Canals
A root canal (also known as endodontic treatment) is a common dental procedure that's used to treat a damaged or infected tooth. When faced with the option to either extract a tooth or save it with a root canal, it's usually better to choose the latter.
While prosthetics such as dental implants, partials or bridges can replace a missing tooth, saving your existing tooth is often more cost-effective and the only way to preserve the natural feel of your tooth.
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To understand root canals, it's important to know the anatomy of teeth. Teeth have four parts: the enamel, dentin, cementum and pulp chamber.
The enamel is the hardest substance in the human body and acts as a protective layer for the dentin. The cementum covers the roots of the teeth and the pulp chamber contains the nerves and blood vessels that support the tooth. If trauma or infection reaches the pulp chamber, a root canal may be necessary to restore oral health.
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A root canal is typically needed when the soft tissue inside a tooth (called the pulp) becomes inflamed or infected. This can be caused by a variety of factors such as a deep cavity, a crack in the tooth or trauma. If left untreated, it may cause pain or an abscess to form.
Common symptoms that indicate a need for a root canal include severe toothache, sensitivity to hot or cold temperatures, swelling or tenderness in the gums, and darkening of the tooth and around the gum line.
Here are some other signs to watch for:
Intense pain when biting down or chewing
Pimples on the gums
Chips or cracks in the enamel
If you're experiencing any of these symptoms, it's best to contact your dentist. They'll be able to determine if a root canal is necessary after conducting an exam and taking X-rays of the affected tooth.
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Once your permanent teeth are in, you no longer need the pulp for the tooth to thrive, so it's possible to clean out the pulp chamber and save your tooth.
All back teeth, and some front teeth, will require a crown after a root canal to prevent future fractures and protect the root canal. If the root canal and crown are done together, treatment will typically take two visits to complete.
Root canal therapy is a procedure that can save a damaged or infected tooth by removing the pulp (soft tissue inside the tooth) and cleaning the pulp chamber. The procedure usually takes 1-2 visits to complete and may be combined with a crown if your tooth's surface is significantly decayed or damaged.
Because every patient is unique, sometimes teeth with especially difficult-shaped roots may need to be referred to an endodontist.
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Exam and X-rays: Your dentist will examine your tooth and take X-rays to determine the depth of the tooth's roots.
Numbing: They’ll numb the area to prevent pain during the procedure.
Protective barrier: A protective barrier is placed around the tooth to protect it from saliva and bacteria during the procedure.
Decay removal: Any existing decay is removed and an opening is created in the crown of the tooth.
Flushing, cleaning and drying: The tooth is flushed, cleaned, and dried as many times as necessary to kill infection-causing bacteria.
Pulp removal: Using a special file, your dentist will carefully remove the pulp from the root canal channels and get it into shape.
Filling the canals: A body-friendly material is used to fill in the canals to maintain their shape.
Placement of post: If the tooth lacks sufficient structure, sometimes a small post is placed in with the filling material to better support the future crown.
Filling and crowning: A filling is placed to seal the interior of the tooth. If your root canal needs a crown, this filling will be used to support the crown.
Final crown placement: Once the final crown is in place, you’ll be able to eat, speak, and smile comfortably for years to come.