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Bonding

An alternative to veneers is a process called bonding, in which a tooth-colored material that looks like the enamel of your teeth is molded and shaped, and then hardened and polished. Bonding can be used to improve the color of a tooth, or close unsightly gaps.

Bonding is generally not as permanent a process as veneers, and can be vulnerable to the same kind of staining your natural teeth are prone to. Bonding can also be more prone to chip and cracks than veneers.

Caps are generally preferred to bonding when such a procedure isn't deemed to be effective in the long run.

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Bridges

Bridges are natural-looking dental appliances that can replace a section of missing teeth. Because they are custom-made, bridges are barely noticeable and can restore the natural contour of teeth as well as the proper bite relationship between upper and lower teeth.

Bridges are sometimes referred to as fixed partial dentures, because they are semi-permanent and are bonded to existing teeth or implants. Some bridges are removable and can be cleaned by the wearer; others need to be removed by a dentist.

Porcelain, gold alloys or combination of materials are usually used to make bridge appliances.

Appliances called implant bridges are attached to an area below the gum tissue, or the bone.

Crowns

Crowns are synthetic caps, usually made of a material like porcelain, placed on the top of a tooth.
Crowns are typically used to restore a tooth's function and appearance following a restorative procedure such as a root canal. When decay in a tooth has become so advanced that large portions of the tooth must be removed, crowns are often used to restore teeth.

Crowns are also used to attach bridges, cover implants, prevent a cracked tooth from becoming worse, or prevent an existing filling from becoming loose or dislocated. Crowns also serve an aesthetic use, and are applied when a discolored or stained tooth needs to be restored to its natural appearance.

Procedures

A tooth must usually be reduced in size to accommodate a crown. An impression is made of the existing tooth in order to fabricate a temporary crown and a second impression is taken of the prepared tooth. The second impression is sent to a special lab, which manufactures a custom-designed crown. A temporary crown is applied until the permanent crown is ready. Permanent crowns are cemented in place.

Crowns are sometimes confused with veneers, but they are quite different. Veneers are typically applied only to relatively small areas.

Caring For Your Crowns

With proper care, a good quality crown could last up to eight years or longer. It is very important to floss in the area of the crown to avoid excess plaque or collection of debris around the restoration.

Certain behaviors such as jaw clenching or bruxism (teeth grinding) significantly shorten the life of a crown. Moreover, eating brittle foods, ice or hard candy can compromise the adhesion of the crown, or even damage the crown.

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Implants

Before development of dental implants, dentures were the only alternative to replacing a missing tooth or teeth.

Implants are synthetic structures that are placed in the area of the tooth normally occupied by the root. Implants are anchored to the jawbone or metal framework on the bone and act as a foundation for an artificial tooth or permanent bridge. In some cases, implants can be used to attach to dentures.

Not everyone is a candidate for a dental implant, however. For a successful implant to take hold, a candidate must have proper bone density and have a strong immune system. In all cases, dental implants require strict oral hygiene.

Implants are so well designed that they mimic the look and feel of natural teeth. Implants are usually made of a synthetic yet biocompatible material like metal or ceramic.

Surgery is necessary to prepare the area for an implant and place the implant in the mouth., Following the procedure, a period of time is required for the implant to take hold and for a bone tissue to build up and anchor the device. In some cases, metal posts are inserted into the implant during a follow-up procedure to connect the tooth.

Because implants require surgery, patients are administered anesthesia and, if necessary, antibiotics to stave off infection following the procedure.

Like any restoration, implants require diligent oral hygiene and proper care to ensure they last a long time.

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Teeth Whitening

Whitening procedures have effectively restored the smile of people with stained, dull, or discolored teeth.

The darker tissue of your teeth, the dentin, can become exposed as the outer layer of enamel is worn away by the effects of aging or things like caffeine and tobacco.

Food particles are naturally attracted to a tooth's enamel by a certain protein. Products like coffee and tea, berries and soy sauce are notorious for staining teeth. Over time, teeth actually become more absorbent and vulnerable to staining from food and other substances.

One type of stain-caused by traumatic injuries, medications and fluorosis-actually begins inside the tooth; brushing and flossing don't help. Another type of stain-one that can be more easily attached by brushing, flossing and rinsing-is caused by external factors such as foods.

More and more people today are choosing tooth-whitening procedures to reverse the effects of aging and abuse from food and tobacco stains.

Some commercially available "whitening toothpastes" can be somewhat effective at removing stains and making teeth a few shades brighter. However, many of these products have abrasive substances that can actually wear away your tooth's enamel.

Whitening agents actually change the color of your teeth, but only are effective on certain types of stains. For example, bleaching agents have a difficult time removing brownish or grayish stains. These products also are not as effective on pitted or badly discolored teeth, or on restorations such as crowns, bridges, bonding and tooth-colored fillings (porcelain veneers or dental bonding may be more appropriate in this case).

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Sealants

The pits and grooves or your teeth are prime areas for opportunistic decay. Even regular brushing sometimes misses some of these intricate structures on the chewing surfaces of your teeth.

Sealants actually were developed about 50 years ago, but didn't become commonly used until the 1970's. Today, sealants are becoming widely popular and effective; young children are great candidates for preventative measures like sealants because in many cases, decay has not set in. Even on teeth where decay is present, sealants have been shown to fight additional damage.

Sealants are applied by first cleaning the tooth surface. The procedure is followed by "etching" the tooth with an abrasive substance, which allows the sealant to better adhere. After the sealant is applied, a warm light source is directed to the site to promote faster drying. Sealants usually need reapplication every five to 10 years.

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Root Canal Therapy

Root canals are tiny passageways that branch off from beneath the top of the tooth, coursing their way vertically downward until they reach the tip of the root.

All teeth have between one and four root canals.

Many tooth problems involve infections that spread to the pulp, which is the inner chamber of the tooth containing blood vessels, nerves and other tissues. When the infection becomes worse, it can begin affecting the roots. A traumatic injury to a tooth can also compromise the pulp, leading to similar problems.

A diseased inner tooth brings a host of problems. Pain and sensitivity are some of the first indications of a problem, while inside, a spreading infection can cause small pockets of pus to develop, leading to an abscess.

Root canal therapy is a remarkable treatment with a very high rate of success. It involves removing the diseased tissue, halting the spread of infection, and restoring the healthy portion of the tooth. In fact, root canal therapy is designed to save a problem tooth; before the procedure was developed and gained acceptance, the only alternative for treating a diseased tooth was extraction.

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General Procedure

When restoration procedures such as root canal therapy, crowns, or fillings are not enough to save a tooth, it may need to be pulled, or extracted.

Tooth extraction procedures today are far less painful than ever before, thanks to powerful anesthetics and sedatives. In many cases, a patient who has a tooth pulled experiences little or no discomfort, and only minor bleeding.

Before a tooth is extracted, the area surrounding the tooth is numbed with a topical/and or injectable anesthetic such as Novocaine.

Patients with extracted teeth sometimes need to take an antibiotic, and at the very least, take precautions following the procedure to ensure that infection doesn't occur.

Smoking, vigorous brushing and rinsing, and drinking liquids through straws are discouraged during the post-operative period because they hinder healing and may cause the wound to open. Cold compresses applied to the outside cheek near the extraction area can help reduce any swelling and promote faster healing.

Wisdom Teeth

Wisdom teeth are the third and final set of molars that erupt in the back corners of the upper and lower normal adult mouth. Unfortunately, most people experience problems from wisdom teeth; in most cases, this is because the teeth erupt too close to existing permanent teeth, causing crowding, improper bites, and other problems.

If wisdom teeth are causing a problem and are not pulled, they can sometimes become impacted. Impacted wisdom teeth can be extremely painful, as well as harmful to your oral health. Symptoms are easy to spot: severe discomfort, inflammation, and some kinds of infections.

Many people need to have their wisdom teeth extracted to avoid serious problems in the future. In general, the lack of the four wisdom teeth does not hamper one's ability to properly bite down, speak or eat.

If you experience any of the following symptoms, you may have an impacted wisdom tooth:

• Facial swelling
• Infection
• Pain
• Gum swelling

POST OP INSTRUCTIONS:

BLEEDING. Following extractions some bleeding is to be expected. If persistent bleeding occurs, place gauze pads over bleeding area and bite down firmly for one-half hour. Repeat if necessary. Biting on a wet Lipton tea bag for a few minutes is also effective.

SWELLING. Ice bag or chopped ice wrapped in a towel should be applied to operated area—one-half hour on and one-half hour off for 4-5 hours.

PAIN. For mild to average pain use any medication you would normally take for a headache or other pain. If a prescription for medication has been given to you, fill it at the pharmacy and start taking immediately. Remember to always take antibiotics until completion. All antibiotic pills must be taken as directed until the bottle is empty.

FOOD. Light diet is advisable during the first 24 hours. Stay away from spicy foods or acidic foods.

BONY EDGES. Small sharp bone fragments may work up through the gums during healing. These are not roots; if annoying, return to this office for their simple removal. If any unusual symptoms occur, call the office at once. The proper care following oral surgical procedures will hasten recovery and prevent complications

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Scaling and Root Planing

Advanced gum disease sometimes requires the dentist to clean below the gum line to remove stubborn, crusty deposits called tartar or calculus, and remove damage near the tooth root. This is done to prevent further damage and restore and stabilize the tooth.

For some patients, a local anesthetic is administered to the affected area. Then, a small scaling instrument and/or ultrasonic cleaning device are used to remove deposits.

After cleaning, the root may need to be smoothed, or planed, to restore it as much as possible to its original shape. Planing also allows your gum tissue to better attach itself and heal properly.

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Dentures

A denture is a removable replacement for missing teeth and adjacent tissues. It is made of acrylic resin, sometimes in combination with various metals.

Types of dentures:

Complete dentures replace all the teeth, while a partial denture fills in the spaces created by missing teeth and prevents other teeth from changing position.

Candidates for complete dentures have lost most or all of their teeth. A partial denture is suitable for those who have some natural teeth remaining. A denture improves chewing ability and speech, and provides support for facial muscles. It will greatly enhance the facial appearance and smile.

Complete or full dentures are made when all of your natural teeth are missing. You can have a full denture on your upper or lower jaw, or both.

Complete dentures are called "conventional" or "immediate" according to when they are made and when they are inserted into the mouth. Immediate dentures are inserted immediately after the removal of the remaining teeth. To make this possible, the dentist takes measurements and makes the models of the patient`s jaws during a preliminary visit.

An advantage of immediate dentures is that the wearer does not have to be without teeth during the healing period. However, bones and gums can shrink over time, especially during the period of healing in the first six months after the removal of teeth. When gums shrink, immediate dentures may require rebasing or relining to fit properly. A conventional denture can then be made once the tissues have healed. Healing may take at least 6-8 weeks.

An overdenture is a removable denture that fits over a small number of remaining natural teeth or implants. The natural teeth must be prepared to provide stability and support for the denture.

Partial dentures are often a solution when several teeth are missing.

Removable partial dentures usually consist of replacement teeth attached to pink or gum-colored plastic bases, which are connected by metal framework. Removable partial dentures attach to your natural teeth with metal clasps or devices called precision attachments. Precision attachments are generally more esthetic than metal clasps and are nearly invisible. Crowns on your natural teeth may improve the fit of a removable partial denture and they are usually required with attachments. Dentures with precision attachments generally cost more than those with metal clasps.

How are dentures made?

The denture process takes about six weeks and four appointments: the initial diagnosis is made; an impression and a wax bite are made to determine vertical dimensions and proper jaw position; a "try-in" is placed to assure proper color, shape and fit; and the patient`s final denture is placed, following any minor adjustments.

First, an impression of your jaw is made using special materials. In addition, measurements are made to show how your jaws relate to one another and how much space is between them (bite relationship). The color or shade of your natural teeth will also be determined. The impression, bite and shade are given to the dental laboratory so a denture can be custom-made for your mouth.

The dental laboratory makes a mold or model of your jaw, places the teeth in a wax base, and carves the wax to the exact form wanted in the finished denture. Usually a "wax try-in" of the denture will be done at the dentist`s office so any adjustments can be done before the denture is completed.

The denture is completed at the dental laboratory using the "lost wax" technique. A mold of the wax-up denture is made, the wax is removed and the remaining space is filled with pink plastic in dough form. The mold is then heated to harden the plastic. The denture is then polished and ready for wear.

Getting used to your denture:

For the first few weeks, a new denture may feel awkward or bulky. However, your mouth will eventually become accustomed to wearing it. Inserting and removing the denture will require some practice. Your denture should easily fit into place. Never force the partial denture into position by biting down. This could bend or break the clasps.

At first, you may be asked to wear your denture all the time. Although this may be temporarily uncomfortable, it is the quickest way to identify those denture parts that may need adjustment. If the denture puts too much pressure on a particular area, that spot will become sore. Your denture can be adjusted to fit more comfortably. After making adjustments, you may need to take the denture out of your mouth before going to bed and replace it in the morning.

Start out by eating soft foods that are cut into small pieces. Chew on both sides of the mouth to keep even pressure on the denture. Avoid sticky or hard foods, including gum. You may want to avoid chewing gum while you adjust to the denture.

Care of your denture:

It's best to stand over a folded towel or a sink of water when handling your denture, just in case you accidentally drop it. Brush the denture (preferably with a denture brush) daily to remove food deposits and plaque, and keep it from becoming permanently stained. Avoid using a brush with hard bristles, which can damage the denture. Look for denture cleansers with the American Dental Association (ADA) Seal of Acceptance. Pay special attention to cleaning teeth that fit under the denture`s metal clasps. Plaque that becomes trapped under the clasps will increase the risk of tooth decay.

Hand soap or mild dishwashing liquid to clean dentures is also acceptable. Other types of household cleaners and many toothpastes are too abrasive and should not be used for cleaning dentures. A denture could lose its proper shape if it is not kept moist. At night, the denture should be placed in soaking solution or water. However, if the appliance has metal attachments, they could be tarnished if placed in soaking solution.

Even with full dentures, you still need to take good care of your mouth. Every morning, brush your gums, tongue and palate with a soft-bristled brush before you put in your dentures. This removes plaque and stimulates circulation in the mouth. Selecting a balanced diet for proper nutrition is also important for maintaining a healthy mouth.

Adjustments:

Over time, adjusting the denture may be necessary. As you age, your mouth naturally changes, which can affect the fit of the denture. Your bone and gum ridges can recede or shrink, resulting in a loose-fitting denture. Loose dentures can cause various problems, including sores or infections. Dentures that do not fit properly can be adjusted. Avoid using a do-it-yourself kit to adjust your dentures, as this can damage the appliance beyond repair. Glues sold over-the-counter often contain harmful chemicals and should not be used on a denture.

If your denture no longer fits properly, if it breaks, cracks or chips, or if one of the teeth becomes loose, see your dentist immediately. In many cases, dentists can make necessary adjustments or repairs, often on the same day. Complicated repairs may require that the denture be sent to a special dental laboratory.

Over time, dentures will need to be relined, re-based, or re-made due to normal wear. To reline or re-base a denture, the dentist uses the existing denture teeth and refits the denture base or makes a new denture base. Dentures may need to be replaced if they become loose and the teeth show signs of significant wear.

Common concerns:

Eating will take a little practice. Start with soft foods cut into small pieces. Chew slowly using both sides of your mouth at the same time to prevent the dentures from tipping. As you become accustomed to chewing, add other foods until you return to your normal diet.

Continue to chew food using both sides of the mouth at the same time. Be cautious with hot or hard foods and sharp-edged bones or shells.

Some people worry about how dentures will affect their speech. Consider how your speech is affected when you have a number of your natural teeth missing.

Pronouncing certain words may require practice. Reading out loud and repeating troublesome words will help. If your dentures "click" while you`re talking, speak more slowly. You may find that your dentures occasionally slip when you laugh, cough or smile. Reposition the dentures by gently biting down and swallowing. If a speaking problem persists, consult your dentist.

Denture adhesives:

Denture adhesives can provide additional retention for well-fitting dentures. Denture adhesives are not the solution for old, ill-fitting dentures. A poorly fitting denture, which causes constant irritation over a long period, may contribute to the development of sores. These dentures may need a reline or need to be replaced. If your dentures begin to feel loose, or cause pronounced discomfort, consult with your dentist immediately.

Close One of the most common jaw disorders is related to a problem with the temporomandibular joint, the joint that connects your lower jaw to your skull, and allows your upper and lower jaw to open and close and facilitates chewing and speaking.

People with temporomandibular joint disorders (TMD) often have a clicking or popping sound when opening and closing their mouths. Such disorders are often accompanied by frequent headaches, neck aches, and in some cases, tooth sensitivity.

Some treatments for TMD involve muscle relaxants, biofeedback, or wearing a small plastic appliance in the mouth during sleep.

Minor cases of TMD involve discomfort or pain in the jaw muscles. More serious conditions involve improperly aligned joints or dislocated jaws. The most extreme form of TMD involves and arthritic condition of the jaw joint. Traumatic injuries can also cause jaw dislocation.

In these cases, jaw surgery, may be required to correct the condition. Some jaw surgery can be preformed arthroscopically.

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Cosmetic Dentistry

People choose aesthetic dental procedures/surgery for various reasons, to repair a defect such as a malformed bite or crooked teeth, treat and injury, or just improve their overall appearance. Whatever the reason, the ultimate goal is to restore a beautiful smile.

For these and many other reasons, aesthetic dentistry has become a vital and important part of the dental profession.

Common aesthetic dental procedures can be performed to correct misshaped, discolored, chipped, or missing teeth. They also can be used to change the overall shape of teeth, from teeth that are too long or short, have gaps, or simply need to be reshaped.

Some of the more common procedures involve:

• Bonding-A procedure in which tooth-colored material is used to close gaps or change tooth color
• Contouring or reshaping - a procedure that straightens crooked, chipped, cracked, or overlapping teeth.
• Veneers - a procedure in which ultra-thin coatings are placed over the front teeth. For example, veneers have been used to correct unevenly spaced, crooked, chipped, oddly shaped or discolored teeth.
• Whitening and bleaching- are used to make teeth whiter through the use of bleaching trays
• Implants - a procedure that gives another option for replacing a missing tooth or teeth, They are so well designed that they mirror the feet of natural teeth.
• Crowns-a procedure to cover and protect the tooth. While a crown can be used for many different reasons such as restoring a tooth that has been broken, has advanced decay or compromised in another way, it can also be used to improve the aesthetics of your smile.

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Invisalign

Invisalign takes a modern approach to straightening your teeth, using a custom-made series of aligners made specifically for you and only you. These aligners are made of smooth, comfortable, and virtually invisible plastic that you simply wear over your teeth.

Wearing the aligners will gradually and gently shift your teeth into place, based on the exact movements that we prescribe for you. There are no metal brackets to attach and no metal wires to tighten. You simply pop in a new set of aligners approximately every two weeks, until your treatment is complete and you achieve that confident smile you have always wanted.

The best part about this process is that most people won't even know your straightening your teeth.