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Braces (Orthodontia)
Braces are applied to teeth for various reasons, including poorly aligned jaws, crooked, crowded and missing teeth, or a bad bite (also called malocclusion).
Various things can cause teeth to become crooked or jaws misaligned, including thumb-sucking or a traumatic injury. Some conditions are inherited.
Children between the ages of 7 and 14 are typical candidates for braces because their facial structures are still developing. Adult braces usually entail additional procedures because their faces have already fully developed.
About Braces
Orthodontics is a field of dentistry that deals with corrections involving jaw and teeth alignment.
Braces employ the use of wires and are usually one of three types:
- Old-fashioned, conventional braces, which employ the use of metal strips, or bands.
- Metal or plastic brackets that are cemented or bonded to teeth.
- Brackets that attach to the back teeth (also called lingual braces).
Procedures
Orthodontic procedures, also called orthodontia, are complex processes.
In most cases, a dentist will need to make a plaster cast of the individual’s teeth and perform full X-rays of the head and mouth.
After orthodontic appliances are placed, they need to be adjusted from time to time to ensure that they continue to move the teeth into their correct position.
Retainers are used following braces to ensure that teeth remain in position.
Aesthetic and Comfort Issues
Advances in technology have vastly improved appearance issues with orthodontia.
Braces today are made from extremely lightweight and natural-colored materials. The materials that braces attach to-brackets-are bonded to the surfaces of teeth but can be later removed.
People can expect to wear braces for about two years—less or more in some cases. Adults are usually required to wear braces for longer periods of time.
Because orthodontic appliances need to be adjusted from time to time to ensure they continue to move the teeth into their correct position, they can create pressure on the teeth and jaws. This mild discomfort usually subsides following each orthodontia adjustment.
Hygiene issues
People who wear braces must be diligent in ensuring that food particles and other debris do not get trapped in the network of brackets and wires. In addition, brackets can leave stains on enamel if the area surrounding them is not cleaned on a daily basis.
Daily oral hygiene such as brushing, flossing and rinsing are a necessity. Some people with orthodontic appliances can benefit from using water picks, which emit small pressurized bursts of water that can effectively rinse away such debris.
Another caveat: Braces and sticky foods don’t mix. Crunchy snacks and chewy substances should be avoided at all costs because they can cause orthodontia to be loosened or damaged.
Space Maintainers
Space maintainers are helpful dental devices that can help teeth grow in normally following premature tooth loss, injury or other problems.
The devices can help ensure that proper spaces are maintained to allow future permanent teeth to erupt.
If your child loses a baby tooth early through decay or injury, his or her other teeth could shift and begin to fill the vacant space. When your child’s permanent teeth emerge, there’s not enough room for them. The result is crooked or crowded teeth and difficulties with chewing or speaking.
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Sealants
The pits and grooves of 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.
Enter sealants, which are thin coatings applied to the chewing surfaces designed to prevent the intrusion of bacteria and other debris into the deep crevices on the tops of your teeth.
Sealants actually were developed about 50 years ago, but didn’t become commonly used until the 1970s. 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 re-application every five to 10 years.
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Missing Teeth
Fixed bridges and implants are often used to replace missing teeth and to correct some kinds of bite problems.
Crowns and bridges are the most effective procedure for replacing missing teeth or bite problems.
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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.
There are several types of fixed dental bridges (cannot be removed), including conventional fixed bridges, cantilever bridges and resin-bonded bridges. Some bridges are removable and can be cleaned by the wearer; others need to be removed by a dentist.
Porcelain, gold alloys or combinations 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.
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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 the tooth.
Crowns are also used to attach bridges, cover implants, prevent a cracked tooth from becoming worse, or an existing filling is in jeopardy of 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. A cast is made of the existing tooth and an impression is made. The impression is sent to a special lab, which manufactures a custom-designed crown. In some cases, 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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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 including pain and sensitivity as the first indications of a problem. However, inside a spreading infection can cause small pockets of pus to develop, which can lead to an abscess.
Root canal therapy is a remarkable treatment with a very high rate of success, and 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.
Procedure
Root canal therapy usually entails one to three visits. During the first visit, a small hole is drilled through the top of the tooth and into the inner chamber. Diseased tissue is removed, the inner chamber cleansed and disinfected, and the tiny canals reshaped. The cleansed chamber and canals are filled with an elastic material and medication designed to prevent infection. If necessary, the drilled hole is temporarily filled until a permanent seal is made with a crown.
Most patients who have root canal experience little or no discomfort or pain, and enjoy a restored tooth that can last almost as long as its healthy original.
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Extractions
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 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, this could mean that the wisdom teeth are 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 future serious problems. 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
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Sealing and Root Planing
Some cases of acute periodontal (gum) disease that do not respond to more conventional treatment and self-care such as flossing may require a special kind of cleaning called scaling and root planing.
The procedure begins with administration of a local anesthetic to reduce any discomfort. Then, a small instrument called a “scaler,” or an ultrasonic cleaner, is used to clean beneath your gum line to remove plaque and tartar.
The root surfaces on the tooth are then planed and smoothed. If effective, scaling and root planing helps the gums reattach themselves to the tooth structure. Additional measures may be needed if the periodontal pockets persist after scaling and root planing.
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Flap Surgery
Your bone and gum tissue should fit snugly around your teeth like a turtleneck. When you have periodontal disease, this supporting tissue and bone is destroyed, forming “pockets” around the teeth. Over time, these pockets become deeper, providing a larger space for bacteria to thrive and wreak havoc.
As bacteria accumulate and advance under the gum tissue in these deep pockets, additional bone and tissue loss follows. Eventually, if too much bone is lost, the teeth will need to be extracted.
Flap surgery is sometimes performed to remove tartar deposits in deep pockets or to reduce the periodontal pocket and make it easier for you or your dental professional to keep the area clean. This common surgery involves lifting back the gums and removing the tartar. The gums are then sutured back in place so that the tissue fits snugly around the tooth again.
A pocket reduction procedure is recommended if daily at-home oral hygiene and a professional care routine cannot effectively reach these deep pockets.
In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone.
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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. Partials with precision attachments generally cost more than those with metal clasps.
How are dentures made?
The denture process takes about one month and five 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.
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.
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Jaw/TMJ
People who grind their teeth can sometimes develop a serious problem with their jaw, which left untreated, can adversely affect the teeth, gums and bone structures of the mouth.
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 include muscle relaxants, aspirin, 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 an arthritic condition of the jaw joint. Traumatic injuries also can cause jaw dislocation.
In these cases, jaw surgery may be required to correct the condition. Some jaw surgery can be performed arthroscopically.
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Maxillofacial Surgery
When facial reconstruction, including procedures involving the oral cavity, is called for, a specialist is needed. Surgical procedures of the neck and head area are performed by a maxillofacial surgeon.
Common maxillofacial procedures include denture-related procedures and jaw surgery.
Jaw Correction
Protruding chins, crooked or buck teeth or misaligned teeth are good candidates for maxillofacial surgery.
In some people, jaws do not grow at the same rate; one may come in larger than the other, or simply not be aligned properly with other bony structures in the skull. This can cause problems other than appearance issues; an improperly aligned jaw can cause problems with the tongue and lips, and speech and chewing problems as well. Jaw surgery can move jaws into their proper place.
Other kinds of maxillofacial surgery can correct problems with upper facial features such as the nose and cheek.
In addition to correcting jaw problems surgically, orthodontic appliances such as braces may be needed to restore bite relationship and ensure continued proper alignment of the jaw. In some cases, tiny wires or small rubber bands may be needed to keep the jaws in place and promote faster healing. In other cases, small “fixation” screws or plates may need to be inserted in the jaws to facilitate easy movement of the jaws following surgery.
Denture Fatigue
People who have worn dentures for a long time can sometimes experience loss of gum tissue and even bone, mostly from the wear and tear of the appliance on the soft tissues of their mouth.
In extreme cases, maxillofacial surgery, including bone grafts, manipulation of soft tissues or even jaw realignment, may be performed to correct such problems.
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Cosmetic Dentistry
Overview
People choose esthetic dental procedures/surgery for various reasons—to repair a defect such as a malformed bite or crooked teeth, treat an 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, esthetic dentistry has become a vital and important part of the dental profession.
Common esthetic 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 and 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. Veneers can change the color or shape of your teeth. For example, veneers have been used to correct unevenly spaced, crooked, chipped, oddly shaped or discolored teeth.
- Whitening and bleaching – As the term implies, whitening and bleaching, a rapidly increasing procedure, are used to make teeth whiter.
Which techniques should be used to improve your smile? A dental exam will take many factors into consideration, including your overall oral health.
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Veneers
Teeth that are badly stained, shaped or crooked may be improved by a veneer placed on the surface of the affected teeth.
Veneers are thin pieces of porcelain or plastic cemented over the front of your teeth to change their color or shape. Veneers are used on teeth with uneven surfaces or are chipped, discolored, oddly shaped, unevenly spaced or crooked. Little or no anesthesia is needed. Veneers have a longer life expectancy and color stability than bonding, and highly resist permanent staining from coffee, tea, or even cigarette smoking.
Veneers are usually made by a dental lab technician working from a model provided by your dentist. Veneers are usually irreversible because it`s necessary to remove a small amount of enamel from your teeth to accommodate the shell.
Porcelain veneers can mask undesirable defects, such as teeth stained by tetracycline, by an injury, or as a result of a root-canal procedure, and are ideal for masking discolored fillings in front teeth. Patients with gaps between their front teeth or teeth that are chipped or worn may consider porcelain veneers.
Typically, veneers entail at least three appointments: diagnosis and treatment planning, preparation, and bonding.
During the tooth preparation visit, usually lasting one to two hours, the teeth are lightly buffed to allow for the small added thickness of the veneer. Usually, about a half a millimeter of the tooth is removed, which may require a local anesthetic. During the same visit, a mold is taken of the teeth, and sent to the laboratory for the fabrication of the veneers.
During the final “bonding” visit, also about one or two hours, the veneers are placed on the tooth surface with water or glycerin on the teeth to check their fit and get a sense of the shade or color. While the veneers are resting on your teeth, they can be adjusted with various shades of cement to match the color of your teeth. To apply the veneer, the tooth is cleansed with specific chemicals to achieve a bond. Once a special cement is sandwiched between the veneer and tooth, a visible light beam, or laser, causes a catalyst to be released, hardening the cement.
During a two-week period of adjustment that follows, you may notice the change of size and shape in your teeth. It is important to brush and floss daily. After one or two weeks, you`ll return for a follow-up appointment. Porcelain veneers are reasonable facsimiles of natural teeth, not perfect replacements. It`s not uncommon to see slight variations in the color of porcelain veneers upon close inspection, as this occurs even in natural teeth.
For certain patients no preparation of the teeth may be necessary. Please see our specialties page for more information.
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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 attacked 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).
Professional whitening performed by our office is considered to be the most effective and safest method; done properly, tooth whitening can last as long as five years. Over-the-counter whitening systems are somewhat effective as long as they are monitored and directions followed closely.
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Bleaching
Bleaching and non-bleaching products are the two basic kinds of whitening products available today.
Non-bleaching products normally use abrasives or chemicals and only remove surface stains on teeth.
Bleaching products work with a chemical called peroxide and can brighten your teeth several shades.
Another process employs the use of a special gel that is placed inside a flexible device you wear around your teeth for a certain period of time. After you remove the device, you must use a second bleaching agent, followed by a special light to activate the chemical action.
Mildly stained teeth usually only require one session of bleaching.
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Chipped, Cracked & Worn Teeth
Special thin laminates, called veneers, can often be used to correct discolored, worn down, cracked and chipped teeth. Veneers can also be used to close unsightly gaps between teeth. Stronger types of veneers made of porcelain, also called composite veneers, typically last longer because they are bonded to the tooth.
Another process called bonding can accomplish some of the same things, but it does not last as long. Material that looks much like the enamel on your teeth is used during a bonding procedure. The material is shaped to the tooth, and when it becomes hard it is polished.
In addition, dental contouring and reshaping can correct chipped, cracked, crooked, or even overlapping teeth. This procedure can alter the shape, length, or position of teeth.
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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 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 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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Grafts
Soft tissue grafts are sometimes performed to treat gum disease, or correct other abnormalities.
The procedure involves taking gum tissue from the palate or another donor source to cover an exposed root in order to even the gum line and reduce sensitivity.
Periodontal procedures are available to stop further dental problems and gum recession, and to improve the aesthetics of your gum line. For example, an exposed tooth root resulting from gum recession may not be causing you pain or sensitivity, but is causing one or more of your teeth to look longer than the others. In other cases, an exposed tooth root causes severe pain because it is exposed to extremes in temperatures or different kinds of food and liquids.
Once contributing factors are controlled, a soft tissue graft procedure will repair the defect and help to prevent additional recession and bone loss.
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Old and Unsightly Fillings
Newer kinds of fillings made from composite resins and porcelain can restore unsightly fillings; many people are surprised how natural these kinds of filling materials can make a tooth once covered by the old-fashioned silver amalgams.
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Bonding
Bonding is a process in which an enamel-like material is applied to a tooth`s surface, sculpted to an ideal shape, hardened, and then polished for an ideal smile. This procedure usually can be accomplished in a single visit.
Bonding is often performed in order to fill in gaps or change the color of your teeth. It typically only entails one office visit, and the results last for several years.
Bonding is more susceptible to staining or chipping than other forms of restoration such as veneers. When teeth are chipped or slightly decayed, bonded composite resins may be the material of choice. Bonding also is used as a tooth-colored filling for small cavities and broken or chipped surfaces.
In addition, bonding can be used to close spaces between teeth or cover the entire outside surface of a tooth to change its color and shape. Crowns, also known as caps, are used in cases where other procedures will not be effective. Crowns have the longest life expectancy of all cosmetic restorations, but are the most time consuming.
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Excessive or Uneven Gums
Many people inherit the problem of excessive or uneven gums. An aesthetic surgical procedure called a gum lift can be used to correct this problem.
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Ridge Augmentation
If you lose one or more permanent teeth, an indentation may result in the gums and jawbone where the tooth used to be. When no longer holding a tooth in place, the jawbone recedes and the resulting indentation looks unnatural. Ridge augmentation is a procedure that can recapture the natural contour of the gums and jaw. A new tooth can then be created that is natural looking and complements your smile.
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Invisalign®
Online Dental Education Library
Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment.
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Crowns and Bridges
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. There are several types of fixed dental bridges (cannot be removed), including conventional fixed bridges, cantilever bridges and resin-bonded bridges. Unlike a removable bridge, which you can take out and clean, your dentist can only remove a fixed bridge. .
Porcelain, gold alloys or combinations 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 the tooth.
Crowns are also used to attach bridges, cover implants, prevent a cracked tooth from becoming worse, or an existing filling is in jeopardy of 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 then made from the existing tooth to create a custom-designed crown. The impression is sent to a special lab, which manufactures a custom-designed crown. In some cases, 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.
