Terms and Definitions:
- Abscessed Tooth
- Amalgam
- Bridges
- Cleaning
- Composit
- Crowns
- A crown is a restoration
that covers, or "caps," a tooth to restore it to its normal shape and
size, strengthening and improving the appearance of a tooth. Crowns are
necessary when a tooth is generally broken down and fillings won't solve
the problem. If a tooth is cracked, a crown holds the tooth together to
seal the cracks so the damage doesn't get worse. Crowns are also used
to restore a tooth when there isn't enough of the tooth remaining to
provide support for a large filling, attach a bridge, protect weak teeth
from fracturing, restore fractured teeth or cover badly shaped or
discolored teeth.
To prepare the tooth for a crown, it is reduced so the crown can fit over it. An impression of the teeth and gums is made and sent to the lab for the crown fabrication. A temporary crown is fitted over the tooth until the permanent crown is made. On the next visit, the dentist removes the temporary crown and cements the permanent crown onto the tooth.
Why crowns and not veneers?Crowns require more tooth structure removal, hence they cover more of the tooth than veneers. Crowns are customarily indicated for teeth that have sustained significant loss of structure or to replace missing teeth. Crowns may be placed on natural teeth or dental implants.
What is the difference between a cap and a crown?
There is no difference between a cap and a crown.
How long do crowns last?
Crowns should last approximately five to eight years. However, with good oral hygiene and supervision, most crowns will last for a much longer period of time. Some damaging habits like grinding your teeth, chewing ice or fingernail biting may cause this period of time to decrease significantly.
How should I take care of my crown?
To prevent damaging or fracturing the crown, avoid chewing hard foods, ice or other hard objects. You also want to avoid teeth grinding. Besides visiting your dentist and brushing twice a day, cleaning between your teeth is vital with crowns. Floss or interdental cleaners (specially shaped brushes and sticks) are important tools to remove plaque from the crown area where the gum meets the tooth. Plaque in that area can cause dental decay and gum disease.
- Dentures
- What is a Denture?
A denture is a removable replacement for missing teeth and the tissues connected to those teeth. It is made of acrylic plastic and sometimes porcelain and metal materials. A denture closely resembles natural gum tissue and teeth.
Complete dentures replace all of the teeth, while partial dentures fill in the spaces created by missing teeth and prevent other teeth from shifting position. Complete dentures are "immediate" or "conventional." An immediate denture is a complete denture or partial denture that is inserted on the same day, immediately following the removal of the natural teeth. The immediate denture acts as a Band-Aid to protect the tissues and reduce bleeding after tooth extraction. The conventional denture is ready for placement in the mouth about 8 to 12 weeks after the teeth have been removed and the gum tissue has healed. However, some dentists may recommend more time before placing a conventional denture.
Who needs a denture?
A partial denture is for people who still have some of their natural teeth. Dentures are not just for elderly patients. Patients of any age may lose some or all of their teeth and may require a denture of some sort. Because teeth are a permanent part of the body, tooth loss can have an emotional impact on some people. It is important to talk to your dentist about any fears, anxiety, or other emotions you are feeling about tooth loss.
What happens when you get a denture?
A dentist can make a full conventional denture when all teeth have been lost or all extraction sites have healed (up to eight weeks or longer.) 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.
New denture wearers need time to get accustomed to their new "teeth," because even the best-fitting dentures will feel awkward at first. While most patients can begin to speak normally within a few hours, many patients report discomfort with eating for several days to a few weeks. To get accustomed to chewing with a new denture, start with soft, easy-to-chew foods. In addition, denture wearers often notice a slight change in facial appearance, increased salivary flow or minor irritation or discomfort.
- Extractions
- Implants
- What
is a Dental Implant?
A dental implant is an artificial tooth root that is surgically anchored into your jaw to hold a replacement tooth or bridge in place. The benefit of using implants is that they don't rely on neighboring teeth for support and they are permanent and stable. Implants are a good solution to tooth loss because they look and feel like natural teeth.
Implant material is made from different types of metallic and bone-like ceramic materials that are compatible with body tissue. There are different types of dental implants: the first is placed directly into the jaw bone, like natural tooth roots; the second is used when the jaw structure is limited, therefore, a custom-made metal framework fits directly on the existing bone.
How do they work?
Strategically placed, implants can now be used to support permanently cemented bridges, eliminating the need for a denture. The cost tends to be greater, but the implants and bridges more closely resemble real teeth.
Can anyone receive dental implants?
Talk with your dentist about whether you are an implant candidate. You must be in good health and have the proper bone structure and healthy gums for the implant to stay in place. People who are unable to wear dentures may also be good candidates. If you suffer from chronic problems, such as clenching or bruxism, or systemic diseases, such as diabetes, the success rate for implants decreases dramatically. Additionally, people who smoke or drink alcohol may not be good candidates.
What can I expect during this procedure?
The dentist must perform surgery to anchor the "artificial root" into or on your jaw bone. The procedure is done in the dental office with local anesthesia. The gum is then secured over the implant, which will remain covered until it fuses with the bone. The dentist then uncovers the implant and attaches an extension, or post, to the implant. With some implants, the implant and post are a single unit placed in the mouth during the initial surgery. Finally, the dentist makes an artificial tooth, or crown, that is attached to the implant post.
How long does the process take?
The process can take up to nine months to complete. Each patient heals differently, so times will vary. After the implant and posts are placed surgically, the healing process can take up to six months and the fitting of replacement teeth no more than two months. Sometimes, if a patient has good bone quality, posts can be placed and replacement teeth fitted in one appointment.
What is the success rate of implants?
The success rate for implants depends on the tooth's purpose and location in the mouth, as well as a patient's overall health.
- Partials
- Root Canal
- What is a Root Canal?
Underneath your tooth's outer enamel and within the dentin is an area of soft tissue called the pulp tissue. While a tooth's pulp tissue does contain nerve fibers, it is also composed of arteries, veins, lymph vessels, and connective tissue. Each tooth's nerve enters the tooth at the very tip of its roots. From there, the nerve runs through the center of the root in small "root canals," which join up with the tooth's pulp chamber. Root canals are very small, thin divisions that branch off from the top pulp chamber down to the tip of the root. A tooth has at least one but no more than four root canals.
Why do I feel pain?
When the pulp becomes infected due to a deep cavity or fracture that allows bacteria to seep in, or injury due to trauma, it can die. Damaged or dead pulp causes increased blood flow and cellular activity, and pressure cannot be relieved from inside the tooth. Pain in the tooth is commonly felt when biting down, chewing on it and applying hot or cold foods and drinks.
Why do I need root canal therapy?
Root canal therapy is necessary because the tooth will not heal by itself. Without treatment, the infection will spread, bone around the tooth will begin to degenerate and the tooth may fall out. Pain usually worsens until one is forced to seek emergency dental attention. The only alternative is usually extraction of the tooth, which can cause surrounding teeth to shift crookedly, resulting in a bad bite. Though an extraction is cheaper, the space left behind will require an implant or a bridge, which can be more expensive than root canal therapy. If you have the choice, it's always best to keep your original teeth.
What is a root canal procedure?
A root canal is a procedure done to save the damaged or dead pulp in the root canal of the tooth by cleaning out the diseased pulp and reshaping the canal. The canal is filled with a rubberlike substance called gutta–percha or another material to prevent recontamination of the tooth. The tooth is then permanently sealed, with possibly a post and/or a crown made of porcelain or metal alloy. This enables patients to keep the original tooth.
What is involved in root canal therapy?
Once your general dentist performs tests on the tooth and recommends therapy, he or she can perform the treatment or refer you to an endodontist (a pulp specialist). Treatment usually involves one to three appointments.
First, you will probably be given a local anesthetic to numb the area. A rubber sheet is then placed around the tooth to isolate it. Next, an opening is drilled from the crown into the pulp chamber, which, along with the root canal, is cleaned of all diseased pulp and reshaped.
Medication may be inserted into the area to fight bacteria. Depending on the condition of the tooth, the crown may then be sealed temporarily to guard against recontamination, the tooth may be left open to drain or the dentist may go right ahead and fill the canals.
If you're given a temporary filling, usually on the next visit it's removed and the pulp chamber and canal(s) are filled with gutta percha or another material to prevent recontamination. If the tooth is still weak, a metal post may be inserted above the canal filling to reinforce the tooth. Once filled, the area is permanently sealed. Finally, a gold or porcelain crown is normally placed over the tooth to strengthen its structure and improve appearance.
What are the risks and complications?
More than 95 percent of root canal treatments are successful. However, sometimes a procedure needs to be redone due to diseased canal offshoots that went unnoticed or the fracture of a filing instrument, both of which rarely occur. Occasionally, a root canal therapy will fail altogether, marked by a return of pain.
What happens after treatment?
Natural tissue inflammation may cause discomfort for a few days, which can be controlled by an over-the-counter analgesic. A follow-up exam can monitor tissue healing. From this point on, brush and floss regularly, avoid chewing hard foods with the treated tooth, and see your dentist regularly.
Are there options to root canal therapy?
The only alternative to root canal therapy is to extract the tooth; however, this alone can cause the surrounding teeth to move, resulting in a bad bite. Though a simple extraction may be perceived as less expensive, the empty space left behind will require an implant or a bridge, which ultimately can be more costly than root canal therapy.
- Scaling (root planing)
- Sealants
- What is a Sealant?
A dental sealant is a thin plastic film painted on the chewing surfaces of teeth to prevent cavities.
How effective are sealants?
Studies have proven that properly applied sealants are 100-percent effective in protecting the tooth surfaces from cavities. As long as the sealant remains intact, small food particles and bacteria that cause cavities cannot penetrate through or around a sealant. Sealant protection is reduced or lost when part or all of the bond between the tooth and sealant is broken. However, clinical studies have shown that teeth that have lost sealants are no more susceptible to tooth decay than teeth that were never sealed.
Why can't I just brush and floss?
While brushing and flossing help to remove food particles and plaque from smooth surfaces of teeth, toothbrush bristles often can't reach into the teeth's depressions and grooves. Sealants protect those areas and prevent food and bacteria from getting in.
How are sealants applied?
Your dentist can apply sealants easily, and it takes only a few minutes to seal each tooth. The dentist first cleans the teeth that will be sealed, which may require the use of a dental drill to open the grooves of the teeth and determine if decay is present. Then he or she will roughen the chewing surfaces with an acid solution, which will help the sealant stick to the teeth. The dentist then "paints" the sealant on the tooth. It bonds directly to the tooth and hardens. Sometimes your dentist will use a special curing light to help the sealant harden. Sealant treatment is painless and takes anywhere from five to 45 minutes to apply, depending on how many teeth need to be sealed. Sealants must be applied properly for good retention.
How long will a sealant last?
As long as the sealant remains intact, the tooth surface will be protected from decay. Sealants hold up well under the force of normal chewing and usually last several years before a reapplication is needed. The risk of decay decreases significantly after sealant application. During your regular dental visits, your dentist will check the condition of the sealants and reapply them when necessary.
Who should receive sealant treatment?
Children, because they have newly erupted, permanent teeth, receive the greatest benefit from sealants. The chewing surfaces of a child's teeth are most susceptible to cavities. Surveys show that the majority of all cavities occur in the narrow pits and grooves of a child's newly erupted teeth because food particles and bacteria cannot be cleaned out. Other patients also can benefit from sealant placement, such as those who have existing pits and grooves susceptible to decay. Research has shown that almost everybody has a 95-percent chance of eventually experiencing cavities in the pits and grooves of their teeth.
Aren't sealants just for kids?
Decay can begin early in life, so dentists usually apply sealants to children's and teenagers' premolars and molars to protect them. But sealants can protect adults' teeth, too. Ask your dentist about sealants for your children or for yourself to see if they would be beneficial.