Our office is Mercury Free. That is to say we do not place amalgam, or silver,
fillings. We place only tooth colored, composite fillings and have had great results and satisfaction from these esthetic
and durable fillings.
The information below was taken from an article with the AGD :
Tooth Colored Fillings
Tooth-colored fillings are made from durable
plastics called composite resins. Similar in color and texture to natural teeth, the fillings are less noticeable, and much
more attractive, than other types of fillings.
Because composite resins
are tooth-colored, they look more natural than other filling materials. You child can smile, talk, and eat with confidence.
A tooth can be filled and sealed at the same time to prevent further decay.
the Academy of General Dentistry published a "Fact Sheet" in the AGD Journal concerning the use of composite (tooth colored) fillings
in back teeth. The biggest limitation is that these fillings do not hold up well for large fillings where porcelain crowns
would probably be the restoration of choice.
What is a composite filling?
A composite resin is a tooth-colored plastic mixture filled with glass (silicon dioxide). Introduced in the 1960s,
dental composites were confined to the front teeth because they were not strong enough to withstand the pressure and wear
generated by the back teeth. Since then, composites have been significantly improved and can be successfully placed in the
back teeth as well. Composites -are not only used for restoring decay, but are also used for cosmetic improvements of the
smile by changing the color of the teeth or reshaping disfigured teeth.
How is it placed?
Following preparation, the dentist places the composite in layers, using a light specialized to harden each layer.
When the process is finished, the dentist will shape the composite to fit the tooth. The dentist then polishes the composite
to prevent staining and early wear.
How long does it take?
Because a composite is more difficult to place than silver fillings, it takes the dentist about 10-20 minutes longer
to place. Placement time depends on the size and location of the cavity.
What are the
main advantages of composites?
Esthetics are the
main advantage, since dentists can blend shades to create a color nearly identical to that of the actual tooth. Composites
bond to the tooth to support the remaining tooth structure, which helps to prevent breakage and insulate the tooth from excessive
long will a composite last?
Studies have shown that composites can last up to 7-10 years, which is comparable to silver fillings except in very large restorations,
where silver fillings or crowns can sometimes last longer than composites.
root canal is a dental procedure used to repair and save a tooth that is badly decayed or becomes infected. During a
root canal, the nerve and pulp are removed and the inside of the tooth is cleaned and sealed. Without treatment, the
tissue surrounding the tooth will eventually become infected and abscesses may form.
canal" is the term used to describe the natural cavity within the center of the tooth. The pulp or pulp chamber is the
soft area within the root canal. The tooth's nerve lies within the root canal.
A tooth's nerve
is not vitally important to a tooth's health and function after the tooth has emerged through the gums. Its only function
is sensory -- to provide the sensation of hot or cold. The presence or absence of a nerve will not affect the day-to-day
functioning of the tooth.
Why Does Tooth Pulp Need to Be Removed?
a tooth's nerve tissue or pulp is damaged, it breaks down and bacteria begin to multiply within the pulp chamber. The bacteria
and other decayed debris can cause an infection or abcessed tooth. An abscess is a pus-filled pocket that forms at the end
of the roots of the tooth. An abscess occurs when the infection spreads all the way past the ends of the roots of the tooth.
In addition to an abscess, an infection in the root canal of a tooth can cause:
that may spread to other areas of the face, neck, or head
- Bone loss around the tip of the
- Drainage problems extending outward from the root. A hole can occur through the side
of the tooth with drainage into the gums or through the cheek with drainage into the skin. A tooth's nerve and pulp can become
irritated, inflamed, and infected due to deep decay, repeat dental procedures( like deep, or recurrent fillings )on a tooth,
and/or large fillings, a crack, break, or chip in the tooth, or trauma to the face.
What Are the Signs That a Root Canal Is Needed?
Sometimes there are no symtoms present
at all; however, signs you may need a root cancal include:
- Severe toothache upon chewing
or application of pressure
- Prolonged sensitivity/pain to heat or cold temperatures (after
the hot or cold has been removed)
- Discoloration (a darkening) of the tooth
- Swelling and tenderness in the nearby gums
- A persistent or recurring pimple on the
What Happens During a Root Canal?
A root canal requires one or more
office visits and can be performed byus or on occassion, an endodontist. An endodontist is a dentist who specializes in
the causes, diagnosis, prevention, and treatment of diseases and injuries of the human dental pulp or the nerve of the tooth.
The choice of who is best suited to treat your root canal depends to some degree on the difficulty of the root canal
procedure needed in your particular tooth and our comfort level in working on your tooth. At your visit, we will
discuss who might be best suited to perform the work in your particular case.
The first step
in the procedure is to take aradiograph( dental xray) see the shape of the root canals and determine if there are any signs
of infection in a surrounding bone. We then use local anesthesia to numb the area near the tooth.
An access hole will then be drilled into the tooth. The pulp along with bacteria, the decayed nerve tissue and related
debris is removed from the tooth. The cleaning out process is accomplished using root canal files. A series of these files
of increasing diameter are each subsequently placed into the access hole and worked down the full length of the tooth to
scrape and scrub the sides of the root canals. Water or sodium hypochloride is used periodically to flush away the debris
and sterilize the canals.
Once the tooth is thoroughly cleaned,
it is sealed. Instances occur inwhich there is an infection, we may put medication inside the tooth to clear it
up and have the patient return for a permanent fill of the tooth. Other occassions allow us to seal the tooth the same day
it is cleaned out. If the root canal is not completed on the same day, a temporary filling is placed in the exterior hole
in the tooth to keep out contaminants -- like saliva and food -- out between appointments.
At the next appointment, to fill the interior of the tooth, a sealer paste and a rubber compound called
gutta percha is placed into the tooth's root canal. To fill the exterior access hole created at the beginning of treatment,
a filling is placed.
The final step may involves further
restoration of the tooth. Because a tooth that needs a root canal often is one that has a large filling or extensive decay
or other weakness, a post and core buildup and a crown are reccomended and needs to be placed on the tooth to
protect it, prevent it from breaking, and restore it to full function.
Post & Core Buildup
Post and core is a restoration used to sufficiently build-up your tooth structure for future restoration with a
crown and place a fiber optic post (pin) in the tooth to retain the crown that will be placed and stabilize your tooth following
a root canal procedure.
There are many
types of dental crowns. We offer various types depending on the specific needs and desires of our patients. Some of these
include : porcelain fused to high noble metal, all porcelain, zirconia, full cast( all metal crowns). Below are some photos
and techniques of the various types we can offer to you .
PFM: All Porcelain : Full Cast :
A crown is a tooth-shaped cover placed over a tooth that is badly damaged
or decayed. A crown is made to look like your tooth. Many people call it a cap.
Crowns may be
placed for several reasons. Usually the tooth has been broken or damaged a great deal by decay. As a result, a filling can't
replace enough of the tooth or make the tooth strong enough. A crown may hold together parts of a cracked tooth. It also
can be used to hold a bridge in place. Crowns can be used to improve appearance as well. They may be placed to cover misshapen
or badly discolored teeth.
Crowns can be made ahead of time (prefabricated) or made to order
in a laboratory. Prefabricated crowns are made of plastic or stainless steel. They can be used on a temporary basis until
a permanent crown is made.
Crowns can be all metal, porcelain fused to metal (PFM), or all
ceramic. Metals include gold alloy, other alloys (palladium) or a base-metal alloy (nickel or chromium). The all-metal or
PFM crowns are stronger and are better choices for back teeth than ceramic crowns. PFM and all-ceramic crowns are the same
color as your natural teeth. They look just like normal teeth.
vary for the different types of crowns, some require more or less of a tooth prep ( the filing down of your natural tooth)
in order to retain(help hold) your crown in place. While crowns are always cemented, or bonded into place, the actual crown
should fit your tooth properly and snugly through retention primarily, not just cement. This is evident when the preparation
is acurate and the crown is properly fabricated by the laboratory technician. the cement merely adheres the crown to your
tooth and provides a seal. All porcelain types of crowns like Lava(trademarked), Empress,or AllCeram are bonded to your
tooth with a curing light. Sometimes all porcelain crowns are chosen for esthetics or for functionality. All porcelain crowns,
because they lack metal substructures, will Never show a margin( that gray line you sometimes see where the crown meets the
gumline, due to recession or a poor fit after the gums have shrunk into their natural placement following a crown preparation)
in the future and it is our office's restoration of choice for most anterior crowns unless individual circumstances prohibit
this for reasons such as previous tooth preparation or a person's particular bite. Please feel free to ask either
doctor about your options if you have been recommended to receive a crown.
Crowns usually last at least five to seven years. In many cases they can last much longer, up to
20 years or more. The life of your crown depends on a number of factors including: the preparation by the dentist, the accuracy
of the lab, home care and proper brushing and flossing, routine dental cleanings to keep the area clean, and genetic factors
that can contribute to oral decay such as autoimmune disases, periodontal disease, diabetes,etc. Your crowns are an investment
so the better you take care of them, the longer they will last!