What are 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 tooth’s appearance. 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.

How is a crown placed?

To prepare the tooth for a crown, it is reduced so the crown can fit over it. An impression, or “mold," is taken of the teeth and gums 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 are typically recommended because too much tooth has been lost due to decay or fracture that cannot be replaced with a filling. A crown covers the entire tooth to protect it. A veneer only covers the outside part of the tooth and is primarily used to change the appearance of the tooth.

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. 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.

What are Veneers?

Veneers are ultra-thin shells of ceramic (porcelain) or a composite resin material, which are bonded to the front of teeth. This procedure requires little or no anesthesia and can be the ideal choice for improving the appearance of the front teeth. Veneers are placed to mask discolorations, to brighten teeth and to improve a smile.

Why a veneer?

Veneers are an excellent alternative to crowns in many situations. They provide a much more conservative approach to changing a tooth`s color, size or shape. Veneers can mask undesirable defects, such as teeth stained by tetracycline and damage due to an injury or as a result of a root-canal procedure. They 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 veneers. Generally, veneers will last for many years, and the technique has shown remarkable longevity when properly performed.

What happens during the procedure?

Patients may need up to three appointments for the entire procedure: diagnosis and treatment planning, preparation and bonding. It`s critical that you take an active role in the smile design. Spend time in the planning of the smile. Understand the corrective limitations of the procedure. To prepare the teeth for the veneers, the teeth are lightly buffed to allow for the small added thickness of the veneer. Usually, about half a millimeter of the tooth is removed, which may require a local anesthetic. Then, a mold is taken of the teeth, which is sent to the laboratory for the fabrication of the veneers. This may take several days. If the teeth are too unsightly, a temporary veneer can be placed. When your ceramic veneers are ready, Doctor places each veneer on the teeth to check their fit and get a sense of the shade or color. While the veneers are resting on your teeth, view the results, and pay particular attention to the color. At this point, the color of the veneers can still be adjusted with the shade of the cement to be used. The color cannot be altered after veneers are cemented. To apply the veneer, the tooth is cleansed with specific chemicals to achieve a bond. A special cement is sandwiched between the veneer and tooth to bond the two together.

How about maintenance?

For about a week or two, you will go through a period of adjustment as you get used to your "new" teeth that have changed in size and shape. Brush and floss daily. After one or two weeks, we will ask you to return for a follow-up appointment.

What are realistic expectations?

Veneers are reasonable facsimiles of natural teeth, not perfect replacements. It`s not uncommon to see slight variations in the color of veneers upon close inspection, as this occurs even in natural teeth. Nevertheless, this procedure can greatly enhance your smile and can heighten self-esteem.

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 an ideal solution to tooth loss; they look and feel like natural teeth.

How do they work?

Once the root part of the implant is “bonded” to the bone, it is ready to be used. An artificial tooth is placed directly on top of the implant. In some cases, several implants are placed. Here, the implants are connected to a bridge. A bridge is a number of teeth (usually 3-4) that are bonded together. The two ends connect to the implants. By doing this, many people avoid needing removable dentures at all.

Can anyone receive dental implants?

however, there are some limitations. 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 gum is then secured over the implant, which will remain covered until it fuses with the bone. This usually takes about 3-6 months. 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. It will be as if you never lost your tooth.

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 a Root Canal?

Underneath your tooth`s outer enamel and within the dentin is an area of soft tissue called the pulp, which carries the tooth`s nerves, blood vessels and connective tissue. 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 it gets injured 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 Doctor 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 be given a local anesthetic to numb the area. Next, an opening is made from the crown into the pulp chamber (where the infected nerve is), which, along with the root canal, is cleaned of all diseased pulp and reshaped. Medication is 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 Doctor 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, and avoid chewing hard foods with the treated tooth. Once the tooth is symptom free, you will need to return to have the tooth fitted for a crown.

What is a Denture?

A denture is a removable replacement for missing teeth, gums and bone that has been caused due to tooth loss. 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. Complete dentures are either "conventional" or "immediate." A conventional denture is placed in the mouth about a month after all the teeth are removed to allow for proper healing, whereas an immediate denture is placed as soon as the teeth are removed. The drawback behind an immediate denture is that it may require more adjustments after the healing has taken place. Dentures can be combined with dental implants for a better fit and more natural bite.

Who needs a denture?

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.

What happens when you get a denture?

Doctor 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 five appointments: the initial diagnosis is made; a mold is taken and measurements are taken to make sure your bite and smile are natural; a "try-in" is placed to ensure 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.

How do you care for a denture?

A denture is fragile, so it is important to handle it with care. Remove and brush the denture daily, preferably with a brush designed specifically for cleaning dentures, using either a denture cleanser or toothpaste. Never use harsh, abrasive cleansers, including abrasive toothpastes, because they may scratch the surface of the denture. Don`t soak your denture in boiling water because it will cause it to become warped. If you wear a partial denture, be sure to remove it before brushing your natural teeth. When not in use, soak it in a cleanser solution or in water. Get in the habit of keeping the denture in the same safe and handy place to reduce the likelihood of misplacement.

Should a denture be worn at night?

While you may be advised to wear your denture almost constantly during the first two weeks – even while you sleep – under normal circumstances it is considered best to remove it at night and soak the denture in cleansing solution or water. Research has shown that removing the denture for at least eight hours during either the day or night allows the gum tissue to rest and allows normal stimulation and cleansing by the tongue and saliva. This promotes better long-term health of the gums.

Are there any alternatives to dentures?

Dentures are no longer the only way to restore a mouth that has little or no non-restorable teeth. Strategically placed support, or 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 the "feel" of real teeth. Dental implants are becoming the alternative of choice to dentures, but not everyone is a candidate for implants.

What is Dental Amalgam (Silver Filling)?

Most people recognize dental amalgams as silver fillings. Dental amalgam is a mixture of mercury, silver, tin and copper. Mercury, which makes up about 50 percent of the compound, is used to bind the metals together and to provide a strong, hard, durable filling. After years of research, mercury has been found to be the only element that will bind these metals together in such a way that can be easily manipulated into a tooth cavity.

Is mercury in dental amalgam safe?

Mercury in dental amalgam is not poisonous. When mercury is combined with other materials in dental amalgam, its chemical nature changes, so it is essentially harmless. The amount of mercury released in the mouth under the pressure of chewing and grinding is extremely small and no cause for alarm. In fact, it is less than what patients are exposed to in food, air and water. Ongoing scientific studies conducted over the past 100 years continue to prove that amalgam is not harmful. Claims of diseases caused by mercury in amalgam are anecdotal, as are claims of miraculous cures achieved by removing amalgam. These claims have not been proven scientifically.

Why do dentists use dental amalgam?

Dental amalgam has withstood the test of time, which is why it is the material of choice. It has a 150-year proven track record and is still one of the safest, durable and least expensive materials used to a fill a cavity. It is estimated that more than 1 billion amalgam restorations (fillings) are placed annually. Dentists use dental amalgam because it is easier to work with than other alternatives. Some patients prefer dental amalgam to other alternatives because of its safety, cost-effectiveness and ability to be placed in the tooth cavity quickly.

Why don`t dentists use alternatives to amalgam?

Alternatives to amalgam, such as cast gold restorations, porcelain and composite resins are more costly. Gold and porcelain restorations take longer to make and can require two dental appointments. Composite resins, or white fillings, are aesthetically appealing but require a longer time to place the restoration.

What about patients allergic to mercury?

The incidence of allergy to mercury is far less than one percent of the population. People suspected of having an allergy to mercury should be tested by qualified physicians, and, when necessary, seek appropriate alternatives. Should patients have amalgam removed? No. To do so, without need, would result in unnecessary expense and potential injury to teeth.

Are dental staff occupationally exposed?

Dentists use premixed capsules, which reduce the chance of mercury spills. And newer, more advanced dental amalgams are containing smaller amounts of mercury than before. An interesting factor can be brought into this: Because dental staff are exposed to mercury more often, one would expect dental personnel to have higher rates of neurological diseases, such as multiple sclerosis. They, in fact, do not.

What are other sources of mercury?

Mercury can be found in air, food and water. We are exposed to higher levels of mercury from these sources than from a mouthful of amalgam.

What is Temporomandibular Joint Disorder?

Temporomandibular joint disorder (TMD) describes a variety of conditions that affect jaw muscles, temporomandibular joints and nerves associated with chronic facial pain. Symptoms may occur on one or both sides of the face, head or jaw, or may develop after an injury. TMD affects more than twice as many women than men.

What is the temporomandibular joint?

The temporomandibular joint (TMJ) is a joint that slides and rotates just in front of your ear, consisting of the temporal bone (side of the skull) and the mandible (lower jaw). Chewing muscles connect the lower jaw to the skull, allowing your jaw to open and close and move forward and sideways. The joint works properly when the lower jaw and its joint (both the right and left) are synchronized during movement. TMD may occur when the jaw twists during opening, closing or side-motion movements. These movements affect the jaw joint and the muscles that control chewing.

What causes TMD?

Trauma to the jaw or jaw joint sometimes plays a role in TMD, but in most cases the cause of the disorder is unknown. Most experts suggest that certain tasks, either mental or physical, may cause or aggravate TMD, such as stressful situations. Most discomfort is caused from overuse of the muscles, specifically clenching or grinding teeth (bruxism). These excessive habits tire the jaw muscles and lead to discomfort, such as headaches or neck pain.

What TMD symptoms can I experience?

Jaw pain or soreness that is more prevalent in the morning or late afternoon Jaw pain when you chew, bite or yawn Clicking when opening and closing your mouth Difficulty opening and closing your mouth Locked or stiff jaw when you talk, yawn or eat Sensitive teeth when no dental problems can be found An earache without an infection

What can I do to treat TMD?

The majority of cases can be treated by unloading (resting) the joint, taking a non-aspirin pain reliever and practicing stress management and relaxation techniques. Most treatment for TMD is simple, often can be done at home, and does not need surgery. For example, control clenching or grinding during the day by sticking your tongue between your teeth. Eating soft foods and avoiding chewing gum also help relax the muscles. Most people will experience relief with minor treatment. More severe cases may be treated with physical therapy, ice and hot packs, posture training and orthopedic appliance therapy (splint, or bite guard). When necessary, stronger pain or anti-inflammatory medications, muscle relaxants or antidepressants may help ease symptoms.

Is TMD permanent?

The condition is often cyclical and may recur during times of stress, good or bad. As the patient, you should be active in your treatment by being aware of the causes of your jaw problems after seeing a dentist for a diagnosis regime. Make routine dental appointments, so your doctor can check TMD on a regular basis.