General Dentistry

Filings

After decay is removed from a tooth, something must be placed in that space to give strength back to the tooth.

Filings: Fillings are the most common restorative procedure.

Inlays and onlays: In addition to fillings, lab fabricated inlays and onlays are sometimes used. Although many patients think of these as fillings as well, they are actually different since they are laboratory fabricated.

White fillings: White fillings are used almost all of the time in our office. They are an attractive, durable alternative to silver (amalgam) fillings. White fillings are made of a strong composite resin that is matched to the surrounding tooth color. In the past, white fillings were placed only on front teeth, but recently a stronger more durable material has been developed that can withstand the chewing pressure of back teeth.

Silver (amalgam) fillings: Although white composite resin fillings are used almost exclusively by our office, there may be unique circumstances that call for a silver (amalgam) filling. Typically, silver fillings are placed on back teeth (molars).

White Porcelain or Resin inlay or onlay: A porcelain or resin inlay or onlay is used when the cavity is too big for a filling, but isn’t so big that a crown is required. An inlay is a filling within the cusp tips of the tooth. Onlays (also known as overlays) will overlay one or more cusps in order to protect and strengthen the tooth.

Before
A noticeable space
between the front teeth.
After
Bonding fills the space, but still
keeps the teeth looking natural.
Crowns

A crown fits over the entire top of the tooth above the gum line. Crowns cover, protect, seal and strengthen a tooth. A crown is needed when a filling just will not work. A crown may be made of gold, white porcelain, or porcelain fused to gold. There are many situations that may call for a crown:

Large decay. If a tooth has decay so deep and large that a filling will not stay, or if the tooth structure is weakened, a crown must be placed on the tooth to save it.

Large old fillings. When large old fillings break down, or get decay around them, they usually need to be crowned. It is important to crown a tooth that has been structurally weakened to prevent a cracked or broken tooth. Once a tooth breaks, it may not be possible to save it.

Cracked tooth. When a tooth is cracked, a filling will not seal the crack. A crown has to be placed over the tooth to hold it and the crack together. If a crown is not placed on the tooth, the tooth will become sensitive to chewing pressure, or will eventually break. It is important to crown a cracked tooth before it breaks, because in some cases a broken tooth cannot be crowned and must be extracted.

Broken / Fractured tooth. A tooth that has broken is usually too weak to hold a filling. A crown will hold the tooth together and prevent it from breaking again. If the fracture involves the nerve, Root Canal Therapy may be required before the tooth is crowned. In some cases, a broken tooth cannot be saved and must be extracted.

Sensitive teeth. Teeth that are very sensitive, either from a lot of “wear”, or from receded gums, sometimes require crowns to seal and protect the teeth from hot and cold sensitivity.

Root Canal Therapy. A tooth that has undergone Root Canal Therapy will need a crown to properly seal and protect the tooth. A tooth with Root Canal Therapy is more brittle than a tooth with a healthy nerve and blood supply. A crown provides the necessary support to the tooth.

In cosmetic dentistry, crowns (sometimes called “caps”) are used less frequently since the advent of veneers, but in some cases a crown may be necessary for a particular tooth. A tooth with a bad fracture or a large filling may be a candidate for a crown instead of a veneer.

Root Canal Therapy. A tooth that has undergone Root Canal Therapy will need a crown to properly seal and protect the tooth. A tooth with Root Canal Therapy is more brittle than a tooth with a healthy nerve and blood supply. A crown provides the necessary support to the tooth.

Before
Discoloration on front teeth and teeth are uneven in length.
After
Veneers return the natural, healthy glow! Teeth are now lengthened evenly.
Root Canals

When the nerve of a tooth becomes infected or abscessed, Root Canal Therapy is the only way to save the tooth. A tooth can become abscessed as a result of deep decay, a cracked tooth, or trauma to the tooth. The only alternative having a Root Canal is an Extraction.

During a Root Canal, the tooth is “numbed” (just like having a filling). Then the unhealthy nerve is removed and medication is placed in the tooth to treat the bacterial abscess (infection). After the infection is removed and treated, a filling is placed in the roots where the unhealthy nerve was.

A tooth that has undergone a Root Canal is more brittle and must be crowned to give the tooth sufficient strength. The tooth is cared for in the same way as other natural teeth. Brush and floss daily, and visit your dentist for regular preventative dental check-ups.

Root Canal Therapy is a dental procedure, performed with local anesthetic, which involves the removal of the nerve inside of the tooth because it has become irreversibly damaged or infected. This is usually due to the entry of bacteria into the centermost part of the tooth called the dental pulp (nerve). Root Canal is a commonly used term for endodontic therapy or root canal therapy. This procedure involves the removal of the entire nerve system, as well as cleaning, shaping and 3-dimensional filling of the canal system with gutta percha and a dental sealer. The procedure enables you to keep your natural tooth, which is preferable to any type of replacement.

Healthy tooth
Tooth in need of root canal
The way root canal therapy is performed today is vastly different than those done a few years ago, not to mention a decade ago. The potential level for quality care has dramatically increased. It is a thing of the past to do root canals in five to six appointments, or by “touch or feel” because we could not see. Root canals can be done painlessly, faster, and more accurately due to the new technology available.

Step 1
After the tooth is “numbed”, a small opening is made into the pulp chamber. The canals are located and measured, so they can be cleansed and shaped.

Step 2
The canals are filled with a rubber-like material called gutta-percha and the opening is sealed with sterile cotton pellets and a temporary filling.

Step 3
The tooth is typically restored within a couple of weeks. A crown is placed over the treated tooth in order to protect it, and if the tooth lacks sufficient tooth structure to hold the core build-up, a post may be placed inside. Any areas of infection around the roots will begin to heal.

The number of visits necessary to complete a root canal will vary depending upon the degree of infection, the number of canals in the tooth, if the canals are calcified, the anatomy of your tooth, and the complexity of the procedure. We always strive to achieve the best possible result; therefore, your treatment may take one visit, or it may take more.