Teeth that have undergone root canal therapy or are at risk of fracture are routinely covered with a crown. This process includes the removal of decay and rebuilding the tooth with a composite material. This process may require the addition of pins or posts for added retention. A bridge consists of three or more crowns fused together with the goal of filling gaps caused by missing teeth. Bridges are very useful in cases where adjacent teeth require crown coverage.
Dental implants are an excellent tooth replacement option and frequently employed in retaining full-arch prostheses. The implant may replaced at the time of the extraction or later after bone healing is complete. Integration of the implant typically takes three to four months. An abutment is placed and ceramic crown is made and seated over the abutment. Implant placement often requires bone grafting and a barrier membrane. If the socket was not well-preserved at the time of the extraction, additional procedures such as ridge augmentation and sinus lifts may be required to facilitate the implant placement. The results of the procedure are usually positive with proper post-operative care.
While complete crown coverage is required for teeth with a significant loss of coronal structure, veneers are a cosmetic procedure aimed at improving appearance. The process typically involves minor enamel reduction to accommodate the veneer body on the face of the tooth. Temporary veneers are made based on an ideal wax model and placed to assure the patient is pleased with the esthetics. The final step consists of the cementation of the ceramic veneers. Typical coverage areas are teeth that appear in the smile line, usually upper arch anterior teeth, but sometimes extending to premolars. An alternative to lab-made ceramic veneers is chairside composite veneers. These are placed in one visit to the office and are a cost-saving alternative.
In the predominant teeth whitening method we employ in cosmetic dentistry consists of custom made bleaching trays and take-home bleaching gel. The bleaching agent is prescription strength carbamide peroxide, which is placed in the trays and worn at home. The bleaching agent is usually highly effective and several shade changes may be achieved. Side effects may include temporary tooth sensitivity which is typically transient.
Tooth decay is an extremely common disease caused bacterial colonization on the tooth surface. Residual byproducts of the bacterial activity attack the tooth surface and progress through the enamel shell into the dentin core. At this point, the process is irreversible and requires treatment. The decay is removed mechanically using a dental handpiece and bur. Once all contamination is cleared, the tooth is restored with a tooth-colored filling material. The prevention of dental decay consists of good oral hygiene and regular professional cleanings.
Root canal therapy is used in situations when irreversible damage has occurred to the inner tissue of the tooth. This may range from painful responses to cold and hot stimuli, to spontaneous and continuous pain associated with late-stage disease. Left untreated the disease often progresses to necrosis of the pulp and it spreads into the adjacent apical bone tissue. Once the removal of infected tissue and bacterial decontamination has been achieved, the canals are cleaned and sealed. The remaining tooth structure is filled, and a crown is typically applied for protection and healing.
Dentures are indicated for tooth replacement when extensive or total tooth loss has occurred. There are two main categories of dentures, partial dentures, where some teeth in the arch are retained, and complete dentures in the edentulous arch. Partial to complete denture options are available for all varieties of applications.
Extractions are typically performed when the tooth prognosis is deemed hopeless, either due to extensive decay or severe periodontal disease. The goal of the procedure is the removal of the tooth with little to no trauma and maximum preservation of the surrounding bone tissue.
The health of the tissues surrounding the teeth is of paramount importance to good oral health. Fortunately, with good oral hygiene and proper dental care, periodontal disease can be successfully treated in many cases. The prevalence of varying degrees of periodontal disease in the population is high and increases with age. While genetic components may play a factor, the primary cause is a lack of adequate oral hygiene. Periodontal disease treatment involves the removal of plaque and calculus from the tooth and root surfaces using ultrasonic instrumentation and hand scalers. This is usually done in a couple of appointments under local anesthesia. Severe cases may require flap surgery. Once the treatment is complete, regular maintenance visits are required.
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