Archive for the ‘Tooth Repair Methods’ Category

If teeth have been lost, then replacement options include implants, dentures, and non-removable bridges.

A bridge uses the teeth on either side of a gap for support and is usually made of porcelain fused to a metal framework. This procedure usually takes from two to three appointments to complete and is very similar to having a crown placed on a tooth.

The dentist will prepare the two teeth on either side of the gap by precisely shaping them to by removing enamel and dentine to specific requirements .

The bridge must be carefully fabricated to fit the prepared teeth and to also fit against the opposing teeth to ensure a correct bite. Accordingly the dentist must take accurate measurements in the form of impressions of both jaws and the actual bite which the ceramic laboratory needs to work with. At the conclusion of the preparation appointment the teeth which are to carry the bridge are covered with temporary crowns made of acrylic in order to protect and stabilize them until the next appointment.

At the second visit, the dentist will remove the temporary bridge, check the fit and appearance of the new bridge and if everything is acceptable to both you and the dentist, the bridge can be cemented into place and the treatment is completed.

Click here to read testimonials from happy patients.

When more than 50% of the chewing surface of a back tooth has been damaged by decay and the drilling and filling process, it is preferable to use an inlay or an onlay to restore and strengthen the tooth rather than an ordinary filling or a more elaborate crown .

Inlays and onlays can be fabricated from porcelain, gold or hard composite resins, all of which may require the services of a dental technician or laboratory.

An inlay is similar to a filling but requires very precise design of the cavity within the confines of the cusp tips of the tooth; an onlay is a more extensive restoration covering one or more of these cusps to prevent their fracture.

Both inlays and onlays are traditionally made of gold or as in some countries, in a non-precious metal. However, in recent years porcelain has become the material of choice because of its comparable strength and superior potential to match the natural colour of teeth.
Inlays and onlays generally require two visits. At the first visit, the old filling, or decay, is removed, and the tooth is prepared for the inlay or onlay. The dentist will then take an impression of the tooth, and send this impression to a dental laboratory. This impression will be used by the laboratory to construct, a porcelain, or gold inlay/onlay that will fit exactly into or onto your tooth. At this time the dentist will place a temporary restoration on your tooth and schedule a second appointment.

At the second visit the temporary restoration is removed. Your dentist will then ensure that the inlay/onlay fits properly and does not interfere with your bite. Once correctly fitted, this permanent restoration is bonded to your tooth with a strong resin, and polished.

Recent technologies have given dentists the ability to use CAD-CAM systems to fabricate inlays and onlays from ceramics in a single visit. This revolutionary technique allows patients the comfort of only needing to be numbed once for these procedures.

Link: http://www.chatswooddental.com.au/testimonials2.html

Traditionally, dentures were the only means available to replace missing teeth and are still an alternative if a bridge or implant is not suitable.

Depending on whether a few or all the teeth are missing, replacement is possible with either a partial or a full denture. Partial dentures may be made from a plastic base or a metal base, usually cobalt-chrome and are kept in place by small wire clips called retention clasps and reciprocators. Full dentures however, are fabricated from acrylic and remain in place by precisely fitting the gum and ridges of bone upper and lower jaws.

In the case of the upper jaw the denture is retained by strong suction against the roof of the mouth while the lower denture stays in place due to gravity.

If the gum has receded too far, it may not be possible for the full denture to stay in place. In such cases, implants are able to stabilize the dentures very effectively.

It usually takes several visits for the dentist to properly fabricate and fit a denture as after each visit, the models and trial dentures must be sent to a dental lab until such time as a satisfactory result is achieved.

To read more about Mini Dental Implants visit this site: www.mdiDentures.com.au

What exactly are dental implants and what can they do for you?

Implants are the best substitutes for natural teeth offering you a permanent and  secure solution for replacing one or more teeth. They are made of biocompatible materials, just the same as hip implants or similar orthopaedic devices, and function as anchors or support for traditional forms of dentistry, such as crowns, bridges or dentures. Many patients will tell you that implants have not only improved their smiles, and overall appearance but also the quality of  their lives!

There are numerous reasons to choose dental implants:

• Aesthetically, they look like real teeth.
• Functionally, dental implants feel and act like real teeth.
• With implants, you can eat and chew again without pain or irritation. Foods that were forbidden are now back in the diet.
• Implants eliminate the need for distasteful adhesives. There is no longer a need to use “glue” when your prosthesis is anchored to implants.
• Implants can actually allow for the improved enjoyment of the textures and flavours of your favourite foods. With less plastic covering the roof of your mouth, you can enjoy natural flavours and sensations again.
• Lastly, implants can help maintain your bone structure and support your facial tissues. They can reduce or eliminate bone atrophy, which causes “shrinkage” or facial cosmetic changes.

What benefits can I really expect?

• Eat whatever you like! Implants improve your health with the ability to chew a wider variety of foods.
• Smile with confidence. Discoloured or missing teeth ruin your appearance but implant-supported restorations help increase your self-esteem.
• Implants increase the retention and stability of your teeth.
• Improve your external facial structure and decrease the likelihood of continued bone loss.

Are implants successful?

Implants, as we know them today, have been in existence for at least forty years with success rates at many treatment centres consistently over 95% with proper personal and professional care. Few forms of medical, orthopaedic or dental treatment have such high success rates.

Who does implant dentistry?

Only suitably trained and experienced dentists should be involved with implant dentistry. Implants usually involve two phases of treatment: placement of the implant and its core (abutment) and placement of the crown, bridge or precision attached denture. Some dentists feel they can offer better solutions for you by using the different expertise of other team members, e.g. performing the surgery or the restoration. Other practitioners feel that performing both the surgery and the restoration within one office is optimal for many patients.

Does it hurt?

Usually, discomfort is not a problem but it is common practice to recommend taking  simple pain-killers for 24 hours after the implant operation. In fact, many patients have said that having a tooth extracted is more painful!

How long will it take?

Recent advances in implant systems have reduced the time for initial implant procedures. Treatment for the simple cases could take anywhere from 2-4 weeks and in more complex cases 6-8 months, based on where the implants are placed and the type of restoration you desire.

Am I too old?

Implant patients can be in their late teens or be mature adults in their seventies and eighties. Good health and adequate bone are the most critical factors in evaluating implant candidates. Even if health issues exist, by taking the right precautions, nearly every patient is able to receive the benefits of Modern Implant Dentistry in our practice.

Is one implant system better than the others?

No. There are many FDA approved implant systems available for your benefit.

What will it feel like when it is done?

Once the entire procedure is complete and the final restorations placed, they will actually feel or function like your natural teeth!

How do I take care of my implants?

Normal routine home care and professional cleaning visits are required. It is important to know that every 6-12 months, you will need to have a routine cleaning and evaluation. An individualized program should be designed for you to optimally care for your new teeth.

Link:  www.ImplantDentist.com.au

When a tooth has decayed excessively, has broken or is brittle due to previous treatments, an artificial crown is often best to replace the damaged natural crown. This procedure takes two or three office visits.

Provided that the roots and bone structure that support the tooth are healthy and strong, a dentist can prepare the tooth for the crown by reshaping it to precise design principles to accommodate a crown.

If the foundation for a crown is too weak, root canal therapy is required so that a metal post may be placed in the root(s) for additional support. If however, the bone that supports the root of the tooth is too weak, the dentist may not recommend the placement of a crown at all, as the tooth may only last a few more years.

The crown must be carefully fabricated to fit the prepared tooth and also fit against the opposing tooth to ensure a correct bite. Accordingly the dentist, must take accurate measurements in the form of impressions of both jaws as well as record of the bite to ensure that the new crown is fabricated to fit and function comfortably against the opposing tooth. At the conclusion of the preparation appointment the tooth which is to be crowned is covered with a temporary crown made of acrylic in order to protect and stabilize it until the next appointment.

At the second visit, the dentist will check and fit the crown over the prepared tooth and if all is well, cement it permanently. The durability of crowns depends on many factors but generally the structure of a crown is able to last a lifetime. However, it is common for crowns to need replacement after 20 years of service.

Click here to read testimonials from happy patients who had a crown fitted to their tooth.

Recommended link: www.cheapercrowns.com

Bonding is an alternative to veneers and can be used to restore teeth that are discoloured, chipped, cracked or misaligned.

The dentist prepares the tooth for bonding by gently etching the surface using a mildly acidic liquid or gel. The surface of this etched tooth is then treated with a liquid resin that allows bonding of a resin putty which can be sculpted to the desired shape. Usually the putty is then hardened by exposure to a special light source for just a few seconds. Upon setting, the new contours are trimmed and polished to provide you with a natural appearance.

Bonding can significantly improve the appearance of a tooth and can usually be done in a single office visit. Because the plastic is not as strong as tooth enamel, it can be chipped, or broken, and is more likely to pick up stains than natural teeth. Bonding usually lasts for three to five years before needing repair.

Click here to see images showing the amazing results of bonding on teeth.

When extensive decay has resulted in damage or death of the pulp in a tooth, the resulting infection of the nerves and blood vessels in the root requires that either the tooth be extracted or a treatment known as root canal therapy be performed.

Root canal treatment typically requires two or more appointments.  Initially the dentist will need to drill an access cavity through the crown, whether natural or artificial, to remove the infected tissue.  The full length of the root canal(s) is then physically cleaned out using very fine filing instruments and then disinfected with the aid of solutions and antibiotic pastes.

If there is an abscess, the dentist may prefer to leave  the tooth open to allow for drainage of fluids that may be causing intense pain due to the pressure within jawbone.  If this is not ideal,  the dentist will place a temporary filling in the tooth and prescribe a course of antibiotics which should be completed before the next appointment.

Once the symptoms have been eliminated and infection brought under control, the canals are filled with a sterile rubbery material called gutta percha and sealed with special pastes.

As most root-filled teeth are brittle and subject to fracture, it is preferable to use an inlay, onlay or crown to restore the tooth rather than an ordinary filling.

Occasionally, if root therapy is unsuccessful and a residual abscess is causing symptoms at the base of the tooth, a surgical procedure known as an apicoectomy may be required  to remove this infected tissue.

If root canal therapy is recommended, it is important to have a tooth treated as soon as possible.  An infection that is allowed to continue, will result in an abscess which will lead to destruction of the underlying bone structure and may make it impossible to save the tooth. In addition, the infection can spread through the bloodstream and lymph system resulting in swelling in the face and neck, septicaemia, fever and potentially, death.

The shape of many teeth makes it impossible to completely eliminate all food particles and sugars from within the deep grooves and pits found on the chewing surfaces, especially in the back teeth.

These areas are usually the first to decay during or even before the early teenage years. Today, these decay-prone areas can be protected early in life by the application of a thin layer of resin which is bonded into the crevices and pits found in the enamel layer. This coating, known as fissure sealants, creates a very effective barrier between oral bacteria and the deeper layers of the tooth.

What is plaque and why does it cause cavities?

After eating and drinking, bacteria colonise the surface of teeth in a sticky film called plaque that attaches on and in between tooth surfaces. Plaque often is found on the chewing surfaces of the back teeth, from which it is difficult to remove by brushing and flossing alone. If plaque is not removed regularly from teeth, acids which are produced by these bacteria will dissolve the protective layers, the enamel and dentine, creating holes (cavities) which allow more and more bacteria to proliferate. This results in more rapid decay, which leads to the destruction of the inner layers of teeth and toothaches, infections, facial swellings etc.

Is it difficult to apply sealants?

No. It is a completely painless treatment that lasts for many years.

Who should get sealants?

Sealants are most effective in reducing cavities in children with newly formed permanent teeth but are also useful in preventing the formation of decay in adult teeth. It is an effective way to reduce the need for fillings and more expensive treatment that may be required to repair the damage from large cavities.

Teeth that are strong can be cosmetically restored by the application of veneers.  These are custom-made porcelain wafers that can be used to restore chipped, gapped, stained, or malaligned teeth.  This is a much more conservative restoration than the use of crowns, and provides a stronger, longer lasting, alternative to bonding.

Initially, the tooth is prepared by removing a small amount of the enamel from the front of the tooth (usually 0.3 – 0.5 mm).  An impression of the tooth is made which is sent to a ceramic laboratory where a technician will construct the veneer.

At the next appointment, the dentist will fit the veneer.  If it meets the dentist’s and patient’s approval, the veneer is bonded to the tooth, trimmed, and polished.  It can take a few hours to shape and bond the veneer, but typically the result is very aesthetically pleasing.

Veneers provide one of the best alternatives for cosmetic dentistry and are most effective when carried out as a full smile makeover. That is, when all the teeth which are visible when smiling are treated simultaneously.

To see some of our success stories use this link:  http://www.chatswooddental.com.au/photo-gallery.html

Author

Dr. Joseph Shohmelian
BDS (Syd) LDS (Vic) FICOI FWMCD
Dental Surgeon
Chatswood Dental
Suite 205 7 Help Street
Chatswood
Sydney NSW
Australia 2067
Phone: +61 2 9411 6300
Fax: +61 2 9411 6222
chatswooddental@pip.com.au