When a tooth suffers decay from bacteria or is otherwise damaged a filling is required. As the term implies, a filling fills the space created by the dentist after he or she removes the damaged portion of the tooth, restoring function. The filling also helps prevent future decay, keeping out food particles.
Fillings are made from several materials and include:
Gold – Considered the “gold standard” of fillings, gold is well tolerated by human tissue and can last in the mouth for 20 years or more. It’s also the most expensive filling.
Amalgam (silver) – Silver fillings are nearly as effective as gold fillings and they are much less expensive. It’s dark color, however, makes silver more noticeable in the mouth. Because of this, some patients opt for less obvious fillings. Also, silver fillings are rarely used in smile zone teeth.
Composite (plastic) – Composite fillings are made from a type of plastic and are matched to the exact color of your teeth. This makes composite fillings the most inconspicuous, but they are also the least durable, lasting on average about 5 years and they can stain from coffee, tea, tobacco, and red wine.
As noted in the dental implants section, a crown is the visible part of your teeth. When a tooth is damaged and the repair is beyond the capabilities of a filling, a crown is your next best option in preserving what remains of your natural tooth. Artificial crowns work like a cap over your existing tooth. They improve strength, durability and esthetics. Crowns are made from a variety of materials, including metal alloys, ceramics, porcelain, or a composite resin and the color is matched to your teeth. Crowns are usually placed in two visits – one visit for the temporary crown and one for the permanent crown.
A bridge, or sometimes referred to as “bridgework,” is a dental procedure where an artificial tooth, known as a pontic, is inserted in an edentulous area supported by two adjacent healthy teeth, literally forming a bridge inside your mouth. A bridge is common surgical solution for patients who are missing several teeth – a medical condition that is more common than many people think.
In addition to the “traditional bridge” today there are three alternatives:
- Cantilever bridge – Similar to a traditional bridge only that the pontic is supported by only one tooth on one side of the edentulous space.
- Maryland bridge – Are supported by a metal or porcelain structure behind the two healthy adjacent teeth. Unlike traditional bridges, the adjacent teeth will not require further preparation for a new crown.
- Implant-supported bridge – Artificial teeth anchored to two or more dental implants
According to the American Dental Association the average adult between 20-64 has three decayed or missing teeth. In many of these cases a bridge is the ideal solution that best balances form, function, recovery time, and cost.
Sedation dentistry is a surgical approach that helps patients with dental anxiety or dental phobia relax enough so that they can successfully schedule their appointment and complete the treatment they require. Dental phobia is an often under reported problem and many patients exhibit at least some measure of dental fear that causes them to delay or ignore treatment. Usually the course of action only exacerbates existing problems.
With sedation dentistry patients are given medications that induce various stages of reduced consciousness. Only general anesthesia renders the patient entirely unconscious. The three main approaches include:
- Nitrous oxide – Is a gas the patient inhales that causes mild relaxation. The gas wears off quickly and in many cases the patient will be allowed to drive home.
- Oral sedatives – The most common oral sedative is diazepam. Diazepam is taken about an hour before the procedure. Patients are fully conscious but less anxious. It is advised that patients are driven home following their appointment as they may feel sleepy even after the drug wears off.
- IV sedatives – IV sedatives place patients in various stages of consciousness ranging from mild unconsciousness to a deep sleep. In many cases patients will not fully remember the procedure.
Gum disease or gingivitis, is among the most common dental ailments. The condition is marked by a buildup of bacteria along the tooth and below the gum line that over time causes damage to the infected tooth. Eventually the gums recede from the tooth forming pockets where more food can build up and bacteria can breed. This causes tooth looseness, further decay, bleeding gums, bad breath and the fracture or loss of the tooth.
Periodontal disease is a more severe form of gingivitis. While thorough annual checkups can prevent this, delayed cleanings have a cumulative effect. If you’ve been diagnosed with periodontal disease your dentist will want to schedule you for a scaling and root planing appointment. During this treatment the plaque and tartar lining your teeth and gums is removed. Additional treatments may be required if after healing, it is determined more cleaning is required.
If multiple treatments are unsuccessful your dentist may suggest periodontal surgery. In these instances gum and bone grafts may be required.
Tooth extraction is usually performed under local anesthesia, numbing the tooth/teeth to be removed and surrounding bone and gum tissues. As your tooth is extracted, steps are taken to ensure the bone that surrounds it is unharmed. Sometimes, a small amount of bone-grafting material is placed into the socket to help preserve bone. This is especially the case when the extraction is the prelude to a dental implant. Prior to surgery X-ray images will confirm the need for extraction and the exact way to proceed.