Dental fillings are a time tested way to treat a tooth cavity that has been caused due to dental decay. The filling process involves removal of the decayed part from the tooth, and replacing the gap with a filling material. Apart from treating tooth decay, dental fillings are also used to repair broken, chipped, or cracked teeth. Sometimes a tooth may have worn out due to misalignment, teeth grinding, nail biting, or other causes. Such conditions can also be treated with dental fillings.
A number dental filling materials are available today, and the dentist may recommend the most appropriate material that matches with the patient’s aesthetic needs and budget. Fillings can be made with gold, silver amalgam, porcelain, or composite resin material. Each type of filling material has its own pros and cons, and a final choice of filling can be made in careful consultation with the dentist.
Gold fillings are the best in terms of quality and durability. Gold is a highly malleable, durable and biocompatible material. The filling may last for at least 10 or 15 years or even a lifetime. Gold is strong enough to withstand chewing and biting forces. The downside with gold is that many people may not want it for the anterior teeth that are visible from outside. Gold is also the costliest material for a dental filling.
Silver Amalgam Fillings
Silver amalgam fillings also offer the advantages of strength and durability just like gold. They are also relatively less expensive compared to most other types of fillings. However, the disadvantages of silver amalgam fillings include poor aesthetics and discoloration of the tooth structure. Silver fillings also need greater removal of the healthy part of the tooth to create sufficient space for the filling. In rare cases, silver amalgam may cause allergic reaction due to the presence of mercury. Our office does not recommend using silver fillings.
Composite fillings are versatile, aesthetically superior and require less tooth preparation. The downside of composite fillings includes lack of durability. Compared to metal fillings, composite material is not so strong, and may wear out faster. These fillings may last only for about five years in many cases.
These fillings offer the aesthetic benefits similar to composite fillings, but without the disadvantage of lack of strength and durability. Porcelain fillings can last for about 15 years or more, but they are also very expensive, just like gold fillings.
The filling procedure begins with the dentist applying a local anesthetic to numb the affected area. The decayed portion from the tooth is then removed with the help of a tiny drill or another instrument or laser. The dentist will then prepare the space for filling by removing any debris from the cavity and disinfecting the space.
Once the filling has been placed firmly, the dentist will perform finishing and polishing to make it appear a natural part of the tooth structure. Tooth colored fillings also involve treatment with a curing light to harden the multiple layers of the filling.
Root canal is a proven and effective treatment to save a tooth structure when the tooth nerve has become infected. The infection in the nerve and pulp inside the dental pulp chamber cannot be easily eliminated with antibiotic oral treatment. If the pain persists, the dentist has no choice but to recommend a root canal treatment to save the tooth.
The treatment involves removal of infected nerve and pulp from the chamber, which is then thoroughly disinfected and sealed. This helps preserve the existing tooth structure. If root canal is not done, the infection may spread to the tissue surrounding the tooth and cause formation of abscesses. Tooth extraction may be the only option in such a case.
The pulp chamber refers to the soft core within the natural root canal in the truth structure. The tooth nerve lies in the root canal. This nerve only performs a sensory function, which makes the tooth feel hot or cold sensations. If the nerve is infected or damaged, the safest option available is to remove the pulp and the nerve completely. This removal does not impact the everyday functioning of the tooth structure, except for the loss of hot and cold sensation. Not removing the infected pulp and nerve can lead to abscess formation, spreading of the infection to other teeth, and even bone loss at the tip of the tooth root.
In some cases, no symptoms may appear externally to show that a root canal treatment is necessary. However, in most cases, the following symptoms may indicate the need for root canal treatment:
Root canal treatment usually begins with the dentist taking digital images to determine the shape of the underlying root canals. Through these images it is possible to identify any signs of infection around the bone. Once the extent of infection is evaluated, the dentist will apply local anesthesia to numb the area around the tooth. The nerve is usually already dead, and the patient may not feel the pain even without local anesthesia. A rubber dam is placed around the tooth to keep it free of saliva during the treatment.
The dentist will drill an access hole into the tooth to remove the infected nerve tissue and other debris from the pulp chamber. Root canal files will be used to scrape, scrub and clean the sides of the root canals. Water or disinfectant solution is used to irrigate the canals and flush out debris. Once the cleaning process is completed, the tooth is sealed to prevent any future chances of infection. In many cases, the tooth structure becomes weak or compromised following a root canal. The dentist will place a dental crown to provide extra strength to the tooth structure in such cases.
A dental crown is a restorative cap shaped like a natural tooth that is placed over a healthy or compromised tooth, depending on the purpose of the crown. Crowns are commonly used for restoration purposes following a root canal treatment, or to improve the shape, size and cosmetic appearance of the tooth. In case of dental bridge treatment, crowns will be used for healthy adjacent teeth to provide support to the artificial tooth. When dental crowns are permanently cemented into place, they encase the complete visible portion of the tooth that exists above the gum line.
The dentist may recommend dental crown treatment for one or more of the following purposes:
Crowns may also be used for the primary teeth of a child to achieve the following goals:
Different qualities in dental crowns are available, and the dentist will recommend the most appropriate type of crowns to match with the unique needs of a patient.
Alloy-based Crowns: Gold alloy, palladium alloy, or a base metal alloy may be used to create dental crowns. Metal crowns require lesser removal of tooth structure, and tooth wear is minimized. Biting and chewing forces can be sustained well with these crowns. Damage and wear and tear is minimal with these crowns, but they are more appropriate for posterior molars due to cosmetic reasons.
Metal fused to Porcelain Crowns: Unlike metallic crowns, porcelain and metal fused crowns can be matched with the natural color of the patient’s teeth. However, the wear and tear is more frequent with these crowns. Due to their cosmetic appearance, these crowns are outstanding and designed for both front and back teeth.
Porcelain crowns: From a cosmetic perspective, these are excellent crowns because they can mimic the natural appearance of the teeth in the best way. However, the wear and tear with these crowns is more than that of fused crowns or metallic crowns.
Dental crowns can typically last between five and 15 years. The longevity of the crown may vary depending on its location and the extent of wear and tear it is exposed to. Patient’s oral hygiene practices will also impact the life span of the crown. People who eat more hard foods or chew their nails or other hard substances should be more careful with dental crowns in order to ensure they lost as long as they should.
Tooth loss can occur due to prolonged tooth decay, gum disease, or injury. For many decades, traditional treatment options such as dental bridges and dentures have been used to restore missing teeth. However, with the introduction of dental implants, a superior and more effective tooth restoration option has been created. A dental implant replaces the natural tooth root with an artificial one, which makes it most effective and long lasting treatment. The root implant provides a solid foundation on which a replacement tooth is placed, which matches with the natural teeth.
Some of the key advantages of dental implants include the following:
Any person with one or more missing teeth who is reasonably healthy to undergo an oral surgery or a routine tooth extraction may be a good candidate for implants. The patient should have sufficient bone and healthy gums in the area where the implant needs to be placed.
A marvelous candidate will value the importance of tremendous oral hygiene practices, and make periodic visits to the dentist for oral health check-ups. Patients with chronic diseases such as diabetes or heart disease, patients who have received radiation therapy, as well as heavy smokers need to be assessed on a case to case basis for implant treatment.
The implant is an artificial tooth root most commonly made of titanium. This root is placed in the targeted spot inside the bone socket where the original root existed. As the healing process of the jawbone takes place, the bone naturally grows around the implant. Complete healing may take about six to 12 weeks. After the healing, an abutment is attached to the root to help the new tooth stay in place over the root firmly. A dental crown is then custom fabricated to fit over the tooth root in order to create a tooth structure that looks, feels, and functions like a natural tooth.
Gum disease is a common problem resulting from the body’s response to bacterial invasion in the gum tissue that causes destruction to be bone and tissue supporting the teeth. Severe conditions of gum disease, when the infection reaches the bone, are known as periodontal disease. The challenge with gum disease is that its symptoms are not easily visible in the beginning. Unless a person visits the dentist for routine periodic dental check-ups, it may be difficult to detect gum disease very early.
Gingivitis and periodontitis are two types of gum disease. Gingivitis is the mild or early stage of gum disease where only the gum tissue surrounding the teeth gets inflamed. In case of periodontitis, the infection spreads into the underlying layers of gum tissue as well as the bone that support the teeth. Gingivitis does not usually cause any pain or discomfort, and tends to become ignored by many patients. It shows up signs of the disease when gums become red and swollen and bleed easily during brushing.
Periodontitis causes the development of significant gaps between the gum and the tooth. If left untreated, harmful bacteria tend to germinate in these pockets, and eventually cause damage to the bone that supports the tooth. Gum recession or shrinking of the gum also occurs in this condition, which can make the tooth appear abnormally longer. In extreme conditions of periodontitis, the dentist may be left with no other option but to extract the tooth. In some cases, the tooth may become too lose because of the widening pocket, and fall out on its own.
Plaque formation takes place on the teeth due to collection of food debris and other pollutants. The harmful bacteria in the plaque produce toxins that cause irritation in the gums and gradually lead to a breakdown of gum tissue. If the plaque is not regularly removed from the teeth, it may eventually start spreading below the gums and cause infection in the bone that supports the teeth.
Prolonged existence of plaque on the teeth causes its hardening, which turns it into tartar. Tartar can be removed only with professional cleaning by a dentist. People who are more prone to gum disease include the following:
A mild condition of gum diseases may be corrected simply by improving oral hygiene habits and visiting the dentist regularly for dental cleanings. However, if the gum disease condition has worsened or turned into periodontitis, the dentist will recommend a treatment called scaling and root planing or sometimes referred to as a “deep cleaning”. This treatment will help remove the build-up of tartar below and above the gum line as well as the diseased tissue. The dentist may also prescribe antibiotics to help eliminate the infection from the mouth. Surgery may be necessary in very severe cases of periodontitis. Learn more about dental laser treatment for gum disease.
The denture is one of the oldest approaches to teeth restoration that is still very much in use today. This time tested approach involves a fabricated set of teeth and surrounding tissue to replace the natural missing teeth. Dentures can be either full or partial, depending on the number of teeth that need to be replaced. If some natural teeth are still healthy, it may not be necessary to remove them and customized partial dentures can be created for the missing teeth.
Complete or full dentures are required when all teeth need to be replaced. These dentures can be immediate or conventional. Many dentists will initially provide immediate dentures until the gum tissue has healed completely following dental extractions. Once the healing is complete, a customized conventional denture will be fabricated to fit in perfectly for long-term use. These dentures may be placed usually about eight to 12 weeks after the dental extractions.
It is important to fabricate customized dentures only after the complete healing because the gums and bones tend to shrink over time, particularly following the tooth removal. This ensures that correctly fitting dentures can be created in the first time. Immediate dentures, on the other hand, are usually considered only as a temporary solution because they are created in advance, and placed immediately after the extractions.
In the case of partial dentures, a gum colored synthetic base is created, which includes artificial replacement teeth over it. A metal framework is connected to hold the partial denture firmly in the mouth. These dentures are used when one or more healthy teeth still remain naturally in place in the lower or upper jaw. The advantage with partial dentures is that they not only replace the missing teeth, but also prevent other teeth from shifting from their natural position.
A key benefit of both complete and partial dentures is that the treatment is simpler and more conservative compared to dental bridges or implants. Dentures are ideal for patients who have suffered substantial loss of bone or gum recession, and may not be fit candidates to receive implants or bridges. In some cases, dental implants may be used as a support to dentures to keep them more firmly in place. The dentist will evaluate the patient’s oral condition and create an appropriate treatment plan to achieve the goals of the patient in the best possible way.
The denture fabrication and placement process may take about four to six weeks in most cases. The patient should be prepared to visit the dentist’s office a few times over the course of this process. As a first step, the dentist will examine the patient’s condition closely and determine the most suitable dentures to address the patient’s needs effectively.
A series of impressions of the jaw will be taken to create fabricate best fitting dentures. Before casting the final denture, a few trials of a denture model will be taken to determine the best fitting dentures. Once the final denture is created, any necessary adjustments will be done before the dentures are fitted.
Dental bonding is a non-invasive dental procedure used for cosmetic as well as restorative purposes to improve the condition of a decayed, broken, chipped, or cracked tooth. The procedure involves the application of a tooth-colored resin material that is bonded with the affected tooth to restore its shape and improve the patient’s smile.
Patients suffering from one or more of the following conditions may be ideal or suitable candidates for bonding procedure:
Except for filling a decayed tooth, anesthesia may not be necessary for dental bonding procedure. A dental shade guide will help the dentist determine the closest matching color for the composite resin material. The dentist will then roughen the surface of the tooth and apply a conditioning liquid in order to ensure strong bonding of the material to the tooth.
The resin is molded in the desired shape, and hardened with a UV light or laser. The hardened material will be trimmed and polished to make it appear naturally matching with the remaining tooth surface. The entire procedure may take anywhere between 30 minutes and one hour for a single tooth.
The biggest advantage of dental bonding is that it is one of the simplest, safest and most painless cosmetic dental treatments. Compared to many other procedures, it is also less expensive. The time consumed during the entire procedure is relatively lesser for a single tooth. For instance, dental crowns and veneers will require customized tooth coverings. This involves fabrication in the lab, which can take about two weeks.
Bonding avoids the need of custom materials, and it can usually be completed in a single dental visit, unless multiple teeth are involved. The procedure is conservative and involves very little removal of tooth enamel. Anesthesia is avoid for all dental bonding treatments, except when it is required to fill a large cavity.
Stain resistance of the dental bonding material is usually weaker when compared to porcelain veneers and dental crowns. The strength of composite resin bonding is also relatively lesser compared to other restorations such as veneers and crowns. Therefore, the chances of breakage of bonding material are somewhat higher than in the case of other treatments. Dental bonding is considered more appropriate for minor cosmetic enhancements, correction of small cosmetic aberrations, and is particularly effective on teeth in the areas of low bite pressure, such as the front teeth.
Dental bonding treatment does not require the patient to follow any special care for the bonded teeth in everyday life. Patient should follow regular healthy oral hygiene practices for all the teeth, including the bonded teeth. Chewing hard materials should, however, be avoided where bonded teeth are involved. Typical bonded material may last for about three to 10 years, depending on the oral and food habits of an individual as well as the extent of bonding performed.
A dental bridge is one of the most effective and time-tested treatments to restore one or more missing teeth. The bridge is created with two crowns for the teeth that are fitted on either side of the missing tooth. These are called abutments or anchoring teeth, and an artificial tooth is placed between them to restore the gap created by a missing tooth. The artificial tooth, which is called a pontic, can be fabricated from porcelain, metal alloys, gold, or a fusion of two materials.
Dental bridges are one of the most popular restorative treatments for missing teeth. Some of the main benefits of bridges include the following:
Dental bridges are commonly available in three different types as follows:
Traditional Bridge: This is the most common type of dental bridge, which is usually made from porcelain fused with metal or 100 percent ceramic material. The bridge involves two crowns for the anchor teeth adjacent to the missing tooth, and a pontic in the middle.
Cantilever Bridge: This bridge is used in a special situation where the patient has adjacent teeth available only on one side of the missing tooth.
Maryland Bridge: Maryland bridge or resin bonded bridge is produced with plastic teeth and gums that are supported by a framework made of metal. Each side of the bridge has metal wings that are bonded to the existing teeth.
The first visit to the dentist for dental bridge treatment involves preparing of the abutments or anchoring teeth. These teeth are re-contoured by removing a tiny portion of the enamel to create room for a crown to be fitted over them. Thereafter, the impressions of the teeth are made, which will be used to fabricate the bridge, crowns and pontic in the laboratory. This process may take about two weeks, during which the dentist will provide a temporary bridge to protect the exposed teeth and gums.
During the second dental visit, the temporary bridge will be taken off, and replaced with a new, permanent dental bridge. The bridge will be checked and adjusted to ensure a perfect fit. Follow-up visits may be necessary to evaluate the normal fit of the metal framework and natural bite. This can vary from case to case. Permanent cementing of the bridge will be done in about two weeks, once the proper fitting has been achieved.
A dental bridge will usually last anywhere between five and 15 years, and in some cases it may last even longer. The patient just needs to maintain terrific or basic oral hygiene practices as any other individual with healthy teeth, and visit the dentist periodically for routine check-ups. No special maintenance is required for the bridge, except that initially the patient should eat softer foods until he or she becomes fully accustomed to the bridge.