You might hear dentists claim that their dental office is metal-free. They are using this philosophy to discourage the use of metal in any of their fillings (restorations). In essence they are fear mongering. This implies that there is something wrong with the use of metal in your mouth or that they have a problem using it. Metals have been used in dentistry for a very long time. No proven harm to any patient in all these years of use. Certainly, the silver fillings don’t look as nice as white ones, but you should not lose sleep over the fact that you have silver fillings or that they are all that you can afford. That said, any new fillings done in our office will be white fillings for a more pleasing look.
Crowns are laboratory made “caps” which fit over a tooth, which has been prepared by the dentist. They are usually made of porcelain, metal, or a combination of porcelain and metal. You might hear people refer to crowns as caps. They are talking about the same thing. Crowns can make teeth more esthetic looking while making the tooth stronger. To make a crown we first have to prepare the tooth by removing older fillings and any decayed areas. We file the tooth at least one to two millimeters all the way around and make an impression of it. We send the impression to the lab and they fabricate a crown in a little over a week. When the patient returns in just over a week the crown(s) are then fitted, checked for color (shade) and then cemented onto the tooth. Crowns can cover up stains or even change the color of the teeth by the use of porcelains, which will improve the esthetics of your smile. Also, crowns can change the shape of teeth.i.e. Creating tighter contacts between the teeth, enlarging the size and shape of the tooth, and closing spaces. Crowns can also be used to slow the advancement of a fracture in a tooth.
A bridge is a custom laboratory-fabricated restoration of two or more teeth made from porcelain, metal, or a combination of both. It will replace one or more missing teeth. For example, if you had one missing tooth in the front of your mouth, a bridge could be made using one of the adjacent teeth. It would be filed down 1-2 mm and a “cap” would be made for this tooth with a false tooth attached to fill the missing tooth space. This is the simplest bridge and is called a cantilever bridge. A common example of a cantilever would be a diving board at a swimming pool. If an adjacent tooth isn’t strong enough to support the bridge by itself, both teeth adjacent to the space teeth could be used. A bridge can be as small as two teeth and as large as fourteen teeth, spanning a whole arch of teeth. Bridges can be supported by implants as well.
When people talk about bonding their teeth, they are talking about placing a layer (“veneer”) of plastic or porcelain over their teeth to change the color and/or shape of their teeth. Usually we are fabricating a whiter smile or perhaps closing a space between the front two teeth. Porcelain provides the best esthetics. It looks more like tooth enamel, covers stained teeth better, and is much harder. It will last longer than plastic. Plastic can produce a nice result and it is considerably cheaper.
Many people are interested in making their teeth whiter. There are many tooth bleaching agents on the market. They aren’t as concentrated as the ones you can get in a dental office and the way that you apply the bleach can be very messy. You certainly don’t want to be using too much or getting it on your gums. Bleach can damage the attachment of the gum to your tooth and it burns gums. Many people think that these bleaching agents will make their teeth whiter. After the bleach removes stain it then only lightens the tooth surface. Enamel will lighten the most followed by dentin. Enamel is the white coating of natural teeth above the gum line. Dentin is naturally yellow and is under the enamel. Since enamel is white, when it lightens, your teeth will look whiter but they have only been lightened. Areas of your tooth surface where enamel has been worn away (i.e. yellow areas of root exposure at the gum line) will only become a lighter yellow. It will look better but it will not become whiter. Most fillings don’t change color after bleaching so you would want to hold on doing new fillings that show until after the bleaching. If you have a front crown that currently matches the other natural teeth you would want to redo that crown afterwards or, perhaps, not do the bleaching. Bleaching should only be done after a hygiene appointment to make sure hard deposits are not bleached into the teeth. Our procedure for bleaching involves making impressions of your upper and lower teeth. From those we fabricate custom fitting trays with reservoirs in front of the teeth to be bleached. These reservoirs allow space for bleach to sit and keep it off the gums. We will then discuss a bleaching schedule for a two-week period tailor-made to suit your needs. If you wish to do a booster bleach in the future we recommend just one week of bleaching after a minimum of at least six months. We sell the bleach syringes at cost and one or two will suffice. Be sure to ask us if you are a candidate for bleaching!!
Implants in dentistry have become a state-of-the-art treatment. When you are missing one tooth an implant can be placed in the space. A crown, which matches the adjacent teeth, can then be cemented to the implant. The big advantage is the dentist doesn’t have to prepare the teeth next to the space. The adjacent teeth are not affected. Not all implants cases are successful. Proper case selection is important. Factors such as regular hygiene appointments, good home care, amount of bone support and health of the patient are some of the important factors determining a successful treatment. With a good workup success can be over 90% with implants. When the space is larger more implants can be placed to support more crowns or even bridges. Implants supported dentures have become a dream for people who have loose dentures allowing them to eat and speak better again. If you are wondering if implants are for you please inquire at our office.
When you would like to change your smile by improving the shape and color or perhaps just making them stronger then Porcelain Veneers could be the answer. These involve preparing the teeth by selectively removing tooth structure and bonding thin layers of porcelain onto the teeth. Porcelain is strong and can be very good at covering up underlying stains. Porcelain Veneers are great for closing spaces between front teeth. Of all the materials used by dentists porcelain is the most tooth-like and doesn’t stain.
Quite often we can eliminate crowding, rotations, spaces, and bite issues just by doing crowns, bridges and or veneers. You might look at your smile and think that you will need braces to correct your smile deficiencies but you might only need some cosmetic dentistry to improve your smile.
Have you ever considered changing your smile? Perhaps there has always been something about your teeth that you didn’t like? The color, the shape, the stains, the gums, the spaces, the size, etc. Ask us about anything smile related and we will do our best to help you get the answers.