Dental Procedures

Dental Procedures

There are many dental procedures performed by a general dentist or other oral health specialist. We have listed some of the typical dental procedures that this office performs, with brief overviews.


  • 1.    Cleaning & Prevention

    The ADA recommends the following for good oral hygiene:

    Brush your teeth twice a day with an ADA-accepted fluoride toothpaste. Replace your toothbrush every three or four months, or sooner if the bristles are frayed. A worn toothbrush won't do a good job of cleaning your teeth.

    Clean between teeth daily with floss or an interdental cleaner. Tooth decay–causing bacteria still linger between teeth where toothbrush bristles can’t reach. This helps remove the sticky film on teeth called plaque and food particles from between the teeth and under the gum line.

    Eat a balanced diet and limit between-meal snacks.

    Visit your dentist regularly for professional cleanings and oral exams.

    Antimicrobial mouth rinses and toothpastes reduce the bacterial count and stop bacterial activity in dental plaque, which can cause gingivitis, an early, reversible form of periodontal (gum) disease. ADA-Accepted antimicrobial mouth rinses and toothpastes have substantiated these claims by demonstrating significant reductions in plaque and gingivitis. Fluoride mouth rinses help reduce and prevent tooth decay. Clinical studies have demonstrated that use of a fluoride mouth rinse and fluoride toothpaste can provide extra protection against tooth decay over that provided by fluoride toothpaste alone. Fluoride mouth rinse is not recommended for children age six or younger because they may swallow the rinse. Consumers should always check the manufacturer’s label for precautions and age recommendations and talk with their dentist about the use of fluoride mouth rinse. Talk to your dentist about what types of oral care products will be most effective for you.

  • Cleaning and Prevention > Exams & Cleanings

    The prophylaxis procedure is a preventive procedure and is also known as a cleaning. This is where plaque, calculus and stains are removed from the teeth. With this type of procedure you can expect a thorough oral examination, necessary radiographs, a head and neck evaluation, an oral cancer screening, laser cavity detection, periodontal probing, intraoral images, electronic charting, and a discussion of the most appropriate treatment to meet your oral health goals. Removal of plaque, calculus and stain is accomplished by dental instruments that scrape away deposits from the teeth. An electric device, called an ultra-sonic scaler, may also be used. This deposit removal is performed on tooth structures that have not been affected by bone loss; typically the crowns of the teeth. Calculus is also known as tartar and is a hard, mineralized deposit, somewhat like cement that is formed from the plaque in the mouth and the minerals in a person's saliva. Plaque is a soft, sticky substance that forms on teeth, regardless of what types of foods are eaten, which is composed of bacteria and bacterial by-products.

    Why is oral hygiene so important? Adults over age 35 lose more teeth to gum diseases (periodontal disease) than from cavities. Three out of four adults are affected at some time in their life.

    The best way to prevent periodontal disease and cavities is:

    • By good tooth brushing and flossing techniques, performed daily
    • Regular professional examinations and cleanings, every 6 months
    • Talk to your Dentist or Hygienist

    How often do I need to have my teeth cleaned? The old system of everyone having their teeth cleaned only twice a year has fallen out of favor. In fact, many believe that the idea actually came from the recommendations of a 1940 toothpaste advertisement! While some people may be able to maintain their dental health with semi-annual cleanings, many patients find that their mouths and teeth stay in better shape when they have their teeth cleaned more frequently. It is best to have a cleaning schedule that is based on personal needs. This may be as often as four times a year. Other important factors affecting the health of your teeth and gums are: smoking, diabetes, stress, clenching and grinding teeth, medication, and poor nutrition.

    After you have the white smile that you have long desired, it is important to keep it that way. Practice good oral hygiene and always remember to brush after consuming staining food and beverages. Going to your dentist for a regular check up and cleaning is a very important step in maintaining a white smile!

  • Cleaning and Prevention > Dental X-Rays

    Dental X-rays are pictures of the teeth, bones, and soft tissues around them to help find problems with the teeth, mouth, and jaw. X-ray pictures can show cavities, hidden dental structures (such as wisdom teeth), and bone loss that cannot be seen during a visual examination. Dental X-rays may also be done as follow-up after dental treatments.

    The X-rays use small amounts of radiation. The following types of dental X-rays are commonly used. Bitewing X-rays show the upper and lower back teeth and how the teeth touch each other in a single view. These X-rays are used to check for decay between the teeth and to show how well the upper and lower teeth line up. They also show bone loss when severe gum disease or a dental infection is present. Periapical X-rays show the entire tooth, from the exposed crown to the end of the root and the bones that support the tooth. These X-rays are used to find dental problems below the gum line or in the jaw, such as impacted teeth, abscesses, cysts, tumors, and bone changes linked to some diseases. Occlusal X-rays show the roof or floor of the mouth and are used to find extra teeth, teeth that have not yet broken through the gums, jaw fractures, a cleft in the roof of the mouth (cleft palate), cysts, abscesses, or growths. Occlusal X-rays may also be used to find a foreign object.

    Panoramic X-rays show a broad view of the jaws, teeth, sinuses, nasal area, and temporomandibular (jaw) joints. These X-rays do not find cavities. These X-rays do show problems such as impacted teeth, bone abnormalities, cysts, solid growths (tumors), infections, and fractures. Digital X-ray is a new method being used in some dental offices. A small sensor unit sends pictures to a computer to be recorded and saved. A full-mouth series of periapical X-rays (about 14 to 21 X-ray films) are most often done during a person's first visit to the dentist. Bitewing X-rays are used during checkups to look for tooth decay. Panoramic X-rays may be used occasionally. Dental X-rays are scheduled when you need them based on your age, risk for disease, and signs of disease.

    Why X-rays are done? Find problems in the mouth such as tooth decay, damage to the bones supporting the teeth, and dental injuries (such as broken tooth roots). Dental X-rays are often done to find these problems early, before any symptoms are present. Find teeth that are not in the right place or do not break through the gum properly. Teeth that are too crowded to break through the gums are called impacted. Find cysts, solid growths (tumors), or abscesses. Check for the location of permanent teeth growing in the jaw in children who still have their primary (or baby) teeth. Plan treatment for large or extensive cavities, root canal surgery, placement of dental implants, and difficult tooth removals. Plan treatment of teeth that are not lined up straight (orthodontic treatment). Without X-rays, dentists may miss the early stages of decay between teeth. Dental X-ray examinations provide valuable information that helps your dentist evaluate your oral health. With the help of radiographs (the term for pictures taken with X-rays), your dentist can look at what is happening beneath the surface of your teeth and gums. If you have questions about your dental X-ray exam, talk with your dentist.

  • Cleaning and Prevention > Home Care

    Good oral hygiene results in a mouth that looks and smells healthy. This means: Your teeth are clean and free of debris. Gums are pink and do not hurt or bleed when you brush or floss. Bad breath is not a constant problem If your gums do hurt or bleed while brushing or flossing, or you are experiencing persistent bad breath, see your dentist. Any of these conditions may indicate a problem. Your dentist or hygienist can help you learn good oral hygiene techniques and can help point out areas of your mouth that may require extra attention during brushing and flossing.

    How to practice a good oral hygiene? Maintaining good oral hygiene is one of the most important things you can do for your teeth and gums. Healthy teeth not only enable you to look and feel good, they make it possible to eat and speak properly. Good oral health is important to your overall well-being. Daily preventive care, including proper brushing and flossing, will help stop problems before they develop and is much less painful, expensive, and worrisome than treating conditions that have been allowed to progress. In between regular visits to the dentist, there are simple steps that each of us can take to greatly decrease the risk of developing tooth decay, gum disease and other dental problems. These include: Brushing thoroughly twice a day and flossing daily Eating a balanced diet and limiting snacks between meals Using dental products that contain fluoride, including toothpaste Rinsing with a fluoride mouthrinse if your dentist tells you to Making sure that your children under 12 drink fluoridated water or take a fluoride supplement if they live in a non-fluoridated area.

  • 2.    Cosmetic Dentistry

    A smile can be the most eye-catching feature of a face. With dentistry's many advances, you no longer have to settle for stained, chipped, or misshapen teeth. You now have choices that can help you smile with confidence. Even the most subtle change in your smile can make a dramatic difference in the way you look and feel about yourself. Talk to your dentist about the options most suitable for you, what your expectations are and the dental fees involved. Some options are: Tooth whitening (bleaching) brightens teeth that are discolored or stained. Bleaching may be done completely in the dental office or the dentist may dispense a system for you to use at home.

    Bonding can improve the appearance of teeth that are chipped, broken, cracked, stained, or have spaces between them. With bonding, tooth-colored materials are applied, or bonded, to the tooth surface. Enamel shaping involves modifying teeth to improve their appearance by removing or contouring enamel. The process, which often is combined with bonding, usually is quick and comfortable and the results can be seen immediately.

    Veneers are thin custom-made shells designed to cover the front side of teeth. Made of tooth-colored materials, veneers are used to treat spaces between teeth and teeth that are chipped or worn, permanently stained, poorly shaped or slightly crooked. Braces are not just for kids. Orthodontics may be needed if teeth are crooked, crowded or do not meet properly. If your dentist thinks you should see a specialist for treatment, he or she will refer you to an orthodontist. Read more about other options on how to keep eye-catching smile:

    • Composite Fillings
    • Porcelain Crowns (Caps)
    • Porcelain Fixed Bridges
    • Porcelain Veneers

  • Cosmetic Dentistry > Composite Fillings

    Advances in modern dental materials and techniques increasingly offer new ways to create more pleasing, natural looking smiles. Researchers are continuing their often decades-long work developing esthetically attractive materials, such as ceramic and plastic compounds that mimic the appearance of natural teeth. Today, more patients ask their dentists about white fillings because they want their teeth to look natural when they laugh, talk and smile.White fillings, also called composite fillings, are made from tooth-colored materials that restore the natural appearance of a decayed or previously filled tooth. Because they blend well with tooth enamel and don’t look like fillings, your dentist may recommend them if the teeth to be restored are near the front of your mouth.

    A composite filling usually requires only one visit, during which the tooth is prepared and restored. An advantage of composite fillings, as compared with other dental restorations, is that they require less of the healthy part of a tooth to be removed to hold the filling in place. This is due to composite materials’ ability to bond to teeth adhesively. The procedure for a composite filling may take a little longer than those for other types of fillings, because after the decay is removed, the tooth must be kept totally isolated from saliva. The dentist carefully applies an adhesive followed by several thin layers of the tooth-colored composite. Once the filling is in place, it is chemically hardened, or cured, for less than a minute with a special light.;

    Composites are preferable for obvious cosmetic reasons, but if the decayed area is large or is subject to heavy chewing pressure, your dentist may recommend another type of material or restoration. Some people may experience some sensitivity to hot and cold temperatures in the newly filled tooth for a few days or as long as a week. If the sensitivity continues beyond that time, contact your dentist. Other types of white fillings include composite inlays and porcelain inlays and onlays. Inlays and onlays are used to restore teeth that are badly damaged by decay or wear. They may be applied to the chewing surfaces of the back teeth when esthetics are of concern.

    Some white fillings may be more expensive than other dental materials, but most patients find these natural-looking restorations well worth the additional cost. White fillings, like other dental materials, may require periodic replacement. If the edge of the filling eventually pulls away from the tooth, bacteria can get between the filling and the enamel and eventually may cause decay. Tooth decay over time may develop elsewhere on the tooth. Regular dental checkups are important because they allow the dentist to detect a problem in the early stage.

  • Cosmetic Dentistry > Porcelain Crowns (Caps)

    Dental Crowns: A dental crown is a tooth-shaped "cap" that is placed over a tooth - covering the tooth to restore its shape and size, strength, and/or to improve its appearance.The crowns, when cemented into place, fully encase the entire visible portion of a tooth that lies at and above the gum line.

    A dental crown may be needed in the following situations:

    • To protect a weak tooth (for instance, from decay) from breaking or to hold together parts of a cracked tooth
    • To restore an already broken tooth or a tooth that has been severely worn down
    • To cover and support a tooth with a large filling when there isn't a lot of tooth left
    • To hold a dental bridge in place
    • To cover misshapened or severely discolored teeth
    • To cover a dental implant

    Permanent crowns can be made from all metal, porcelain-fused-to-metal, all resin, or all ceramic.

    • Metals used in crowns include gold alloy, other alloys (for example, palladium) or a base-metal alloy (for example, nickel or chromium). Compared with other crown types, less tooth structure needs to be removed with metal crowns, and tooth wear to opposing teeth is kept to a minimum. Metal crowns withstand biting and chewing forces well and probably last the longest in terms of wear down. Also, metal crowns rarely chip or break. The metallic color is the main drawback. Metal crowns are a good choice for out-of-sight molars.
    • Porcelain-fused-to-metal dental crowns can be color matched to your adjacent teeth (unlike the metallic crowns). However, more wearing to the opposing teeth occurs with this crown type compared with metal or resin crowns. The crown's porcelain portion can also chip or break off. Next to all-ceramic crowns, porcelain-fused-to-metal crowns look most like normal teeth. However, sometimes the metal underlying the crown's porcelain can show through as a dark line, especially at the gum line and even more so if your gums recede. These crowns can be a good choice for front or back teeth.
    • All-resin dental crowns are less expensive than other crown types. However, they wear down over time and are more prone to fractures than porcelain-fused-to-metal crowns.
    • All-ceramic or all-porcelain dental crowns provide the best natural color match than any other crown type and may be more suitable for people with metal allergies. However, they are not as strong as porcelain-fused-to-metal crowns and they wear down opposing teeth a little more than metal or resin crowns. All-ceramic crowns are a good choice for front teeth.
    • Temporary versus permanent. Temporary crowns can be made in your dentist's office whereas permanent crowns are made in a dental laboratory. Temporary crowns are made of acrylic or stainless steel and can be used as a temporary restoration until a permanent crown is constructed by the dental laboratory.

    What Steps Are Involved in Preparing a Tooth for a Crown?

    Preparing a tooth for a crown usually requires two visits to the dentist -- the first step involves examining and preparing the tooth, the second visit involves placement of the permanent crown.

    First Visit: Examining and preparing the tooth.

    At the first visit in preparation for a crown, your dentist may take a few X-rays to check the roots of the tooth receiving the crown and surrounding bone. If the tooth has extensive decay or if there is a risk of infection or injury to the tooth's pulp, a root canal treatment may first be performed.

    Before the process of making your crown is begun, your dentist will anesthetize (numb) your tooth and the gum tissue around the tooth. Next, the tooth receiving the crown is filed down along the chewing surface and sides to make room for the crown. The amount removed depends on the type of crown used (for instance, all-metal crowns are thinner, requiring less tooth structure removal than all-porcelain or porcelain-fused-to-metal ones). If, on the other hand, a large area of the tooth is missing (due to decay or damage), your dentist will use filling material to "build up" the tooth to support the crown.

    After reshaping the tooth, your dentist will use impression paste or putty to make an impression of the tooth to receive the crown. Impressions of the teeth above and below the tooth to receive the dental crown will also be made to make sure that the crown will not affect your bite.

    The impressions are sent to a dental laboratory where the crown will be manufactured. The crown is usually returned to your dentist's office in 2 to 3 weeks. If your crown is made of porcelain, your dentist will also select the shade that most closely matches the color of the neighboring teeth. During this first office visit your dentist will make a temporary crown to cover and protect the prepared tooth while the crown is being made. Temporary crowns usually are made of acrylic and are held in place using a temporary cement.

    Second Visit: Receiving the permanent dental crown.

    At your second visit, your dentist will remove your temporary crown and check the fit and color of the permanent crown. If everything is acceptable, a local anesthetic will be used to numb the tooth and the new crown is permanently cemented in place.

    How Should I Care for My Temporary Dental Crown?

    Because temporary dental crowns are just that -- a temporary fix until a permanent crown is ready, most dentists suggest that a few precautions be taken with your temporary crown. These include:

    • Avoid sticky, chewy foods (for example, chewing gum, caramel), which have the potential of grabbing and pulling off the crown.
    • Minimize use of the side of your mouth with the temporary crown. Shift the bulk of your chewing to the other side of your mouth.
    • Avoid chewing hard foods (such as raw vegetables), which could dislodge or break the crown.
    • Slide flossing material out-rather than lifting out-when cleaning your teeth. Lifting the floss out, as you normally would, might pull off the temporary crown.
  • Cosmetic Dentistry > Porcelain Fixed Bridges

    About Bridges

    Dental bridges literally bridge the gap created by one or more missing teeth.A bridge is made up of two crowns for the teeth on either side of the gap – these two anchoring teeth are called abutment teeth – and a false tooth/teeth in between. These false teeth are called pontics and can be made from gold, alloys, porcelain, or a combination of these materials. Dental bridges are supported by natural teeth or implants.

    The Benefits of Dental Bridges

    • Restore your smile
    • Restore your ability to properly chew and speak
    • Maintain the shape of your face
    • Distribute the forces in your bite properly by replacing missing teeth
    • Prevent remaining teeth from drifting out of position

    Types of Dental Bridges That Are Available

    There are three main types of dental bridges:

    Traditional bridges involve creating a crown for the tooth or implant on either side of the missing tooth, with a pontic in between. Traditional bridges are the most common type of bridge and are made of either porcelain fused to metal or ceramics.

    Cantilever bridges are used when there are adjacent teeth on only one side of the missing tooth or teeth.

    Maryland bonded bridges (also called a resin-bonded bridge or a Maryland bridge) are made of plastic teeth and gums supported by a metal framework. Metal wings on each side of the bridge are bonded to your existing teeth.

    The Process for Getting a Dental Bridge

    During the first visit for getting a dental bridge, the abutment teeth are prepared. Preparation involves recontouring these teeth by removing a portion of enamel to allow room for a crown to be placed over them. Next, impressions of your teeth are made, which serve as a model from which the bridge, pontic, and crowns will be made by a dental laboratory. Your dentist will make a temporary bridge for you to wear to protect the exposed teeth and gums while your bridge is being made.

    During the second visit, your temporary bridge will be removed and the new permanent bridge will be checked and adjusted, as necessary, to achieve a proper fit. Multiple visits may be required to check the fit of the metal framework and bite. This is dependent on each individual's case. If the dental bridge is a fixed (permanent) bridge, your dentist may temporarily cement it in place for a couple of weeks to make sure it is fitting properly. After a couple weeks, the bridge is permanently cemented into place.

  • Cosmetic Dentistry > Porcelain Veneers

    Dental/Porcelain Veneers

    Dental veneers (sometimes called porcelain veneers or dental porcelain laminates) are wafer-thin, custom-made shells of tooth-colored materials designed to cover the front surface of teeth to improve your appearance. These shells are bonded to the front of the teeth changing their color, shape, size, or length.

    Dental veneers can be made from porcelain or from resin composite materials. Porcelain veneers resist stains better than resin veneers and better mimic the light reflecting properties of natural teeth. Resin veneers are thinner and require removal of less of the tooth surface before placement. You will need to discuss the best choice of veneer material for you with your dentist.

    What Types of Problems Do Dental Veneers Fix?

    Veneers are routinely used to fix:

    • Teeth that are discolored -- either because of root canal treatment; stains from tetracycline or other drugs, excessive fluoride or other causes; or the presence of large resin fillings that have discolored the tooth
    • Teeth that are worn down
    • Teeth that are chipped or broken
    • Teeth that are misaligned, uneven, or irregularly shaped (for example, have craters or bulges in them)
    • Teeth with gaps between them (to close the space between these teeth)

    What's the Procedure for Getting a Dental Veneer?

    Getting a dental veneer usually requires three trips to the dentist – one for a consultation and two to make and apply the veneers. One tooth or many teeth can simultaneously undergo the veneering process described below.

    • Diagnosis and treatment planning. This first step involves active participation between you and your dentist. Explain to your dentist the result that you are trying to achieve. During this appointment your dentist will examine your teeth to make sure dental veneers are appropriate for you and discuss what the procedure will involve and some of its limitations. He or she also may take X-rays and possibly make impressions of your mouth and teeth.
    • Preparation. To prepare a tooth for a veneer, your dentist will remove about ½ millimeter of enamel from the tooth surface, which is an amount nearly equal to the thickness of the veneer to be added to the tooth surface. Before trimming off the enamel, you and your dentist will decide the need for a local anesthetic to numb the area. Next, your dentist will make a model or impression of your tooth. This model is sent out to a dental laboratory, which in turn constructs your veneer. It usually takes 1 to 2 weeks for your dentist to receive the veneers back from the laboratory. For very unsightly teeth, temporary dental veneers can be placed for an additional cost.
    • Bonding . Before the dental veneer is permanently cemented to your tooth, your dentist will temporarily place it on your tooth to examine its fit and color. He or she will repeatedly remove and trim the veneer as needed to achieve the proper fit; the veneer color can be adjusted with the shade of cement to be used. Next, to prepare your tooth to receive the veneer, your tooth will be cleaned, polished, and etched -- which roughens the tooth to allow for a strong bonding process. A special cement is applied to the veneer and the veneer is then placed on your tooth. Once properly position on the tooth, your dentist will apply a special light beam to the dental veneer, which activates chemicals in the cement causing it to harden or cure very quickly. The final steps involve removing any excess cement, evaluating your bite and making any final adjustments in the veneer as necessary. Your dentist may ask you to return for a follow-up visit in a couple of weeks to check how your gums are responding to the presence of your veneer and to once again examine the veneer's placement.

    What Are the Advantages of Dental Veneers?

    Veneers offer the following advantages:

    • They provide a natural tooth appearance.
    • Gum tissue tolerates porcelain well.
    • Porcelain veneers are stain resistant.
    • The color of a porcelain veneer can be selected such that it makes dark teeth appear whiter.
    • Veneers offer a conservative approach to changing a tooth's color and shape -- veneers generally don't require the extensive shaping prior to the procedure that crowns do, yet offer a stronger, more aesthetic alternative.

    What Are the Disadvantages of Dental Veneers?

    The downside to dental veneers include:

    • The process is not reversible.
    • Veneers are more costly than composite resin bonding.
    • Veneers are usually not repairable should they chip or crack.
    • Because enamel has been removed, your tooth may become more sensitive to hot and cold foods and beverages.
    • Veneers may not exactly match the color of your other teeth. Also, the veneer's color cannot be altered once in place. If you plan on whitening your teeth, you need to do so before getting veneers. Though not likely, veneers can dislodge and fall off. To minimize the chance of this occurring, do not bite your nails; chew on pencils, ice, or other hard objects; or otherwise put excessive pressure on your teeth. Teeth with veneers can still experience decay, possibly necessitating full coverage of the tooth with a crown. Veneers are not a good choice for individuals with unhealthy teeth (for example, those with decay or active gum disease), weakened teeth (as a result of decay, fracture, large dental fillings), or for those who have an inadequate amount of existing enamel on the tooth surface.
    • Individuals who clench and grind their teeth are poor candidates for porcelain veneers, as these activities can cause the veneers to crack or chip. There may be a period of adjustment for you to become accustomed to the new feel of your restored teeth. This could take anywhere from a few days to a week.

    How Long Do Dental Veneers Last?

    Veneers generally last between 5 and 10 years. After this time, the veneers would need to be replaced.

    Do Dental Veneers Require Special Care?

    Dental veneers do not require any special care. Continue to follow good oral hygiene practices including brushing and flossing as you normally would.Even though porcelain veneers resist stains, your dentist may recommend that you avoid stain-causing foods and beverages (for example, coffee, tea, or red wine).

    Are There Alternatives to Dental Veneers?

    Yes, alternatives to veneers include bondings and crowns. Veneers offer a nice intermediate option. Veneers may be best suited for individuals who want to change the shape of their teeth more than just a little bit -- as is done with bonding -- but not enough to require a crown.

    As with all dental care, discuss your treatment options and expectations thoroughly with your dentist. Regular visits to your dentist are a must for maintaining healthy teeth.

  • 3.    Dental Implants

    Crowns and conventional bridges or dentures may not be your only options when replacing missing teeth. For some people, dental implants offer a smile that looks and feels very natural. Surgically placed below the gums over a series of appointments, implants fuse to the jawbone and serve as a base for individual replacement teeth, bridges or a denture.

    Implants offer stability because they fuse to your bone. Integration of the implants into your jaw also helps your replacement teeth feel more natural and some people also find the secure fit more comfortable than conventional substitutes.

    Reasons to Replace Your Missing Teeth

    • Obvious gaps between teeth when smiling or speaking is a cosmetic concern.
    • Missing teeth can affect speech.
    • Although a missing molar may not be noticeable when talking or smiling, but it can affect your chewing.
    • After tooth removal, the biting force on your remaining teeth can begin to change. Compensation for the lost tooth can put you at risk for extra pressure and discomfort on jaw joints.
    • If a missing tooth is not replaced the surrounding teeth can begin to shift. Plaque and tartar can collect in new hard-to-reach places created by shifting teeth. This can cause tooth decay and periodontal disease over time.
    • Bone loss can occur in the space of the missing tooth.

    Who Is A Candidate For A Dental Implant?

    People who are in good health, with healthy gums and who have a jawbone that can support an implant, have the option of dental implants. Health is more of a factor than age because things like chronic illness can interfere with healing and tobacco use puts you at a greater risk for gum disease (which can weaken the bone and tissues needed for implant support). Meticulous oral hygiene is required for implant success. If your overall health is good and your teeth and gums are healthy you could be a good candidate for a dental implant. Talk to your dentist about all options.

    What's Involved?

    Implant placement is usually a three-part process and can take several months.

    Step 1- The implant is surgically placed into your jaw by your dentist, with the top of the implant slightly above the top of the bone. A screw will be inserted into the implant to keep gum tissue and other debris from entering. The gum will then be closed over the implant for approximately three to six months while the implant fuses with your jawbone (a process called osseointegration). Due to the tenderness and swelling that may occur, pain medication is usually prescribed. Your dentist may also recommend a diet consisting of soft foods, cold foods, and warm soup during this healing process.

    Step 2- After the healing time is complete, the implant will be uncovered and your dentist will attach a post (or abutment) to the implant. The gum tissue is then allowed to heal around the new post. After your gums have healed the impant and post will serve as the foundation for your new tooth.

    (This step is not required with some implants because the implant and post are all in one unit.)

    Step 3- Finally, your dentist will make a custom artificial tooth (a dental crown) based on a size, shape, color, and fit that will blend with your other teeth. After the crown is completed it will be attached to the implant post.

    Other Considerations

    Implants can be a good replacement for the original tooth, however, it does require surgery, and is not an option for everyone. Patients should have good overall health and good oral health, as well as have adequate bone to support an implant, or be a good candidate for surgery to build up the area needing an implant. The treatment time is longer and cost higher than alternative procedures. Regular dental visits are a must to promote long-term success of your implant--some patients have two to four professional cleanings a year. Your dentist will also suggest a new home-care routine to suit your individual needs. This includes brushing twice a day and flossing once a day, the use of a special toothbrush, an interproximal brush, or a mouth rinse to prevent cavities and periodontal disease.

    Considering tooth implant? Read more...

    • Single Tooth Implant
    • Implant Supported Bridges
    • Implant Supporting Lower Dentures

  • Dental Implants > Single Tooth Implants

    When Is This Used?

    Single-tooth implants can be used in people who are missing one or more teeth. An implant is surgically placed in an opening that is made by your dentist in the jawbone. After the implant integrates (attaches) to your bone, it acts as a new "root" for the crown that will be replacing your missing tooth. A crown (cap), which is made to look like a natural tooth, is attached to the implant and fills the space left in the mouth by the missing tooth. For this procedure to work, there must be enough bone in the jaw, and the bone has to be strong enough to hold and support the implant. In addition, natural teeth and supporting tissues near where the implant will be placed must be in good health.

    What Can You Expect From Your Implant?

    Single-tooth implants will work and look like your natural teeth. However, for some patients, it will be difficult to make the implant look exactly like your natural teeth. At times your implant will not be placed straight, but will be inserted on an angle in the bone because of the amount of bone that you have and the amount of bone that is needed to place the implant properly. A crown placed over an implant that is at an angle may not appear as natural as your own tooth. However, it will typically give you a very good result. Another situation in which it may be difficult to match the appearance of a natural tooth is when the crown is made more bulky to close a space. Studies so far have shown that these implants can last as long as 25 years.

  • Dental Implants > Implant Supported Bridges

    What Is It?

    An implant-supported bridge is similar to a regular dental bridge, but it is supported by implants and not by natural teeth. In most cases, when an implant-supported bridge is used, one implant is placed in the jawbone for each missing tooth and then, instead of placing a separate crown on top of each implant, the crowns are connected to each other to form one piece.

    When Is This Used?

    An implant-supported bridge is used when more than one tooth is missing. It also may be used when your dentist is concerned that you might put too much pressure on individual implants that are not connected to each other. For example, clenching or grinding your teeth can put a lot of pressure on individual implants and increase the chance that they will loosen from the bone and fail. If an implant-supported bridge is used, it reduces the pressure on the individual implants in the bone, and spreads it across the entire bridge. If the implants will be placed next to natural teeth, the natural teeth and surrounding gums must be in good health. If you don't have enough bone to place and support the dental implants, the supporting bone can be built up using bone augmentation before the actual implant procedure begins.

  • Dental Implants > Implants Supporting Lower Dentures

    What Is It?

    An implant-supported denture is a type of overdenture that is supported by and attached to implants. An implant-supported overdenture is attached to implants, while a regular denture rests on the gums, is not supported by implants, and tends to fit less firmly in the mouth. An implant-supported denture is used when a person doesn't have any teeth in the jaw, but has enough bone in the jaw to support implants. An implant-supported denture has special attachments that snap onto attachments on the implants.

    Implant-supported dentures usually are made for the lower jaw because regular dentures tend to be less stable there. Usually, a regular denture made to fit an upper jaw is quite stable on its own and doesn't need the extra support offered by implants. However, you can receive an implant-supported denture in either the upper or lower jaw. You can remove an implant-supported denture easily. Some people prefer to have fixed (permanent) crown and bridgework in their mouths that can't be removed. Your dentist will consider your particular needs and preferences when suggesting fixed or removable options.

    How Does It Work?

    There are two types of implant-supported dentures: bar-retained and ball-retained. In both cases, the denture will be made of an acrylic base that will look like gums, with porcelain or acrylic teeth that look like natural teeth attached. Bar-retained dentures require at least three implants. Ball-retained dentures need at least two.

    • Bar-retained dentures — A thin metal bar that follows the curve of your jaw is attached to two to five implants that have been placed in your jawbone. Clips or other types of attachments are fitted to the bar the denture, or to both. The denture fits over the bar and is securely clipped into place by the attachments.
    • Ball-retained dentures — (stud-attachment dentures) — Each implant that has been placed in the jawbone holds a metal attachment that fits into another attachment on the denture. In most cases, the attachments on the implants are ball-shaped ("male" attachments), and they fit into sockets ("female" attachments) on the denture. In some cases, these attachments are reversed, with the denture holding the male attachments and the implants holding the female ones.

  • 4.   Restorations

    Tooth restorations are the various ways your dentist can replace or restore missing teeth or missing parts of the tooth structure. Tooth structure can be missing due to decay, deterioration of a previously placed restoration, or fracture of a tooth. Examples of restorations include the following:

    • Fillings are the most common type of dental restoration. Teeth can be filled with gold, silver amalgam, or tooth-colored, plastic and glass materials called composite resin fillings.
    • Crowns are a tooth-shaped "cap" that is placed over a tooth to restore its shape and size, strength, appearance, to hold a bridge in place or cover a dental implant.
    • Bridges are false teeth that are designed to "bridge" the gap created by one or more missing teeth. Bridges can be anchored on either side by crowns and cemented permanently into place.
    • Implants are replacement tooth roots. Implants are actually a small post made of metal that are placed into the bone socket where teeth are missing. The implant is covered with a replacement tooth called a crown.
    • Dentures are a removable replacement for missing teeth and surrounding tissues. They are made of acrylic resin sometimes combined with metal attachments. Complete dentures replace all the teeth; partial dentures are considered when some natural teeth remain and are retained by metal clasps attached to the natural teeth.

    Ways to restore a tooth, read more...

    • Composite Fillings
    • Crowns (Caps)
    • Dentures and Partial Dentures
    • Fixed Bridges
    • Root Canal Therapy
  • Restorations > Root Canal Treatment

    Root Canal Treatment

    A root canal is a treatment used to repair and save a tooth that is badly decayed or becomes infected. During a root canal procedure, the nerve and pulp are removed and the inside of the tooth is cleaned and sealed. Without treatment, the tissue surrounding the tooth will become infected and abscesses may form. A tooth's nerve is not vitally important to a tooth's health and function after the tooth has emerged through the gums. Its only function is sensory -- to provide the sensation of hot or cold. The presence or absence of a nerve will not affect the day-to-day functioning of the tooth. When a tooth's nerve tissue or pulp is damaged, it breaks down and bacteria begin to multiply within the pulp chamber. The bacteria and other decayed debris can cause an infection or abscessed tooth. An abscess is a pus-filled pocket that forms at the end of the roots of the tooth. An abscess occurs when the infection spreads all the way past the ends of the roots of the tooth. In addition to an abscess, an infection in the root canal of a tooth can cause:

    • Swelling that may spread to other areas of the face, neck, or head
    • Bone loss around the tip of the root
    • Drainage problems extending outward from the root. A hole can occur through the side of the tooth with drainage into the gums or through the cheek with drainage into the skin.

    What Damages a Tooth's Nerve and Pulp?

    A tooth's nerve and pulp can become irritated, inflamed, and infected due to deep decay, repeated dental procedures on a tooth, and/or large fillings, a crack or chip in the tooth, or trauma to the face.

    Signs That a Root Canal Is Needed

    Sometimes no symptoms are present; however, signs you may need a root canal include:
    • Severe toothache, pain upon chewing or application of pressure
    • Prolonged sensitivity/pain to heat or cold temperatures (after the hot or cold has been removed)
    • Discoloration (a darkening) of the tooth
    • Swelling and tenderness in the nearby gums
    • A persistent or recurring pimple on the gums

    What Happens During a Root Canal?

    A root canal requires one or more office visits and can be performed by a dentist or endodontist. An endodontist is a dentist who specializes in the causes, diagnosis, prevention, and treatment of diseases and injuries of the human dental pulp or the nerve of the tooth. The choice of which type of dentist to use depends to some degree on the difficulty of the root canal procedure needed in your particular tooth and the general dentist's comfort level in working on your tooth. Your dentist will discuss who might be best suited to perform the work in your particular case. The first step in the procedure is to take an x-ray to see the shape of the root canals and determine if there are any signs of infection in a surrounding bone. Your dentist or endodontist will then use local anesthesia to numb the area near the tooth. Anesthesia may not be necessary, since the nerve is dead, but most dentists still anesthetize the area to make the patient more relaxed and at ease.

    Next, to keep the area dry and free of saliva during treatment, your dentist will place a rubber dam (a sheet of rubber) around the tooth. An access hole will then be drilled into the tooth. The pulp along with bacteria, the decayed nerve tissue and related debris is removed from the tooth. The cleaning out process is accomplished using root canal files. A series of these files of increasing diameter are each subsequently placed into the access hole and worked down the full length of the tooth to scrape and scrub the sides of the root canals. Water or sodium hypochlorite is used periodically to flush away the debris.

    Once the tooth is thoroughly cleaned, it is sealed. Some dentists like to wait a week before sealing the tooth. For instance, if there is an infection, your dentist may put a medication inside the tooth to clear it up. Others may choose to seal the tooth the same day it is cleaned out. If the root canal is not completed on the same day, a temporary filling is placed in the exterior hole in the tooth to keep out contaminants -- like saliva and food -- out between appointments. At the next appointment, to fill the interior of the tooth, a sealer paste and a rubber compound called gutta percha is placed into the tooth's root canal. To fill the exterior access hole created at the beginning of treatment, a filling is placed.

    The final step may involve further restoration of the tooth. Because a tooth that needs a root canal often is one that has a large filling or extensive decay or other weakness, a crown, crown and post, or other restoration often needs to be placed on the tooth to protect it, prevent it from breaking, and restore it to full function. Your dentist will discuss the need for any additional dental work with you.

  • 5.     Periodontal Treatment

    If you have been told you have periodontal (gum) disease, you're not alone. An estimated 80 percent of American adults currently have some form of the disease. Everyone should be checked by their Dentist or Hygienist to determine if they need periodontal treatment.

    Periodontal diseases range from simple gum inflammation to serious disease that results in major damage to the soft tissue and bone that support the teeth. In the worst cases, teeth are lost.

    Gum disease is a threat to your oral health. Research is also pointing to possible health effects of periodontal diseases that go well beyond your mouth (more about this later). Whether it is stopped, slowed or gets worse depends a great deal on how well you care for your teeth and gums every day, from this point forward.

    What causes periodontal disease?

    Our mouths are full of bacteria. These bacteria, along with mucus and other particles, constantly form a sticky, colorless "plaque" on teeth. Brushing and flossing help get rid of plaque. Plaque that is not removed can harden and form bacteria-harboring "tartar" that brushing doesn't clean. Only a professional cleaning by a dentist or dental hygienist can remove tartar.

    Read more about periodontal disease.

    • Diagnosis
    • Treatment
    • Maintenance
    • Glossary
  • 6.    Zoom Whitening

    Zoom Whitening: See the Light and Unleash Your White

    Authored By: Linda Dyett
    Reviewed By: Larry Addleson, DDS, FAACD

    Zoom is a bleaching process widely used throughout the country and around the world to lighten discoloration of enamel and dentin. Tooth discoloration may result from drinking coffee, tea, cola and red wine; or from smoking. The aging process also can stain and darken your teeth. The Zoom in-office tooth whitening procedure uses the Zoom Advanced Power Chairside Lamp – said to accelerate the bleaching process – to activate the 25 percent hydrogen peroxide whitening. As the hydrogen peroxide is broken down, oxygen enters the enamel and dentin to bleach the stained substances, leaving the structure of the tooth unchanged.

    The Zoom In-Office Whitening Procedure

    The complete procedure takes about 2 hours. A regular teeth cleaning is recommended prior to the actual Zoom teeth whitening session.The procedure begins with a short preparation to cover the lips and gums, leaving the teeth exposed. The dentist or dental assistant then applies the Zoom hydrogen peroxide whitening gel, which works together with the Zoom light to penetrate the teeth and break up the stains and discoloration. The gel remains in place for 15 minutes while the light is activated. During this time, you can relax, watch TV or listen to music.The gel is applied for three 15-minute sessions of light activation. Individuals with a strong gag reflex or anxiety may have difficulty undergoing the entire procedure. Immediately afterwards, a sensitivity-reducing fluoride paste-gel is applied to the teeth.

    Maintaining Zoom Whitening Effects

    To help maintain your whitened teeth, you are given a Zoom home-use touch-up kit, including custom-fitted whitening trays. By following some simple post-whitening care instructions, your teeth will be lighter than they were before.

    Zoom Whitening Consideration

    Sensitivity during treatment may occur in some people. The Zoom light produces minimal heat, which is usually the source of discomfort. Rarely, minor tingling is experienced immediately after the procedure, but always dissipates. Ask your dentist for an anti-sensitivity toothpaste prior to treatment to lessen sensitivity. As with other tooth whitening products, Zoom whitening is not recommended for children under 13 years of age, or for pregnant or lactating women. Also, it is important to remember that whitening treatment may not be as effective for some people as it is for others. Only your dentist can determine if Zoom teeth whitening is right for you after performing a thorough oral examination that includes a shade assessment.


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