- Bridges, Crowns, & Veneers
- Dental Implants
- Periodontal Therapy
- Root Canals
Both crowns and bridges strengthen weakened teeth by covering and surrounding them 360 degrees. Crowns cover a single tooth. Bridges cover multiple teeth, replacing any missing teeth in between. Veneers cover the only front surface of a tooth, and are primarily used to improve the aesthetics of your smile.
When a tooth has been weakened by root canal therapy or a large filling, it should be covered with a crown. When a tooth doesn’t get needed crown it cracks and splits under chewing pressure. Sometime the split cannot be repaired and the tooth has to be extracted. If weakened teeth receive a crown soon after a root canal, the tooth can be saved.
When crown is made for a tooth it is first numbed and shaped to have an even taper from top to bottom. This shape will allow the crown to slide down and fit snugly over the tooth. An impression of the tooth is made, and a temporary crown covers the tooth while the dental lab makes the permanent crown. Later the temporary crown is removed and the permanent crown is cemented. Crowns can be made of porcelain (for superior aesthetics) or of gold (on back teeth where chewing and grinding forces are greater). Crowns last on average 10 years or more.
A bridge replaces missing teeth when there are existing teeth on both sides of the space. Crowns cover these adjacent teeth with the replacement teeth attached in between the crowns. Because a bridge is a single piece of porcelain connecting the teeth, you can’t floss a bridge like you would the other teeth. Floss must be passed under the bridge from the side to keep gums healthy and prevent decay on the roots of the teeth that support the bridge.
Veneers are a thin porcelain facing bonded by strong cement to the front surface of the teeth for aesthetic improvement. Veneers can correct problems of stain, discoloration, or crooked or poorly shaped teeth.
The patient shown on the left didn’t like the stain or general yellow color of her teeth. She also had old discolored fillings and areas of recession, root exposure, and tooth sensitivity. To correct these problems she had 10 veneers made for the upper teeth and 10 for the lower teeth. She was thrilled with the appearance of her teeth, felt confidence to smile more often, and had much less sensitivity of the teeth.
There are two types of dentures: partial or full dentures. Partial dentures are a removable replacement for missing teeth that clasps onto remaining teeth. A full denture is a removable set of all teeth in the upper or lower jaw. Dentures have the advantage of being an economic replacement for multiple teeth. Disadvantages of dentures include continued bone loss, less chewing strength than natural or fixed teeth, food entrapment, loose teeth, sore spots on the gums, and deficient nutrition. A denture should be removed and rinsed after eating in addition to being thoroughly brushed once a day. It is recommended to wear the denture everyday and to take the denture out while sleeping.
While dentures are an improvement over having no teeth at all, they do not address the problem of bone loss in the jaws. Bone loss begins once the teeth have been extracted and is continuous.
Once the teeth are extracted the jaw bones begin to shrink. Continued bone loss will cause the dentures to gradually become more and more loose. Loose denture cause sore spots on the gums and make it harder to eat. What’s more, after years of bone resorption the upper lip becomes unsupported, the nose droops, the corners of the mouth frown and wrinkle, and the lower jaw closes too far causing the chin to jut forward. This is the appearance of old age. It has been nicknamed “witch’s chin” or “bitter beer face.” Restoring the jaws to their proper height will take years off your appearance.
Implants are the answer to the problem of bone loss. We recommend implants to secure a denture and stop bone loss in the jaws. If you are missing teeth, the earlier in life you have implants placed, the sooner you’ll stop the bone loss. Prevent the problems associated with bone loss (old appearance, difficulty eating, poor nutrition, loose and uncomfortable dentures) by getting implants now. Learn more about our dental implant services.
Dentures should be checked at least once a year to see if they need to be relined to fit the shrinking jaw bones. Denture teeth eventually wear out or the denture may break, and a new set is made every 8-15 years on average.
Periodontal therapy is care of the gums to promote healthy support for the teeth. Treatment can range from a simple cleaning every six months to surgical treatment of advanced gum disease. The goal of periodontal therapy is to make home care easier for you and to encourage optimal health of the gums.
Gum disease is caused by plaque. You are more likely to get gum disease if you have poor home care, smoke, have diabetes, or poor nutrition. Healthy gums do not bleed with brushing or flossing. Healthy gums have a shallow collar of gum tissue surrounding each tooth.
Gingivitis is mild irritation of the gums that may result in bleeding. If your gums bleed when you brush, this gingivitis can be eliminated with thorough, gentle toothbrushing and flossing. After two or three days of good home care, gingivitis will disappear.
If gingivitis advances to chronic gum disease the collar of gum tissue around the tooth gets deeper, creating an area where plaque and bacteria can hide, too deep for toothbrush and floss to clean out. If left untreated, chronic gum disease leads to bone loss around the teeth. As the bone level recedes, teeth lose their support, become loose, and can be lost.
For patients with healthy gums or mild gingivitis, a cleaning and dental exam are recommended every six months.
Calculus, or tartar, builds up on the inside of the lower front teeth (see pictures above) and in other areas. This hard, crusty build-up cannot be removed with toothbrush and floss. Plaque sticks more easily to calculus than to a smooth, clean tooth. Calculus and plaque irritate the gums and cause gingivitis and gum disease. Our hygienists are skilled at gently removing the calculus with instruments that clean better than home care.
For patients with chronic gum disease there is a phase of treatment to get the disease under control, and there is a phase of treatment to prevent the gum disease from returning.
Scaling The initial treatment for gum disease is a deep cleaning or scaling. Bacteria hiding in deep pockets is removed. The gums are numbed so there is no discomfort during this treatment. The gum tissue health will improve after this scaling treatment. About a month later the health of the gums is reevaluated. If healthy, cleanings may be recommended every three or four months instead of every six months. This will ensure maintenance of healthy gums. If the gums are not healthy after scaling the next level of treatment may be local antibiotics or surgery. In specific areas of deep pockets, an antibiotic powder can be placed to kill bacteria and improve gum health.
If needed, periodontal surgery allows for a clear view of the full root surface for better cleaning, and also removes excess gum tissue to make pockets around the teeth more shallow. Once you’ve had gum surgery it is recommended to have more frequent cleanings–every three or four months instead of every six months.
Laser Therapy We also offer laser treatment in conjunction with periodontal therapy. This laser is directed into the pocket of gum tissue around the tooth to kill more bacteria. Our hygienists will let you know if laser treatment is recommended in your case.
All these treatment options have the goal of changing deep pockets of gum tissue into more shallow pockets of gum tissue. Shallow gums can then be cleaned and maintained on a daily basis with toothbrush and floss. Healthy gums will support the teeth for a lifetime.
Recession & Gum Grafting Recession often happens in people without gum disease. The most common cause of recession is scrubbing too aggressively when using a toothbrush. Recession can lead to sensitivity of the teeth where root surfaces are exposed.
Gingival grafting can correct recession and restore the height of gum tissue. Covering root surfaces will reduce or eliminate tooth sensitivity in these areas, and improve the aesthetics of your smile.
Root canal therapy removes pulp tissue from a tooth to replace it with a filling material. It alleviates the pain and swelling associated with an abscessed tooth. When the teeth are properly numbed a root canal is no more painful than having a filling done.
Once a tooth has had a root canal it becomes more brittle and at risk of breaking. A crown covers the tooth 360 degrees to strengthen it and reduce the risk of it breaking. This patient can expect to keep these teeth for many more years.
Once a tooth has had a root canal, it no longer has a nerve. This means the tooth should be free of sensitivity and be painless to chew on.