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Bridges
All of your teeth play an important role in speaking, chewing and in maintaining proper alignment of other teeth. Tooth loss does not have to occur as you age, but if you do lose teeth, they must be replaced to maintain proper function of your mouth. Fortunately, there are options for correcting tooth loss.
What exactly is a bridge or fixed partial denture?
Teeth were designed to complement each other. Unusual stresses are placed on the gums and other oral tissues when teeth are missing. Over time, a missing tooth causes bone loss at the site. Teeth support your lips and cheeks, so open space can change the sound of your speech. We typically notice these changes with complete dentures, but we do not realize that the loss of just one or two teeth can have similar results.
A bridge fills the gap where teeth are absent. A bridge is either fixed (permanently in place) or removable (can be taken out). A fixed bridge is held in place by crowns cemented to your natural teeth on either side of the open space. Fixed restorations offer more stability. A removable bridge is attached to the teeth with metal clasps or by precision attachments.
What if I only have teeth on one side of the space?
A Cantilever bridge only needs teeth on one side to attach a new tooth. Another alternative is a dental implant. An implant acts as a replacement for a missing tooth’s root. It provides a stable foundation to attach a new tooth without any treatment to your neighboring teeth. Implants help slow bone loss. They look, feel and function more like your natural teeth. You must have the proper bone structure and healthy gum tissue to be a good candidate for a dental implant. During your treatment discussion, we will provide answers to help you choose the best solution for your mouth.
Crowns
When your dental care requires a crown, the reasons will usually fall within one of the following basic categories:
• Replace a missing tooth
• To restore a tooth to its original shape
• To strengthen a tooth
• To improve the cosmetic appearance of a tooth
• To protect a tooth following root canal treatment
Crowns and bridges (which are composed of crowns), are very reliable solutions for major dental problems caused by accidents, diseases or wear. Small defects in a tooth can be restored with a filling, but extensive damage requires the durability and reliability that crowns offer.
Often, the concern with dental treatment is not in understanding how the procedure is performed, but when to choose between different options. Following are some guidelines to help you.
For cosmetic results: Crowning teeth only to improve their appearance is actually a poor choice. Dental crowns are best utilized as a way to restore teeth that are no longer strong enough to protect the root. This is the case with teeth that are cracked, have excessive wear, or a large area has been destroyed by decay. For cosmetic treatment, we recommend the most conservative approach in order to preserve the natural tooth. Alternative dental options like veneers, bonding or teeth whitening can often achieve the desired results.
For health & longevity: The loss of even one tooth can impact the function of your bite and change your appearance. Adjacent teeth can shift position or become more vulnerable to chips and cracking when a gap is present. Crowns are ideal treatment to hold space in your bite either individually (implant/crown) or as a bridge.
Unresolved pain: Many people have unexplained pain in back teeth. This can be due to hairline cracks in the chewing part of the tooth. Crowns can offer relief from pain and allow return of full dental function in many cases.
Why do I need a crown following a Root Canal?
Root canal treatment usually involves the removal of the tooth’s pulp, a small thread-like tissue that was important for tooth development. The pulp is the soft tissue that contains the blood vessels, nerves and connective tissue of a tooth. It lies in a canal that runs through the center of the dentin- the hard tissue on the inside of the tooth that supports the outer layer of tooth enamel. The crown is the portion of the tooth visible above the gums.
Once blood supply no longer reaches the dentin, the outer layers of the tooth become brittle. This change in the tooth occurs at a rate that is different for everyone. Replacing the tooth’s crown strengthens the tooth and protects the root.
Full and Partial Dentures
Missing teeth can negatively affect eating, speaking, and the aesthetics of your smile. They can also cause your jaw to lose bone mass, your remaining teeth to shift, and our face to suffer alterations in appearance. Dentures restore the look and function of your smile and we custom-craft them just for you. Today’s dentures are natural-looking, more comfortable and last for decades with proper care.
Crafting a custom denture is a multi-step process. We take all the steps to ensure a superior fit and natural-looking result. We also make your visits efficient and comfortable.
If you are missing only a few teeth, partial dentures (replacing a few teeth) may be a great choice for you. If you are missing more teeth, complete dentures may be needed.
The Advantage of Implant Secured Dentures
Dental implants can make dentures secure and reliable. You no longer have to use messy adhesives or worry about slipping. Dental implants also prevent bone loss, helping keep the ridge that your denture sits on strong for a longer period of time.
Amalgam and Resin Fillings
For years there has been debate in the dental profession regarding the pros and cons of using amalgam (silver colored) fillings - which contain mercury – to restore cavities. Patients often ask about composite resin (tooth colored) fillings when they are not sure about the use of amalgam. It is important to know that mercury has not been proven scientifically to be harmful when placed in teeth.
We recommend the material to be used based on the pattern of decay in the tooth. The most important result when placing a filling is ending up with a tight seal to prevent leaving space for further decay. Amalgam is more pliable than composite and can be easily pressed into small spaces. Therefore, certain teeth can be better treated with amalgam.
When possible, we prefer to place resin fillings for our patients. Resin can be matched to your natural tooth color making it possible to have fillings that are undetectable.
Root Canal Therapy
Why do teeth need root canal treatment?
The nerve and blood vessels in teeth (known as dental pulp) are there to help the tooth grow to maturity. They protect against bacteria within the body. Bacteria play a defensive role in the mouth, but can become destructive when they attack the body through the dental pulp or through gum disease. Research found the correlation between gum disease and coronary heart disease several years ago.
Bacteria cause decay in teeth. When decay is deep, it can allow bacteria to invade the dental pulp. Decay is removed to protect the pulp. Patients usually just think about restoring the function and appearance of the tooth. However, repeated bacterial attacks (recurrent decay) can weaken the pulp to such an extent that the nerve can no longer recover, and so the pulp dies.
How do I know if something is wrong?
You don’t always know. Different nerve systems in teeth respond in different ways. The nerve may die quietly and never cause any symptoms. A routine x-ray may alert the dentist to a problem. Or, the dying nerve may cause discomfort and require immediate attention. When a nerve becomes irreversibly damaged, then either the pulp or the tooth has to be removed.
Will my tooth feel different?
The treated tooth is often referred to as being “dead” because it has lost its internal nerve and blood vessels. However nerves and blood supply to the outside surface of the tooth still exist, so when root canal treatment is successful the tooth should feel normal.
Do I need to see a specialist?
Whether you see a root canal specialist (endodontist) or we treat your tooth depends on many factors. The molar teeth have a more complicated nerve system than the front teeth, are harder to access and may require more specialized equipment.
Is there a treatment alternative?
If you choose not to have root canal treatment, the only alternative is to remove the sick tooth. However this can require a dental implant or bridge to fill the empty space and prevent the shifting of surrounding teeth. These solutions will ultimately cost more than the root canal therapy, and they will never equal the quality of keeping your natural teeth.
Whether or not you should replace missing teeth depends on function and aesthetic reasons. People today are aware of their mouth and smile, so someone displaying black gaps between their front teeth may feel self-conscious about speaking or smiling. Back teeth may not be immediately noticed in a smile, but they are very important in terms of chewing function. Every tooth stabilizes the teeth adjacent and those immediately above or below. When teeth shift, it can stimulate gum disease, food packing (leading to further decay) and bite problems.
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