The choice of material used to restore a tooth back to its shape and function can be based on several factors such as:
As a team, we are willing to answer any questions you may have with regard to these choices, and Dr. Caroline will offer you options which will suit your individual dental situation.
Although fillings replace missing or damaged tooth structure, they do not strengthen teeth. Teeth that have been filled are much weaker than unfilled teeth. This principle underlies our commitment to preventing decay or damage before it occurs, and our recommendation to crown structurally compromised teeth.
After the diseased part of the tooth is removed and the tooth shape is prepared for the filling, the tooth is restored with one of several options of materials. We are pleased to offer the following options:
Composite Resin (White)
The composite filling material we use is composed of extremely small quartz particles in resin. Many of our patients prefer this choice for fillings due to their natural appearance. The material is color-matched to the tooth, and is bonded to the tooth structure through a multi-step chemical process. The composite is placed on the tooth in layers, each layer is cured (hardened) with a light, the filling is then shaped and polished. The final filling is virtually invisible. The process of completing a successful composite filling is very technique-sensitive and meticulous, and a very dry area is required to achieve an optimum seal with the tooth. Although these fillings are durable, they do have limits with regard to strength for larger restorations. For these reasons, a composite filling may not be recommended in all situations.
A composite resin may also be used to add structure to a tooth that is deficient, for example, closing a gap between the teeth. This procedure is also called bonding.
The amalgam filling has been used as a restorative dental material in North America since 1833. Amalgam is less often used today, but can restore teeth with large areas of decay, where the area cannot be kept dry as required for a composite filling, or as a lower-cost alternative to other materials. It is composed of silver, tin, copper and mercury, which is used as a "wetting agent" to bind the other metals together. Once the filling material is mixed, it is placed into the tooth. As it begins the hardening process, the filling is carved into shape. Other non-metallic options are available, and Dr. Caroline will be happy to discuss these with you.
Inlays & Onlays
When a stronger or larger restoration is required, an "inlay" (which fits inside the tooth) or "onlay" (which covers over one or more of the cusps or bumps on the tooth) may be the best choice. In the range of dental restorations available, inlays and onlays fit between a "filling" and a "crown". These types of restorations are an indirect procedure, which means that the final restoration is fabricated outside of the mouth. They are strong with a very precise fit, which makes them a desirable choice.
Two appointments are required. The first step requires the removal of the old filling or disease, and designing the new preparation. An impression (mould) of the tooth is made and a temporary filling is then placed to seal the tooth. When the final restoration is completed, a second appointment is required to remove the temporary filling and replace it with the final restoration.
These restorations are typically made from porcelain (white), resin (white), or gold. If the strength, beauty, and conservative nature of these fillings interest you, we would be pleased to further discuss this option with you.
A dental crown or "cap" is a restoration that covers all or part of the tooth that you see above the gum line. A crown may be the best choice to restore a tooth that is badly decayed, discolored, cracked, fractured, has a large filling or root canal, or is to be used as an anchor for a bridge. A crown helps to splint the tooth together. It can be made of gold, porcelain (white), zirconia (a white core material), or a combination of these materials.
A crown is an indirect procedure, which means that it is fabricated outside of the mouth. The first step requires the removal of the diseased part of the tooth or old filling, and rebuilding and reshaping the tooth. An impression (mould) of the tooth is made and a temporary crown is then placed to seal the tooth. When the new crown is completed, a second appointment is required to remove the temporary crown and replace it with the final restoration. A well make crown can preserve the integrity of the tooth for many years. If you wish to know if a crown will be able to serve your dental needs, please contact us at 403-346-0077 for further information.
Replacing missing teeth
Why should anyone replace a missing tooth?
A missing tooth should be replaced as close to extraction time as possible to prevent major problems that can occur over time. Our teeth function in relationship to one another, and the loss of just one tooth upsets this equilibrium. Tooth loss affects our ability to chew. The forces that are normally distributed are transferred to other teeth which can compromise their support, causing increased wear and deterioration. Bite problems can develop as the adjacent teeth tip over and drift into the empty space and the opposing teeth can over-erupt into the space as well. The bone in the space starts to resorb away, taking with it the supporting gum tissue which often exposes the sensitive root surfaces on the adjacent teeth. Loss of several teeth can compromise the jaw relationship and joint health, affect our speech, and cause collapse of the overlying facial muscles and skin.
What treatments can be done?
Dr. Caroline is pleased to offer several solutions to this dilemma:
A bridge is one option that can be made to replace one or several missing teeth. A bridge is created from several crowns attached together and is glued to the anchor teeth on either side of the space, thus "bridging the gap". A bridge is an indirect restoration, fabricated outside of the mouth. In the procedure, the teeth adjacent to the space are reshaped for crowns. An impression (mould) of the teeth is made and a temporary bridge is then placed to seal the reshaped teeth. When the bridge is completed, a second appointment is required to remove the temporary bridge and replace it with the final restoration.
A bridge can be constructed from gold, gold and porcelain, or if a more esthetic bridge is desired, zirconia (a white core material) and porcelain where appropriate.
Dental implants are a very desirable option for replacing a single tooth, many teeth, or as a foundation for a secure denture. The procedure requires planning and surgery, and not everyone is a candidate based on your physical and dental health, but the end result can allow you to eat, speak and smile confidently again. The surgery required is a very precise procedure and many patients report little to no discomfort afterwards. A dental implant is a small titanium screw that is placed in the bone where the tooth root used to be. The titanium and the surrounding bone fuse together to create a strong and stable structure onto which a dental structure is built. In the case of a single implant, the crown placed on the implant emerges from the gums and looks and feels like a natural tooth. Because the implant serves as an artificial tooth root, it helps to prevent bone loss in the area. Another great advantage of the implant is that it can replace missing teeth without involving the adjacent teeth. Dental implants may be an option for you. Please contact us for further information.
A Partial Denture is a removable appliance made of acrylic or acrylic and metal. One of its advantages is that it may replace several missing teeth in one appliance. A partial denture is anchored to the remaining teeth, and the stability of the appliance rests on the stability, gum health, and contour of those teeth as well as its design. Sometimes a partial denture is fabricated as a temporary solution due to an accident, or until a more secure restoration can be planned. If you have an interest in this service, Dr. Caroline will be happy to discuss this option with you.
A complete denture is an appliance which is designed for patients with no remaining upper or lower teeth. The denture acts as a substitute for their natural teeth and is made of white and pink acrylic. For patients who have been missing their teeth for a long time, or for those whose natural teeth are beyond repair, a fully-customized denture may be a welcome solution. There is a common misconception that a denture will solve all one's dental problems, but a denture does not function like our teeth which are anchored and stable. They can be challenging to keep in place and a readjustment to speaking, tasting food, and eating habits will be necessary. As changes in your mouth occur over time, the denture will need to be relined or remade to accommodate these changes. Dr. Caroline will help you determine if you are in need of this type of appliance, and will be glad to review all your options with you.
Implant Supported Dentures
Perhaps you have had great success with your complete dentures. For some patients though, changes in their mouth have made wearing dentures uncomfortable, speech difficult, and their looseness and slippage embarrassing. An implant-supported denture may be a solution to these concerns. An implant supported denture is a complete upper or lower denture that is anchored to dental implants with clips, snaps, or magnets. Benefits include a less bulky appliance, reduced stress on gum tissues increasing comfort, and the halt to continued bone loss in the area of the implants. If the function and comfort of your denture is of concern to you, please ask us if an implant supported denture may be of benefit to you.
We perform a range of oral surgery procedures. Most routine extractions can be done in our office, including wisdom teeth. Dr. Caroline also routinely removes teeth for those patients who will be having immediate dentures placed. If you have had an extraction and require more information, please read our Patient Instructions Following Surgery.
A dental emergency is usually not expected; therefore Dr. Caroline tries to accommodate our patients as soon as possible. Please help us accomplish this by calling our office as early in the day as possible, or immediately after the dental accident. As a team, we wish to relieve your discomfort! If you have had a tooth knocked out please see our instructions.
Root Canal Treatment
A root canal treatment may be indicated if the nerve and blood vessels inside the tooth, the "pulp" is irreversibly damaged or has become infected by bacteria due to decay. A root canal may also be needed if a tooth has fractured and exposed the pulp. The procedure involves removing the damaged pulp, thoroughly cleaning the empty pulp chamber inside the tooth, and sealing this space and the tooth from further bacterial invasion. The word "root canal" can bring forth several emotions. They have received a lot of bad press. Rest assured that advances in technology and materials have made this service much more comfortable and many patients compare the level of comfort similar to having a filling placed. Along with the body's healing ability, the success of the root canal treatment depends on the ability to remove the diseased tissue from inside the tooth and place a thorough, dense filling. To aid Dr. Caroline in accomplishing this goal, she uses her microscope to help her see very fine details of the internal anatomy of the tooth. Dr. Caroline recommends the placement of a crown on teeth which have had root canal treatment that are structurally compromised. The alternative to root canal treatment is often extraction of the tooth, so the completion of this treatment may save a tooth to function for many more years than expected.