Teeth cleanings are a very important part of oral hygiene and involves the removal of dental plaque from teeth with the intention of preventing cavities, gingivitis and periodontal disease. While proper home care is the first step in maintaining oral health, it is essential to have professional cleanings every six months, or more frequently depending on the need. These visits, referred to as “dental prophylaxis”, are generally performed by a certified dental hygienist whose training specializes in keeping patients maintained in optimum oral health. We regularly use the Ultrasonic SCALEX, but cleaning may be manual according to your needs.
Through the use of dental x-rays, dentists are able to diagnose many diseases of the oral cavity. This technology is an essential element of proper diagnosis, and used in very small doses, is a safe tool to provide proper dental care. The newest radiography available uses digital technology to capture a very precise image while subjecting the patient to a smaller dose of radiation.
Dental Cone Bean Computed Tomography (CT) is a special type of x-ray equipment used when regular dental or facial x-rays are not sufficient. Your dentist may use this technology to produce three dimensional (3-D) images of your teeth, soft tissues, nerve pathways and bone in a single scan.
Panoramic radiograph is a panoramic scanning dental x-ray of the upper and lower jaw, it shows a two dimensional view of a half circle from ear to ear. Panoramic X-ray offer multiple planes of maxilla and mandible and the structures that are superficial and deep to the through are blurred.
Mouth guards are often recommended for patients with bruxism as it provides cushioning and protection of teeth. Bruxism is the unconscious grinding of the teeth. Most patients with bruxism clench their jaws and grind their teeth at night while they sleep. Bruxism is caused from a temporomandibular joint disorder (TMD). Patients with TM often experience pain in their jaw and face and can have impaired eating and speaking in serious cases.
Oral Sleep Apnea
Millions of people today are living with undiagnosed and untreated sleep apnea. Left untreated, this sleep disorder is linked to increased risk of hearth attack, stroke, diabetes and other illness. Many people, however, dislike using a CPAP machine to treat the issue.
For patients with mild to moderate sleep apnea, there are alternative options available. Custom designed mouth guards called Mandibular Advancement devices (MAD) are individually shaped to each patients mouth and eases sleep apnea symptoms by moving the jaw forward. The realignment of the jaw opens up the airway to improve breathing and often puts a stop to snoring. Severe sleep apnea will often require the use of CPAP machine.
Repeat studies show that mercury vapors can, and do, escape from metal fillings. These vapors can travel to other parts of the body, including heart, lungs, kidney, liver, intestines, pancreas and ovaries. Effects of mercury poisoning can take upwards of 20 years to manifest and often onset slowly. However, chronic mercury toxicity has been linked to neurological impairment, decreased fertility, depression, dizziness, gastrointestinal problems, migraines, irregular heart beat, memory loss, numbness oral ulcers and more.
In Dental Betel we use alternatives such as composite fillings and all ceramic crowns, which do not contain any mercury.
A tooth-colored restorative material composed of plastic with small glass or ceramic particles that are mixed into a gel-like substance. After being applied to a tooth, the material is then hardened with a curing light. This type of fillings are often preferred by patients over silver amalgam fillings as they restore the natural appearance of the tooth.
Since composite filling bond to the tooth, they restore most of the original strength of the tooth where silver weakens the teeth making them more susceptible to breaking.
If you have been told by your dentist you need to have an old filling or crown replaced, you may be wondering why this is necessary. Often, patients are unaware that replacement of an outdated restoration is necessary, especially when they have not experienced any pain or problems. In fact, most dental problems may not be evident to patients. Sometimes, however, patients believe the old adage, “if it doesn’t hurt, don’t fix it”. If left untreated, however dental problems can lead to more expensive dental procedures and eventual tooth loss.
How do I know if I need a filling?
Only your dentist can detect whether you have a cavity that needs to be filled. During a checkup, your dentist will use a small mirror to examine the surfaces of each tooth.
Anything that looks abnormal will then be closely checked with special instruments. Your dentist may also X-ray your entire mouth or a section of it. The type of treatment your dentist chooses will depend on the extent of damage caused by decay.
What to Expect During a Filling:
Local anesthesia – at the beginning of your filling procedure, you may be given local anesthesia to numb the area around the tooth.
Tooth decay removal – then the dentist will cut through the enamel using a drill to remove any decay. After the dentist removes the decay, the dentist will shape the space to ready it for the filling.
Etching – for a bonded filling your dentist will etch the tooth with an acid gel before placing the filling.
Resin application – for certain types of fillings the dentist will layer on the resin and harden it using a bright light. This makes it strong.
Polishing – after the filling has been placed, your dentist will polish the tooth.
What is a crown?
A crown is a cover or “cap” your dentist can put on a tooth. The crown restores the tooth to its normal shape, size and function. The purpose of a crown is to make the tooth stronger or improve the way it looks.
Why do I need a crown?
You may need a crown if you:
have a cavity that is too large for a filling
have a missing tooth and need a bridge
need to cover a dental implant
have a tooth that is cracked, worn down or otherwise weakened
have had root canal treatment—the crown will protect the restored tooth
want to cover a discolored or badly shaped tooth and improve your smile!
How is a crown placed?
Several steps are involved, and two dental visits are generally needed to complete the treatment.
The dentist prepares the tooth by removing its outer portion so the crown will fit. Any decay is also removed. If additional tooth structure is needed to support the crown, the dentist may build up the core of the tooth.
An impression is made to provide an exact model for the crown.
You will get a temporary crown while you wait for the permanent crown to be ready—usually less than two weeks. While you have the temporary crown, this tooth may be sensitive to hot and cold. Also, avoid chewing gum or sticky foods during this time.
The dentist or a laboratory technician then uses the model to help make the crown.
When the new crown is ready, the dentist places it in your mouth and makes the necessary adjustments. When you and your dentist are satisfied with how it looks and feels, the crown is cemented in place.
What is it made from?
Crowns are made from several types of materials as ceramics and zirconiums. In the process of making a crown, the material often is colored to blend in with your natural teeth.
Your dentist wants to create a crown that looks natural and fits comfortably in your mouth. To decide on the material for your crown, your dentist will consider the tooth location, the position of the gum tissue, the patient’s preference, the amount of tooth that shows when you smile, the color or shade of the tooth, and the function of the tooth.
After a Crown
You shouldn’t feel any discomfort or sensitivity after a crown is placed. However, if your tooth has not had a root canal, it will still contain the nerve. You may therefore have some temporary sensitivity to cold. If you notice pain or sensitivity when you bite down, contact your dentist. Usually this means that the crown is too high. When you bite, you are hitting the crown first. The crown needs to be adjusted. This can be done easily.
Types of Crowns
Emax crown is a type of all-ceramic crown which is preferred for its longer lasting aesthetic qualities. It has an appealing color which is combined with extra strength and durability and is made from a single block of lithium disilicate ceramic that has been harvested for its toughness and durability.
This is a crown that is considered to be the best match with your own natural teeth. There is no metal alloy base with this crown which means no unsightly looking gray line around the gum line. They are strong, long lasting and unlikely to crack or fracture as compared to many other types of crowns.
They are two ways to do emax crown:
Monolithic: The crown is made out of uniform piece of ceramic without individual layers fused together.
Bi-layered: This type of crown is supported by a structure core (magnesium aluminate spinel and lithium disilicate) where the laboratory technician applies veneering porcelain to create the final esthetic restoration.
Zirconia crown is a dioxide form of the metallic element zirconium and is similar to a natural diamond, possessing both beauty and strength. After an extract subframe is forged, feldespathic porcelain is built upon it until the perfect crown form is attained. Zirconia crown are biocompatible made of material that works well with the bodily tissue, they are very strong and resistant to corrosion, and have optical characteristic similar to the natural tooth, thus facilitating perfect aesthetic results and a completely natural tooth.
They are two ways to do zirconia crown:
Monolithic: Made from a uniform piece of ceramic (zirconia toughened alumina).
Bi-layered: This crown is supported by structure core (zirconia) where the laboratory technician applies veneering porcelain to create the final aesthetic restoration.
PORCELAIN FUSED TO METAL (PFM)
PFM has been the most common option done in the past 35 years. Tooth-colored ceramic is baked on top of a metallic alloy structure. However the porcelain portion can also chip or break off and sometimes the metal underlying the crown porcelain can show through as a dark line, especially at the gum line and even more so if your gums recede.
Crowns Over Implants
After you loose a tooth, other teeth will slowly shift into the empty space. The movement is very slow and can take a year or more to notice. Upper teeth will erupt downwards to fill the gap and teeth on either side may lean inwards to take up the space. A dental implant is generally recommended as the best option to replace a missing tooth.
What is the process of getting my implant done?
After four to six months, after the implant has been made when the implant and the bone has bond together, a second step of the procedure is necessary to uncover the implant and attach an extension. This temporary healing cap completes the foundation on which your new tooth will be placed. Your gums will be allowed to heal from 2 to 6 of weeks following this procedure.
Finally, we will take an impression to be able to create a replacement tooth called a crown and attached it to a small metal post, called an abutment. Once this is done on the laboratory, we will place it above your implant and tight it with a torque that goes from 15 to 35 newtons. If the crown is screwed to the abutment, the screw hole will be covered with restorative material such as tooth-colored filling material (composite).
After a short time, you will experience restored confidence in your smile and your ability to chew and speak. Every case is different, and some of these steps can be combined when conditions permit. We will work with you to determine the best treatment plan.
What material is used to the crown over my implant?
Depending on each case, we choose between two materials for the final crown emax (metal free) or zirconium. We will explain you and let you know which material we recommend for you.
Dentures are removable appliances that can replace missing teeth and help restore your smile.
When you lose all your teeth whether from gum disease, tooth decay or injury facial muscles can sag, making you look older. Dentures can help fill out the appearance of your face and profile. They can be made to resemble your natural teeth and improve the look of your smile.
Types of Dentures
Conventional denture is made after all your teeth have been extracted and the gums are healed.
Immediate denture is inserted immediately after the teeth are removed. Your dentist takes measurements and makes models of your jaw during prior visits. Immediate dentures offer the benefit of never having to be without your teeth, they must be relined several months after your bone supporting the teeth reshapes as it heals, causing the denture to become loose.
This denture is a type of over-denture that is supported by, and attached to, implants. A regular denture rests on the gums, and is not supported by implants. 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 implant. These dentures have special attachments that snap on to attachments on the implants. These Dentures usually are made for the lower jaw because regular dentures end 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.
A removable partial denture consist of replacement teeth attached to a pink or gum-colored plastic with clasps that attached to the adjacent teeth, that holds it in the mouth. Partial denture are used when one or more natural teeth remain in the upper or lower jaw. Not only does a partial denture fill in the spaces created by missing teeth, it prevents other teeth from changing position.
Sometimes teeth need to be removed due to decay, disease or trauma. Having a tooth removed or “pulled” is called an extraction.
An extraction is performed with anesthesia, which numb any pain so you will feel only pressure.
Before an extraction occurs, a thorough examination of your teeth will be performed. This is done to allow your dentist to evaluate the position of the teeth and determine if future problems may occur. X-rays can view additional risk factors such as decay or deterioration. Early examinations are recommended to identify problems that can arise in the future.
Should I replace the missing tooth?
After a tooth is extracted, other teeth will slowly shift into the empty space. The movement is very slow and can take a year or more to notice. Upper teeth will erupt downwards to fill the gap and teeth on either side may lean inwards to take up the space.
A dental implant is generally recommended as the best option to replace a missing tooth. Usually, a dentist will wait four months for the bone to fill in before placing a dental implant. We also recommend a bone graft at the time of the extraction, to facilitate future implant placement, this procedure is known as “socket preservation” which is basically, preserve the existing bone level after the extraction
There are situations when teeth are severe fractured or decayed, in those cases a surgical approach is needed to extract the tooth.
Dental bonding is a procedure in which a tooth-colored resin material (a durable plastic material) is applied and hardened with a special light, which ultimately “bonds” the material to the tooth to restore or improve person’s smile. Dental bonding is an option that can be considered:
To repair chipped or cracked teeth
To improve the appearance of discolored teeth
To close spaces between teeth
To make teeth look longer
To change the shape of teeth
To protect a portion of the tooth’s root that has been exposed when gums recede
What Are the Advantages and Disadvantages of Dental Bonding?
Advantages: Dental bonding is among the easiest and least expensive of cosmetic dental procedures. Unlike veneers and crowns, which are customized tooth coverings that must be manufactured in a lab, bonding usually can be done in one office visit unless several teeth are involved. Another advantage, compared with veneers and crowns, is that the least amount of tooth enamel is removed.
Disadvantages: Although the material used in dental bonding is somewhat stain resistant, it does not resist stains as well as crowns. Another disadvantage is that the bonding materials do not last as long nor are as strong as other restorative procedures, such as crowns or veneers. Additionally, bonding materials can chip and break off the tooth.
Because of some of the limitations of dental bonding, it is seen as best suited for small cosmetic changes, for temporary correction of cosmetic defects, and for correction of teeth in areas of very low bite pressure (for example, front teeth). Consult with us about the best cosmetic approach for your particular problem.
Because bonding material can chip, it is important to avoid such habits as biting fingernails; chewing on pens, ice, or other hard food objects; or using your bonded teeth as an opener. If you do notice any sharp edges on a bonded tooth or if your tooth feels odd when you bite down, call us.
How Long Does Bonding Material Last?
The lifespan of bonding materials for the teeth depends on how much bonding was done and your oral habits. Typically, however, bonding material lasts from three years up to about 10 years before needing to be touched up or replaced.
Crown: A replacement tooth
Pontic: Artificial Tooth
Abutment: The top of the dental implant that connects the implant to the crown
A bridge is a fixed dental restoration used to replace a missing tooth (or several teeth) by joining an artificial tooth permanently to adjacent teeth or dental implant.
Placing a bridge usually takes more than one visit. On your first visit, your dentist prepares the teeth on either side of the gap and takes the impression and send it to the laboratory. Technicians make the bridge out of metal, ceramics, glass-ceramics or zirconium. Your dentist will place a temporary bridge to protect your exposed teeth while you are waiting for the permanent one.
The Maryland Bridges:
An alternative to the tradition bridge and utilizes ”wings” on the sides of the pontic which attach it to the abutment teeth, meaning that little or no damage is done to those teeth in the process. They are the most often used in the front of the mouth and only if the abutment teeth are whole (no crowns or major fillings) the are no considered as strong as conventional bridges, and unlike other tooth replacement options the Maryland bridge cannot be made translucent, their structure requires them to be completely opaque, making them look somewhat artificial in the mouth.
Fixed Bridge Over Implant
Another tooth replacement option is a fixed bridge supported by implant and not by natural teeth, this requires insert implants in the jawbone for each missing tooth, then the crowns are connected to each other to perform one piece.
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, this can increase the chances that they will loosen from the bone and fail. An implant supported bridge reduces the pressure on the individual’s 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.
Requires a prior evaluation of your full bite from your dentist.
Cantilever bridges are another option for replacing missing teeth. They are very similar to traditional bridges, but the pontic is supported by an abutment on only one side, rather than on both sides. So there is only one natural tooth or implant next to the gap, and a bridge can still be secured. Like traditional bridges, your dentist will need to prepare the adjacent tooth to support the bridge by removing its enamel. Because these restorations are only are only supported on one side, they may act as a lever in some cases explains the National Institute of Health (Note: this may lead to complications like fractured teeth or loosened crowns. This option is not for every patient and will require a prior evaluation of your full bite from your dentist.
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