dental treatment information

Tooth Whitening

Dramatically whiten your smile.

The Problem:

Dull colored or stained teeth.

The Solution:

Plastic whitening trays will be made from models of your teeth. You will then place a special whitening gel in each tray and wear the trays in your mouth for several hours per day. (Many patients wear their trays after dinner and before bed.) A significant change in tooth color is usually seen in just four to six weeks.

Advantages:

Modern tooth whitening systems are highly effective and have dramatic results. Many celebrities consistently whiten their teeth to improve their appearance.

Disadvantages:

Occasionally, patients may experience some gum or tooth sensitivity when using their trays. These symptoms subside when whitening is discontinued for several days.

Alternatives:

Occasionally, teeth may be stained in a way that limits the effectiveness of tooth whitening. In those instances, porcelain laminates or crowns are an excellent alternative.

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Bonding

Restore chipped teeth and fill gaps between teeth.

The Problem:

• Unsightly gaps between front teeth.
• Slightly chipped teeth.
• Rough or jagged edges on front teeth.
• Dull colored or stained teeth.

The Solution:

Composite resin is a white, tooth colored material that can be shaded to match your teeth. This material is applied to your teeth and sculpted to cover or replace the problem area. The material bonds to the surface of your teeth like a glue. It is often "cured" or hardened with an intense ultraviolet light.

Advantages:

When skillfully applied and sculpted, this material allows you to have a natural, beautiful improvement in your smile.

Disadvantages:

Bonding is initially less expensive than porcelain veneers. However, it tends to break down and discolor in several years and will need to be replaced. For this reason, porcelain restorations are usually more cost effective over time.

Alternatives:

Porcelain laminates or crowns are an excellent, longer lasting alternative.

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Porcelain Laminates

Completely reshape your teeth for a beautiful, white smile.

The Problem:

• Stained or discolored teeth.
• Unsightly gaps between front teeth.
• Chipped teeth.
• Rough or jagged edges on front teeth.
• Teeth that are too small or large in proportion to the rest of the mouth.
• Crooked or worn teeth.

The Solution:

A porcelain laminate (often called a veneer) is a thin shell of porcelain that covers the front of each tooth. They bond directly to the front of the tooth, similar to the way artificial fingernails work. Each porcelain laminate is a work of art, carefully crafted in a laboratory to fit your individual smile.

Advantages:

In the hands of a highly skilled dentist, porcelain laminates can provide you with an incredibly natural, beautiful smile. They are virtually undetectable and can dramatically improve your appearance. They are durable and long-lasting when compared to other cosmetic treatments.

Disadvantages:

Although they are highly durable, porcelain laminates are not permanent. Well crafted laminates will last many years, but will eventually need to be replaced.

Alternatives:

Porcelain laminates are an excellent investment. However, they are not appropriate for teeth with excessive decay. In those cases, porcelain crowns are the only alternative. In the event that you desire only to improve tooth alignment, orthodontic treatment may be another alternative.

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Composite Fillings

The clear alternative to traditional mercury fillings.

The Problem:

• Decay on a portion of any tooth.
• Desire to replace old-fashioned mercury (silver) fillings.
• Desire to maintain a white, beautiful smile.

The Solution:

A composite filling is a tooth colored quartz-like material. After tooth decay is removed and cleaned, this tooth colored material is layered into the tooth. Each layer is hardened or cured with highly intense visible light, and the final surface is shaped and polished to match the tooth. The final restoration is virtually invisible.

Advantages:

Composite fillings are more than just attractive. They are environmentally non-toxic because they use no mercury. They are stronger because they bond directly to the surface of the tooth. They protect the tooth from fracturing because they don't require the severe "undercut" (removal of healthy tooth structure) of a mercury filling.

Disadvantages:

The initial investment in a composite filling is higher than that for a mercury filling. This is due to the fact that the composite material is more expensive and the restoration is more difficult and time consuming to place. However, this initial higher investment is offset in the long run by the health benefits and reduced likelihood of restoring potentially fractured teeth.

Alternatives:

Inlays/onlays are sometimes good alternatives to composite fillings, offering excellent long term durability. In cases of extensive decay, inlays/onlays or crowns are the only alternative.

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Porcelain Inlays and Onlays

An excellent way to restore teeth with small to moderate decay.

The Problem:

• Any level of decay on a portion of any tooth.
• Need for a long-term, durable restoration.
• Desire to limit the amount of healthy tooth structure removed.
• Need to strengthen and reinforce tooth.

The Solution:

Decay is removed and cleaned from the tooth and a highly accurate impression or mold is made of the prepared surface. This mold is used to create a model of the tooth which is then sent to a special laboratory that will create a gold or porcelain (tooth colored) restoration called an inlay or onlay. The inlay or onlay is then cemented into the prepared surface of the tooth.

An inlay covers only one or two surfaces of the tooth and is used to restore a small amount of decay. An onlay actually covers one or more cusps (the chewing surface of the tooth.)

Advantages:

Porcelain offers a fine alternative to other tooth restoration materials. Made to perfectly match the shade and shape of your teeth, it's durable, it's strong, and it's virtually undetectable.

Inlays and onlays are incredibly strong due to the fact that they are created in a laboratory. This protects the tooth from fracturing and actually strengthens the tooth. In addition, inlays and onlays fit almost perfectly into the prepared surface of the tooth, reducing the size of the seam between the restoration and the tooth. This helps keep decay from eventually occurring under the restoration.

Inlays and onlays require the removal of only decayed areas of the tooth, leaving more healthy tooth structure intact. This can help prevent the expense of root canal therapy in the future.

Disadvantages:

Due to the fact that they are crafted in a laboratory, inlays and onlays require a greater initial investment than regular fillings. However, in the long run, inlays and onlays are a better investment than fillings due to their extremely long life and highly accurate fit. Gold inlays and onlays generally have a greater long term durability than porcelain inlays and onlays.

Alternatives:

In cases of extensive decay, crowns are the only alternative.

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Porcelain Crowns (Caps)

Protect and keep badly decayed or fractured teeth.

The Problem:

• Badly decayed teeth.
• Fractured teeth.
• The "sunken face" look associated with missing teeth.
• Need to protect and strengthen teeth.

The Solution:

A crown (often called a cap) covers the tooth and restores it to its original shape and size. Decay is removed and cleaned from the tooth and a highly accurate impression or mold is made of the prepared surface. This mold is used to create a model of the tooth which is then sent to a special laboratory that will create a gold or porcelain (tooth colored) crown. The crown is then cemented onto the prepared surface of the tooth.

Advantages:

Porcelain offers a fine alternative to other tooth restoration materials. Made to perfectly match the shade and shape of your teeth, it's durable, it's strong, and it's virtually undetectable.

Crowns are incredibly strong due to the fact that they are created in a laboratory. This protects and strengthens the remaining tooth structure. In the hands of a skilled dentist, a crown will fit almost perfectly onto the prepared surface of the tooth, reducing the size of the seam between the crown and the tooth. This helps keep decay from eventually occurring under the crown.

Crowns should be placed before the tooth is so decayed that it may fracture. This can often help prevent the expense of root canal therapy in the future. It can also prevent the possibility that a fractured tooth may need to be removed, requiring the expense of a bridge or implant to replace the missing tooth.

Disadvantages:

Crowns are excellent restorations and have few disadvantages. They are highly durable, but they will eventually need to be re-cemented or replaced due to normal wear.

Occasionally, a tooth may still need root canal therapy after being crowned. However, this indicates that the interior of the tooth was already sick (infected) and would have eventually needed root canal therapy anyway.

Alternatives:

In the event that a tooth is so decayed or fractured that it needs to be removed, the best alternatives to a crown are bridges and implants that replace the missing tooth.

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Porcelain Fixed Bridges

A great way to replace missing teeth.

The Problem:

• A missing tooth or teeth.
• Potential bite and jaw joint problems from teeth shifting to fill the space.
• The "sunken face" look associated with missing teeth.
• Desire to improve chewing ability.
• Desire for a more permanent solution than dentures.

The Solution:

A bridge is a single appliance that is generally attached to two teeth on each side of the space where a tooth is missing. An artificial tooth attached in the middle of the bridge fills in the gap where the missing tooth was. The teeth on either side of the gap are prepared for crowns (see crowns) and a highly accurate impression or mold is made of the prepared area. This mold is used to create a gold or porcelain (tooth colored) bridge in a special laboratory. The bridge is then cemented onto the prepared surface of the teeth, effectively creating the appearance of a "new" tooth.

In some instances, a resin-bonded bridge may be used. In this case, the two teeth on each side of the gap are not prepared for crowns. Instead, the bridge consists of a false tooth with metal brackets on the back of each side of the gap. The brackets are attached to the backs of the real teeth on each side.

Advantages:

Porcelain offers a fine alternative to other tooth restoration materials. Made to perfectly match the shade and shape of your teeth, it's durable, it's strong, and it's virtually undetectable.

Unlike dentures, a fixed bridge is never removed. It is stable in the mouth and works very similar to natural teeth. By filling the gap and stopping the movement of other teeth, a fixed bridge is an excellent investment, providing better chewing ability, heading off jaw joint problems and saving money that would otherwise might be spent on future dental treatment.

Disadvantages:

Fixed bridges are excellent restorations and have few disadvantages. They are highly durable, but they will eventually need to be re-cemented or replaced due to normal wear.

Alternatives:

In the event that the use of a fixed bridge is not feasible, the best alternative is a dental implant.

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Dental Implants

An excellent way to replace missing teeth.

The Problem:

• A missing tooth or teeth.
• Potential bite and jaw joint problems from teeth shifting to fill the space.
• The "sunken face" look associated with missing teeth.
• Desire to improve chewing ability.
• Desire for a more permanent solution than dentures.

The Solution:

A dental implant is an appliance used to replace the roots of teeth. The implant is surgically attached to the jaw bone and an artificial tooth is attached to the top of the implant, creating a natural looking, undetectable replacement for the missing tooth. In the event that more than one tooth is missing, several implants may provide a base for a series of artificial teeth known as a fixed bridge (see fixed bridges.) Implants can even be used to secure a full set of removable dentures for people who have no remaining natural teeth. This can greatly improve chewing ability and reduce the risk of choking.

It generally takes about six months for the surgical implant to heal before the final installation of the artificial tooth or teeth can be finished.

Advantages:

Dental implants with artificial teeth are the closest thing to regrowing your natural teeth. They are strong, stable, durable and virtually undetectable. By filling gaps left by missing teeth, implants can provide better chewing ability and head off jaw joint problems. They are far superior to removable dentures.

Disadvantages:

Dental implants are excellent, state-of-the-art restorations and have few disadvantages when compared to alternatives such as dentures. However, dental implants do require surgery and time to heal, and they are initially more expensive than dentures or fixed bridges. These disadvantages are offset by the ease of use, saved time and long term health benefits of implants.

Alternatives:

Dentures are a poor alternative to dental implants. However, in some cases, where finances are a primary concern, dentures are the only alternative.

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