A smile can be the most eye-catching feature of a face. With
dentistry's many advances, you no longer have to settle for
stained, chipped or misshapen teeth. You have choices that
can help you smile with confidence. Talk to the doctor about
the options most suitable for you, what your expectations are
and the dental fees involved.
If you're missing one or more teeth, you may notice a difference
in chewing and speaking. A bridge may be used to replace
missing teeth, help maintain the shape of your face and
alleviate the stress in your bite.
There are two types of tooth replacement: fixed bridge
and implant.
A fixed bridge replaces missing teeth with artificial teeth,
looks great and literally bridges the gap where one or more
teeth may have been. The restoration can be made from gold,
alloys, porcelain or a combination of these materials and
is bonded onto surrounding teeth for support.
An implant attaches artificial teeth directly to the jaw
under the gum tissue. A small titanium fixture may be used
to surgically place the implant in the upper or lower jawbone
to replace the root of your missing tooth and provide an
anchor for a crown.
The success of any bridge or implant depends on its foundation — the
other teeth, gums or bone to which it is attached — so it's
very important to keep your remaining teeth, gums and jaw
healthy and strong.
A crown covers a tooth and restores it to its normal shape
and size. A crown can make your tooth stronger and improve
its appearance. It can cover and support a tooth that has
a large filling. It can be used to attach a bridge, prevent
a weak or brittle tooth from breaking or restore one that's
already broken. A crown is a good way to cover teeth that
are discolored, badly shaped or out of position. Crowns
are also used to cover dental implants.
A crown may be made of gold or porcelain. It is made to
fit the tooth precisely. It looks somewhat like a thimble
and is cemented onto the prepared tooth.
If the doctor recommends a crown, it's probably to correct
one of these conditions. The doctor's primary aim, like yours,
is to help you keep your teeth healthy and your smile bright.
There are times when it is necessary to remove a tooth.
Sometimes a baby tooth has long or misshapen roots that prevent
it from falling out and the tooth must be removed to make
way for the permanent tooth to erupt. At other times, a tooth
may have so much decay that it puts the surrounding teeth
and jaw at risk of decay, so the doctor may recommend removal
and replacement with a bridge or implant. Infection, orthodontic
correction or problems with a wisdom tooth can also require
removal of a tooth.
When it is determined that a tooth needs to be removed,
the dentist may extract the tooth during a regular checkup
or the dentist may request another visit for this procedure.
While the procedure is typically very quick, it is important
to share any concerns or preferences for sedation that you
may have.
Advances in modern dental materials and techniques have provided
new ways to create more pleasing, natural-looking smiles.
As a result, dentists and patients have several choices when
it comes to selecting materials used to repair missing, worn,
damaged or decayed teeth.
Traditional dental restoratives include gold, porcelain
and composite. The strength and durability of traditional
dental materials continue to make them useful for situations
where restored teeth must withstand extreme forces that result
from chewing, such as in the back of the mouth.
Newer dental restoratives include ceramic and plastic compounds
that mimic the appearance of natural teeth. These compounds,
often called composite resins, are often used on the front
teeth where a natural appearance is important. They can be
used on the back teeth as well depending on the location
and extent of the tooth decay. Composite resins are usually
more costly than the older amalgam fillings.
Several factors influence the performance,
durability, longevity and expense of dental restorations.
These factors include: the components used in the filling
material, the amount of tooth structure remaining, where
and how the filling is placed, the chewing load that the
tooth will have to bear and the length and number of visits
needed to prepare and adjust the restored tooth.
The ultimate decision about what to use is best determined
by the patient in consultation with the dentist. Before your
treatment begins, discuss the options with the doctor. To
help you prepare for this discussion it is helpful to understand
the two basic types of dental restorations: direct and indirect.
Direct restorations are fillings placed immediately into
a prepared cavity in a single visit. They include dental
amalgam, glass ionomers, resin ionomers and composite (resin)
fillings. The dentist prepares the tooth, places the filling
and adjusts it during one appointment.
Indirect restorations generally require two or more visits.
They include inlays, onlays, veneers, crowns and bridges
fabricated with gold, base metal alloys, ceramics or composites.
During the first visit, the dentist prepares the tooth and
makes an impression of the area to be restored. The dentist
then places a temporary over the prepared tooth. The impression
is sent to a dental laboratory, which creates the dental
restoration. At the next appointment, the dentist cements
the restoration into the prepared cavity and adjusts it as
needed.
If you have missing teeth, it is crucial to replace them.
Without all your teeth, chewing and eating can destabilize
your bite and cause you discomfort.
Implants are a great way to replace your missing teeth.
An implant is composed of two parts that mimic a tooth’s
root and crown. The implant’s “root” is
a titanium steel rod that is placed into the jaw bone and
acts as a root. Once the rod is in place, a crown is then
attached to it to replace the top part of your tooth. You
now have an entirely new tooth made of steel and porcelain,
and it will look just like your natural tooth.
In the past, if you had a tooth with a diseased nerve, you'd
probably lose that tooth. Today, with a special dental procedure
called root canal treatment, you may save that tooth.
Inside each tooth is the pulp and the nerve. The nerve
is the vestige of the tissue that originally formed the tooth.
Once the tooth has been in the mouth for a time, the functioning
of the nerve is no longer necessary.
When a tooth is cracked or has a deep cavity, bacteria
can enter the pulp. Germs can cause an infection inside the
tooth. Left without treatment, pus builds up at the root
tip, in the jawbone, forming a "pus-pocket" called
an abscess. An abscess can cause the pulp tissue to die.
When the infected pulp is not removed, pain and swelling
can result. Certain byproducts of the infection can injure
your jawbones and your overall health. Without treatment,
your tooth may have to be removed.
Treatment often involves from one to three visits. During
treatment, your general dentist or endodontist (a dentist
who specializes in problems of the pulp) removes the diseased
pulp. Next the pulp chamber and root canal(s) of the tooth
are cleaned and sealed. Often posterior teeth that have endodontic
treatment should have a cast crown placed in order to strengthen
the remaining structure. Then as long as you to continue
to care for your teeth and gums with regular brushing, flossing
and checkups so that the root(s) of the restored tooth are
nourished by the surrounding tissues, your restored tooth
can last a lifetime.
Most of the time, a root canal is a relatively simple procedure
with little or no discomfort involving one to three visits.
Best of all, it can save your tooth and your smile!
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