Amalgam is a mixture of silver and mercury and has been the standard material used for decades for fillings and to replace missing tooth structure. The advantage to silver amalgam is its ability to seal tooth structure and its durability.
back to top
Anesthesia relates to the process of either blocking or temporarily removing sensation to allow you to be treated with minimal discomfort. Local anesthetics are typically used for dental related procedures to remove sensation in a specific area. General anesthetics are more commonly used in a hospital setting to remove sensation from the entire body during a surgical procedure.
Local anesthetics are useful for dental treatment procedures such as fillings, preparation of teeth for crowns or placement of dental implants. Local anesthetics create a feeling of temporary numbness by blocking the sensation of the nerve in the area of the dental treatment. It is important to provide an accurate health history to your doctor in order to be given the appropriate type of anesthetic. For example, if you are being treated for conditions related to your heart, a local anesthetic may be selected without epinephrine such as carbocaine.
Novocaine is a very common injectable local anesthetics used in a dental office setting. Newer anesthetics are also used today that are much less likely to cause an allergic response such as carbocaine, lidocaine or septocaine.
back to top
People with certain medical conditions such as a heart condition or total joint replacement may need to take antibiotics before any invasive dental procedures. Some dental procedures like removing a tooth, dental implant surgery, dental cleanings, etc. tend to allow bacteria to enter the blood stream. The bacteria in the blood stream can eventually reach either the damaged area of the heart or the artificial joint and cause an infection. In the heart this infection is called “infective endcarditis” and may become life-threatening. With artificial joints, the infection may cause the joint to fail.
The American Dental Association works closely with the American Heart Association to determine which people require antibiotic prophylaxis prior to dental work and which dental procedures present a higher risk and need antibiotic prophylaxis. These guidelines have changed many times over the last few decades with fewer heart conditions requiring antibiotic prophylaxis. Research has shown that there is a greater risk of a bad reaction to the antibiotics or the development of resistant strains of bacteria than a risk of infective endocarditis because of dental work in people with minor heart problems.
Although the ADA has worked with the American Association of Orthopedic Surgeons, the guidelines for antibiotic prophylaxis are still open to interpretation. There is a consensus that antibiotic prophylaxis is only appropriate for total joint replacements and that pins, plates or other orthopedic parts are not at risk. The most critical period for total joint replacements is the first two years, and it is agreed that antibiotic prophylaxis is necessary during that time.
Specific antibiotics will be prescribed to for procedures that may introduce a significant amount of bacteria in the blood stream. Ask your prosthodontist if you need antibiotic prophylaxis.
back to top
The best method for treating an infection associated with a tooth is to remove the cause of the infection either by a root canal or removing the tooth. In some cases antibiotic therapy is also used to fight the infection, especially it has been long-standing or if the symptoms have become severe. If the infection has spread and the face begins to swell, antibiotic therapy is critical. Often a sinus infection can cause the upper back teeth to ache, but the problem is not dental related. Antibiotic therapy is necessary to successfully eliminate a sinus infection. Several antibiotics exist that are well-suited to treat dental infections, and your dental professional will decide the best antibiotic based on the type of infection and your medical history.
back to top
Bonding uses tooth-colored filling material to change the appearance of teeth and improve your smile. For minor imperfections, especially in younger people, bonding may be the perfect answer to repair chipped teeth, close spaces between teeth and change the shape of teeth. The tooth-colored filling material used in bonding is a resin or plastic filled with glass beads that can bond to enamel that has been etched with a mild acid. If used carefully, the bonding materials may last for many years. Major changes in the shape and color of your teeth may require the use of porcelain or dental veneers.
back to top
Braces are used to help align and straighten teeth and position them to correct a person’s bite, while also working to improve dental health. They are often used to fix underbites, overbites, crooked teeth and various other flaws of the teeth and jaw. Braces can be either cosmetic or structural. Dental braces or orthodontic braces are often used in combination with other orthodontic tools to help widen the palate or jaws and assist in shaping the teeth and jaws.
Orthodontics is a dental specialty that focuses on the study and treatment of improper bites, which may be a result of crooked teeth, an uneven jaw or both. Orthodontic treatment can be carried out for purely esthetic reasons to improve the general appearance of patients' teeth. There are also orthodontists who work on reconstructing the entire face rather than focusing exclusively on teeth.
back to top
Traditional methods to replace a missing tooth or teeth include the fabrication of a bridge. To replace a missing tooth with a bridge, at least one tooth on either side of the space created by the missing tooth must be prepared for a crown. Then a false tooth is joined to the crowns, and the entire structure is cemented to the prepared teeth. The patient cannot remove the bridge, and special aids are available to keep it clean.
back to top
Crowns cover or "cap" a tooth to restore the normal function and appearance of the tooth. Crowns may be made as all metal, porcelain fused to metal or all-ceramic (porcelain). Crowns are indicated for teeth with very large fillings, teeth that have had a root canal, fractured teeth and misshapen and/or discolored teeth.
back to top
Cone Beam Computed Tomography (also known as CBCT or a Cone Beam Cat Scan) is an advanced dental x-ray that shows the dentist in 3D a larger area of the patients head and neck areas. CBCT is used to analyze a person’s health or disease of their teeth, supporting bones, joints and implants. It has been very helpful in advancing the treatment and placement of dental implants by allowing the dentist to see and measure in 3D the hard and soft tissue of the jaws. It can also be used for the production of guides for computer aided and guided surgery. CBCTs are made by rotating a radiation beam around the person’s head. The radiation is directed at the head in the shape of a cone which provides one small dose of radiation over a larger surface in one circular path. This small amount of radiation is picked up by a sensor plate and the information is then processed by a computer and is seen in many forms and views on a computer screen. CBCT should used when necessary because there is a lot of concern about radiation exposure with this more advanced x-ray. Compared to a single hospital head and neck Cat Scan (CT), a single CBCT can provide 1/30th the radiation exposure and equal results.
back to top
Cosmetic dentistry is any dental work that improves the appearance of a person’s teeth, gums or smile. The American Dental Association does not recognize cosmetic dentistry as a formal specialty area of dentistry.
back to top
Traditional methods to replace a missing tooth or teeth include the fabrication of dental bridges. To replace a missing tooth with a dental bridge, at least one tooth on either side of the space created by the missing tooth must be prepared for a crown. Then a false tooth is joined to the crowns, and the entire structure is cemented to the prepared teeth. The patient cannot remove the dental bridge, and special aids are available to keep it clean.
back to top
Dental composites are tooth-colored materials that consist of a mixture of glass and modern plastics. They are used by prosthodontists to restore teeth to their natural state. A prosthodontist can hand sculpt a missing tooth structure to its original shape and color. A prosthodontist may also use dental composites to build, reshape or change the color of teeth.
back to top
Dental fillings are a procedure that replaces lost tooth structure. In advanced cases of lost tooth structure, porcelain or gold crowns and onlays may be required. In simple cases the missing tooth structure can be replaced with composite material or silver amalgam.
Amalgam is a mixture of silver and mercury and has been the standard material used for decades for fillings and to replace missing tooth structure. The advantage to silver amalgam is its ability to seal tooth structure and its durability.
Composites are tooth colored materials that consist of a mixture of glass and modern plastics. They are used by prosthodontists to restore teeth to their natural state. A prosthodontist can hand sculpt a missing tooth structure to its original shape and color. A prosthodontist may also use the composite materials to build, reshape or change the color of teeth.
back to top
Dental implants are metal cylinders made of titanium surgically placed in the jawbone where teeth are missing. They replace the roots of missing teeth and support single crowns, large bridges and dentures. State-of-the- art technology makes it possible for these replacement teeth to look, feel and function like natural teeth.
back to top
When a tooth is overly sensitive to cold or sweets the exposed tooth can be repaired with dental sealants. By using modern chemicals that can microscopically bond to the exposed tooth, a prosthodontist can help remove the painful symptoms of tooth sensitivity with dental sealants.
back to top
Dental veneers are used to modify the shape and color of teeth. Dental veneers are thin shells of porcelain that are etched and then bonded to the enamel of the teeth. Tooth preparation is necessary to avoid over bulking of the tooth, but it is limited to the enamel and usually involves only a few surfaces of the tooth.
back to top
Dentures are removable replacements for missing teeth. Complete dentures replace all teeth and removable partial dentures replace some teeth. By matching each individual’s unique smile and bite, dentures can improve facial appearance and self-confidence. They can also solve pronunciation problems caused by missing teeth and aid with chewing.
back to top
A digital X-ray is a black and white picture that shows the health or disease state of teeth, dental implants, supporting and surrounding bone of the head and joints and dental restorations. Your dentist may require a limited four to eighteen film series per year or several individual films for one procedure. The X-ray is made by focusing a small beam of radiation energy at a digital sensor or an X-ray film. The X-ray image then can be seen on a computer screen or on X-ray paper. Dental X-rays should only be taken when necessary and are very safe. The beam is limited in energy and focused on a very small area, reducing scatter radiation to surrounding tissues. The use of protecting lead aprons can be used to cover various body parts such as the abdominal area of an expectant mother or the thyroid gland. The need for such protective equipment should be made at the discretion of the dentist and the patient. Your dental insurance may allow for a number of routine dental X-rays to be taken per year.
back to top
Many people have an attractive smile with a few minor imperfections. Enamel shaping to correct these slight flaws can improve a person’s perception of their smile. Enamel shaping can correct uneven edges of the front teeth or round off sharp pointed tips of the teeth and make the smile more proportioned and even. It is important that the smile has some “character” and has some slight unevenness to make it look more natural.
back to top
Endodontics is one of the nine dental specialties recognized by the American Dental Association. The specialty focuses on the tooth pulp and the tissues surrounding the root of the tooth. Deep inside the hard surface of a tooth is the pulp which contains blood vessels, nerves and connective tissue. The pulp extends from the crown of the tooth to the tip of the root, and it can become inflamed or infected from dental decay, trauma or gum disease. The irritated nerves of the pulp can cause pain, and chronic inflammation and infection may lead to a tooth abscess.
The most common endodontic treatment is a root canal where all of the pulp tissue is removed from the tooth, the inner chamber and canals of the tooth are cleaned and shaped with special instruments and a filling is placed to seal the root. Although the tooth can no longer respond to temperature changes or feel a tooth preparation, the tooth can function for many years after endodontic treatment. Most teeth, especially back teeth, will need to be restored with a crown or cap following endodontic treatment.
Most root canals resolve the inflammation and infection that cause discomfort, but there are times when the anatomy of the tooth or the persistence of the infection may require additional endodontic treatment. Often retreatment of the root canal will work, but chronic infection may need a more aggressive endodontic treatment. A common procedure in these cases would be an “apicoectomy” where the end of the tooth’s root is surgically removed and the root is sealed.
back to top
Esthetic restoration can help you achieve a more natural-looking smile and improve your teeth’s natural beauty and strength. Prosthodontists can replace stained, chipped, missing or worn teeth with inlays, crowns, veneers, bridges and implants with the most advanced restorative materials to help bring back you beautiful smile.
back to top
Fillings are a procedure that replaces lost tooth structure. In advanced cases of lost tooth structure porcelain or gold crowns and onlays may be required. In simple cases the missing tooth structure can be replaced with composite material or silver amalgam.
Amalgam is a mixture of silver and mercury and has been the standard material used for decades for fillings and to replace missing tooth structure. The advantage to silver amalgam is its ability to seal tooth structure and its durability.
Composites are tooth colored materials that consist of a mixture of glass and modern plastics. They are used by prosthodontists to restore teeth to their natural state. A prosthodontist can hand sculpt a missing tooth structure to its original shape and color. A prosthodontist may also use the composite materials to build, reshape or change the color of teeth.
back to top
Fluoride decreases dental decay. Since 1945 the U.S. Government has advocated the controlled addition of fluoride to public drinking water. In small amounts, ingested fluoride seems to strengthen the enamel while it is being formed in young children or pregnant women. Recommended levels of fluoride in water should range from 0.5mg – 1.0mg per liter of water with 0.7mg per liter as optimal. Too much fluoride in water will change the appearance of the enamel making permanent teeth look discolored and pitted. Applying fluoride topically to the teeth in the form of toothpaste or gels stimulates the re-mineralization of the enamel and topical fluoride gel can also decrease the sensitivity of exposed root surfaces.
Fluoridation of water supplied by the government was quite controversial when the program was introduced in 1945. Even today some groups protest the mandatory addition of fluoride to public water.
back to top
People with severe dental problems are candidates for a full mouth reconstruction. Full mouth reconstructions combine esthetics with the science of restorative dentistry to improve the health, function and beauty of the smile. Orthodontics may also be employed to help properly position the jaw.
back to top
Dental implants are metal cylinders made of titanium surgically placed in the jawbone where teeth are missing. They replace the roots of missing teeth and support single crowns, large bridges and dentures. State-of-the-art technology makes it possible for these replacement teeth to look, feel and function like natural teeth.
back to top
Defective or unsightly “fillings” can be replaced by all-ceramic inlays, a tooth-colored material bonded to the tooth. Instead of using the more traditional cement, this bonding process may actually improve the strength and beauty of the tooth.
An onlay is the same as an inlay, except that it extends to replace a cusp. Crowns are onlays which completely cover all surfaces of a tooth.
back to top
Dental lasers are a new treatment option for many people that can be used to treat diseases of hard and soft tissues and teeth. The dental laser is a machine that focuses a beam of energy down a hollow tube of a thin strand of glass filament. This focused heated energy can melt and vaporize the tissue being worked on. It also cauterizes or burns off small blood and lymphatic vessels lessening bleeding and swelling, and kills bacteria limiting disease potential. Depending on the type of laser used, they can help with the preparation of a tooth for a cavity, the whitening or lightening of your tooth enamel, the desensitizing of a sensitive tooth, sterilization of bone for a surgical procedure, and the cutting of gum tissues for major and minor dental surgery. With laser surgery may also reduce the need for dental anesthesia, given your prosthodontist more control with bleeding, less swelling after a procedure and less discomfort.
back to top
Dental lasers are a new treatment option for many people that can be used to treat diseases of hard and soft tissues and teeth. The dental laser is a machine that focuses a beam of energy down a hollow tube of a thin strand of glass filament. This focused heated energy can melt and vaporize the tissue being worked on. It also cauterizes or burns off small blood and lymphatic vessels lessening bleeding and swelling, and kills bacteria limiting disease potential. Depending on the type of laser used, they can help with the preparation of a tooth for a cavity, the whitening or lightening of your tooth enamel, the desensitizing of a sensitive tooth, sterilization of bone for a surgical procedure, and the cutting of gum tissues for major and minor dental surgery. With laser surgery may also reduce the need for dental anesthesia, given your prosthodontist more control with bleeding, less swelling after a procedure and less discomfort.
back to top
Mouth guards can describe many different devices that range from a simple commercially available athletic guard to a sophisticated guard custom made for a person with a history of teeth grinding. In the dental profession “mouth guard” typically refers to a soft well-fitting device that is worn on either the upper or lower teeth to protect the teeth from trauma during contact sports or any activity that might result in a blow to the mouth or jaw. Although over-the-counter mouth guards are available at athletic equipment stores, your prosthodontist can make a custom-fitted mouth guard that will protect your teeth and adapt precisely to your teeth. The more sophisticated guard designed for a person with a specific dental diagnosis is usually called an occlusal splint or orthotic device.
back to top
Nitrous oxide or "laughing gas" is given to a person with a mixture of oxygen and has a calming effect that helps anxious people relax during their dental treatment. The person remains conscious and can talk to their dentist during their visit. After treatment, the nitrous is turned off and oxygen is administered for 5 minutes to help clear the system of any remaining gas. The effects wear off almost immediately allowing the person to drive home following the treatment. Nitrous oxide rarely has side effects when given properly, although some people may experience minor nausea.
back to top
An occlusal splint or orthotic device is a custom made treatment for people who grind their teeth, have a history of TMJ pain and dysfunction or have completed a full mouth reconstruction. An occlusal splint is custom made using detailed study models on an instrument called an articulator that simulates the movement of the jaws. The splint is made from a processed acrylic resin and is designed to guide the jaw as it moves side to side and front to back. This precise custom device not only protects the teeth from harmful habits, but it supports the TMJ and the muscles that are used in chewing.
back to top
Porcelain veneers are used to modify the shape and color of teeth. Veneers are thin shells of porcelain that are etched and then bonded to the enamel of the teeth. Tooth preparation is necessary to avoid over bulking of the tooth, but it is limited to the enamel and usually involves only a few surfaces of the tooth.
back to top
As teeth erupt and grow normal grooves form that help chew food. In some cases these pits and grooves grow so deeply that they become difficult to clean and trap bacteria. The trapped bacteria may directly lead to decay.
Pit and fissure sealants are bonded tooth colored materials that can be used to seal deep grooves and pits in tooth enamel. A prosthodontist can thoroughly evaluate the groove and pit for decay. If none has formed, the area can be cleaned and disinfected without the use of a dental drill. The tooth can then be sealed from bacterial decay.
back to top
Radiography, also known as a dental x-ray is a black and white picture that shows the health or disease state of teeth, dental implants, supporting and surrounding bone of the head and joints and dental restorations. Your dentist may require a limited four to eighteen film series per year or several individual films for one procedure. The x-ray is made by focusing a small beam of radiation energy at a digital sensor or an x-ray film. The x-ray image then can be seen on a computer screen or on x-ray paper. Dental x-rays should only be taken when necessary and are very safe. The beam is limited in energy and focused on a very small area, reducing scatter radiation to surrounding tissues. The use of protecting lead aprons can be used to cover various body parts such as the abdominal area of an expectant mother or the thyroid gland. The need for such protective equipment should be made at the discretion of the dentist and the patient. Your dental insurance may allow for a number of routine dental x-rays to be taken per year.
back to top
For patients missing some, but not all of their teeth, a removable partial denture may be recommended. This type of denture uses the remaining teeth to hold the removable prosthesis in place. It is typically made of a metal framework with pink plastic to replace the gum tissue and plastic or resin denture teeth. With the advanced training of a prosthodontist, removable partial dentures designs are frequently offered.
back to top
Endodontics is one of the nine dental specialties recognized by the American Dental Association. The specialty focuses on the tooth pulp and the tissues surrounding the root of the tooth. Deep inside the hard surface of a tooth is the pulp which contains blood vessels, nerves and connective tissue. The pulp extends from the crown of the tooth to the tip of the root, and it can become inflamed or infected from dental decay, trauma or gum disease. The irritated nerves of the pulp can cause pain, and chronic inflammation and infection may lead to a tooth abscess.
The most common endodontic treatment is a root canal where all of the pulp tissue is removed from the tooth, the inner chamber and canals of the tooth are cleaned and shaped with special instruments and a filling is placed to seal the root. Although the tooth can no longer respond to temperature changes or feel a tooth preparation, the tooth can function for many years after endodontic treatment. Most teeth, especially back teeth, will need to be restored with a crown or cap following endodontic treatment.
Most root canals resolve the inflammation and infection that cause discomfort, but there are times when the anatomy of the tooth or the persistence of the infection may require additional endodontic treatment. Often retreatment of the root canal will work, but chronic infection may need a more aggressive endodontic treatment. A common procedure in these cases would be an “apicoectomy” where the end of the tooth’s root is surgically removed and the root is sealed.
back to top
When a tooth is overly sensitive to cold or sweets the exposed tooth can be sealed. By using modern chemicals that can microscopically bond to the exposed tooth, a prosthodontist can help remove the painful symptoms.
back to top
Sedation is meant to help people calm their nerves through the use of medication or inhaled gas prior to and/or during a treatment procedure. Sedation is helpful for patients with fears related to dental treatment, for patients with a low pain tolerance, or perhaps for patients requiring longer dental appointments. There are different types of sedation used depending on the situation.
Nitrous oxide or "laughing gas" provides a calming effect during the dental appointment and can be flushed out of the system to allow the person to drive home following the treatment. Oral sedation involves taking a carefully selected medication to help put a person in a more relaxed state. People that are having dental treatment completed under oral sedation will have to arrange for a ride as they would not be safe to drive themselves.
IV sedation (intravenous sedation) provides for the opportunity to adjust the level of sedation medication based on each individual patient’s needs. For those having treatment completed under IV sedation, it is best to have a close friend or family member with you at the time of the procedure. At the very least it is mandatory to arrange for transportation.
Sedation is endorsed by the American Dental Association and is an effective way to help many patients feel comfortable during their dental visit. Before using a sedative or anesthetic, it is important to tell your doctor about any medications or herbal supplements you are taking or medical treatments you are receiving.
back to top
You may be seeking an especially satisfying and esthetic enhancement of your smile and one that retains the natural healthy appearance of gums. Prosthodontics is the specialty of dentistry with advanced training in the restoration of teeth to their natural form, color and function.
back to top
A space maintainer is made of stainless steel and/or plastic and is used to keep the space open until the mouth until the tooth is replaced or grows in. It can be removable. Some space maintainers are cemented into a person’s mouth. This is called a fixed space maintainer.
back to top
Many products are now available for patients to whiten their teeth. These products include commercially available strips, custom fabricated trays with a beaching gel or bleaching in a dental office using UV light or laser as the catalyst.
back to top
Porcelain veneers are used to modify the shape and color of teeth. Veneers are thin shells of porcelain that are etched and then bonded to the enamel of the teeth. Tooth preparation is necessary to avoid over bulking of the tooth, but it is limited to the enamel and usually involves only a few surfaces of the tooth.
back to top
A dental X-ray is a black and white picture that shows the health or disease state of teeth, dental implants, supporting and surrounding bone of the head and joints and dental restorations. Your dentist may require a limited four to eighteen film series per year or several individual films for one procedure. The X-ray is made by focusing a small beam of radiation energy at a digital sensor or an X-ray film. The X-ray image then can be seen on a computer screen or on X-ray paper. Dental X-rays should only be taken when necessary and are very safe. The beam is limited in energy and focused on a very small area, reducing scatter radiation to surrounding tissues. The use of protecting lead aprons can be used to cover various body parts such as the abdominal area of an expectant mother or the thyroid gland. The need for such protective equipment should be made at the discretion of the dentist and the patient. Your dental insurance may allow for a number of routine dental X-rays to be taken per year.
back to top
