Advanced Procedures

Crowns

Crowns are full coverage restorations used to cover a tooth that is likely to break or is too broken down to be restored with a filling. After a root canal treatment or when a large filling wears out, a crown is put in place. There is a higher chance that a crown will be needed if the hole made by a cavity is large. Even after a filling is put in a large cavity, a tooth is more likely to break. Keep in mind that the jaw muscles are the strongest in the human body, and teeth must withstand tremendous pressures. Crowns ride over the weakened tooth, providing strength and protecting the tooth against breakage. A broken or cracked tooth is a severe matter and much more challenging to treat. Crowns prevent this, as well as making for a beautiful smile.

It takes two appointments to restore a tooth with a crown. Decay is removed from the tooth, and then the tooth is shaped to receive the crown. An impression is then taken of the tooth for use in fabricating a crown. Between the two visits, a crown is made from various materials like Zirconia (a ceramic with metal-like properties), Lithium Disilicate (A ceramic material), or Gold. During this time, a temporary crown is worn. In the second visit, the temporary crown is removed. The permanent crown is adjusted as needed and then cemented in place.

Bridges

Bridges are an option for filling the space created by a missing tooth. To look like the missing tooth bridges are formed, and it takes its place in the mouth. The sides of a bridge use the two surrounding teeth for support, hence the name. A bridge replaces the missing tooth, both functionally and cosmetically. Bridgework is as much an art as it is an exact science. The materials used may be gold alloys, porcelain bonded to metal alloy, or all ceramic material. The choice of material depends on requirements for strength, wear, and esthetics.

A missing tooth must be replaced as soon as possible for several reasons. If not treated, the teeth surrounding the gap begin to shift inward, creating a whole chain reaction of bad things. Teeth use their neighbors for support, and, with one missing, they start to “fall.” A missing tooth worsens the bite changes in response to the pressure. Missing teeth can eventually result in problems with the entire jaw, e.g., temporomandibular joint. The surrounding teeth deteriorate, and it is just a matter of time before they are lost. Gum disease becomes a serious problem, with the difficulty of treatment increasing as the neglect continues.

Dentures

There are different types of dentures, but they share a standard function. They replace teeth that have become loose or due to bone loss have fallen out. When bone loss around the roots of teeth is significant enough to loosen or let them fall out, it’s time for dentures. Relax. No one enjoys losing their natural teeth, but you can still regain the ability to speak and eat at a satisfactory level. It is important to remember that dentures are not a replacement for natural teeth; they are just a replacement for missing or broken teeth. Nothing will ever be the same as the original, natural tooth.

An examination of the mouth must be performed to determine which teeth are to be removed. After loose teeth are extracted, dentures get fitted to go over or around the mouth’s remaining teeth. There is an adjustment period after getting the dentures, and it can take some awhile to get used to this. But once accustomed to the dentures, they can be very comfortable. Often implants can be used to stabilize the dentures further.

Implants

Implants also can be used as support as part of an implant bridge. Implants are an alternative to partial dentures and have several advantages. One advantage of this is not having an adjustment period to acclimatize the patient who only feels teeth; not metal supports intruding into the mouth. This procedure also slows the bone loss that would happen when you have missing teeth. Another advantage is no discomfort or difficulty in eating. Best of all, of course, they don’t have to be taken out all the time.

Root Canals

Root canal treatment (also referred to as root canal therapy or endodontic therapy) is necessary when a cavity reaches the tooth’s inner pulp (nerve and blood supply). Sometimes deep restorations or trauma to a tooth may also cause nerve damage to the point it needs root canal therapy. Once this occurs, the pulp becomes infected and can even extend through the root tip and begin to eat away at the surrounding bone (this is an abscess). By the time the pulp is infected, it must be treated, and cannot heal independently. It can even weaken the entire immune system. The infected pulp is dangerous, not to mention very painful. Symptoms that the pulp has become infected may include sensitivity to hot/cold or sweets, pain, swelling, pain to biting or pressure, and a bad taste in the mouth. Sometimes, no symptoms are apparent, and the person is unaware of any problem until a checkup.

A root canal will be performed to clean out the infected tooth pulp and disinfect the tooth’s canals. The only other treatment would be to extract the tooth. A filling is put in the canal(s) to resolve the infection and prevent any further infection. For restoring a tooth with root canal therapy, usually, a core build-up and crown are used.

Temporomadibular Joint (TMJ) Treatments

Misalignment of the teeth, trauma, or excess muscle tension creates problems in this joint. Aside from the two bones that meet there, cartilage buffers them, and five muscles are involved in the area. If something goes wrong, a good deal of trouble can result.

Problems in this area can cause:

  • Headaches
  • Earaches
  • Trouble/soreness in opening and closing the mouth
  • Clicking or popping of the jaw
  • Pain in the jaw muscles
  • Soreness in the area, sometimes extending to the face

Dental treatments for the condition can include replacing missing teeth, moving teeth, adjusting the bite, filling gaps between teeth, etc. No one solution is right for all cases. Sometimes a plastic mouthpiece is used to prevent clenching or grinding that is contributing to the problem. If untreated and taken to extremes, surgery may be required to repair a badly damaged joint.