Dental Tips Blog


Is a Crown or a Filling the Best Option For You?

Posted in Fillings

Crowns and fillings are both types of dental restorations that can be used to repair a tooth that has been chipped or damaged by decay.  Typically, small restorations call for a filling and a crown is placed when so much of the tooth has been removed that it would not be structurally sound with just a filling in it.

In some cases, the damage falls in the middle of these two alternatives and your dentist will give you the option of whether to restore the tooth with a dental filling or to place a crown.  A filling will be far less expensive and can be completed in a single visit, but a crown has some significant advantages that should be considered before making a decision.

The main advantage of a crown is that the result will be a much stronger tooth that should last a long time.  A filling is placed within the walls of the tooth and relies on the tooth for strength and support.  If the tooth has been removed, the walls will be thin and there is a significant likelihood that the tooth wall will eventually crack.  If the filling occupies an entire corner of the tooth, there is less tooth material for the filling to adhere to.

A crown is like a cup placed over the top of the tooth.  Unlike a filling, a crown if made in a dental lab outside the mouth and is made of more durable material than a filling.  In addition, a crown has more tooth area to adhere to than a large filling and is less likely to come off.

If given the option between a crown and a filling, you will need to weight the risk that the filling will cause the tooth to crack, further damaging the tooth and requiring additional dental work against the cost of a crown.  If you go with the large filling and the tooth cracks, you will end up paying significantly more than going forward with the crown in the first place.


Comparing Porcelain Veneers With Lumineers

Porcelain veneers are a cosmetic dental procedure that are an excellent option for many patients who want to improve the look of their smiles.  Porcelain veneers are thin porcelain shells that are bonded to the front of the patients’ teeth.

They have the look and feel of natural tooth material and can be used to hide discolorations and imperfections in the patient’s teeth.  They can also be used to fill small gaps and to create the appearance of a straighter, more even smile without using braces in patients with moderately crooked teeth.

Porcelain veneers are similar to Lumineers which are similar, but not quite the same.  When porcelain veneers are placed, the surface of the patient’s teeth is shapes and a small amount of the enamel is removed where the porcelain veneer is to be placed.  This allows the tooth to retain the normal size and appearance.  Otherwise, the thickness of the veneer would make the tooth appear bulky.

The downside to this procedure is that it is not reversible.  Since some of the tooth’s natural protective material is removed during the process, the veneers cannot later be removed.

Lumineer are thinner than porcelain veneers and are bonded in place without shaping the patient’s teeth.  The advantage is that the process is less invasive and is reversible.  It requires less time in the dental chair and little if any drilling.

However, porcelain is naturally translucent and since Lumineers are so thin, they may allow too much of the patient’s natural tooth color to show through.  In addition, since Lumineers are placed directly on top of the patient’s natural teeth, they can result in a smile that appears bulky or “toothy.”

Lumineers and porcelain veneers each have advantages and disadvantages.  Your dentist can help you decide which one is right for you.


Recognizing Gingivitis

Gingivitis is type of gum disease that causes swelling and inflammation of the gums.  It is usually very mild and is easily treatable, but if left untreated it can cause serious oral health problems.  If you see signs of gingivitis, it is important to see your dentist right away and get it taken care of before it progresses into more serious gum disease.

Gingivitis is characterized by red, swollen gums that bleed when you brush your teeth.  As the disease progresses, the gums will become tender or sore and the inflammation will increase.  This stage of the disease is often accompanied by bad breath and an unpleasant taste in the mouth.  If left untreated, the patient’s gums will begin to discharge pus, their teeth will loosen and fall out, and the swelling and pain will continue to intensify.

Gingivitis is caused by poor oral hygiene that leads to the buildup of plaque.  Plaque is full of bacteria that attack the gums.  Proper brushing and flossing habits remove plaque and can prevent gingivitis from forming.  In addition, you should see your dentist at least once a year for cleaning and examination.  Smoking, substance abuse, weakened immune systems, and diabetes have all been linked to an increased risk of gingivitis.  If you fall into any of these categories, you should schedule a dental cleaning and examination more frequently.

Treatment consists of a thorough dental cleaning followed by rinsing with an antiseptic mouthwash.  In more severe cases, your dentist may prescribe antibiotics to help fight the infection.  Gingivitis usually resolves after a cleaning with no further complications as long as the patient follows good oral hygiene habits.


Is Teeth Whitening Right For You?

Teeth whitening is a popular cosmetic dental procedure for patients seeking  a brighter, whiter smile.  There are various types of teeth whitening products on the market including over the counter products such as whitening gels, strips, and trays and also whitening products applied or prescribed by a dentist.

Most patients are good candidates for teeth whitening, but there are a few patients who should consult with their dentist before using these products.  There may be more suitable alternatives available for these patients.

Teeth whitening products use peroxide based agents to achieve the desired whitening effect.  Over the counter products have a lower concentration of whitening agent and accordingly they are less effective and take longer than professionally applied or dispensed products.

Anyone who has an allergic reaction to peroxide should not use these products.  Also, a common side effect is increased tooth sensitivity.  If you have sensitive teeth, using a whitening product can aggravate the sensitivity. Talk to your dentist before using these products.

The whitening agent in these products is only effective on dental enamel.  It will not change the color of tooth colored fillings, crowns, and other dental restorations.  Using a whitening agent on teeth with these types of restorations will result in uneven whitening.  The natural teeth will be whiter than the restorations.  Replacing the restorations may be an option or you could choose use veneers or bonding to achieve the same effect.  Your cosmetic dentist can help you decide which option would work best for you.

Yellowish teeth respond best to the teeth bleaching process.  Dark brown stains don’t respond as well and teeth stained gray by tetracycline will take much longer to respond to the treatment.  It is important to have realistic expectations to avoid being disappointed by the results.


Is Teeth Whitening Effective?

In the past decade, teeth whitening (also called teeth bleaching) has become a very popular cosmetic dental treatment.  Teeth whitening treatments fall into three categories:  treatment professionally applied in a dental office, treatments prescribed and dispensed by a dentist for patient home use, and over the counter bleaching trays.

The effectiveness of each of these varies and they all have the same possible side effects.  Gum tissue irritation is a possibility with all three types of treatment and some patients experience tooth sensitivity that usually goes away as soon as the treatment is ended.

The most effective whitening treatment is a professionally applied treatment.  This treatment is done in a dentist’s office using stronger bleaching agents which may be accelerated by using ultraviolet light.  Results are immediate and the patient’s teeth will be several shades lighter after a single treatment.   Gum irritation is minimized by protecting the gums with a rubber dam or by applying a protective gel.

Treatments prescribed and dispensed by a dentist are the next most effective treatment.  These treatments use customized bleaching trays that do a better job of keeping the bleaching agent against the patient’s teeth and can have bleaching agents that are stronger than those available over the counter.  In addition, because the trays are custom fitted for each patient, irritation of gum tissue is usually less of an issue.  Four to six treatments are usually needed to achieve several shades of whitening.

Over the counter bleaching products are least effective, but also the least expensive option.  These products can achieve noticeable results, but take somewhat longer than products prescribed by a dentist due to lower concentrations of bleaching agents.  In addition, since the bleaching trays are designed to fit any patient, gum irritation is more likely to be an issue.


All Porcelain Crowns

Posted in Crowns

Older porcelain crowns often chip or wear, leaving the fused metal base exposed. The area of the crown near the gumlines often leaves an exposed metal line along the tooth as well. This can appear dark and grey, leaving the patient self conscious of how their smile appears.

There is a way to avoid metal showing when you smile. All-porcelain crowns are a type of dental restoration that does not use any metal base for its fabrication. The entire crown is made of tooth-colored material so that no matter where it is placed in the mouth, you will not have to worry about metal showing. This is beneficial for patients who grind their teeth, or need to have their bites adjusted.

All-porcelain crowns also appear more natural in color than traditional crowns. Because teeth are actually more than one shade, porcelain crowns can use two or even three shades throughout the tooth to make it a better match.

Crowns are essential in treating teeth with large, older, broken restorations or large areas of decay. When a tooth has broken down so much, then thin outer shell of enamel is not enough to support a filling. Instead, crowns cover the entire surface of the tooth allowing it to hold up to normal uses like chewing. This distributes the pressure equally over the tooth and allows it to last years to come.

Some people also find that they are sensitive to certain metals. Tissue irritation and bleeding may occur. Because all porcelain crowns contain no metal, they are a wonderful option for these patients.

If you are in need of a crown, or have metal crowns and are thinking of having them replaced, consider all porcelain crowns. They function just as efficiently as other crowns but are much more aesthetically pleasing and easier on the delicate gum tissues.


Root Canal Therapy

Posted in Root Canals

Most people wonder why root canals are really necessary. After all, they have a reputation for being lengthy and uncomfortable. However, the truth is that they are just like having any other filling procedure done. Local anesthetic (or sedation if you like) is used to numb the area so that patients have little to no discomfort during their treatment. Depending on what tooth is being treated and how many roots it has, the procedure can be shorter or longer than others.

When it comes to repairing and saving teeth, root canal therapy is the last step in salvaging a tooth before it progresses so far that it needs to be extracted. As decay or bacteria spread through the dense enamel, sometimes it exposes the inner nerve canal of the tooth to the infection. When this happens it is necessary to remove the infected nerve tissue and place a filling material inside of the canal. Just treating the cavity alone is not enough, as it would block a bacterial infection inside of the nerve tissue. When the bacteria have nowhere to exit, it forms an abscess out of the tip of the tooth root.

Root canals are used to treat abscessed, broken, fractured and decayed teeth. A variety of different filling materials may be used to fill the infected canal, and then a crown is placed on top. A crown is necessary because the tooth is no longer living and may become more brittle after the pulp chamber has been accessed for treatment. This allows the tooth to stand up to normal forces during chewing.


Hospital Sleep Dentistry

Are you afraid of the dentist or having dental work? If so, if you’re like other people with dental anxiety you may put off dental care until your needs are so extensive that you can’t put it off any longer.

You should know that you don’t have to let dental anxiety keep you from the dental office any longer. Specially trained dentists offer sedation and sleep dentistry options so that every patient can be relaxed throughout their entire visit.

Sedation dentistry uses three different types of sedation:

Nitrous Oxide – also called “laughing gas”, nitrous is delivered through a nosepiece that the patient breathes from during the appointment. The nitrous gases are also mixed with oxygen and help the patient into a very relaxed state. The patient is still fully aware of their surroundings and can interact with care providers.

Oral medication – taken about an hour before the appointment, oral sedation medications create a light sleep in the patient. The patient still responds to the dental care team asking questions, for example, to turn their head or open their mouth. They are fairly easy to arouse, as if taking a light nap.

Intravenous medication – delivered through an IV, this method of sedation puts patients into a deeper sleep than other types of dental sedation treatments. The patient is unaware of what is being completed during the appointment until the sedation medications have been cut off.  Dental care under fully unconscious sedation is usually completed in a hospital setting using a specially equipped surgical suite.

In all hospital sleep dentistry appointments that require treatment (i.e. fillings, root canals, crowns), local anesthetic is used. This numbs the nerves in the area where the treatment will be completed and allows patients to wake up without any pain.

All hospital sleep dentistry patients have their heart rates, blood pressure and pulsoximetry levels monitored throughout the appointment. For patients using oral or IV sedation, they will need to be accompanied by another adult friend or family member to transport them during the day of their appointment.


Porcelain Veneers

One of the most publicized cosmetic dental procedures available today is that of porcelain veneers. Dental veneers allow smiles to be completely made over like the Hollywood movie stars that you see on television. There is no need for other treatments like braces or crowns. The veneer actually creates the appearance of whiter, straighter teeth.

Placed on the front surface of the tooth similar to an artificial nail, the shape and shade of the veneer transforms the entire appearance of the tooth. Normally several veneers are used in order to improve the overall smile, but single veneers may be used when there is just one tooth that may need cosmetic improvement. An example may be a rotated or discolored tooth.

Veneers often require little to no tooth preparation for them to be placed. Other types of treatment like crowns require tremendous amounts of tooth preparation. Porcelain veneers are minimally invasive so that if one were to ever come off there would not be a noticeable change in the tooth below it.

There is no need to whiten when you have veneers, because the all porcelain material holds the same shade for the entire life of the veneer. While it can gather some surface stain, your hygienist or dentist can easily polish this off.  Also, there is no metal base used in a veneer so that means there is no risk of a thin silver line around the gumline as is sometimes seen with certain types of crowns.

Not everyone is a candidate for veneers. If you have been thinking of a smile makeover but don’t want to endure lengthy orthodontic work, contact your dentist for a consultation about how dental veneers can change your smile completely.


Help For Dental Anxiety and Dental Phobia

Very few people actually look forward to a visit to the dentist (except maybe to get those braces off).  In fact, the percentage of American adults who experience some anxiety or fear of the dentist has been estimated as high as 75%.  Most dental patients are able to deal with their anxiety and tolerate dental most procedures with local numbing agents in relative comfort.

Some patients have a stronger reaction to dental care and are uncomfortable throughout the procedure.  Not only does the patient suffer, but the procedure will be more difficult when the patient is noticeably uncomfortable.

Finally there are patients that who are so adverse to dental care that they avoid it at all costs.  These patients are said to have dental phobia.  By avoiding dental care, these patients end up exactly where they don’t want to be – in the dentist’s chair.  Because they have been avoiding dental care for so long, their oral health is poor and they are prone to needing extensive dental care which is what they were avoiding in the first place.

Fortunately, there is relief available for all types of patients.  Most dentists offer mild sedation in the form of nitrous oxide or “laughing gas.”  For patients with mild anxiety, nitrous oxide will put them in a relaxed state similar to being intoxicated.

Patients with a stronger aversion to dentistry may need to seek out a dentist with additional training in conscious sedation techniques.  This usually involves oral sedatives that are stronger than nitrous oxide, but the patient is still conscious.

Finally, patients with severe dental anxiety or dental phobia should consult with a dentist specially trained in sleep sedation dentistry.  These dentists have extensive training in conscious sedation using intravenous sedatives and fully unconscious sedation.

No matter what level of dental anxiety or dental fear you have, there are dentists specially trained in various sedation options who can help you get the dental care you need.

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