Restore Your Smile

You are missing teeth, you cover your mouth when you smile, and you keep your lips pursed together when you laugh. Your face looks somewhat squashed (lip and nose distance are shorter than they were when you had teeth), people think you are quiet or reserved, you have a hard time eating all the foods you want to, and it may be difficult for you to make new friends.

Your smile is a window into your being - it is what people first see - and judgments are made if your smile is less than it should be.

The following are treatment options to create that new you:

Crowns

The professional term what a patient calls "caps." These are restorations that are made of:

1. Porcelain/ceramics
2. Porcelain/gold
3. Gold

They are used:

1. To restore a broken tooth
2. To restore a tooth to proper function when the tooth is worn
3. To rebuild and strengthen the tooth when there is more filling in the tooth than healthy tooth structure
4. To restore chipped and cosmetically needy teeth when veneers are not appropriate
5. After root canal treatment to protect a tooth from breaking
6. For patients who have cracked tooth syndrome
7. When the tooth has a very large cavity (infection) and not much tooth is left after removing this infection
8. To alter a collapsed facial structure when a person has worn down their teeth through grinding/bruxism

Fixed bridges

These are crowns linked together to:

1. Span a space of missing teeth
2. Stabilize teeth that have less bone around them due to dental diseases
3. Restore many broken down teeth in an area
4. To close off an area to prevent food getting stuck in between teeth
5. To prevent teeth from shifting/moving
6. To alter a collapsed face by building up the bite

Fillings

Restoring your smile: Dental Filling Choices

The standard while I was growing up was the "amalgam" filling. This material is made of liquid elemental mercury (approximately 48%) and silver shavings (approximately 49%), with the rest being copper, tin, and zinc. The major problem with these materials is the following:

1. Weakens the tooth. The tooth preparation has to be like a trapezoid. Therefore, what you see in your mouth is really 2/3 of the real filling width. Since it goes in like a paste and hardens over 24 hours, we have to create a mechanical undercut so they will not fall out. It provides no strength for the tooth.
2. It does not bond to the tooth. So, it does not hold the tooth together.
3. I am still busy from patients breaking their teeth due to these materials. All these fillings will fail at a certain point (nothing lasts for ever) and patients usually need crowns and/or root canal treatment. In some cases, extraction is the only procedure available.

Today the main choice of fillings are:

1. Composite: a tooth colored silica/resin matrix that bonds to the tooth chemical and mechanically on the micron scale. We use a light to photo cure them in seconds. They are best when small and do not take much mechanical stress from chewing.
2. Cerec: this is a cad/cam ceramic/porcelain material.
1. CAD = computer aided design
2. CAM = computer aided manufacturing
3. Ceramic/porcelain--made in a vacuum oven, high strength, no porosities in the material, very dense. The finest material for fillings in the world:
   1. Has a wear factor closer to real enamel than any other material
   2. Bonded in-supports and strengthens the tooth
   3. Just take away the bad part of the tooth and place the material after it comes out of the manufacturing unit we have in our office
   4. Will outlast any other filling material by a factor of 2 to 4 or more.
   5. Tooth colored to blend into your tooth

What is right for me?

Several factors influence the performance, durability, longevity, and strength of dental restorations. However, the longest lasting, most durable material in the world is Cerec.

Implants

These have been personally used by me for over 20 years. They have a wonderful track record for over 30 years and would be my first choice for a missing tooth under the correct conditions. They are made out of medical grade titanium and replace the root you are missing.

Many patients wish to know how implant restorations feel. They feel like "teeth" and are taken care of the same way. This now becomes your third set--remember nature gave you two!

Who is a candidate?

1. Anyone with one missing tooth.
2. Anyone with a mouth full of missing teeth--these patients have to wear complete dentures. These are crippling treatments for those who want to enjoy crunchy vegetables and avoid facial collapse.
3. Anyone with some missing teeth in an area--those that want to avoid the use of a partial denture.

We provide implant care for the following reasons:

1. It is a health issue. The full denture moves around when we eat. We are concerned about mouth sores and continued bone loss of the jaws (no implants/teeth and jaw continues to wear away).
2. It is a cosmetic issue. Real teeth look better than having plastic in our mouths.
3. It is conservative. Why drill away healthy tooth structure to place a bridge?
4. It is a comfort and food issue. Food gets stuck under plastic partial dentures/full dentures. The partial denture damages the teeth they are attached to.

We have placed implants on 18 to 84-year-olds.