General dentistry covers a broad range of dental services, and at Broadway Dental we are proud to offer many of these services to our patients. Restorations, Sealants, Root Canals, and Mercury Free Fillings are just a few of the general dentistry services that we provide. Your oral health is very important to us. Find more information about our many general dentistry services in the links below.
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The goal of restorative dentistry is to return destroyed or lost tooth structure to full form and function. If you have a filling, crown, or dental implant, you have already benefited from restorative dentistry.
Today’s dentists have superb ways of repairing decayed teeth. Besides traditional silver amalgam or gold alloy fillings, composite resins and dental ceramics have come on the scene that are as durable as they are beautiful. These materials can be used to create tooth restorations that are virtually indistinguishable from natural teeth.
Here are some of the restorative procedures we provide to help you achieve the strongest and best-looking teeth possible:
Fillings do just what the name implies — seal a small hole in your tooth, i.e., a cavity, caused by decay. This prevents the decay (a bacteria-induced infection) from spreading further into your tooth and entering the sensitive inner root canal — a condition that requires root canal treatment.
To fill a tooth, we first clinically examine it and review x-rays to determine the extent of the decay. Then we remove the decayed area of the tooth, usually with a dental drill or another handheld instrument. Your tooth will be anesthetized first, so you won’t feel anything. If numbing injections normally provoke anxiety for you, please let us know; we can discuss medication that can help with this. After we remove the decay, all debris is cleaned from the tooth, and then the filling material is applied.
Fillings can be divided into two broad categories: metal and tooth-colored.
- Amalgam — The classic “silver” filling in use for more than a century, dental amalgam is actually an alloy made up of mercury, silver, tin, and copper. The mercury combines with the other metals in the amalgam to make it stable and safe.
- Cast Gold — Among the most expensive restorative dental materials, cast gold combines gold with other metals (but no mercury) for a very strong, long-lasting filling.
- Composite — A popular choice for those who don’t want their fillings to show, composites are a mixture of plastic and glass, which actually becomes bonded to the rest of the tooth.
- Porcelain — These high-tech dental ceramics are strong, lifelike, and don’t stain as composites can.
Inlays & Onlays
When the damage done to a tooth by decay is too extensive to be treated with a simple filling, yet not significant enough to need a full-coverage crown, the best solution may be an inlay or onlay. These fillings are fabricated outside the mouth (usually by a dental laboratory) and then bonded to the tooth by the dentist. It is considered an “inlay” when the filling fits within the little points or “cusps” of a back (premolar or molar) tooth. It is an “onlay” if it covers one or more of these cusps.
In order to receive an inlay or onlay, the tooth and surrounding area must be numbed with a local anesthetic and the decay removed. We then take an impression of the tooth, either digitally or with a putty-like material, and send it to the dental laboratory, where the inlay or onlay will be made. We will attach a temporary filling to your tooth to protect it until the permanent restoration is ready. At your next visit, the permanent inlay/onlay will be attached to your tooth with either a resin that hardens under a special curing light, or a type of permanent cement. Inlays and onlays are strong, long-lasting, and require no greater level of care than any other tooth.
If you could have fillings that matched the natural color of your teeth so well that nobody could tell the difference — and wouldn’t contain any mercury — would you choose them over silver fillings?
We thought so! Both scientific studies and clinical experience have shown that tooth-colored restorations (fillings) are safe, reliable and long-lasting. Plus, they look great.
Not only do tooth-colored fillings offer an aesthetic alternative to “silver” (mercury-containing) fillings that’s hard to match — they may also allow for a more conservative treatment method that preserves more of the tooth’s structure. When you put these advantages together, it’s no wonder some dentists say we’re moving past the silver-filling era.
Tooth-colored fillings are made of a blend, or “composite,” of plastic resins and silica fillers. These substances mimic many of the qualities of natural tooth structure, such as wear-resistance and translucency. Dental composites also help strengthen teeth.
Based on looks alone, it’s easy to see why you’d want a tooth-colored restoration in the front of your mouth. But to understand some of the other advantages composite resins offer — even for back teeth — let’s look a little closer at the tooth restoration process.
The Process of Filling a Tooth
There are many reasons why a tooth may need to be filled or restored: decay and chipping are two common ones. No matter which material is chosen, the procedure is almost the same. After the area has been anesthetized (usually by a numbing injection), the tooth is “prepared” by removing decay and making it ready for the restoration. Next, the filling material is placed directly into the tooth. Once it has securely bonded to the tooth structure, the process is essentially complete.
Now, here’s the difference: In order to achieve a good structural bond with a traditional silver filling, it is often necessary to shape the tooth by making a series of “undercuts” that help hold the material in place. This means that some healthy tooth material must be removed, leaving less of the tooth’s structure intact. In time, the structurally-weakened tooth can be prone to cracking.
But composite resin fillings don’t require undercutting to make a strong union — instead, they form an intimate physical and mechanical bond directly to the prepared tooth. This more conservative treatment may ultimately lead to a better and longer-lasting restoration.
When Can Tooth-Colored Fillings Be Used?
Composite resins are generally appropriate for small to moderate-sized restorations — which encompass the most common types of fillings. They are durable, fracture-resistant, and able to withstand chewing pressure. Depending on how much of the tooth needs restoration, the procedure may be accomplished in just one visit. Alternatively, if a large volume of tooth material must be replaced, a part may be fabricated outside the mouth and later bonded to the tooth.
Whatever the situation, the best way to determine whether tooth-colored fillings are right for you is to come in and consult with us. We can explain the appropriate options and help you select the best way to proceed with treatment. Working together, we can help you achieve — and keep — a healthy-looking smile.
Full or partial tooth loss, if left untreated, doesn’t just affect a person’s self-image — it can also increase the risk of developing nutritional problems and other systemic health disorders. Fortunately, there’s a reliable and time-tested method for treating this condition: full or partial dentures.
Dentures are just one option for replacing missing teeth; some of the others include fixed bridgework and dental implants. Each method has its particular pluses and minuses, which should be carefully considered. There are also several varieties of dentures available to address specific issues, from partial dentures to implant-supported overdentures. During a consultation, we can explain the available options and help determine which is best in your individual situation.
How Do Removable Dentures Work?
Full or partial dentures consist of a gum-colored base made of plastic resin, which fits over the remaining alveolar (bone) ridge that formerly held the teeth. The prosthetic teeth projecting from the base are designed to look and function just like your natural teeth. Dentures are held in place primarily by the suctioning effect of their close fit against the alveolar ridges — that’s why it’s so important that they are fitted properly. The upper denture also gets extra support from the large surface area of the roof of the mouth (palate), which generally makes it extremely stable.
At first, wearing dentures may require some getting used to in terms of talking and eating, as the dentures become “balanced” in the space formerly occupied by the teeth. But over time, the muscles, nerves and ligaments of the mouth learn to work in new ways, which allows these functions to occur normally. Dentures also help support the facial skeleton and the soft tissues of the lips and cheeks, which can help create a more youthful appearance.
Types of Full Dentures
These are usually a temporary means of helping you transition to successful denture wearing. Because of the muscular readjustment required, as well as the natural shrinkage of gums, the dentures which are placed immediately after tooth extraction won’t fit as well as permanent dentures made when the healing is complete. They do, however, provide you with new teeth right away, and give you time to adjust.
Conventional Full Dentures:
After a period of time, we can fabricate permanent dentures that conform to your mouth with near-perfect accuracy. These are carefully crafted to look as much like your own natural teeth as possible, and are able to function properly in your mouth for a long time.
To increase the stability of a lower or upper denture, it’s possible for it to be securely anchored using two or more dental implants. The upper jaw requires more implants (generally three or more) than the lower jaw due to a lesser bone density. Many people find this option offers a great balance of comfort, functionality and value.
Types of Partial Dentures
Transitional Partial Dentures:
These relatively inexpensive removable plastic dentures serve as a temporary tooth replacement and space maintainer as you wait for your mouth to heal from tooth extraction, for example. Once the healing process is complete, dental implants can be placed.
Removable Partial Dentures (RPDs):
Usually made of cast vitallium, these well-constructed, metal-based removable partial dentures are much lighter and less obtrusive than those made of plastic. They are a little more expensive than plastic dentures but will fit better. They are, however, much less expensive than implants or fixed bridgework.
As dentists, our main goal is to preserve your natural teeth and keep them healthy for as long as possible. There are times, however, when it is in your best interest (or your child’s) to have a tooth extracted (removed). This could be the case for a variety of reasons. Perhaps you have a tooth that has been severely damaged by trauma or decay; or an impacted wisdom tooth that may cause trouble for you later on. Maybe your teenager will soon undergo orthodontic treatment and has insignificant space for his adult teeth, referred to as crowding. Or your younger child has a baby tooth that’s stubbornly adhering, even though it’s past time for it to go.
Whatever the reason, tooth extraction is more often than not a very routine procedure. How straightforward this minor surgery is will depend on where the tooth to be extracted is located in the mouth, and what its roots are like. For example, a front tooth with a single straight root is easier to remove than a molar with multiple roots. This is especially true when that molar is a wisdom tooth that is impacted, meaning it is below the surface surrounded by gum tissue and bone. Often, a wisdom tooth is blocked from fully erupting (growing in) by other teeth in its path.
Still, tooth extraction is nothing to be feared when done by an experienced hand. Keep in mind that a tooth is not rigidly fixed in its surrounding bone, though that’s how some may picture it. In fact, it is attached to the bone via a network of fibers that form what’s known as the periodontal ligament. By carefully manipulating the tooth, we can dislodge these fibers and free the tooth without much trouble.
Reasons for Extracting a Tooth
As mentioned above, there can be a variety of reasons for extracting a tooth. We are always happy to discuss the pros and cons of any dental treatment with you, including extraction.
Trauma or Disease
— In both of these situations, we can try to save the tooth in several ways. The damaged tooth might need a full-coverage crown, a root canal treatment, or both. But sometimes even these methods are not enough to keep the tooth functioning well and looking good; it might be better to remove the tooth and replace it with a strong and lifelike dental implant.
— Teeth are sometimes extracted when there are too many of them for the size of the dental arches (jaws), a situation known as crowding. After an adequate amount of space is opened up through the extraction of one or more teeth, the remaining teeth can be aligned properly. The teeth most frequently removed for orthodontic reasons are the first premolars, which are right next to the eyeteeth (canines).
Impacted Wisdom Teeth
— Early removal of impacted wisdom teeth can prevent damage to neighboring healthy teeth, bone, gum tissue, even nerves and blood vessels. If an impacted wisdom tooth is in a bad position, it’s best to remove it before its roots are fully formed.
— If a baby tooth is out of position or not lost in the right sequence, the permanent tooth underneath it might not erupt normally. In this case, removing the baby tooth could prevent a need for orthodontic treatment later on.
The Process of Extracting a Tooth
The first step in any extraction is a radiographic (x-ray) examination to assess the position of the tooth roots and the condition of the surrounding bone. This will allow any possible complications to be anticipated. We take a thorough medical and drug history to ensure that you are healthy enough to undergo the procedure. We will also discuss the options for anesthesia. Tooth extraction is usually carried out with local anesthesia, which will numb the teeth to be removed, and the surrounding bone and gum tissues. Additional sedatives might also be used, including oral sedatives (taken in pill form), nitrous oxide (which is inhaled) and/or conscious sedation, which is given intravenously (into a vein). The latter is usually required for more complicated (or multiple) tooth extractions. By the time the sedation medication has worn off, you won’t even be aware that the surgery was done.
As we remove your tooth, we’ll be very careful not to damage the bone that surrounds it. Sometimes, in the process of removing a tooth, we might want to put a small amount of lab-processed bone-grafting material into the socket to help preserve the bone volume there. This is particularly important when the extraction is going to be followed at some point by the placement of a dental implant, which needs to fuse to existing bone, or orthodontics, which gently moves teeth through bone.
What to Expect After Tooth Extraction
Immediately after your tooth is extracted, the socket will be covered with sterile gauze to apply gentle pressure for 10-20 minutes to control any bleeding. Small sutures (stitches) might also be used for this purpose. It’s normal to experience some mild to moderate post-operative discomfort and/or swelling. Taking non-steroidal, anti-inflammatory drugs such as ibuprofen and/or aspirin the day of surgery should control most symptoms. We may also prescribe antibiotics for you to ensure infection-free healing. Using ice packs on the outside of your jaw, and eating softer foods until you feel more comfortable can also be helpful. Within a few days, all should be back to normal.
Root canal treatment — also called endodontics (“endo” – inside, “dont” – tooth) — is a set of specialized procedures designed to treat problems of the soft pulp (nerve) tissue inside the tooth. While some mistakenly think of it as an unusually painful treatment, in most cases the procedure is no more uncomfortable than getting a filling. It’s actually one of the most effective ways of relieving some kinds of tooth pain.
A root canal procedure becomes necessary when infection or inflammation develops in the pulp tissue of the tooth. Pulp tissue consists of blood vessels, connective tissue and nerve cells — which explains why a problem here may cause you to feel intense pain. In time, the pain may go away… at least temporarily. Without treatment, however, the infection won’t. It can lead to a dental abscess, and may even contribute to systemic problems in other parts of the body.
Root Canal Treatment Is Your Friend
We’ve all heard the gag: “I’d rather have a root canal…” This comedy line, comparing the procedure to something truly undesirable, may be funny — but putting off needed endodontic treatment is no joke. The idea that a root canal procedure invariably comes with complications and pain is a shopworn myth. It’s certainly true that infection or inflammation in the tooth’s pulp can be excruciatingly painful. But you should remember that having a root canal results in eliminating this acute pain and is not the cause of the pain.
Need another reason not to delay root canal treatment? How about this: A natural tooth that’s saved via root canal treatment and restoration helps you avoid the problems that commonly occur when teeth must be removed. These include unwanted tooth migration or shifting, which can lead to difficulties in chewing; the need for bridgework or dental implants, which may be costly and complicated; and even the eventual loss of bone structure from the area of the missing tooth.
Causes of Root Canal Problems
Root canal problems stem from infection and inflammation of the tooth’s pulp tissue. One potential cause of infection is deep tooth decay. Untreated dental cavities eventually allow bacteria to work their way down to the center of the tooth, where they may infect the pulp tissue. Another path by which bacteria may come into contact with pulp is via chipped or cracked teeth. Any opening in the protective enamel coating has the potential to allow bacteria access to the tooth’s pulp.
Trauma to the tooth — the kind that might result from a sports injury or automobile accident, for example — is also a major cause of pulp tissue damage. In this case, it’s essential to seek treatment immediately, both to try and save the tooth, and to prevent future problems.
In some cases, extensive dental work itself may cause damage to the pulp tissue that will need to be treated via a root canal. Having multiple fillings or restorations on the same tooth increases the chances of this type of injury. Occasionally, common procedures like crown preparation or orthodontics may eventually lead to root canal problems.
What to Expect During Root Canal Therapy
If an examination shows that you do need root canal therapy, don’t worry — it’s one of the most routine and effective procedures in the arsenal of dental treatments and can often be accomplished in just one visit.
The root canal process generally begins the same way as a filling does, and with no greater discomfort: an anesthetic is administered to numb the tooth and the surrounding area. For many patients, the worst is already over.
Next, a small opening is made in the surface of the affected tooth to give access to the pulp chamber and root canals. Tiny instruments are used, sometimes with the aid of a microscope, to remove the dead and dying pulp tissue from inside these narrow passageways. The chamber and empty canals are then cleaned, disinfected, and prepared to receive a filling of inert, biocompatible material. Finally, adhesive cement is used to seal the opening in the tooth, preventing future infection.
Following root canal treatment, your tooth may feel some sensitivity or tenderness for a few days. Over-the-counter pain relievers like ibuprofen are generally effective in relieving discomfort, but prescription medications may also be given if needed. During this period, it may help to avoid biting hard on the affected tooth. All of these symptoms, however, should be temporary.
To further protect the tooth and restore it to full function, it’s usually necessary to have a crown or other restoration placed on it. Restorations can take many forms, from traditional gold crowns to tooth replicas made of high-tech tooth-colored material. In any case, you will have made an investment in preserving your dental health for years to come.
Signs and Symptoms of Root Canal Problems
How do you know when you need a root canal? Sometimes, it’s painfully obvious. If you feel constant and severe pain and pressure in your mouth, or noticeable swelling and extreme sensitivity in your gums, then it’s clear you need to come in for evaluation and treatment right away. Another telltale symptom of pulp tissue damage is sharp pain when you bite down on food. Lingering pain after eating hot or cold foods is also an indication of potential trouble. If you notice any of these symptoms, please come in for an examination.