What is a Dental Implant?

A dental implant is an artificial tooth root that is surgically anchored into your jaw to hold a replacement tooth or bridge in place. The benefit of using implants is that they don't rely on neighboring teeth for support and they are permanent and stable. Implants are a good solution to tooth loss because they look and feel like natural teeth.

Implant material is made from different types of metallic and bone-like ceramic materials that are compatible with body tissue. There are different types of dental implants: the first is placed directly into the jaw bone, like natural tooth roots; the second is used when the jaw structure is limited, therefore, a custom-made metal framework fits directly on the existing bone.

How do they work?

Strategically placed, implants can now be used to support permanently cemented bridges, eliminating the need for a denture. The cost tends to be greater, but the implants and bridges more closely resemble real teeth.

Can anyone receive dental implants?

Talk with your dentist about whether you are an implant candidate. You must be in good health and have the proper bone structure and healthy gums for the implant to stay in place. People who are unable to wear dentures may also be good candidates. If you suffer from chronic problems, such as clenching or bruxism, or systemic diseases, such as diabetes, the success rate for implants decreases dramatically. Additionally, people who smoke or drink alcohol may not be good candidates.

What can I expect during this procedure?

The dentist must perform surgery to anchor the "artificial root" into or on your jaw bone. The procedure is done in the dental office with local anesthesia. The gum is then secured over the implant, which will remain covered until it fuses with the bone. The dentist then uncovers the implant and attaches an extension, or post, to the implant. With some implants, the implant and post are a single unit placed in the mouth during the initial surgery. Finally, the dentist makes an artificial tooth, or crown, that is attached to the implant post.

How long does the process take?

The process can take up to nine months to complete. Each patient heals differently, so times will vary. After the implant and posts are placed surgically, the healing process can take up to six months and the fitting of replacement teeth no more than two months. Sometimes, if a patient has good bone quality, posts can be placed and replacement teeth fitted in one appointment.

What is the success rate of implants?

The success rate for implants depends on the tooth's purpose and location in the mouth, as well as a patient's overall health.

How do I care for implants?

Poor oral hygiene is a big reason why some implants fail. It is important to floss and brush around the fixtures at least twice a day. Your dentist will give you specific instructions on how to care for your new implants. Additional cleanings of up to four times per year may be necessary to ensure that you retain healthy gums.

What are Veneers?

Veneers are ultra-thin shells of ceramic (porcelain) or a composite resin material, which are bonded to the front of teeth. This procedure requires little or no anesthesia and can be the ideal choice for improving the appearance of the front teeth. Veneers are placed to mask discolorations, to brighten teeth and to improve a smile.

Veneers are an excellent alternative to crowns in many situations. They provide a much more conservative approach to changing a tooth's color, size or shape. Veneers can mask undesirable defects, such as teeth stained by tetracycline and damage due to an injury or as a result of a root-canal procedure. They are ideal for masking discolored fillings in front teeth. Patients with gaps between their front teeth or teeth that are chipped or worn may consider veneers. Generally, veneers will last for many years, and the technique has shown remarkable longevity when properly performed.

Bleaching
Your wedding is coming up, and you want your smile to be its brightest. Or maybe you have an important speaking engagement. Whatever the reason, tooth bleaching isn't just for movie stars, and it isn't just for one day. Many people have had their teeth bleached, and probably millions more are thinking about it. The desire for a brighter smile with whiter teeth is very strong, and tooth bleaching safely lightens the color of the teeth, lasting for up to five years. The most effective and safest method of tooth bleaching is dentist-supervised.

CEREC is a dental restoration product that allows a dental practitioner to produce an indirect ceramic dental restoration using a variety of computer assisted technologies, including 3D photography and CAD/CAM. With CEREC, teeth can be restored in a single sitting with the patient, rather than the multiple sittings required with earlier techniques. Additionally, with the latest software and hardware updates, crowns, veneers, onlays and inlays can be prepared, using different types of ceramic material.

Technology
The cavity preparation is first photographed and stored as a three dimensional digital model and proprietary software is then used to approximate the restoration shape using biogeneric comparisons to surrounding teeth. The practitioner then refines that model using 3D CAD software. When the model is complete a milling machine carves the actual restoration out of a ceramic block using diamond head cutters under computer control. When complete, the restoration is bonded to the tooth using a resin. CEREC is an acronym for Chairside Economical Restoration of Esthetic Ceramics.

In dentistry, crowns and bridges refers to the restoration of natural teeth that have been damaged, decayed or lost. A crown can be made to restore an individual tooth damaged by decay or fracture back to it's original form and function, while a bridge is used to replace one or more missing teeth. These restorations are cemented onto the teeth and are referred to as "fixed" dentistry as opposed to a restoration of missing teeth with a removable appliance or partial denture.

Both procedures require the use of a local anesthetic and the grinding or preparation of the teeth, with a crown, the damaged tooth, with a bridge, the adjacent teeth. A badly decayed or broken tooth may require that the tooth be "built up" with a special restorative material during the preparation of the teeth. With a fixed bridge, the prosthesis will span the area of a missing tooth, known as a pontic, while the two or more adjacent supporting teeth are called abutments. An impression is taken of the prepared area, and a temporary crown or bridge is placed.

Some slight discomfort is possible after the teeth are prepared. Generally local aneasthetic will eliminate the discomfort. Warm salt water rinses can also speed the recovery of the gums in the area. The permanent crown will fit considerably better than the temporary crown, so the temporary crown gives little indication of how the final crown will fit or feel. It is important that the temporary crown or bridge stay in place until the final crown or bridge is placed. If the temporary should come off early, please call at the clinic.

After about two weeks, the crown or bridge is ready to be fitted, adjusted, and cemented in place.

Crowns and bridges can be made of several materials(gold/metal/ceramic i.e. porcelain ). Full gold crowns are normally done on the very last teeth in the mouth where strength is most important and appearance is less important. Porcelain fused to metal offers most of the strength of full gold, but the esthetics of a tooth colored crown. A thin layer of "High Noble Metal" is made to exactly fit over the prepared tooth model, then porcelain is layered and fired in a ceramic oven at over 2000 degrees, till the desired shape and size is achieved.

Front teeth can be restored with porcelain fused to gold, but sometimes an all porcelain crown is used. Dr's Espinal & Willis uses castable porcelain that is stronger and more life-like than conventional porcelains. With porcelain fused to gold and all porcelain Empress crowns, the color of the porcelain is shaded to match the existing teeth, or in some cases, lighter to cosmetically brighten the smile.

Some of the indications for a crown are:

• A previously filled tooth where there now exists more filling than tooth. The existing tooth structure becomes weakened and can no longer support the filling.
• Extensive damage by decay.
• Discolorations and compromised esthetics.
• Fractures
• Root canal - After root canal, teeth tend to become brittle and are more apt to fracture. These teeth need to be protected by a crown.
• Bridges are recommended to replace one or two missing teeth. They require healthy adjacent teeth to support the replacement teeth. Missing more than one or two teeth is generally better replaced with removable partials.

What is a Root Canal?

Underneath your tooth's outer enamel and within the dentin is an area of soft tissue called the pulp tissue. While a tooth's pulp tissue does contain nerve fibers, it is also composed of arteries, veins, lymph vessels, and connective tissue. Each tooth's nerve enters the tooth at the very tip of its roots. From there, the nerve runs through the center of the root in small "root canals," which join up with the tooth's pulp chamber. Root canals are very small, thin divisions that branch off from the top pulp chamber down to the tip of the root. A tooth has at least one but no more than four root canals.

Why do I feel pain?

When the pulp becomes infected due to a deep cavity or fracture that allows bacteria to seep in, or injury due to trauma, it can die. Damaged or dead pulp causes increased blood flow and cellular activity, and pressure cannot be relieved from inside the tooth. Pain in the tooth is commonly felt when biting down, chewing on it and applying hot or cold foods and drinks.

Why do I need root canal therapy?

Root canal therapy is necessary because the tooth will not heal by itself. Without treatment, the infection will spread, bone around the tooth will begin to degenerate and the tooth may fall out. Pain usually worsens until one is forced to seek emergency dental attention. The only alternative is usually extraction of the tooth, which can cause surrounding teeth to shift crookedly, resulting in a bad bite. Though an extraction is cheaper, the space left behind will require an implant or a bridge, which can be more expensive than root canal therapy. If you have the choice, it's always best to keep your original teeth.

What is a root canal procedure?

A root canal is a procedure done to save the damaged or dead pulp in the root canal of the tooth by cleaning out the diseased pulp and reshaping the canal. The canal is filled with a rubberlike substance called gutta–percha or another material to prevent recontamination of the tooth. The tooth is then permanently sealed, with possibly a post and/or a crown made of porcelain or metal alloy. This enables patients to keep the original tooth.

What is involved in root canal therapy?

Once your general dentist performs tests on the tooth and recommends therapy, he or she can perform the treatment or refer you to an endodontist (a pulp specialist). Treatment usually involves one to three appointments.

First, you will probably be given a local anesthetic to numb the area. A rubber sheet is then placed around the tooth to isolate it. Next, an opening is drilled from the crown into the pulp chamber, which, along with the root canal, is cleaned of all diseased pulp and reshaped.

Medication may be inserted into the area to fight bacteria. Depending on the condition of the tooth, the crown may then be sealed temporarily to guard against recontamination, the tooth may be left open to drain or the dentist may go right ahead and fill the canals.

If you're given a temporary filling, usually on the next visit it's removed and the pulp chamber and canal(s) are filled with gutta percha or another material to prevent recontamination. If the tooth is still weak, a metal post may be inserted above the canal filling to reinforce the tooth. Once filled, the area is permanently sealed. Finally, a gold or porcelain crown is normally placed over the tooth to strengthen its structure and improve appearance.

What happens after treatment?

Natural tissue inflammation may cause discomfort for a few days, which can be controlled by an over-the-counter analgesic. A follow-up exam can monitor tissue healing. From this point on, brush and floss regularly, avoid chewing hard foods with the treated tooth, and see your dentist regularly.

Are there options to root canal therapy?

The only alternative to root canal therapy is to extract the tooth; however, this alone can cause the surrounding teeth to move, resulting in a bad bite. Though a simple extraction may be perceived as less expensive, the empty space left behind will require an implant or a bridge, which ultimately can be more costly than root canal therapy

We Find Decay The Easy Way

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One of the most important things we do for our patients is to identify and fill cavities. Since even the smallest spot of decay can threaten the integrity of the entire tooth, finding and filling cavities is the key to preventing further problems of all kinds. Historically, that's why lengthy poking and prodding sessions have been an acceptable, if not very comfortable, part of typical dental exams. However, many people don't realize that these methods of decay detection are only 50% to 75% successful. Cavities often hide along fissure lines, or inside biting or occlusal surfaces. Further, these mechanical exploratory methods are limited to finding only those cavities that are equal to or larger than the probe head. For all these reasons, we've invested in DIAGNOdent: a revolutionary new, thorough means of detecting cavities, so your exam can be fast, easy, and nearly imperceptible.

Laser Reflection Spots Imperfection
DIAGNOdent technology uses a simple laser diode to inspect your teeth, comparing reflection wavelength against a known healthy baseline wavelength to uncover decay. How? First, we aim the laser onto one of your healthy enamel tooth surfaces to give us a benchmark reading. Then, we continue on around your mouth, shining the laser into all suspect areas. As the laser pulses into grooves, fissures and cracks, it reflects fluorescent light of a specific wavelength. This light is measured by receptors, converted to an acoustic signal, evaluated electronically to reveal a value between one and 100, then displayed on a screen. Anytime the laser encounters a surface that reads differently than the healthy baseline value, it stimulates emission of fluorescent light of a different wavelength. A reading of 10-20 indicates some enamel softening, pointing to a potential problem area that merits close monitoring. A reading of 21-100 indicates a definite area of decay requiring a filling.

Early Detection, Precise Correction
Using DIAGNOdent technology allows us to catch more areas of decay sooner and with more precision. Further, it requires no x-rays, and is a relatively comfortable procedure. Not only can it help prevent the spread of decay, but catching decay early means fillings required are simpler and shallower, preserving more of the tooth. This allows us to use minimally invasive filling procedures, such as drill-free air abrasion. Finally, we're able to objectively monitor any suspicious areas without repeated x-rays, harm to tissues, or need for protective measures.

Our practice delivers innovative, high quality digital imaging solutions. Our state-of-the art sensor and intuitive, easy-to-use imaging software, provides numerous benefits to our patients.

Patient Benefits:

• Reduced exposure to radiation
• Less waiting time
• Shorter appointments
• Involved in co-diagnosis
• Better understanding of treatment

What is a Filling?

A filling is a way to restore a tooth damaged by decay back to its normal function and shape. When a dentist gives you a filling, he or she first removes the decayed tooth material, cleans the affected area, and then fills the cleaned out cavity with a filling material.

By closing off spaces where bacteria can enter, a filling also helps prevent further decay. Materials used for fillings include gold, porcelain, a composite resin (tooth-colored fillings), and an amalgam (an alloy of mercury, silver, copper, tin and sometimes zinc).

Which Type of Filling is Best?
No one type of filling is best for everyone. What's right for you will be determined by the extent of the repair, whether you have allergies to certain materials, where in your mouth the filling is needed, and the cost. Considerations for different materials include:

Gold fillings are made to order in a laboratory and then cemented into place. Gold inlays are well tolerated by gum tissues, and may last more than 20 years. For these reasons, many authorities consider gold the best filling material. However, it is often the most expensive choice and requires multiple visits.

Amalgam (silver) fillings are resistant to wear and relatively inexpensive. However, due to their dark color, they are more noticeable than porcelain or composite restorations and are not usually used in very visible areas, such as front teeth.

Composite (plastic) resins are matched to be the same color as your teeth and therefore used where a natural appearance is desired. The ingredients are mixed and placed directly into the cavity, where they harden. Composites may not be the ideal material for large fillings as they may chip or wear over time. They can also become stained from coffee, tea or tobacco, and do not last as long as other types of fillings generally from three to 10 years.

Porcelain fillings are called inlays or onlays and are produced to order in a lab and then bonded to the tooth. They can be matched to the color of the tooth and resist staining. A porcelain restoration generally covers most of the tooth. Their cost is similar to gold.

If decay or a fracture has damaged a large portion of the tooth, a crown, or cap, may be recommended. Decay that has reached the nerve may be treated in two ways: through root canal therapy (in which nerve damaged nerve is removed) or through a procedure called pulp capping (which attempts to keep the nerve alive).

What Happens When You get a Filling?
If your dentist decides to fill a cavity, he or she will first remove the decay and clean the affected area. The cleaned-out cavity will then be filled with any of the variety of materials described above.

How Do I Know if I Need a Filling?
Only your dentist can detect whether you have a cavity that needs to be filled. During a checkup, your dentist will use a small mirror to examine the surfaces of each tooth.

Anything that looks abnormal will then be closely checked with special instruments. Your dentist may also X-ray your entire mouth or a section of it. The type of treatment your dentist chooses will depend on the extent of damage caused by decay.

More conservative than a crown, inlays and onlays are two methods of restoring normal tooth structure after decay or other damage. Inlays and onlays are known as indirect fillings because unlike a standard filling that is done in our office, both are made in a laboratory and cemented or bonded to the surface of the tooth during a second visit. And unlike standard fillings, inlays and onlays do not weaken the tooth structure, but actually strengthens it. After the procedure, the tooth can bear up to 50 to 75 percent more chewing force.

An inlay is done when the tooth structure replaced is within the cusp tips of the tooth. If the damage is more extensive and the new structure covers the entire chewing surface including one or more tooth cusps, the procedure is called an onlay.

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