Posts for: December, 2015
For over a hundred years dental amalgam — a combination of silver, mercury, tin and other metals — has been an effective filling material for teeth damaged by decay. But it has one major drawback — its metallic appearance stands out in stark contrast to the natural color of teeth.
As an alternative, composite resin fillings can match the color, shape and texture of natural teeth. These materials and the techniques used to bond them are proving just as effective as and more aesthetically pleasing than dental amalgam.
Fillings help protect and preserve a decayed tooth. By first removing decayed tooth structure through drilling, the resulting void is filled with durable material that strengthens the tooth and provides it protection from further decay.
The ultimate goal for restoration is to return the tooth to as near normal form and function as possible. Dental amalgam serves well in terms of function, providing the tooth strength in the face of the daily biting forces it encounters. In contrast, composite resins excel in appearance, but haven’t always matched the durability of amalgam. They’re material construction has improved over time, though, as well as the techniques used to bond them to teeth.
Most of these bonding techniques incorporate layering. The first step is to seal the dentin (the porous, living tissue just below the enamel); we then build up the composite material layer by layer within the tooth using special bonding adhesive and curing lights. In some cases where a large volume of tooth structure must be replaced, the restoration is first formed on the tooth and then removed for curing before being cemented into the tooth or a separate restoration is formed by a dental lab.
The end result is a tooth which both looks and functions like a fully intact tooth. Though care must be taken not to subject composite resin restorations to undue forces (no cracking open nutshells, for example), your new filling should continue to serve you and look great for a long time to come.
If you would like more information on metal-free restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.”
So you’re tearing up the dance floor at a friend’s wedding, when all of a sudden one of your pals lands an accidental blow to your face — chipping out part of your front tooth, which lands right on the floorboards! Meanwhile, your wife (who is nine months pregnant) is expecting you home in one piece, and you may have to pose for a picture with the baby at any moment. What will you do now?
Take a tip from Prince William of England. According to the British tabloid The Daily Mail, the future king found himself in just this situation in 2013. His solution: Pay a late-night visit to a discreet dentist and get it fixed up — then stay calm and carry on!
Actually, dental emergencies of this type are fairly common. While nobody at the palace is saying exactly what was done for the damaged tooth, there are several ways to remedy this dental dilemma.
If the broken part is relatively small, chances are the tooth can be repaired by bonding with composite resin. In this process, tooth-colored material is used to replace the damaged, chipped or discolored region. Composite resin is a super-strong mixture of plastic and glass components that not only looks quite natural, but bonds tightly to the natural tooth structure. Best of all, the bonding procedure can usually be accomplished in just one visit to the dental office — there’s no lab work involved. And while it won’t last forever, a bonded tooth should hold up well for at least several years with only routine dental care.
If a larger piece of the tooth is broken off and recovered, it is sometimes possible to reattach it via bonding. However, for more serious damage — like a severely fractured or broken tooth — a crown (cap) may be required. In this restoration process, the entire visible portion of the tooth may be capped with a sturdy covering made of porcelain, gold, or porcelain fused to a gold metal alloy.
A crown restoration is more involved than bonding. It begins with making a 3-D model of the damaged tooth and its neighbors. From this model, a tooth replica will be fabricated by a skilled technician; it will match the existing teeth closely and fit into the bite perfectly. Next, the damaged tooth will be prepared, and the crown will be securely attached to it. Crown restorations are strong, lifelike and permanent.
Was the future king “crowned” — or was his tooth bonded? We may never know for sure. But it’s good to know that even if we’ll never be royals, we still have several options for fixing a damaged tooth. If you would like more information, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Crowns and Bridgework.”
Braces are a common part of many teenagers’ life experience — but not every bite problem is alike. Sometimes, there’s a need for accurately moving only a few teeth while making sure others don’t. This is where Temporary Anchorage Devices (TADs) can help streamline that effort and even reduce treatment time.
Orthodontics wouldn’t work at all if we didn’t already have a natural tooth movement mechanism in our mouths. That ability rests with the periodontal ligament, a tough, elastic tissue between the teeth and the bone that firmly attaches to both with tiny collagen fibers. Though quite secure in holding teeth in place, the ligament attachment also allows teeth to move in response to changes in the bone and jaw structure.
Braces are made of brackets cemented to tooth surfaces through which tiny wires pass. The wires are anchored, usually to other teeth or groups of teeth, and tightened to apply pressure against the other teeth. The ligament does the rest: as the teeth are “pressured” to move in a certain direction, new bone, ligament and an anchoring substance known as cementum forms behind it to secure the tooth in its new position.
The anchorage teeth are not intended to move. In some situations, though, it’s difficult to keep them from not moving — much like trying to keep a boat anchor from not dragging through sand on the sea bottom. TADs help alleviate this problem: it’s a mini-screw or mini-implant that’s temporarily placed in the jawbone to which the tension wire can be secured. They’re placed in the best positions for isolating the teeth that need to be moved without compromising the position of nearby teeth that don’t.
With the site numbed with a local anesthetic, we install the TAD through the gum tissue into the bone with a special device; their screw-shaped design holds them securely in place. They’re then removed when the orthodontic treatment is complete.
While a simple procedure, precise placement requires collaboration between the orthodontist and the oral surgeon or dentist who installs them. They also need special attention during daily hygiene to keep them clean. Still, with difficult bite situations they can help bring about the right outcome — a straight and beautiful smile.
If you would like more information on orthodontic treatment options, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “What are TADs?”