Veneers are thin pieces of porcelain or plastic cemented over the front of your teeth to change their color or shape. Veneers are used on teeth with uneven surfaces or are chipped, discolored, oddly shaped, unevenly spaced or crooked.

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Teeth that are badly stained, shaped or crooked may be improved by a veneer placed on the surface of the affected teeth.

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Veneers are thin pieces of porcelain or plastic cemented over the front of your teeth to change their color or shape. Veneers are used on teeth with uneven surfaces or are chipped, discolored, oddly shaped, unevenly spaced or crooked. Little or no anesthesia is needed. Veneers have a longer life expectancy and color stability than bonding, and highly resist permanent staining from coffee, tea, or even cigarette smoking.

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Veneers are usually made by a dental lab technician working from a model provided by your dentist. Veneers are usually irreversible because it`s necessary to remove a small amount of enamel from your teeth to accommodate the shell.

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Porcelain veneers can mask undesirable defects, such as teeth stained by tetracycline, by an injury, or as a result of a root-canal procedure, and 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 porcelain veneers.

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Typically, veneers entail at least three appointments: diagnosis and treatment planning, preparation, and bonding.

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During the tooth preparation visit, usually lasting one to two hours, the teeth are lightly buffed to allow for the small added thickness of the veneer. Usually, about a half a millimeter of the tooth is removed, which may require a local anesthetic. During the same visit, a mold is taken of the teeth, and sent to the laboratory for the fabrication of the veneers.

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During the final "bonding" visit, also about one or two hours, the veneers are placed on the tooth surface with water or glycerine on the teeth to check their fit and get a sense of the shade or color. While the veneers are resting on your teeth, they can be adjusted with various shades of cement to match the color of your teeth. To apply the veneer, the tooth is cleansed with specific chemicals to achieve a bond. Once a special cement is sandwiched between the veneer and tooth, a visible light beam, or laser, causes a catalyst to be released, hardening the cement.

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During a two-week period of adjustment that follows, you may notice the change of size and shape in your teeth. It is important to brush and floss daily. After one or two weeks, you`ll return for a follow-up appointment. Porcelain veneers are reasonable facsimiles of natural teeth, not perfect replacements. It`s not uncommon to see slight variations in the color of porcelain veneers upon close inspection, as this occurs even in natural teeth.

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For certain patients no preparation of the teeth may be necessary.

Crowns are synthetic caps, usually made of a material like porcelain, placed on the top of a tooth. Crowns are typically used to restore a tooth's function and appearance following a restorative procedure such as a root canal. When decay in a tooth has become so advanced that large portions of the tooth must be removed, crowns are often used to restore the tooth.

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Bridges

Bridges are natural-looking dental appliances that can replace a section of missing teeth. Because they are custom-made, bridges are barely noticeable and can restore the natural contour of teeth as well as the proper bite relationship between upper and lower teeth.

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Bridges are sometimes referred to as fixed partial dentures, because they are semi-permanent and are bonded to existing teeth or implants. Some bridges are removable and can be cleaned by the wearer; others need to be removed by a dentist.

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Porcelain, gold alloys or combinations of materials are usually used to make bridge appliances.

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Appliances called implant bridges are attached to an area below the gum tissue, or the bone.

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Crowns

Crowns are synthetic caps, usually made of a material like porcelain, placed on the top of a tooth.

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Crowns are typically used to restore a tooth's function and appearance following a restorative procedure such as a root canal. When decay in a tooth has become so advanced that large portions of the tooth must be removed, crowns are often used to restore the tooth.

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Crowns are also used to attach bridges, cover implants, prevent a cracked tooth from becoming worse, or an existing filling is in jeopardy of becoming loose or dislocated. Crowns also serve an aesthetic use, and are applied when a discolored or stained tooth needs to be restored to its natural appearance.

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Procedures

A tooth must usually be reduced in size to accommodate a crown. An impression is made of the existing tooth and an impression is made. The impression is sent to a special lab, which manufactures a custom-designed crown. In some cases, a temporary crown is applied until the permanent crown is ready. Permanent crowns are cemented in place.

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Crowns are sometimes confused with veneers, but they are quite different. Veneers are typically applied only to relatively small areas.

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Caring For Your Crowns

With proper care, a good quality crown could last up to eight years or longer. It is very important to floss in the area of the crown to avoid excess plaque or collection of debris around the restoration.

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Certain behaviors such as jaw clenching or bruxism (teeth grinding) significantly shorten the life of a crown. Moreover, eating brittle foods, ice or hard candy can compromise the adhesion of the crown, or even damage the crown.

Whitening procedures have effectively restored the smile of people with stained, dull, or discolored teeth. The darker tissue of your teeth, the dentin, can become exposed as the outer layer of enamel is worn away by the effects of aging or things like caffeine and tobacco.

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Whitening procedures have effectively restored the smile of people with stained, dull, or discolored teeth.

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The darker tissue of your teeth, the dentin, can become exposed as the outer layer of enamel is worn away by the effects of aging or things like caffeine and tobacco.

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Food particles are naturally attracted to a tooth's enamel by a certain protein. Products like coffee and tea, berries and soy sauce are notorious for staining teeth. Over time, teeth actually become more absorbent and vulnerable to staining from food and other substances.

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One type of stain-caused by traumatic injuries, medications and fluorosis-actually begins inside the tooth; brushing and flossing don't help. Another type of stain-one that can be more easily attacked by brushing, flossing and rinsing-is caused by external factors such as foods.

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More and more people today are choosing tooth-whitening procedures to reverse the effects of aging and abuse from food and tobacco stains.

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Some commercially available "whitening toothpastes" can be somewhat effective at removing stains and making teeth a few shades brighter. However, many of these products have abrasive substances that can actually wear away your tooth's enamel.

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Whitening agents actually change the color of your teeth, but only are effective on certain types of stains. For example, bleaching agents have a difficult time removing brownish or grayish stains. These products also are not as effective on pitted or badly discolored teeth, or on restorations such as crowns, bridges, bonding and tooth-colored fillings (porcelain veneers or dental bonding may be more appropriate in this case).

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Professional whitening performed by our office is considered to be the most effective and safest method; done properly, tooth whitening can last as long as five years. Over-the-counter whitening systems are somewhat effective as long as they are monitored and directions followed closely.

Root canals are tiny passageways that branch off from beneath the top of the tooth, coursing their way vertically downward, until they reach the tip of the root.

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Root canals are tiny passageways that branch off from beneath the top of the tooth, coursing their way vertically downward, until they reach the tip of the root.

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All teeth have between one and four root canals.

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Many tooth problems involve infections that spread to the pulp, which is the inner chamber of the tooth containing blood vessels, nerves and other tissues. When the infection becomes worse, it can begin affecting the roots. A traumatic injury to a tooth can also compromise the pulp, leading to similar problems.

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A diseased inner tooth brings a host of problems; pain and sensitivity are some of the first indications of a problem; but inside, a spreading infection can cause small pockets of pus to develop, leading to an abscess.

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Root canal therapy is a remarkable treatment with a very high rate of success, and involves removing the diseased tissue, halting the spread of infection and restoring the healthy portion of the tooth. In fact, root canal therapy is designed to save a problem tooth; before the procedure was developed and gained acceptance, the only alternative for treating a diseased tooth was extraction.

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Procedure

Root canal therapy usually entails one to three visits. During the first visit, a small hole is drilled through the top of the tooth and into the inner chamber. Diseased tissue is removed, the inner chamber cleansed and disinfected, and the tiny canals reshaped. The cleansed chamber and canals are filled with an elastic material and medication designed to prevent infection. If necessary, the drilled hole is temporarily filled until a permanent seal is made with a crown.

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Most patients who have root canal experience little or no discomfort or pain, and enjoy a restored tooth that can last almost as long as its healthy original.

Simple toothaches can often be relieved by rinsing the mouth to clear it of debris and other matter. Sometimes, a toothache can be caused or aggravated by a piece of debris lodged between the tooth and another tooth. Avoid placing an aspirin between your tooth and gum to relieve pain, because the dissolving aspirin can actually harm your gum tissue.

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Broken, Fractured, or Displaced Tooth

A broken, fractured or displaced tooth is usually not a cause for alarm, as long as decisive, quick action is taken.

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If the tooth has been knocked out, try to place the tooth back in its socket while waiting to see your dentist.

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First, rinse the mouth of any blood or other debris and place a cold cloth or compress on the cheek near the injury. This will keep down swelling.

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If you cannot locate the tooth back in its socket, hold the dislocated tooth by the crown - not the root. Next, place it in a container of warm milk, saline or the victim's own saliva and keep it in the solution until you arrive at the emergency room or dentist's office.

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For a fractured tooth, it is best to rinse with warm water and again, apply a cold pack or compress. Ibuprofen may be used to help keep down swelling.

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If the tooth fracture is minor, the tooth can be sanded or if necessary, restored by the dentist if the pulp is not severely damaged.

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If a child's primary tooth has been loosened by an injury or an emerging permanent tooth, try getting the child to gently bite down on an apple or piece of caramel; in some cases, the tooth will easily separate from the gum.

Our goal is to help you to minimize the risk of emergency treatment. This is why we commit a generous amont of time designing a Lifetime Treatment Plan that will help you to offset the possibility of unforseen pain or tooth breakage.

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A knocked out tooth or bitten tongue can cause panic in any parent, but quick thinking and staying calm are the best ways to approach such common dental emergencies and prevent additional unnecessary damage and costly dental restoration. This includes taking measures such as application of cold compresses to reduce swelling, and of course, contacting our office as soon as possible.

If a tooth has been broken or damaged by decay, your dentist will try to fix it with a filling, crown or other treatment. Sometimes, though, there's too much damage for the tooth to be repaired. In this case, the tooth needs to be extracted. A very loose tooth also will require extraction if it can't be saved, even with bone replacement surgery (bone graft).

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Here are other reasons: 

• Some people have extra teeth that block other teeth from coming in.
• Sometimes baby teeth don't fall out in time to allow the permanent teeth to come in.
• People getting braces may need teeth extracted to create room for the teeth that are being moved into place.
• People receiving radiation to the head and neck may need to have teeth in the field of radiation extracted.
• People receiving cancer drugs may develop infected teeth because these drugs weaken the immune system. Infected teeth may need to be extracted.
• Some teeth may need to be extracted if they could become a source of infection after an organ transplant. People with organ transplants have a high risk of infection because they must take drugs that decrease or suppress the immune system.
• Wisdom teeth, also called third molars, are often extracted either before or after they come in. They commonly come in during the late teens or early 20s. They need to be removed if they are decayed, cause pain or have a cyst or infection. These teeth often get stuck in the jaw (impacted) and do not come in. This can irritate the gum, causing pain and swelling. In this case, the tooth must be removed. If you need all four wisdom teeth removed, they are usually taken out at the same time.

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Preparation 

Your dentist or oral surgeon will take an X-ray of the area to help plan the best way to remove the tooth. Be sure to provide your full medical and dental history and a list of all medicines you take. This should include both prescription and over-the-counter drugs, vitamins and supplements.

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If you are having wisdom teeth removed, you may have a panoramic X-ray. This X-ray takes a picture of all of your teeth at once. It can show several things that help to guide an extraction:

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• The relationship of your wisdom teeth to your other teeth
• The upper teeth's relationship to your sinuses
• The lower teeth's relationship to a nerve in the jawbone that gives feeling to your lower jaw, lower teeth, lower lip and chin. This nerve is called the inferior alveolar nerve.
• Any infections, tumors or bone disease that may be present

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Some doctors prescribe antibiotics to be taken before and after surgery. This practice varies by the dentist or oral surgeon. Antibiotics are more likely to be given if:

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• You have infection at the time of surgery
• You have a weakened immune system
• You will have a long surgery
• You have specific medical conditions

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You may have intravenous (IV) anesthesia, which can range from conscious sedation to general anesthesia. If so, your doctor will have give you instructions to follow. You should wear clothing with short sleeves or sleeves that can be rolled up easily. This allows access for an IV line to be placed in a vein. Don't eat or drink anything for six or eight hours before the procedure.

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If you have a cough, stuffy nose or cold up to a week before the surgery, call your doctor. He or she may want to avoid anesthesia until you are over the cold. If you had nausea and vomiting the night before the procedure, call the doctor's office first thing in the morning. You may need a change in the planned anesthesia or the extraction may have to be rescheduled.

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After the extraction, someone will need to drive you home and stay there with you. You will be given post-surgery instructions. It is very important that you follow them.

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How It's Done 

There are two types of extractions:

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• A simple extraction is performed on a tooth that can be seen in the mouth. General dentists commonly do simple extractions. In a simple extraction, the dentist loosens the tooth with an instrument called an elevator. Then the dentist uses an instrument called a forceps to remove the tooth.
• A surgical extraction is a more complex procedure. It is used if a tooth may have broken off at the gum line or has not come into the mouth yet. Surgical extractions commonly are done by oral surgeons. However, they are also done by general dentists. The doctor makes a small incision (cut) into your gum. Sometimes it's necessary to remove some of the bone around the tooth or to cut the tooth in half in order to extract it.

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Most simple extractions can be done using just an injection (a local anesthetic). You may or may not receive drugs to help you relax. For a surgical extraction, you will receive a local anesthetic, and you may also have anesthesia through a vein (intravenous). Some people may need general anesthesia. They include patients with specific medical or behavioral conditions and young children.

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If you are receiving conscious sedation, you may be given steroids as well as other medicines in your IV line. The steroids help to reduce swelling and keep you pain-free after the procedure.

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During a tooth extraction, you can expect to feel pressure, but no pain. If you feel any pain or pinching, tell your doctor.

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Follow-Up 

Your doctor will give you detailed instructions on what to do and what to expect after your surgery. If you have any questions, make sure to ask them before you leave the office.

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Having a tooth taken out is surgery. You can expect some discomfort after even simple extractions. Usually it is mild. Research has shown that taking nonsteroidal anti-inflammatory drugs (NSAIDs) can greatly decrease pain after a tooth extraction. These drugs include ibuprofen, such as Advil, Motrin and others. Take the dose your doctor recommends, 3 to 4 times a day. Take the first pills before the local anesthesia wears off. Continue taking them for 3 days. Ask your doctor for complete instructions.

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Surgical extractions generally cause more pain after the procedure than simple extractions. The level of discomfort and how long it lasts will depend on how difficult it was to remove the tooth. Your dentist may prescribe pain medicine for a few days and then suggest an NSAID. Most pain disappears after a couple of days.

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A cut in the mouth tends to bleed more than a cut on the skin because it cannot dry out and form a scab. After an extraction, you'll be asked to bite on a piece of gauze for 20 to 30 minutes. This pressure will allow the blood to clot. You still have a small amount of bleeding for the next 24 hours or so. It should taper off after that. Don't disturb the clot that forms on the wound.

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You can put ice packs on your face to reduce swelling. Typically, they are left on for 20 minutes at a time and removed for 20 minutes. If your jaw is sore and stiff after the swelling goes away, try warm compresses.

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Eat soft and cool foods for a few days. Then try other food as you feel comfortable.

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A gentle rinse with warm salt water, started 24 hours after the surgery, can help to keep the area clean. Use one-half teaspoon of salt in a cup of water. Most swelling and bleeding end within a day or two after the surgery. Initial healing takes at least two weeks.

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If you need stitches, your doctor may use the kind that dissolve on their own. This usually takes one to two weeks. Rinsing with warm salt water will help the stitches to dissolve. Some stitches need to be removed by the dentist or surgeon.

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You should not smoke, use a straw or spit after surgery. These actions can pull the blood clot out of the hole where the tooth was.

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Risks

A problem called a dry socket develops in about 3% to 4% of all extractions. This occurs when a blood clot doesn't form in the hole or the blood clot breaks off or breaks down too early.

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In a dry socket, the underlying bone is exposed to air and food. This can be very painful and can cause a bad odor or taste. Typically dry sockets begin to cause pain the third day after surgery.

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Dry socket occurs up to 30% of the time when impacted teeth are removed. It is also more likely after difficult extractions. Smokers and women who take birth control pills are more likely to have a dry socket.

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A dry socket needs to be treated with a medicated dressing to stop the pain and encourage the area to heal.

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Infection can set in after an extraction. However, you probably won't get an infection if you have a healthy immune system.

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Other potential problems include:

• Accidental damage to nearby teeth, such as fracture of fillings or teeth
• An incomplete extraction, in which a tooth root remains in the jaw — Your dentist usually removes the root to prevent infection, but occasionally it is less risky to leave a small root tip in place.
• A fractured jaw caused by the pressure put on the jaw during extraction — This occurs more often in older people with osteoporosis (thinning) of the jaw bone.
• A hole in the sinus during removal of an upper back tooth (molar) — A small hole usually will close up by itself in a few weeks. If not, more surgery may be required.
• Soreness in the jaw muscles and/or jaw joint — It may be tough for you to open your mouth wide. This can happen because of the injections, keeping your mouth open and/or lots of pushing on your jaw.
• Long-lasting numbness in the lower lip and chin — This is an uncommon problem. It is caused by injury to the inferior alveolar nerve in your lower jaw. Complete healing may take three to six months. In rare cases, the numbness may be permanent.

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When To Call a Professional 

Call your dentist or oral surgeon if:

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• The swelling gets worse instead of better.
• You have fever, chills or redness
• You have trouble swallowing
• You have uncontrolled bleeding in the area
• The area continues to ooze or bleed after the first 24 hours
• Your tongue, chin or lip feels numb more than 3 to 4 hours after the procedure
• The extraction site becomes very painful -- This may be a sign that you have developed a dry socket.

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If you have an infection, your dentist usually will prescribe antibiotics.

Superficial Cleaning and Polish:

This is the most common type of cleaning. It is a routine cleaning, which is necessary to remove surface stains and other debris only on tooth surface above the gum line. This type of cleaning is performed with an ultrasonic instrument or prophy jet.

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Bi-Annual Normal Routine Cleaning:

This is necessary for regular dental maintenance, usually at six month intervals (sometimes three depending on whether you build tarter and plaque along the gum line quicker than others). This type of cleaning is performed using an ultrasonic scaler and hand instruments on the entire tooth above the gum line and below to remove any tartar, plaque and mineral deposits. This type of cleaning is combined with superficial cleaning and polish of the tooth surface with a prophy jet.

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Extensive "Debridement" Cleaning: 

Again this type of cleaning is usually only necessary when an individual has not had his/her teeth cleaned in more than a year, or if there is heavy calculus/mineral deposits under the gum line fused to the tooth and roots. This type of cleaning is may require a longer appointment or two visits and is performed using an ultrasonic scaler and hand instruments followed by superficial cleaning and polish. 

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Deep Scaling and Root Planing: 

This type of cleaning is more invasive and may be more painful. It is necessary in moderate or advanced stages of gum disease when bone loss and pocketing occur and when mineral deposits have fused deeper down the root surface. This procedure may require a form of anesthesia for patient comfort and is performed in quadrants and will require one-quarter of the mouth to be done at a time. Followed by a normal cleaning and evaluation appointment 2-4 weeks after treatment, these periodontal maintenance visits will need to take place in three month intervals until normal tissue health is achieved. 

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Advanced Periodontal (Gum) Disease Requires a Specialist, a periodontist: Routine Periodontal Cleaning: 

This type of cleaning is necessary for regular dental maintenance, usually in three to six month intervals, following a diagnosis of periodontal disease, where bone loss and gum tissue damage are extensive due to lack of care or other reasons. A periodontist will perform scale root planing to avoid tooth loss. This treatment is also necessary if the patient accumulates plaque and calculus far in excess of normal levels which must be removed for adequate oral health.

What is preventive dental care?

Preventive dental care is all the things you do (or should do) to take care of your teeth and gums: brushing, flossing, eating a healthy diet, and seeing your dentist regularly to help avoid dental disease.

We provide preventive and oral hygiene instruction, application of fluoride and sealants, coronal polishing for all patients, scaling for plaque induced gingivitis patients.

A dental filling, also called a "dental restoration," is intended to replace tooth structure lost to decay. Dental fillings may last many years but eventually all fillings need to be replaced. Constant assault from eating and drinking, or stress from clenching or grinding, eventually may cause a dental filling to fail. Fillings that have worn away, chipped, cracked or fallen out may leave gaps between the tooth and the filling that can provide an entry point for food particles and decay-causing bacteria.

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These bacteria cannot be removed easily with a toothbrush or other means, and decay may develop along the edge of the filling or underneath it. Decay that is undiagnosed and untreated can progress to infect the dental pulp (which contains the tooth's nerve and blood supply), which often results in the need for root canal treatment or, possibly, loss of the tooth.

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Regular dental examinations are important because problems with existing fillings generally can be detected in the early stage. Although you may not be able to tell that your filling is worn, your dentist can identify any weaknesses in it during a regular checkup. During the examination, the dentist determines if the existing fillings are intact or if any have cracked or worn away. He or she uses an instrument called an explorer to gently detect any worn spots around the filling's edge. This instrument will help your dentist determine if the dental filling is sealed to the tooth, or if it is sufficiently worn and needs replacement.

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Dental X-rays, usually called "radiographs," may be taken to help detect decay under existing dental fillings or between teeth, neither of which can be seen simply by looking at the tooth. If the dentist finds evidence that a filling has failed or detects decay on the radiograph, the dental filling should be replaced promptly.

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Don't wait until the tooth hurts or a crack appears in the filling of the tooth to talk to your dentist. Early detection and treatment can minimize the need for extensive and costly procedures.