Questions About Dental Procedures, Habits
- What is Bonding?
- How does Bonding work?
- How long will Bonding last?
- What is Cosmetic Contouring?
- What are Implants?
- Am I a candidate for Implants?
- What is a Bridge?
- Is a Bridge permanent?
- How long does this procedure take?
- Silver fillings are too visible, what are my other options?
- What is a Composite Restoration?
- How Are They Placed?
- What are inlays and onlays?
- What are Veneers?
- What is the difference between direct and indirect Veneers?
- What does Veneering a tooth involve?
- How long will Veneers last?
- What is Tooth Whitening (Bleaching) and is it safe?
- How is Tooth Whitening done?
- What About Over-The-Counter Tooth Whitening Options?
- What is plaque?
- What is daily oral health care?
- How do I brush my teeth?
- How do I floss my teeth?
- How often should a child see the dentist?
- Why visit the dentist twice a year when my child has never had a cavity?
- Will X-rays be taken at every appointment?
- How can I help my child enjoy good dental health?
- My Child sucks his thumb, what effect can it have on the bite?
- Will dentures change how I speak?
- How often should I schedule dental appointments?
Answers About Dental Procedures, Habits
The term bonding is used to describe procedures where tooth-colored dental resins and composites are used. Direct bonding techniques can be used to change the shapes and colors of teeth as well as to close unattractive spaces. It can also
be used to repair chipped or broken teeth or even to cover up unsightly stains. Unlike crowns or caps, direct bonding requires only a minimal amount of tooth reduction thus making it a very conservative procedure.
After slight preparation, the tooth is etched with a weak phosphoric acid solution to create a more porous and rougher surface for increased bonding strength. Next, a composite (plastic) resin in placed on the tooth and shaped, contoured and hardened with a special curing light. It is then further shaped and highly polished creating a very natural appearance. The procedure usually requires only one visit and is not painful.
The bonded composite has an average life of four to eight years, and often lasts longer depending on how and where in the mouth it is applied and how it is maintained. The area can be touched up and even re-bonded over time as necessary.
Cosmetic contouring (or recontouring) is the reshaping of a patient’s own teeth. This process involves removal of a very small amount of tooth structure to help achieve a more desirable appearance. Chipped or fractured areas are smoothed out and specific angles or edges can be rounded or squared to alter the way your smile looks.
Contouring can create better alignment or create a more feminine or masculine appearance. It is sometimes done to prevent chipped areas from getting worse. Recontouring of the teeth is generally done with no discomfort to the patient and no anesthetic. Often it is done in conjunction with bleaching as a very conservative and inexpensive approach to a beautiful smile.
Dental implants are metal anchors placed in the jaw bone underneath the gum tissue to support artificial teeth where natural teeth are missing. Unlike other types of tooth replacements, such as removable dentures or fixed bridges that are cemented to remaining teeth, dental implants are actually placed into the jaw bone under the gum tissue. These implants are usually made from a space-age metal called titanium, which is readily accepted by the body, and artificial teeth that look like natural teeth are then attached to the implants. Accepted by the American Dental Association, dental implants have been used for many years, and hundreds of thousands have been placed. Due to a phenomenon known as osteointegration, meaning that bone actually attaches itself to the implant, these anchors provide a strong foundation that allows people with missing teeth to chew efficiently and comfortably.
Anyone who is missing teeth and can benefit from increased chewing efficiency, and improved appearance or speech, is a candidate for dental implants. Implants can be the solution when it has become difficult or impossible to wear a removable denture. Portions of the jaw that are missing due to an accident, disease, or birth defect can often be reconstructed using implants.
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You are a candidate if you have enough jaw bone, and dense enough bone, to secure the implants; you do not have a disease or condition that interferes with proper healing after implant surgery (e.g. uncontrolled diabetes, or radiation/chemotherapy for treating cancer) A discussion with your oral and maxillofacial surgeon and restorative dentist (the dentist who will make your new teeth) will determine if you are a candidate for dental implants. As a rule, age is not a barrier to implant treatment if you are in good health. In fact, thousands of people of all ages are turning to dental implants to replace a single missing tooth, several teeth, or all teeth.
A missing tooth or teeth can create an unhealthy situation over time. It is very important to restore these gaps. When one or more teeth are lost or missing, the neighboring teeth can shift, tip or even erupt into the space. Teeth that have drifted from their normal and healthy position are often more susceptible to decay and gum disease. Further, this movement can lead to changes in a patient’s bite that can ultimately put stress on the jaws, muscles, teeth and temporomandibular joints (TMJ). Over time this can affect a patient’s ability to chew and may even change the facial appearance depending on the location and number of missing teeth.
There are two ways to replace a missing tooth or teeth: fixed and removable. A bridge is a permanent or fixed replacement, while a denture is a removable replacement. A bridge consists of replacement teeth (one or more) that are attached to crowns on the adjacent teeth. The replacement teeth are shaped and contoured to blend in with the natural teeth in the mouth.
This procedure takes two or more visits to complete. At the first visit, the adjacent teeth are reduced, an impression is taken and sent to a dental laboratory for fabrication. At the second visit, the bridge is fit and placed permanently in the mouth. Like crowns, bridges can be made from variety of materials for strength and aesthetic appearance. While it should always be discussed with your dentist before treatment, a fixed restoration is generally considered to be the favored solution for tooth replacement.
Natural tooth-colored fillings have become widely accepted and are often used in place of metallic restorations where aesthetics is a primary concern. There are even studies that show that in some cases, use of certain tooth-colored materials can strengthen a tooth, making it a better choice than the metallic predecessor – amalgam. Two basic types of tooth-colored restorations are used: composite and ceramic.
Composites have been used for many years however their chemical make-up has changed and improved exponentially. The bonding agents used to make the composites adhere to the tooth have improved just as dramatically. Because of the improvements, the use of composites has become widely accepted by dentists and the indications for their use are more numerous. They are being used to close undesirable spaces, improve the shape, size and color of a tooth, replace an unsightly amalgam restoration, cover abraded or worn areas of a tooth (usually at the gum line) and to cover stains. Composites can also be used to protect thermally sensitive areas and to repair and strengthen broken teeth.
Once the tooth has been prepared and all decay removed, chemicals and materials are placed on the tooth to increase bond strength and to protect the tooth. Next, the composite material is placed incrementally into the tooth and is hardened by exposure to a special curing light. The restoration is then contoured to fit the bite and then is highly polished. These fillings require a bit more time than the silver fillings because of the number of steps involved.
Inlays and onlays are ceramic or resin indirect fillings. They are typically used for the larger and more broken down areas. In these cases, more of the tooth’s surface needs to be protected. These restorations are indirect because they require two visits and fabrication by a dental laboratory. Ceramic restorations are much more durable and will not stain. Naturally speaking, the final result with ceramics is spectacular.
Veneering a tooth means to cover its facial or front surface. It is actually very similar to placing acrylic fingernails on top of natural nails. Veneers are used to enhance shapes and colors of teeth as well as to close spaces between teeth and to cover up significant stains such as those caused by tetracycline.
There are two types of veneers: direct and indirect. Direct veneers are done in a single visit and with a composite or plastic material. Indirect veneers are usually done in two visits and require a dental laboratory to fabricate the final restoration. The indirect veneer can be either a composite material or more commonly, a porcelain material. Due to the advancements in the porcelain substrates and the bonding materials used to place them, they are often used in place of crowns for a more conservative and natural looking smile.
First Step During the first visit, a local anesthetic is used and the tooth or teeth are reduced by approximately 0.5mm to 2.0mm. An impression of the teeth in this state is then taken and sent to a dental laboratory for fabrication of the veneers. This usually takes one to two weeks to complete. A temporary restoration may or may not be placed depending on the amount of reduction necessary. There may or may not be slight sensitivity to hot and cold during this period. Second Step At the second visit, a local anesthetic may be used for the patient’s comfort in seating the veneers. After thoroughly cleaning and preparing the teeth, the veneers are then placed with a resin material and cured or hardened with a special curing light.
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There are many different variations of porcelains used today and this should be discussed with the dentist ahead of time. Typically, the porcelains should last about 15 years, however, with proper care and maintenance, they can last longer. Porcelain veneers resist staining, reflect light and are among the strongest and most natural looking restorations available.
Bleaching is a very conservative and non-invasive approach to creating a brighter and more appealing smile. Teeth can often take on a darker and unattractive appearance with age or from contact with staining substances. The discoloration can be caused by tobacco, coffee or tea, juices, poor hygiene, genetics, and natural aging.
There are two commonly used methods for bleaching: at-home and in-office. Both begin with an office consultation to determine if the patient is a good candidate for the bleaching process. The at-home technique is the most popular and least expensive. The in-office method allows the dentist to place a higher concentration of bleach over the teeth. At-Home Method A custom mouth piece or tray is made to fit your teeth by the dental office. This tray fits over the patient’s teeth and holds the bleaching material against the teeth for a specified period of time. There are different concentrations of bleach that are worn via the tray for one to five hours per day for an average of 10 to 14 days. The regimen will be determined by the dentist and may differ for each patient. If the teeth become more sensitive to hot and cold, a desensitizing material may be used in the same tray on alternating days. Results are usually excellent with this method. In-Office Method The gum tissues are covered to protect them from being irritated by a higher concentration of the bleaching material. The bleach is then activated by a high intensity light or a laser to accelerate the process. This method is usually repeated at separate appointments and is considerably more expensive than the at-home method. Most patients require a touch-up after one to five years, depending on the patient’s habits and desires.
Both at-home and in-office treatments are considerably more effective than the whiteners available at retail. The over-the-counter products have much lower concentrations of bleach and sometimes use materials and ill-fitting trays that can cause damage to the teeth and gums. Reliable Results Bleaching has become very popular for a whiter and brighter smile because it’s fast, simple and inexpensive with excellent and predictable results.
Many of the foods you eat cause the bacteria in your mouth to produce acids. Sugared foods, such as candy and cookies, are not the only culprits. Starches, such as bread, crackers, and cereal, also cause acids to form. If you snack often, you could be having acid attacks all day long. After many acid attacks, your teeth may decay. Plaque also produces substances that irritate the gums, making them red, tender or bleed easily. After a while, gums may pull away from the teeth. Pockets form and fill with more bacteria and pus. If the gums are not treated, the bone around the teeth can be destroyed. The teeth may become loose or have to be removed. In fact, gum disease is a main cause of tooth loss in adults. One way to prevent tooth decay and gum disease is by eating a balanced diet and limiting the number of between-meal snacks. If you need a snack, choose nutritious foods such as raw vegetables, plain yogurt, cheese or a piece of fruit.
The best way to remove decay-causing plaque is by brushing and cleaning between your teeth every day. Brushing removes plaque from the tooth surfaces. Brush your teeth twice a day, with a soft-bristled brush. The size and shape of your brush should fit your mouth, allowing you to reach all areas easily. Use a toothpaste that contains fluoride, which helps protect your teeth from decay. When choosing any dental product, look for the American Dental Association Seal of Acceptance, an important symbol of a dental product’s safety and effectiveness. Cleaning between the teeth once a day with floss or interdental cleaners removes plaque from between the teeth, areas where the toothbrush can’t reach. It is essential in preventing gum disease. By taking care of your teeth, eating a balanced diet and visiting your dentist regularly, you can have healthy teeth and an attractive smile your entire life.
Place your toothbrush at a 45-degree angle against the gums. Move the brush back and forth gently in short (tooth-wide) strokes. Brush the outer tooth surfaces, the inner tooth surfaces, and the chewing surfaces of the teeth. Use the toe of the brush to clean the inside surfaces of the front teeth, using a gentle up-and-down stroke. Brush your tongue to remove bacteria and freshen your breath.
Break off about 18 inches of floss and wind most of it around one of your middle fingers. Wind the remaining floss around the same finger of the opposite hand. This finger will take up the floss as it becomes dirty. Hold the floss tightly between your thumbs and forefingers. Guide the floss between your teeth using a gentle rubbing motion. Never snap the floss into the gums. When the floss reaches the gum line, curve it into a C shape against one tooth. Gently slide it into the space between the gum and the tooth. Hold the floss tightly against the tooth. Gently rub the side of the tooth, moving the floss away from the gum with up and down motions. Repeat this method on the rest of your teeth. Don’t forget the back side of your last tooth. People who have difficulty handling dental floss may prefer to use another kind of interdental cleaner. These aids include special brushes, picks or sticks. If you use interdental cleaners, ask your dentist about how to use them properly, to avoid injuring your gums.
The American Academy of Pediatric Dentistry recommends a dental check-up at least twice a year for most children. Some children need more frequent dental visits because of increased risk of tooth decay, unusual growth patterns or poor oral hygiene. Your pediatric dentist will let you know the best appointment schedule for your child.
Regular dental visits help your child stay cavity-free. Teeth cleanings remove debris that build up on the teeth, irritate the gums and cause decay. Fluoride treatments renew the fluoride content in the enamel, strengthening teeth and preventing cavities. Hygiene instructions improve your child’s brushing and flossing, leading to cleaner teeth and healthier gums. Tooth decay isn’t the only reason for a dental visit. Your pediatric dentist provides an ongoing assessment of changes in your child’s oral health. For example, your child may need additional fluoride, dietary changes, or sealants for ideal dental health. The pediatric dentist may identify orthodontic problems and suggest treatment to guide the teeth as they emerge in the mouth.
The pediatric dentist will review your child’s medical and dental history. He or she will gently examine your child’s teeth, oral tissues, and jaws. The teeth will be cleaned and polished, followed by the application of a fluoride solution. Your pediatric dentist won’t talk just to you about dental health, he or she will talk to your child with easily understandable words, pictures, and ideas. Your child will be motivated to take responsibility for healthy smile.
No. Pediatric dentists, acting in accord with guidelines from the American Academy of Pediatric Dentistry, recommend X-rays only when necessary to protect your child’s dental health. For example, X-rays maybe needed to diagnose tooth decay or abnormalities. Or, they may be required for orthodontic treatment. Your pediatric dentist will discuss the need for X-rays with you before any are taken.
The following steps will help your child be part of the cavity-free generation:
1. Beware of frequent snacking
2. Brush effectively twice a day with a fluoride toothpaste
3. Floss once a day
4. Have sealants applied when appropriate
5. Seek regular dental check-ups
6. Assure proper fluoride through drinking water, fluoride products or fluoride
Most children stop sucking their fingers between the ages of three to five. If your child continues this habit past the time of the eruption of the first permanent tooth, then it can have a permanent effect on the adult bite. The habit should be stopped before these teeth come in. From a preventive point of view, infants should be given pacifiers, as they will do much less harm than finger habits, and most children will discontinue their use earlier.
Pronouncing certain words may require practice. Reading out loud and repeating troublesome words will help. If your dentures “click” while you’re talking, speak more slowly. You may find that your dentures occasionally slip when you laugh, cough or smile. Reposition the dentures by gently biting down and swallowing. If a speaking problem persists, consult your dentist.
Your dentist will advise you about how often to visit. Regular dental check-ups are important. The dentist will examine your mouth to see if your dentures continue to fit properly. The dentist also examines your mouth for signs of oral diseases including cancer. With regular professional care, a positive attitude and persistence, you can become one of the millions of people who wear their dentures with a smile.