Restorative Dental Care
New and Replacement Fillings
At Oregon City Dentistry, Oregon City dentist Dr. Sam Greenstein and his team offer many filling options. Fillings are placed to restore or fix areas that have decayed or broken. There are many different types of fillings to treat the area, which include amalgam, composite, gold and porcelain.
Dental amalgam has been around for a long time and is often referred to as “silver filling”. Amalgam is a mixture of metals such as silver, copper, mercury and tin. There are several other choices that are more esthetic so please ask us about all your choices for restoring your teeth or replacing old fillings.
Composite fillings are tooth colored fillings that are “bonded” to the tooth. They can be placed in either front or back teeth. The size and location in the back teeth determine if this restoration can be placed due to the amount of bite force that is generated. Composite is placed in small layers and then cured or hardened with a light. The filling is then shaped and polished.
Gold fillings are often referred to as inlays or onlays are made just like jewelry is. The tooth is prepared by removing the decay or old filling and an impression is made and sent to a dental lab. The lab then makes the restoration and at a second visit, the restoration is cemented onto the tooth.
Porcelain is used in several different types of dental restorations including inlays, onlays, crowns and veneers. This, just like gold, involves two visits and is bonded to your tooth at the second visit.
Crowns are done to strengthen broken or weakened teeth. Dental crowns can be made from gold, porcelain or a combination of both. Gold crowns withstand biting and chewing forces well. They won’t chip or break and have the potential to last the longest.
Porcelain fused to gold crowns have an inner metal shell and then porcelain is baked on the metal in a high heat oven giving the crown a white tooth like appearance. These can be a good choice for both front and back teeth. They are strong enough to withstand heavy biting pressure and have great cosmetic appearance at the same time.
Dental crowns also can be done exclusively in porcelain. They possess a translucency that makes them the most cosmetically pleasing of all the different types of dental crowns. They are an excellent choice for front teeth because they are very life-like in appearance.
A dental bridge is a false tooth or teeth known as a pontic which is joined between two crowns to fill in the area left by a missing tooth or teeth. The two crowns holding it in place are attached onto your teeth on each side of the false tooth. This is known as a fixed bridge. Fixed bridges cant be taken out of your mouth. Bridges require your commitment to serious oral hygiene but will last as many as ten years or longer.
The teeth are prepared at the first visit and an impression is taken. A temporary bridge will be made for the two weeks it takes to make the permanent bridge in the lab. This temporary bridge will serve to protect your teeth and gums. At the second visit the temporary bridge will be removed and the permanent bridge will be cemented after the bite has been correctly adjusted.
Dentures are removable replacements for people missing all of their teeth. Their comfort depends on muscle, bones, tongue and saliva. There are several different types of dentures.
These replace all of your teeth, upper and lower.
These are placed at the time of extractions and may require additional adjustments as the healing process continues. It often takes months for your bone and tissue to stabilize after tooth extractions.
A removable partial denture fills in the space created by missing teeth and fills out your smile. It helps you to properly chew food which is often difficult when teeth are missing. Partial dentures usually consist of replacement teeth attached to pink or gum colored plastic bases which are connected by a metal framework. Newer all plastic or flexi-partial dentures are now available. Removable partials attach to your natural teeth with clasps to hold them in place.
Generally these are placed over dental implants and “snap” onto the implants giving the denture more stability and better fit.
Dental implants are fixtures of titanium that are surgically placed into your jaw bone. The implant acts as an anchor for a crown or denture to fit over.
When a crown is placed on an implant, most people can’t even tell it is an implant because it is so natural looking. It is very important that you have enough bone in the area of the missing tooth or teeth for the implants to attach to. This will be determined between the oral surgeon and the dentist.
Implants are not only used to replace a single tooth but can also benefit people who may be missing several or all of their teeth. Implants are increasingly being used to replace bridges and removable partial dentures.
Who is a candidate for dental implants?
Potentially anyone who is missing a tooth or teeth, as long as you have enough bone in the missing area. If you don’t have enough bone, a bone graft may be necessary.
Implants are surgically placed in your jaw bone under anesthesia. After placement, it typically takes 3-4 months for the bone to grow around the threads of the implant creating a strong bond between the bone and implant. Rarely (1-2% of cases), an implant may be rejected. If this occurs the surgeon will then place another implant of larger size. After the healing period, a crown or denture is then fitted to the implant.
While dentures and removable partials are usually loose and unstable, implants provide you with dental replacements that are natural looking and very functional. Implants look and feel better than their removable counterparts and offer the same force for biting as bridges that are fixed. Best of all, they will last a lifetime if properly maintained.
Root Canal Therapy
Root Canal Therapy is a process by which the inside of the tooth (pulp tissue or nerve) is removed. The tiny canals within the tooth are inflamed or infected causing tooth pain.
The first step in the procedure after numbing the tooth is to place a “rubber dam” held on by a small clamp on the tooth being worked on. The dam is used to keep the tooth isolated and dry.
A small hole is made in the chewing surface of the tooth to gain access to where the nerve and pulp tissue is inside the tooth. The cleaning process is then begun by using small files in an electric handpiece to clean, shape and remove the infected tissue. The tooth is irrigated throughout the procedure with a cleansing solution (bleach) to flush away any debris present.
The goal is to clean the entire length of the tooth’s canal space after which it is filled back in with a sealer and material called gutta percha. A filling is then placed where the small hole was made. A crown will need to be done to protect the tooth because the tooth is very brittle and can break.