Restorative: Fillings, Crowns, Bridges

Restorative Dentistry

Damaged, decayed and/or broken teeth can be restored to their original function, shape and appearance with restorative dentistry, such as fillings and crowns. These restorations may last years to decades, and their success is dependent upon the patient always maintaining a healthy mouth through regular daily brushing and flossing, and by visiting the dentist at least twice a year. Today’s dentistry offers many options for restoring teeth, and here are some descriptions of the most common kinds of restorations.

Fillings

Fillings can directly replace the part of a tooth that is lost to a smaller amount of decay or fracture. Fillings may last many years, depending upon the patients chewing habits and their long-term oral health care.

To keep you comfortable when a filling is done, we use a small amount of local anesthetic to numb the tooth and the surrounding lip, gums, or tongue. The numbness typically lasts from one to three hours. Then, we will remove old filling material and the decayed, weakened tooth structure. The tooth is then carefully inspected to make sure that only healthy, non-decayed tooth structure remains.

There are two filling materials that we can use to fill cavities: composite resin and amalgam.

Tooth-Colored Composite Resin

Tooth-colored composite resin fillings have been available for over 30 years. The technology has been greatly improving over the years. Composites are now an ideal option for restoring a tooth to its original shape, function, and color. Additionally, more of the healthy tooth structure may to be saved while placing the filling, and composite resin fillings are bonded to the tooth, reducing the possibility of tooth fracture in some cases.

The disadvantages of composite resin fillings are:

  • It is a more expensive material to use than silver colored amalgam
  • There are some limitations to where in the mouth it can be used effectively
Silver-Colored Amalgam

Silver amalgam has been a standard filling material for the last 150 years. It is a strong, long-lasting material that is less expensive than tooth-colored composite resin fillings.

The disadvantages of amalgam fillings are:

  • It is dark in color
  • Often, more of the healthy tooth structure must be removed in order to place the silver colored filling properly (compared to the tooth-colored composite resins)
  • Silver amalgam fillings contain mercury, which, on its own, is toxic. When mercury is combined with the silver, there is a negligible amount of mercury exposure, but we still do not know level of mercury exposure is completely safe. The Food and Drug Administration now suggests that silver amalgam fillings may be harmful to children, unborn children, pregnant mothers, and people with immune system sensitivities to mercury. The FDA is scheduled to create a more specific policy on silver amalgam fillings in 2009. It is important to note that removal of existing amalgam fillings may also pose a slight threat of mercury exposure, and that removal of silver amalgam fillings should not be performed to a pregnant mother

Crowns

Crowns are a great option to repair and restore a tooth that has larger amounts of decay, larger fillings that are breaking down or if the tooth is significantly fractured. Crowns, sometimes called "caps", are indicated on teeth that need extra structural support. If a tooth is weakened due to severe decay or very large fillings, it is prone to fracture under normal biting forces. A crown helps to support and stabilize the tooth to ensure its long-term health and reduce its risk for fracture.

Crowns are available in three materials: porcelain, porcelain fused to metal, and gold.

Porcelain crowns have superior esthetics and are great for anterior teeth. They may have some risk of fracture in posterior teeth.

Porcelain-fused-to-metal crowns have great esthetics and are very strong. There are a few circumstances where they fracture or wear the opposing teeth, and the dentist will review the advantages or disadvantages for each individual tooth.

Gold crowns are an excellent choice for molars, as they require the smallest amount of tooth structure to be removed. They do wear down the opposing teeth that they chew against.

In all circumstances, the dentist will give the patient all the appropriate options from which to choose. Our goal is for you to have the restorations and the mouth that you want.

Bridges

Dental Bridges are strong, permanent, fixed restorations to replace a missing tooth. They consist of two crowns on either side of the missing tooth space, with a false tooth, called a pontic, in between. They are fabricated similar to crowns, and can be made of porcelain fused to metal, or full gold. They are a very durable, life-like replacement for a missing tooth. We engineer the bridge for strength as well as beauty. The care of bridges is similar to natural teeth, with brushing and flossing being critical to maintain the healthy bridge and underlying teeth. Flossing a bridge requires that the floss be threaded around the pontic to ensure the health of the gums around the bridge.

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