Veneers
The indirect technique usually involves two appointments because the veneers will be fabricated at a dental laboratory. At the first appointment the teeth are prepared, impressions taken, and the teeth are given a temporary covering. In two to three weeks the veneers are back from the laboratory, the temporaries are removed and the veneers are bonded to the teeth. The laboratory fabricated veneers are usually made using porcelain or pressed ceramic and are very aesthetic.
The advantage of veneers versus crowns is that much less tooth material is removed, and the procedure is generally more comfortable. The preparation for veneers or crowns is dictated by the remaining sound tooth structure and is more of an art since the tooth is shaped to strengthen what remains while achieving the desired esthetic result.
Dental Crowns
What are Dental Crowns?
A dental crown (also referred to as a cap) is a cemented covering that fits over a decayed, damaged, or cracked tooth. Because of its full coverage, dental crowns will be recommended when your damaged tooth is missing a significant amount of structure above the gum line, is likely to fracture due to the size of the existing restoration or has had root canal therapy.
Whenever possible, a dental onlay will be recommended to perform the same protective and restorative features as a dental crown. Onlays allow more of your natural tooth to be preserved.
Crowns and onlays are made of a variety of different materials such as porcelain, gold alloys, acrylic resin, zirconia or a mix of these materials. Porcelain gives the dental crown or onlay the most natural appearance, allowing it to better blend in with the rest of your teeth but it is the weakest. A newer material, zirconia, can be used by itself since it is quite fracture resistant yet is esthetically shaded like a natural tooth.
The Applications
At a glance, a dental crown can be used to:
- Replace a large filling when there is little tooth structure remaining
- Protect a weak tooth from fracturing
- Attach a dental bridge
- Restore a fractured tooth
- Restore a dental implant
- Cosmetically cover a discolored or poorly shaped tooth
- Protect a tooth that has had root canal treatment
The Crowning Process
Applying a dental crown or onlay typically takes two visits to our Kingston biological holistic dentistry practice. During your first visit, our dental team will prepare your tooth to receive its new crown or onlay: shaping it in a way to provide retention for the final crown/onlay yet being as conservative as possible. Sometimes a filling material will need to be used to build up the missing tooth structure first.
Next, our team will take impressions of your teeth. These impressions will be sent to our lab where models are made, allowing them to create your dental crown or onlay that is specifically designed for your bite and smile. For many crowns and onlays, we are now optically scanning the teeth rather than taking impressions.
Lastly, before leaving our Kingston office, we will fabricate a temporary crown or onlay for your tooth to protect it until the permanent crown/onlay is ready. The temporary crown/onlay also preserves the relationships of your tooth being crowned/onlayed, to its neighbors, so that the next visit is as short as possible and comfortable. During this next visit, your final crown or onlay will be placed with a permanent cement which can be a resin that hardens when exposed to special light or it can be other, biocompatible materials.
Once the final crown or onlay is placed, proper dental hygiene (including daily brushing and utilization of a Waterpick®) is required to maintain a healthy environment for your investment. Given proper care, your dental crowns and onlays can last a lifetime.
Getting Crowned
Dental crowns and onlays are crafted from today’s highest-quality dental materials including porcelain, resins, high noble gold alloys and/or zirconia. They are designed to replicate your natural tooth in color, shape and function; you should not be able to tell the difference from the teeth you were born with.
Bridges
Missing teeth no longer have to plague your smile. At Drs. Viglielmo: Biological Dentistry, our skilled Kingston, NY biological dentists utilize dental bridges to fill gaps with permanent, beautiful replacement teeth.A dental bridge is a restorative-prosthetic dentistry treatment. Dental bridges prevent teeth shifting that can lead to cavities, periodontal problems and to bite problems (occlusion) and/or jaw problems (TMJ). Dental bridges can safeguard the position of the existing teeth and solve the problem of missing teeth.
Bridging the Gap
For dental bridgework which replaces a single tooth, at least three Dental crowns are usually required. Two of the crowns involved in the bridging process will be placed over sound teeth on either side of the missing tooth gap. These adjacent teeth are referred to as “abutment teeth”. The crowned abutment teeth support a third crown placed between them. That third crown is referred to as a “pontic”. If more than one tooth is missing, more crowns will be required to bridge the gap between the abutment teeth. For example, if you have three missing teeth then four abutment teeth may be necessary to create a seven-tooth bridge.
There are other, conservative techniques to replace missing teeth including resin-bonded bridges (Maryland Bridges) which preserve tooth structure on the abutment teeth.
Abutment Teeth
Which technique recommended depends on many factors including:
- The number of missing teeth that need to be replaced
- Where in the mouth the bridge is located
- Size and length of the abutment tooth roots
- Amount of bone support around each abutment tooth
- Gum health around each abutment tooth
- The amount of force that the bridge will have to support
Caring for Your Crowns & Bridgework
Dental crowns and dental bridges need the same care as your natural teeth. Be sure to brush and use your Waterpick® around them every day to lessen bacterial build up, which can help to preserve your investment. If you tend to grind your teeth at night, then consider wearing a nightguard to lessen the unconscious forces placed on your dentition while you sleep. Furthermore, be sure to maintain regularly scheduled cleanings with your trusted Kingston, NY biological dentists.
Benefiting from a Dental Bridge
A dental bridge can replace missing teeth while safeguarding the remaining, existing teeth. It is a great restorative dentistry treatment that can improve oral health and bring both beauty and vibrancy to your smile.
Implants
While implants are typically more expensive than other methods of tooth replacement, they may provide superior benefits. Implants are stronger than natural teeth and generally last 10-20 years. They may also be a more favorable approach than bridgework since implants do not depend on neighboring teeth for support.
To receive implants, you need to have healthy gums and adequate bone to support the implant. You must also be committed to excellent oral hygiene and regular dental visits as these are critical to the long-term success of dental implants.
Root Canals
Once the pulp becomes infected, the infection can begin to eat away at the surrounding bone (this is known as an abscess). If the pulp is infected, not only is it painful but it will require treatment since it cannot heal on its own. Symptoms that indicate the pulp has become infected may include sensitivity to hot, cold or sweets, pain, swelling, pain in response to biting or pressure, and a bad taste in the mouth. However, there are times when no symptoms are apparent and you may be unaware of any problem until a checkup.
A root canal is performed to clean out the infected tooth pulp and disinfect the canals of the tooth. Alternate treatment would be to extract the tooth. Once the infection is resolved, the canal is filled in to help prevent any further infection. Usually a core build-up and crown is recommended for restoring a tooth that has undergone root canal therapy.
For patients who may have an underlying, systemic immune challenge, root canal therapy may not be advised since the area around a root canaled tooth may always remain inflamed. Adding any further inflammation to the body might not be in your best interest and an extraction would be recommended.
Dentures
This restoration method is used to restore your smile and mouth function if your teeth have been lost. The dentures are custom-created to resemble natural teeth and are positioned to take the place of natural teeth. Complete dentures are removable and may require adjustments in order to create a proper fit with the gums and mouth.
A removable partial denture is a device used when one or more natural teeth still remain in the upper or lower jaw. They usually consist of replacement teeth attached to a gum-colored plastic base which is held in place in the mouth.
New dentures may feel awkward or loose for the first few weeks until the muscles of your cheek and tongue learn to keep them in place and you are comfortable eating and speaking. Although this may require some practice, you will adjust and enjoy the benefits a full mouth of teeth can provide.
Extractions
Good oral hygiene should always be practiced since the loss of a single tooth can have major impact upon your oral health and appearance. Although dentists will use every measure to prevent tooth loss, there are sometimes occasions when it is necessary for a tooth may need to be extracted. A tooth may need to be extracted for the following reasons:
- Severe decay
- Advanced periodontal disease
- Infection or abscess
- Malpositioned teeth
- Fractured teeth or roots
- Impacted teeth
After careful examination and treatment, the dentist may advise a patient to have a tooth extracted. Before a tooth is removed, the dentist will take an x-ray in order to understand the shape and position of the tooth and surrounding bone. Based on the degree of difficulty, we may refer you to an oral surgeon specialist.
For a simple extraction, we will first apply a local anesthetic to prevent pain and discomfort. The tooth will be loosened with a tool called an elevator and then removed with dental forceps. Once the procedure is complete, the area may be closed with one or two stitches. We will then provide you with care instructions to alleviate discomfort and ensure proper healing.