General Treatment

Bonding/White Fillings

Bonding is a common solution for:

Fixing or repairing chipped or cracked teeth
Reducing unsightly gaps or spaces between teeth
Hiding discoloration or faded areas on the tooth’s surface

Often used to improve the appearance of your teeth and enhance your smile. As the name indicates, composite material, either a plastic or resin, is bonded to an existing tooth. Unlike veneers or crowns, composite bonding removes little, if any, of the original tooth.

Composite bonding has many advantages:

It is a quick process, which typically lasts less than one hour.
It does not reduce the tooth’s original structure and is relatively inexpensive.
Composite resins come in many different shades and provide better matching of shades to the natural color of your teeth.
Composite bonds, however, are not as durable and long-lasting as veneers and crowns and may need to be re-touched or replaced in the future.

Composite bonds stain more easily and therefore require proper care and regular cleaning. In order to ensure the longest possible duration of the bonding, composites should be brushed and flossed daily. Common staining elements include coffee, tea, tobacco, foods and candy.

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Crowns and Bridges

Crowns

A crown is a permanent covering that fits over an original tooth that is either decayed, damaged or cracked to make the tooth more secure. A crown is done when there is not enough tooth structure remaining to support a filling. Crowns are made of a variety of different materials such as porcelain, gold, acrylic resin or a mix of these materials. Porcelain generally has the most natural appearance.

The treatment plan for a patient receiving a crown involves:

Numbing the tooth to remove the decay in or around it.
Re-sculpturing the tooth to provide an ideal fit for the crown.
Making an impression of your teeth in order to create a custom-made crown (usually takes one to two weeks).
Making a temporary crown out of acrylic resin and fitting it onto the tooth during the interim period when the permanent custom-made crown is being created.
Applying the permanent crown (when received from the lab) by removing the temporary crown and fitting the permanent one onto the tooth.
After ensuring that the crown has the proper look and fit, the dentist cements it into place.

This process generally consists of a minimum of 2-3 visits over a two to three week period.

Procedure:

Once the procedure is completed, proper dental hygiene, including daily brushing and flossing, is required to maintain healthy, bacteria-free teeth, gums and crowns. This helps in the prevention of gum disease. Given proper care, your crowns can last a lifetime.

Bridges

A bridge is a fixed dental device that fills a space that a tooth previously occupied. A bridge may be necessary to prevent:

Shifting of the teeth that can lead to bite problems (occlusion) and/or jaw problems and resultant periodontal disease.
Bridges safeguard the integrity of existing teeth and help maintain a healthy, vibrant smile.

There are three main types of bridges, namely:

Traditional Fixed bridge- this is the most popular and consists of a filler tooth that is attached to two crowns, which fit over the existing teeth and hold the bridge in place.
The “Maryland” bridge is commonly used to replace missing front teeth and consists of a filler that is attached to metal bands that are bonded to the abutment teeth. The metal bands consist of a white-colored composite resin that matches existing tooth color.
The Cantilever bridge is often used when there are teeth on only one side of the span. A typical three-unit cantilever bridge consists of two crowned teeth positioned next to each other on the same side of the missing tooth space. The filler tooth is then connected to the two crowned teeth, which extend into the missing tooth space or end.

Procedure:

Once the natural tooth or abutments have been prepared, we will shape the bridge carefully over them to ensure a comfortable fit. Next, an impression is taken so the lab can create a custom restoration for you. They are carefully fabricated to resemble your natural tooth structure and color so you can maintain the natural beauty of your smile.

During your second office visit, the final restoration will be comfortably placed into your mouth. We will take the time necessary to ensure it fits perfectly to fit, function and feel like your natural teeth.

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Teeth Whitening

Your teeth will darken over time. Changes in the color of your teeth can be caused by such factors as the food and beverages consumed (like coffee, tea, wine and soda). Other known factors for discoloration may include childhood medications or illnesses, tobacco use or improper oral hygiene. Restoring your natural white smile is a priority for our dental whitening team. We can provide a variety of options for whitening your smile.

During the first visit, we will take impressions of your mouth to create custom whitening trays. The trays will perfectly fit onto your teeth to reduce the possibility of the bleaching solution damaging the gums.

Once the impressions have been made, you will be instructed to place whitening solution into the trays and wear them 30 minutes or up to overnight. You should notice a dramatic improvement within seven to 10 days. We will take before and after photos to compare the amazing transformation.

Bleaching is only effective on natural teeth and in some cases, may not be effective at all. We will discuss with you the potential results for whitening your teeth during your first visit.

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Veneers

Veneers are thin, semi-translucent “shells” typically attached to your front teeth. Veneers are customized from porcelain material and permanently bonded to your teeth. Veneers are a great alternative to otherwise painful dental procedures to improve the appearance of your smile.

Common problems that veneers are used for:

Spaces between the teeth
Broken or chipped teeth
Unsightly, stained or discolored teeth
Permanently stained or discolored teeth
Crooked or misshapen teeth

Veneers are a great aesthetic solution to your smile that may even help you avoid orthodontic treatment. We carefully try to match the color of the veneers to your natural color of your surrounding teeth. Subtle changes to your smile can be achieved with veneers. In order to ensure the longest possible duration of veneers, they should be brushed and flossed daily.

In most cases, veneer application is completed in only two office visits. After the tooth is prepared during the first visit, an impression is made and sent to the lab for a custom restoration to be created. During that time, a temporary restoration will be fitted to your tooth to resemble your natural teeth, allowing you to continue with your daily life.

During the second visit, we will place your final restoration and ensure it fits comfortably and securely into your mouth.

Please contact our office if you have any further questions on veneers.

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Dental Implants

Dental implants are artificial tooth replacements that were first developed half a century ago by a Swedish scientist named Per-Ingvar Branemark. Implants arose from the patient’s need to secure loose-fitting dentures. Since the advent of the implant, engineering and enhancements to the implant have enabled dentists to expand the implant’s usefulness, including the replacement of missing or lost teeth. Today, implant techniques provide a wide range of tooth replacement solutions including:

Single Tooth Replacement
Anterior Replacement
Posterior Replacement
Full Upper Replacement

Types of Implants

There are three main types of implants:

The root implant
The plate form implant
The subperiosteal implant

The root implant—by far, the most popular—is the most effective because it mirrors the size and shape of a patient’s natural tooth. This implant is often as strong as the patient’s original tooth. The implant or artificial root is placed into the jawbone under local anesthesia, then allowed to heal and integrate with the bone. Once the healing process is completed and the jawbone is attached to the implant, the patient returns to the dental office where the implant is fitted with the new tooth. This process generally takes anywhere from three to eight months.

The plate form implant is ideal in situations where the jawbone is not wide enough to properly support a root implant. The plate form implant is long and thin, unlike the root implant, and anchors into thin jawbones. It is inserted the same way as a root implant. In certain cases, the plate form implant is immediately fitted with the restoration without waiting for the healing process to run its course.

The subperiosteal implant is used when the jawbone has receded to the point where it can no longer support a permanent implant.

Implant as a Treatment Option

If the missing tooth space has no surrounding teeth, the dentist may decide an implant is the most appropriate treatment choice or option.

Post Implant Care

Although proper oral hygiene is always recommended for maintaining good dental health, it is especially important when a patient has received a dental implant. Bacteria can attack sensitive areas in the mouth when teeth and gums are not properly cleaned, thus causing gums to swell and jaw bones to gradually recede. Recession of the jawbone will weaken implants and eventually make it necessary for the implant to be removed. Patients are advised to visit their dentists at least twice a year to ensure the health of their teeth and implants. Dental implants can last for decades when given proper care.

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Dentures/Partial Dentures

Replacing your missing or damaged teeth will benefit not only your appearance but your overall health. Using state-of-the-art technology and updated materials, dentures can now be custom designed to look more natural and feel more comfortable.

It may take some time to adjust to your dentures. Speaking and eating may feel different at first, but these regular activities will resume normally once you are accustomed to your dentures.

Complete Dentures

Complete dentures are artificial, removable replacements for the natural teeth of the upper or lower jaw or both.

Upper dentures
Upper dentures are held in place by a vacuum created between your appliance and the palate of your mouth.
Lower dentures
Lower dentures are horseshoe-shaped to accommodate the tongue, and, due to lack of suction, are often held in place by implants placed in the jaw for support.

Even with upper and lower dentures, it is important that you visit the dentist at least once per year for evaluation of your gums, fit of your dentures and for an oral cancer screening.

Partial Dentures

Partial dentures are removable appliances that replace missing teeth by attaching via a metal framework to your natural teeth.

Caring for your removable appliances:

Proper denture care is essential to the durability of your dentures and the overall health of your mouth.

Brush your dentures daily with a soft-bristled tooth brush. (Don’t forget to brush your gums and tongue as well.)
While not being worn, keep your dentures in denture solution and/or water (not hot) to prevent warping.
Handle with care and keep out of the reach of children and pets
If your dentures become loose, chip, break or crack, see your dentist.
For partial dentures, brush your natural teeth and partial every time after eating.

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Extractions

Your third molars are more commonly called “wisdom teeth.” Usually appearing in the late teens or early twenties, third molars often lack the proper space in the jaw to erupt fully or even at all. This common condition is called impaction. When any tooth lacks the space to come through or simply develops in the wrong place of your jaw and becomes impacted, problems can arise. Primarily, damage to adjacent teeth and crowding occur.

In certain cases, the wisdom tooth that cannot come through becomes inflamed under the gums and in the jawbone, causing a sac to develop around the root of the tooth that then fills with liquid. This can cause a cyst or an abscess if it becomes infected. If either of these situations goes untreated, serious damage to the underlying bone and surrounding teeth and tissues can result.

An extraction is the complete removal of a tooth. Extractions are sometimes necessary if a primary tooth is preventing the normal eruption of a permanent tooth, if the tooth has suffered extensive tooth decay or trauma that cannot be repaired, if the patient has gum disease, or if the tooth is impacted (usually the wisdom teeth). Depending on the complexity of the case, an extraction can be performed surgically or non-surgically. A mild anesthesia is used to ensure your child is as comfortable as possible throughout the procedure.

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Inlays/Onlays

Inlays and onlays are indirect restorations. They are a great alternative to traditional metal fillings, primarily because less of the tooth structure needs to be removed. Inlays and onlays are suitable for treating mild to moderate decay, and can be used to restore a cracked or fractured tooth if the damage is not extensive enough to require a crown.

Generally, inlays are small restorations that fit within the contours of the biting surface of a tooth, while onlays cover a portion or the entire chewing surface.

Inlays and onlays can be made from porcelain, gold or composite resin. Once fabricated, they are securely bonded to the tooth.

Advantages of inlays and onlays

Since they can be fabricated from tooth-colored materials, inlays and onlays are aesthetically pleasing. Unlike traditional metal fillings, the restoration is virtually invisible.
Less removal of the tooth structure is required to achieve optimal results.
They do not cause excessive wear and tear to opposing tooth structures.
Inlays and onlays prevent the need for more significant treatment in the future.

The process for placing inlays and onlays generally requires two or more office visits. Initially, once the decay is removed, your dentist will take an impression of the tooth. A temporary restoration is placed until the custom made inlay/onlay is manufactured in a laboratory.

Following a proper oral hygiene regimen daily, ensures the success and longevity of your new restoration.

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Crown Lengthening

As one of many specialty periodontal procedures performed by our office, crown lengthening is a long-lasting restorative process utilized to help patients regain a beautiful smile and allow them to eat and speak with comfort and confidence.

Crown lengthening is a simple surgical procedure where the position of the gum around a tooth is adjusted to expose more of the tooth structure. If a tooth is decayed, broken below the gum line or has insufficient crown height, there might not be enough tooth structure available to accommodate restoration procedures, such as a crown or bridge. In these instances, crown lengthening surgery may be necessary in order to provide more tooth structure for your dentist to work with.

For the patient’s comfort, a local anesthetic is used to numb the surgical area. Typically, little to no discomfort is felt as your dentist reshapes the gum and bone tissue to expose more structure of the damaged tooth. Following the surgery, the treated area may be a little tender, sore or swollen; painkillers and antibiotics may be prescribed to help relieve discomfort and prevent infection from occurring.

In most cases, recovery time after crown lengthening surgery is minimal, and patients can resume their normal routines the day after surgery.

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Bone Grafting

A bone graft may be needed in areas where bone is missing. A surgical procedure, bone grafting replaces missing bone and aids in the re-growth of new bone by placing material from the patient’s own body or an artificial, synthetic or natural substitute into the area where bone existed. The new bone growth strengthens the grafted area by forming a bridge between the existing bone and the graft material. Over time, new bone growth will replace much of the grafted material.

For periodontal needs, bone grafts are most commonly used to restore or regenerate bone as needed prior to the placement of bridges or implants

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Post-Op Instructions

Below are general post-op instructions for different procedures. Please contact us directly if you are experiencing symptoms not discussed below or have a dental emergency.

Root Canal Therapy

We recommend refraining from eating for a minimum of two hours after the procedure or until the anesthesia has worn off. It is common to feel tenderness in the treated area, as well as pressure when biting down. Avoid eating on the treated side of your mouth for a minimum of 24-hours. Therefore, refrain from eating hard and chewy foods until the permanent crown is placed. The discomfort should subside within a week. Because back teeth are very brittle after root canal treatment, a crown is recommended to help secure the tooth from further damage.

To help reduce possible infection, be sure to take any medications/antibiotics as prescribed by Dr. Clark. Please contact us if you notice any of the following:

Increased and persistent soreness around the treated tooth and/or surrounding area
Loss of the temporary filling
A fracture in the tooth
A allergic reaction to the prescribed medication

Crowns & Bridges

Do not eat anything for at least two hours after the procedure, or till after the anesthesia has worn off.

Temporary Restoration

Brush gently around the temporary restoration and avoid pulling up on the restoration while flossing. Instead, pull the floss out the side of the tooth down by the gums. Please avoid hard and chewy foods while you have your temporary restoration, including gum.

For the first few days following the procedure, you may be sensitive to hot and cold beverages and/or foods. Soreness around the treated area is to be expected for a few days. If your gums are tender, you can do warm salt water rinses. You may use Advil or Tylenol to help reduce the discomfort.

Permanent Restoration

Once your permanent restoration has been placed, avoid chewing extra crunchy or sticky foods with the new crown for a minimum of 24 hours (or as directed by our staff) to allow the cement to set completely. It may take a few days to adjust to the new bite. If after those few days, your bite still seems wrong, please contact our office for an adjustment.

Be sure to maintain proper oral hygiene habits, including daily brushing and flossing to ensure the longevity of your restoration.

White Fillings (Bonding)

Refrain from eating anything for at least two hours following your procedure, or at least until the anesthesia has worn off.

Patients should expect sensitivity to hot or cold foods and beverages for the first few days following treatment. Mild soreness is also common, but can be treated with Advil or Tylenol.

Be sure to brush and floss daily to ensure the longevity of your restoration.

Scaling & Root Planing

We recommend your rinse your mouth two to three times a day with warm, salt water (8 oz. of water with 1 teaspoon of salt) for a couple of days after your procedure. Start this immediately, combined with healthy oral hygiene habits like daily brushing and flossing; be gentle around the treated areas.

You may take Advil or Tylenol to reduce any discomfort associated with the procedure. This tenderness should subside after a few days. You may also be sensitive to hot and cold foods and beverages for a few days after the procedure as well. We recommend avoiding hard and chewy foods for at least three days, allowing the treated area to heal properly.

Patients may also experience jaw stiffness and minor swelling around the treated area. You may use cold compresses or a hot towel to alleviate these symptoms. If this pain or swelling persists, please contact our office.

You should avoid smoking for at least three days after the procedure. We recommend cessation of smoking completely to allow your gums to heal and fight infection better, and to help prevent reactivation of periodontal disease.

Porcelain Veneers

Patients should avoid eating for a minimum of two hours after the procedure, or until the anesthesia wears off.

Temporary Restoration

Take extra precautions while brushing and flossing around your temporary restoration, being careful not to pull up on the restoration while flossing. Do not eat any chewy or hard foods on the temporary. Patients may experience sensitivity to hot or cold foods and beverages. Mild discomfort is also to be expected, but can be treated with Advil or Tylenol.

Please contact our office if your temporary comes off between appointments.

Permanent Veneers

Once your permanent restoration has been placed, it may take a few days to adjust to the new bite. If after those few days, your bite still seems wrong, please contact our office for an adjustment.

Be sure to maintain proper oral hygiene habits, including daily brushing and flossing to ensure the longevity of your restoration.

Extractions

Bleeding

Bleeding lasting for the first 24 hours of surgery is normal. If heavier bleeding occurs:

Put a piece of gauze over the surgery site.
Bite firmly on the gauze for a minimum of 30 minutes. Avoid chewing on it. If bleeding still persists, boil a tea bag and bite on it up to 30 minutes.
Call our office if the bleeding persists.
For the first 48 hours, do not suck on the surgery area, spit, suck on a straw or smoke.

Rinsing

Do not spit on the day of the surgery.
Do not rinse the area the day of the surgery.
You may brush your teeth and tongue, but avoid the surgery site.

Eating

We recommend a very soft or liquid diet for the first 24-48 hours after the surgery. As the surgery site begins to heal, you can return to a normal diet being careful of chewing on the surgery site.

Pain & Swelling

It is common for patients to experience mild swelling. You can use a cold compress over your face 20-30 minutes at a time during the first 24 hours following the surgery. Do not use ice packs after the first 36 hours. You may use Advil or Tylenol to help reduce any discomfort. Please contact our office if the pain persists.

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