One of the world's most common diseases is dental caries, so we lead the fight against dental decay by cleaning and filling cavities. To treat a cavity, we remove the decayed portion of a tooth and fill it with different material options. The most common filling materials we use are composites, amalgams and glass ionomers.
Composites are tooth-colored fillings that we can use to match the natural color of your teeth. They provide good durability for small to medium cavities and remove less tooth structure than conventional silver fillings. They are well suited for treating front or highly visible teeth because of their natural look, making them good options for repairing some chipped or broken teeth as well as treating decayed teeth.
Amalgam is a silver-colored filling made from a combination of metals such as silver, tin, copper and mercury which gives it its renowned strength and durability. Because of its strength, amalgam is useful for restoring molars in the back of the mouth where most of the heavy chewing occurs and where it is less visible.
Glass ionomer restorations are tooth-colored restorations often used for filling areas of decay, erosion and wear. They aren't as esthetic or strong as composite fillings, but work well in areas that aren't subject to heavy forces. They are relatively easy to place, release fluoride to prevent decay and work well in filling baby teeth.
Crowns, Onlays and Inlays
Crowns, onlays and inlays are restorations done indirectly, meaning they're fabricated outside of the office by a dental laboratory. Different types of materials are used to manufacture these restorations and we will review these options prior to treating your tooth. The most common materials we use are gold, porcelain, ceramometal and zirconia for these durable restorations.
Compared to fillings which cover smaller portions of a tooth, a crown (often called a cap) encases the entire visible portion of a tooth. Crowns are often done when a tooth is broken or decayed to such an extent that fillings aren't able to repair the problem. The crown is able to act as a tooth's "outer surface" to protect the decayed or damaged tooth and restore form and appearance. It is not a "false tooth" but is a restoration to prevent a tooth from fracturing any further, especially on teeth that have had root canal treatment.
The procedure usually takes two visits. During the first appointment, the tooth is prepared by reducing the size and shape of the tooth, an impression is taken and a temporary crown is placed to protect the tooth. Using the impression, the crown is made by the laboratory which typically takes two weeks. On your second appointment, we remove the temporary, seat and adjust the permanent crown, have you check the appearance and cement it permanently.
Onlays and Inlays
Onlays are variations of a crown with the procedures being similar to a crown. The difference is the design of the preparation in which onlays usually require less tooth removal and preserves some of the visible outer surface of a tooth. Onlays are good options for teeth that still have adequate remaining healthy tooth structure and will still cover the entire biting surface of a tooth to prevent fractures.
Inlays are variations of a filling and do not cover much of the tooth's surface. They are done for patients who elect to use one of the materials listed above instead of amalgam or composite.
We restore teeth using durable modern materials to fix decayed and broken teeth, but we can also use these materials to improve the appearance of your smile. When teeth are misaligned, have small chips, cracks, gaps, discolorations or are misshapen, we can do bonding, crowns or veneers to change their appearance.
For details of our teeth whitening procedures, please see our Other Services page.
Dental bonding is a way to make small cosmetic improvements to your teeth. Minimal tooth preparation is required and composite filling material is bonded to the tooth with a very strong adhesive. Bonding is done directly on teeth, so it can simply be done in one visit. However, bonding typically doesn't last as long and is less resistant to stains making it not a strong option for larger restorations.
As discussed above, crowns are used to restore form and function of teeth as well as to prevent fractures. Modern materials have allowed us to place strong, metal-free crowns on front (and back) teeth that look natural and difficult to distinguish from surrounding teeth. We may place porcelain or zirconia crowns on front teeth that need a stronger restoration than bonding can provide.
We recommend porcelain laminate veneers as a stronger more color stable option over composite bonding, especially for larger restorations and when multiple teeth are treated. Porcelain veneers are thin custom-made facings that cover the visible surfaces of the front teeth to improve their appearance. They are often placed on multiple teeth simultaneously to improve your smile. We design the veneers to look natural and proportional with your other teeth to fit your smile.
We need to prepare teeth for veneers so we anesthetize the area and usually do minimal reduction of your teeth. Porcelain veneers are done indirectly so, similar to crowns, impressions are taken and sent to a laboratory to make your esthetic veneers. You will have temporaries placed while the laboratory takes two weeks to perform their artwork. When you return on the next visit, we remove the temporaries, fit the customized veneers, make necessary adjustments and check that you're satisfied with the appearance. These thin facings are very strong once bonded onto the teeth.
Porcelain laminate veneers and porcelain crowns can transform the appearance of your teeth, giving you a beautiful and confident smile.
Composite veneers are not often done in our office as they require the same amount of work, similar costs and have the limitations of bonding.
Sealants are a great way to prevent tooth decay in the grooves of your back teeth. These "pits and fissures" are the most vulnerable areas for developing cavities, especially on growing children. We recommend sealants on patients who are at high risk of getting cavities. They are simply done by bonding in a clear resin onto a cleaned surface to seal out food and bacteria. They often last about seven to ten years and can be reapplied if they wear or break off. However, sealants do not cover the entire tooth, so cavities can still form in separate areas from the fissures. Maintaining a healthy diet and proper brushing and flossing is still recommended.