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Frequently Asked Questions
What is Bonding?
How does Bonding work?
How long does Bonding last?
What is Cosmetic Contouring?
Why do I need to replace a missing tooth?
What are my choices to replace a missing
tooth?
What are Implants?
Who needs Implants?
Am I a candidate for Implants?
How long does each procedure take?
Silver fillings are too visible, what are
my other options?
What is a Composite Restoration?
How They Are Placed?
What are Veneers?
What is the difference between direct and
indirect Veneers?
What does Veneering a tooth involve?
How long will Veneers last?
What is Tooth Whitening (Bleaching) and is
it safe?
How is it done?
What About Over-The-Counter Options?
What is Bonding?
The term bonding is used to describe procedures where tooth-colored
dental resins and composites are used to change the shapes
and colors of teeth as well as to close unattractive spaces.
It can also be used to repair chipped or broken teeth or even
to cover up stains. Unlike crowns or caps, direct bonding
procedures require only one visit, and a minimal amount of
tooth reduction, making it a very conservative procedure.
How
does Bonding work?
After slight preparation, the tooth is etched with a weak
phosphoric acid solution to create a more porous and rougher
surface for increased bonding strength. Next, a bonding agent
is applied to the tooth and cured with a special LED light.
Then, a composite (plastic) resin is placed on the tooth and
contoured into the appropriate shape and hardened with the
curing light. It is then further shaped and highly polished,
to create a natural appearance. The procedure usually requires
only one visit and often does not require anesthesia.
How
long does Bonding last?
The bonded composite has an average life of four to eight
years, and often lasts longer depending on how and where in
the mouth it is applied and how it is maintained. The area
can be touched up and even re-bonded over time as necessary.
The disadvantage to bonding over porcelain restorations is
the tendency for the margins (where the tooth and bonding
come together) to stain.
What
is Cosmetic Contouring?
Cosmetic contouring (or recontouring) is the reshaping of
a patient's own teeth. This process involves removal of a
very small amount of tooth structure to help achieve a more
desirable appearance. Chipped or fractured areas are smoothed
out and specific angles or edges can be rounded or squared
to alter the way your smile looks. In conjunction with bleaching,
this procedure can create dramatic results.
Why
do I need to replace a missing tooth?
When a person loses one or more teeth, the neighboring teeth
can shift, tip or even "super-erupt" into the space.
Teeth that have drifted from their normal and healthy position
are often more susceptible to decay and gum disease. Perhaps
even more important, this movement can lead to changes in
a patient's bite that can ultimately put stress on the jaws,
muscles, teeth and the temporomandibular joints (TMJ). Over
time this can affect a patient's ability to chew and may even
change the facial appearance depending on the location and
number of missing teeth.
What
are my choices to replace a missing tooth?
There are three ways to replace a missing tooth or teeth:
1. A fixed prosthesis, A bridge is a permanent or fixed replacement.
A bridge consists of replacement teeth (one or more) that
are attached to crowns on the adjacent teeth. The replacement
teeth are shaped and contoured to blend in with the natural
teeth in the mouth.
2. A removable prosthesis. A denture is a removable replacement.
A denture can be either partial or complete, a partial denture
has replacement teeth attached to either a metal or flexible
plastic framework, while a complete denture replaces all the
teeth in either the upper or lower arch, attached to an acrylic
base.
3. implants.
What
are Implants?
Dental implants are metal cylinders placed in the jaw bone
underneath the gum tissue to support artificial teeth where
natural teeth are missing. Unlike other types of tooth replacements,
such as removable dentures or fixed bridges that are cemented
to remaining teeth, dental implants are actually placed ("implanted")
into the bone under the gum tissue. These implants are generally
made from titanium, which is readily accepted by the body,
and artificial teeth that look like natural teeth are then
attached to the implants. Accepted by the American Dental
Association, dental implants have been used for many years,
and hundreds of thousands have been placed. Implants are actually
able to fuse to the bone after placement, which means they
look and function like natural teeth. This procedure has an
overall success rate of around 90%, which allows me to recommend
them with confidence.
Who
needs Implants?
Anyone who is missing teeth and can benefit from increased
chewing efficiency, and improved appearance or speech, is
a candidate for dental implants. Implants can be the solution
when it has become difficult or impossible to wear a removable
denture. Portions of the jaw that are missing due to an accident,
disease, or birth defect can often be reconstructed using
implants.
Am
I a candidate for Implants?
You are a candidate if:
• your jaw has enough dense bone, to secure the implants
• you do not have a disease or condition that interferes
with proper healing after implant surgery (e.g. uncontrolled
diabetes, or radiation/chemotherapy for treating cancer)
A discussion with your oral and maxillofacial surgeon and
Dr. Bass will determine if you are a candidate for dental
implants. As a rule, age is not a barrier to implant treatment
if you are in good health. In fact, thousands of people of
all ages are turning to dental implants to replace a single
missing tooth, several teeth, or all teeth.
How long does each procedure take?
A bridge takes two or more visits to complete. At the first
visit, the adjacent teeth are reduced, an impression is taken
and sent to a dental laboratory for fabrication. At the second
visit, the bridge is fit and placed permanently in the mouth.
Like crowns, bridges can be made from variety of materials
for strength and esthetic appearance.
A partial or complete denture takes approximately 5 visits,
spaced about 1 week apart, due to turnaround time in the lab.
The first two visits are comprised of record taking, impressions,
shade and shape selection, and recording of the appropriate
facial dimensions. The third visit is typically a try-in of
the denture in wax, while the fourth visit is generally the
delivery of the denture. Dentures typically require one or
more adjustment appointments due to the remodeling of a patients
tissue under the appliance.
An implant requires the longest investment of time. Implants
generally need 6 weeks of healing time before they can be
“loaded” or withstand the biting forces, The crown
or restoration will be placed after this healing period.
Silver
fillings are too visible, what are my other options?
Natural tooth-colored fillings have become widely accepted
and are often used in place of metallic restorations. Studies
have shown that in some cases the use of certain tooth-colored
materials can strengthen a tooth, making it a better choice
than the metallic predecessor - amalgam. Another key benefit
of tooth colored fillings is the obvious improved appearance
over a metal based filling. Two basic types of tooth-colored
restorations are used: composite and ceramic.
What
is a Composite Restoration?
Composites have been in use for many years, mostly for aesthetic
applications. The newest generations of composites have improved
their chemical make-up so dramatically that the materials
today can be used in many different applications, including
the restoration of decay, closing undesirable spaces, improving
the shape, size and color of a tooth, replacing an unsightly
amalgam restoration, covering abraded or worn areas of a tooth
(usually at the gum line) and to cover stains. Composites
can also be used to protect thermally sensitive areas and
to repair and strengthen broken teeth.
How They Are Placed?
Once the tooth has been prepared and all decay removed, chemicals
and materials are placed on the tooth to increase bond strength
and to protect the tooth. Next, the composite material is
placed incrementally into the tooth and is hardened by exposure
to a special curing light. The restoration is then contoured
to fit the bite and then is highly polished. These fillings
require a bit more time than the silver fillings because of
the number of steps involved. Composite fillings can also
be a bit more sensitive, at first, to extreme hot and cold
and they may discolor over time if the patient smokes or drinks
a lot of coffee, tea or cola. They can also be more expensive
and some composites may wear faster than silver fillings;
however, they yield a much more natural and aesthetic result.
CERAMIC FILLINGS
Ceramic fillings, like composites, come in several different
types that can be used for different situations. Ceramics
are typically used for the larger and more broken down areas.
In these cases, an inlay or onlay to cover more of the tooth's
surface may be indicated. These restorations are called indirect
because they require fabrication by a dental laboratory, and
therefore require two visits for completion. The ceramic restorations
are considerably more expensive and therefore simple, one-visit
composite fillings are typically used instead. Ceramic restorations
are much more durable and will not stain. The final result
with ceramics can be spectacular.
What
are Veneers?
Veneering a tooth means to cover its facial or front surface.
It is actually very similar to placing acrylic fingernails
on top of natural nails. Veneers are used to enhance shapes
and colors of teeth as well as to close spaces between teeth
and to cover up significant stains such as those caused by
tetracycline.
What
is the difference between direct and indirect Veneers?
There are two types of veneers: direct and indirect. Direct
veneers are done in a single visit and with a composite or
plastic material. Indirect veneers are usually done in two
visits and require a dental laboratory to fabricate the final
restoration. The indirect veneer can be either a composite
material or more commonly, a porcelain material. Due to the
advancements in the porcelain substrates and the bonding materials
used to place them, they are often used in place of crowns
for a more conservative and natural looking smile.
What
does Veneering a tooth involve?
During the first visit, a local anesthetic is used and the
tooth or teeth are reduced by approximately 0.5mm - 2.0mm.
An impression of the teeth is then taken and sent to a dental
laboratory for fabrication of the veneers. This usually takes
one to two weeks to complete. A temporary restoration may
or may not be placed depending on the amount of reduction
necessary. There may or may not be slight sensitivity to hot
and cold during this period.
At the second visit, a local anesthetic may be used for the
patient’s comfort in seating the veneers. After thoroughly
cleaning and preparing the teeth, the veneers are then placed
with a resin material and cured or hardened with a special
curing light.
How
long will Veneers last?
There are many different variations of porcelains used today
and this should be discussed with the dentist ahead of time.
Typically, the porcelains should last about 15 years, although
with proper care and maintenance, they can last longer. Porcelain
veneers resist staining, reflect light and are among the strongest
and most natural looking restorations available.
What is Tooth Whitening (Bleaching) and
is it safe?
Bleaching is a very
conservative and non-invasive approach to creating a brighter
and more appealing smile. Teeth can often take on a darker
and unattractive appearance with age or from contact with
staining substances. The discoloration can be caused by tobacco,
coffee or tea, juices, poor hygiene, genetics, and natural
aging.
How
is it done?
There are two commonly used methods for bleaching: at-home
and in-office. Both begin with an office consultation to determine
if the patient is a good candidate for the bleaching process.
The at-home technique is the most popular and least expensive.
The in-office method allows the dentist to place a higher
concentration of bleach over the teeth.
At-Home Method
A custom mouth piece or "tray" is made to fit your
teeth by the dental office. This tray fits over the patient's
teeth and holds the bleaching material against the teeth and
away from the gums for a specified period of time. There are
different concentrations of bleach that are worn via the tray
for one to five hours per day for an average of 10 to 14 days.
The regimen will be determined by the dentist and may differ
for each patient. If the teeth become more sensitive to hot
and cold, a "desensitizing" material may be used
in the same tray on alternating days. Results are usually
excellent with this method.
In-Office Method
The gum tissues are covered to protect them from being irritated
by a higher concentration of the bleaching material. This
method is usually repeated at separate appointments and is
more expensive than the at-home method. The only benefit is
that the bleaching is achieved more quickly, although recent
studies suggest that the bleaching result is retained longer
with the at home method. Because of this, Dr. Bass generally
recommends the at home method except in cases of “bleach
emergency”
What
About Over-The-Counter Options?
Both at-home and in-office treatments are considerably more
effective than the whiteners available at retail. The over-the-counter
products have much lower concentrations of whitening agent,
and sometimes use materials and ill-fitting trays that can
cause damage to the gums. Over the counter options can be
appropriate for very mild staining, but the results are not
as dramatic nor as good for the teeth and gums as with the
agents used by dentists.
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