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Basic

Tooth Extractions

Good oral hygiene should always be practiced because the loss of a single tooth can have a major impact on your oral health and appearance. Although dentists will use every measure to prevent tooth loss, there still sometimes necessary occasions when a tooth may need to be extracted. A tooth may need to be extracted if the following occurs:

  • Severe decay
  • Advanced periodontal disease
  • Infection or abscess
  • Orthodontic correction
  • Malpositioned teeth
  • Fractured teeth or roots
  • Impacted teeth

After careful examination and treatment, the dentist may advise you 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 a specialist called an oral surgeon.

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.

It is critical to keep the extraction area clean to prevent infection. We will provide you with dry, sterile gauze to bite down on for 30-45 minutes to limit bleeding while clotting takes place. For the next 24 hours, you shouldn’t smoke, rinse your mouth vigorously, or brush teeth directly next to the extraction site.

A certain amount of pain and discomfort is to be expected following an extraction, which can be minimized with a pain killer and ice packs applied to the face for 15 minutes at a time. After a routine extraction, discomfort should lessen within three days to two weeks. If you have prolonged or severe pain, swelling, bleeding or fever, call our office immediately.

Fillings

A filling is a way to restore a tooth damaged by decay back to its normal function and shape. If you have a tooth that requires a filling, the dentist will first remove the decayed tooth material, clean the affected area, and then fill the cleaned out cavity with a filling material. A filling also helps prevent further decay by closing off any cracks or spaces where bacteria can enter.

There are a variety of filling materials available including gold, silver, plastic and porcelain. The dentist will work with you to determine which material is best for you, depending on the extent of repair, where in your mouth the filling is needed, and cost. Each of the filling materials is briefly explained below:

  • Gold fillings are custom made in a laboratory and then cemented into place. While gold fillings are often the most expensive choice, many consider it the best filling material. Gold inlays are well-tolerated by gum tissues and may last more than 20 years.
  • Amalgam (silver) fillings are a more inexpensive choice and are tolerant to wear. However, due to their dark color they are more noticeable than porcelain or composite restorations and are not recommended for fillings in very visible areas such as front teeth.
  • Composite (plastic) resins are custom made to the exact color of your natural teeth, creating a more natural appearance. White while fillings may be less noticeable than other materials, they usually only last between 3 and 10 years. They may not be ideal for large fillings as they may chip or wear over time. They can also become stained from coffee, tea or tobacco.
  • Porcelain fillings are called inlays or onlays and are custom created in a lab and then bonded to the tooth. They can be matched to the color of the tooth, resist staining, and are about the same cost as gold fillings. A porcelain restoration generally covers most of the tooth, making the filling nearly undetectable.

If decay or a fracture has damaged a large portion of the tooth, a crown, or cap, may be recommended. Decay that has reached the nerve may be treated through root canal therapy or through a procedure called pulp capping.

Bonding

Bonding involves adhering composite resin material that is matched to the color of the tooth, to the front of the tooth. This is done to repair damage done to the tooth by decay, to alter the alignment of the tooth, close gaps between the teeth, or for cosmetic purposes. First the surface of the tooth is roughened in order to accept the bonding and hold it. A gel is applied to micro etch the tooth surface, and a primer/bond agent is applied so the material adheres to the surface. Then the material itself is placed on the tooth and hardened with intense light. The composite resin material is shaped and polished to get a lustrous finish as a last step.

Root Canal Treatment

Root canal treatment (also referred to as root canal therapy or endodontic therapy) is made necessary when a cavity is allowed, through neglect, to reach all the way to this pulp. (Regular cleanings and checkups prevent and detect problems early) Sometimes deep restorations or trauma to a tooth may cause the nerve to be damaged to the point it needs root canal therapy, also. Once this occurs the pulp becomes infected, and can even extend through the root tip and begin to eat away at the surrounding bone (this is an abscess). By the time the pulp is infected it must be treated, and cannot heal on its own. It can even weaken the entire immune system. This is dangerous, not to mention very painful. Symptoms that the pulp has become infected may include sensitivity to hot/cold or sweets, pain, swelling, pain to biting or pressure, and a bad taste in the mouth. Sometimes, however, no symptoms are apparent and the person is unaware of any problem until a checkup.

A root canal is then performed to clean out the infected tooth pulp, and disinfect the canals of the tooth. The only other treatment would be to extract the tooth. Once the infection is resolved, the canal(s) are filled in to prevent any further infection. Usually a core build-up and crown is recommended for restoring a tooth that has had root canal therapy.