PROCEDURES

icon-2a

A composite (tooth colored) filling is used to repair a tooth that is affected by decay, cracks, fractures, etc. The decayed or affected portion of the tooth will be removed and then filled with a composite filling. There are many types of filling materials available, each with their own advantages and disadvantages. You and Dr. Rosenthal or Anand can discuss the best options for restoring your teeth. Composite fillings, along with sivler amalgam fillings, are the most widely used today. Because composite fillings are tooth colored, they can be closely matched to the color of existing teeth, and are more esthetically suited for use in front teeth or the more visible areas of the mouth. As with most dental restorations, composite fillings are not permanent and may someday have to be replaced. They are very durable, and will last many years giving you a long lasting beautiful smile.

Reasons for composite fillings:

  • Chipped teeth
  • Closing space between two teeth
  • Cracked or broken teeth
  • Decayed teeth
  • Worn teeth

How are composite fillings placed? Composite fillings are usually placed in one appointment. While the tooth is numb, Dr. Rosenthal or Anand will remove decay as necessary. The space will then be thoroughly cleaned and carefully prepared before the new filling is placed. If the decay was near the nerve of the tooth, a special medication will be applied for added protection. The composite filling will then be precisely placed, shaped and polished, restoring your tooth to its original shape and function. It is normal to experience sensitivity to hot and cold when composite fillings are first placed, however this will subside shortly after your tooth acclimates to the new filling. Good oral hygiene practices, eating habits, and regular dental visits will aid in the life of your new fillings.

A crown (or a cap) is a covering that encases the entire tooth surface restoring it to its original shape and size. A crown protects and strengthens tooth structure that cannot be restored with fillings or other types of restorations. Although there are several types of crowns, porcelain (tooth colored) are the most popular because they resemble your natural teeth. They are highly durable and will last many years, but like most dental restorations, they may eventually need to be replaced. Porcelain crowns are made to match the shape, size and color of your teeth giving you a natural, long lasting beautiful smile.

Reasons for crowns:

  • Broken of fractured teeth
  • Cosmetic enhancement
  • Decayed teeth
  • Fractured fillings
  • Large fillings
  • Tooth has had root canal treatment

What does getting a crown involve? A crown procedure usually requires two appointments. Your first appointment will include taking several highly accurate molds (or impressions) that will be used to create your custom crown. A mold will also be used to create a temporary crown which will stay on your tooth for approximately two weeks until your new crown is fabricated by a dental laboratory. While the tooth is numb, the dentist will prepare the tooth by removing any decay and shaping the surface to properly fit the crown. Once these details are accomplished, your temporary crown will be placed with temporary cement and your bite will be checked to ensure even contacts. At your second appointment your temporary crown will be removed, the tooth will be cleaned and your new crown will be carefully placed to ensure the spacing and bite are accurate. You will be given care instructions and encouraged to have regular dental visits to check your new crown.

A dental bridge is a fixed (non removable) appliance and is an excellent way to replace missing teeth. There are several types of bridges. You and Dr. Rosenthal or Anand will discuss the best options for your particular case. The “traditional bridge”: is the most popular type and is usually made of porcelain fused to metal. Porcelain fixed bridges are the most popular because they resemble your natural teeth. This type of bridge consists of two crowns that go over two anchoring teeth (abutment teeth) and are attached to pontics (artificial teeth), filling the gap created by one or more missing teeth (see video). Dental bridges are highly durable and will last many years, however they may need replacement or need to be re-cemented due to normal wear.

Reasons for a fixed bridge:

  • Fill the space of missing teeth
  • Maintain facial shape
  • Prevent remaining teeth from drifting out of position
  • Restore chewing and speaking ability
  • Restore your smile
  • Upgrade from a removable partial denture to a permanent dental appliance

What does getting a fixed bridge involve?: Getting a bridge usually requires two or more visits. While the teeth are numb, the two anchoring teeth are prepared by removing a portion of enamel to allow for a crown. Next, a highly accurate impression (mold) is made which will be sent to a dental laboratory where the bridge will be fabricated. In addition, a temporary bridge will be made and worn for several weeks until your next appointment. At the second visit, your permanent bridge will be carefully checked, adjusted, and cemented to achieve a proper fit. You will receive instructions at the conclusion of your treatment. Proper brushing, flossing and regular dental visits will aid in the life of your new permanent bridge.

Dental implants are a great way to replace missing teeth and also provide a fixed solution to having removable partial or complete dentures. Implants provide excellent support and stability for these dental appliances. Dental implants are artificial roots and teeth (usually titanium) that are surgically placed into the upper or lower jaw bone by a dentist. The teeth attached to implants are very natural looking and often enhance or restore a patient’s smile! Dental implants are very strong, stable, and durable and will last many years, but on occasion, they will have to be re-tightened or replaced due to normal wear.

Reasons for dental implants:

  • Replace one or more missing teeth without affecting adjacent teeth
  • Resolve joint pain or bite problems caused by teeth shifting into the missing tooth space.
  • Restore a patient’s confident smile.
  • Restore chewing, speech and digestion
  • Restore or enhance facial tissues
  • Support a bridge or denture, making them more secure and comfortable

What does getting dental implants involve? The process of getting implants requires a number of visits over several months. X-rays and impressions (molds) are taken of the jaw and teeth to determine bone, gum tissue, and spacing available for an implant. While the area is numb, the implant will be surgically placed into the bone and allowed to heal and integrate itself into the bone for up to six months. Depending on the type of implant, a second surgery will be required in Order to place the post that will hold the artificial tooth in place. After several weeks of healing the Crown is made and fitted to the post portion of the anchor. Because several fits may be required, this step may take one to two months to complete. After confirming a perfect fit, the artificial tooth is securely attached to the implant, providing excellent stability and comfort to the patient. You will receive care instructions when your treatment is completed. Good oral hygiene, eating habits, and regular dental visits will aid in the life of you new implant.

Root canal therapy is needed when the nerve of a tooth is affected by decay or infection. In order to save the tooth, the pulp (the living tissue inside the tooth), bacteria and any decay are removed and the resulting space is filled with special, medicated, dental materials, which restore the tooth to its full function. Having a root canal done on a tooth is the treatment of choice to save a tooth that otherwise would die and have to be removed. Many patients believe that removing a tooth that has problems is the solution, but what is not realized is that extracting a tooth will ultimately be more costly and may cause significant problems to the adjacent teeth. Root canal treatment is highly successful and usually lasts a lifetime, although on occasion, a tooth will have to be retreated due to new infections or extracted due to a root fracture.

Signs and symptoms for possible root canal therapy:

  • An abscess on the gums
  • Sensitivity to hot and cold
  • Severe tooth ache pain
  • Sometimes no symptoms are present
  • Swelling and or tenderness

Reasons for root canal therapy:

  • Decay has reached the tooth pulp
  • Infection or abscess have developed inside the tooth or at the root tip
  • Trauma or fracture to the tooth

What does root canal therapy involve? A root canal procedure requires one or two appointments and can be performed by Dr. Anand. While the tooth is numb, a rubber dam will be placed around the tooth to keep it dry and free of saliva. An access opening is made on top of the tooth and a series of root canal files are placed into the opening, one at a time, removing the pulp, nerve tissue and bacteria. If tooth decay is present, it will also be removed with special dental instruments. Once the tooth is thoroughly cleaned, it will be sealed with either a permanent filling, or, if additional appointments are needed, a temporary filling will be placed. The roots inside the cavity of the tooth will be filled and sealed with special dental materials. A filling will be placed to cover the opening on top of the tooth. In addition, all teeth that have root canal treatment should have a crown placed. this will protect the tooth and prevent it from breaking, and restore it to its full function. After treatment, your tooth may still be sensitive, but this will subside after 7-10 days as the inflammation diminishes and the tooth heals. You will be given care instructions after you appointment. Good oral hygiene practices and regular dental visits will aid in the life of your tooth.

Tablet/Oral Sedation

Advantages

  • Mild to moderate pain control / sedation
  • Not reversible (comfortable ride home)
  • Minimal cost: $50.00 – $100.00

Disadvantages

  • Mild to moderate pain control / sedation (may not be enough)
  • Difficult to control the level of sedation achieved for a given patient
  • Prior arrangements essential (empty stomach & ride home)
  • Patient must be in good overall health

Best For

  • Mildly fearful patients
  • As a “pre-medication” before intravenous sedation
  • To help “pass the time” of treatment
  • Short / easy procedures
  • When cost is a factor
  • When predictable sedation is not essential

Intravenous Sedation

Advantages 

  • Moderate to significant pain control / sedation
  • Moderate to significant control of gag reflexes
  • Not reversible (comfortable ride home)
  • Easy to control the level of sedation, predictable comfort
  • Can be combined with oral sedation for a comfortable ride to the office
  • Moderate cost: $600.00 – 700.00 per visit

Disadvantages

  • Moderate to significant pain control / sedation (more than enough for most)
  • Prior arrangements essential (empty stomach & ride home)
  • Patient must be in good overall health
  • Moderate cost: $600.00 – 700.00 per visit

Best For 

  • Patients in good overall health
  • Patients who have a difficult time getting numb
  • Fearful patients
  • Patients with a hyperactive gag reflex
  • Patients who have had bad reactions to/with local anesthesia
  • Long / difficult / extensive procedures
  • When comfort is important
  • When predictable sedation is essential

Air abrasion is a drill-less technique that is being used by some dentists to remove tooth decay and to perform other procedures.

How Does Air Abrasion Work?

During air abrasion, an instrument that works like a mini sandblaster is used to spray away decay. During air abrasion, a fine stream of particles is aimed at the stained or decayed portion of the tooth. These particles are made of silica, aluminum oxide, or a baking soda mixture and are propelled toward the tooth surface by compressed air or a gas that runs through the dental handpiece. Small particles of decay on the tooth surface are removed as the stream of particles strikes them. The particles of decay are then “suctioned” away through a thin tube.

Is Air Abrasion Safe?

Yes, air abrasion is safe. The only precautions needed before air abrasion are protective eye wear (to prevent eye irritation from the spray) and the use of a rubber dam (a rubber sheet that fits around teeth) or protective resin applied to nearby teeth and gums to protect areas of the mouth that aren’t being treated. The suctioning of particles also prevents them from being breathed into the lungs.

What Are the Advantages of Air Abrasion?

Compared with the traditional drilling method, the advantages of air abrasion are many and include the following:

  • Air abrasion generates no heat, pressure, or vibration.
  • Air abrasion sometimes reduces the need for anesthesia, particularly if the cavity is shallow.
  • Air abrasion leaves more of the healthy tooth tissue behind.
  • Air abrasion reduces the risk of fracturing and chipping of the tooth, which some dentists believe can affect the life span of the filling.
  • The procedure is relatively simple, although it may take longer than traditional drilling.

What Are the Disadvantages?

  • Air abrasion is not necessarily free of pain. The air and abrasive particles can cause sensitivity.
  • Air abrasion is not recommended for deep cavities (those close to the tooth’s pulp). It is best suited for removing small cavities that form early on the surface of teeth.
  • If hard enamel needs to be removed to access the decay, this cannot be done with air abrasion and a traditional drill and bur must be used. Once access to the decay has been achieved, air abrasion can then be used.
  • Crowns, onlays, and inlays cannot be prepared using air abrasion.

Who Are the Best Candidates for Air Abrasion Procedures?

Air abrasion is ideal for use in children and others who are fearful and have minimal decay.
What Other Types of Procedures Are Performed With Air Abrasion?

Air abrasion can also be used to:

  • Remove some old composite restorations, but not metallic restorations such as silver amalgam fillings
  • Prepare a tooth surface for bonding or sealants
  • Remove superficial stains and tooth discolorations

Will Dental Insurance Pay for Air Abrasion?

Because dental insurance plans and coverage polices vary widely from plan to plan, it is best to contact your dental insurance provider to determine if air abrasion is a covered procedure.