Restorative

Direct Veneering (Bonding)

A veneer is a thin layer of restorative material that is bonded to a tooth, to improve its appearance.

Direct veneering is done in the dental office using a plastic material made of composite resin. Composite resin comes in many different shades to closely match the color of the natural tooth. The composite resin is shaped and contoured to rebuild the tooth and improve its appearance. Direct veneering is usually done in one appointment.

A shade of composite is selected to match the natural teeth. The surface of the tooth is prepared and an etching agent is placed on the prepared surface to roughen the surface. A bonding agent is placed on the tooth to help the composite resin bond to the tooth surface. The composite is placed on the tooth in layers – each layer is cured (hardened) by using a bright light. Once it has hardened completely, the composite resin is shaped and polished to give the tooth a natural smooth look.

Composite veneers do not last as long as porcelain. A drawback of direct bonding (composite veneers) is if the seal between the tooth and composite is not perfect and there is a possibility of getting decay. Habits such as nail-biting or chewing on hard objects could damage veneers. It is also important to avoid staining foods and beverages such as blueberries, cherries, coffee, tea, and red wine to prevent the plastic resin material from becoming discolored.

Direct veneering is a cost-effective and quick solution to improve the appearance of one or more teeth.

Teeth Whitening (Bleaching)

Teeth whitening is the process of removing most stains from the surface of the teeth to make them whiter and brighter. Teeth become discolored over time due to aging, diet, and health habits. Smoking, red wine, coffee, tea, and certain medications are some items that cause staining of teeth. Modern whitening procedures and techniques, supervised by your dentist, can have a dramatic effect on your smile.

Your dentist uses modern techniques and materials and creates customized whitening trays to fit perfectly your teeth. Once you have decided to whiten your teeth, your dentist will need a couple of appointments to begin treatment.

At the first appointment, impressions will be taken of your teeth. These impressions are sent to a lab so the technician can fabricate the whitening trays. At the second appointment, your whitening trays will be tried in to check the fit and you will be taught how to use the whitening material that has been chosen by your dentist. A shade of the present color of your teeth will be recorded. This shade is used as a comparison to assist in monitoring the progress of the whitening.

Bleaching materials are available in different strengths. These strengths will be prescribed as needed by your dentist. Usually, a 3-6 week treatment is recommended, but this can vary depending on the amount of existing discoloration and the amount of whitening required.

Teeth may become sensitive during the bleaching process, which usually subsides once treatment is completed. Sensitivity may be more intense if defective fillings with open margins exist in the mouth. The whitening material may seep into these open areas and irritate the nerve within the tooth. Any defective fillings should be replaced prior to bleaching.

Bleaching may be indicated before any esthetic fillings are placed, to obtain a more pleasing final shade for your teeth. Several weeks should be allowed between bleaching and the final placement of the restoration to allow for some regression of the bleaching, which normally occurs. If white fillings are already present, and you want to have your teeth bleached, the fillings themselves will not lighten in color, and therefore will probably have to be replaced after the bleaching is completed.

Veneers

A veneer is a thin layer of plastic or porcelain that is bonded to a tooth, to improve its appearance. Veneers can be placed directly onto the tooth using plastic or can be made indirectly using porcelain. Porcelain veneers are generally longer-lasting, stronger, stain-resistant, and more esthetic in appearance.

Veneering is a type of restoration that can fix the following:

1. Cracked or chipped teeth
2. Crooked or misshapen teeth
3. Diastamas (the spaces between teeth)
4. Stained or discolored teeth

Porcelain veneers are thin shells of porcelain that are bonded to the front surface of the teeth.

Although they are thin and fragile prior to insertion, however, once they are bonded to the natural tooth, they are quite strong. Porcelain veneers are custom-made by a professional dental technician in a laboratory.

The placement of indirect veneers usually requires two appointments. At the first appointment, a thin layer of enamel is removed from the front surface of the teeth to make room for the veneer. An impression (mold) is taken using a tray filled with a rubber material, that fits in your mouth. This impression will give an exact replica of the prepared teeth. The impression is sent to a lab where the veneers are custom-made.

Depending on the specific situation, it may be possible to fabricate temporary veneers from plastic to place over the prepared teeth until the porcelain veneers are ready from the lab. These temporary veneers are cemented or lightly bonded into place, and are only esthetic replacements.

At the second appointment, the temporary veneers are removed. The porcelain veneers are tried in and adjusted. Once you and your dentist are satisfied with the fit and the appearance of the veneers, they are ready for cementation. The surface of the teeth and the veneers are prepared by using a mild chemical that roughens the surfaces. A bonding agent is placed over the roughened surfaces, to help the veneer adhere better to the teeth. The veneers are bonded using composite resin, then finished and polished. Porcelain veneers can improve the appearance of your teeth, giving you a beautiful, confident smile.

What is a Crown?

A crown is placed on an individual tooth, (somewhat like a thimble over your finger) where there is no longer sufficient tooth structure left to place a filling. It can replace the crown of a broken down, cracked, heavily restored, or unaesthetic tooth. Crowns can be made entirely of porcelain, a combination of precious metal and porcelain, or all metal. Each crown is custom-made individually by a dental technician. Crown placement is a simple procedure that is done in a few appointments at the dental office.

Porcelain Fused To Metal Crowns

Porcelain fused to metal crowns are crowns made with porcelain and metal. They are made by a dental technician using semi-precious or precious metal and porcelain. The metal is fabricated into a thin metal coping (thimble-like cap) which forms the substructure of the crown. This metal substructure is what provides the high strength of porcelain fused to a metal crown. The porcelain is then bonded to the metal substructure to match the shape and color of your natural teeth. The metal and porcelain are baked at high temperatures fusing the porcelain with the metal. Porcelain fused to metal crowns usually have a small amount of metal visible on the lingual (tongue side) of the crown. This is usually in a spot where you cannot see it. The metal is necessary to give the crown structural support. Porcelain fused to metal crowns is cemented onto the tooth preparation using a long-lasting strong cement. Although porcelain fused to metal crowns are strong, care is still needed when eating certain foods such as nuts, hard fruits, raw vegetables, and sticky candies and toffees.

All-Ceramic Crowns

All-ceramic crowns (caps) are made entirely of porcelain. A lab technician using materials that will match your natural tooth’s color, shape, and size makes these crowns. All-ceramic crowns are hard and durable providing sound support, although they are not as strong as a metal-based crown. However, because there is no metal involved, ceramic crowns may be more esthetic in appearance, providing a more natural restoration. These metal-free restorations may also be indicated for patients with metal sensitivities.

White Fillings

White fillings (composite resins) are restorations that can be used in the front and back teeth. They are made up of light-sensitive composite quartz agents. White fillings come in a variety of shades that will match the color of most teeth. Although they do not have the same strength as metal fillings, they are more aesthetically pleasing and have a natural appearance.

White fillings are bonded to the natural tooth, whereas, metal fillings are mechanically held in place within the natural tooth. As such, white fillings require less tooth structure to be removed and are generally a more conservative restoration. However, the bonding process is affected by moisture contamination and so white fillings are usually not done if the filling is deep, or where the saliva in the mouth cannot be controlled.

White fillings can usually be placed in one appointment. During the appointment, the tooth requiring the filling is prepared with minimal removal of sound tooth structure. A mild chemical (etch) is placed to roughen the surfaces of the tooth. Next, a bonding agent is applied to the roughened surface to help the composite resin stick better to the tooth. Composite resin is then placed into the prepared tooth in layers. Composite resin is soft so it is easily manipulated and shaped to resemble the natural tooth form. Each layer is cured (hardened) using a bright light. Once the last layer has been cured, the filling is shaped and polished to its final form, to give it a natural appearance.

With white fillings, you can chew and eat right away because the light instantly hardens them.

You may experience some sensitivity to temperature for a few days to a week. Contact your dentist if it persists.