WHAT IS TOOTH RESTORATION?
The goal of tooth restoration is always the same: preserve as much of the natural tooth and dental function as feasibly possible while preventing any further damage, ensuring a long, healthy life for your teeth. Restoring a tooth can include procedures such as fillings, inlays, onlays, veneers, crowns, bridges, dentures, and, yes, even dental implants.
If you have a tooth or several teeth that you know require restoration, the above list of procedures can be confusing.
What are these procedures? What do they involve? And when some seem to be so similar, what leads a dentist to choose one over the other when creating a treatment plan?
Here are the top 10 questions patients like you have about their options when it comes to tooth restoration.
1. WHAT HAPPENS WHEN A DENTIST FILLS A TOOTH?
Fillings are used to restore teeth that have been affected by mild to moderate decay.
Fillings are a one-visit procedure that—depending on the material being used and the skill of the dentist—can be expected to take about one hour. Anesthetic is used so that the patient doesn’t experience discomfort throughout the procedure.
Your dentist will start by removing all of the decay from the tooth to prevent further spread to the surrounding healthy tissues. Once the decay has been completely removed your dentist will prepare the tooth for the filling application by cleaning the area from any lingering plaque, bacteria, or debris.
If the decay was extensive enough to expose the root of the tooth, your dentist will first place what is called a “dental liner” to protect the nerve. The filling is then applied to the tooth and, depending on the material, a curing light may be used to harden the layers. Your dentist finishes the procedure by cleaning and polishing the restored tooth.
2. WHAT IS AN INDIRECT FILLING?
Indirect fillings refer to both inlays and onlays. You can think of them as a partial crown. They are a dental prosthetic that is either made in a lab or in the office and then applied to the tooth.
Indirect fillings are used on teeth that have become too damaged to hold a filling but not damaged enough to require a crown. An inlay will sit within the grooves of a tooth whereas an onlay is used to replace one or more of the cusps (the pointy part) of a tooth.
3. ARE MERCURY AMALGAM FILLINGS STILL SAFE?
In 2009, the American Dental Association Council on Scientific Affairs concluded that dental amalgams are a safe, cost-effective choice for patients. That same year the Food and Drug Administration (ADA) classified dental amalgams as a class II medical device deeming it a safe and effective restoration material.
Amalgam fillings, also popularly known as mercury or silver fillings, is covered by most dental policies. In addition to being a cost-effective material, they also have a longer lifespan in comparison to its alternatives.
While the FDA has classified amalgams as class II medical device it is with some caveats—they recommend that they not be applied to those who are pregnant, children, or anyone who has a compromised immune system.
The good news is that you have options. You do not need to get a mercury filling if you are worried about the effects on your health or their appearance. At Bela Family Dental of Kershaw, we offer composite fillings for those requiring tooth restoration.
4. WHAT IS TOOTH BONDING?
Tooth bonding is the application of tooth-colored composite resin directly to the tooth and then hardened using a curing light. Bonding, similar to veneers, can be used to fix minor gaps, chips, cracks, unevenness, discoloration, or mishappen teeth.
This wallet-friendly procedure is done in one visit and minimally invasive. Unlike similar procedures, it does not require the tooth to be reshaped or enamel to be removed.
5. WHAT IS THE PROCEDURE FOR HAVING A TOOTH BONDED?
Your dentist will match the color of the composite resin to shade of your other teeth. Your dental team will then prepare the tooth with a conditioning liquid that slightly roughens the surface at a microscopic level. This gives the bonding material something to lock onto, securely adhering the bonding material to your tooth.
Next, the composite resin is applied to the prepared tooth. It’s pliable until cured so your dentist can mold it into the ideal shape to restore your tooth. Once your dentist achieves the desired shape, a curing light is used to harden the material.
Your dentist will continue to trim and shape the hardened resin for a natural fit. The final result is polished to a tooth-like shine. The process typically takes between 30 to 60 minutes for each tooth.
6. WHAT ARE COMPOSITE FILLINGS?
Composite fillings are different from composite bonding. But like bonding, the material used is a tooth-colored composite.
Composite fillings are used to protect and restore teeth that have been compromised by minor to moderate decay. They are preferred by many patients as their white coloring makes them a natural-looking restoration, but composite fillings are not always covered by dental plans.
Composite fillings are done in one visit. The material is applied to the tooth in layers, cured with light, and polished to a shine. They are able to withstand the regular stresses that teeth endure from chewing, biting, and talking.
7. WHY DO I NEED A CROWN?
Dental crowns are used to protect and restore dental function to weak, damaged teeth. If not enough of the natural tooth is left to support a direct or indirect filling, you’ll need a crown. Crowns are also used to cover a dental implant and teeth that have undergone root canal therapy.
It is important to preserve as much of a natural tooth as possible—even if just the root of a tooth is healthy. Doing so helps to preserve your overall oral health since all of the parts of your mouth work together as a system. Protect your natural tooth from enduring further damage with a crown. This will hopefully prevent further decay. And you should avoid further decay because once a tooth has been removed, the newly created space can lead to migrating, shifting, or twisting of the neighboring teeth.
Even if you’ve lost a considerable portion of a tooth, a crown helps to prevent this shifting and moving by filling in the space and supporting the surrounding teeth as the natural tooth once did.
8. WHAT IS INVOLVED IN THE DENTAL CROWN CREATION PROCESS?
The dental crown fabrication process varies depending on the treatments you are receiving, technology in your dentist’s office, and the material you’ve chosen for your crown.
If the crown is going to cover an implant or root canal, your dentist or endodontist will need to complete the implant or root canal first. With weak or worn teeth, your tooth will be sculpted into a post-like shape to support the crown.
Once your bite has been prepared to receive a crown, your dentist will take impressions of your mouth. These impressions provide the dentist with precise measurements of each nook and cranny of your bite and teeth.
Depending on the material you’ve chosen and the technology in the dental office, the impressions will either be sent to a lab or to an in-house fabricating machine. If your crown is being fabricated by a lab, your dentist will place a temporary crown on your damaged tooth while you wait for the permanent one to be created.
When the crown is complete, it can be placed. Depending on the materials and “anchor” point, the crown may be bonded to the natural tooth or screwed into a dental implant abutment.
9. HOW LONG CAN I EXPECT MY DENTAL RESTORATION TO LAST?
Dental crowns, on average, last about 10 to 15 years.
Dental bonding typically lasts between four and eight years. Porcelain veneers can be expected to last 15 to 20 years.
Composite resin fillings have a lifespan of about five to seven years. And amalgam fillings last 10 to 15 years.
All of these are averages and not a guarantee. It’s important to take proper care of your restorations to get as many years from them as possible.
10. WHAT IS THE PROCESS FOR GETTING A DENTAL BRIDGE?
The process of getting a dental bridge takes several visits.
If the bridge will be supported by a natural tooth, the first appointment will involve preparing the tooth. As with dental crowns, your tooth will need to be shaped into a post to act as the anchor for the bridge to have a secure pier to sit on. Once reshaped, your dentist will take impressions of your mouth to get precise measurements of your bite for the bridge fabrication process.
You’ll receive a temporary bridge while you wait for yours to be fabricated. Wait time is typically about four weeks. Once received, your dentist will have you come in for a second appointment to place your bridge. They may make minor adjustments to the shape of your bridge after placing it to ensure a virtually perfect fit.