The prospect of receiving restorative treatment in a dental office can seem intimidating, and anxiety regarding dental treatment is the primary reason for untreated dental caries (tooth decay) and missed appointments. This is especially true when the uses for different types of restorations are unclear, as dental terminology appears murky at best. While an oral health professional has the capability to effectively explain these differences, understanding why different restorations are used, how long they will last, and how they appear in the mouth can afford patients confidence before they arrive at an office for treatment. Fillings, crowns, bridges, and implants are several types of restorative work that can be explained in greater detail.
Dental fillings are usually recommended when treating smaller, more localized areas of tooth decay. They are available in several metallic substances (including gold and amalgam, which last for a long time) or can be made of tooth-colored materials such as glass ionomers (which release fluoride) or composites (which are a translucent white color, and are less resistant to force). The material used when fillings are necessary is a matter of patient preference and can be explained in greater depth by an oral health professional prior to treatment.
Fillings can be placed on one surface, two surfaces, or three surfaces depending on the extent and location of tooth decay. To determine which restoration is best, dental health professionals use a series of assessments including radiographs and an examination with a dental explorer (an instrument which checks to see if any surfaces feel sticky or tacky).
All teeth are comprised of two sides (the interproximal areas), a front and back surface, and the biting or chewing surface (termed the “occlusal”). The most common types of fillings include either one or both interproximal surfaces of the teeth (mesial or distal), the occlusal surface, or all three. Whenever decay encompasses more of a tooth’s structure, crowns are recommended rather than fillings.
Crowns are used when tooth decay infects most of the dentin of a tooth structure. They can be made of silver, gold, and porcelain, but new materials are continuously introduced. An accurate impression of a tooth needs to be made in order for a crown to be comfortable and functional. At the initial appointment, a tooth is drilled to a small, symmetrical “peg” on which the crown can be placed. While an accurate crown is being created in a dental lab, a temporary crown is placed on the tooth in order to assess it for health, determine if the fit is accurate, and, sometimes, to wait until the patient can afford a permanent crown. At the final appointment, the permanent crown is cemented into place. Crowns typically last for years, and, if they do come loose, they can be re-cemented during a regular cleaning.
When several teeth are absent or need to be crowned, a bridge is recommended. A bridge is a succession of crowns (abutment teeth) that can be anchored into place with cement on one specific tooth (the pontic tooth). Crowns can be exclusively made of metal or porcelain or, in many cases, are a mixture of porcelain fused to metal (thus affording patients an attractive appearance while providing the durability of metallic crowns). Like crowns, bridges are also cemented into place and can last patients for a lifetime if meticulous oral hygiene is preformed daily.
Implants are practical for patients who have many teeth extracted and who also possess proper brushing and flossing habits. An implant is a lifelike tooth structure attached to a screw. Implants are placed into the alveolar bone (the bone in the jaw that surrounds the teeth), and consequently, the bone is “tricked” into thinking that real teeth are still present. Ultimately, this results in less alveolar bone loss to the patient, which helps them to avoid the development of periodontal infections. The possibility of implants failing due to poor oral hygiene is taken very seriously by dental health professionals, and accordingly, candidates for implants must take an interest in maintaining healthy teeth and gums.
Restorative dental work can benefit patients by preventing future tooth decay and restoring the teeth to their normal function. Feeling good about receiving these types of treatments is simply a matter of understanding and feeling familiar with their uses.
For more information about dental restorations, smile design, or general dental issues, contact your Ballwin and St. Louis, MO dentist, Dr. Kevin F. Postol today.