FILLINGS

Tooth Fillings

We are a mercury-free practice, which means that Dr. Sievers uses composite resin for all of the fillings that he preforms. Many people still have silver/mercury fillings in their mouths from years past. These fillings are not especially pleasing to the eye, and they can result in a weaker tooth structure. Resin (tooth colored fillings) are unnoticeable and also add strength to weakened teeth.

Disadvantages of Silver Fillings

Silver fillings have many drawbacks. The edges of the silver filling can wear down, become weak or break. This results in the tooth not being protected and lets cavities get started once again. With age, the metal of a silver filling expands, contracts, and can split a tooth.

Silver fillings contain 50 percent mercury. They can corrode, leak and cause stains on your teeth and gums. You can safely have your silver fillings replaced with resin fillings with the proper procedure.

Advantages of Composite/Resin (Tooth-Colored) Restorations

There are many advantages to tooth-colored restorations. The tooth remains intact and stronger.
Some benefits of tooth-colored resin fillings are:

—They look more aesthetically pleasing since they match your natural tooth color and appearance.
—They require less drilling, so not as much tooth structure needs to be removed.
—They harden in seconds instead of days like other materials.
—They bond to the tooth giving it greater strength, which helps prevent breaks.
—They can be repaired if damaged.

CROWNS

Dental Crowns

Our goal is to provide dentistry that is undetectable, and appears natural. For teeth that are badly damaged, dental crowns can be an effective treatment option. These treatments are used for a long-lasting correction of major dental problems. We replace existing crowns and fillings with restorations that look and feel like your natural teeth.

Typically, the dental crown procedure is completed in two stages. During the first stage, portions of your natural tooth’s structure is removed to accommodate the dental crown. An impression is made and sent to the lab, where your dental crown is created in two-three weeks. A temporary crown will be in place between visits to ensure the most natural look and feel. When you return, the temporary crown is removed and your new, custom dental crown is securely bonded in place.

For some patients, the dental crown procedure is altered to meet specific goals. For example, if crowns are being utilized to anchor a dental bridge or as a dental implant restoration, the steps in the dental crown procedure will be slightly different. Also, teeth with extensive damage may require that a root canal be performed prior to placing the crown. A consultation with Dr. Sievers can help you better understand steps in your dental crown procedure.

Dental crowns are made of metal, ceramic, or porcelain fused to metal. The type of crown recommended by Dr. Sievers will depend on which tooth is restored, your unique needs and goals.

Porcelain Crowns vs Porcelain Veneers

Both porcelain crowns and porcelain veneers have unique advantages and limitations that make them appropriate for treating specific dental concerns. For example, all ceramic or porcelain dental crowns improve both the appearance and function of injured or damaged teeth. They cover and protect the entire surface area of the tooth, eliminating pain and restoring strength. Porcelain veneers, on the other hand, typically address only cosmetic concerns and are applied to otherwise healthy teeth. Stains, minor chips, misalignment, or other imperfections can be concealed with the thin porcelain shells, which slide over the front surface of teeth. Also, because they cover less of the natural tooth, less tooth structure has to be removed to accommodate porcelain veneers.

INLAYS & ONLAYS

Inlays and Onlays

When more than half of the tooth’s biting surface is damaged, a dentist will often use an inlay or onlay. Inlays and onlays can be made of porcelain, gold, or composite resin. These pieces are bonded to the damaged area of the tooth. An inlay, which is similar to a filling, is used inside the cusp tips of the tooth. An onlay is a more substantial reconstruction, similar to the inlay but extending out over one or more of the cusps of the tooth.

Inlays and onlays require two appointments to complete the procedure. During the first visit, the filling being replaced or the damaged or decaying area of the tooth is removed, and the tooth is prepared for the inlay or onlay. To ensure proper fit and bite, an impression of the tooth is made by the dentist, and sent to a lab for fabrication. The dentist will then apply a temporary product.

At the second appointment, the temporary sealant is removed. Then we make sure that the inlay or onlay fits correctly. If the fit is satisfactory, the inlay or onlay will be bonded to the tooth and polished to a smooth finish.

EXTRACTION

Extractions

You may need a tooth extraction for any number of reasons. Some teeth are extracted because they are severely decayed. Others may have advanced periodontal disease, or have broken in a way that cannot be repaired. Teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth), or in preparation for orthodontic treatment.

The removal of a single tooth can lead to problems related to your chewing ability, problems with your jaw joint, and shifting teeth, which can have a major impact on your dental health. At the time of extraction the doctor will need to numb your tooth, jaw bone and gums that surround the area with a local anesthetic.

After tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. Bite on a gauze pad for 30-45 minutes immediately after the appointment. If the bleeding or oozing still persists, place another gauze pad and bite firmly for another 30 minutes. You may have to do this several times to staunch the flow of blood.

After the blood clot forms it is important to not disturb or dislodge the clot. Do not rinse vigorously, suck on straws, smoke, drink alcohol or brush teeth next to the extraction site for 72 hours. These activities may dislodge or dissolve the clot and hinder the healing process. Limit vigorous exercise for the next 24 hours, as this increases blood pressure and may cause more bleeding from the extraction site.

After the tooth is extracted you may feel some pain and experience some swelling. An ice pack or an unopened bag of frozen peas or corn applied to the area will keep swelling to a minimum. Take pain medications as prescribed. The swelling usually subsides after 48 hours.

Use pain medication as directed. Call our office if the medication doesn’t seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time even if signs and symptoms of infection are gone. Drink lots of fluids and eat nutritious, soft food on the day of the extraction. You can eat normally as soon as you are comfortable.

Impacted Teeth (referred to an Oral Surgeon)

Wisdom teeth, otherwise known as third molars, are the last set of teeth to develop. Sometimes these teeth emerge from the gum line and the jaw is large enough to allow room for them, but most of the time, this is not the case. More often, one or more of these third molars fails to emerge in proper alignment or fails to fully emerge through the gum line and becomes entrapped or "impacted" between the jawbone and the gum tissue. Impacted wisdom teeth can result in swelling, pain, and infection of the gum tissue surrounding the wisdom teeth. In addition, impacted wisdom teeth can cause permanent damage to nearby teeth, gums, and bone and can sometimes lead to the formation of cysts or tumors that can destroy sections of the jaw. Therefore, dentists recommend people with impacted wisdom teeth have them surgically removed.

Other teeth, such as the cuspids and the bicuspids can become impacted and can cause the same types of problems described with impacted wisdom teeth. Teeth that are broken or unhealthy may have to be extracted.

IMPLANTS

Dental Implants

Dental implants are designed to provide a foundation for replacement teeth that look, feel and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything and can smile with confidence, knowing that teeth appear natural. Dental implants can help preserve facial and jaw structure, preventing the bone deterioration which occurs when the teeth are lost.

Dental implants are titanium anchors, which act as tooth root substitutes. They are surgically placed into the jaw bone. Small posts are then attached to the implant, which protrude through the gums. These posts provide stable anchors for artificial replacement teeth.

For most patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jaw bone. For the first three to six months following surgery, the implants are beneath the surface of the gums, gradually bonding with the jaw bone. You should be able to wear temporary dentures and eat a soft diet during this time.

After the implant has bonded to the jaw bone, the second phase begins. The surgeon will uncover the implants and attach a small healing collar. This is when Dr. Sievers will make an impression for a new tooth. Then posts or attachments can be connected to the implants and the replacement teeth are then made over the posts or attachments. The entire procedure usually takes six to eight months. During this time, you may wear some type of temporary replacement tooth (teeth).

DENTURES

Dentures

Dr. Sievers will evaluate your dental situation, and if appropriate refer you to a specialist for some of the following denture choices.

A denture or a complete denture as it is often called, is an appliance that is inserted in the mouth, replaces natural teeth and provides support for the cheeks and lips.Most dentures are made of acrylic and can be fabricated two different ways.

Dentures are removable dental appliances that replace missing teeth. Unlike dental implants and dental bridges, which are more or less permanently affixed to the bone, dentures are prosthetic teeth attached to a supporting structure. Dentures can be removed at night, for cleaning, or whenever desired. The most affordable dentures are those made with traditional plastic prosthetic teeth, but even more expensive porcelain cosmetic dentures usually cost less than implants. Read the sections below for an overview of the various types of dentures, as well as denture alternatives and price information.

A conventional denture is made after all teeth have been extracted and the tissues (gums) have healed. An immediate denture is fabricated and inserted immediately after the teeth are extracted and the tissues are allowed to heal under the denture. An upper denture has acrylic, usually flesh colored, that covers the palate (roof of the mouth). A lower denture is shaped like a horseshoe to leave room for the tongue.

The teeth are made of plastic, porcelain or a combination thereof. Dentures can be fabricated to fit over endodontically treated teeth and a complete denture can be attached to dental implants to allow for a more secure fit of the appliance.

Dentures over a normal course of time will wear and need to be replaced or relined in order to keep the jaw alignment normal. The alignment will slowly change as the bone and gum ridges recede or shrink due to the extraction of the teeth. Regular dental examinations are still important for the denture wearer so that the oral tissues can be checked for disease or change.

Denture Alternatives

For those who want more stable and comfortable denture alternatives, dental implants and dental bridges may be an option. Implants are similar to dentures, in that they are prosthetic teeth used to replace natural teeth, but they are attached to the jaw by means of metal studs implanted permanently into the bone. Bridges are groups of just a few prosthetic teeth attached to adjacent natural teeth with metal and plastic connectors. Bridges help to preserve some of the mouth's structural integrity by leaving as many natural teeth in place as possible. Your dentist can help you decide if either of these denture alternatives is better suited to your individual needs.

BRIDGES

Dental Bridges

If you’re missing one or more teeth, you are aware of their importance to your appearance and dental health. Your teeth work together for many daily functions, including eating and speaking. A dental bridge is a device used to replace missing teeth. It attaches artificial teeth to adjacent natural teeth. Bridges are either permanently attached (fixed bridges), or they can be removable. Bridges are a traditional way to restore your dental health and appearance.

Although you may need a bridge for more than one missing tooth, most commonly a dental bridge is made up of two dental crowns for the teeth on either side of the gap from one missing tooth. An artificial tooth replaces the missing tooth in between. Natural teeth or dental implants can be used to support the bridge. The dental bridge type you choose will depend on how many and which teeth are missing, your goals, and the cosmetic results you desire.

Fixed Bridges

are applied by either placing crowns on the support teeth or by bonding the artificial teeth directly to the natural support teeth. Fixed bridges offer more stability than their removable counterparts. Fixed bridges are bonded into place and can only be removed by a dental professional.

Removable Bridges

are attached to the teeth with metal clasps or by precision attachments. Removable bridges can be taken out and cleaned.

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