Crowns are full coverage restorations that are used to cover a tooth that is likely to break or is too broken down to be restored with a filling. They are most commonly done after root canal treatment or when a large filling wears out. Larger areas of decay are more likely to need a crown to fully restore the tooth. Deep and larger and areas of decay require more of the natural tooth structure to be removed which causes the tooth to lose strength. A large filling may fill the area but it will not provide the necessary strength the tooth needs and is more susceptible to breaking. Keep in mind that the jaw muscles are the strongest in the human body. Teeth are subjected to tremendous pressures. Crowns ride over the weakened tooth, providing strength and protecting the tooth against breakage. A broken or cracked tooth is a far more serious matter and much more difficult to treat. Crowns prevent this, as well as making for a nice smile.
It takes two appointments to restore a tooth with a crown. In the first visit, any decay is removed from the tooth and it is shaped to accept the crown. Then, an impression is made of the tooth for use in fabricating a crown. Between the two visits, the impression is sent to the lab where the crown is made, usually of high-strength porcelain over silver alloy, all ceramic material, or gold. During this time a temporary crown is worn. In the second visit this temporary crown is removed and the permanent crown fabricated in the lab is placed. The permanent crown is adjusted as needed and then cemented in place.
DENTURES AND PARTIALS There are different types of dentures and partials, but they share the same common function. They replace teeth that have become loose or been lost due to bone loss or decay. The entire mouth is examined and a determination is made as to which teeth will have to be removed and which will remain. Often the patient has a choice between a full denture or a partial. A denture replaces all of the teeth, where as a partial only replaces some of the teeth, allowing the patient to retain some of his/her natural teeth. Based on which removable appliance is chosen, the next step is to extract (remove) the teeth to be replaced. Dentures or partials are fitted to go over or around whatever teeth remain in the mouth, depending on the type. There is an adjustment period after dentures and partials are placed in the mouth. It can take some time to get used to your new denture or partial. Once accustomed to them, most patients are able to eat and speak with confidence. Sometimes, implants are used to further stabilize dentures and partials.
This is an option for filling the space created by a missing tooth. It is formed to look like the missing tooth, and it takes its place in the mouth. The sides of a bridge use the two surrounding teeth for support, hence the name. A bridge replaces the missing tooth, both functionally and cosmetically. Bridge work is as much an art as it is an exact science. The materials used may be gold alloys, porcelain bonded to metal alloy, or all ceramic material. The choice of material depends on requirements for strength, wear, and/or esthetics.
It is important that a missing tooth be replaced as soon as possible for several reasons. If not treated, the teeth surrounding the gap begin to shift inward, creating a whole chain reaction of bad things. Teeth use their neighbors for support, and, with one missing, they start to “fall.” As this worsens, the bite changes in response to the pressure. This can eventually result in problems with the entire jaw, e.g. TMJ.
Implants are another way to replace missing teeth. Implants involve a sterile screw placed in the bone by an oral surgeon. After allowing time for the bone to grow into and around the implant, we are then able to attach a crown, bridge, or denture to the implant itself. Implants offer advantages over bridges and dentures because they provide advanced stability and do not require any augmentation of surrounding teeth. Implants have been around for about 30 years, but have recently become more and more popular as technology has advanced. Patients like implant restorations because they look and feel just like natural teeth and are very easy to clean and care for.
Root canals are necessary when teeth become diseased due to decay, fracture, or trauma. When this happens, the nerves of these teeth can become very sensitive or die completely. This can cause extreme pain, swelling, and further damage to surrouding teeth and tissues. To save these teeth, a root canal is required. We make a small opening in the tooth and use this opening to clean the nerve out of the tooth with chemicals and small instruments called files. Once the nerve is cleaned out of the tooth, the infection is gone and the sensitivity is eliminated. We then seal the tooth to prevent further infection from causing issues in the future. Depending on the extent of the damage to the tooth prior to root canal therapy, some teeth require crowns after treatment to ensure that these teeth do not break and provide a good, stable, long lasting tooth for many years.
In most situations, we are able to perform this service in the office, however, in some instances, Dr. Motz may refer the patient to an Oral Surgeon (a Dental Professional who specializes in removing teeth.)
What to do after extraction of a tooth
A few days after the extraction of a tooth, the wound usually heals to the point where you can function normally. In the meantime, you can follow a few simple rules to promote healing, prevent complications, and make yourself more comfortable.
A gauze pack is placed on the extraction site to limit bleeding and confine the blood while clotting takes place. The gauze pack should be left in place for 60 minutes after the tooth is removed. Refrain from talking as much as possible until the bleeding stops. If bleeding or oozing continues after the pack is removed, fold a piece of clean gauze or papertowel into a pad that is thick enough to bite on. Dampen the pad with water and place it directly on the extraction site. Apply pressure by closing the teeth firmly over the pad. Maintain this pressure for about 30 minutes and change the pad every 30 minutes until the bleeding stops. Remember that a lot of saliva and a little blood may look like a lot of bleeding. You may spit out the saliva once in a while. If heavy bleeding continues, please call the office.
The Blood Clot
After an extraction, a blood clot forms in the tooth socket. This clot is part of the normal healing process. It is important to avoid activities that might disturb the clot. To protect the clot do not smoke, rinse your mouth vigourously, or drink through a straw for 24 hours. These activities create suction in the mouth, which could dislodge the clot and delay healing. Do not clean the teeth next to the healing tooth socket for 24 hours. Brush and floss the other teeth thoroughly. Limit strenuous activity for 24 hours after the extraction. This reduces bleeding and will help the blood clot to form.
Swelling and Pain
After a tooth is removed, you may have some discomfort and notice some swelling. You can help reduce swelling and pain by applying a cold compress, bag of frozen vegetables, ice bag, or cold moist cloth to the face for the first 24-48 hours. Medication may be prescribed to control pain and prevent infection. Use them only as directed. If you have prolonged pain, severe pain, swelling, bleeding, or fever call the office immediately.
For 48 hours after the extraction, drink lots of fluids and eat soft nutritious foods. Avoid alcoholic beverages as they dry out the tissues and delay healing. Also avoid hot liquids and hard foods since they can dissolve and disturb the blood clot. Chew as much as possible on the side opposite the extraction site.
The morning after the extraction, gently rinse your mouth with one half teaspoon of salt in 8 ounces of warm water. This helps to remove residue from the site and remove any unpleasant taste. You may rinse after meals as well to keep food particles out of the extraction site. Remember to always rinse gently so the blood clot is not disturbed.
Keep Lips Moist
Due to the stretching of the mouth during surgery, the lips may dry out and crack, especially at the corners. Keep them lubricated with Chap stick, Vaseline, or other lip ointment.
It may take 6-8 weeks for the tissue around the extraction site to heal. Bone typically takes 4-6 months to heal. Healing can take longer for patients who smoke, have diabetes, or take certain medications like steroids or fosamax. Remember, that extractions are minor surgery, and to give yourself time to recover.