Fillings

Traditional dental restoratives, or fillings, may include gold, porcelain, and composite. The strength and durability of traditional dental materials continue to make them useful for situations where restored teeth must withstand extreme forces that result from chewing, such as in the back of the mouth.

Newer dental fillings include ceramic and plastic compounds that mimic the appearance of natural teeth. These compounds, often called composite resins, are usually used on the front teeth where a natural appearance is important, as well as on the back teeth depending on the location and extent of the tooth decay.

What's Right for Me?

Several factors influence the performance, durability, longevity and expense of dental restorations, including:

• The components used in the filling material
• The amount of tooth structure remaining
• Where and how the filling is placed
• The chewing load that the tooth will have to bear
• The length and number of visits needed to prepare and adjust the restored tooth.

Before your treatment begins, your doctor will discuss with you all of your options, and help you choose the best filling for your particular case. To help you prepare for this discussion it may be helpful to understand the two basic types of dental fillings — direct and indirect.

• Direct fillings are fillings placed immediately into a prepared cavity in a single visit. They include glass ionomers, resin ionomers, and composite (resin) fillings. The dentist prepares the tooth, places the filling, and adjusts it in just one appointment.
• Indirect fillings generally require two or more visits. They include inlays, onlays, veneers, crowns, and bridges fabricated with gold, base metal alloys, ceramics, or composites. During the first visit, the dentist prepares the tooth and makes an impression of the area to be restored. The dentist then places a temporary covering over the prepared tooth. The impression is sent to a dental laboratory which creates the dental restoration. At the next appointment, the dentist cements the restoration into the prepared cavity and adjusts it as needed.

Sealants

Sometimes brushing is not enough, especially when it comes to those hard-to-reach spots in your mouth. It is difficult for your toothbrush to get in between the small cracks and grooves on your teeth. If left alone, those tiny areas can develop tooth decay. Sealants give your teeth extra protection against decay and help prevent cavities.

Dental sealants are a plastic resin that bonds and hardens in the deep grooves on your tooth's surface. When a tooth is sealed, the tiny grooves become smooth, and are less likely to harbor plaque. With sealants, brushing your teeth becomes easier and more effective against tooth decay.

Sealants are typically applied to children's teeth as a preventative measure after the permanent teeth have erupted as a way to prevent tooth decay. However, adults can also receive sealants on healthy teeth. It is more common to seal "permanent" teeth rather than "baby" teeth, but every patient has unique needs, and your dentist will recommend sealants on a case-by-case basis.

Sealants last from three to five years, although it is fairly common to see adults with sealants still intact from their childhood. A dental sealant only provides protection when it is fully intact so if your sealants come off, let your dentist know, and schedule an appointment for your teeth to be re-sealed.

Anterior Composites

Indications:

• Decay
• Fracture, chip
• Broken teeth
• Fluorosis
• Decalcification
• Esthetics (peg lateral)

Patient Benefit:

• Esthetics, self esteem
• The removal of decay and the placement of a filling restores the original form and function of a tooth

Posterior Composites

Indications:

• Decay
• Fracture, chip
• Broken teeth
• Decalcification
• Malformed teeth

Patient Benefit:

• The removal of decay and the placement of a filling restores the original form and function of a tooth

Stainless Steel Crown

Indications:

• Primary molars with extensive mesial and distal decay
• Malformed enamel
• Advanced wear due to grinding
• A missing permanent replacement tooth
• A primary tooth that has had a pulpotomy, or large fracture
• Class V decayv
• 2 surface filling with recurrent decay on a tooth that will be retained for more than 1 year

Patient Benefit:

• Primary molars, and in particular first primary molars with decay on more than one surface, will have the benefit of a much more durable and reliable restoration with a stainless steel crown After placement, the tooth is once again healthy and in most cases will last until the tooth fairy says it’s time to go!

Extraction

Indications:

• Abscessed tooth/pain
• Dual eruption
• Crowding
• Orthodontics

Patient Benefit:

• Extractions save time, money and pain

Pulpotomy

Indications:

• Decay that involves the pulp on a permanent tooth
• A pulpotomy removes the unhealthy tissues only in the crown portion in the tooth

Patient Benefit:

• Removing the decayed portion of the root will help prevent further decay and an abscessed tooth

Pulpectomy

Indications:

• Decay that invades the pulp on an anterior tooth
• A pulpectomy removes the entire root

Patient Benefit:

• Removing the decayed portion of the root will help prevent further decay and an abscessed tooth

Operculectomy

Indications:

• The removal of the operculum, or flap of tissue, that is covering the distal portion of a tooth
• There may be a need for a filling or a sealant after the tissue removal

Patient Benefit:

• An operculectomy allows access to a tooth that needs a filling or a sealant

Fiberotomy

Indications:

• This is the cutting of the fibers surrounding a tooth
• This procedure is a request from an Orthodontist to prevent the shifting of teeth after treatment with braces

Patient Benefit:

• By cutting these fibers, the “memory” of the tooth is stopped, and shifting is prevented
• These fibers will reattach

Frenectomy

Indications:

• This is the removal of a frenum, a band of tissue that connects the lip to the cheek, or the tongue to the floor of the mouth
• The frenum acts as a rubber band between the front teeth, sometimes preventing the space from closing

Patient Benefit:

• Removal of this tissue creates the opportunity for the front teeth to mover together as they erupt
• This will reduce the need for orthodontic treatment in the future