Restorative Procedures
Fillings, Crowns and Bridges

Today the incidence of tooth decay has significantly diminished. Over the years  the use of fluorides and an increase in patient awareness have helped especially our children to have beautiful smiles with very few restorations.  However, teeth are still susceptible to decay, infection, and breakage and sometimes need to be restored back to health.  Through improved techniques and modern technology, we are now able to detect decay earlier and offer more options for restoring a tooth.

Should your teeth ever require a restorative treatment, you will have a large number of possibilities. Please feel free to discuss what is available. We will gladly  recommend what we believe to be the most comfortable, least invasive treatment and best option for you or your loved ones.  

Reasons for restorative dentistry:

  • Remove decay and stop future damage. 
  • Replace old, failing or unattractive dental restorations. 
  • Seal deep cracks to prevent decay in young patients.
  • Fill unattractive spaces between front teeth. 
  • Improve or correct food getting stuck between teeth. 
  • Prevent the loss of a tooth. 
  • Relieve dental pain. 
  • Repair damaged and decayed teeth. 
  • Replace missing teeth. 
  • Restore normal eating and chewing.

Remember to look after your teeth and they will look after you!

Composite Fillings 
Fillings do not have to be ugly anymore. In fact they have become so natural looking that it is sometimes difficult to see them in your tooth. Composites are really epoxy resin filled with tiny glass or silica particles. They resemble something like "epoxy concrete". A composite (tooth colored) filling is used to repair a tooth that is affected by decay, cracks, fractures, etc.  The decayed or affected portion of the tooth will be removed and then filled with a composite filling.

Composite fillings are widely used today.  They  are glued (bonded) to the tooth and therefore strengthen the remaining tooth structure. Because composite fillings are tooth colored, they can be closely matched to the color of existing teeth, and are more aesthetically suited for use in front teeth or the more visible areas of the mouth.

Composite fillings can last 10 to 15 years and may someday have to be replaced.  As with other restorations in your mouth, oral hygiene techniques and regular professional care will have a major effect on the life span of a filling.

Reasons for composite fillings:

Chipped teeth.
Closing space between two teeth.
Cracked or broken teeth.
Decayed teeth.
Worn teeth.

How are composite fillings placed?
Composite fillings are usually placed in one appointment.  While the tooth is anaesthetized, we will remove decay as necessary.  The tooth surface will then be thoroughly cleaned and carefully etched with acid for 10 seconds. This removes bacteria and prepares the tooth surface for bonding of the composite.  If the decay was near the nerve of the tooth, we will tell you about it.  The composite material will then be  placed, shaped in thin layers and hardened with a white curing light. After the filling is complete it will be polished to restore your tooth to its original shape and function.

Sometimes you may experience sensitivity to hot and cold when composite fillings have been placed. If all is well however this will subside shortly after your tooth gets used to the new filling.

You will be given care instructions at the conclusion of your treatment.  Good oral hygiene practices, eating habits, and regular dental visits will improve the life of your new fillings.

Onlay Restoration
Onlays are used if a tooth has lost too much tooth structure to be restored with a conventional filling. An onlay restoration is a custom made filling made outside the mouth and then cemented onto or into the tooth. Aesthetic (tooth coloured) onlays can be made of composite material or tooth-colored ceramics.  Gold onlays are used to a lesser extend today because they do not look as beautiful. An onlay is sometimes also referred to as a partial crown. It used to be made by a professional dental laboratory and is permanently cemented onto the tooth by your dentist. Today some dentists utilize computers and milling machines that can make an onlay in their surgery at the time of your appointment.

Onlays can be utilized to conservatively repair teeth that have large defective fillings or have been damaged by decay or trauma.  Onlays are an ideal alternative to crowns (caps) because less tooth structure is removed in the preparation of onlays.  Onlays are essentially identical to inlays with the exception that one or more of the chewing cusps have also been affected and need to be included in the restoration.

Reasons for onlay restorations:

Broken or fractured teeth.
Cosmetic enhancement.
Decayed teeth.
Fractured fillings.
Large fillings.

What does getting an onlay involve?
An onlay procedure usually requires one or two appointments.  Your first appointment will include taking several highly accurate impressions that will be used to create your custom onlay and a temporary restoration.

While the tooth is anaesthetized, we will remove any decay and/or old filling materials.  The preparation will then be cleaned and carefully prepared in a specific way for an onlay restoration.  An impression is then taken and a temporary filling will be fabricated. This protects your tooth while your onlay is made by a dental laboratory.

At your second appointment, your onlay will be carefully fitted and cemented into place.  A few adjustments may be necessary to make sure that your bite is comfortable.

Crowns (Caps)
A crown (or cap) is a covering that covers the entire broken down tooth surface to restore it to its original shape and size.  A crown protects and strengthens tooth structure. They are therefore used on teeth that have lost to much tooth structure and cannot be restored with any other type of restoration.

Today there are many types of crowns. Porcelain, zirconium oxide and pressed glass ceramics as well as metal ones. Ceramic crowns look beautiful, do not show any grey lines near your gum and are highly durable if cared for properly. Metal crowns are virtually indestructible but do not looks as good as ceramic ones. Crowns should last 10 - 15 years but may eventually need to be replaced.  Ceramic crowns are made to match the shape, size, and color or your teeth giving you a natural, long-lasting beautiful smile.

Reasons for crowns:

Broken, cracked or fractured teeth.
Cosmetic enhancement.
Decayed teeth with large defects.
Fractured fillings with new decay.
Large fillings that weaken the tooth.
Teeth with root canal treatments.

What does getting a crown involve?
A crown procedure usually requires two appointments.  Your first appointment will include preparation of the tooth, taking accurate impressions and fabrication of a temporary acrylic crown. The temporary crown will protect your tooth for approximately four weeks until your new crown is back from the dental laboratory.

While the tooth is anaesthetized, we will prepare the tooth by removing any decay and building up missing tooth structure. Then the surface will be shaped to accommodate the new crown. Once these steps are accomplished, your temporary crown will be placed with temporary cement. The temporary crown will be adjusted to ensure you are biting comfortably.

At your second appointment your temporary crown will be removed, the tooth will be cleaned, the crown fitted and carefully cemented to ensure the spacing and bite are accurate.

You will be given homecare instructions and encouraged to have regular professional cleanings to care for your new crown.

Fixed Bridges 
A dental bridge is a fixed (non-removable) appliance and is an excellent way to replace missing teeth.

There are several types of bridges.  We can discuss the best options for your particular case.  The “traditional bridge” is the most popular type and is usually made of metal or zirconium oxide covered with porcelain.  This type of bridge consists to two or more crowns that go over anchoring teeth (abutment teeth). Additional teeth called pontics are attached to the crowns, filling the gaps created by one or more missing teeth.

A bridge should last 10-15 years. Normally the teeth involved break down before the bridge becomes defective.

Reasons for a fixed bridge:

Fill space of missing teeth.
Maintain facial shape.
Prevent remaining teeth from drifting out of position.
Restore chewing and speaking ability.
Restore your smile.
Upgrade from a removable partial denture to a permanent dental appliance.

What does getting a fixed bridge involve?
Getting a bridge usually requires two or more visits.  While the teeth are numb, the anchoring teeth are prepared as for a crown.  Next, an impression is taken which will be sent to a dental laboratory where the bridge will be fabricated.  In addition, a temporary bridge will be made and worn for about 4 weeks until your next appointment.

At the second visit, the temporary bridge will be removed, the teeth cleaned and your permanent bridge will be carefully fitted. After final adjustments it will be cemented.

We will gladly give you homecare instructions to clean under and around the bridge at the end of the procedure.  Proper brushing, flossing and regular professional cleans will aid in the life of your new bridge

Root Canal Therapy 
A root canal therapy is needed when the nerve of a tooth is affected by decay, trauma or infection.  In order to save the tooth, the pulp (the living tissue inside the tooth), nerves, bacteria, and any decay are cleaned out and the resulting space is filled with special dental materials, which restore the tooth. 

Having a root canal done on a tooth is the only treatment to save a tooth that otherwise would have to be removed.  Many patients believe that removing a tooth is the solution. Removing a tooth that could be saved is very often a short term solution resulting in a long term problem.

Teeth that have had root canal treatment may become brittle over time. This is especially the case if large amounts of tooth structure have been lost. In a case like this it is recommended that a crown should be fabricated after a few months to protect the tooth and prevent fracture of the crown.

Signs and symptoms for possible root canal therapy:

  • An abscess (or pimple) on the gums.
  • Sensitivity from cold that last for more than 30 minutes.
  • Sensitivity to hot which improves when drinking cold water.
  • Severe throbbing toothache that starts by itself (often at night).
  • Sensitivity to biting, tapping.
  • The tooth feeling "longer" than the others.
  • Sometimes no symptoms are present.
  • Swelling and/or tenderness.

Reasons for root canal therapy:

  • Decay has reached the tooth pulp (the living tissue inside the tooth).
  • Infection or abscess have developed inside the tooth or at the root tip.
  • Injury or trauma to the tooth.
  • X-rays showing an infection forming at the tip of the root.

What does root canal therapy involve?
A root canal procedure requires one or more appointments and can be performed by a dentist or endodontist (a root canal specialist).

While the area is anesthetized, a rubber dam (a sheet of rubber) will be placed around the tooth to keep it dry and free of saliva.  The tooth is carefully opened up and the dead tissue and bacteria removed. Normally the tooth is rinsed with disinfectant solutions and small instruments are used to shape the internal canals to clean and prepare thecanal for filling at the end. If there is swelling and infection the tooth will receive some antibiotic dressing and will be left with a temporary filling till the final appointment.

At the final appointment, usually a few weeks later, the roots and the inside cavity of the tooth will be cleaned again. After drying the canals with be filled with special points and sealed with a special cement.  A composite filling will be placed to cover the opening on top of the tooth.  

Teeth that have had root canal treatments should have a crown placed a few months later or after all symptoms have subsided.  This will protect the tooth and prevent it from breaking should the patient bite on something hard.

After treatment, your tooth may still be sensitive for a few weeks, but this will normally subside with time as the inflammation diminishes and the tooth settles down.

Dentures & Partial Dentures
A denture is a removable dental appliance used to replace missing teeth and surrounding tissue.  They are made to closely resemble your natural teeth and may even enhance your smile.

There are two types of dentures - complete and partial dentures.  Complete dentures are used when all the teeth are missing, while partial dentures are used when some natural teeth remain.  A Partial denture not only fills in the spaces created by missing teeth, it prevents other teeth from shifting.

A Complete denture may be either “conventional” meaning that it is made after the gums have healed or the person has been wearing dentures before. The second or “immediate” denture is placed immediately after teeth are removed.  Immediate dentures are made in advance and immediately placed after the teeth are removed, thus preventing the patient from having to be without teeth during the healing process.  Once the tissues shrink and heal, immediate dentures need to be relined and adjustments will have to be made.

Today, dentures can be made to fit onto dental implants. This improves their fit and function drastically and can change the life of patients who have been suffering from loose or ill fitting dentures.

Dentures are very durable appliances and will last many years, but may have to be relined when tissues and bone change, remade, repaired, or readjusted due to normal wear.

Reasons for dentures:

Complete Denture - Loss of all teeth in an arch.
Partial Denture - Loss of several teeth in an arch.
Enhancing smile and facial tissues.
Improving chewing, speech, and digestion.

What does getting dentures involve?
The process of getting dentures requires about four appointments, usually over a month.  Highly accurate impressions and measurements are taken and used to create your custom denture.  A “try-in” appointment is schedudel to ensure proper shape, color, and fit.  During the try-in the patient has a chance to see what the final product will look like. If anything needs to be changed, it can still be done at this stage. 

At the final appointment, we will make final adjustments and then place the completed denture, ensuring a natural and comfortable fit.

It is normal to experience increased saliva flow, some soreness, and possible speech and chewing difficulty at the beginning. This however this will usually subside as your muscles and tissues get used to the new situation.

You will be given homecare instructions for your new dentures.  Proper cleaning of your new dental appliance, good oral hygiene, and regular dental visits will aid in the life of your new dentures