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Restorative Care

Restorative Care

We ask a lot of our teeth over our lifetime. We subject them to a variety of foods; endure habits such as grinding/clenching of teeth or chewing ice; and the constant interaction of sugar and dental plaque which leads to dental decay – the leading cause of tooth damage and the most common disease known to humans.

Restorative Dentistry is indicated when teeth must be rebuilt to their original structure by the use of direct and indirect restorative materials. Specific conditions that determine the need for restorative dentistry include:

  • Initial or recurring decay (cavities)
  • Replacement of failed restorations (old, leaking fillings)
  • Abrasion or wearing away of tooth structure (teeth grinding, clenching)
  • Erosion of tooth structure (acid from reflux disease; citrus fruits; soda)
  • Unsupported or weak tooth structure (fillings that are too large)
  • Fractures (cracked or broken teeth or fillings)

What is the Definition of Restorative Care?

Restorative Dentistry is the study, diagnosis and integrated management of diseases of the teeth and their supporting structures and the rehabilitation of the dentition to functional and aesthetic requirements of the individual. What does that mean? Like the restoration of an older car or a building, restorations of your teeth are required when teeth have broken down or worn down and are at risk of being non-repairable.

Dr. John’s video talks about decay

Do you need Restorative Care?

The primary purpose of teeth is to tear and crush food, so that when mixed with enzymes in the mouth, the digestive process can begin. Eating the foods you want your whole life depends on the health of your teeth. Lack of enough healthy teeth to chew with can lead to digestive problems and health changes due to lack of proper nutrition. Remember, 29% of people with dentures eat only soft foods. So we restore our broken/decayed/worn out teeth so they are healthy enough to eat and chew our food.

How are teeth restored?

  1. Direct Restorations

Direct restorations are fillings placed immediately into a prepared cavity in a single visit. They include dental amalgam and most composite (resin) fillings. The dentist prepares the tooth, places the filling and adjusts it during one appointment.

Amalgam (silver/mercury)

The word “amalgam” when referring to dental fillings means a mixture of two or more metals in which mercury is a component. Dental amalgam is a mix of approximately 43 percent to 54 percent mercury with other metals, including silver, copper and tin. Dental amalgams have commonly been called “silver fillings” because of their silver color when they are first placed.

Is Dental Amalgam Safe?

When amalgam fillings are placed in or removed from teeth, they can release a small amount of mercury vapor. Amalgam can also release small amounts of mercury vapor during chewing, and people can absorb these vapors by inhaling or ingesting them. High levels of mercury vapor exposure are associated with adverse effects in the brain and the kidneys. Since the 1990s, several federal agencies have reviewed the scientific literature looking for links between dental amalgam and health problems. According to the Centers for Disease Control and Prevention (CDC), there is little scientific evidence that the health of the vast majority of people with dental amalgam is compromised, nor that removing amalgam fillings has any beneficial effect on health. A 2004 review of the scientific literature conducted for the U.S. Public Health Service found “insufficient evidence of a link between dental mercury and health problems, except in rare instances of allergic reaction,” according to the FDA.

In spite of this, several countries have banned the use of dental amalgam including Norway, Finland, Sweden, and Japan. The Minamata Convention, negotiated under the auspices of the United Nations Environmental Programme (UNEP), sets a deadline for banning the manufacture, import, and export of several categories of products containing mercury, such as batteries, light bulbs, and cosmetics, by 2020. However, it excludes dental amalgam from this list, instead laying out measures that countries should be using to reduce its use. It does not set a timetable and leaves much to the discretion of individual countries.

Our Policy on Silver/Mercury Fillings: We believe that there are safer, more effective filling materials than dental amalgam, and as a result we have not placed mercury fillings since 2002. We encourage our patients to make informed choices regarding their existing silver/mercury fillings and we respect your decision to leave or remove these materials from your teeth based on your beliefs regarding the effect of these fillings on your overall health.

Composite (resin)

Composite is a mixture of acrylic resin and powdered glass-like particles that produce a tooth-colored filling. This type of material may be self-hardening or may be hardened by exposure to blue light. Composite is used for fillings, inlays and veneers. Sometimes it is used to replace a portion of a broken or chipped tooth.

  1. Indirect Restorations

Indirect restorations used to require two or more visits, before one-visit CEREC dentistry (see discussion of CEREC below). They include inlays, onlays, veneers, crowns and bridges fabricated with gold, ceramics or composites. During the first visit, the dentist prepares the tooth and makes an impression of the area to be treated. The impression is sent to a dental laboratory, which creates the dental restoration (crown). At the next appointment, the dentist cements the restoration to the prepared tooth and adjusts it as needed. Our office has the CEREC restorative technology, where we can design and place indirect porcelain restorations in one visit.

Porcelain (ceramic)

All-porcelain (ceramic) materials include porcelain, ceramic or glass-like fillings and crowns. They are used in inlays, onlays, crowns and cosmetic veneers. Porcelain fused to metal is another application for this material and has similar properties as described below with the notable exceptions of increased durability due to the metal substructure, the necessity for more tooth removal for that substructure and, in rare cases, a localized, allergic reaction may occur.

Gold Alloys

Gold alloys contain gold, copper and other metals that result in a strong, effective filling, crown or bridge. They are primarily used for inlays, onlays, crowns and fixed bridges.

CEREC

Our practice has used the CEREC Tooth Restoration System since 2006.

CEREC is an acronym:

Chairside: The technology is done in the office while patients are in the chair
Economical: The procedure is economical
 for patients
Restorations: The procedure restores teeth to their natural beauty, function, and strength
Esthetic: The restorations are metal-free and tooth-colored
Ceramic: High-strength ceramics are used that are close in composition to natural tooth structure

CEREC is an advanced dental restorative system that allows us to restore decayed teeth, place crowns, or remove defective amalgam fillings in just one appointment. This allows you to have the highest quality, most lifelike dental restorations in just one visit to the dentist…in, out, and on with your busy life.

The state of the art CEREC system was developed in 1985 at the University of Zurich in Switzerland by a dentist, Dr. Werner H. Moermann, and an electrical engineer, Dr. Markus Brandistini. At the heart of the system is innovative technology.

Why the CEREC Procedure?

Dr John CEREC
~ Because We Value YOUR Time

Let’s face it, very few of us have perfect teeth, free of decay and fillings. You can probably see a filling or two in your own mouth. In many cases, those fillings are made of metal material and can go bad, weaken the tooth, or get additional decay under or around it. In fact, 1.2 billion of these metal fillings will need to be replaced in the next 10 years. CEREC is a method used by thousands of dentists worldwide since 1987 not only to replace these fillings, but also to restore any tooth that is decayed, weakened, broken, etc. to its natural strength and beauty. Better yet, it’s done with all-ceramic materials that are tooth colored in a single appointment!

 

How does the CEREC procedure work?

~ Exam and Preparation

We examine your tooth and determine the appropriate treatment. It could be a partial crown or a full crown, depending on how much healthy tooth structure is remaining and our clinical judgment. Next, we gently administer an anesthetic and prepare your tooth for the restoration, removing decayed and weakened tooth tissue. This preparation is just like we would do for many other restorative techniques.

~ Optical Impression

Then we take an Optical Impression of the prepared tooth. Instead of filling a tray with impression “goop” that you must bite into and hold in your mouth until it hardens, we coat the tooth with a non-toxic, tasteless powder. A LED camera is then used to take a digital picture of your tooth. This whole Optical Impression process only takes a minute or two.

~ No Temporaries

Next, the CEREC technology creates the restoration for your tooth. The CEREC 3D software takes the digital picture and converts it into a 3-dimensional virtual model on the computer screen. Dr. John then uses his dental expertise to design the ceramic block into a custom restoration using the CEREC 3D computer program. Within a few minutes, we click a button, and the restoration design data is sent to a separate milling machine in the office. A ceramic block that matches your tooth shade is placed in the milling machine. About 10 – 20 minutes later, your all-ceramic, tooth-colored restoration is finished and ready to bond in place. Finally, your Dentist tries the restoration in your mouth to ensure proper fit and bite. The restoration is then polished and bonded to the prepared tooth. Your tooth is restored with no “temporary” or return trip necessary. All of this is done in a single appointment!