Randall LaFrom, DDS and Associates presents:
With that in mind, we have dedicated this section of our web site
towards providing definitions, explanations and insight as to the procedures and
concepts behind why they are done.
Amalgams
Amalgams are a mix of metals. They contain approximately 50% mercury. The rest
of it is either silver, copper or tin or other traces metals to give the mix
a consistency that will allow dentists to place it and pack it inside a tooth.
The benefit of amalgam is it's easy to fill and it's cheap. The problem is that
in addition to the toxicity of the materials is that the metal has a different
level of expansion than does a human tooth and as a result, typically within
10-15 years, we often see most of the teeth fractured as a result of the expansion
of the metal. Just as the mercury in a thermometer will expand and give a higher
reading from the expansion of the mercury, the same thing happens to the fillings
in your mouth when you eat or drink ot of cold things. At our office, we do
mercury-free restorations only to eliminate the potential toxicity to our patients
as well as lower the risk of the teeth breaking after the restoration is placed.
Composites and Porcelain offer excellent alternatives to mercury.
Bleaching
Teeth can often be whitened by the several new techniques of "bleaching"
available today. One of the common methods used is the "in-office"
method where a strong bleaching agent is placed over the isolated teeth and
a special light is used to activate the bleaching material that will lighten
the teeth. This method is generally more controlled and probably better for
people who have tetracycline stains or streaks on their teeth. The "home"
techniques involve making custom trays which fit into the mouth and these are
then filled with bleaching materials. When worn for a few hours a day, noticeable
results are seen generally within a few days to a couple weeks. Results vary
from individual to individual and it is probably best to check with your dentist
to help decide which method works best for you. Some of the factors involved
include the intensity of the stains, whether or not you have fillings or crowns
on your front teeth as well as what may have caused the stains.
Composites
Composite, or white plastic fillings, are used when esthetics is a concern.
While the currently available materials used for composites may not be quite
as strong as the mercury/silver fillings on the chewing surfaces, they do excellently
in the grooves, and dramatically lower the development of cavities. Composites
are typically placed in the cavities in the front teeth. Many of the newer composites
are boasting longevity comparable to the metal fillings and they have less stress
and risk of fracture to the tooth since they are bonded to the teeth. We use
a special light which hardens (or "cures") the material, allowing
us more time to form the material and make sure the color is just right prior
to the material setting.
Crowns and Bridges
Crowns are placed over a tooth when a large portion of the tooth is lost, decayed
or has broken off and there is a risk for further fracture or undue stress.
Usually, when a filling is more than half of the size of the tooth, the tooth
is weakened. If the filling would comprise a significant portion of the tooth,
often the tooth can fracture under the stresses of chewing and therefore, placing
a crown over the tooth protects the chewing surface and prevents that from happening.
Crowns that are white (sometimes called "caps") are made of porcelain
and are usually placed in areas of esthetic concern. Gold crowns might be placed
in the molar region or when there is heavy grinding that might damage the opposing
teeth. A bridge is generally placed when a tooth is missing and there are teeth
on either side to support a connecting piece to restore function and esthetics
to the area.
Dentures
Dentures are false teeth. They are typically made from impressions (molds) that are
taken of the inside of the mouth and they are made of a type of plastic or porcelain
that duplicates the shape, size and function of the teeth. When only some teeth are
replaced, it is called a "partial denture". Some people stil refer to these
as upper or lower "plates".
Implants
Dental implants, simply put, are typically titanium posts that are imbedded into
the jawbone and then plastic or porcelain teeth are placed over the portion of the
implant that sticks out of the gums. They usually take several months to complete
since the bone must fuse to the posts before any kind of pressure can be put on the
implant itself. They can be used when there are no support teeth available to put
a bridge in, or when only a single tooth is missing and you don't wish to impinge
on the adjacent teeth by putting crowns over those to help fill in the gap. Implants
can be time consuming and costly, however, the benefits are definitely there for
selected individuals. We advise that you discuss your options thoroughly before
deciding either way on implants.
Lasers
This area of dentistry is evolving continuously. The benefits of using a laser
in dentistry become more and more evident as research studies the many uses.
Initially the laser was used primarily for soft tissue treatment. This would
be for gum surgery, tissue healing or doing biopsies or tissue removal. Now
it has expanded it's usage for desensitizing teeth and the removal of small
fillings and cavities. The benefits are that it can often be used without anesthetic.
It is a very precise instrument and allows us to prepare surfaces for better
bonding of the white filling or porcelain restoration. The disadvantages are,
the laser can't cut metal or mercury restoarions and can only be used in a limited
"hard-tissue" treatments. Because of the angle of the laser tip and
the method of delivery, it has not quite gotten to the point where it will out
cut a standard handpiece.
Micro-abrasion
A new area of dentistry has evolved, primarily from a new technique using a mini-sand
blaster which sprays a focused high pressure spray of aluminum oxide. We can actually
do small fillings and remove old composite fillings actually quite easily and comfortably,
often without any anesthetic using this instrument. It is referred to as the "Soft-Prep".
There are other brands of micro-abrasion machines out there, but this is the one
we use.
Root Canals
A root canal is typically done whenever the decay or injury to the tooth invades
the inner part of the tooth where the pulp is. This is where the nerve and the blood
supply are located. When a root canal is done, the inner portion of the pulp is removed,
along with any infection that may have invaded the inside walls of the tooth. Then
a sealer material is placed with a rubbery plastic to fill the hole so that new infection
can't get into the tooth. Generally, by removing the nerve and blood supply to the
tooth, it can potentially weaken a tooth and therefore, it is common to protect the
integrity of the tooth by placing a crown over the tooth.
Sealants
Sealants used to be considered for childrens teeth only. Now we are finding that
adults too, can benefit from sealants. Sealants are plastic coatings that are placed
on the etched surface in the deep grooves of teeth - typically on the back molars
and sometimes on pre-molars. It helps prevent sugars and bacteria from getting into
those deep fissures and cause decay.
TMJ
The temporo-mandibular joint (TMJ) is a very unique and fragile joint. Because of
the numbers of tendons, ligaments and muscles that are used to hold it in position,
it is subject to trauma and stress. As a result, headaches, jaw soreness and and
neckaches can all be related to problems related to the TMJ. Sometimes the small
disc that separates the lower jawbone from the socket where it rests gets displaced
and a bite splint may be used among other therapies to "reposition" the
jaw into the proper alignment.
There is a wealth of knowledge available to the general public on more detailed description
of dental procedures from both the California Dental Association (CDA) as well as the American Dental Association
(ADA)
This information was provided by Dr. Randall LaFrom and Associates for your benefit.