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Many of us have dental fillings in place for many years and the question becomes when should they be replaced? Dental fillings are man made materials used to replace tooth structure that has been damaged by tooth decay. The dental filling will allow your dentist to restore both function and shape of your tooth back to its natural form.

Types Of Dental Fillings

Amalgam (Silver). Use of amalgam has seen some controversy over the years due to its mercury content. Amalgam is made up of a mixture of various metals. Use of amalgam has some drawbacks (beyond its mercury content) which include:

1. No Bonding Properties. Amalgam cannot be bonded to existing tooth structure. This means that a tooth must be over prepared removing more natural tooth structure than necessary to ensure the amalgam filling will hold in place.

2. Not A Cosmetic Restoration. Amalgam is a darker color and cannot be matched to your existing teeth.

3. Increased Risk Of Tooth Fracture. Another disadvantage to using a metal allow is that it can expand and contract over time based on your oral environment. If the metal allow expands too much it can cause your tooth to weaken and fracture over time.

Composite Resin. This has become the preferred dental restoration for most dentists and patients. The advantages of composite resin include:

1. Cosmetic Restoration. Dental composite is a tooth colored material that can be matched to your existing teeth. If done properly a dental composite can match perfectly to your natural teeth.

2. Excellent Bonding Properties. Unlike dental amalgam restorations, a composite resin filling can be directly bonded to your natural tooth structure. This creates a stronger attachment to the teeth.

3. Conservative Restoration. Since a composite resin can be bonded directly to the tooth much less natural tooth structure needs to be removed. There is no need to take away any more tooth structure than is absolutely necessary to restore the tooth back to its natural form and function.

The main disadvantage to the use of composite resin is the presence of Bisphenol-A (BPA) in some dental composites. If this is a concern to you, ask your dentist if they are using BPA free dental composite.

Signs A Dental Filling Needs To Be Replaced

Temperature Sensitivity. This can be quite uncomfortable but it is important to see your dentist when it arises. If the pain goes away after exposure to hot or cold after a few seconds, it is usually repairable but if the pain lingers for a longer time after removal of exposure, it may indicate damage to the nerve that cannot be repaired with a simple dental filling.

Pain Upon Biting. This can indicate a fracture beginning in your tooth from an existing dental restoration.

Throbbing, Constant Pain. If the tooth decay reaches the nerve of the tooth it will create a toothache pain. Root canal therapy may be required at this point.

Fractured Dental Filling. If you notice a piece of your dental filling has broken off you need to see your dentist immediately to have it repaired or replaced.

Conclusion

Being aware of your signs and symptoms is key to knowing when to see your dentist. Regular dental examinations and dental x-rays are needed to fully evaluate your existing dental fillings and give your dentist all the information needed as to when your dental fillings need replacement. It is best to diagnose replacement as soon as possible to avoid more extensive dental work.

Cosmetic dentistry includes a number of dental procedures aimed at improving the appearance of the teeth and smile.  A very common cosmetic procedure is the dental veneer.

Dental veneers are wafer thin, custom fabricated shells of tooth colored materials designed to cover the front surface of teeth to improve your overall smile and appearance. These custom fabricated shells are adhesively bonded to the front of the teeth. This allows the cosmetic dentist the ability to change your teeth’s color, shape, size, or length.

Dental veneers can be fabricated from dental porcelain or from composite (resin) materials. Dental veneers can be used to create bright, white smiles with beautifully aligned, shapely teeth. Dental veneers also protect the surface of broken or damaged teeth, and may eliminate the need for more extensive treatments. Other advantages of dental veneers include durability, an improved smile, and the need for much less tooth structure removal compared to traditional or porcelain crowns.

Why are Dental Veneers Needed?

Dental Veneers are utilized for a variety of reasons in cosmetic dentistry. These reasons can include:

Crooked Teeth. Some minor modifications can be done, which may eliminate the need for orthodontic movement.

Genetics. Certain people are born with abnormal sized/shaped teeth, or gaps between their teeth that widen with age.

Wear and Tear.  Teeth wearing down is a natural part of aging. Aged teeth are more likely to be small,  have chips, fractures, cracks or a generally uneven appearance.

Worn Enamel. Over time, the thin, hard translucent substance covering your teeth (enamel) may become worn, see through,  dull, or discolored. Such wear and discoloration may be natural or result from a genetic predisposition. However, it often results from consuming soft drinks, tea or coffee, smoking, using certain medications, etc.

Material Used for Dental Veneers

The most commonly utilized materials for dental veneers are composite resins and dental porcelain. Porcelain veneers are the more appropriate answer for severe cases involving dullness, wear, tooth discoloration, extensive chipping, cracking, gaps in teeth or uneven teeth. Composite bonding or just dental bonding is an inexpensive, effective and minimally invasive way to restore and correct small chips, cracks and discoloration in the teeth. Porcelain veneers generally require some reduction of the enamel tooth surface, while bonded dental veneers can oftentimes be done without tooth modification. Porcelain veneers are very strong, and do not change color. Bonded veneers tend to chip and pick up stain over time.

Techniques Used in Dental Veneers

Indirect Technique – This technique means that the composite or porcelain veneers are fabricated outside the mouth by a dental technician in a laboratory.

Direct Technique – This technique means that the composite veneers are created directly on your teeth by your dentist during your appointment.

When are Veneers Good Treatment?

The removal by a dentist of any natural tooth structure is permanent, so modern cosmetic dentistry has moved to offer patients the most minimally invasive options first. If your natural teeth are functionally and cosmetically adequate, dental veneers may not be the right treatment for you.

On the other hand, if you have any of the aforementioned cosmetic issues, your treatment options may  include veneers. Dental Veneers do have the advantage of a proven ability to enhance the appearance of the mouth, smile and other facial features that are better supported by properly shaped teeth.

If modification of the tooth surface is necessary to achieve optimum results, some cosmetic dentists will recommend less invasive alternatives to dental veneers. One such alternative would be, teeth whitening for people with mildly discolored teeth who only want a whiter and brighter smile. If crooked teeth or alignment issues are involved, the teeth whitening alternative may also be combined with orthodontic treatments. Invisalign, full braces, or use of an orthodontic appliance for minor tooth movement may be all that you need to acquire the smile you desire.

Care of Dental Veneers

Care must be taken not to abuse dental veneers because the wafer thin porcelain shells or composite layers can be damaged or break. Your dentist may advise you against grinding, fingernail chewing, and biting directly into things such as carrots or pizza crusts. If you grind at night your dentist  may recommend you wear a night guard while sleeping. It is even more important to have excellent dental hygiene, so that you do not get tooth decay forming under your dental veneer. You should also see your dentist for regular cleanings.

Dental Veneers Conclusion

Dental veneers, whether porcelain veneers or composite veneers, are a great option for those who wish to change their smile. Dental veneers give the cosmetic dentist and patient the ability to change color, shape, and size in an easy manner. As always, before pursuing dental veneers of any kind, please have a thorough dental examination and professional cleaning performed to ensure your mouth is healthy and able to withstand the new treatment.

Dental Bonding (also referred to as Adhesive Dentistry) is the process whereby your dentist or cosmetic dentist rebuilds, reshapes, and/or covers tooth defects using tooth-colored materials (composite resins).

Chipping a tooth is one of the most common dental emergencies  that patients and dentists face. Luckily, with modern materials and techniques, it is a situation that is can very easily and quickly be fixed. If the chipped or missing area of tooth is less than about 1/3rd of the tooth surface, dental bonding can be utilized as an option to replace the missing tooth structure with a matching tooth colored material. In situations like this, the dentist can restore your tooth in as little as 45 minutes, sometimes, with no need for local anesthesia. If the chipping covers more than 1/2 of the tooth surface, dental bonding is not generally, a good long term answer. The dentist may instead, recommend a traditional crown PFM (Porcelain fused to a metal framework crown) ,an all porcelain crown or a porcelain veneer.

What is Dental Bonding?

Dental Bonding is a procedure used in cosmetic dentistry to restore a tooth after it has discolored, decayed, broken or chipped. The cosmetic dentist will use a tooth colored material called a dental composite to rebuild the tooth to its former shape,color, and size.

Steps Involved in Dental Bonding

-Preparation. Very little preparation is needed for dental bonding, especially in the case of a chipped tooth. Anesthesia is usually not even needed unless the dental bonding is needed to restore a deeply damaged or traumatized tooth, a fracture close to the nerve, a sensitive tooth, or a tooth damaged by a tooth cavity. Your dentist will need to roughen up the surface and clean the edges to prepare the area to accept the dental bonding. Your dentist will also select a color match for the composite resin they will use. This is generally done by matching to your existing tooth structure.

-The Actual Dental Bonding Process. As mentioned earlier the surface of the tooth will be roughened and an acid etch (phosphoric acid), will be applied to the tooth. The etch removes surface debris and  opens up tiny tubules to bond to. Next, a primer is applied to wet the surface and allow the adhesive  to flow into those tubules. Third, the adhesive bonding agent is applied, this  allows for the material to adhesively bond to the remaining tooth structure. The tooth-colored composite resin is then applied to the effected area, molded, and smoothed to the desired shape. A special light is then used to harden or cure the material. Once the material is hardened, your dentist will need to do more shaping and polish it to match the sheen of the rest of the tooth surface. One of the most important parts of the entire process is in the final shaping and polishing. It is important to blend the composite resin properly to get a result that looks and feels like your natural tooth structure. Once the dentist is happy with the result, they will check your bite. By checking your bite the dentist ensures that your teeth are all biting evenly and not hitting the new restoration first when biting and chewing. The correct bite will allow the bonding a better chance to last.

The entire process should take anywhere between 30-60 minutes depending on size of chip. If done properly, dental bonding should not be noticeable to anyone. It should match your existing tooth structure perfectly.

Dental Bonding - Marielaina Perrone DDS

Dental Bonding – Chipped Front Tooth

Advantages of Dental Bonding

-Dental bonding is probably one of the most fulfilling cosmetic dentistry procedures to perform.

Dental bonding can be completed in office in one short visit. As opposed to a porcelain crown or porcelain veneer which take 1-2 hours . Crowns and veneers take multiple visits to complete and need a dental laboratory to custom fabricate the porcelain crown or porcelain veneer.

-Local Anesthesia is usually not needed unless there is trauma or tooth decay involved.

Disadvantages of Dental Bonding

-Dental bonding can stain over time

-Dental Bonding can break down over time. It is not as strong as an all porcelain crown or even a porcelain veneer.

-Dental Bonding can chip just like a natural tooth. Precautions need to be taken when eating and chewing.

Dental Bonding - Marielaina Perrone DDS

Dental Bonding – Replacing older Metal Restorations

Dental bonding is an effective and cost effective way to repair and reshape damaged teeth. If you think you may need dental bonding, your dentist can let you know if this procedure is a good option for you.