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In our practice the doctors will use a wide variety of methods to restore your teeth in a conservatively to help you reach a state of good oral health.

• Composites (White fillings)
• Crowns
• Fixed bridges
• Dentures and Partials
• Full Mouth rehabilitation

 

 

White fillings

A composite resin is a tooth-colored plastic mixture filled with glass (silicon dioxide). Introduced in the 1960s, dental composites were confined to the front teeth because they were not strong enough to withstand the pressure and wear generated by the back teeth. Since then, composites have been significantly improved and can be successfully placed in the back teeth as well. Composites are not only used to restore decayed areas, but are also used for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth.

One of the simplest ways to improve your smile is by placing white fillings when restoring decayed teeth or replacing old silver fillings. There is a lack of agreement on whether the mercury on amalgams is toxic. Never the less there are some countries where the used of dental amalgam has been forbidden. White fillings have the advantage of adhering to the tooth structure and reinforce the tooth while amalgams often weakened teeth and cause cracks that will progress to fractures which could lead to tooth lost.

Before	After

Crowns

What are crowns?
A crown is a restoration that covers, or 'caps,' a tooth to restore it to its normal shape and size, strengthening and improving the appearance of a tooth. Crowns are necessary when a tooth is generally broken down and fillings won’t solve the problem. If a tooth is cracked, a crown holds the tooth together to seal the cracks so the damage does not get worse. Crowns are also used to support a large filling when there is not enough of the tooth remaining, attach a bridge, protect weak teeth from fracturing, restore fractured teeth, or cover badly shaped or discolored teeth.

¿What material is the crowns made of?
There are several types of crows but they can be grouped into three categories according to the material use to build them: Metal crows, Porcelain crowns and porcelain fused to metal crowns.

Metal crowns:
The most popular metal crown is made of gold. Gold is a material that has some advantages: its wear is similar to natural teeth, it is hypoallergenic and it last long. Crowns can also be made of other metals with lower gold or no gold content. Generally speaking, if you want a metal crown only insist a one with a high gold content.

Porcelain fused to metal crown:
These are the most popular crowns today, and they are considered the standard of care because they have been successfully used for quite a while. This kind of crown won’t show metal because the thin metal core is cover by the porcelain, and the esthetic can be further improve if the junction between the crown and the tooth is made with a porcelain but margin.

Porcelain Crowns
These crowns are made of porcelain only and have no metal at all. Since metal is eliminated the esthetics improv3e significantly because it has greater depth of color and the translucency and light reflection is more similar to that of natural teeth. This is especially important when restoring anterior teeth. There is a variety of porcelains available in the market to make this kind of crowns and they will vary on their esthetic characteristic as well as their strength to support bite forces.

Porcelain Crowns	Tooth preparation	Cemented Porcelain Crowns

How is a crown placed?
To prepare the tooth for a crown, it is reduced so the crown can fit over it. An impression of teeth and gums is made and sent to the lab for the crown fabrication. A temporary crown is fitted over the tooth until the permanent crown is made. On the next visit, the dentist removes the temporary crown and cements the permanent crown onto the tooth.

Will it look natural?
Yes. The dentist's main goal is to create crowns that look like natural teeth. That is why dentists take an impression. To achieve a certain look, a number of factors are considered, such as the color, bite, shape, and length of your natural teeth. Any one of these factors alone can affect your appearance. If you have a certain cosmetic look in mind for your crown, discuss it with your dentist at your initial visit. When the procedure is complete, your teeth will not only be stronger, but they may be more attractive.

What is the difference between a crown and a veneer?
To make a crown is necessary to remove more dental structure, compare to a veneer, because it will covers the tooth all around. When the tooth is healthy a veneer will allow restoring only the front part of the tooth. Crowns are used in teeth with a big destruction of its structure. Crowns can be placed over natural teeth or implants.

Which care is necessary with a crown?
To prevent fractures or damage to the crown, avoid chewing hard foods, ice or other hard objects. You also want to avoid teeth grinding. Besides visiting your dentist and brushing twice a day, cleaning between your teeth is vital with crowns. Floss or interdental cleaners (specially shaped brushes and sticks) are important tools to remove plaque from the crown area where the gum meets the tooth. Plaque in that area can cause dental decay and gum disease.

Fixed Bridges

What is a fixed bridge?
A fixed bridge is when we replaced a missing tooth by building an appliance that attaches to the next teeth at both sides of the space. These bridges have two crowns join to the missing tooth, which are cemented to the teeth and can’t be removed by the patient. Patient will feel it as its natural teeth.

¿When is a fixed bridge indicated?
If you are missing teeth and you want to have a good oral health, you may need a bridge. A bridge is a very comfortable way to replace a tooth. When a tooth is missing it causes the adjacent teeth to move, making the teeth susceptible to decay and gum disease. A fixed bridge will restored the bite, speaking ability, as well as preserve the facial appearance by preventing the collapse of your facial features that can cause premature wrinkles and age lines.

¿What is required to place a bridge?
To fabricate a traditional fixed bridge for you, we first need to prepare the adjacent abutment teeth that will act as anchors. Then we will take impressions for the lab to build your bridge and make a plastic temporary bridge that you will use for a period of two to three weeks. On the next appointment, the final bridge is fitted over the teeth and the bite is adjusted.

¿How do I care for the bridge?
After your bridge is placed, it is more important than ever to brush, floss and see your dentist regularly. If you do not keep a good daily hygiene your teeth and gums can become infected, requiring further treatment and resulting in possible loss of the bridge. We usually recommend using floss threaders that help remove bacteria from hard to reach spaces between the bridge and adjacent teeth and gums.

Partial and Full Dentures

What is a denture?
A denture is a removable appliance that replaces missing teeth as well as adjacent tissues. These prosthesis are made of acrylic resin and sometimes also have a metal frame. Complete dentures replace all the teeth, while a partial denture fills in the spaces created by missing teeth and prevents other teeth from changing position. Complete dentures are either "conventional" or "immediate". A conventional denture is placed in the mouth about a month after all of the teeth are removed to allow for proper healing, whereas an immediate denture is placed as soon as the teeth are removed. The drawback behind an immediate denture is that it may require more adjustments after the healing has taken place.

Who needs a denture?
When somebody has some natural teeth remaining a partial denture may be an adequate solution. While someone who has lost most or all of their teeth will probably need a complete denture. Both appliances will improve the chewing ability and speech, and provides support for facial muscles therefore enhancing the facial appearance and smile.

What will it take to get a denture?
The denture fabrication process takes about a month. On the initial appointment we will take an impression of your mouth, then a wax bite registration is made to determine the relationship between your upper and lower jaw, as well a choosing the color, shape and size of the denture teeth that are adequate to your face. A wax "try-in" will allow us to assure proper color, shape and fit. Then the patient's final denture is placed, but it will usually be necessary for the patient to come to the clinic for minor adjustments a few more times until he is comfortable.

How do you care for a denture?
You will need to handle it with care because this is a fragile appliance. Remove and brush the denture daily, preferably with a brush designed specifically for cleaning dentures, using either a denture cleanser or toothpaste. Never use harsh, abrasive cleansers, including abrasive toothpastes, because they may scratch the surface of the denture. Don't sterilize your denture with boiling water because it will cause it to become warped. If you wear a partial denture be sure to remove it before brushing your natural teeth.

Can I wear my denture at night?
At first you may be advised to wear your new denture almost constantly even while you sleep. But after this initial period it is best to remove it at night. Research has shown that removing the denture for at least eight hours during either the day or night allows the gum tissue to rest and allows normal stimulation and cleansing by the tongue and saliva. This promotes better long-term health of gums.

What would be an adequate prevention care program for patients with dentures?
It is important to continue having regular dental checkups so that a dentist can examine oral tissues for signs of disease or cancer. As you age, your mouth will continue to change as the bone under your denture shrinks or recedes. To maintain a proper fit over time, it may be necessary to adjust your denture or possibly remake your denture. Never attempt to adjust a denture yourself and do not use denture adhesives for a prolonged period because it can contribute to bone loss. When in doubt, consult your dentist.

Full Mouth Rehabilitation

These Patients suffer a multifactorial problem that will required a comprehensive approach to be able to return them to a state of normal function, free of pain and with a beautiful smile. A person with a compromised dentition can suffer from an inadequate ability to chew, low self -esteem, pain or discomfort, and TMJ.

Before	After

Before	After

A full mouth reconstruction is one of the biggest challenges in dentistry but it involve all the disciplines of dentistry and sometimes even orthodontics and orthognathic surgery (surgical repositioning of the bones).

A full mouth reconstruction will usually required several steps:

1. Eliminate disease from the oral cavity. This means that gum disease, decay, and infections must be cured.

2. Design the restorative or usually the combination of restorative procedures such as: fillings, implants, fixed crowns and bridges or removable prosthesis, that will be used. Some times, there are several treatment approaches that are presented to the patient so he can chose the one that fits better his expectations and budget.

3. In those cases where surgical procedures such as implants or maxillofacial surgeries are required, they will be performed at this time.

4. The restoratives procedures selected are made to reconstruct an optimal bite and a beautiful smile.

5. A prevention and maintenance program to fit the individual needs is designed an implemented to protect the stability of the treatment for the years to come.

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