ADVANCED PROCEDURES

CROWNS
Crowns are full coverage restorations that are used to cover a tooth that is likely to break, or is too broken down to be restored with a filling. They are most commonly done when a large filling wears out or after a root canal has been completed. The larger the hole made by a cavity that has to be treated, the more likely a crown will be needed. Even after a filling is put in a large cavity, a tooth is more likely to break. Keep in mind that the jaw muscles are the strongest in the human body. Teeth are subjected to tremendous pressures. Crowns cover the  weakened tooth, providing strength and protecting the tooth against breakage. A broken or cracked tooth is a far more serious matter and much more difficult to treat. Crowns prevent this, as well as making for a nice smile.

It takes two appointments to restore a tooth with a crown. At the first appointment,  any old filling or decay is removed from the tooth and it is shaped to accept the crown. Then an impression is made of the tooth for use in fabricating a crown. Between the two visits the crown is made, usually of high-strength porcelain over gold alloy, all ceramic material, or gold. During this time a temporary plastic crown is worn. At the second visit, this temporary is removed. Then the permanent crown is adjusted as needed and then cemented in place.

DENTURES

There are different types of dentures, but they share their common function. They replace teeth that have become loose or have been lost due to bone loss. When bone loss around the roots of teeth is great enough to loosen them or let them fall out, it's time for dentures. Relax. No one enjoys losing their natural teeth, but you can still eat and talk regularly.

The entire mouth is examined and a determination is made as to which teeth will have to be removed, and which will remain. At a later visit, the loose teeth are then extracted. Dentures are fitted to go over or around whatever teeth remain in the mouth, depending on the type. There is an adjustment period after dentures are placed in the mouth, and it can take some getting used to. But once accustomed to the dentures, all the normal functionality and appearance return. Often implants can used to further stabilize the dentures.

IMPLANTS
A dental implant is an option to replace a missing tooth. In this procedure, a small titanium cylinder is surgically implanted into the bone and allowed to set. The bone grows around it forming a tight connection, which additionally slows or stops the bone loss that occurs when the root of a natural tooth is missing. Once the implant is firmly set in the mouth, the dentist then works to attach the replacement tooth onto the top of the implant. This permanent solution has the advantages over bridge work that it does not stress the surrounding teeth for support, it doesn't require any enamel reduction of adjacent teeth, and, should the tooth wear out, another can simply be replaced on the shaft.

Implants can also be used as support as part of an implant bridge. This is an alternative to partial dentures, and has several advantages. First, there is no adjustment period. Second, this slows the bone loss that can occur after tooth extraction. Third, there is no discomfort or difficulty in eating. And, best of all you don't have to take the teeth out to soak them at night.


ROOT CANAL TREATMENT
Root canal treatment (also referred to as root canal therapy or endodontic therapy) is made necessary when a cavity is allowed to reach all the way to this pulp. Regular cleanings and checkups prevent and detect problems early. Sometimes deep restorations or trauma to a tooth may cause the nerve to be damaged to the point it needs root canal therapy, also. Once this occurs the pulp becomes infected. This infection can even extend through the root tip, into the bone and begin to eat away at the surrounding bone (this is an abscess). By the time the pulp is infected it must be treated, and cannot heal on its own. It can even weaken the entire immune system. This is dangerous, not to mention very painful. Symptoms that the pulp has become infected may include sensitivity to hot/cold or sweets, pain, swelling, pain to biting or pressure, and a bad taste in the mouth. Sometimes, however, no symptoms are apparent and the person is unaware of any problem until a checkup.

A root canal is then performed to clean out the infected tooth pulp, and disinfect the canals of the tooth. The only other treatment would be to extract the tooth. Once the infection is resolved, the canals are filled in to prevent any further infection. Usually a core build-up and crown is recommended for restoring a tooth that has had root canal therapy.

BRIDGES
This is an option for filling the space created by a missing tooth or teeth. It is formed to look like the missing tooth, and it takes the place of the missing tooth in the mouth. A bridge utilizes adjacent teeth for support of the repacement tooth. The bridge is not removable. It is one continuous piece, anchored to the adjacent teeth, that is cemented into place. A bridge replaces the missing tooth or teeth, both functionally and cosmetically. Bridge work is as much an art as it is an exact science. The materials used may be gold alloys, porcelain bonded to metal alloy, or all ceramic material. The choice of material depends on requirements for strength, wear, and/or esthetics.

It is important that a missing tooth be replaced as soon as possible for several reasons. If not treated, the teeth surrounding the gap begin to shift inward, creating a whole chain reaction of bad things. Teeth use their neighbors for support, and, with one missing, they start to "fall." As this worsens the bite changes in response to the pressure. This can eventually result in problems with the entire jaw joint or TMJ. The surrounding teeth deteriorate and it is just a matter of time before they, too, are lost.  

 
TMJ TREATMENTS
TMJ stands for temporal-mandibular joint. Temporal, as in temple area of skull; mandibular as in mandible, or lower jaw; joint as in it's where the head and jaw meet. Problems in this joint may be caused by a misalignment of the teeth, trauma, or excess muscle tension. Aside from the two bones that meet there, cartilage buffers them and five muscles are involved in the area. If something goes wrong, problems can result.

Problems in this area can cause:
  • Headaches
  • Earaches
  • Trouble/soreness in opening and closing the mouth
  • Clicking or popping of the jaw
  • Pain in the jaw muscles
  • Soreness in the area, sometimes extending to the face
Dental treatments for the condition can include replacing missing teeth, moving teeth, adjusting the bite, filling gaps between teeth, etc. There is no one solution that is right for all cases. Sometimes a plastic mouthpiece is used to prevent clenching or grinding that is contributing to the problem. If untreated and taken to extremes, surgery may be required to repair a badly damaged joint.



11501 Cumberland Rd., Suite 200
Fishers, IN 46037
(317) 678 - 1414 

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