Patient Education

Dental Crowns

A crown is a type of dental restoration which completely caps or encircles a tooth or dental implant. Crowns are often needed when a large cavity threatens the ongoing health of a tooth. They are typically bonded to the tooth using a dental cement. Crowns can be made from many materials, which are usually fabricated using indirect methods. Crowns are often used to improve the strength or appearance of teeth.

The most common method of crowning a tooth involves using a dental impression of a prepared tooth by a dentist to fabricate the crown outside of the mouth. The crown can then be inserted at a subsequent dental appointment. Using this indirect method of tooth restoration allows use of strong restorative materials requiring time consuming fabrication methods requiring intense heat, such as casting metal or firing porcelain which would not be possible to complete inside the mouth.


Teeth Whitening

During a person’s lifetime, a variety of food and beverages (soda, spicy food, coffee, red wine, etc.) have a tendency to stain teeth. Dental bleaching, also known as tooth whitening, is a common procedure in general dentistry but most especially in the field of cosmetic dentistry. According to the FDA, whitening restores natural tooth color and bleaching whitens beyond the natural color. There are many methods available, such as Kor and Zoom laser whitening, or whitening gel application with custom trays. Other methods such as toothpaste and whitening strips can also be effective, although success found at a much slower rate.

Bleaching methods use carbamide peroxide which reacts with water to form hydrogen peroxide. Carbamide peroxide has about a third of the strength of hydrogen peroxide. This means that a 15% solution of carbamide peroxide is the rough equivalent of a 5% solution of hydrogen peroxide. The peroxide oxidizing agent penetrates the porosities in the rod-like crystal structure of enamel and bleaches stain deposits in the dentin. Power bleaching uses light energy to accelerate the process of bleaching in a dental office.


Dental Implants

A dental implant is a “root” device, usually made of titanium, used in dentistry to support restorations that resemble a tooth or group of teeth to replace missing teeth.

Virtually all dental implants placed today are root-form endosseous implants, i.e., they appear similar to an actual tooth root (and thus possess a “root-form”) and are placed within the bone. The bone of the jaw accepts and osseointegrates with the titanium post. Osseointegration refers to the fusion of the implant surface with the surrounding bone. Dental implants will fuse with bone over time.

Dental implants can be used to support a number of dental prostheses, including crowns, implant-supported bridges or dentures. They can also be used as anchorage for orthodontic tooth movement. The use of dental implants permits undirectional tooth movement without reciprocal action.

Most patients with enough bone can have implants, although individual decisions are made between you, your oral surgeon, and Dr. Thomas. Usually an x-ray and a CT-scan are done to determine if you have enough bone to place the implant and also to determine the size and kind of the implant that should be placed.


Veneers & Laminates

Dr. Thomas can perform a smile makeover and get you in your new, beautiful smile in a few weeks. A veneer is a thin layer of restorative material placed over a tooth surface, either to improve the aesthetics of a tooth, or to protect a damaged tooth surface. There are two main types of material used to fabricate a veneer, composite and dental porcelain. A composite veneer may be directly placed (built-up in the mouth), or indirectly fabricated by a dental technician in a dental laboratory, and later bonded to the tooth, typically using a resin cement. In contrast, a porcelain veneer may only be indirectly fabricated.

Dr. Thomas will do a complete examination of your teeth and will determine if veneers are indicated for you. Usually with veneers it is possible to improve the esthetics of your teeth and smile dramatically.

Veneers can improve the shape of your teeth, make your teeth as white as you want and give you the smile you have always wanted. Veneers are bonded to your tooth structure, which gives them strength.

Also because they are very thin, they are considered one of the most conservative cosmetic treatments available.  Ask us how veneers can improve your smile.


Root Canal Treatment/Endodontics

Endodontic therapy is a sequence of treatment for the pulp of a tooth which results in the elimination of infection and protection of the decontaminated tooth from future mircobial invasion. This set of procedures is commonly referred to as a “root canal.” Root canals and their associated pulp chamber are the physical hollows within a tooth that are naturally inhabited by nerve tissue, blood vessels, and other cellular entities. Endodontic therapy involves the removal of these structures, the subsequent shaping, cleaning, and decontamination of the hollows with tiny files and irrigating solutions, and the obturation (filling) of the decontaminated canals with an inert filling such as gutta percha.


Inlays & Onlays

Onlay

When decay or fracture incorporate areas of a tooth that make composite restorations inadequate, an onlay might be indicated. Similar to an inlay, an onlay is an indirect restoration which incorporates a cusp or cusps by covering or onlaying the missing cusps. All of the benefits of an inlay are present in the onlay restoration. The onlay allows for conservation of tooth structure when the only alternative is to totally eliminate cusps and perimeter walls for restoration with a crown. Just as inlays, onlays are fabricated outside of the mouth and are typically made out of gold or porcelain. Gold restorations have been around for many years and have an excellent track record. In recent years, newer types of porcelains have been developed that seem to rival the longevity of gold. If the onlay or inlay is made in a dental laboratory, a temporary is fabricated while the restoration is custom-made for the patient. A return visit is then required to fit the final prosthesis.

Inlay

An inlay is an indirect restoration (filling) consisting of a solid substance, such as porecelain, fitted to a cavity in a tooth and cemented into place. An onlay is the same as an inlay, except that it extends to replace a cusp. Crowns are onlays which completely cover all surfaces of a tooth.

Sometimes, a tooth is planned to be restored with a composite filling, but the decay or fracture is so extensive that a filling would compromise the structural integrity of the restored tooth or provide substandard opposition to occlusal (i.e., biting) forces. In such situations, an indirect porcelain inlay restoration may be indicated. When an inlay is used, the tooth-to-restoration margin may be finished and polished to such a super-fine line of contact that recurrent decay will be all but impossible. While these restorations might be ten times the price of direct restorations, the superiority of an inlay in terms of resistance to occlusal forces, protection against recurrent decay, precision of fabrication, marginal integrity, proper contouring for gingival (tissue) health, and ease of cleansing offers an excellent alternative to the direct restoration.


TMJ

The temporomandibular joint is the joint of the jaw and is frequently referred to as TMJ. There are two TMJs, one on each side, working in unison. The name is derived from the two bones which form the joint: the upper temporal bone which is part of the cranium (skull), and the lower jaw bone called the mandible. The unique feature of the TMJs is the articular disc. The disc is composed of fibrocartilagenous tissue (like the firm and flexible elastic cartilage of the ear) which is positioned between the two bones that form the joint. The TMJs are one of the few synovial joints in the human body with an articular disc, another being the sternoclavicular  joint. The disc divides each joint into two. The lower joint compartment formed by the mandible and the articular disc is involved in rotational movement—this is the initial movement of the jaw when the mouth opens. The upper joint compartment formed by the articular disk and the temporal bone is involved in translational movement—this is the secondary gliding motion of the jaw as it is opened widely. The part of the mandible which mates to the under-surface of the disc is the condyle and the part of the temporal bone which mates to the upper surface of the disk is the glenoid (or mandibular) fossa.

Pain or dysfunction of the temporomandibular joint is commonly referred to as “TMJ”, when in fact, TMJ is really the name of the joint, and Temporomandibular joint disorder (or dysfunction) is abbreviated TMD. This term is used to refer to a group of problems involving the TMJs and the muscles, tendons, ligaments, blood vessels, and other tissues associated with them. Some practitioners might include the neck, the back and even the whole body in describing problems with the TMJs.

Temporomandibular joint disorder, TMJD (in the medical literature TMD), or TMJ syndrome, is an umbrella term covering acute or chronic pain, especially in the muscles of mastication and/or inflammation or the temporomandibular joint, which connects the mandible to the skull. The primary cause is muscular hyper- or parafunction, as in the case of bruxism, with secondary effects on the oral musculoskeletal system, like various types of displacement of the disc in the temporomandibular joint. The disorder and resultant dysfunction can result in significant pain, which is the most common TMD symptom, combined with impairment of function. Because the disorder transcends the boundaries between several health-care disciplines — in particular, dentistry and neurology — there are a variety of treatment approaches.

The temporomandibular joint is susceptible to many of the conditions that affect other joints in the body, including ankylosis, arthritis, trauma, dislocations, developmental anomalies, neoplasia, and reactive lesions.

Signs and symptoms of temporomandibular joint disorder vary in their presentation and can be very complex, but are often simple. On average the symptoms will involve more than one of the numerous TMJ components: muscles, nerves, tendons, ligaments, bones, connective tissue, and the teeth. Ear pain associated with the swelling of proximal tissue is a symptom of temporomandibular joint disorder.

Symptoms associated with TMJ disorders may be:

■        Blinking

■        Biting or chewing difficulty or discomfort

■        Clicking, popping, or grating sound when opening or closing the mouth

■        Dull, aching pain in the face

■        Earache (particularly in the morning)

■        Headache (particularly in the morning)

■        Hearing loss

■        Migraine (particularly in the morning)

■        Jaw pain or tenderness of the jaw

■        Reduced ability to open or close the mouth

■        Neck and shoulder pain

■        Dizziness