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 after root canal treatment, or when a large filling wears out. 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 ride over 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.
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 after root canal treatment, or when a large filling wears out. 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 ride over 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. In the first any 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 crown is worn. In 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 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. 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 and one just carries on as usual. 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 shaft 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 shaft. This permanent solution has the advantages over bridge work that it does not stress the surrounding teeth for support, 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 to acclimatize the patient who, once the work is done, only feels teeth, not metal supports intruding into the mouth. Second, this slows the bone loss occasioned by missing teeth. Third, there is no discomfort or difficulty in eating. And, best of all, of course, they don't have to be taken out all the time.
We also offer mini dental implants. These implants are about half the diameter of traditional implants are used mainly to stabilize lower dentures. These implants can be placed in one appointment. The cost is 50-70% of standard dental implants. Like everything, there are advantages and disadvantages to them so we will be happy to provide you a personalized consult.
All on 4 Implant treatment is a much more extensive process where you can get "teeth in a day" where typically a denture or fixed bridge is placed 4 implants. Cost varies greatly depending upon what materials are used and the number of implants that are required. The best way to dial this in is know that you will spend $20,000-$25,000 per arch although lower cost options do exist with implants. Cost varies greatly because of material types. Dr Mitchell welcomes a conversation to help figure out which treatment and material types will be best for your situation. The world of dental implants blesses us with many options but they are too extensive and too specific to be comprehensive here on our website. We welcome a conversation about any of the options you may be interested in.
Root Canal Treatment
Root canal treatment (also referred to as root canal therapy or endodontic therapy) is made necessary when a cavity is allowed, through neglect, 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, and can even extend through the root tip 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. Which is why routine radiographs or xrays are so very important!
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 canal(s) 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.
Keep in mind that all root canals and the teeth that we do them are not created equal. There are cases where Dr Mitchell feels that you are better off seeing a specialist due to the level of calcification and the extensive equipment needed to do those procedures to their BEST. There are other cases where in house treatment is possible to that level of excellence. It is our mission to do what is best for you every single time.
Bridges
This is an option for filling the space created by a missing tooth. It is formed to look like the missing tooth, and it takes its place in the mouth. The sides of a bridge use the two surrounding teeth for support, hence the name. A bridge replaces the missing tooth, 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, e.g. TMJ. The surrounding teeth deteriorate and it is just a matter of time before they, too, are lost. Gum disease becomes a serious problem, with the difficulty of treatment increasing as the neglect continues.
TMD/TMJ Treatments
TMJ stands for temporal-mandibular joint. TMD stands for Tempromandibular Disorder. Temporal, as in temple area of skull; mandibular as in mandible, or lower jaw; joint as in its 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 a good deal of trouble 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. Most issues can be relieved with splint and other cotherapies.
Oral Appliance Therapy for Sleep Apnea
There are more than 80 different oral devices on the market for the treatment of obstructive sleep apnea and snoring. The great preponderance of them are varieties of "mandibular repositioning dental appliances," devices that move the lower jaw forward. Most of the remainder are "tongue retaining appliances." Both serve to reduce the likelihood of the sleeper’s tongue falling backward far enough to block the airway.
Thankfully we've figured out what works best for most patients in this area and narrowed it down to a handful of devices that we are happy to evaluate you for to determine what will suit you best. Sleep apnea must be diagnosed by your physician to be eligible for treatment.
Oral appliances are most effective in the treatment of mild to moderate sleep apnea although they do provide a treatment alternative for patients with severe Obstructive Sleep Apnea (OSA) who cannot or will not tolerate positive airway pressure therapy. Despite their double-retainer-like appearance, oral appliances are said to be comfortable to use. Sometimes for more complicated sleep apnea an oral appliance and CPAP are used in combination.