At Kathleen Nichols DDS, we believe the first step in keeping your smile beautiful is to make sure your teeth and gums are healthy. We offer comprehensive new patient exams, as well as routine exams at cleaning appointments. We recommend having your teeth cleaned at least every 6 months.
Your initial oral examination includes a visual examination, charting, periodontal probing, diagnosis and treatment recommendations. We will also take x-rays, which includes the panoramic x-ray for proper diagnosis of the anterior (front) and posterior (back) teeth as well as the bite-wing x-ray series for proper diagnosis of proximal decay of posterior teeth.
Fillings are used to replace tooth structure that has been removed in order to get rid of decay. Caught early enough, tooth decay can be treated easily and comfortably. If it is not treated, tooth decay can lead to pain and/or infection requiring root canal treatment or extraction.
Composite resin is a filling material designed for aesthetic dental restorations. Formulated to resemble the color of your natural tooth, composite resin is often used for filling dental cavities or for dental bonding on front teeth.
Composite resin consists of glass or quartz filler added to a resin medium, which produces a tooth-colored filling. The invention of composite resin offers a substitute to the amalgam (Silver) dental fillings we’ve grown so accustomed to. This plastic and glass mixture contains no metal and can be shaped to resemble a real tooth. The result is a tooth with a natural look and feel. Onlookers usually can’t tell that a tooth has even been filled.
There are many advantages to tooth-colored restorations. Resin fillings are bonded to the teeth creating a tight, superior fit to the natural tooth. Such restorations can be used in instances where much of the tooth structure has been lost. The tooth remains intact and stronger.
A crown is used to cover and protect a tooth which is likely to break, or is too broken down to be restored with a filling. Crowns are most commonly used to protect a tooth after root canal treatment, or when a large filling wears out. The larger the hole in the tooth that was made by tooth decay, the more likely that tooth will need a crown to protect it.
It takes two appointments to restore a tooth with a crown. At the first of these appointments, any decay is removed from the tooth and it is shaped to fit the crown. Then, an impression of the tooth is made. This impression is used in making the crown, to ensure that it fits your mouth. Between the first and second visits, the crown is made. It is usually made of high-strength porcelain covering a foundation that is made of either a gold alloy, an all-ceramic material, or gold. In between the two appointments, a temporary crown is worn. At the second visit, this temporary crown is removed and the permanent crown is cemented in place.
Many people have unexplained pain from filled back teeth, which is usually due to hairline cracks in the chewing part of the tooth. Placing crowns on these teeth can relieve the pain and allows a return of full dental function for these teeth. A crown covers the weakened tooth, protecting it from breaking under the tremendous pressure of day to day use. In teeth with root canal fillings, crowns can prevent breakage.
A bridge is an option that is used to fill the space created by a missing tooth. It is important that a missing tooth be replaced as soon as possible. If it is not treated, the teeth surrounding the gap begin to shift inward, which leads to a chain reaction of bad things. Your teeth work together for many daily functions from eating to speaking. With missing teeth, it’s difficult to do these things. Missing teeth can and should be replaced. A bridge replaces a missing tooth, both functionally and cosmetically.
Normally, teeth use their neighbors for support, and with one missing, they start to "fall." As this worsens, the bite changes in response to pressure from daily use. This can eventually result in problems with the entire jaw. The surrounding teeth begin to deteriorate and unless this deterioration is handled, it is just a matter of time before they too are lost. Gum disease becomes a serious problem which becomes more difficult to treat as the neglect continues.
Oral functionality and appearance are also important reasons for wearing a bridge. A bridge helps support your lips and cheeks. The loss of a back tooth may cause your mouth to sink and your face to look older.
Bridge work is as much an art as it is a science. The materials used for the bridge may be gold alloys, porcelain bonded to a metal alloy, or an all-ceramic material. The choice of material depends on what is needed for strength, wear, and/or aesthetics.
Root canal therapy, or endodontic therapy, is necessary when decay has been neglected to the point that the infection reaches all the way to the pulp of the tooth. Your tooth pulp is a collection of blood vessels and nerves that helps to build the surrounding tooth. Infection of the pulp can be caused by trauma to the tooth, deep decay, cracks and chips, or repeated dental procedures.
Symptoms that the pulp has become infected may include: sensitivity to hot or cold, to sweets or pressure on the tooth. There may be pain in the tooth and gums, swelling of the tooth, and a bad taste in the mouth. Sometimes, however, there are no symptoms and the person is unaware of any problem until they have a checkup.
If you experience any of these symptoms, your dentist will most likely recommend non-surgical treatment to eliminate the diseased pulp. This injured pulp is removed and the root canal system is thoroughly cleaned; and once the infection is resolved, the canal or canals involved are filled in to prevent any further infection. Usually a core build-up and crown are recommended to restore a tooth that has had root canal therapy. The alternative to root canal therapy is extraction.
Dentures replace teeth that have become loose, or that have been lost due to bone loss around the roots of teeth. In determining the need for dentures, the entire mouth is examined. An evaluation is made regarding which teeth will have to be removed, and which will remain. The loose teeth are then extracted and dentures are fitted. There is an adjustment period after dentures are placed in the mouth, and they can take some getting used to. After this adjustment period, normal dental functions and appearance return. Often implants can be used to further stabilize dentures.
A partial denture is useful for a person missing some teeth, but still having a number of natural teeth. This device is also called a removable prosthesis, and is a means by which artificial replacement teeth are held in the mouth. The prosthesis is commonly kept in place by means of clasps. These are thin finger-like structures, usually made of a special resilient metal alloy or sometimes plastic, that rest upon and wrap around some remaining natural teeth. Clasps keep the prosthesis securely in place but still allow a person to easily take it out for regular cleaning and proper brushing of remaining natural teeth.
All-on-Four, sometimes referred to as All-on-4, is a technique for total rehabilitation of the edentulous. This surgical and prosthetic medical procedure was developed, institutionalized and systematically analyzed in the 1990s through studies funded by Nobel Biocare in collaboration with a Portuguese dentist Paulo Maló. It consists of the rehabilitation of the edentulous maxilla and mandible with fixed prosthesis by placing four implants in the anterior maxilla, where bone density is higher, allowing the highest success rate. The procedure is best for patients with significant tooth loss or decay and for people whose bone loss in the jaw area prevents them from getting dental implants.
This All-on-Four solution is a procedure that, as the name implies, only requires four dental implants per jaw to support a fully customized set of replacement teeth. All-on-Four is attractive to patients wanting to get rid of their dentures, and to people with failing teeth in need of a full upper and/or lower restoration. The All-on-4 Procedure provides patients with new teeth that are firmly fixed in place, and look and function as close to natural teeth as possible.
Unlike dentures which are removable, All-on-4 provides the patient with a set of teeth that are connected to the implants, and are solidly fixed in place (what we call an implant-supported fixed bridge). They may only be removed by the dentist, are bushed and cleaned like normal teeth (though flossing is different), and are the closest thing possible to natural teeth in terms of look, feel and function.
The All-on-4 bridge also allows the patient to bite with much more force than dentures, since the stresses are transferred directly to the bone rather than to gum tissue as with dentures. This means that patients can eat almost any of their favorite foods without worrying about their teeth.
The All-on-four treatment concept offers clinicians and their patients various clear benefits:
You may need a tooth extraction for any number of reasons. Some teeth are extracted because they are decayed, others may have advanced periodontal disease or may have broken in a fashion which cannot be repaired. Other teeth may have to be removed because they are poorly positioned in the mouth, such as impacted wisdom teeth. Teeth that are malpositioned or crowded may have to be extracted in preparation for orthodontic treatment.
When a tooth is missing its neighboring teeth tend to shift, sometimes significantly, which in turn can have a major impact on your dental health. Even the removal of a single tooth can lead to problems. To avoid these complications we recommend that you replace the tooth that has been extracted. There are a number of options available to replace missing teeth including dental implants and dental bridges.