Restoring your teeth
If you have been reading these in sequence, you should have noticed it has been a progression of how and why treatment gets done in the order it does. If you haven’t been going in sequence, it is no big deal; you can still read about each topic, you just may not understand why things are done when they are.
It is now time to start restoring your teeth. At this time we will stick with restoring damaged teeth, not elective, cosmetic changes, though it is worthwhile to mention something about cosmetic briefly. Wouldn’t you want everything done to be cosmetic? I can’t think of anyone who would want something done to be an intentional eyesore. Teeth need to be restored for basically three reasons; they either have caries (decay), they have fractured or they are malformed. There are multiple methods of restoring teeth which include amalgam (silver fillings), and composite (tooth colored fillings), both of which are done directly in the mouth. There are also inlays, onlays and crowns (caps), all of which are made indirectly (outside of the mouth) from an impression and then cemented in some way onto the tooth. These can be made from a variety of materials including high noble metals (gold), semi-precious metals, non-precious metals, and a wide array of tooth colored ceramics, including porcelain. Like most anything where there are options, each has its pros and cons. In general, smaller areas will be restored with fillings and the more tooth structure that is missing, the more a crown is needed. Each and every case needs to be evaluated on its own and the patient’s desires too must be taken into account. Traditionally silver fillings have always been less expensive than tooth colored fillings, though I personally don’t think there is a reason for it. Sure the material itself costs a little less, and it may take a little less time to place a silver filling than a composite, but is it that significant? I believe you should be paying for the expertise offered in being able to remove the damaged portion of tooth and replace it such that it once again looks and functions like your tooth should. Composite fillings are more technique sensitive than are silver fillings, so sometimes silver fillings need to be placed out of necessity. If that isn’t the case, a tooth colored filling will be the default choice for our office. The larger a filling gets, the more likely it will break as well as it becomes more likely for the tooth that remains to fracture off. In those cases, as well as when there is a visible fracture line running through the tooth that is still intact, a crown is the recommended treatment. Instead of placing a filling within the tooth, a crown is placed over and around the prepared tooth.
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