Restorative Dentistry

Amalgam and Composite Fillings

pretty womman smiling with perfect teeth

Composite fillings are tooth-colored to blend in with the remaining natural part of the tooth. The term composite refers to the actual filling material, which is a mixture of glass or quartz filler in a resin medium.

Composite fillings provide good durability and resistance to fracture in small-to-mid size restorations that need to withstand moderate chewing pressure. In addition to being more aesthetically pleasing, composite fillings are "bonded" or attached with adhesive directly to the tooth surface. This often allows for a more conservative repair than traditional fillings with their inability to bond to the tooth structure. Since traditional fillings do not bond to the tooth, amalgam is packed into the tooth, and may loosen over time. Amalgam fillings often require that more tooth structure be removed to create a space that will hold the filling in place.

Composite fillings require that the tooth be kept clean and dry during the entire filling process, and they are subject to stain and discoloration over time. The life expectancy of a white filling can depend greatly on where it is in your mouth and how heavily your teeth come together when you bite.

Dental Bonding

Dental bonding is composed of a ceramic resin that is brushed onto the tooth and hardened with intense light. Prior to bonding application the tooth surface must be prepared to accept the bonding. This is accomplished by roughening the tooth surface and applying a gel to micro-etch the surface. A primer agent is then applied so the bond will adhere properly. Dental bonding is used for:

• Repairing tooth decay damage
• Improving tooth alignment
• Filling gaps between teeth
• Cosmetic reasons (improving tooth appearance)

Dental Bridge

Bridges are used to replace a missing tooth in both a cosmetic and functional fashion. A bridge structure is one or more artificial teeth anchored in place by natural teeth, crowns, or implants, on each side of the bridge. Using a bridge to fill the gap from missing teeth helps restore proper bite and prevent teeth from shifting to fill the gap (which may lead to additional bite and jaw joint issues). Bridges can be constructed from gold, porcelain and metal, or all ceramic. Ceramic bridge color is made to match your natural tooth color. Material choice will depend on structural requirements, wear, and esthetics. Bridges are used to:

• Replace missing teeth
• Prevent teeth from shifting
• Correct bite issues due to missing teeth
• Help prevent jaw joint problems from altered bite
• Improve appearance (cosmetic reasons)

Dental Crowns

Crowns are used to restore severely damaged teeth due to fracture or decay. After the tooth surface is cleaned and prepared the crown is placed to cover the remainder of the tooth. The crown strengthens the tooth structure and helps prevent future decay. Crowns also improve the tooth's look, shape, and alignment. Crowns are used to:

• Restore a fractured tooth
• Restore a tooth severely damaged by decay
• Protect a tooth from fracture
• Cover a discolored or unattractive tooth
• Cover a dental implant
• Anchor a bridge

Dental Dentures

Dentures are a "replacement" option for missing teeth. There are two variations of dentures: partial dentures and full dentures. The difference between the two lies in how many natural teeth remain.

When the condition of the teeth has deteriorated so far that they can no longer be repaired, removal is the only option.

A complete denture is a removable prosthesis of white plastic teeth in a pink gum-colored plastic base; the denture rests on the remaining gum ridge once all of the teeth in the arch have been removed.

It is important to note that life with an upper and/or lower denture is a major lifestyle change when compared to natural teeth. Dentures impact the type of food you are able to eat, your self-confidence in social situations and even your self-esteem.

Dental Implant

Implants may be the best option for replacing a single or multiple missing teeth. An implant is a metal post that is attached directly to the jawbone. After the bone and surrounding tissue has healed an artificial tooth is attached to the implant. Implants provide superior benefits compared to bridge work as they do not depend on neighboring teeth for structural support, although they are more expensive. Implants are the closest dental structure in durability to natural teeth and have greater cosmetic appeal. Implants are used to:

• Replace missing teeth
• Prevent teeth from shifting
• Correct bite issues due to missing teeth
• Help prevent jaw joint problems from altered bite
• Improve appearance (cosmetic reasons)

Root Canal

A root canal becomes needed when tooth decay is so badly neglected it reaches the tooth pulp. Once the pulp is infected it cannot heal on its own. Sometimes tooth trauma such as a fracture can lead to the need for a root canal as well. In addition to being painful, untreated infections can reach the root tip and compromise the entire immune system. Symptoms of pulp infections may be:

• Sensitivity to hot/cold
• Sensitivity to sweets
• Pain, especially when biting
• Swelling
• Bad taste in the mouth

A root canal procedure includes cleaning out the infected pulp, disinfecting the canals and filling the void with a rubber like substance to prevent further infection. Sometimes a crown is recommended to restore the tooth shape, look, and to strengthen the tooth structure.

Dental Veneers

Rendering of jaw with porcelain veneer on tooth

Tooth veneers are a popular cosmetic dentistry technique for creating a beautiful smile. They consist of thin sections of durable porcelain that are custom made for the unique shape of your teeth. Dental laboratories create the veneers to match the exact color and shape specifications sent in by your dentist, and once completed, they will be bonded onto the front surface of your teeth.

Veneers are often chosen as alternatives to crowns and other restorations, and they can be used to completely alter the shape of your smile and teeth. They are quite durable and can last for several years, allowing you to enjoy a beautiful and long-lasting smile.

Tooth Extractions

Picture of an extracted tooth and dental tools

A tooth extraction is the procedure done to remove a tooth that is damaged beyond repair from its socket in the jawbone. Extractions are also done to remove wisdom teeth that may be impacted or create future problems.

Many extractions can be performed in our Portland office; however, more complicated procedures may be referred to one of our trusted oral surgeons.

Extractions are generally classified as either non-surgical (also known as "simple") or surgical (involving cutting through the gums and tooth). A simple procedure can quickly become a surgical procedure if the tooth fractures or refuses to loosen under pressure. We perform these procedures only after making the extraction site(s) profoundly numb.