A common problem that often is seen in the dental office is plaque accumulation around the teeth. Plaque contains bacteria that produce substances which can be harmful to the gingiva (gums). If the plaque is allowed to remain, it can become a hard coating around the teeth that is called calculus (tartar). This frequently produces red, swollen, sometimes painful and often bleeding gum tissue that is known as gingvitis.
In the calculus continues to build around the pockets of the teeth, the pockets will deepen and can result in bone loss. This is referred to as periodonti- tis because it involves both the gums and the bone supporting the teeth. The teeth become mobile due to bone loss. This is the major cause of tooth loss in adults. Since this process often is painless and shows few symptoms, patients may be unaware that there is a problem. Regular dental examinations are essential for the early diagnosis and treatment of periodontal prolems.
Cosmetic dentistry is a new and exciting branch of restorative dentistry that uses tooth colored fillings, inlays or onlays, crowns, veneers, or direct bond- ing to correct chipped, discolored, or misshapen teeth or to close spaces between teeth. The use of amalgam has decreased recently, as patient pref- erences, smile enhancement, and constantly improved tooth colored restorative materials are made available to the dentist.
Unlike amalgams, composites strengthen rather that weaken teeth because they bond to enamel. Additionally manufactures have continued to strengthen them and make them more wear resistant over time so that some are not similar in wear characteristics to that of enamel.
Tooth bleaching (whitening has become a very popular, conservative choice for people who want to lighten their teeth. Porcelain veneersor direct bond- ing are other options available to brighten a smile.
The term instant orthodontics can be done with bonding, veneers, crowns, or onlays by changing the length, shape, size, profile, angle or appearance of a tooth or teeth. Occasionally, overlap/overbites or crossbites can be corrected as well.
Teeth that are severely broken or decayed can be restored by removal of the decay, tooth preparation, and coverage with a crown. Some other indica- tions for a crown are:
- A previously filled tooth in which more filling than tooth remains. The ex- isting tooth structure has been weakened and can no longer support the filling.
- Discolorations or compromised esthetics.
- Cusp fractures
- Abutments for a bridge
- After a root canal filling because teeth tend to dry out and become brittle
and are more apt to fracture.
Depending on the diagnosis, threatment plan, and discussion with the pa- tient, teeth that are missing can be replaced with several options. They include the following:
- Fixed bridge
- Partial denture
- Full denture
- Dental implant