FLLINGS- Germs that live in our mouth produce acid, and that acid causes breakdown of our teeth called decay, or cavities. If not too extensive and after decay is removed, a filling can often be placed to restore the damaged tooth structure. Dr. Heard uses the most modern and beneficial filling material, composite resin. Composite filling material is designed to look and function like natural tooth structure. It is bonded to the tooth which helps strengthen and reinforce the tooth, while also sealing out germs and reducing sensitivity. These properties and many others help make composite fillings superior to metal alloy fillings. Dr Heard takes pride in making each filling match your tooth in color and shape, making them virtually invisible. As cavities go, smaller is definitely better so early detection is very important! When detected and treated in the early stages, decay can be restored easily and painlessly without injections (no shots!). Dr. H completes many fillings each day without any numbness or pain. When untreated, decay will lead to pain, infection, root canals, and eventual loss of the tooth.
CROWNS- When decay becomes too extensive for a filling, or if a portion of a tooth breaks, a crown may be necessary. A crown is a very strong restoration that fully covers a vulnerable or weak tooth. The crown provides the strength that a tooth needs to resist the forces of chewing and clenching, and effectively seals out germs from the inner parts of the tooth. Crowns can be made from a wide variety of materials and Dr. Heard carefully chooses what materials will work best for each patient. Our most common crown is made from Zirconia on the inside, and custom shaded enamel-like porcelain on the outside, resulting in a crown that is incredibly strong, yet looks and feels just like your other teeth.
Dr. Heard normally uses two appointments to restore a tooth with a crown. In the first appointment, any decay is removed from the tooth and the tooth is made ready to receive the crown. An impression is made of the tooth and opposing teeth, to be sent to a dental laboratory. Dr. Heard then fabricates and places a temporary crown to cover the tooth until the real crown is back from the laboratory. At the lab, skilled technicians create a unique, customized crown that precisely fits your tooth. This process is very complex and involves digital cad-cam design and robotic milling machines, not to mention several lab technicians trained in different steps of the process. Once the crown is complete, at the second visit the temporary crown is removed and the new crown is cemented into place with very strong and durable adhesive. Adjusting the bite and fit of the new crown insures it looks and feels natural.
BRIDGES- One option commonly chosen to replace a lost tooth is a bridge. It is a new tooth formed to look, feel, and function like the missing tooth. The new tooth is made attached to crowns for the teeth on either side, and is cemented in place just as a crown would be.
There are many benefits to having a tooth replaced soon after it is lost. Once a space opens up between teeth, the teeth surrounding the space will begin to shift. Teeth behind the space tend to lean forward, and teeth opposing the missing tooth will begin to move into the new space. As the teeth shift, changes in the bite can cause many problems, including additional tooth loss, decreased ability to eat/chew, joint pain and dysfunction, as well as completely missing the opportunity to replace the lost tooth.
The process for placing a bridge is very similar to that of a crown. It normally involves two appointments, a temporary bridge, and lastly- adjustment and cementation of the real bridge made by the laboratory.
BONDING- Bonding involves directly adhering enamel-like composite resin to a tooth. Bonding is a similar process to placing a filling, but usually bonding is completed for reasons other than decay. Some of the many reasons patients choose bonding include: repairing damage from chips or flakes in enamel, altering the angle or alignment of a tooth, closing gaps between the teeth, or changing the shape, size, or color of a tooth for cosmetic purposes. The most common application of bonding is enlarging an undersized tooth to better fit in a given space. Bonding is a one appointment procedure and is almost always completed without any shots or numbness, yet it is painless! When completed by a talented dentist, bonding cannot be discerned from natural tooth structure. Bonding is also much less expensive than other ways to change the appearance of teeth.
Many patients feel direct composite bonding is one of Dr. Heard's specialties because of his artistic abilities and attention to detail! Patients have been overjoyed to have gaps filled in without braces or teeth reshaped, giving them the beautiful smile they have always dreamed of having. If you are interested in this cosmetic procedure, Dr. Heard will be happy to show you several before and after pictures from his patients.
VENEERS- Veneers are similar to bonding in that they can greatly enhance the appearance of anterior teeth. Whereas bonding covers only a portion of a tooth, a veneer covers the entire front surface of the tooth. Veneers are a great option for patients who have permanent tooth discoloration that cannot be corrected with whitening techniques. Veneers can either be placed directly with composite resin (similar technique as bonding), or indirectly as a lab-fabricated porcelain veneer. Porcelain veneers usually offer the greatest results in realism, beauty, and durability since they are made by a skilled lab-technician. The very strong porcelain used to create the veneer functions much like new enamel once bonded in place. When several veneers are placed together, an entire smile can be created or improved.
The indirect technique for porcelain veneers usually involves two appointments. At the first appointment the teeth are prepared, impressions taken, and temporary veneers are placed. In two to three weeks the veneers are back from the laboratory, the temporaries are removed, and the new veneers are bonded to the teeth.
WHITENING- Whitening the teeth, often called bleaching, is performed by removing stains that accumulate in the outer layers of our enamel. These stains are usually a result of coffee, tea, chocolate, cigarette smoke, or other darkly pigmented products that come in contact with our teeth. No bleach is used, but rather a very concentrated form of Hydrogen Peroxide gel lifts stain particles out of enamel, revealing natural, healthy, whiter enamel. Many companies exist that claim great results whitening teeth using over-the-counter strips, gels, or trays. The newest craze is whitening performed by workers in salons or malls. The problem with over-the-counter gels, no matter how you obtain them, is that the FDA limits the strength and effectiveness of hydrogen peroxide gel that can be sold by anyone other than a licensed dentist. This means that OTC products must use a weaker, less effective concentration of whitening gel. So while modest improvement may occur for some patients, the desired results are often unachieved, and invested money is wasted. Another concern with most OTC whitening methods is the way in which the gel is applied in the mouth, strips or trays that are made at home usually fit poorly around the teeth, which allows the gel to come into contact with the gums surrounding the teeth. This can cause gingival irritation, soreness, or even mild chemical burns.
Dentists supply patients with a stronger, more effective whitening gel, that is prescription only. The hydrogen peroxide gel can be carefully applied in a dental office or applied in a custom tray at home. Currently here at CAFD we prefer the at-home method because we believe it provides the best results at the least expense! Custom whitening trays used with prescription strength gel are very safe and highly effective in helping our patients achieve a brighter, whiter smile! In this method you spend only 10-15 minutes with us as we take impressions of your teeth. We then use the impressions to fabricate clear trays that fit precisely and comfortably over your teeth. A few days after the impression appointment you stop by to pick up your custom whitening kit. It includes the new trays we made for your teeth, several tubes of prescription strength whitening gel, and a case to keep it all together. A small amount of bleaching gel is placed in the trays and they are worn for 20-30 minutes each night until your naturally white enamel is revealed. You can repeat the whitening process as often as you desire to maintain your bright smile! The trays are reusable and additional whitening gel can be purchased at our office. Our fee for this service is well below that of other offices, so take advantage of it, today!
IMPLANTS- A dental implant is often the best option to replace a missing tooth, or even several teeth. In this procedure, an implant designed to replicate the root of the tooth is placed in the bone. After several weeks of healing, the new implant is ready to receive a crown, bridge, or even a denture. One of the many benefits of implants is they slow or in most cases stop the bone loss that normally occurs when a natural tooth is missing, and they do not involve altering the surrounding teeth.
ROOT CANAL TREATMENT- Root canal treatment (also referred to as root canal therapy or endodontic therapy) is essentially removing infected or dead tissue from the inside of a tooth, cleaning and shaping the internal spaces, and filling those spaces (canals) with a special material to seal out future sources of inflammation. Root canal treatment is necessary when the nerve space inside a tooth either becomes infected with bacteria or when the nerve of a tooth dies. The most common source of infection in a tooth is deep decay, which allows germs access to the hollow space inside the tooth. Sometimes deep restorations or an injury to a tooth may cause damage to the nerve which leads to nerve death, or necrosis. When a tooth becomes necrotic, cleaning the dead tissue from inside the root canal is the only effective treatment. If untreated, the inflammation caused by either infected or necrotic nerve tissue can spread into the surrounding bone, causing an abscess. A Large abscess can even spread into the neck and face. This can be dangerous and is usually very painful. Symptoms of a nerve infection may include sensitivity to hot/cold or sweets, pain, swelling, pain to biting or chewing food, and a bad taste in the mouth. In some cases however, a chronic infection can occur with no symptoms at all.
Root canals admittedly developed a bad reputation in the past. Many patients assume pain and discomfort will be associated with the procedure, but thanks to modern medications and improved treatment techniques, root canals can now be completed in one appointment, and without pain. Most of our patients are surprised at how comfortable and easy the appointment is. Dr. Heard completes most root canals for our patients, but in some cases he will recommend that a specialist in root canals, called an Endodontist, perform the treatment. Most teeth that require a root canal will also need to be restored with a large filling called a build-up, and then covered and protected with a crown.
TMJ THERAPY- The TMJ, or temporomandibular joint, is the joint where our skull and lower jaw meet. The TMJ is actually two separate joints, just in front of our ears. The TMJ is one of our most complex joints, being able to rotate, slide forward, and even move sideways. Problems with this joint are sometimes referred to as TemporoMandibular Disorder (TMD), and may be caused by many things including misalignment of the teeth, grinding / clenching, or trauma.
Symptoms associated with TMD include:
- Headaches (typical or migraine)
- Earaches or ringing in the ears
- Tightness/soreness when opening and closing the mouth
- Clicking or popping in the joint
- Pain in the muscles of the face, neck, or upper back
Many patients suffering from TMD are unaware they have been treating only symptoms of the condition while ignoring the source, and have often seen many different doctors seeking help. Frequent headaches or pain in the neck and back may not seem related to our teeth or TMJ, but in fact are common symptoms of TMD that can be eliminated with proper therapy. Treatments for the condition may include the use of a custom splint or guard that is worn over the teeth to correct and improve the bite, allowing muscles to relax and inflammation in the joint to subside. Other treatments may include adjusting the bite, replacing missing teeth, orthodontically repositioning teeth, or replacing poorly fitted dental work. If TMD remains untreated, surgery may eventually be required to repair or replace a badly damaged joint.
Dr. Heard has sought out special training in TMD therapy and has learned the most current and effective treatment techniques from experts in the field. If you are experiencing these debilitating symptoms, Dr. Heard can perform a simple diagnostic evaluation to help determine the best course of treatment for you. Don't continue suffering from the symptoms of TMD, let Dr. Heard identify and treat the source of your discomfort.