Dental Fillings and Onlays
Fillings are done to remove decay, and replace the affected tooth structure. It is called a filling because new a material fills hole that decay left. In our office, most teeth are treated with bonded tooth colored composite resin fillings. Caught early enough, cavities can be treated easily and painlessly. If not treated decay can lead to tooth pain and/or infection, and the tooth would need root canal treatment or extraction.
What if your cavity is too big for a filling? Do you need a crown?
Some teeth are not good candidates for fillings, due to too much tooth missing from decay or a large, older filling which needs replacement. If this is the case, and the situation is not severe enough to require a crown, then an onlay can be place.
An onlay looks like a large filling that is made in a dental lab. The doctor will take an impression of your tooth and send it to a lab. You go home with a temporary material in your tooth and come back for a second appointment to have your onlay cemented to the tooth.
Drs. Smallberg and Satornino usually use emax onlays. Emax is one of the most cosmetic materials used in dentistry. The advantage of the onlay is that it is stronger than a tooth colored filling, and preserves more tooth structure than a crown.
The American Dental Association (ADA) recommends parents have a dental assessment of infants by one year of age. We find that most children do not need routine visits until about age 3.
Drs. Smalberg and Satornino are both experienced in treating children of many different ages. We find that by speaking to children the right way, most of them can be treated in our office, without having to refer to a specialist. If a child has very specific specialized needs, we work with the most qualified pediatric dentists in the region.
For those children that are seen in our office, we focus on preventative care first, just as we do with our adult patients. Proper home care is emphasized and reviewed with the parent/guardian and child together.
We frequently recommend sealants to protect teeth from decay. If you look at your back teeth, you can probably see the “hills and valleys” of enamel (protective outer layer on teeth). A sealant fills in the narrow “valleys,” which is where plaque can easily collect and form a cavity. The sealant forms an extra layer of protection, so that plaque cannot get into the narrow areas of the tooth and form a cavity.
Non-Surgical Periodontal Therapy
The gums, ligaments, and bone around the teeth form the foundation for ones teeth. All structures are also referred to as the periodontium. When the periodontium is not healthy, it jeopardizes the teeth just as a bad foundation would threaten the stability of a house. Signs of unhealthy periodontium (gum disease) may be as follows: gums that are red and bleed easily, persistent bad breath, gums that are pulled away from the tooth, loose teeth, and changes in the position or bite of the teeth. Any of these signs may mean something is wrong. With the proper care, however, it may be possible to return them to a healthy state. This is where appropriate gum treatments come in. If you’re having a problem, come in and see us so we can take care of it right away. The treatment usually involves a deep cleaning or root planing done under a local anesthetic, along with local antibiotic agents. If the gum disease gets too severe it may need to be treated through surgery or extraction. This is why it is important to get it treated at the first sign of a problem.
If your gum condition is too severe for non-surgical intervention alone, the doctors work with the region’s best periodontists to coordinate your care.
Root canal treatment (also referred to as root canal therapy or endodontic therapy) is made necessary when a cavity is allowed, through neglect, to reach all the way to this pulp. (Regular cleanings and checkups prevent and detect problems early) Sometimes deep restorations or trauma to a tooth may cause the nerve to be damaged to the point it needs root canal therapy, also. Once this occurs the pulp becomes infected, and can even extend through the root tip and begin to eat away at the surrounding bone (this is an abscess). By the time the pulp is infected it must be treated, and cannot heal on its own. It can even weaken the entire immune system. This is dangerous, not to mention very painful. Symptoms that the pulp has become infected may include sensitivity to hot/cold or sweets, pain, swelling, pain to biting or pressure, and a bad taste in the mouth. Sometimes, however, no symptoms are apparent and the person is unaware of any problem until a checkup.
A root canal is then performed to clean out the infected tooth pulp, and disinfect the canals of the tooth. The only other treatment would be to extract the tooth. Once the infection is resolved, the canal(s) are filled in to prevent any further infection. Usually a core build-up and crown is recommended for restoring a tooth that has had root canal therapy.
Most patients will receive root canal therapy in our comfortable dental office. If a specialist is needed, Dr. Smallberg or Dr. Satornino will prepare your treatment plan and refer you to a local endodontist.
Tooth extractions may be necessary for a variety of reasons if a root canal or alternative treatment is unsuccessful or not considered an option. Dr. Smallberg and Dr. Satornino will make every effort to preserve the natural tooth, recommending a tooth extraction as a last resort when necessary for oral health.
If your tooth extraction is complex or if you have impacted wisdom teeth, we will refer to the one of the region’s best oral surgeons.