A dental extraction is the removal of a tooth. There are a number of reasons that this may be necessary. Dental infection and pain is by far the most common reason for extraction; however, sometimes teeth need to be removed because of an impacted tooth, space for orthodontics, or to fix a malocclusion (improper bite).
The implant is a wonderful advancement in the field of dentistry. It allows patients who have lost a tooth (or teeth) to comfortably and confidently restore it back its original size, shape and feel. A dental implant does not come out of your mouth. It is an artificial root that is placed in the bone and allowed to heal for 3-4 months. Once osseous integration (healing) of the implant has occurred, the dentist can complete restoration of the implant by placing an abutment and crown. Implants are one of the best ways to try and recreate your original dentition that has been lost.
A denture is a span of false teeth that replace missing teeth. This can be fixed (cemented bridge) or removable (take out at night) and may be as short as two teeth or as long as an entire arch. Fixed means that the implants are placed in the mouth and the teeth are cemented or screwed to the implants and cannot be removed. These types of restorations are typically made out of porcelain and have a superior aesthetic value compared to a removable resin based denture.
They also give the edentulous (without teeth) patient total confidence they need to chew and smile without worrying about teeth becoming displaced and falling out. You care for them much like your original teeth with routine dental exams and cleanings. Many times these types of prosthetics are referred to as All on Four, full mouth rehabilitation, or roundhouse bridge.
The implant supported removable partial or complete denture is for the patient that wants the security and stability of an implant retained restoration, but the economics of a removable denture. When replacing multiple teeth, it can get expensive to do each one in porcelain. A resin based denture and teeth can give you a fine overall look by replacing all the teeth for less than a porcelain/zirconia restoration.
Although the aesthetics may be compromised, we can get a good looking prosthetic with the comfort and control that is far superior to a traditional denture that relies on suction to the gums and support from the tongue to hold it in place. Patients of these types of restoration are typically able to eat steak, corn on the cob and apples without the denture dislodging. This type of security is a game changer in the world of dentures.
Root canal treatment (RCT) is necessary when the inside of the tooth has been affected by disease or a crack inside the tooth. Inside every tooth is a nerve and blood vessels. If the nerve gets infected and swells, it can cause very acute pain. Think of a root canal as a disinfecting procedure. During the procedure we remove the nerve, blood vessels and clean the inside of the tooth.
Once RCT is completed then a build up and crown is placed over the top of the tooth to protect it from forces of chewing, grinding, and occlusion. The final crown and build up is very important and time sensitive procedure. Without it, the tooth WILL hopelessly fracture or get infected again allowing the pain to return.
In the rare event that a root canal fails and a retreat is not possible, sometimes a root amputation or apicoectomy is recommended. A root amputation is when a multi-rooted tooth, typically a molar, has one of its diseased roots removed.
Apicoectomy is when the just the tip of the root is removed. Once the root or the root tip is removed and the tooth is cleaned from the bottom, it is closed up with a biocompatible material. These procedures are used much less often due to the success of implants. Many times it is more beneficial to invest in the placement of a new implant that will have a higher degree of success.
It is important to know that bone primarily exist in our jaws to support the structures that are present around it; such as your teeth. After an extraction, we immediately begin to lose that supporting bone. In order to prevent this from occurring too quickly, we recommend a procedure called bone grafting.
Immediate bone grafting is the placement of treated and sterile bone, or bone substitute, in the socket of the extracted tooth. When the implant is placed (usually 3-5 months after extraction), there will be plenty of bone to support the functional needs of the implant. If left to heal without bone grafting, the extraction site may lose a substantial amount of bone and compromise the gingival contours of the implant and cause our aesthetics to be unsatisfactory.
There are times when an implant is the best option to replace a tooth but the area, where we need to place it, does not have enough bone around it to support the functional needs of an implant. When that happens, we need to perform bone augmentation. Many times we can harvest bone from part of the jaw to place in the area of the defect. Using your own bone is by far the best way to achieve success; however, there are other options for bone grafting and augmentation.
All of our patients at Lanier Valley Dentistry will receive an oral cancer screen at each comprehensive and periodic exam. Our staff identifies approximately 1-3 cases of lesions, tumors or oral cancer each year. Identification and early diagnosis of oral and facial lesions and oral cancer screening is one of the most important evaluations we do.
There are many sinuses (air space) located within the human skull. The maxillary sinus is located directly above the maxillary (upper) teeth. Sometimes there is not enough bone for an implant. In those cases, the sinus needs to be augmented with a bone graft to make the space suitable for the placement of an implant. Without a sinus lift, the implant would not have adequate bone to support the function of chewing.
In this procedure, a small window is made into the sinus next to the future implant site. The tissue is carefully manipulated to add the grafting material. The window in the sinus is closed and the bone graft material is allowed to heal for 4-5 months. After that time, the implant can be placed.
When a young adult tooth has gotten a large cavity that extends to the root canal space, apexification may be required to treat the tooth. Young teeth do not have fully formed roots and the tip of the root is very large. We cannot do root canals on these teeth until they have finished developing. Therefore, we do a procedure called apexification which places calcium hydroxide (medicine) on the tooth to promote apical (tip of root) closure of the root.
Pulpotomy is the removal of the part of the nerve that is in the pulp chamber or coronal pulp (the area inside the crown – not the root). This is typically done on baby teeth when decay has reached the root canal’s space. We cannot do conventional root canals on baby teeth because of the complex root systems. This is typically a very successful treatment option for saving baby teeth when coupled with a stainless steel crown.
Remember, many baby teeth do not come out until the child is around 12 years of age. For that reason, they are very important to keep clean so that the child can properly chew, speak, and concentrate without dental pain.
When a tooth is painful and root canal is necessary but time or amount of infection does allow for the ability to complete treatment, a pulpectomy is recommended. This is just the removal of the nerve in the tooth without the cleaning and shaping of the canals.