Congratulations on your decision to pursue restorative care [porcelain/gold crowns, porcelain veneers, inlays, onlays]. The decision for restoration is always a serious one, but I am confident it is the best decision for long term preventive dental health.
What is Restorative Dentistry?
Have you ever thought about how your teeth should fit together comfortably or how your jaw should function? Few people do… until unconscious habits or missing teeth compromises their chewing or they develop TMJ pain or they are experiencing sensitive, worn, or fractured teeth.
Then the call on the skills of a specially trained dentist to restore the chewing surfaces, bite and jaw function to as harmonious a pattern as possible. To just fill spaces where teeth have been lost; or to place a crown on a broken tooth is not necessarily Restorative Dental Care.
During restorative care…
The entire architectural blueprint of a normal, healthy tooth form, chewing pattern and stable joint for that individual patient must be well thought out.
What does this have to do with you?
Understanding these destructive conditions is the essence of advanced preventive dental care.
Whether for a single tooth or multiple crowns, our goal for our patients is the peace of mind in knowing your teeth are in the strongest possible condition.
As a preventive dentist, my goal is to encourage people to undergo restorative dental care at as young an age as feasible. Predictability is the key to long term dental health.
For your comfort…
Most people are apprehensive about dental treatment. We are proud of our ability to do sophisticated care comfortably for you.
The use of current techniques can virtually eliminate any discomfort during and after dental treatment. Since your comfort is our first concern, we take the time to insure we understand how to make your visits pleasant.
To do this, it is essential for us to thoroughly prepare for the treatment and allow enough time so as not to be rushed.
If there are extensive needs, I ask your understanding. You did not get this way overnight and my experience is that if we have “all our ducks in a row” ahead of time, we actually save time.
The interim… Prototypes
Can you find the prototype?
You are never left without your teeth being covered and protected. A prototype is a healing, provisional restorative. There is a vast difference, however, between the temporaries you may have had in the past and a prototype.
A prototype crown is placed temporarily until the final crown is custom made and ready to be placed. It is a trial of the final result. The prototype should enhance healing of the gums and/or accommodation of a trial bite. Ideally all changes and healing occur during the provisional phase so that little, if any, adjustments are needed in the final restoration.
There are many factors in predictable restorative care:
Our goal is that any restorative care last as long as possible. Most failures are related to improper fit, unbalanced biting function and factors affecting gum and bone health. Predictability is achieved through sophisticated attention to detail that makes the difference between “just” a crown and restoring a mouth to health using crowns. I have not found a shortcut to excellence.
Some essential factors include…
- Polishing the seam where the tooth and crown join. This is why we have invested in advanced electric hand-pieces and high resolution magnification.
- Attention to detail in how the crown emerges from the tooth [contour, shape, position and smoothness] enhances long-term gum and bone health.
- Whenever significant tooth structure is destroyed by a previous filling, decay or fracture, a “bonded” material is placed to protect the tooth and strengthen the crown.
- A medicated cord is placed at the gum line prior to finishing and polishing to protect the gums from unnecessary trauma.
- The tooth is washed with an antibacterial solution to thoroughly clean the surface. This minimizes sensitivity after treatment and reduces the chance for nerve infection and a future root canal.
- Detailed impression techniques help the laboratory insure a good marginal seal of the final crown preventing gum disease and potential future decay.
- The most stable impression materials are used assuring the least number of impressions for a predictable result.
- I never use Nickel or Beryllium found in cheaper crowns because of their potential for allergic responses.
- I use proven local labs that place high value on craftsmanship. Our knowing each other further helps consistence and predictability
- For esthetic crowns, I use all ceramic materials whenever possible. Costs are more expensive, but definitely worth the investment.
- At the second visit, the tooth is again washed with an antibacterial solution, thoroughly cleansed and sealed.
- I use an improved adhesive that has fluoride for anti-decay activity, or advanced composite resins that bond to the tooth.
Daniel Balaze, DMD, FAGD is a Restorative Dentist practicing in Laguna Niguel, CA.