A dental crown is a tooth-shaped “cap” or cover that we place over a tooth that is badly damaged from trauma or decay to restore its shape, strength, size and functionality. We also use them for cosmetic reasons to improve a tooth's appearance with natural, life-like results. Crowns are generally handcrafted by dental laboratory technicians using high-quality dental porcelains (ceramic materials) that are made to fit on precise replicas (molds) of the prepared teeth. In our office, we generally make temporary crowns to protect the teeth to keep them comfortable and functional while the permanent crown(s) is being made. And once a crown is placed (cemented into position), it fully encases the entire visible portion of the tooth that lies at and above the gum line.

When Are They Necessary?

There are many reasons a crown may be needed. Some of these include:

• To repair a tooth that is worn down, broken or badly damaged by decay or injury.
• To restore a tooth so severely damaged by decay that the tooth's structure is no longer intact enough to place a filling or where a filling can't restore the tooth to its former strength.
• To protect a tooth that has minor cracks or fractures from further damage.
• To create a bridge to replace a missing tooth, in which the teeth on either side, known as abutments, must be “crowned” to attach to the “pontic” (from the French word, “pont” that means bridge).
• To create the visible part of the tooth that sits atop a dental implant.
• To improve the appearance of a tooth providing a more appealing shape and color.

To learn more on this topic, read the Dear Doctor article, “Porcelain Crowns & Veneers.” You can also contact us to discuss your questions or to schedule a consultation.

If you don't like your smile when you look in the mirror, or feel self-conscious because your teeth are discolored, there are a variety of whitening procedures that can help you obtain the smile of your dreams.

Choosing the Right White: With strips, trays and toothpastes all claiming to be the best tooth whitening systems, it can be hard to choose how to whiten your teeth. Our office can help you decide the best approach based on your individual needs, time constraints and budget. Whiteners may not correct all types of discolorations.

Whitening in Our Office: This procedure is called chair-side or professional bleaching and may require more than one office visit. Each visit may take from 30 minutes to one hour. We use an in-office whitening gel that is professionally applied to your teeth and activated by a light source, giving you significantly whiter teeth in less than an hour. Typically, teeth with a yellowish hue respond best to whitening.

Whitening Your Teeth at Home: If you are an adult who practices good oral hygiene and doesn't suffer from periodontal disease, our office can help you decide whether an at-home whitening system, or having your teeth whitened in our office best meets your needs. If you decide to go with an at-home system, you will wear a custom-made whitening tray that looks like a thin, transparent night guard. You fill the tray with a mild whitening gel and need to wear the gel filled tray for a specified period of time each day (per our office's instructions). This procedure must be continued over a period of time that generally extends from 2-4 weeks.

Whitening Products Found in Stores: If you are considering over-the-counter whitening products we can also recommend products that will offer you the best results. Whitening toothpastes that have the American Dental Association (ADA) Seal of Acceptance contain special chemical or polishing agents that generally provide some stain removal effect.

Contact us today to schedule an appointment or to discuss any questions that you may have regarding teeth whitening. Read more about this topic in the Dear Doctor magazine article “Teeth Whitening.”

If you believe you need a crown or if we have already confirmed this fact, you need to understand that there are several options. The most common are gold crowns, porcelain-fused-to-metal crowns and all porcelain crowns. Each has both pros and cons; thus we will work with you to determine which will work best for your specific needs. However, to help you learn more now, here are some facts.

Gold Crowns

Made from cast gold, this type of crown has been around for over 100 years and is the most successful type of crown. It can last more than 50 years and thus many dentists prefer gold restorations for their own teeth, where cosmetics is not a concern.

All Porcelain Crowns

All porcelain crowns can produce an incredible, life-like appearance. However, because they are made purely from dental porcelain (a type of glass), they tend to be more fragile than gold crowns and may be more at risk with certain high biting forces. Thus they may not be as durable. Porcelain can also cause wear to the natural teeth they bite against. Therefore they are typically preferred for front teeth, rather than back teeth. They have an aesthetic longevity of about 10 years and a functional longevity of about 20 years.

Porcelain-Fused-To-Metal Crowns

As the name states, porcelain-fused-to-metal (PFM) crowns provide the best of both worlds. They are made of natural tooth-colored dental porcelain that is fused on top of a precious or noble metal (usually gold or platinum). They are stronger than porcelain alone and are a good option for back teeth because they offer a better cosmetic result than gold crowns. This is also true for front teeth, however the gold support beneath the porcelain can compromise its life-like qualities. These crowns also have a proven track record and have been used with excellent results for over 40 years.

Learn more about crowns when you read, “Gold or Porcelain Crowns.” Or you can contact us today to discuss your questions or to schedule a consultation.

You probably know that tooth decay results when the bacteria in your mouth release acids after consuming sugars. After you eat sugars, particularly the type of sugar known as sucrose, increased acid in your mouth begins to dissolve the enamel and dentin in your teeth, and you end up with cavities.

What are the Types of Sugars?
Modern diets include several types of sugars. Most of these are fermented by oral bacteria, producing acids that are harmful to teeth.

• Sucrose (commonly known as sugar)
• Glucose (released from starch consumption)
• Lactose (milk sugar) — Less acid is produced from this type of sugar
• Fructose (found naturally in fruit and also added to many processed foods)
• Maltose

Recommended intake of “free sugars” is no more than 10 teaspoons per day. Note that a can of soda contains over 6 teaspoons! Soft drinks are the largest source of sugar consumption in the U.S. In 2003, for example, Americans drank an average of 52 gallons of soft drinks. Average per capita consumption of all sugars in the U.S. was 141.5 pounds (64.3 kg) one of the highest levels in the world.

Sugar substitute xylitol (which is chemically similar to sugar but does not cause decay) can be part of a preventive program to reduce or control tooth decay. Chewing gum sweetened with xylitol stimulates saliva flow and helps protect against decay.

Sugars Released from Starches
Starches are foods like rice, potatoes, or bread. When you eat refined starches, such as white bread and rice, enzymes in your saliva release glucose. However, these foods have a lower potential to produce decay than foods with added sugars. When sugars are added to starchy foods, as in baked products and breakfast cereals, the potential for decay increases.

Less refined starches such as whole grains require more chewing and stimulate secretion of saliva, which protects from harmful acids.

The Case for Fruit
Fresh fruit has not been shown to produce cavities, so it makes sense to eat them instead of sugary desserts and snacks. Dried fruit is more of a problem because the drying process releases free sugars.

Contact us today to schedule an appointment to discuss your questions about diet and oral health. You can also learn more by reading the Dear Doctor magazine article “Nutrition & Oral Health.”

Anytime you are considering an implant surgery to replace missing teeth, you should take the time to gather the facts so that you have clear understanding of the procedure, your options and any potential risks. You should also feel comfortable with the dental team who is treating you. For these reasons, we created the following comprehensive list of questions so that you can obtain the answers you need to help you feel at ease prior to treatment.

• Am I a good candidate for dental implants?
• What is the success rate for dental implants?
• How long have you been placing implants and how many do you place each year?
• Can you show me some before and after photos that illustrate your work?
• What are the risks, benefits and alternatives to dental implants?
• Are dental implants ever rejected?
• How do you assess whether I have enough bone to anchor dental implants?
• Can you tell me about the surgical procedure for implant placement?
• How long will the entire process take from my first appointment until I have my implant(s) and crown(s) in place?
• Do I have to go without teeth while my implants are healing?
• What type of anesthesia will you use during my implant surgery?
• What can I expect in the hours and days following my implant surgery?
• How long will it take my implants to heal?
• How long can I expect my implants to last?
• Will there be any maintenance required with my implant(s)?
• How much will dental implant(s) cost?
• Will my insurance cover all or a portion of the cost?

To learn more, read “Dental Implants, Evaluating Your Professional Options For Care.” Or, you can contact us to discuss your questions or to schedule an appointment.