What are my cosmetic dental restorative options?

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If you are self-conscious about your teeth or smile and have been thinking about what’s often called a “smile makeover”, there are some options that may help you.

To help you understand what is available, here is an overview of the cosmetic dental treatment options Dr. Westersund offers in Calgary:

Teeth Whitening Procedures

Are your teeth not as pearly white as they could be? Teeth whitening procedures can be done at home (Home Whitening) or In-Office. Before any tooth whitening, all cavities must be filled and your gums must be healthy.

Home Whitening uses custom made trays that fit tightly over your teeth. Once a day you will place a gel in the whitening trays and wear the trays over your teeth. Over a period of several days to weeks, your teeth will whiten.

In-Office Whitening speeds up the process for you. This treatment is usually done in one office appointment, about two hours long. Some patients then will use Home Whitening to help the process. In our office, we will place protection over your gums and then place the gels on your teeth. A bright light source warms and activates the whitening agent to oxidize stains on the tooth surface. In many cases the one session can whiten your teeth to four to six shades lighter.

Some patients will experience minor tooth sensitivity during whitening procedures. We can remedy this by alternating concentrated fluoride with the whitening gel in the mouth trays.

Filling” Replacement – Nothing lasts forever

“Personally, I hate the word “Filling”. It makes me think of something you put into a pie. If I had my choice, patients would ask for a “Restoration”. We are “restoring” your tooth that is either broken down or decayed to better health.  But the public often uses the word ‘Filling.” So whether you  call it a “Filling” or a “Restoration, we  know what you are talking about. ” Dr. Westersund

Dental restorations come in two types: Direct (made in your mouth) and Indirect (made in a laboratory).

Direct Restorations are typically not as durable as Indirect Restorations. But a lot depends on the size of the dental restoration that  you need. Anytime you are going to need a dental restoration it is crucial you discuss what kind of restoration with your dentist, no matter who he or she is. There is nearly always a choice. Even if it is doing nothing, or in the worst case scenario, removing a tooth. Always ask for your choices if you are unsure and they are not provided. 

 

Types of fillings:

Gold Fillings

Cast gold fillings are made from a mixture of gold and other metals such as silver and copper, and are based on a model (or cast) of your tooth. A cast gold filling is created in a dental lab, and then sent to the dentist, who cements it in place in your mouth. This takes at least two visits: during the first visit, all decay is cleaned out from your mouth, and then a mold of your tooth is made, and the hole in the tooth is filled with a temporary filling.

At the dental lab, the mold of your tooth is used to make a model. A filling that is the same size and shape as your tooth is built, based on this model. You will have a follow up appointment about two weeks later to cement the gold filling in place.

Gold fillings are ancient. They were the first dental treatments done and examples of these are first seen in the Middle East before the rise of the Egyptians. Gold is a great material for the mouth as it is very slow to react with chemicals and fluids in the mouth and does not corrode. Some countries view gold restorations as a status symbol and ask for gold fillings in front teeth. That is not so much the case in Calgary.

“In 35 years of being a dentist, I have only done gold fillings twice, both times on a full upper denture. And one of these was on my own father.” Dr. Westersund

There are times when a gold crown is the best treatment we can give you. This is usually on a lower back molar when there is almost no tooth available above the level of the gum tissue. We will discuss your options if and when such a situation arises.

Amalgam Fillings

Dental amalgam is a mixture of mercury, silver, tin and copper. Mercury, which makes up about 50 percent of this mixture, binds the metals together to provide a strong, hard, durable restorations.

There are many viewpoints on amalgam restorations. Some people believe that amalgams are the worst restoration possible because of the metals used in them. There are instances of patients being severely affected by metals. They avoid them at all costs. Others have had amalgam restorations for decades with no noticeable negative effect.

“As a more ‘mature’ dentist, I have seen nearly all variations of these two sides or beliefs and I think that listening to what the patient wants is the best in the long run.”

There are some advantages to  amalgam restorations:

1) They are usually cheaper to deliver. Dentistry is expensive and amalgams can be a more affordable option for some patients.

2) They FAIL in a very predictable manner. You can nearly always tell when an amalgam restorations is no longer ‘filling’ the tooth totally but allowing fluids (saliva) to leach around its edges. Failing restorations are showing corrosion, are staining the tooth around the edges of the restoration, and are beginning to chip and fall apart. It does not take much corrosion and breakdown to allow bacteria to get under the edges of an amalgam restoration as bacteria are tiny. Bacteria cause decay so a failing amalgam restoration is a problem in the making.

Remember that “DECAY” does not cause pain. You do not get pain from decay. Decay is only the softening and breakdown of tooth structure from the acids produced by bacteria that are growing in a tooth or restoration defect. The affects of decay cause pain. The exposure of the inner tooth structure, the migration of bacteria into the “pulp” or “nerve” of the tooth, the build up of infection and pressure in the tooth pulp or the bone surrounding the tooth … these are the causes of TOOTH PAIN.

When you have tooth pain, you often are looking at needing a Root Canal Treatment or possibly an extraction of the tooth. If you want to keep your dental bills to a minimum, our advice is to not wait for the pain to start!

Resin (Plastic) Dental Restorations

These are alternatives to amalgam restorations and are placed directly on your teeth. They are made of plastic resin. Resin restorations are a great choice for restoring many teeth and are a common material used today. They have their good and bad qualities, just like all things.

Pro: They are done directly in the mouth so you only need one appointment. They are less expensive than Indirect restorations so they can save you money up front.

Con: They are generally not as durable as a porcelain restoration, especially if the restoration is larger and requires the sides of the tooth to be restored. Plastic restorations work best in smaller cavities. The industry standard for longevity of resin restorations is from 3 to 5 years. I have seen smaller resin restorations last more than 10 years in smaller sized areas and I have seen others last less than a year in larger, higher use areas. It is important that you know all the facts before deciding what is best for you so be sure to ask myself or my team for the information relevant to your needs.

Another option

Some patients will use the resin restorations as a less expensive alternative and just replace it more often as need be. A great choice if the restoration is small to begin with. But understand that every time a dentist removes and replaces a restoration, the hole in your tooth will get bigger. Maybe not much bigger but teeth are pretty tiny and it does not take long before the structure of the tooth is weakened. Anytime a dentist works on a tooth it causes some trauma to the tooth and that trauma can accumulate. Anytime a dentist works on a tooth there is the possibility that the trauma may be sufficient that you will subsequently need a Root Canal. We cannot tell you with certainty when any tooth may require more extensive and expensive treatment. As a general rule, Dr. Westersund tells his patients that it is best for them if he is in their mouth doing work the least number times over their lifespan.

“If it was my mouth, I would always do the longest and least invasive treatment available and I would be proactive on my decision vs. Reactive to a problem. The choice is always yours of course so get all the facts, ask questions and choose what is best for you.” Dr. Westersund

Indirect Dental Restorations

Indirect Dental Restorations come in many forms and materials. Some are metal, some are metal and porcelain, some are all porcelain, and some are resin.

Porcelain restorations have evolved into one of the more popular restorative options. These restorations are quite durable in most cases. They are generally made in a Dental Laboratory. There was a time when this was limited to a metal crown or partial crown, sometimes with a porcelain material baked on top of the metal. The ones with porcelain baked on top are called Porcelain Fused to Metal (PFM) restorations.

Starting in 1997, new materials came out that allowed the dentists in Alberta to reduce or eliminate the metal from the Indirect restorations. This allowed dentists to use materials that were more aesthetic and yet still strong. Over the last 15 + years the materials have improved and become more varied.

Indirect restorations can be made any size. They can be used to fill the tiniest of cavities up to replacing the entire crown. They can be used over root canal teeth, healthy teeth, dental implants, and as bridges to fill in a gap in your teeth. And the aesthetics are very natural with shade choices and custom shading available to match nearly every situation.

Because the Indirect restorations are made outside of the mouth, they can be made of materials that are much more dense and therefore stronger than resin or amalgam restorations.   There is a step between appointments. This the process:

  • Preparation of the tooth
  • Impression of the prepared tooth
  • Temporary restoration placed
  • One week wait for the Dental Lab to create your new restoration
  • Bonding of the restoration into your tooth.

The Alberta Dentistry Association (ADA) lists the pros and cons of every material option on its website.

Broken, Cracked, Chipped, or Lost Teeth

 

Restorative dental treatments are exactly that…the restoration of natural teeth that have been damaged, decayed or lost.

Once Dr. Westersund has examined your teeth and evaluated your dental and medical history, he will provide a diagnosis and treatment options.

To renew your smile, find out how teeth whitening or cosmetic dental treatments can help to turn a damaged tooth back to its original form and function.

 

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