Composite Fillings

Fillings are used to replace tooth structure that has been removed in order to get rid of decay. Caught early enough, tooth decay can be treated easily and comfortably. If it is not treated, tooth decay can lead to pain and/or infection requiring root canal treatment or extraction. Composite resin is a filling material designed for aesthetic dental restorations. Formulated to resemble the color of your natural tooth, composite resin is often used for filling dental cavities or for dental bonding on front teeth. Composite resin consists of glass or quartz filler added to a resin medium, which produces a tooth-colored filling. The invention of composite resin offers a substitute to the amalgam (silver) dental fillings we’ve grown so accustomed to. This plastic and glass mixture contains no metal and can be shaped to resemble a real tooth. The result is a tooth with a natural look and feel. Onlookers usually can’t tell that a tooth has even been filled.

What Are The Advantages Of Tooth-Colored Restorations?

There are many advantages to tooth-colored restorations. Resin fillings are bonded to the teeth creating a tight, superior fit to the natural tooth. Such restorations can be used in instances where much of the tooth structure has been lost. The tooth remains intact and stronger.

Crowns

A crown is used to cover and protect a tooth which is likely to break, or is too broken down to be restored with a filling. Crowns are most commonly used to protect a tooth after root canal treatment, or when a large filling wears out. The larger the hole in the tooth that was made by tooth decay, the more likely that tooth will need a crown to protect it.

How Long Does It Take To Fit A Dental Crown?

It takes two appointments to restore a tooth with a crown. At the first of these appointments, any decay is removed from the tooth and it is shaped to fit the crown. Then, an impression of the tooth is made. This impression is used in making the crown, to ensure that it fits your mouth. Between the first and second visits, the crown is made. It is usually made of high-strength porcelain covering a foundation that is made of either a gold alloy, an all-ceramic material, or gold. In between the two appointments, a temporary crown is worn. At the second visit, this temporary crown is removed and the permanent crown is cemented in place.

What Are The Benefits Of A Dental Crown?

Many people have unexplained pain from filled back teeth, which is usually due to hairline cracks in the chewing part of the tooth. Placing crowns on these teeth can relieve the pain and allows a return of full dental function for these teeth. A crown covers the weakened tooth, protecting it from breaking under the tremendous pressure of day to day use. In teeth with root canal fillings, crowns can prevent breakage.

Bridges

A bridge is an option that is used to fill the space created by a missing tooth. It is important that a missing tooth be replaced as soon as possible. If it is not treated, the teeth surrounding the gap begin to shift inward, which leads to a chain reaction of bad things. Your teeth work together for many daily functions from eating to speaking. With missing teeth, it’s difficult to do these things. Missing teeth can and should be replaced. A bridge replaces a missing tooth, both functionally and cosmetically.

Why Do I Need A Dental Bridge?

Normally, teeth use their neighbors for support, and with one missing, they start to “fall.” As this worsens, the bite changes in response to pressure from daily use. This can eventually result in problems with the entire jaw. The surrounding teeth begin to deteriorate and unless this deterioration is handled, it is just a matter of time before they too are lost. Gum disease becomes a serious problem which becomes more difficult to treat as the neglect continues. Oral functionality and appearance are also important reasons for wearing a bridge. A bridge helps support your lips and cheeks. The loss of a back tooth may cause your mouth to sink and your face to look older.

What Materials Are Used For A Dental Bridge?

Bridge work is as much an art as it is a science. The materials used for the bridge may be gold alloys, porcelain bonded to a metal alloy, or an all-ceramic material. The choice of material depends on what is needed for strength, wear, and/or aesthetics.

Root Canal Therapy

Root canal therapy, or endodontic therapy, is necessary when decay has been neglected to the point that the infection reaches all the way to the pulp of the tooth. Your tooth pulp is a collection of blood vessels and nerves that helps to build the surrounding tooth. Infection of the pulp can be caused by trauma to the tooth, deep decay, cracks, and chips, or repeated dental procedures.

How Do I Know If The Tooth Pulp Has Become Infected?

Symptoms that the pulp has become infected may include: sensitivity to hot or cold, to sweets or pressure on the tooth. There may be pain in the tooth and gums, swelling of the tooth, and a bad taste in the mouth. Sometimes, however, there are no symptoms and the person is unaware of any problem until they have a checkup.

How Is A Root Canal Performed?

If you experience any of these symptoms, your dentist will most likely recommend non-surgical treatment to eliminate the diseased pulp. This injured pulp is removed and the root canal system is thoroughly cleaned; and once the infection is resolved, the canal or canals involved are filled in to prevent any further infection. Usually, a core build-up and crown are recommended to restore a tooth that has had root canal therapy. The alternative to root canal therapy is extraction.  

Complete Dentures

Dentures replace teeth that have become loose, or that have been lost due to bone loss around the roots of teeth. In determining the need for dentures, the entire mouth is examined. An evaluation is made regarding which teeth will have to be removed, and which will remain. The loose teeth are then extracted and dentures are fitted. There is an adjustment period after dentures are placed in the mouth, and they can take some getting used to. After this adjustment period, normal dental functions and appearance return. Often implants can be used to further stabilize dentures.

Partial Dentures

A partial denture is useful for a person missing some teeth, but still have a number of natural teeth. This device is also called a removable prosthesis and is a means by which artificial replacement teeth are held in the mouth. The prosthesis is commonly kept in place by means of clasps. These are thin finger-like structures, usually made of a special resilient metal alloy or sometimes plastic, that rest upon and wrap around some remaining natural teeth. Clasps keep the prosthesis securely in place but still allow a person to easily take it out for regular cleaning and proper brushing of remaining natural teeth.

Implant Supported Denture

Implant Supported Denture is a technique for total rehabilitation of the edentulous. This surgical and prosthetic medical procedure was developed, institutionalized and systematically analyzed in the 1990s through studies funded by Nobel Biocare in collaboration with a Portuguese dentist Paulo Maló. It consists of the rehabilitation of the edentulous maxilla and mandible with fixed prosthesis by placing four implants in the anterior maxilla, where bone density is higher, allowing the highest success rate. The procedure is best for patients with significant tooth loss or decay and for people whose bone loss in the jaw area prevents them from getting dental implants.

How Is The Implant Supported Denture Different From Dentures?

This Implant Supported Denture solution is a procedure that only requires four dental implants per jaw to support a fully customized set of replacement teeth. Implant Supported Denture is attractive to patients wanting to get rid of their dentures, and to people with failing teeth in need of a full upper and/or lower restoration. The Implant Supported Denture procedure provides patients with new teeth that are firmly fixed in place, and look and function as close to natural teeth as possible. Unlike dentures which are removable, Implant Supported Dentures provide the patient with a set of teeth that are connected to the implants, and are solidly fixed in place (what we call an implant-supported fixed bridge). They may only be removed by the dentist, are bushed and cleaned like normal teeth (though flossing is different), and are the closest thing possible to natural teeth in terms of look, feel and function. The Implant Supported Denture Bridge also allows the patient to bite with much more force than dentures, since the stresses are transferred directly to the bone rather than to gum tissue as with dentures. This means that patients can eat almost any of their favorite foods without worrying about their teeth.

What Are The Benefits Of Implant Supported Dentures?

The Implant Supported Denture treatment concept offers clinicians and their patients’ various clear benefits:

• Stability even in minimum bone volume
• Good clinical results
• Planning with NobelGuide treatment concept
• Prosthetic flexibility
• Increased efficiency

Tooth Extractions

You may need a tooth extraction for any number of reasons. Some teeth are extracted because they are decayed, others may have advanced periodontal disease or may have broken in a fashion which cannot be repaired. Other teeth may have to be removed because they are poorly positioned in the mouth, such as impacted wisdom teeth. Teeth that are malpositioned or crowded may have to be extracted in preparation for orthodontic treatment.

Should I Replace An Extracted Tooth?

When a tooth is missing its neighboring teeth tend to shift, sometimes significantly, which in turn can have a major impact on your dental health. Even the removal of a single tooth can lead to problems. To avoid these complications, we recommend that you replace the tooth that has been extracted. There are a number of options available to replace missing teeth including dental implants and dental bridges.

Laser Dentistry

The nonsurgical laser is a visible light laser that is used to help detect decay in the pits and grooves common in back teeth where it can be difficult to discover. This technology allows us to detect the decay at a very early stage and determine if it needs to be filled or just cleaned out and sealed. In both cases, the tooth is made healthy with minimal loss of tooth structure and no filling is visible. These laser dentistry procedures can most often be performed without the need for any anesthesia.

What Are Soft Tissue Lasers?

Soft tissue lasers are used exclusively for cutting or removal of soft tissue from the gum or other parts of the mouth. They are also used for killing bacteria in periodontal pockets and to stimulate the cells in the area for more rapid and complete healing.

What Are Hard Tissue Lasers?

The hard tissue laser is used primarily for the removal of diseased tooth structure. It has the benefit of leaving a clean, sterile surface that kills all bacteria prior to placing the filling.

Frenectomy

A frenectomy is the repositioning or clipping of one of the muscle attachments either between the gums and the lip or at the base of the tongue. This procedure is used to remove a muscle attachment that interferes with normal movement or speech. Additionally, often times these muscle attachments, when positioned closer to the margins of the gum tissue, can cause excessive loss and recession of the gum tissue around the teeth. Removing or lowering this attachment can help to prevent further gum recession and root exposure. While six of the main frenum attachments (muscle attachments) are between the inner part of the lips and the gum tissue, the other main frenum attachment is located at the base of the tongue and can restrict its movement. In more extreme cases, the individual would not be able to extend their tongue all the way, and the attachment would force the tongue to curl up. By relieving this muscle attachment, it enables full extension of the tongue and proper speech, which may have been hindered before.

What Is A Laser Frenectomy Treatment?

Conventional treatment for releasing the frenum involved a procedure where the frenum was cut with a blade or scissors, with or without sutures to reposition its attachment. Today, there is a procedure called “laser frenectomy” in which the Waterlase is used to zap the frenum with laser pulses without even touching it, gently severing it from its attachment. Healing time for laser frenectomy is reduced drastically, as the Waterlase does not create tissue trauma or charring, as some older lasers did. The actual procedure takes 3-5 minutes, and full healing with new skin is evident within 10 days. The new frenum attachment is at least 5 mm higher up, clearing the gums and releasing the tongue or the lip respectively. There is minimal post-operative discomfort involved with laser frenectomy. The area feels sore for 2-3 days.

Smile Makeover

A beautiful, healthy smile can transform your life. Modern cosmetic dentistry can change your image by brightening, straightening, or reshaping your teeth. If you have teeth that are worn, shifted, missing, or broken, then a smile makeover may be the answer for you. Smile Makeover involves careful consideration of your facial appearance, skin tone, hair color, tooth shape, gum tissue, and lips position in order to develop a plan to create Your Best Smile Ever!

Am I A Candidate For A Smile Makeover?

You could be a candidate for a smile makeover if you have any number of common dental problems such as…

• My teeth are crooked.
• Too much of my gums show.
• I am unhappy with the appearance of my smile.
• My teeth are uneven.
• My teeth are chipped or broken.
• I have missing teeth.
• My teeth are stained & discolored.
• I am embarrassed to smile.

Smile Makeovers can change your life. If you believe you can benefit from a smile makeover, please contact us.

Teeth Whitening

Having a beautiful smile may be even easier than you think. Many people achieve the look they’ve been dreaming of with our simple whitening procedure. Whitening can dramatically improve the appearance of those stains resulting in a brighter, more attractive smile! Dental bleaching can be used to correct tooth discoloration. Discolorations can be caused by staining, aging, or chemical damage to teeth. We have different options available to create the dazzling smile you have always wanted. We offer the take-home method of bleaching in which custom trays are fabricated and bleaching gel is placed in the trays at home over a period of time until the desired result is achieved. If you want instantly brighter teeth we offer in-office teeth whitening treatments which can lighten your teeth as much as eight shades in about an hour! In cases of extreme tooth discoloration, crowns or veneers may be the only choice.

Professional Teeth Whitening Vs. Over-The-Counter

Over the counter whitening products are different than professional whitening products in their concentration. Custom made whitening trays made at our dental office offer superior fit and less leakage of the whitening gel that can harm your root surfaces and gums, and possibly the nerves of your teeth if used improperly on a consistent basis. Though over the counter whitening products are easily accessible, it is often best to use professional teeth whitening to ensure the safety and efficacy of the whitening process.

Dental Bonding

Dental bonding is a process that can fix minor imperfections of the teeth. This is a great solution if you have spaces, cracks, or stains in your teeth. It is excellent for small defects in the teeth. Bonding involves adhering composite resin material to the front of the tooth. This material has been matched to the color of the tooth, so that it looks like part of your natural tooth.

How Does Dental Bonding Work?

First, the surface of the tooth is roughened in order to accept the bonding and hold it in place. A gel is then applied to micro-etch the tooth surface, and a primer/bonding agent is applied so that the bonding material adheres to the surface. Then, the bonding material is placed on the tooth and hardened with intense light. It is then shaped and polished to a lustrous finish.

Porcelain Veneers

Porcelain veneers are thin shells of ceramic that bond directly to the front surfaces of the teeth. They can be used to whiten teeth, reduce or eliminate spaces between teeth, repair broken or chipped teeth, or correct misshapen or crooked teeth. Veneers are a fantastic way to repair or enhance the appearance of front teeth.

Do Veneers look like normal teeth?

When bonded to the teeth, the ultra-thin porcelain veneers are virtually undetectable and highly resistant to coffee, tea, or even cigarette stains. For strength and appearance, their resemblance to healthy, white tooth enamel is comparable to normal teeth.

Implant Supported Denture

Implant Supported Denture is a technique for total rehabilitation of the edentulous. This surgical and prosthetic medical procedure was developed, institutionalized and systematically analyzed in the 1990s through studies funded by Nobel Biocare in collaboration with Portuguese dentist, Paulo Maló. It consists of the rehabilitation of the edentulous maxilla and mandible with fixed prosthesis by placing four implants in the anterior maxilla, where bone density is higher, allowing the highest success rate. The procedure is best for patients with significant tooth loss or decay and for people whose bone loss in the jaw area prevents them from getting dental implants.

How Is The Implant Supported Denture Different From Dentures?

This Implant Supported Denture solution is a procedure that only requires four dental implants per jaw to support a fully customized set of replacement teeth. Implant Supported Denture is attractive to patients wanting to get rid of their dentures, and to people with failing teeth in need of a full upper and/or lower restoration. The Implant Supported Denture procedure provides patients with new teeth that are firmly fixed in place, and look and function as close to natural teeth as possible. Unlike dentures which are removable, Implant Supported Dentures provide the patient with a set of teeth that are connected to the implants and are solidly fixed in place (what we call an implant-supported fixed bridge). They may only be removed by the dentist, are bushed and cleaned like normal teeth (though flossing is different), and are the closest thing possible to natural teeth in terms of look, feel and function. The Implant Supported Denture Bridge also allows the patient to bite with much more force than dentures since the stresses are transferred directly to the bone rather than to gum tissue as with dentures. This means that patients can eat almost any of their favorite foods without worrying about their teeth.

What Are The Benefits f Implant Supported Denture?

The Implant Supported Denture treatment concept offers clinicians and their patients’ various clear benefits:

• Stability even in minimum bone volume
• Good clinical results
• Planning with NobelGuide treatment concept
• Prosthetic flexibility
• Increased efficiency

Digital X-Rays

In our office, we use digital radiography which allows us to take x-rays using 90% less radiation than conventional x-rays. This digital technique also allows us to enhance the images for better diagnosis of any dental concerns.

Intraoral Camera

At the office of Merrell & Nichols DDS, we take pride in using the latest technologies to ensure our patients get their best care ever. In our office, we use an intraoral camera to take actual photos of teeth for patient education.

Sealants

In some cases, the tooth structure has fine grooves or pits which accumulate plaque, not because the person doesn’t brush, but because they are too narrow or small to allow even one bristle of a toothbrush into them. These areas will develop decay if they are not cleaned. Sealants are used to prevent decay by filling in these pits and grooves. This coating seals the grooves and pits, making it possible to brush off all the plaque and keep your teeth healthy.

Saliva Testing For Periodontal Disease

Saliva testing provides information on 11 different species of bacteria known to trigger periodontal disease. In addition to identifying the bacterial pathogens, the test provides a bacterial-related risk of disease progression and suggestions for suitable antibiotic and periodontal therapy protocols. Periodontal disease is a chronic inflammatory disease that affects the gum tissue and other structures supporting the teeth. If left untreated, it can lead to tooth loss. Besides helping with tooth retention, successful periodontal treatment can help patients with diabetes to better control their disease. (1,2) About 50% of Americans have gingival bleeding, the more common but less severe form of periodontal disease. (3) Several research studies have associated gum disease with other chronic inflammatory diseases such as diabetes, cardiovascular disease, and rheumatoid arthritis. References: 1) Swedish (Sweden) Koromantzos PA, Makrilakis K, Dereka X, et al. A randomized, controlled trial on the effect of non-surgical periodontal therapy in patients with type 2 diabetes. Part I: effect on periodontal status and glycaemic control. J Clin Periodontol. 2011;38:142-147. 2) Simpson TC, Needleman I, Wild SH, et al. Treatment of periodontal disease for glycaemic control in people with diabetes (Review). Cochrane Database Syst Rev. 2010;(5):CD004714. 3) Albandar JM, Kingman A. Gingival recession, gingival bleeding, and dental calculus in adults 30 years of age and older in the United States, 1988-1994. J Periodontol. 1999;70:30-43.

Gum Disease

Gum disease (Periodontal Disease) is responsible for about 70% of adult tooth loss. It is characterized by swollen, inflamed gums surrounding the teeth. Plaque, a sticky substance that forms in the mouth from food, saliva, and bacteria, gets inside the space between the gum line and the tooth. If not removed, plaque hardens into a substance called calculus, or tarter, that is very difficult to remove. Eventually, the bacteria in the plaque and tartar eat away at the fibers that hold the gums to the teeth, creating deep pockets. As bacteria spreads, the pockets become deeper until the bacteria finally eat away the bone that holds the tooth in place.

How Is Gum Disease Diagnosed?

Gum disease is diagnosed through a process that measures the depth of the pockets around each tooth. Pockets that are greater than 3 millimeters in depth are considered hazardous and will generally require treatment. The early detection and prevention of gum disease is another reason to see your dentist regularly.

How Is Gum Disease Treated?

Gum disease is treated by carefully removing the bacteria and substances that form in the pockets around the teeth. The removal of this material occurs on a microscopic level and requires great skill. Our dental team has had advanced training regarding how to effectively remove all of the bacteria. This process of removing the bacteria usually requires several visits to our office. Once the bacteria has been removed, the pockets must be cleaned and maintained on a regular basis by a registered hygienist. Otherwise, the bacteria will return.

Night Guards And Sports Guards

Grinding and clenching your teeth, known as bruxism, can lead to cracked teeth, pain, and even tooth loss. Temporomandibular joint disorders (TMJ/TMD) can develop from bruxism and are extremely uncomfortable disorders of the jaw. Night guards and splints help to treat both these conditions. Bruxism and temporomandibular joint disorders (TMJ/TMD) are two painful conditions that can affect your quality of life. If you are suffering from either of these conditions, give us a call. We can create a treatment plan for you to help your condition and make your life more comfortable.

Bruxism

Bruxism is the medical name for teeth grinding or clenching. Some people who suffer from bruxism are not even aware of the exact problem. You might have dental problems, an aching jaw, or even a cracked tooth and not realize that the problem is that you have been grinding your teeth. While some teeth grinding and clenching is caused by stress or anxiety, most teeth grinding occurs at night. If left untreated, the results can be quite problematic including:

• Headaches
• Jaw Pain
• Loose Teeth
• Fractured teeth
• Worn teeth
• Hearing loss
• TMJ/TMD

Many people with bruxism use a night guard while they are sleeping. This is a custom-fitted appliance that will help protect your teeth from the grinding.

Temporomandibular Joint Disorders

Temporomandibular joint disorders occur when the temporomandibular joint of the jaw, the place where your lower jaw is hinged to your skull, becomes injured or inflamed. This condition may be referred to as either TMJ or TMD. TMJ/TMD can have multiple causes. Some of the most common are:

• Bruxism
• Dislocation of the cushioning disc within the joint
• Arthritis
• Injury to the jaw including blunt trauma and whiplash

This condition is quite painful. If you are suffering from any of the following symptoms, you should be evaluated for TMJ/TMD:

• Pain in your face, jaw, neck, or shoulders, especially when chewing, speaking, or yawning
• Clicking and popping in the jaw joint
• “Locking” of the jaw
• Swelling
• Fatigue in the jaw
• Difficulty chewing

Like bruxism, night guards are helpful for people with TMJ/TMD. The guard keeps your teeth slightly separated and prevents them from clenching, which can exacerbate the condition. If your condition is more severe, you may require a splint to hold your jaw in place so that the joint can heal. As the name implies, night guards are worn while you are sleeping. Splints are worn all day. Just like any other protective sports gear, a mouth guard is essential for protecting your teeth from injuries in and around the mouth. It is often over looked but, mouth guards are available for athletes of all ages.

Importance of Mouth Guards

A mouth guard acts as a shield not only your teeth, but also for the soft tissues and gums. It doesn’t matter if the sport involves rough contact, light contact, or no contact at all, there is always the potential for athletes to be at risk for broken teeth and/or oral injuries. According to the American Dental Association reports that athletes who play sports with a mouth guard are 60 times less likely to damage their teeth than those who chose to play without one. If you think you or your child might be a candidate for a Sports Guard, visit with us at your next visit about protecting your teeth while you play sports.

The i-CAT® is an imaging system allowing our dentists to get highly detailed, 3D images of your dental anatomy. Like 2D digital x-rays, this system enables our office to efficiently and effectively plan:

• Dental implant placement
• Tooth extractions
• TMJ treatments
• Airway/Sinus assessments and sleep apnea
• Orthodontic assessments

The clear, detailed digital images produced provide optimal visualization of your facial structures. It also lets Dr. Nichols see the image from any angle and at any distance, so a complete and in-depth plan can be created to determine the course of treatment.

What Are The Benefits Of i-CAT Imaging Vs. Traditional CT Scans?

Patients can take advantage of a more complete dental treatment with i-CAT imaging. Special features for patients include:

• One, 10-second scan that provides enough data for a complete diagnosis.
• A safer diagnosis with less radiation than traditional CT scanners.
• Increased comfort – patients are seated in an open environment with plenty of space.
• A more cost effective imaging system.
• Dr. Nichols can easily share the data with patients, so that patients stay informed and are able to make educated decisions on their course of treatment.