Our Services
Whether your dental requirements are a complete dental exam and cleaning, full mouth restoration, or anything in between, we will provide you with exceptional care. We will enhance the natural beauty of your smile. Below are some of the many services we provide to our patients. Your smile is our first priority.
If you have any questions, concerns, or would like to schedule an appointment, please call us today. We look forward to providing you with the personal care you deserve.
Cleaning and Protection - Dental Exam
A comprehensive dental exam will be performed by your dentist at your initial dental visit. At regular check-up exams, your dentist and hygienist will include the following:
- Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
- Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
- Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
- Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
- Examination of existing restorations: Check current fillings, crowns, etc.
Cleaning and Protection - Professional Dental Cleaning
Professional dental cleanings (dental prophylaxis) are usually performed by Registered Dental Hygienists. Your cleaning appointment will include a dental exam and the following:
- Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments.
- Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
- Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.
Cleaning and Protection - Dental X-Rays
Dental radiographs (x-rays) are essential, preventative, diagnostic tools that provide valuable information not visible during a regular dental exam. Dentists and dental hygienists use this information to safely and accurately detect hidden dental abnormalities and complete an accurate treatment plan. Without x-rays, problem areas may go undetected.
Dental x-rays may reveal:
- Abscesses or cysts.
- Bone loss.
- Cancerous and non-cancerous tumors.
- Decay between the teeth.
- Developmental abnormalities.
- Poor tooth and root positions.
- Problems inside a tooth or below the gum line.
- Detecting and treating dental problems at an early stage can save you time, money, unnecessary discomfort, and your teeth!
Are dental x-rays safe?
We are all exposed to natural radiation in our environment. The amount of radiation exposure from a full mouth series of x-rays is equal to the amount a person receives in a single day from natural sources.
Dental x-rays produce a low level of radiation and are considered safe. Dentists take necessary precautions to limit the patient's exposure to radiation when taking dental x-rays. These precautions include using lead apron shields to protect the body and using modern, fast film that cuts down the exposure time of each x-ray.
How often should dental x-rays be taken?
The need for dental x-rays depends on each patient's individual dental health needs. Your dentist and dental hygienist will recommend necessary x-rays based on the review of your medical and dental history, dental exam, signs and symptoms, age consideration, and risk for disease.
A full mouth series of dental x-rays is recommended for new patients. A full series is usually good for three to five years. Bite-wing x-rays (x-rays of top and bottom teeth biting together) are taken at recall (check-up) visits and are recommended once or twice a year to detect new dental problems.
Cleaning and Protection - Home Care
A beautiful, healthy smile that lasts a lifetime is our ultimate goal when treating patients. Your personal home care plays an important role in achieving that goal. Your personal home care starts by eating balanced meals, reducing the number of snacks you eat, and correctly using the various dental aids that help control the plaque and bacteria that cause dental disease.
Tooth brushing - Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste.
Place the brush at a 45 degree angle to the gums and gently brush using a small, circular motion, ensuring that you always feel the bristles on the gums.
Brush the outer, inner, and biting surfaces of each tooth.
Use the tip of the brush to clean the inside of the front teeth.
Brush your tongue to remove bacteria and freshen your breath.
Electric toothbrushes are also recommended. They are easy to use and can remove plaque efficiently. We recommend the Sonicare and offer them to our patients at our cost. Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.
Flossing - Daily flossing is the best way to clean between the teeth and under the gumline. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.
Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
Curve the floss into a "C" shape around each tooth and under the gumline. Gently move the floss up and down, cleaning the side of each tooth.
Floss holders are recommended if you have difficulty using conventional floss.
Rinsing - It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush. If you are using an over-the-counter product for rinsing, it's a good idea to consult with your dentist or dental hygienist on its appropriateness for you.
Use other dental aids as recommended by your dentist or dental hygienist: Interdental brushes, rubber tip stimulators, tongue cleaners, irrigation devices, fluoride, medicated rinses, etc., can all play a role in good dental home care.
Cosmetic Dentistry - White Composite Fillings
A white composite (tooth colored) filling is used to repair a tooth that is affected by decay, cracks, fractures, etc. The decayed or affected portion of the tooth will be removed and then filled with a composite filling.
At the office of Paul Evans, DDS, we practice mercury-free dentistry. Only non-mercury materials are ever used. When amalgam fillings are removed, extra care is taken to prevent exposing our patients and staff to mercury vapor or debris.
As with most dental restorations, composite fillings are not permanent and may someday have to be replaced. They are very durable, and will last many years, giving you a long lasting, beautiful smile.
Reasons for composite fillings:
- Chipped teeth.
- Closing space between two teeth.
- Cracked or broken teeth.
- Decayed teeth.
- Worn teeth.
How are composite fillings placed?
Composite fillings are usually placed in one appointment. While the tooth is numb, your dentist will remove decay as necessary. The space will then be thoroughly cleaned and carefully prepared before the new filling is placed. If the decay was near the nerve of the tooth, a special medication will be applied for added protection. The composite filling will then be precisely placed, shaped, and polished, restoring your tooth to its original shape and function. The latest techniques and materials are always used to ensure long lasting, beautiful tooth colored restorations.
It is normal to experience sensitivity to hot and cold when composite fillings are first placed, however this will subside shortly after your tooth acclimates to the new filling.
You will be given care instructions at the conclusion of your treatment. Good oral hygiene practices, eating habits, and regular dental visits will aid in the life of your new fillings.
Cosmetic Dentistry - Porcelain Crowns (Caps)
A crown (or cap) is a covering that encases the entire tooth surface restoring it to its original shape and size. A crown protects and strengthens tooth structure that cannot be restored with fillings or other types of restorations.
Although there are several types of crowns, porcelain (tooth colored crown) are the most popular, because they resemble your natural teeth. They are highly durable and will last many years, but like most dental restorations, they may eventually need to be replaced. Porcelain crowns are made to match the shape, size, and color of your teeth giving you a natural, long-lasting beautiful smile.
Reasons for crowns:
- Broken or fractured teeth.
- Cosmetic enhancement.
- Decayed teeth.
- Fractured fillings.
- Large fillings.
- Tooth has a root canal.
What does getting a crown involve?
A crown procedure usually requires two appointments. Your first appointment will include taking several highly accurate molds (or impressions) that will be used to create your custom crown. A mold will also be used to create a temporary crown which will stay on your tooth for approximately two weeks until your new crown is fabricated by a dental laboratory.
While the tooth is numb, the dentist will prepare the tooth by removing any decay and shaping the surface to properly fit the crown. Once these details are accomplished, your temporary crown will be placed with temporary cement and your bite will be checked to ensure you are biting properly.
At your second appointment your temporary crown will be removed, the tooth will be cleaned, and your new crown will be carefully placed to ensure the spacing and bite are accurate.
You will be given care instructions and encouraged to have regular dental visits to check your new crown.
Cosmetic Dentistry - Porcelain Fixed Bridges
A dental bridge is a fixed (non-removable) appliance and is an excellent way to replace missing teeth.
There are several types of bridges. You and your dentist will discuss the best options for your particular case. The "traditional bridge" is the most popular type and is usually made of porcelain fused to metal. Porcelain fixed bridges are most popular because they resemble your natural teeth. This type of bridge consists of two crowns that go over two anchoring teeth (abutment teeth) and are attached to pontics (artificial teeth), filling the gap created by one or more missing teeth.
Dental bridges are highly durable and will last many years, however they may need replacement or need to be re-cemented due to normal wear.
Reasons for a fixed bridge:
- Fill space of missing teeth.
- Maintain facial shape.
- Prevent remaining teeth from drifting out of position.
- Restore chewing and speaking ability.
- Restore your smile.
- Upgrade from a removable partial denture to a permanent dental appliance.
What does getting a fixed bridge involve?
Getting a bridge usually requires two or more visits. While the teeth are numb, the two anchoring teeth are prepared by removing a portion of enamel to allow for a crown. Next, a highly accurate impression (mold) is made which will be sent to a dental laboratory where the bridge will be fabricated. In addition, a temporary bridge will be made and worn for several weeks until your next appointment.
At the second visit, you permanent bridge will be carefully checked, adjusted, and cemented to achieve a proper fit. Occasionally your dentist may only temporarily cement the bridge, allowing your teeth and tissue time to get used to the new bridge. The new bridge will be permanently cemented at a later time.
You will receive care instructions at the conclusion of your treatment. Proper brushing, flossing and regular dental visits will aid in the life of your new permanent bridge.
Cosmetic Dentistry - Porcelain Veneers
Do you want to look younger, healthier, sexier and more successful? Porcelain veneers can do all of this and more. Gorgeous porcelain veneers will straighten misaligned teeth, hide unsightly discolored teeth and give you a new beautiful smile that will change your life, and make you more confident. Most of the time this process can be completed in as little as two visits. You will receive daily compliments.
Veneers are very thin pieces of durable, tooth shaped porcelain that are custom made (for shape and color) by a professional dental laboratory. They are bonded onto the front of teeth to create a beautiful and attractive smile.
Veneers can completely reshape your teeth and smile. They can often be alternatives to crowns and the ideal solution in treating many dental conditions.
As with most dental restorations, veneers are not permanent and may someday need replacement. They are very durable and will last many years, giving you a beautiful long lasting smile.
Reasons for porcelain veneers:
- Cosmetically, to create a uniform, white, beautiful smile.
- Crooked teeth.
- Misshapen teeth.
- Severely discolored or stained teeth.
- Teeth that are too small or large.
- Unwanted or uneven spaces.
- Worn or chipped teeth.
What does getting porcelain veneers involve?
Getting veneers usually requires two visits to complete the process, with little or no anesthesia required during the procedure. The teeth are prepared by lightly buffing and shaping the surface to allow for the thickness of the veneer. A mold or impression of the teeth is taken and a shade (color) will then be chosen by you and the dentist.
On the second visit the teeth will be cleansed with special liquids to achieve a durable bond. Bonding cement is then placed between the tooth and veneer and a special light beam is used to harden and set the bond.
You will receive care instructions for veneers. Proper brushing, flossing and regular dental visits will aid in the life of your new veneers.
Cosmetic Dentistry - Teeth Whitening/Bleaching
Can you imagine your smile whiter and brighter? Our Zoom 2® teeth whitening system is the same technique used on TV's "Extreme Makeover". With one visit you can erase years of stain from your teeth. Your friends and family will notice the difference!
Teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel and is an ideal way to enhance the beauty of your smile.
Because having whiter teeth has now become the number one aesthetic concern of most patients, there are a number of ways to whiten teeth. The most popular method is using a home tooth whitening system that will whiten teeth dramatically. Since teeth whitening only works on natural tooth enamel, it is important to evaluate replacement of any old fillings, crowns, etc. Replacement of any restorations will be done after bleaching so they will match the newly bleached teeth.
Teeth whitening is not permanent. A touch-up maybe needed every several years, and more often if you smoke, drink coffee, tea, or wine.
Reasons for teeth whitening:
- Fluorosis (excessive fluoridation during tooth development).
- Normal wear of outer tooth layer.
- Stained teeth due to medications (tetracycline, etc.).
- Yellow, brown stained teeth.
What does teeth whitening involve?
This type of teeth whitening usually requires two visits. At the first appointment, impressions (molds) will be made of your teeth to fabricate custom, clear plastic, trays.
At your second appointment, you will try on the trays for proper fit, and adjustments will be made if necessary. The trays are worn with special whitening solution either twice a day for 30 minutes or overnight for a couple of weeks depending on the degree of staining and desired level of whitening. It is normal to experience tooth sensitivity during the time you are whitening your teeth, but it will subside shortly after you have stopped bleaching.
You will receive care instructions for your teeth and trays, and be encouraged to visit your dentist regularly to help maintain a beautiful, healthy, white smile.
Teeth Whitening in about 90 minutes
For those who prefer a "quick fix," teeth whitening can be done in about 90 minutes using the Zoom 2 whitening system in our office. This is the same system seen on TV's Extreme Makeover show! You will still be fitted for custom trays so that you may "touch up" with whitening gel at home as needed.
Periodontal Disease - What is it?
The word periodontal means "around the tooth". Periodontal disease attacks the gums and the bone that support the teeth. Plaque is a sticky film of food debris, bacteria, and saliva. If plaque is not removed, it turns into calculus (tartar). When plaque and calculus are not removed, they begin to destroy the gums and bone. Periodontal disease is characterized by red, swollen, and bleeding gums.
Four out of five people have periodontal disease and don't know it! Most people are not aware of it because the disease is usually painless in the early stages.
Not only is it the number one reason for tooth loss, research suggests that there may be a link between periodontal disease and other diseases such as, stroke, bacterial pneumonia, diabetes, cardiovascular disease, and increased risk during pregnancy. Researchers are determining if inflammation and bacteria associated with periodontal disease affects these systemic diseases and conditions. Smoking also increases the risk of periodontal disease.
Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.
Signs and symptoms of periodontal disease:
- Bleeding gums - Gums should never bleed, even when you brush vigorously or use dental floss.
- Loose teeth - Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).
- New spacing between teeth - Caused by bone loss.
- Persistent bad breath - Caused by bacteria in the mouth.
- Pus around the teeth and gums - Sign that there is an infection present.
- Receding gums - Loss of gum around a tooth.
- Red and puffy gums - Gums should never be red or swollen.
- Tenderness or Discomfort - Plaque, calculus, and bacteria irritate the gums and teeth.
Periodontal Disease - Diagnosis
Periodontal disease is diagnosed by your dentist or dental hygienist during a periodontal examination. This type of exam should always be part of your regular dental check-up.
A periodontal probe (small dental instrument) is gently used to measure the sulcus (pocket or space) between the tooth and the gums. The depth of a healthy sulcus measures three millimeters or less and does not bleed. The periodontal probe helps indicate if pockets are deeper than three millimeters. As periodontal disease progresses, the pockets usually get deeper.
Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category below:
Gingivitis
Gingivitis is the first stage of periodontal disease. Plaque and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed.
Periodontitis
Plaque hardens into calculus (tartar). As calculus and plaque continue to build up, the gums begin to recede from the teeth. Deeper pockets form between the gums and teeth and become filled with bacteria and pus. The gums become very irritated, inflamed, and bleed easily.Slight to moderate bone loss may be present.
Advanced Periodontitis
The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed. Unless treated, the affected teeth will become very loose and may be lost. Generalized moderate to severe bone loss may be present.
Periodontal Disease - Treatment
There is finally a quick and painless answer to periodontal disease! It is the Perio Protect method. We are the only office in Nevada County that offers this revolutionary treatment. The Perio Protect method, in most cases, eliminates the need for painful and costly surgery. If you want to learn more about this exciting new treatment click on this link to www.perioprotect.com
Periodontal treatment methods depend upon the type and severity of the disease. Your dentist and dental hygienist will evaluate you for periodontal disease and recommend the appropriate treatment.
Periodontal disease progresses as the sulcus (pocket or space) between the tooth and gums gets filled with bacteria, plaque, and tartar, causing irritation to the surrounding tissues. When these irritants remain in the pocket space, they can cause damage to the gums and eventually, the bone that supports the teeth!
If the disease is caught in the early stages of gingivitis, and no damage has been done, one to two regular cleanings will be recommended. You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings.
If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planning (deep cleaning) will be recommended. It is usually done one quadrant of the mouth at a time while the area is numb. In this procedure, tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planning). This procedure helps gum tissue to heal and pockets to shrink. Medications, special medicated mouth rinses, and an electric tooth brush may be recommended to help control infection and healing.
If the pockets do not heal after scaling and root planning, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean. Your dentist may also recommend that you see a Periodontist (specialist of the gums and supporting bone).
Periodontal Disease - Maintenance
It only takes twenty four hours for plaque that is not removed from your teeth to turn into calculus (tartar)! Daily home cleaning helps control plaque and tartar formation, but those hard to reach areas will always need special attention.
Once your periodontal treatment has been completed, your dentist and dental hygienist will recommend that you have regular maintenance cleanings (periodontal cleanings), usually four times a year. At these cleaning appointments, the pocket depths will be carefully checked to ensure that they are healthy. Plaque and calculus that is difficult for you to remove on a daily basis will be removed from above and below the gum line.
In addition to your periodontal cleaning and evaluation, your appointment will usually include:
- Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
- Examination of existing restorations: Check current fillings, crowns, etc.
- Examination of tooth decay: Check all tooth surfaces for decay.
- Oral cancer screening: Check the face, neck, lips, tongue, throat, cheek tissues, and gums for any signs of oral cancer.
- Oral hygiene recommendations: Review and recommend oral hygiene aids as needed. (Electric toothbrushes, special periodontal brushes, fluorides, rinses, etc.)
- Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.
Good oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control!
Restorations - What are they?
It's great news that the incidence of tooth decay has significantly diminished over the years due to the use of fluorides and an increase in patient awareness. However, teeth are still susceptible to decay, infection, and breakage and sometimes need to be restored back to health. Through improved techniques and modern technology, we are now able to offer more options for restoring a tooth back to its normal shape, appearance and function.
Should your teeth ever require a restorative treatment, you can rest assured knowing we will always discuss with you the available options, and recommend what we believe to be the most comfortable and least invasive treatment. Providing you with excellent care is our number one priority when creating your beautiful smile.
Reasons for restorative dentistry:
- Enhance your smile.
- Fill in unattractive spaces between teeth.
- Improve or correct an improper bite.
- Prevent the loss of a tooth.
- Relieve dental pain.
- Repair damaged and decayed teeth.
- Replace missing teeth.
- Replace old, unattractive dental treatments.
- Restore normal eating and chewing.
- Remember to give your teeth the attention they need today!
Restorations - Dental Implants
Do you have missing teeth? Dental implants will replace those vacant spaces and be an anchor for bridges. Dental implants will restore strength, function and beauty to your smile. We work with an accomplished and experienced oral surgeon to place the implant. This is a routine procedure, which can be done with local anesthetic or under IV sedation. After the implant is placed, we place a stunning, life-like crown on the implant.
Dental implants are a great way to replace missing teeth and also provide a fixed solution to having removable partial or complete dentures. Implants provide excellent support and stability for these dental appliances.
Dental implants are artificial roots and teeth (usually titanium) that are surgically placed into the upper or lower jaw bone by a dentist or Periodontist - a specialist of the gums and supporting bone. The teeth attached to implants are very natural looking and often enhance or restore a patient's smile!
Dental implants are very strong, stable, and durable and will last many years, but on occasion, they will have to be re-tightened or replaced due to normal wear.
Reasons for dental implants:
- Replace one or more missing teeth without affecting adjacent teeth.
- Resolve joint pain or bite problems caused by teeth shifting into missing tooth space.
- Restore a patient's confident smile.
- Restore chewing, speech, and digestion.
- Restore or enhance facial tissues.
- Support a bridge or denture, making them more secure and comfortable.
What does getting dental implants involve?
The process of getting implants requires a number of visits over several months.
X-rays and impressions (molds) are taken of the jaw and teeth to determine bone, gum tissue, and spacing available for an implant. While the area is numb, the implant will be surgically placed into the bone and allowed to heal and integrate itself onto the bone for up to six months. Depending on the type of implant, a second surgery may be required in order to place the "post" that will hold the artificial tooth in place. With other implants the post and anchor are already attached and placed at the same time.
After several weeks of healing the artificial teeth are made and fitted to the post portion of the anchor. Because several fittings may be required, this step may take one to two months to complete. After a healing period, the artificial teeth are securely attached to the implant, providing excellent stability and comfort to the patient.
You will receive care instructions when your treatment is completed. Good oral hygiene, eating habits, and regular dental visits will aid in the life of your new implant.
Restorations - Inlay Restorations
An inlay restoration is a custom made filling made of composite material, gold, or tooth-colored porcelain. It is made by a professional dental laboratory and is permanently cemented into the tooth by your dentist.
Inlays can be utilized to conservatively repair teeth that have large defective fillings or have been damaged by decay or trauma. Inlays are an ideal alternative to conventional silver and composite fillings. Also, they are more conservative than crowns because less tooth structure is removed in the preparation of inlays.
As with most dental restorations, inlays are not always permanent and may someday require replacement. They are highly durable and will last many years, giving you a beautiful long lasting smile.
Reasons for inlay restorations:
- Broken or fractured teeth.
- Cosmetic enhancement.
- Decayed teeth.
- Fractured fillings.
- Large fillings.
What does getting an inlay involve?
An inlay procedure usually requires two appointments. Your first appointment will include taking several highly accurate impressions (molds) that will be used to create your custom inlay and a temporary restoration.
While the tooth is numb, the dentist will remove any decay and/or old filling materials. The space will then be thoroughly cleaned and carefully prepared, shaping the surface to properly fit an inlay restoration. A temporary filling will be applied to protect the tooth while your inlay is made by a dental laboratory.
At your second appointment your new inlay will be carefully and precisely cemented into place. A few adjustments may be necessary to ensure a proper fit and that your bite is comfortable.
You will receive care instruction at the conclusion of your treatment. Good oral hygiene practices, a proper diet, and regular dental visits will aid in the life of your new inlay.
Restorations - Onlay Restorations
An onlay restoration is a custom made filling made of composite material, gold, or tooth-colored porcelain. An onlay is sometimes also referred to as a partial crown. It is made by a professional dental laboratory and is permanently cemented onto the tooth by your dentist.
Onlays can be utilized to conservatively repair teeth that have large defective fillings or have been damaged by decay or trauma. Onlays are an ideal alternative to crowns (caps) because less tooth structure is removed in the preparation of onlays. Onlays are essentially identical to inlays with the exception that one or more of the chewing cusps have also been affected and need to be included in the restoration.
As with most dental restorations, onlays are not always permanent and may someday require replacement. They are highly durable and will last many years, giving you a beautiful long lasting smile.
Reasons for onlay restorations:
- Broken or fractured teeth.
- Cosmetic enhancement.
- Decayed teeth.
- Fractured fillings.
- Large fillings.
An onlay procedure usually requires two appointments. Your first appointment will include taking several highly accurate impressions (molds) that will be used to create your custom onlay and a temporary restoration.
While the tooth is numb, the dentist will remove any decay and/or old filling materials. The space will then be thoroughly cleaned and carefully prepared, shaping the surface to properly fit an onlay restoration. A temporary filling will be applied to protect the tooth while your onlay is made by a dental laboratory.
At your second appointment, your new onlay will be carefully and precisely cemented into place. A few adjustments may be necessary to ensure a proper fit and that your bite is comfortable.
You will receive care instruction at the conclusion of your treatment. Good oral hygiene practices, a proper diet, and regular dental visits will aid in the life of your new onlay.
Restorations - Composite Fillings
A composite (tooth colored) filling is used to repair a tooth that is affected by decay, cracks, fractures, etc. The decayed or affected portion of the tooth will be removed and then filled with a composite filling.
At the office of Paul Evans, DDS, we practice mercury-free dentistry. Only non-mercury materials are ever used. When amalgam fillings are removed, extra care is taken to prevent exposing our patients and staff to mercury vapor or debris.
As with most dental restorations, composite fillings are not permanent and may someday have to be replaced. They are very durable, and will last many years, giving you a long lasting, beautiful smile.
Reasons for composite fillings:
- Chipped teeth.
- Closing space between two teeth.
- Cracked or broken teeth.
- Decayed teeth.
- Worn teeth.
How are composite fillings placed?
Composite fillings are usually placed in one appointment. While the tooth is numb, your dentist will remove decay as necessary. The space will then be thoroughly cleaned and carefully prepared before the new filling is placed. If the decay was near the nerve of the tooth, a special medication will be applied for added protection. The composite filling will then be precisely placed, shaped, and polished, restoring your tooth to its original shape and function.
It is normal to experience sensitivity to hot and cold when composite fillings are first placed, however this will subside shortly after your tooth acclimates to the new filling.
You will be given care instructions at the conclusion of your treatment. Good oral hygiene practices, eating habits, and regular dental visits will aid in the life of your new fillings.
Restorations - Crowns (Caps)
A crown (or cap) is a covering that encases the entire tooth surface restoring it to its original shape and size. A crown protects and strengthens tooth structure that cannot be restored with fillings or other types of restorations.
Although there are several types of crowns, porcelain (tooth colored crown) are the most popular. They are highly durable and will last many years, but like most dental restorations, they may eventually need to be replaced. Porcelain crowns are made to match the shape, size, and color or your teeth giving you a natural, long-lasting beautiful smile.
Reasons for crowns:
- Broken or fractured teeth.
- Cosmetic enhancement.
- Decayed teeth.
- Fractured fillings.
- Large fillings.
- Tooth has a root canal.
What does getting a crown involve?
A crown procedure usually requires two appointments. Your first appointment will include taking several highly accurate molds (or impressions) that will be used to create your custom crown. A mold will also be used to create a temporary crown which will stay on your tooth for approximately two weeks until your new crown is fabricated by a dental laboratory.
While the tooth is numb, the dentist will prepare the tooth by removing any decay and shaping the surface to properly fit the crown. Once these details are accomplished, your temporary crown will be placed with temporary cement and your bite will be checked to ensure you are biting properly.
At your second appointment your temporary crown will be removed, the tooth will be cleaned, and your new crown will be carefully placed to ensure the spacing and bite are accurate.
You will be given care instructions and encouraged to have regular dental visits to check your new crown.
Restorations - Dentures & Partial Dentures
Whether you need dentures for the first time, or you need to replace your old dentures, we can provide you with beautiful and natural dentures. We will work with you to match your tissue color, teeth shape and pick the color you desire. Your friends and family will not be able to tell you are wearing dentures. Give us a call for a free consultation.
A denture is a removable dental appliance replacement for missing teeth and surrounding tissue. They are made to closely resemble your natural teeth and may even enhance your smile.
There are two types of dentures - complete and partial dentures. Complete dentures are used when all of the teeth are missing, while partial dentures are used when some natural teeth remain. A Partial denture not only fills in the spaces created by missing teeth, it prevents other teeth from shifting.
A Complete denture may be either "conventional" or "immediate." A conventional type is made after the teeth have been removed and the gum tissue has healed, usually taking 4 to 6 weeks. During this time the patient will go without teeth. Immediate dentures are made in advance and immediately placed after the teeth are removed, thus preventing the patient from having to be without teeth during the healing process. Once the tissues shrink and heal, adjustments will have to be made.
Dentures are very durable appliances and will last many years, but may have to be remade, repaired, or readjusted due to normal wear.
Reasons for dentures:
- Complete Denture - Loss of all teeth in an arch.
- Partial Denture - Loss of several teeth in an arch.
- Enhancing smile and facial tissues.
- Improving chewing, speech, and digestion.
What does getting dentures involve?
The process of getting dentures requires several appointments, usually over several weeks. Highly accurate impressions (molds) and measurements are taken and used to create your custom denture. Several "try-in" appointments may be necessary to ensure proper shape, color, and fit. At the final appointment, your dentist will precisely adjust and place the completed denture, ensuring a natural and comfortable fit.
It is normal to experience increased saliva flow, some soreness, and possible speech and chewing difficulty, however this will subside as your muscles and tissues get used to the new dentures.
You will be given care instructions for your new dentures. Proper cleaning of your new dental appliance, good oral hygiene, and regular dental visits will aid in the life of your new dentures.
Restorations - Fixed Bridges
A dental bridge is a fixed (non-removable) appliance and is an excellent way to replace missing teeth.
There are several types of bridges. You and your dentist will discuss the best options for your particular case. The "traditional bridge" is the most popular type and is usually made of porcelain fused to metal. This type of bridge consists to two crowns that go over two anchoring teeth (abutment teeth) and are attached to pontics (artificial teeth), filling the gap created by one or more missing teeth.
Dental bridges are highly durable and will last many years, however they may need replacement or need to be re-cemented due to normal wear.
Reasons for a fixed bridge:
- Fill space of missing teeth.
- Maintain facial shape.
- Prevent remaining teeth from drifting out of position.
- Restore chewing and speaking ability.
- Restore your smile.
- Upgrade from a removable partial denture to a permanent dental appliance.
What does getting a fixed bridge involve?
Getting a bridge usually requires two or more visits. While the teeth are numb, the two anchoring teeth are prepared by removing a portion of enamel to allow for a crown. Next, a highly accurate impression (mold) is made which will be sent to a dental laboratory where the bridge will be fabricated. In addition, a temporary bridge will be made and worn for several weeks until your next appointment.
At the second visit, you permanent bridge will be carefully checked, adjusted, and cemented to achieve a proper fit. Occasionally your dentist may only temporarily cement the bridge, allowing your teeth and tissue time to get used to the new bridge. The new bridge will be permanently cemented at a later time.
You will receive care instructions at the conclusion of the procedure. Proper brushing, flossing and regular dental visits will aid in the life of your new permanent bridge.
Restorations - Root Canal Therapy
Root canal therapy is needed when the nerve of a tooth is affected by decay or infection. In order to save the tooth, the pulp (the living tissue inside the tooth), nerves, bacteria, and any decay are removed and the resulting space is filled with special, medicated, dental materials, which restore the tooth to its full function.
Having a root canal done on a tooth is the treatment of choice to save a tooth that otherwise would die and have to be removed. Many patients believe that removing a tooth that has problems is the solution, but what is not realized is that extracting (pulling) a tooth will ultimately be more costly and cause significant problems for adjacent teeth.
Root canal treatment is highly successful and usually lasts a lifetime, although on occasion, a tooth will have to be retreated due to new infections.
Signs and symptoms for possible root canal therapy:
- An abscess (or pimple) on the gums.
- Sensitivity to hot and cold.
- Severe toothache pain.
- Sometimes no symptoms are present.
- Swelling and / or tenderness.
Reasons for root canal therapy:
- Decay has reached the tooth pulp (the living tissue inside the tooth).
- Infection or abscess have developed inside the tooth or at the root tip.
- Injury or trauma to the tooth.
What does root canal therapy involve?
A root canal procedure requires one or more appointments and can be performed by a dentist or endodontist (a root canal specialist).
While the tooth is numb, a rubber dam (a sheet of rubber) will be placed around the tooth to keep it dry and free of saliva. An access opening is made on top of the tooth and a series of root canal files are placed into the opening, one at a time, removing the pulp, nerve tissue, and bacteria. If tooth decay is present, it will also be removed with special dental instruments.
Once the tooth is thoroughly cleaned, it will be sealed with either a permanent filling or, if additional appointments are needed, a temporary filling will be placed.
At the next appointment, usually a week later, the roots and the inside cavity of the tooth will be filled and sealed with special dental materials. A filling will be placed to cover the opening on top of the tooth. In addition, all teeth that have root canal treatment should have a crown (cap) placed. This will protect the tooth and prevent it from breaking, and restore it to its full function.
After treatment, your tooth may still be sensitive, but this will subside as the inflammation diminishes and the tooth has healed.
You will be given care instructions after each appointment. Good oral hygiene practices and regular dental visits will aid in the life of your root canal treatment.
Amalgam Removal
Many patients are concerned about amalgam fillings these days. Sometimes called "mercury" fillings or "silver" fillings, amalgam was the predominant filling material used for decades. While these fillings do last a long time and are less expensive, they also have some disadvantages. For example, mercury is a significant ingredient in this filling material. While there is a debate within the dental and health communities regarding the risks associated with mercury in amalgam, our office chooses to never use it. There are other modern materials that do not contain mercury.
Another drawback to amalgam fillings is the fact that they are often a cause of fractures in teeth possibly leading to crowns, root canals and sometimes tooth loss.
Finally, there is the esthetic issue: Amalgam fillings are dark and unattractive while composites and porcelain restorations are natural looking and esthetic.
Whenever amalgam fillings are removed, special precautions are taken to protect our patients from mercury exposure. A dental dam (barrier) is used along with high speed suction, a secondary evacuation system and water spray are always used.
