* Infected or sick tooth due to decay or injury
* Chronic tooth pain from contact with hot and cold liquids
* Pain from pressure or biting down
* Danger of infection spreading
Inside each tooth is a pulp chamber that contains the nerves and blood supply for the tooth. When the pulp becomes infected due to decay or injury to the tooth, the pulp must be removed from the center of the tooth and the canals of each root. Once the infected pulp is removed, the remaining chamber is filled with a rubber-based material to seal it off.
All teeth that have had root canal therapy must be protected with a tooth-like artificial covering known as a crown (see crown section.) This is because teeth that have had the pulp removed are more susceptible to fracture.
Root canal therapy is an excellent way to save a tooth that would otherwise die and need to be removed.
If a tooth is sick, there are no disadvantages to root canal therapy. On rare occasions, however, root canal therapy may need to be redone to ensure that all of the infection has been removed.
The only real alternative is to remove the sick tooth. However, this will require a dental implant or bridge to fill the empty space and prevent the shifting of surrounding teeth. These solutions will ultimately cost more than the root canal therapy, and they will never equal the quality of keeping your natural tooth.
Dull colored or stained teeth
Plastic whitening trays will be made from models of your teeth. You will then place a special whitening gel in each tray and wear the trays in your mouth for several hours per day. (Many patients wear their trays after dinner and before bed or simply while sleeping.) A significant change in tooth color is usually seen in just ten to fourteen days. We also offer an in-office light assisted intense bleach treatment along with only five days of home bleaching.
Modern tooth whitening systems are highly effective and have dramatic results. Many celebrities consistently whiten their teeth to improve their appearance.
Occasionally, patients may experience some gum or tooth sensitivity when using their trays. These symptoms subside when whitening is discontinued for several days.
Accelerated whitening is another option for some patients. This process can result in whiter, brighter teeth in just one office visit. Please consult with the doctor to see if this procedure may work for you. Occasionally, teeth may be stained in a way that limits the effectiveness of tooth whitening. In those instances, porcelain laminates or crowns are an excellent alternative.
* Decay on a portion of any tooth
* Desire to replace old-fashioned mercury (silver) fillings
* Desire to maintain a white, beautiful smile
A composite filling is a tooth colored quartz-like material. After tooth decay is removed and cleaned, this tooth colored material is layered into the tooth. Each layer is hardened or cured with highly intense visible light, and the final surface is shaped and polished to match the tooth. The final restoration is virtually invisible.
Composite fillings are more than just attractive. They are environmentally non-toxic because they use no mercury. They are stronger because they bond directly to the surface of the tooth. They protect the tooth from fracturing because they don't require the severe "undercut" (removal of healthy tooth structure) of a mercury filling.
The initial investment in a composite filling is higher than that for a mercury filling. This is due to the fact that the composite material is more expensive and the restoration is more difficult and time consuming to place. However, this initial higher investment is offset in the long run by the health benefits and reduced likelihood of restoring potentially fractured teeth.
Inlays/onlays are sometimes good alternatives to composite fillings, offering excellent long term durability and bite stability. Inlays and Onlays are superior to white composite fillings in all cases but are more costly because they are fabricated in porcelain. In cases of extensive decay, inlays/onlays or crowns are the only alternative.
* Stained or discolored teeth
* Unsightly gaps between front teeth
* Chipped teeth
* Rough or jagged edges on front teeth
* Teeth that are too small or large in proportion to rest of the mouth
* Crooked teeth
* Worn teeth
A porcelain laminate (often called a veneer) is a thin shell of porcelain that covers the front of each tooth. They bond directly to the front of the tooth, similar to the way artificial fingernails work. Each porcelain laminate is a work of art, carefully crafted in a laboratory to fit your individual smile. Dr. Kim has extensive training in conservative "Ultra-thin" veneers therefore conserving as much tooth structure as possible.
In the hands of a highly skilled dentist, porcelain laminates can provide you with an incredibly natural, beautiful smile. They are virtually undetectable and can dramatically improve your appearance. They are durable and long-lasting when compared to other cosmetic treatments.
Although they are highly durable, porcelain laminates are not permanent. Well crafted laminates will last many years, but will eventually need to be replaced.
Porcelain laminates are an excellent investment. However, they are not appropriate for teeth with excessive decay. In those cases, porcelain crowns are the only alternative. In the event that you desire only to improve tooth alignment, orthodontic treatment may be another alternative.
* Badlydecayed teeth
* Fractured teeth
* Need to protect and strengthen teeth
A crown (often called a cap) covers the tooth and restores it to its original shape and size. Decay is removed and cleaned from the tooth and a highly accurate impression or mold is made of the prepared surface. This mold is used to create a model of the tooth which is then sent to a special laboratory that will create a gold or porcelain (tooth colored) crown. The crown is then cemented onto the prepared surface of the tooth.
Porcelain offers a fine alternative to other tooth restoration materials. Made to perfectly match the shade and shape of your teeth, it's durable, it's strong, and it's virtually undetectable.
Crowns are incredibly strong due to the fact that they are created in a laboratory. This protects and strengthens the remaining tooth structure. In the hands of a skilled dentist, a crown will fit almost perfectly onto the prepared surface of the tooth, reducing the size of the seam between the crown and the tooth. This helps keep decay from eventually occurring under the crown. Crowns should be placed before the tooth is so decayed that it may fracture. This can often help prevent the expense of root canal therapy in the future. It can also prevent the possibility that a fractured tooth may need to be removed, requiring the expense of a bridge or implant to replace the missing tooth.
Crowns are excellent restorations and have few disadvantages. They are highly durable, but they will eventually need to be re-cemented or replaced due to normal wear.
Occasionally, a tooth may still need root canal therapy after being crowned. However, this indicates that the interior of the tooth was already sick (infected) and would have eventually needed root canal therapy anyway.
In the event that a tooth is so decayed or fractured that it needs to be removed, the best alternatives to a crown are bridges and implants that replace the missing tooth.
* A missing tooth or teeth
* Potential bite and jaw joint problems from teeth shifting to fill the space
* The "sunken face" look associated with missing teeth
* Desire to improve chewing ability
* Desire for a more permanent solution than dentures
A bridge is a single appliance that is generally attached to two teeth on each side of the space where a tooth is missing. An artificial tooth attached in the middle of the bridge fills in the gap where the missing tooth was. The teeth on either side of the gap are prepared for crowns (see crowns) and a highly accurate impression or mold is made of the prepared area. This mold is used to create a gold or porcelain (tooth colored) bridge in a special laboratory. The bridge is then cemented onto the prepared surface of the teeth, effectively creating the appearance of a "new" tooth.
In some instances, a resin-bonded bridge may be used. In this case, the two teeth on each side of the gap are not prepared for crowns. Instead, the bridge consists of a false tooth with metal brackets on the back of each side of the gap. The brackets are attached to the backs of the real teeth on each side.
Unlike dentures, a fixed bridge is never removed. It is stable in the mouth and works very similar to natural teeth. By filling the gap and stopping the movement of other teeth, a fixed bridge is an excellent investment, providing better chewing ability, heading off jaw joint problems and saving money that might otherwise be spent on future dental treatment
Fixed bridges are excellent restorations and have few disadvantages. They are highly durable, but they will eventually need to be re-cemented or replaced due to normal wear.
In the event that the use of a fixed bridge is not feasible, the best alternative is a dental implant.
Dental implants are titanium alloy screws which are anchored into the jawbone. The titanium alloy is the same material that is used in other implants such as hip and knee replacements. Implants are designed to "fuse" (osseointegrate) to the bone to ensure strength and security. An abutment attached to the implant will hold the crown in place.
About Tooth Loss
Tooth loss can be detrimental to your long term oral health. Bone loss is one of the leading side effects of missing teeth, not to mention your smile. The stimulation that your jaw bone recives from your teeth maintains it's strentgh. If you have dentures or even a partial denture, you are loosing bone. Your teeth provide you with more function than just chewing.
Leading dental organizations now consider dental implants the "standard of care" for the replacement of missing teeth. Your doctor uses dental implants from BioHorizons ® which have long-term documented success rates that are above the industry average. See for yourself what thousands of patients already know.
Dental implant treatment restores confidence in your smile. You can speak clearly and eat the foods you love, without the fear of loose, ill-fitting dentures causing you embarrassment. What a wonderful way to improve your health and quality of life! Turn back the clock and feel like yourself again. You are going to love your new smile.
* Remove plaque from the teeth - Plaque is a sticky substance that forms in the mouth from food, saliva and bacteria. Plaque sticks to teeth and causes tooth decay and gum disease.
* Remove calculus (tarter) above the gum line - Calculus is plaque that has hardened on the tooth surface and is difficult to remove. (Calculus below the gum line indicates gum disease and requires a different procedure to remove it.)
* Polish and remove stains from teeth
Brush your teeth twice daily using a soft toothbrush. Gently vibrate the brush in a circular fashion at a 45-degree angle to the gum line. Then gently vibrate the brush back and forth on each tooth surface until you have effectively cleaned the entire mouth. You should also brush your tongue to remove the bacteria that causes bad breath.
You can use any soft bristled, ADA approved toothbrush. We also recommend the use of modern electric toothbrushes such as Sonicare and Braun.
Floss daily to remove plaque between teeth that you can't reach with regular brushing. Take 12" to 18" of dental floss and wrap it around the middle finger of each hand. Pull the floss tightly, and then use your thumb and forefingers to slide the floss gently between each set of teeth. Curve the floss around each tooth and move the floss up and down along the tooth, going as low as you can comfortably get under the gum line. Use a fresh section of floss for each tooth until you have flossed the entire mouth.
Always rinse thoroughly with water after brushing (or after meals if you are unable to brush.) You may occasionally use a mouthwash to rinse. However, recent studies indicate that the over-use of mouthwash in an otherwise healthy mouth can change the normal biological activity of the mouth, leading to dried tissues and other problems.
* Protect normal pits and grooves on the chewing surface of back teeth
* Stop small amounts of decay from growing larger
Normal pits and grooves on the chewing surfaces of back teeth can trap food that can't be removed by brushing or washed out by water or saliva. A sealant is a tough, plastic material designed to bond (stick) to tooth enamel. These clear or tooth colored sealants are painted onto the tooth surface to "seal" the pits and grooves and protect against decay. They are generally applied to children's first permanent back teeth. They can also be useful for adults in certain situations.
Sealants are an excellent way to protect chewing surfaces of teeth from decay. They are a much better financial investment than treating decay after it has started.
Sealants are not permanent. They generally last about five years with normal wear, but can wear off or chip off earlier in certain instances. Also, sealants do not prevent decay between teeth or the onset of gum disease, so regular home care and dental visits are important.
There are no appropriate alternatives to sealants. If a tooth has decay, it will need a filling or other restoration.
How do x-rays help?
Dental x-rays or radiographs are very important. They allow the dentist to detect problems that cannot be seen by the naked eye. These items include: loss of bone supporting the teeth (periodontal disease), cysts (sacks of fluid that form on the roots of teeth), cancerous and non-cancerous tumors, decay that occurs between teeth, and the location of teeth that haven't yet erupted into the mouth.
By using an x-ray to make certain no pathology is present, we can help save you time, expense, pain, and money by possibly avoiding additional treatments. In some cases, when dental x-rays show the location of tumorous growths, x-rays can be responsible for saving your life.
Are dental x-rays safe?
We use the most modern x-ray technology available today. Because our x-ray machines are digital, your radiation exposure is reduced by about 90 percent! The amount of radiation exposure your body receives on an airplane flight from Los Angeles to New York exceeds the amount of exposure you receive from a conventional, not digital, dental x-ray machine. Contrast this minimal exposure with the risk of not finding a problem until it has become serious, and you can see why we prescribe preventive diagnostic x-rays.
Gum disease (Periodontal Disease) is responsible for about 70 percent 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 tarter eat away at the fibers that hold the gums to the teeth, creating deep pockets. As bacteria spread, the pockets become deeper until the bacteria finally eat away the bone that holds the tooth in place.
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.
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 have been removed, the pockets must be cleaned and maintained on a regular basis by a certified dental hygienist. Otherwise, the bacteria will return.