Now accepting CDCP Dental Plans
General Dentistry
Teeth Fillings
Composite Fillings
Composite fillings are a commonly known polymer base, tooth-coloured restorative material that is used to repair a damaged or decayed tooth. The affected portion of the tooth is removed (is decayed) and then filled with a composite filling. It is then cured with a visible blue light which causes it to harden almost instantly.
Composite resin dental fillings are strong, durable, and make for a very natural-looking smile. However, it is key for patients to know, after filling is completed, that there needs to be proper home care to keep it clean. Otherwise, if a patient has poor oral hygiene, years after the filling has been completed, the decay can start again underneath the old white filling (recurrent decay).
Your dentist or dental hygienist may recommend composite resin dental fillings for the following reasons:
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To restore chipped or worn teeth
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To close a space between two teeth
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To repair cracked or broken teeth
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To repair damage caused by tooth decay
Silver Fillings (Amalgam)
Silver fillings are still used in limited cases where white fillings cannot be effective or will not last. For patients with very high cavity risk, silver fillings might be a more favourable option for long term cavity resistance. Also, in an area with lots of bleeding or moisture (for example, the back surface of your last molar, cavity under the root surface), the dentist cannot keep it dry (white filling will not last long if it cannot be kept dry when placed), a silver filling might be used.
Glass Ionomer Fillings
Glass ionomer fillings are a special material used for children and elderly patients with lots of root decay or sub-optimal oral hygiene. This material releases fluoride after placement (bioactive) to help reduce the rate of getting a cavity again in the same spot.
Crowns
A crown (or cap) is a dental restoration that covers the entire visible surface of an affected tooth. If a tooth is damaged but not lost, a crown can be used to restore its shape, appearance and function; the result is a tooth that works very much like a natural tooth.
Your dentist or dental hygienist may recommend a crown for the following reasons:
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To repair broken or fractured teeth
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For cosmetic enhancement
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To restore decayed/very compromised teeth
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To cover or protect a fractured filling
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For root canal teeth
Different type of crowns:
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Zirconia crown (tooth coloured) is a white coloured metal that is used mostly for patients who grind their teeth a lot (bruxism). It is reasonably aesthetic, very strong (low chance of breakage), and is most commonly used on molars.
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Emax crown (tooth coloured) is a compressed ceramic that is very aesthetic and still very strong. It is not as strong as the Zirconia crown, but more aesthetically pleasing. This type of crown can be used on the front or back teeth.
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Gold crown (gold colour) is still used for molars that are not visible. It can be used on the back molars for strength, similar to a Zirconia crown.
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Porcelain fused to metal (tooth coloured) is porcelain on the surface fused to a metal base, for a high aesthetic and reasonable strength. This crown is not as durable as an Emax or Zirconia crown. It can be used on the front teeth and molars for non-bruxisers.
Dental Bridge
A dental bridge is a fixed (non-removable) dental restoration that consists of one or more prosthetic teeth that bridge the gap created by missing teeth. There are several types of fixed dental bridges, including traditional fixed bridges, cantilever bridges and resin-bonded bridges. The porcelain fixed bridge is the most commonly used and best resembles the look and feel of your natural teeth. This type of bridge involves the preparation of the adjacent teeth. The artificial tooth (or teeth) is fused between two crowns that go over the anchoring teeth on either side of the gap.
Dental bridges are highly durable and can enhance your smile and teeth for many years. Your dentist may recommend a dental bridge for the following reasons:
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To fill space of missing teeth
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To prevent remaining teeth from drifting out of position
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To restore chewing and functioning
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To restore cosmetics and your smile
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To upgrade from a removable appliance to a fixed appliance
Extractions
Dental extractions are needed for the following reasons:
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Severely broken tooth (broken at gumline) that can not be restored
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Severely mobile tooth due to advanced periodontitis
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Due to orthodontic need to gain space to resolve crowding and correct bite pattern
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Wisdom teeth that are poorly positioned and causing problems
Wisdom Extractions
When first assessing wisdom teeth extractions, we look at the X-ray to assess the difficulty of the extraction. We do lots of wisdom teeth extractions in our Edmonton office. However, if the wisdom teeth removal involves high complexity, high risks (close to the nerve, long curved root, deeply impacted), we will refer you to an oral surgeon to do the extraction.
We take precautions for patients who have a certain medical history:
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Blood thinners may need to stop a few days before the procedure to allow blood to clot.
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Diabetic patients need to be aware that a prolonged time of healing may be needed.
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Patients undergoing bisphosphonate therapy need a consultation with a doctor before extraction to avoid the chance of bone necrosis (bone death)
Post-operative care after extraction is important for proper healing and avoiding complications. This includes no smoking, no alcohol, no active rinse, soft diet, and no intensive lifting to avoid dry socket complication, prolonged bleeding and pain.
Root Canal Therapy
Root canal therapy is the process of removing infected, injured or dead pulp (the living tissue inside the tooth) from the space inside your tooth, which is called the root canal system. The canal is then filled with materials designed to prevent infection from recurring and restore the tooth to its full function. A successful root canal treatment lets you keep your tooth, rather than having it extracted. Keeping your tooth helps to prevent adjacent teeth from drifting out of line causing further problems.
Your dentist may recommend root canal therapy for the following reasons:
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Decay has reached the tooth pulp (nerve) with or without symptoms (irreversible pulpitis)
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Infection or abscess has developed inside the tooth or at the root tip (internal root resorption)
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Injury or trauma to the tooth caused the nerve to die, tooth can turn grey/dark (sports/vehicle accidents)
The sequence of a root canal involves:
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Make sure you are well frozen, test with endo ice, so you do not feel any pain.
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Remove the decay/cavity, and get access to the pulp chamber (where nerves are). Front teeth on average have only one nerve, premolar on average have 1 to 2 nerves, molars on average have 3 to 4 nerves.
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Clean the infected or dead nerve with small instruments and rinse with a solution to ensure it is clean.
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To prevent infection again, it requires sealing the cleaned nerve space with an inert material called Gutta Percha.
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Then we close up with final filling for restoration. A crown is required for molars that involve chewing.
Silver Diamine Fluoride (SDF)
Silver diamine fluoride (SDF) is a safe and effective non-restorative treatment option that few dentists know how to use. Silver Diamine Fluoride is an FDA-approved antibiotic liquid clinically applied to control active dental cavities and prevent further progression of disease. While the ideal way to treat teeth with decay is by removing the decay and placing a restoration, this alternative treatment allows us to stop decay with non-invasive methods without the need to use freezing and a dental drill.
Clinical uses for SDF:
• Behavioural or medical management patients
• Carious lesions that cannot be treated in one visit
• Difficult to treat lesions (at the gum line, under the crown, large decays)
• High-risk caries
• Pediatrics with behavioural issues
• Root caries (common with elderly patients with dry mouth)
• Tooth sensitivity can also be managed
After the application of SDF, the lesion will appear dark, which means the caries have arrested. We try to avoid cosmetic zone application without special approval from the patient. Once the decay has been fully stopped, it will require regular 6-month monitoring to make sure the lesion is hard (cavity has been arrested) and dark (an indication that SDF has worked). You can still do restoration (fillings or crowns) over the top of the arrest decay OR monitor if the patient chooses not to restore due to financial or medical limitation.
