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Dental Restorations

Even if you work hard at preventing oral health problems, now and then you may need restorative dentistry work. Restorative dentistry is the study, diagnosis, and management of diseases of the teeth and related areas. From diagnostic radiology to reconstructive dentistry, here are the ways dentists help restore damaged teeth.

Overview: How Dentists Repair Damaged Teeth

You can break, chip, or fracture a tooth in both dramatic and mundane ways. The damage may be the result of an extreme sports mishap, or it could just as easily happen while crunching contentedly on ice. Spectators and athletes are both at risk.

Fortunately, modern dentists know how to deal with this common, sometimes uncommonly painful, problem. From filling and bonding to crowns, veneers, and root canals, your dentist has a full arsenal of possible responses ready to deploy in your defense.

Chipped tooth repair

How a dentist repairs a chipped or broken tooth depends on how bad the damage is. The length of time she’ll need to make a thorough repair also varies based on the injury. In cases with only minor harm, repair may be done in just one office visit. Injuries that are more extensive may mean more than one visit, though.

Here’s a brief overview of the chief ways your dentist may fix a chipped, fractured, or broken tooth:

Filling

Most people think of a filling as work that’s done to repair tooth decay. While that is often the case, when a small amount of tooth is lost, a filling may be used to rebuild the tooth to its original shape.

…when a small amount of tooth is lost, a filling may be used to rebuild the tooth to its original shape…

Fillings most often require only one trip to the dentist. Depending on the site of the tooth and other factors, the dentist will use either an amalgam (metallic looking) or a composite (white to match the tooth surface) filling. When it hardens, the filling helps to support the rest of the tooth.

Bonding

Bonding is a type of work in which a dentist applies a special plastic resin that is matched to the damaged tooth’s natural color. The resin is first applied to the tooth and sculpted. Then, it’s “cured” using a unique ultraviolet light or laser, which bonds the resin to the tooth.

Compared to veneers and crowns, which involve time-consuming and more costly lab work, bonding is relatively easy and inexpensive. The bonding procedure can most often be done in under an hour.

Dental Veneers

A cosmetic dentistry fix, dental veneers are shells of porcelain or resin composite material tailored to cover problem areas. This type of repair typically blends in with existing teeth.

Veneers are considered stronger and more natural looking than bonding. The procedure results in less removal of the original tooth than is required for crowns, but may take as many as three trips to the dentist.

Crowns

Dental crowns (or “caps”) are used to stabilize and maintain the normal look of a tooth. A crown provides a protective layer and allows the repaired tooth to resume normal functioning. They are most often used when a tooth has been damaged so much that a dental filling would not work.

Crowns involve a multi-step procedure. First, a temporary crown is placed over the tooth while the permanent crown is made. When the permanent crown is ready, the dentist extracts the temporary crown and cements the permanent one in place. The permanent crown may need to be altered to provide a comfortable fit, and that may mean a third visit to the dentist.

Implants

Figures from the American Academy of Implant Dentistry state that three million Americans currently have dental implants. Today’s dental implants can now require just 5 or 6 actual implants as opposed to treating each individual tooth. This is why some patients need just three appointments to replace every all their teeth.

According to Science Daily, dental implants have the potential to become even more advanced following the success of a new type of nano coating material. The primary reason dental implants fail is peri-implantitis, an inflammatory process that occurs when biofilm, an evolved form of oral bacteria, develops on implants and destroys the tissue surrounding them. But in a recent study, a UK research team created a nano coating that restricted the growth of bacteria and biofilm on dental implants by 97.5%.

Root Canals

When tooth damage leads to an infection or inflammation of the pulp, a “root canal” may be called for. Root canals may be done by a dentist or by a dental specialist called an endodontist.

This work begins with the extraction of the damaged tooth’s pulp. Next, the tooth is cleaned and shaped, and the root canal is sealed. After root canal work, the dentist may attach a crown, which provides a protective layer and allows the repaired tooth to resume normal functioning, or she may perform another type of restoration to the treated tooth.

Dental Restoration Failure

Researchers have traditionally linked dental filling failure to the materials used. However, new research suggests that, as with overall health, personal factors are also to blame when restorations fail.

Dental Filling Failure Linked to Personal Factors, Not Materials

Patient factors like smoking, drinking and genetics play a role in how well a dental filling performs, researchers now say. Specifically, “people who drink alcohol or men who smoke are more likely to suffer a failed dental filling.”

In addition, the researchers found that genetic differences in some patients are associated with dental filling failure.

The team also looked at traditional amalgam materials compared to newer resin fillers. They found “no major difference in filling failure rates” associated with the materials used.

Dental Filling Failure: The Traditional View

Dental fillings sometimes fail, and they do so for a variety of reasons. For example, the initial tooth decay may reemerge or the filling may become detached. Previously, it was not clear whether newer materials, such as composite resin fillings, were as tough as amalgam fillings. Solving this puzzle has helped drive the new research.

Working with a large number of records from a dental school in Pittsburgh, researchers investigated filling failure rates for patients. The data included information about dental filling failures that occurred within 5 years of the filling’s placement. Overall, the team found that there were no major differences between filling failure rates for amalgam or composite fillings. They found the composite fillings to be at least as durable as the amalgam ones.

The Difference: Patient Based Factors

The records used also contained patient lifestyle information, such as smoking and drinking habits. Moreover, the records included a DNA sample from each patient. This allowed the team to look into whether these factors might have an effect on dental filling failure. The results were eye opening. The team found that “within two years of the procedure, fillings failed more often in patients who drank alcohol.” In addition, in men who smoked, the overall filling failure rate was higher.

Furthermore, the researchers found a link between a genetic difference in an enzyme found in teeth and increased dental filling failure. They have not yet confirmed that this is responsible for filling failures. However, the data suggests that personal factors, rather than material properties may lead to failed fillings.

“A better understanding of individual susceptibility to dental disease and variation in treatment outcomes will allow the dental field to move forward,” a researcher involved in the study said. “In the future, genetic information may be used to personalize dental treatments and enhance treatment outcomes.”

Source: Frontiers. “Dental filling failure linked to smoking, drinking and genetics.” ScienceDaily, 6 November 2017.