Pediatric dentistry is the study, practice, teaching, and research of oral care treatments and preventions in children. It is recommended that children visit their pediatric dentist twice a year. Parents should schedule the first visit within six months of their child’s first baby tooth coming in, or by 12 months of age. Regular checkups thereafter will help prevent oral health complications as your little one grows up.

Brushing and flossing every day is the best way to prevent cavities and gum disease. However, if your child has aggressive signs of an oral disease, home hygiene will not do the job on its own and restorative treatments will be necessary. Such pediatric dental treatments include:

Tooth fillings: Cavities and irreversible tooth enamel erosion will need to be treated with fillings. These complications usually occur from a poor diet of excessive acidic liquids and foods, as well as inadequate home hygiene. Baby teeth are more likely to be affected than permanent teeth because the enamel is thinner and less mineralized. The filling will help prevent the cavity from progressing.
Pediatric pulp therapy: A baby root canal is similar to its root canal counterpart in the way that the pulp inside a tooth will be treated in an effort to save or restore it.
Crowns: Made of stainless steel, crowns are placed on a child’s baby molars in an effort to protect them. This could be because the teeth have not formed properly or are already very decayed.
Tooth extractions: Removing a tooth might be necessary if your child is experiencing trauma, disease, overcrowding, or decay.
Space maintainers: After a tooth is extracted, a space maintainer is placed at the extraction site to ensure that your child’s tooth erupts properly.

To ensure that your child has all possible defenses to fight tooth decay, plaque, and tooth loss, there are two preventive dental treatments available. These treatments include:

Sealants: A thin coating is placed on the deep pits and grooves of baby and permanent teeth to help prevent tooth decay.
Fluoride treatment: A mineral that has been proven to decrease the progression of cavities. Since its introduction to the water supply in 1945, dental cavities in children and adults have significantly decreased. Your child can get fluoride in two other ways:
- Dietary fluoride supplements: Offered in tablet or liquid form, this supplement is only recommended for those who drink water low in fluoride or have a higher risk of developing cavities.
- Topical fluoride therapy: This treatment is best used for children between three and six years old. It comes in a variety of forms, such as over-the-counter fluoridated toothpaste, gels, pastes, or varnishes. The applied treatments are done only in a professional dental office.

Dental bonding

Dental bonding is a conservative cosmetic treatment that improves the appearance of chipped, discolored, or misshapen teeth using composite resin to repair and restore the tooth surface.

Bonding can transform the appearance of a smile. The procedure is commonly used for:

Repairing chips and minor cracks
Covering stained or discolored enamel
Closing small gaps between teeth
Remodeling the contours of teeth which are undersized, crooked, or misshapen
Rebuilding areas where enamel erosion has taken place
Creating inconspicuous, tooth-colored fillings

The procedure begins with an exam to make sure the tooth is healthy and a good candidate for bonding. The tooth surface is prepared, and a specially formulated dental adhesive is applied which enables the composite resin to “bond” to the tooth structure.

The composite resin is put in place and molded to the desired shape. The resin material is carefully color-matched so the bonding is indistinguishable from natural tooth enamel. Once in place, the resin is hardened with a curing light. The bonding is given a final check for fit and shape, then smoothed and polished.

Bonding is a popular choice in cosmetic dentistry because it is convenient, cost-effective, and minimally invasive.

Bonding can frequently be completed in one visit, and often without the use of anesthetic.
Bonding is less expensive than veneers or crowns.
While veneers and crowns last longer and are less vulnerable to chipping or staining, these procedures require the removal of more tooth structure.

Dental bonding is not an option for every tooth. Major chips and cracks, deep decay, or serious misalignment might require alternative treatment. Talk to your dentist to discover whether bonding is the right choice to enhance the natural beauty of your smile.

Crowns & Bridgework

Decayed, broken, and missing teeth affect your oral health and your self-confidence. When a tooth has suffered structural or cosmetic damage, a dental crown can restore a tooth’s function and appearance.

A crown is a custom-made “cap” that covers the entire visible surface of a tooth. Your dentist might recommend a crown to:

Strengthen and protect a tooth if extensive decay hasn’t left enough healthy tooth structure for a traditional filling
Protect a cracked, broken, or brittle tooth from further damage
Restore and reinforce a tooth after a root canal procedure
Cover a deeply discolored or irregularly shaped tooth
Complete a dental implant procedure
Serve as an anchor for a dental bridge

Most crown placements require two appointments. During the first visit, tooth preparation includes reshaping the top and sides of the tooth so the crown fits comfortably. If too much healthy tooth structure has been lost, the dentist builds up the tooth with filling material so that it will support a crown securely.

An impression or a computer model is made of the prepared tooth, and a temporary crown, typically made of composite resin, is put in place to protect the tooth while the finished crown is fabricated at a dental lab. Every crown is custom designed to make sure it fits comfortably, aligns with the surrounding teeth, and doesn’t interfere with bite or jaw movement.

At a second visit, the dentist puts the finished crown in place and makes any needed adjustments to ensure that it fits properly before bonding it to the tooth. When the placement is ideal, the crown is secured in place using a special dental cement.

Crowns are made of several different materials. Your choice of crown can be based on factors such as durability, visibility, natural appearance, and cost:

Metal crowns: Because they are alloys of gold, platinum, or other metals, these crowns are the longest lasting. They’re often chosen for back molars where they are less visible.
All-porcelain/All-ceramic: These color-matched, translucent crowns are the most realistic looking option, especially for front teeth. They are also suitable for those with metal allergies.
Porcelain fused to metal: These crowns have a porcelain layer applied over a metal core. Matched to your natural enamel color, these crowns look very realistic, although they’re not as translucent as all-porcelain crowns.
Stainless steel: Typically used for baby teeth, pre-formed stainless steel crowns are a durable, cost-effective option when a crown is needed for a primary tooth.
Composite resin: Made of color-matched resin, these crowns are a more affordable choice than porcelain or metal. Generally, however, they are only used as temporary crowns since they’re much less durable than other options.

Because a crown improves both the form and the function of a tooth, it is one of the most popular restorative treatments available. Talk to your dentist to discover how a crown can enhance the health and the appearance of your smile.

Dental Implants

The bacteria in plaque produce acids that erode tooth enamel, eventually creating a hole, or cavity, in the tooth surface. Left untreated, this decay can spread to the interior of the tooth, and might lead to the need for a crown, a root canal, or even extraction. When caught early, your dentist can treat your cavity conservatively by restoring your tooth’s function and appearance with a filling.

What kind of filling do you need? Your choice of restoration will depend on the location of the cavity and how much of the tooth structure is affected.

Direct Filling

For most small to moderate cavities, direct fillings can be bonded to the tooth immediately after removing decay and cleaning and shaping the tooth.

Composite resin, dental amalgam, and glass ionomer fillings are typically used for this type of single visit restoration.

Indirect Filling

An indirect filling is the right choice for molars and premolars with larger areas of decay or damage. Indirect fillings fit more securely, last longer than direct fillings, and can even strengthen the remaining tooth structure. An inlay fills the tooth surface inside the cusps, while an onlay typically covers the center of the tooth and one or more cusps.

Indirect fillings can be made of composite resin, gold, or porcelain, and are created from a mold taken after the tooth is cleaned and prepped. The finished filling is bonded to the tooth at a second visit.

Once you know what type of filing you need, you and your dentist can choose the best filling material for your tooth based on durability, aesthetics, longevity, and cost considerations:

Composite Resin

Made of acrylic resin mixed with powdered quartz, glass, or other ceramic particles, composite resin can be used for both direct and indirect fillings.

Composite resin fillings are popular, especially for fillings in the front teeth, because they are color-matched to blend with natural enamel. These fillings generally preserve more of the tooth structure and are quite durable, although gold or porcelain might be a stronger choice for chewing surfaces. Composite resin fillings are more expensive than amalgams, and, unlike porcelain fillings, are more prone to staining.

Dental Amalgam

An amalgam, or silver-colored, filling is composed of several different metals, including silver, tin, copper, and mercury.

Because this filling is very durable, it’s often the filling of choice for biting surfaces. It’s also one of the most cost-effective options. Amalgam fillings sometimes require the removal of more tooth structure than composite resin fillings, and won’t blend in with natural enamel. If you are concerned about the metals used in amalgams, discuss alternatives with your dentist.

Glass Ionomer

Glass ionomer fillings use a flexible cement paste made with silicate glass powder. This filling material bonds to the tooth itself and hardens quickly. Resin-modified ionomers harden even more quickly under a curing light.

Many glass ionomer fillings contain fluoride that is released over time, helping to prevent new cavities. These fillings don’t blend as well with enamel as other tooth-colored options, and, because they are quite a bit less durable than other filling materials, they’re more suitable for baby teeth, cavities along the gum line or other non-biting surfaces, and temporary fillings.

Gold

A gold filling is an alloy of gold, copper, and other metals. Gold is typically used in indirect fillings, and is extremely durable, lasting 20 years or more. Gold fillings are a more expensive option than composite resin, and, like silver amalgams, these fillings are visible.

Porcelain

A porcelain filling is made from specially formulated ceramic materials and is used in indirect fillings.

Because porcelain fillings are both color-matched to the tooth and translucent, they are the most natural looking filling available. They are resistant to staining and cracking and are quite durable. Porcelain is a more expensive choice than composite resin, more comparable to the cost of a gold filling.

If you have a small or moderate cavity, there are a variety of filling choices available to address your functional, aesthetic, and cost concerns. Discuss these options with your dentist to discover which filling is best suited to restore and protect your healthy, attractive smile.

Fillings

If you have recently dealt with an injury or disease that affected your oral health, there are options available to recover the smile you once had. You may even be able to achieve a better smile than the one you had. Dental implants make it possible to renew your smile if you have lost some teeth. There are several options when it comes to dental implants, depending on how many teeth need to be replaced: just one tooth or several teeth in a row.

A dental implant is a metal post, usually made of titanium, which replaces the root portion of a missing tooth. Your dentist will then place a replacement tooth to the post, which can be permanently attached or removable. Permanent replacement teeth are more stable and feel more like natural teeth.

An ideal candidate for dental implants:

Is a non-smoker
Has maintained good oral health
Has healthy gums with no signs of gum disease

Dental implants are very versatile. If you’re missing one tooth, one implant and one replacement tooth will take care of your problem. If you’re missing several teeth in a row, a few strategically placed implants can support a permanent bridge. Similarly, if you have lost all of your teeth, a full bridge or full denture can be permanently fixed in your mouth with a strategic number of implants.

Unlike dental implants, bridges and dentures are not fixed to the bone. This can result in them being unstable, making it difficult to eat or smile with the confidence you want. Dental implants look, feel, and act more natural, just like your natural teeth. They also have a stronger biting force. Implants do not rely on neighboring teeth for support, which is definitely an advantage since this means they won’t compromise the health of your surrounding healthy teeth. Implants are also likely to last a lifetime, whereas bridges are only expected to last seven to ten years and even less if a root canal is required.

Your new dental implants should be treated just like natural teeth. They require brushing and flossing at least twice every day and regular checkups and cleanings with your dentist. The better you take care of your implants, the more likely they truly will last you a lifetime.

Oral Cancer Screenings

Oral cancer screenings check for any precancerous or cancerous conditions in the mouth. An oral cancer screening is completed with an ultraviolet light that allows your dentist to view issues that cannot be detected with the naked eye. Precancerous lesions identified under this light are much easier to be removed and are more likely to be cured.

Tobacco use of any kind, such as cigarettes, cigars, pipes, chewing tobacco, snuff, dip and vaping
Heavy alcohol consumption
Family history of cancer
Human papillomavirus (HPV)
Significant sun exposure
Red or white spots or sores anywhere in the oral cavity
A sore that bleeds easily or does not heal
A lump, thickening, or rough spot
Pain, tenderness, or numbness anywhere in the mouth or on the lips
Difficulty chewing, swallowing, speaking, or moving the jaw or tongue
Avoid all tobacco products
Drink alcohol in moderation
Maintain a healthy, balanced diet
Limit your exposure to the sun and always wear UV-A/B-blocking, sun-protective lotions on your skin as well as your lips
Ask your dentist to perform an oral exam since early detection of oral cancer can improve the chance of successful treatment

Sealants

Oral Cancer Screenings

The most likely location for a cavity to develop in your child's mouth is on the chewing surfaces of the back teeth. The deep and varied crevices in these teeth make it easy for food particles to hide, and it can be difficult to keep these teeth clean, even with regular brushing. Your child’s dentist might recommend sealants to prevent cavities and prevent the need for more extensive dental treatments in the future.

Sealants are invisible plastic resin coatings that are painted on the chewing surfaces of back teeth. Sealants smooth out teeth, making them easier to brush, as well as create a protective barrier, so food and bacteria cannot penetrate the tooth.

Because tooth enamel does not contain any nerves, placing a sealant is painless and does not routinely require anesthetic. First, the tooth or teeth to be sealed are examined, and if any minimal decay is found, it will be gently removed. After the tooth is cleaned and dried, an acidic gel will be placed on the tooth or teeth to prepare the tooth for the sealant. After a few seconds, the gel will be rinsed off, and the sealant will be applied onto the grooves of the tooth. A special blue light is used to harden the sealant.

Sealants can last up to ten years and require minimal care. Brushing and flossing regularly will keep them clean. Sealants can occasionally become loose, but they can easily be reapplied during a dental appointment.

Sealants can reduce tooth decay by up to 70%, and are a great way to prevent the need for expensive restorative treatment later in life.

Professional Teeth Cleanings

Twice a year when you visit your dentist for a checkup and professional cleaning, you are probably given instructions on proper oral hygiene. This will include brushing and flossing your teeth at least twice a day, using a toothpaste containing fluoride, and using a soft bristled toothbrush. Toothbrushes can’t reach every area of your mouth, which is why floss is such an important tool to reach all the nooks and crannies in and around each tooth. It’s important to remove the food particles and residue to prevent tooth decay and gum disease from developing. There are other tools that you can add to your oral hygiene routine, such as interdental cleaning devices.

Some patients don’t like flossing, have difficulty flossing correctly, or don’t floss enough. Interdental brushes are a great alternative to removing extra debris between your teeth, especially near the molars where it may be harder to reach with floss. These brushes look similar in shape to a pencil, with a metal wire core and soft nylon filaments twisted around the brush head. They are easy to use and even improve the amount of tooth surface area they can clean. If you’re suffering from gum disease, interdental brushes are a more gentle approach to flossing. With minimal bleeding of the gums, and ultimately minimal damage, interdental brushes can help to halt the progression of gum disease.

There are different types and sizes of interdental brushes, so choosing one that works uniquely for your teeth may be a hard choice. Here’s what to keep in mind when choosing your interdental brush:

The correct size of brush depends on the amount of spacing between your teeth.
If you have dental crowns or fillings, consider choosing a brush that has a coating on the inner wire.
Decide which type of handle works best for you, a straight handle or a curved handle. Typically, a straight-handled brush works better.
If you have sensitive teeth or roots, consider choosing an interdental brush made of rubber instead of nylon.

Also known as a water pick or water jet, an oral irrigation device is another alternative to flossing. It uses a stream of pressurized, pulsating water to clean in between the teeth and around the gum line. This type of device is recommended for people who are unable to tolerate flossing every day. If you have sensitive gums, orthodontic appliances, diabetes, or dental implants, an oral irrigation device might be a better option compared to traditional flossing. Oral irrigation devices are less irritating, easier to maneuver, and can remove more plaque than traditional flossing or for those who only brush.

TMJ/TMD Treatment

The temporomandibular joints (TMJ) connect the temporal bones on each side of the skull to the mandible, or lower jawbone. These complex, hinge-like joints allow the mouth to open and close, move back and forth, and slide from side to side. Muscle, bone, and cartilage work together for easy and comfortable facial movement so we can speak, eat, swallow, yawn, and smile.

When the joint doesn’t function as smoothly as it should, the limited movement and discomfort which result could be caused by Temporomandibular Joint Disorder, or TMD.

Temporomandibular Joint Disorder can develop due to arthritis, bruxism (tooth grinding), genetics, an injury or infection near the jaw, a misaligned bite, or a combination of factors. Sometimes the cause is unclear. TMD could be indicated if you suffer from any of these symptoms:

Painful chewing
Persistent pain and discomfort around the TMJ or in the face or neck
Earaches or ringing in the ears
Changes in bite alignment
Muscle spasms near the jaw
Clicking, popping, or grating noises when the jaw moves
Jaws that are limited in movement or lock open or shut

If you suspect you might have TMD, your dentist or doctor will conduct a careful examination of your temporomandibular joints, their range of movement, and your head and neck. When needed, imaging studies can be used for further examination of the joint.

Often, conservative treatment is effective in treating TMD. Your dentist or doctor will tailor treatment to the cause and symptoms of your TMD:

Use of over-the-counter pain relievers, ice packs, and moist heat compresses
Behavior modification for habits which can cause jaw pain (gum chewing, jaw clenching, nail biting, poor posture)
Techniques for relaxation and stress relief
Muscle relaxants, corticosteroids, or anti-inflammatory medication
Physical therapy
A custom-fitted mouthguard, bite plate, or bite splint to protect teeth and jaw from the pressures of tooth grinding
Dental treatment to improve minor bite misalignment
Orthodontic treatment to treat more serious bite misalignment

If necessary, surgical procedures can provide more extensive examinations and treatment. These include:

Arthroscopy: A minimally invasive procedure performed under anesthesia, which uses a thin tube with a video lens and light inserted through a small incision in front of the ear. This technology allows the surgeon to get a close look at the joint and the area surrounding it. Arthroscopic surgery can repair some types of TMJ damage.
Arthroplasty: Surgery performed under anesthesia, can repair, replace, or reposition damaged parts of the joint. Arthroplasty can be used to remove bony growths, repair or replace the articular disc that cushions your joint, and access areas that an arthroscopy can’t.

Jaw pain isn’t always due to TMD, and many cases of TMD are temporary. But frequent discomfort, limited movement, or any other persistent symptoms are a good reason to see your dentist or doctor for a thorough examination and diagnosis. Prompt treatment will help prevent further damage to the joint and make facial and jaw movement comfortable once again.

Orthodontic Treatment

Early orthodontic treatment, also known as interceptive orthodontic treatment, is used to prevent future orthodontic issues. Between the ages of seven and 14, the teeth and jaw are still developing, making them more malleable for effective interceptive orthodontic treatment. Sometimes patients as young as seven years old are able to begin orthodontic treatment, though their candidacy depends on specific conditions of their mouths.

To determine if your child is eligible for early orthodontic treatment, we recommend visiting the orthodontist at age seven. The earlier problems are caught, the better your child’s oral health will be in the future.

Your child must have at least one of the following conditions in order to be considered for early orthodontic treatment:

Crowded teeth: When a child’s jaw is too small, the result is severe dental crowding, where some or all of their teeth overlap.
Gapped teeth: Excessively spaced teeth. A gap in the upper front teeth is the most common type an orthodontist sees.
Underbite: The lower front teeth overlap the upper teeth as a result of the lower jaw being pushed forward.
Jaw irregularities: An unusual jaw size or narrow dental arch.
Crossbites: When the jaw shifts to one side.
Thumb or pacifier sucking: Long-term thumb or pacifier sucking has affected the teeth or jaw growth.
Mouth breathing: If your child only breathes through their mouth, it can cause crooked teeth, facial deformities, or poor growth.
Extra or missing teeth: Orthodontic treatment will need to be adjusted accordingly. For extra teeth, extractions may be necessary.

Palatal Expanders

When the jaw has formed abnormally and is not wide enough for permanent teeth to erupt, this device expands the jaw over time to create more space. A wider jaw allows your child to receive more effective and quicker orthodontic treatment, by means of clear aligners or traditional metal braces. This device is also useful for children with a narrow palate; it helps align the upper teeth and jaw. Other common conditions where a palatal expander may be needed include impacted teeth, crossbites, dental crowding, and breathing problems. Palatal expanders can only be used on younger children since their jaws are still developing.

Traditional Braces

An orthodontist’s go-to for orthodontic treatment, traditional braces are commonly used in instances of misaligned teeth, crooked teeth, or other bite problems. While this equipment is reserved for patients between ten and 14, some children younger than ten might need traditional braces if they have severely overcrowded teeth, an underbite, gapped teeth, or missing teeth.

Headgear

This device may be necessary if your child’s jaw is severely misaligned. It is used together with braces and is secured around the head and face with a neck strap. It’s important to note that braces are only capable of correcting teeth positioning. Headgear encourages proper jaw growth. There are three common types of headgear:

Cervical pull for overbites and underbites
Reverse-pull for underbites and crossbites
High pull for open bites

Clear Aligners

Also known as invisible braces, clear aligners have steadily grown in popularity over the years because they are removable, hard to see, and comfortable to wear. While usually meant for adults, some younger children can use them if they still have baby teeth.

Periodontal (Gum) Disease Therapy

Gum disease, also known as periodontal disease or periodontitis, is a bacterial infection that inflames the soft tissue around your teeth and becomes more severe if left untreated. Over time, gum disease will erode the bone that supports your teeth, leading to tooth mobility and loss.

Depending on the stage of progression, gum disease causes red, swollen, tender, receding, and bleeding gums, periodontal pockets, halitosis, pus-filled abscesses, gapping, and changes in bite. When prevention is no longer an option, especially in the later stages when damage is permanent, nonsurgical and surgical treatments are available to reduce the effects of gum disease.

Treatment is always going to be dependent on the stage of gum disease. There are many options available, both nonsurgical and surgical.

Nonsurgical Treatments

Antibiotics: Oral antibiotics, either in pill or topical form, may be enough to fight off infection.
Scaling and root planning: Similar to a routine dental cleaning, SRP cleans much deeper. Local anesthesia will need to be used to numb your gums while your dental hygienist cleans away bacteria underneath your gum line and smooths the tooth roots to prevent further plaque and bacteria from accumulating beneath your gum line.

Surgical Treatments

Flap surgery: Your periodontist will make an incision along your gum line, temporarily shifting the gum tissues away from your teeth. With the tooth roots more easily seen, your periodontist is able to clean them more thoroughly. If bone loss has occurred, your periodontist may re-contour your bone ridge to make it easier for your daily oral hygiene routine.
Dental bone grafts: If a significant amount of bone loss has occurred, bone-grafting material will be placed in areas where there is a lack of bone tissue. Dental bone grafts serve as a “scaffolding” to encourage new bone growth.
Gum grafts: Gum disease causes gum recession, so a gum graft might be necessary to restore lost tissue around your teeth. Tissue is obtained from the roof of your mouth or a tissue bank and is sutured into the areas lacking gum tissue.
Guided tissue regeneration: A biocompatible membrane will be placed between your existing bone and tooth, keeping unwanted tissue from growing in the area and allowing bone to grow instead.
Platelet-rich plasma (PRP): This procedure helps regenerate bone or gum tissue. Platelet-rich plasma is taken from a sample of your blood, is then placed in a centrifuge to separate red and white blood cells, and finally the plasma is placed in areas lacking bone or tissue to encourage growth.

Porcelain Veneers

Periodontal (Gum) Disease Therapy

A dental veneer is a thin, durable porcelain shell that is custom-fabricated to cover the front of a tooth. Veneers can restore the appearance of teeth with chips, cracks, and stains, can close small gaps between the teeth, and can reshape misshapen or slightly misaligned teeth.

Veneers are a popular choice for cosmetic enhancement because they are a straightforward and natural-looking way to create a brighter and more uniform smile. The veneer process is completed over several appointments:

Consultation

You and your dentist discuss your goals for your smile and whether you’re a good candidate for veneers.

Examination

Your teeth and gums are examined. Measurements, photographs, X-rays, and impressions are taken as needed.

Preparation

A small amount of enamel is removed from the front of the tooth so that the veneer will fit flush with the tooth surface. An impression is taken of the prepared tooth and the teeth around it, and a color is chosen for the porcelain.

Fabrication

The veneers are lab-fabricated to the desired shape and size, using the dental impression and the dentist’s detailed instructions for a precise fit and tint.

Application

When the veneers are ready, they are placed at a final appointment. After checking for shape, color, and fit, and making adjustments if necessary, your dentist will clean the teeth and use dental cement to bond the veneers in place.

Before deciding on veneers, discuss with your dentist whether they’re the right choice for you:

Veneers Are Permanent

Prepping for a veneer requires the removal of a small amount of tooth enamel, so veneers will need to be replaced if they are damaged or dislodged. Proper care keeps veneers their best and brightest.

Veneers Aren’t for Everyone

Teeth and gums must be healthy before beginning the procedure. More serious orthodontic misalignments and habitual conditions such as tooth grinding and jaw clenching make veneers impractical.

The Advantages of Veneers

While there are less expensive options for cosmetic restorations, veneers offer benefits that whitening and bonding treatments don’t.

Veneers cover staining which whitening treatments alone can’t eliminate.
The porcelain used is semi-translucent, like actual enamel, so the veneers will look more natural than bonding. Veneers are more stain resistant, too.
Veneers are less vulnerable to chipping or other damage than bonding, and have a longer lifespan, typically lasting from ten to 15 years with proper care.

While the cost of veneers is comparable to the cost of crowns, veneers preserve more of the tooth’s underlying structure than crowns do.

If chips, gaps, stains, cracks, misshapen teeth, or other small imperfections in your smile are causing an outsized impact on your confidence, talk to your dentist to discover how veneers could be the right choice to restore and enhance your smile.

Root Canal Treatment

Every tooth has two sections: a crown, the visible part of the tooth above the gum line, and one or more roots, which anchor the teeth within the jaw. Each tooth has three basic layers: an outer layer of hard enamel (which protects the crown) or cementum (which covers the root), a middle layer of softer dentin, and inside the center of the tooth, the pulp.

Pulp is living tissue containing nerves, blood vessels, and connective tissue. It’s found in the pulp chamber within the crown and in the root canals that lead from the pulp chamber to the tip of each root.

When tooth pulp is infected or dying, it can’t be restored. Without prompt treatment, tooth extraction is often necessary. Moreover, an infection in the pulp can spread to the gum tissue, the jawbone, and other parts of the body. A root canal procedure can prevent tooth loss and more widespread infection by removing infected pulp tissue and restoring the integrity of the tooth structure.

Even with the protective layers surrounding it, tooth pulp is vulnerable to infection and injury:

A deep cavity can extend to the pulp chamber, permitting bacteria to reach the pulp and cause infection.
Similarly, a broken or cracked tooth can allow bacteria access to the pulp chamber.
With serious gum disease, infection can spread from the gums to the pulp inside the roots.
Tooth trauma can critically damage the nerves or the blood vessels inside the tooth, leading to pulp death.

A root canal procedure is relatively straightforward. If you are anxious about the procedure, your dentist can recommend sedations options.

First, the area around the tooth is numbed. A dental dam is often placed around the tooth to isolate the area.
An opening in the crown is made to allow access to the pulp inside.
Small, precise instruments are used to clean the inner pulp chamber and root canals and to remove dead or dying tissue.
The area is thoroughly disinfected.
The inside of the tooth is shaped to hold a filling.
The roots and pulp chamber are filled with gutta-percha or a dental composite and sealed.

A crown is typically used to protect and reinforce the tooth after treatment. A temporary filling or crown will be placed on the tooth to prevent bacteria and food from entering the site while a permanent crown is created. This permanent crown will be placed at a later visit. The entire process usually takes from one to three appointments.

A tooth that needs root canal treatment might be symptom-free, but any of these symptoms are strong indications that the pulp has suffered infection or injury:

Persistent tooth pain, which can be dull or sharp and severe
Pain when chewing or when any pressure is placed on the tooth
Prolonged sensitivity to heat or cold
A cracked, broken, darkened, or discolored tooth
Gum tissue near the tooth which is sore, red, or swollen
A pimple-like bump on the gums that persists or keeps recurring. This is the sign of an abscess, an infection in the gum or bone near the root of the tooth.

A root canal should be performed by an endodontist or a dentist who has special training in treating the interior of the tooth. Call your dentist immediately if you have any symptoms of pulp infection or injury. Prompt endodontic treatment can relieve tooth pain and prevent further infection. And, with proper dental care and regular checkups, your restored tooth can last a lifetime.

Tooth Extractions

Root Canal Treatment

Dentists prefer to preserve your natural teeth as much as possible, but sometimes that just isn’t an option. There are two ways a tooth can be removed, depending on how severe the damage is to the tooth:

Simple extraction: Local anesthesia is used, which is a numbing agent either applied or injected into the extraction site. Simple extractions are performed on teeth that are visible to the naked eye. An elevator and forceps will only be needed to remove the tooth.
Surgical extraction: Under general anesthesia, where you are completely unconscious during the procedure, surgical extractions are performed when the tooth cannot be easily accessed. Either the tooth has not fully erupted or it has broken under the gum line. A small incision in your gum will need to be made in order for the surgeon to gain access to the tooth. Gum tissue will be pushed back and bone surrounding the problem tooth will be removed, or part of the tooth itself will be cut. This process makes it easier for your surgeon to remove your tooth with an elevator and forceps.

Tooth extractions are most commonly discussed in reference to removing wisdom teeth. However, a tooth extraction can be required for a number of other reasons, such as tooth decay, gum disease, overcrowded teeth, impacted teeth, broken teeth, and baby teeth that have not fallen out naturally.

Tooth decay - this is the most common reason for removing a tooth. Patients who have avoided visiting their dentist for years may face this reality. Without the bi-yearly checkups and professional cleanings, your dentist will never be able to diagnose early onset tooth decay before it’s too late. As time goes on, your tooth will experience these stages:

Tooth decay affects tooth enamel.
Once worn through tooth enamel, the inner part of the tooth begins to deteriorate.
As the decay eats a hole through the center of the tooth, the tooth suffers even more damage.
When bacteria reach the center of the tooth, the ending result is a root canal infection.

The longer you go without treatment, the more severe the infection and damage will be. If your dentist has come to a point where your tooth cannot be saved, an extraction, followed by a bridge or implant, will be strongly recommended. Cavities detected early can be resolved with a simple filling.

Gum disease: Just as destructive as tooth decay in its advanced stages, gum disease attacks the gum tissue, ligaments, and bone that support the teeth. As these structures deteriorate, the teeth become looser until finally they fall out on their own or require an extraction, followed by gum disease and tooth replacement treatment.
Overcrowded teeth: As part of a patient’s orthodontic treatment plan, a tooth extraction may be necessary if there is overcrowding in the mouth. The extraction creates more space for the remaining teeth to be pulled and shifted into proper alignment.
Impacted teeth: Impaction occurs when a tooth has not fully erupted beyond the gum line, or only partially erupts. Overcrowding, a tooth that is twisted or tilted at abnormal angles, or a tooth that comes in displaced, are all reasons why a tooth may become impacted. Wisdom teeth are often impacted because the jaw is not large enough to accommodate these teeth.
Broken teeth: A tooth may need to be extracted when a tooth breaks at or near the gum line, making it nearly impossible to perform a tooth restoration.
Baby teeth: Sometimes, baby teeth can come in at an abnormal position, causing the permanent tooth underneath it to not erupt normally. Removing this baby tooth will allow the permanent tooth to erupt without issue.

Removable Dentures

Missing teeth impact not only appearance, but oral health as well. If you’ve lost some or all of your teeth because of trauma, periodontal infection, or decay, dentures are one of the options which can offer you a healthier, more attractive smile. Full or partial dentures:

Make eating and chewing easier
Facilitate clearer speech
Provide support for cheeks and lips for a healthier, more youthful appearance
In the case of partial dentures, prevent remaining teeth from shifting out of place
Restore self-confidence
Create a natural-looking smile

Your dentist will examine your gums, jawbone, and remaining teeth to determine whether dentures are your best option for tooth replacement, and which type of full or partial denture will best suit your needs. Custom dentures are individually crafted in specialized labs in a variety of different materials. Suitability, durability, aesthetic, and cost considerations can all be factors in your decision.

Full dentures replace all of the teeth on the upper and/or lower jaw. For all types of full dentures, detailed impressions and measurements will be taken of your gums and mouth to create an ideal fit. The way your jaws work together will be evaluated to ensure that your dentures won’t affect your bite. Your dentist will also consider the shape of your face and your lips for a natural-looking, aesthetically pleasing smile.

Conventional Dentures

Conventional full dentures are created after the gums and jawbone have healed post-extraction, which usually requires several months. Temporary dentures can be used during the healing period.

Immediate Dentures

These dentures are fabricated in advance before any necessary extractions occur, and can be placed right away, without waiting for the gums and bone to heal. Because the gums and jawbone can shrink after tooth loss, it might take several months of adjustments to create the most comfortable fit. Immediate dentures are often used as a temporary denture.

Implant Supported Dentures

Dental implants are first surgically placed in the jawbone where they fuse with the bone over a period of months. Once the implants are secure, removable dentures are fabricated which clip onto the implants. (Fixed dentures are also an option, attached to the implants using special screws which can only be removed by a dentist.) This type of denture is very secure, and, because implants stimulate jawbone tissue like natural tooth roots do, helps prevent bone loss.

Partial dentures replace multiple missing teeth in the upper or lower jaw. Most of them require healthy adjacent teeth for secure placement. Unlike bridges, which are fixed permanently to adjacent teeth, partial dentures are removable, and are held in place with different types of attachments:

Clasp Attachments

A common form of partial denture has a metal clasp attached to the end of the denture that fits snugly around a supporting tooth, holding it securely in place. These clasps are sometimes visible when speaking or smiling.

Precision Attachments

Small interlocking metal parts on both the partial denture and the adjacent teeth connect together for an unobtrusive, secure fit. These dentures might require crowns for the adjacent teeth and can be more expensive than clasp attachments.

Flexible Partial Dentures

Made of thermoplastic material, flexible dentures use translucent, gum-colored extensions that discreetly fit around the base of the teeth near the gumline.

Implant-Supported Partial Dentures

Partial dentures use stud or clip attachments to hold the denture securely to the dental implants.

Dentures, like natural teeth, require daily care. Your dentist can recommend the type of cleaning routine, soft brush, non-abrasive cleaner, and soaking solution which is best for removing any plaque and bacteria which build up on the denture.

Any discomfort or any damage to the appliance should be reported to your dentist at once. Keep up with regular dental checkups to make sure your denture is fitting properly and that your gums and other oral tissues are healthy.

Whether you choose dentures, bridges, or implants, replacing missing teeth restores the function and transforms the appearance of your smile. To discover if dentures are the best choice for you, discuss your questions, concerns, and options with your dentist.

Teeth Whitening

Over time, stain-causing foods and beverages, smoking, and thinning enamel can dim the brightest smile. If you are feeling self-conscious about your teeth, your dentist can help you discover the whitening treatment that is best for you.

Home treatments can be helpful in reducing surface stains. These methods are less expensive than in-office whitening, but, because they can’t offer the strength of professional whiteners, they aren’t as effective, and they usually require several weeks of daily application.

Whitening Toothpastes and Rinses

Whitening toothpastes and rinses use mild abrasives and bleaching agents, most often peroxides, to remove surface stains caused by foods, beverages, and smoking. They can also help keep teeth their brightest after a professional whitening. While toothpastes and rinses can’t do much to affect tooth color or deep staining, surface stains can show some improvement after several weeks.

Whitening Strips

These flexible plastic strips come in two sizes, to fit both upper and lower teeth, and are coated on one side with a thin film of peroxide-based gel. The gel-side of each strip is positioned on the front of the teeth and gently pressed into place. The strip needs to adhere to each tooth completely to ensure even whitening, and shouldn’t touch sensitive gum tissue to avoid irritation. The strips are usually recommended for use twice a day, for 30 minutes each time. Total treatment time can vary from several days to several weeks.

Stock Gel Trays

Gel tray whitening systems provide a mouthguard-like appliance that is filled with whitening gel and placed over the teeth. Trays can come pre-filled with gel or with individual gel applications in syringes. Stock trays aren’t always a perfect fit, and it’s important to make sure the whitening gel doesn’t contact the gums and other soft tissue in the mouth. Use time will vary with different manufacturers.

While all these whitening methods can brighten your smile, there are some circumstances which make a professional whitening your best option. Professional whitening agents are more powerful and can help eliminate darker stains which over the counter (OTC) products can’t remove. For those with deeper or darker staining, or for those who would like to see immediate results, in-office whitening is the best choice.

An office whitening treatment is generally faster, more effective, and lasts longer because dentists use gels with a higher concentration of peroxide than those gels found in OTC products. Your dentist will examine you first to make sure your teeth and gums are healthy, protect your surrounding gum tissue and mouth during the procedure, and monitor treatment throughout. Office whitening usually takes from 30-90 minutes.

Light-Activated Whitening

Some office whitening treatments make use of halogen, LED, or UV lighting as part of the procedure. Light doesn’t whiten teeth itself. Instead, it works with the gel solution, activating the molecules in the whitening gel and speeding up the chemical reaction which eliminates stains.

Custom Gel Trays

Custom trays created in the dentist’s office are an option for those who want to use a whitening gel at home. Professionally crafted trays will fit your teeth perfectly and allow a more precise application of the peroxide gel, which will also be provided. Custom trays can require about two weeks of use for maximum whitening.

Some teeth are not good candidates for typical whitening procedures at home or in-office. If you have deeper discoloration caused by trauma or medications taken during tooth formation, or if you have dental bonding, veneers, crowns, or bridges which are darker than your natural enamel, talk to your dentist to decide which whitening treatment or cosmetic procedure is the best option to achieve your brightest smile.

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