Restorative Dentistry
 You don't have to live with damage, discoloration or gaps when it comes to your teeth. There is a procedure that is right for you and your unique situation. From bridges, to dentures, to implants, we can help or point you in the right direction.
Fillings
Fillings are used to restore areas of your tooth affected by decay. Dr. Miranda Ruleford uses both amalgam (silver) and composite (tooth-colored) materials to "fill in" the surface of the tooth after all decay has been removed.
Reasons for Fillings
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Restoring small to medium sized cavities
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Restoring a chipped anterior (front) tooth |
What Does a Filling Involve?
First, your doctor will answer any questions you have and will apply anesthetic to the tooth requiring the filling. Then they will thoroughly remove the decay that is present and prepare the tooth for either the composite filling.
What Are Composite Fillings?
Composite fillings are tooth-colored to blend in with the remaining natural part of the tooth. The term composite refers to the actual filling material, which is a mixture of glass or quartz filler in a resin medium.
Composite fillings provide good durability and resistance to fracture in small-to-mid size restorations that need to withstand moderate chewing pressure. In addition to being more aesthetically pleasing, composite fillings are "bonded" or attached with adhesive directly to the tooth surface. This often allows for a more conservative repair than traditional fillings with their inability to bond to the tooth structure. Since traditional fillings do not bond to the tooth, amalgam is packed into the tooth, and may loosen over time. Amalgam fillings often require that more tooth structure be removed to create a space that will hold the filling in place.
Composite filling material is also commonly used to repair front teeth that have chipped or worn. Where possible, aesthetic bonding of composite material to front teeth is generally much less expensive than veneers or crowns. However, bonding typically does not last as long as veneers or crowns.
Dental Bridge
Dental bridges are fixed appliances that will work to restore the structure and function of your teeth after tooth loss. These appliances are non-removable, so they will become a permanent part of your smile. There are many different types of bridges, and we can help you to choose the option that is right for your unique dental needs.
A traditional bridge is the most common type of bridge that is used to improve tooth loss, and it is made of metal and porcelain. The bridge contains two porcelain crowns fused to metal that will slip over two anchoring teeth found on either side of the artificial teeth. The bridge then fills the gap that was created due to tooth loss.
Reasons for Choosing a Fixed Bridge
There are numerous reasons that you might choose a fixed bridge to correct your tooth loss:
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Restore the smile
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Improve your ability to speak and chew like normal
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Maintain your normal face shape
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Fill in the spaces left by missing teeth
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Prevent the remaining teeth from shifting positions
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Upgrade from removable dentures |
Dental Crowns
A crown is a covering that will wrap and protect the entire surface of a tooth, allowing it to look and function just like the original tooth. Crowns work to strengthen the tooth while protecting the existing structure, extending the life of the tooth longer that it would be with a filling or another restoration.
 Reasons for Choosing a Dental Crown
Dental crowns can correct a variety of problems that you might be experiencing with your teeth:
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Fractured or broken teeth
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Severely decayed teeth
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Cosmetic imperfections
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Fractured fillings
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Tooth protection needed after a root canal |
Composite Bonding
Bonding is a procedure where we apply a tooth-colored composite material to a tooth, shape it, allow it to harden and polish it. It can be used in certain situations where a tooth has been damaged or become stained. These are generally minor repairs that can be resolved through this relatively inexpensive means rather than through a more costly dental procedure.
Here's How it Works
The dentist prepares the tooth surface so the bonding material will adhere. Once it has been applied, the dentist will shape it so it has a natural appearance. Then the material is allowed to harden, usually with the help of a light. Finally, the composite is polished and buffed so that the surface is smooth.
This is not a process that is recommended if you are a smoker as smoke causes staining. Also, the material is not as durable as porcelain veneers and crowns so it chips more easily; eventually it may require replacing.
Bonding is a perfectly adequate and more affordable solution to certain dental problems. Dental bonding can take less time to accomplish and may not even require anesthesia. Depending upon the issue, insurance may cover it.
Root Canal Therapy
A "root canal," or endodontic therapy, is a procedure available to save a tooth that is infected and would otherwise require extraction. There are many reasons that teeth can become infected, including: cavities, previous large fillings, crowns, cracks, trauma and extreme wear.
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 (nerve and blood supply), bacteria and any decay are removed, and the resulting space is filled with an inert material called gutta percha. After the tooth is healed, getting a crown is recommended, because the tooth will become brittle.
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 problematic tooth is the best (and most economical) solution. Extracting, or pulling a tooth, could ultimately be more costly and cause significant problems for adjacent teeth, as well as causing loss of bone around the extraction site.
While root canal therapy has a high degree of success, it is not 100% guaranteed. It is very important to have a permanent restoration (usually a crown) placed within 30 days of the root canal. If a permanent restoration is not placed, the tooth can fracture or further decay to the point where the root canal must be re-done or, worse, the tooth must be removed.
Reasons for Root Canal Therapy
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Decay has reached the tooth's pulp (the living tissue inside the tooth)
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Infection or abscess has developed inside the tooth or at the root tip
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Injury or trauma to the tooth
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Extreme wear due to bruxism (grinding) |
Crown Lengthening
When a tooth has a deep cavity, a crown and buildup are usually needed to restore the tooth. If the cavity extends too far below the gums, it becomes impossible to predictably make a crown that will last for any length of time. Performing crown lengthening where indicated improves the prognosis for the tooth.
Crown lengthening nearly always involves removing and recontouring some of the bone around the tooth. This results in more tooth structure above the gums and smooth flowing gum contours. Not every tooth that needs a crown also needs crown lengthening surgery, it is only necessary when a deep cavity or crack is present.
Single and Multiple Tooth Implants
A dental implant is a titanium post designed to replace missing teeth. The post is surgically placed into the jawbone where the tooth is missing, and provides a more permanent solution.
 Crowns and conventional bridges or dentures may not be your only options when replacing missing teeth. For some people, dental implants offer a smile that looks and feels very natural. Implants are surgically placed below the gums over a series of appointments, and fuse to the jawbone. Implants offer stability because they fuse to your bone, a process called osseointegration. Integration of the implants into your jaw also helps your replacement teeth feel more natural, and some people find the secure fit more comfortable than conventional substitutes. Candidates for dental implants must have healthy gums and adequate bone to support the implant.
Reasons for Dental Implants
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Replace a missing tooth
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Maintain healthy bone levels
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Help support overdentures
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Keep the look and feel of a real tooth where one is missing |
What Does a Dental Implant Involve?
Implant Site Preparation
The gum tissue is opened to expose the bone area where the implant will be placed. In situations where there is insufficient bone structure, bone grafting may be a recommended procedure. Once healthy bone has been established, a special drill is used to prepare the bone to receive the implant.
Placing the Implant
After the bone has been prepared, the implant is placed and the tissue is sutured. After seven to ten days the sutures are removed. The healing process takes three to six months. This is the amount of time it usually takes the implant to become part of the bone of the jaw.
Attaching the Post
When the gum tissue is ready, a special post is attached to the implant; it is the support for the new porcelain crown. Today's technologies often include zirconium abutments attached to the implant post, to assure that the new porcelain tooth possesses translucency properties similar to a natural tooth.
Placing the Crown
After impressions are taken a crown is made and shaded to match your existing teeth. The crown is then slipped over the post and cemented. This final prosthetic crown appears as a natural tooth.
There is a high rate of failure of implants in patients who smoke, so dental implants tend to not be an option for patients who are actively smoking. We will help you determine whether dental implants will be a good tooth replacement option for you. Proper brushing and flossing will maximize the longevity of your new dental implant.
Dentures
Complete Dentures
A complete denture is a removable prosthesis of white plastic teeth in a pink gum-colored plastic base; the denture rests on the remaining gum ridge once all of the teeth in the arch have been removed.
A complete denture is a removable prosthesis of white plastic teeth in a pink gum-colored plastic base; the denture rests on the remaining gum ridge once all of the teeth in the arch have been removed.
It is important to note that life with an upper and/or lower denture is a major lifestyle change when compared to natural teeth. Dentures impact the type of food you are able to eat, your self-confidence in social situations and even your self-esteem.
Reasons for a Full Denture
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All teeth missing in the same arch
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Restore chewing ability
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Restore a natural looking smile
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Economical alternative to other procedures |
An upper full denture will almost always feel better than a lower full denture. In order to dramatically improve the fit of a lower full denture, we frequently suggest using dental implants as a retentive mechanism. Implants placed in the lower jaw can help anchor the denture and significantly improve comfort. Sometimes, the implants can even be placed in the jaw after a denture has been in use for several years.
Partial Dentures
A Partial Denture is an economical solution that allows all missing teeth in the same arch (either the upper or the lower) to be replaced with one appliance. A partial denture is inherently much more stable and therefore more comfortable than a complete denture. There are many factors that help us to determine if you are a candidate for tooth replacement with a partial denture. Among these factors, the health of the gums and the shape of the anchor teeth are most important.
Reasons For Partial Dentures
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Multiple teeth missing in the same arch
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Restore chewing function |
The metal clasps are usually visible and usually affect the beauty of your smile. Often, there are options available to reduce or eliminate the need for visible clasps.
Finally, partial dentures can be designed to allow for the future loss of teeth which may not be as healthy as the rest. Alternatives to partial dentures include bridges, implants, and, occasionally, full dentures.
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