Dental Questions: Why would a dentist place a temporary filling?

A filling is a filling, right? Then why would a dentist send you home with a "temporary" filling? What makes it any different from the permanent fillings you have on your other teeth? Do you need to worry about it falling out? Read on to see how and why dentists use temporary fillings to save and protect teeth!

A temporary or sedative filling is a type of dental procedure performed on a tooth with an uncertain prognosis or as an intermediate measure before further treatment. Imagine a patient who comes in for an emergency appointment with a large, painful cavity. While definitively saving the tooth may require a few different lengthy treatments, a dentist can remove decay and provide a temporary filling that same visit. This allows a tooth to be stabilized and desensitized so the patient can continue to function until a more definitive plan can be made. Many times, it is simply too early to determine the status of the tooth's nerves or gums and thus a temporary filling acts as a good interim measure. 

The most common material used in temporary fillings is a tooth colored compound called glass ionomer. This product bonds to tooth enamel, reacts well with moisture and has a natural calming effect on aggravated tooth nerves. Additionally, it enhances the effects of fluoride to provide extra defense against decay. The trade off is that glass ionomer is much weaker than permanent filling materials and does not stand up against tooth brushing, eating or chewing over time. Still, it's properties make it an ideal material to be used in temporary situations. 

How long will your temporary filling last? That question is impossible to answer without knowing the condition of the remaining tooth. In general, you should always end your temporary filling appointment with a plan for a permanent solution in the future. If you would like to know more about fillings, crowns, root canals or other dental procedures, please give our office a call!

Case Presentation: Smile Improvement Using Crowns and Veneers

In dentistry, many small changes can add up to make a huge difference! Today's patient came to our office dissatisfied with the uneven appearance of their front teeth. Note how the left central incisor has a large chip while the two lateral incisors are very different shapes. Additionally, the teeth do not have a uniform color shade, causing the crown on the patient's right central incisor to stick out noticeably.

Dr. Kari Ann Hong used a combination of three new zirconia veneers and a full zirconia crown on the right central incisor to create a matching shape and color across all the anterior teeth. She also provided minimal recontouring to the gums around the right incisor to create a more symmetric gum line. The result is an undeniably more natural smile! If you would like to know about the services we offer and what Dr. Hong can do for your smile, please give our office a call!

Best Cosmetic Dentist in the Conejo Valley

Check out this new video testimonial from one of our very satisfied patients! Twenty years ago, Jennifer suffered from pain and headaches associated with stress on her temporomandibular joint (TMJ). In solving this, her previous dentist used dental crowns and veneers to improve the way her teeth came together and ease her TMJ pain. Although the procedure was successful, twenty years of wear combined with gum recession had affected the appearance and function of these restorations. 

An important component of the dentistry we provide is managing our patients' fears and expectations. Jennifer was understandably very nervous coming into her appointment to have her crowns and veneers replaced. On top of the typical stress of a dental visit, she was concerned if the new restorations would fit as well as the originals. Fortunately, Dr. Kari Ann Hong is an expert in providing dentistry with a compassionate touch. Jennifer put on our noise isolating headphones and relaxed while Dr. Kari finished the appointment in just two and a half hours! She even left our office in custom temporary crowns that mimicked the esthetics and mechanics of the permanent units to come. 

Having your smile rejuvenated can be a stressful and daunting process. However, we pride ourselves in creating a relaxing atmosphere that makes the experience enjoyable! If you would like to know more about dental crowns, veneers or implants, please contact our office at (805) 480-9820 or at staff@thousandoaksfamilydentistry.com.

BruxZir Crowns

At our office, we want all of our dental work to be beautiful, functional and enduring. Many times, finding the intersection point of these three qualities requires us to turn to new technologies and developments in dental materials. In the case of dental crowns, we utilize BruxZir milled zirconia as a beautiful restorative solution that stands up to even the toughest conditions.

In the human mouth, the farther back a tooth is, the more relative force it will receive during a regular day. Teeth closest to the jaw joint are situated right next to the masseter, the muscle responsible for chewing, biting and closing the mouth. This muscle can generate incredible amounts of force, enough to crack or fracture your own teeth. Because of this, many types of crowns will chip, break or fail in the rear of the mouth.

A diagram highlighting the masseter muscle. 

In the past, porcelain fused to metal (PFM) crowns were the best tooth colored solution for posterior teeth, as their solid metal underpinnings are incredibly durable. However, the baked on porcelain can fracture and break during normal wear, requiring replacement or adjustment. Gold crowns were popular as well, so long as the patient was comfortable without a tooth colored restoration. Other materials, such as full porcelain crowns, are simply too fragile to be placed in such a functional position.

In contrast, Bruxzir crowns combine longevity, strength and natural beauty. They are milled out of a solid piece of engineered zirconia to match the color and shape of the original tooth. Since it is a single piece of material, it better matches the light characteristics of natural teeth. There is no metal backbone block out and less tooth structure has to be removed to accommodate the newly made crown.

While some materials (such as Emax) offer better translucency and color properties, nothing can stand up to BruxZir’s durability. They are essential chip, grind and crack proof. Even with heavy grinders and clenchers, the single piece zirconia will not fail or erode. No other material can offer this level of endurance in an esthetic, tooth colored package.

Even taking a hammer to a BruxZir crown will not ruin it's structural integrity. 

We typically only place BruxZir crowns on molars and more rearward teeth. While these units are esthetically superior to PFMs, they are not as cosmetically versatile as Emax crowns. In essence, their incredible strength comes with the price of poorer relative translucency. For front teeth experiencing less average force and wear, we will typically place this more esthetic material. Of course, we still place PFM and gold crowns, but most patients are eligible and more willing to be fitted with these state-of-the-art units.

If you have any further questions about BruxZir crowns, or any other crown materials at our office, please give us a call. We would love to talk you through your crown options, and which material would work best for you personally!

Crowns and Bridges

Hands down, dental crowns and bridges are the most versatile restorative tools at our office. Whether going on previously decayed teeth, root-canaled teeth or a dental implant, they offer convenience, beauty and excellent flexibility. Please take a moment and read why we love crowns and bridges at Thousand Oaks Family Dentistry!

In it’s simplest form, a dental crown is a hard, solid object that replaces the natural “crown” of the tooth. It can add structural rigidity, biting function or esthetic value to any damaged or decayed teeth. Similarly, bridges are three (or more) crowns made in tandem, were the outermost two units are attached to your natural teeth (or implants). The goal is to “bridge” the gap created by a tooth that was previously removed. Both crowns and bridges are prepared using the same techniques.

Crowns and Bridges are placed for a number of reasons. Crowns can be used to fix teeth that have too much decay to be rebuilt with a dental filling. They can also restore structure after a tooth becomes cracked (depending on the nature of the crack). Bridges are used to replace once-missing teeth in almost any area of the mouth. All that is required is that the gap is “surrounded” by viable teeth for the bridge to be mounted to. Likewise, implant crowns are the final restorative step in implant surgery and give the implant its beauty and functional ability.

The basics of how a tooth is prepared for a crown. (Read top left to lower right)

To prepare a tooth for a crown or bridge, we essentially remove a ~1.5mm gap from around all surfaces of the tooth, in addition to any defects or decay. The walls of the teeth are slightly tapered, so that the crown can be placed easily and has ample tooth structure to hold on to. At the gumline, a distinct ridge (called the “margin”) is created to give an explicit surface for the crown to be cemented against. In the case of bridges, this step is done on two separate teeth, with special care given to making both teeth completely parallel. For implant crowns, these steps and designs are built into the shape of the abutment, which is essentially a manufactured “undertooth” made at an off site dental lab.

1) A natural tooth is broken/decayed and cannot be repaired with a filling 2) The tooth is prepared for a crown, giving it clearance for the new unit and proper structure. 3) The final crown is cemented and delivered. 

Preparing and delivering bridges is done with much the same technique. However, a missing tooth is replaced in the process. 

After your tooth is prepared, we have a number of material options for making your crown or bridge. In nearly every case, we will use tooth colored materials and restorations. We can match almost any esthetic concerns, from color to matching staining patterns and the shape of adjacent teeth. For front teeth, we often use eMAX lithium disilicate crowns for their excellent esthetic properties and strength. In molars and back teeth, we typically place a material called Bruxzir. Bruxzir is an engineered zirconia that surpasses all other crown materials in terms of hardness and durability. We also have a number of more traditional crown materials at our disposal, ranging from gold to zirconia and porcelain fused to metal (PFM). Picking a crown material is a discussion between you and Dr. Kari that considers your whole-mouth condition and your specific wants and needs.

An example of an eMAX bridge/crown. 

At a crown preparation appointment, we start by getting you numb and taking an initial impression for our temporary crown. We then prepare the teeth, taking care to provide ample clearance for the new unit. Once the tooth is fully prepared, we take a final impression and make notes for the lab. Finally, we use our first impression to make an acrylic temporary. While this will not be as strong as your final crown, it will allow you to leave with a fully shaped tooth. This is important for esthetics, chewing function and for maintaining the space between the prepared tooth and the opposing tooth. After two weeks, the lab will deliver your crown, which will be adjusted, seated and cemented in a quick follow up appointment. The process for implant crowns is slightly different, but still requires appointments for initial impressions followed by the actual crown delivery.

If you have any further questions concerning dental crowns, please give our office a call. We place and deliver crowns almost every day and can walk you through your unique needs. There should be no confusion, fear or apprehension surrounding your crown or bridge treatment!

New Technology- The Wand

For many patients, the dreaded “ Novacaine* shot” is a source of anxiety, fear and apprehension. The process almost seems backwards; you have to sit through a painful injection just so you can avoid being in pain later. However, this does not have to be the case.

At Thousand Oaks Family Dentistry, all of our operatories are equipped with a device called The Wand. This device uses modern technology to provide pain-minimized and often undetectable dental anesthetic delivery.

While this system still utilizes a needle, this is the end of its similarities with traditional syringes. It uses air power and electric servos to target the primary source of anesthetic discomfort: delivery speed. In almost all dental shots, pain isn’t sourced from the actual needle, but rather from the medicine entering the tissue. The Wand counteracts this by giving the dentist complete control over speed of delivery.

By adding the anesthetic at a slower and more consistent speed, the tissue has time to numb at an appropriate pace to delivery. This minimizes pain and gives the doctor absolute control over location and amount of medicine delivered. Many of our patients are unaware that they have even received a shot by the time we are done!

*Note: Novacaine is no longer a commonly used anesthetic in dental offices. Our office uses a variety of optimized Novacaine variants for different applications and conditions.