Treatments to Repair Teeth

In situations where the damage to the tooth is minimal, several types of repair are available. The least expensive type of repair is a filling made of either silver amalgam or tooth colored composite (glass embedded in plastic resin). These types of fillings are generally placed during a single visit.

Because of their poor physical properties, these types of fillings usually last 7-10 years for amalgam and 5-7 years for composite fillings. Amalgams and composites are limited to situations where the damage to the tooth is limited. Because of our concerns about the mercury in silver amalgam fillings, we have elected not to place these types of fillings in our patients.

When moderately more extensive damage is present, or in situations where a longer lasting restoration is desired, cast or processed restorations can be fabricated. These restorations include porcelain inlays and onlays, gold inlays and onlays, and processed (heat cured composite) inlays and onlays.

These restorations require at least two visits to complete and are fabricated at a dental laboratory using a mold of your tooth. The chief advantage of these types of restorations lies in their longevity. These restorations generally last 2-3 times longer than fillings placed during a single visit (silver and direct composites).

If a large portion of the tooth is damaged, and the tips of the tooth are weak, a full coverage restoration is often required. These are commonly called caps or crowns and can be made from a variety of metals, porcelains, composites or a combination of all three. Like inlays and onlays, crowns require two visits to complete. Because inlays, onlays, and crowns have hard, finely fitted margins (the margin is where the edge of the restoration meets the edge of the tooth) they tend to last much longer and feel more natural. Tooth colored crowns (all porcelain or porcelain crowns with a metal substructure) can closely resemble natural teeth and make it possible to create beautiful long lasting smiles.

If the remaining tooth is severely broken down, it is often necessary to reconstruct the top of the tooth with posts, cores, or pin buildups. These treatments provide an adequate foundation prior to restoring a tooth with a crown or bridge. Many teeth that have had endodontic therapy (root canal therapy) require posts and buildups as well as those teeth damaged due to accidental tooth fracture.

Occasionally the damage to the tooth extends into the nerve causing the death of the pulp tissue. In these cases, nerve treatment, more commonly known as root canal therapy, is required. Root canal therapy involves removing the remaining pulp tissue, cleaning the interior of the pulp chamber and root canal spaces, and sealing the canals with a permanent sealer.

After completion of this treatment, some type of filling or crown is required to seal the opening in the tooth and strengthen the remaining tooth.