Restorative
Almost everybody will probably experience some tooth decay during their lifetime. When this occurs, it is important to remove the decay, clean the tooth, and repair the tooth with some type of restoration. Additionally, lost or missing teeth should be be replaced to protect your overall oral health. Included here are descriptions of the various restorations we offer at Liberatore Family Dental to protect and restore decayed or missing teeth.

Composite Fillings
Inlays & Onlays
Crowns (Caps)
Fixed Bridges
Dental Implants

Composite Fillings
Composite fillings are a good alternative to traditional mercury fillings. They are used when there is decay or a cavity on a portion of any tooth, a need or desire to replace old silver fillings, or cosmetic concerns.

How it Works: A composite filling are tooth colored and made from a quartz-like material. After decay is removed and cleaned from the tooth, this composite material is layered into the tooth. Each layer is hardened with highly intense light, and the final surface is shaped and polished to match the tooth.

Advantages: Composite fillings blend with your natural teeth, are environmentally sound because they are made without mercury, and they bond to the tooth, making them stronger and longer lasting. Because they don't require the dentist to undercut the tooth, they help prevent tooth fractures.

Disadvantages: Initially, composite fillings are more expensive than mercury, or silver fillings, due to the cost of the materials and time involved in implementing them. In the long run, however, the cost is offset by health benefits and reduced likelihood of restoring fractured teeth.

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Inlays & Onlays
Inlays and onlays are a restoration method for a small amount of decay on any tooth. They are appropriate when there is a need for a long-term, durable restoration, the desire to limit the amount of healthy tooth structure removed, or a need to strengthen and reinforce a tooth.

How it Works: Decay is removed and cleaned from the tooth and a mold is made of the prepared surface. This mold is used to create a model of the tooth from which a gold or porcelain (tooth colored) restoration called an inlay or onlay is created. The inlay or onlay will be cemented into the surface of the tooth. An inlay covers only one or two surfaces of the tooth and is used to restore a small amount of decay. An onlay covers one or more cusps (the chewing surface of the tooth.)

Advantages: Inlays and onlays are very strong because they are created in a laboratory. This prevents fracturing and also strengthens the tooth. They also prevent future decay because they fit almost perfectly into the prepared surface of the tooth, reducing the size of the seam between the restoration and the tooth. Inlays and onlays only require the removal of decayed areas of a tooth, leaving more healthy tooth structure intact and utimately helping prevent future root canal therapy.

Disadvantages: Because they are made in a laboratory, inlays and onlays initially cost more than regular fillings, but because they last longer and fit better they are a good investment. Gold inlays and onlays generally have a greater long term durability than porcelain inlays and onlays.

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Crowns (Caps)
Crowns serve to protect and keep badly decayed or fractured teeth.

How it Works: Decay is removed and cleaned from the tooth and an impression or mold is made of the prepared surface, from which a model of the tooth is created. This model is then sent to a special laboratory that will create a gold or porcelain (tooth colored) crown. The crown is cemented onto the surface of the tooth.

Advantages: Crowns are very strong due to the fact that they are created in a laboratory. This protects and strengthens the remaining tooth structure. In the hands of a skilled dentist, a crown will fit almost perfectly onto the prepared surface of the tooth, reducing the size of the seam between the crown and the tooth. This helps keep decay from eventually occurring under the crown. Crowns should be placed before the tooth is so decayed that it may fracture. This can often help prevent the expense of root canal therapy in the future. It can also prevent the possibility that a fractured tooth may need to be removed, requiring the expense of a bridge or implant to replace the missing tooth.

Disadvantages: Crowns are excellent restorations and have few disadvantages because they are highly durable. They will eventually need to be re-cemented or replaced due to normal wear. Occasionally, a tooth may still need root canal therapy after being crowned, but this indicates that the interior of the tooth was already infected and would have eventually needed root canal therapy anyway.

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Fixed Bridges
Fixed bridges are a great way to replace missing teeth and prevent potential bite and jaw joint problems from teeth shifting to fill the space. They also provide a more permanent solution than dentures.

How They Work: A bridge is a single appliance that is generally attached to two teeth on each side of the space where a tooth is missing. An artificial tooth attached in the middle of the bridge fills in the gap where the missing tooth was. The teeth on either side of the gap are prepared for crowns (see crowns) and a highly accurate impression or mold is made of the prepared area. This mold is used to create a gold or porcelain (tooth colored) bridge in a special laboratory. The bridge is then cemented onto the prepared surface of the teeth, effectively creating the appearance of a "new" tooth. In some instances, a resin-bonded bridge may be used. In this case, the two teeth on each side of the gap are not prepared for crowns. Instead, the bridge consists of a false tooth with metal brackets on the back of each side of the gap. The brackets are attached to the backs of the real teeth on each side.

Advantages: Unlike dentures, a fixed bridge is never removed. It is stable in the mouth and works very similar to natural teeth. By filling the gap and stopping the movement of other teeth, a fixed bridge provides better chewing ability and prevents jaw joint problems, avoiding expensive future treatments.

Disadvantages: Fixed bridges are excellent restorations and have few disadvantages because they are highly durable, but they will eventually need to be re-cemented or replaced due to normal wear.

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Dental Implants
Dental implants are an excellent way to replace missing teeth and prevent potential bite and jaw joint problems from teeth shifting to fill the space. They also provide a more permanent solution than dentures.

How They Work: A dental implant is an appliance used to replace the roots of teeth. The implant is surgically attached to the jaw bone and an artificial tooth is attached to the top of the implant, creating a natural looking, undetectable replacement for the missing tooth. To replace multiple teeth, several implants may provide a base for a series of artificial teeth known as a fixed bridge (see fixed bridges.) Implants can even be used to secure a full set of removable dentures for people who have no remaining natural teeth, greatly improving chewing ability and reducing the risk of choking. It generally takes about six months for the surgical implant to heal before the final installation of the artificial tooth or teeth can be finished.

Advantages: Dental implants with artificial teeth are the closest thing to your natural teeth. They are strong, stable, durable and virtually undetectable, and can provide better chewing ability and head off jaw joint problems.

Disadvantages: Dental implants are excellent, state-of-the-art restorations and have few disadvantages when compared to alternatives such as dentures. However, they require surgery and time to heal, and they are initially more expensive than dentures or fixed bridges.

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Cosmetic
Tooth Whitening
Dental Implants
Porcelain Crowns

Tooth Whitening
Tooth whitening can make a dramatic difference in dull colored or stained teeth.

How it Works: Plastic whitening trays are made from models of your teeth. A special whitening gel is then placed in each tray and you wear the trays in your mouth for several hours per day. A significant change in tooth color is typically seen in just four to six weeks.

Advantages: Tooth whitening systems are highly effective and are used with excellent results.

Disadvantages: Some patients may experience gum or tooth sensitivity when using their trays. An alternative, accelerated whitening (done in our practice) is another option for some patients. This process can result in dramatically whitened teeth in just one office visit.

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Dental Implants
Dental implants are an excellent way to replace missing teeth and prevent potential bite and jaw joint problems from teeth shifting to fill the space. They also provide a more permanent solution than dentures.

How They Work: A dental implant is an appliance used to replace the roots of teeth. The implant is surgically attached to the jaw bone and an artificial tooth is attached to the top of the implant, creating a natural looking, undetectable replacement for the missing tooth. To replace multiple teeth, several implants may provide a base for a series of artificial teeth known as a fixed bridge (see fixed bridges.) Implants can even be used to secure a full set of removable dentures for people who have no remaining natural teeth, greatly improving chewing ability and reducing the risk of choking. It generally takes about six months for the surgical implant to heal before the final installation of the artificial tooth or teeth can be finished.

Advantages: Dental implants with artificial teeth are the closest thing to your natural teeth. They are strong, stable, durable and virtually undetectable, and can provide better chewing ability and head off jaw joint problems.

Disadvantages: Dental implants are excellent, state-of-the-art restorations and have few disadvantages when compared to alternatives such as dentures. However, they require surgery and time to heal, and they are initially more expensive than dentures or fixed bridges.

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Porcelain Crowns
Porcelain crowns can protect and keep badly decayed or fractured teeth while maintaining a beautiful smile.

How it Works: Decay is removed and cleaned from the tooth and a highly accurate impression or mold is made of the prepared surface. This mold is used to create a model of the tooth which is then sent to a special laboratory that will create a porcelain (tooth colored) crown. The crown is then cemented onto the prepared surface of the tooth.

Advantages: Crowns are very strong due to the fact that they are created in a laboratory. This protects and strengthens the remaining tooth structure. In the hands of a skilled dentist, a crown will fit almost perfectly onto the prepared surface of the tooth, reducing the size of the seam between the crown and the tooth. This helps keep decay from eventually occurring under the crown. Crowns should be placed before the tooth is so decayed that it may fracture. This can often help prevent the expense of root canal therapy in the future. It can also prevent the possibility that a fractured tooth may need to be removed, requiring the expense of a bridge or implant to replace the missing tooth.

Disadvantages: Crowns are excellent restorations and have few disadvantages because they are highly durable. They will eventually need to be re-cemented or replaced due to normal wear. Occasionally, a tooth may still need root canal therapy after being crowned, but this indicates that the interior of the tooth was already infected and would have eventually needed root canal therapy anyway.

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Cleanings & Prevention
Cleanings & Exams
By actively preventing disease and decay through regular home care, professional dental cleanings and regular exams, you can maintain a healthy, beautiful smile and avoid costly treatments in the future.

Cleanings
Professional cleanings, or dental prophylaxis, performed by a certified dental hygienist is essential for preventing gum disease and tooth decay. In a professional cleaning, your hygienist will remove plaque* from the teeth, remove calculus* (tartar) above the gum line, and polish and remove stains from teeth.

Dental Examinations
Dental examinations help to diagnose disease before it becomes hazardous to your health. In addition, regular examinations can save you money by alleviating problems while they are small, and before they become expensive to repair, or in some cases, impossible to repair. Your dental examinations generally include the following:

Dental X-Rays

How do X-Rays Help?
Dental x-rays allow the dentist to see things about your oral health that cannot be seen by the naked eye, including cysts (sacks of fluid that form on the roots of teeth), cancerous and non-cancerous tumors, invisible decay that occurs between teeth, and the location of teeth that haven't grown all the way in. The use of x-rays to find these problems can prevent expensive treatments and, in cases where x-rays show the location of tumorous growths, can even save your life.

Are Dental X-Rays Safe?
Modern dental x-ray machines are very safe; in fact it is less than the amount of radiation exposure your body receives on an airplane flight from Los Angeles to New York. This minimal exposure is insignificant when compared with the risk of not finding an illness until it is too late, which is why we prescribe regular diagnostic x-rays.

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Gum Disease
Diagnosis
Treatment
Long-Term Care

Gum disease (Periodontal Disease) is responsible for about 70 percent of adult tooth loss and is characterized by swollen, inflamed gums surrounding the teeth. Plaque* gets inside the space between the gum line and the tooth. If plaque is not removed, it eventually hardens into a substance called calculus or tartar that is very difficult to remove. The bacteria in the plaque and tartar eventually eat away at the fibers that hold the gums to the teeth, creating deep pockets. As bacteria spread, the pockets become deeper until the bacteria finally eat away the bone that holds the tooth in place.

Diagnosis
Gum disease is diagnosed by measuring the depth of the pockets around each tooth. Pockets that are greater than 3 millimeters in depth will generally require treatment, making early detection and prevention of gum disease a good reason to see your dentist regularly.

Treatment
Gum disease is treated by removing the bacteria and substances that form in the pockets around the teeth. Our dental team has had advanced training regarding how to effectively remove all of the bacteria on a microscopic level. The process usually requires several visits to our office. Once the bacteria has been removed, the pockets must be cleaned and maintained on a regular basis by a certified dental hygienist to prevent the bacteria from returning.

Long-Term Care
Once you have contracted periodontal disease, you will always have the disease due to the damage that it does to your body. Careful daily hygiene and regular dental visits to clean your pockets are required to keep the bacteria from returning. A regular appointment schedule called "periodontal maintenance" to keep your pockets free of bacteria will be arranged after your initial treatments.

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