Cindee Melashenko DMD
(250) 494-8545
 

General treatments  

There is no dental treatment that is better than “no dental treatment.”  Regular maintenance and preventative care are far less costly and much less invasive than waiting for a tooth ache. That being said, the odds are stacked against most of us. The World Health Organization estimates that nearly all adults will experience some degree of tooth decay. When tooth decay does occur, it is imperative to remove the decay, clean the tooth and repair the tooth with some type of restoration, as early as possible.

We have outlined potential treatments we routinely offer to protect and restore decayed or missing teeth.


Composite Fillings

The clear alternative to traditional mercury fillings

The Problem:

  • Decay on a portion of any tooth
  • Desire to replace old-fashioned mercury (silver) fillings
  • Desire to maintain a white, beautiful smile

The Solution

A composite filling is a tooth colored resin with clear glass particles to give it strength. Tooth coloured fillings come in many shades so they very closely match the colour of natural teeth.  They are bonded into place and require less removal of healthy tooth structure than silver fillings.

Advantages

Composite fillings are more than just attractive. They are environmentally non-toxic because they use no mercury. They are stronger because they bond directly to the surface of the tooth. They have less risk of fracturing because they don't require the severe "undercut" (removal of healthy tooth structure) of a mercury filling.

Disadvantages

Tooth coloured fillings may decay around the edge of the filling if we cannot keep the tooth clean and dry while placing the tooth coloured filling. Composite fillings don’t bond very well to roots or under the gum. Fillings are meant to be for small areas of decay only. If the decay is large the filling material is not strong enough to last for a long time and will often end up breaking down. Composite fillings can collect stain over time from foods such as black tea, coffee and wine.

Alternatives

Inlays/onlays or crowns are good alternatives to composite fillings when the decay is under the gum or when the fillings are large, offering excellent long-term durability. In cases of extensive decay, inlays/onlays or crowns are the only alternative.


Crowns

Protect and keep badly decayed or fractured teeth

The Problem

  • Badly decayed teeth (not much tooth left)
  • Fractured teeth (below the gumline)
  • Need to protect and strengthen teeth

The Solution

A crown (often called a cap) covers the tooth and restores it to its original shape, size and colour.  They improve the strength, function and appearance of a broken down tooth that may otherwise be lost. Decay is removed and cleaned from the tooth and a highly accurate 3D scan is made of the prepared surface. This scan is used to create a virtual model of the tooth which is then sent to an onsite milling unit that will create a porcelain (tooth colored) crown. The crown is then cemented onto the prepared surface of the tooth, often in 1 visit.

Advantages

Crowns are incredibly strong due to the fact that they are made of strong porcelain (or gold). This protects and strengthens the remaining tooth structure.

Crowns should be placed before the tooth fractures. This can often help prevent the expense of a root canal. It can also prevent the risk of tooth loss and replacement costs –i.e. bridge or implant. 

Disadvantages

Occasionally (11%), a tooth may need a root canal after being crowned. This procedure may fracture the crown and the crown may need to be replaced. The gum can recede over time showing the root and the dark root and the edge of the crown. The porcelain may chip and metal may wear over time.

Alternatives

In the event that a tooth is so decayed or fractured that it needs to be removed, the best alternative is a dental implant (metal root that replaces your root). 


FIXED BRIDGES

A great way to replace missing teeth

The Problem:

  • A missing tooth or teeth
  • Potential bite and jaw joint problems from teeth shifting to fill the space
  • The "sunken face" look associated with missing teeth
  • Desire to improve chewing ability
  • Desire for a more permanent solution than dentures
  • Want something that doesn’t come out at night

The Solution

A bridge is a span of teeth joined together that is fixed to the two teeth on either side of the space. 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.

Advantages

Unlike dentures, a fixed bridge is never removed. It provides better chewing ability and looks much nicer than a hole or space.

Disadvantages

The force of the missing tooth is now having to be shared by the teeth on either side. There is a higher risk of fracture and tooth loss when bridges are placed. If the teeth on either side of the gap do not need crowns this puts more risk on these teeth that otherwise wouldn’t be there –i.e. root canals, root fracture.

Alternatives

Dental implants, removable partial dentures.


ROOT CANAL THERAPY

Protect and keep a sick or dying tooth

The Problem:

  • Infected or sick tooth due to deep decay
  • Chronic tooth pain from teeth with big fillings
  • Pain from pressure or biting down – cracked teeth
  • Danger of infection spreading into your body
  • Trauma – fall/hit

The Solution

Inside each tooth is a pulp chamber that contains the nerves and blood supply for the tooth. When the pulp becomes infected due to decay or injury, the pulp must be removed from the canals of each root to prevent pain and prevent the infection from spreading. Once the infected pulp is removed, the remaining chamber is filled with a rubber-based material to seal it off.

All teeth that have had root canal therapy must be protected with a tooth-like artificial covering known as a crown (see crown section.) This is because teeth that have had the pulp removed are more susceptible to fracture.

Advantages

Root canal therapy is an excellent way to save a tooth that would otherwise die and need to be removed, and to get rid of the pain! 

Disadvantages

Occasionally root canal therapy may need to be redone because the infection could not be completely removed.

Alternatives

The only real alternative is to remove the sick tooth. However, this will require a dental implant or bridge to fill the empty space and prevent the shifting of surrounding teeth. These solutions cost more than the root canal therapy and crown.