There seems to be a misconception floating around about dental restorations and the options available. Both my staff and I have met people who ask about these restorations. They say one reason they are apprehensive about having dental treatment is the severe amount of tooth removal during a dental restoration procedure. In particular they are referring to crowns. They say it makes them hesitate as they know that their tooth will be shaved down to a “peg” and they wonder if that’s necessary.
New Innovations in Cosmetic Dentistry Brings Brighter Smiles
Over the last few years dentistry has entered an exciting time for dental restorations, with continual new advances. A cosmetic and restorative dentist has various types of restorations they can utilize, depending on the patient’s specific need. In other words, the crown is not the only natural-colored restoration available. This means patients can now benefit from treatment that is as tooth conserving as possible, until the situation merits more invasive procedures. This contributes positively to a person’s long term dental health.
Does it matter if a more extensive restoration is placed, compared with a less extensive restoration? Definitely. For example, if you had a moderate-sized cavity on your tooth, wouldn’t it make sense to replace only that decayed and damaged area alone? Unfortunately, traditional dentistry does not necessarily allow for the least invasive procedures. On the other hand, the more conservative approach would be to remove the decay, prepare the tooth and place the smallest restoration possible. If eventually that same tooth were exposed to more decay, only then would more natural tooth be removed to eliminate the decay. Only in extreme situations, such as a severe, irreparable fracture or extensive bone loss, would a tooth perhaps need to be extracted. Therefore, the more conservative the approach taken now, the more options there are in the future.
Years ago, the crown or “cap” was the only option when there was a large amount of decay on a tooth or if a larger filling needed to be replaced. The crown offered protection for the tooth, as well as the ability to withstand the powerful biting forces of your jaws. Unfortunately, to prepare a tooth to be fitted for a crown, the tooth must be drilled down on all five sides of the tooth, whether or not there was decay or destruction. In other words, the mere design of a crown required this extensive removal, even of healthy, unaffected natural tooth. Furthermore, prior to the invention of state-of-the-art natural restorations, the only way to have the strength and durability required was to have the crown’s core be reinforced by metal.
The goal in preparing a tooth for a restoration has evolved from whittling a tooth down to a “nub” to saving as much of a person’s natural tooth as possible. Through extensive research, over the last several years materials were developed that offered everything needed in a tooth-colored restorative material: strength, durability, no use of metal, and color that mimics the natural beauty of teeth. This allows restorations that are less invasive to be used when the situation permits. These tooth conserving restorations include “inlays” and “onlays” for posterior (back) teeth, and porcelain “veneers” for anterior (front) teeth. These restorations require precise laboratory fabrication. Certainly, crowns are still prescribed when the tooth destruction is severe. The state-of-the-art process of placement or “bonding” (curing) of these conservative restorations contribute to less tooth removal than crowns of years ago. Similar to these non-metallic materials, the materials now used for the traditional crowns also offer good strength and durability.
Why is it ideal to minimize natural tooth reduction? Of course, it’s best to keep as much of your own tooth structure, because the natural tooth is the optimal substance as far as strength, durability, and compatibility with surrounding gum and bone structure. Moreover, nothing can exactly replace the benefits of your natural teeth. When the dental professionals talk about the mission of keeping your teeth for life, this is where it all begins.
Minimize Tooth Decay to Keep Your Beautiful Smile
The primary objective is to minimize tooth decay and gum disease, and maintain good oral health. Preventive dental activities, such as brushing, flossing and professional cleanings and exams, play an important role. That’s why dental health education is strongly emphasized at your office visits. However, human nature and genetics also play a role in how your dental health will fare. This is where tailored regimens are prescribed to optimize each patient’s dental problems.
The secondary objective is to minimize natural tooth loss, once decay does set in. This philosophy of keeping as much of your healthy, natural teeth as possible will further ensure keeping teeth for a lifetime. For example, some people may think it’s an equal option to either extract a tooth or to have a root canal performed. However, by the simple existence of a natural tooth in the gums (even if the tooth had root canal therapy) stimulates the bone and gum growth necessary to maintain its healthy level. Without a tooth, the bone and gum level may drop, possibly affecting the bone and gum level of neighboring teeth. Also, the opposing tooth may drift and the adjacent teeth may tip into the empty position, which affects the way teeth come together when chewing. So what appears to some to be an equally satisfactory solution is in reality detrimental to a person’s dental health.
Thanks to advancements in dental technology, patients are now able to benefit from the range of restorations that minimize tooth removal according to each tooth’s specific needs. This in turn maximizes the preservation of natural tooth, to give everyone a fighting chance to keep their teeth for their lifetime.
Dr. Wynn Okuda is an award winning international leader in cosmetic dentistry. He is one of only 280 dentists in the world to be accredited by the American Academy of Cosmetic Dentistry (AACD). Dr. Okuda turned the dental profession on its head nearly a decade ago , replacing pain, fear, & discomfort with the Dental Day Spa system. His offices for cosmetic, restorative and implant dentistry are located in Honolulu, Hawaii.
Dr. Okuda has been featured in the New York Times, Wall Street Journal, Reader’s Digest, American Spa, Shape Magazine, Better Homes & Garden, Health & Fitness Sports Magazine, New Woman, and dozens more!
Dr. Okuda is the founder of “Give Back A Smile”, a charitable foundation of the AACD which helps survivors of domestic violence throughout the nation to restore their smiles and lives. He has assembled nearly 1,000 cosmetic dentists nationwide to help fight against domestic violence.