Dr. Yenna provides a large array of restorative dental work. Patients find comfort in knowing that Dr. Yenna does not use silver/amalgam fillings as a restorative material. All filling materials used are tooth colored composites. Composites have been around for years; and as the material has advanced in it’s quality over the past few years, it has been recommended as an alternative material vs. silver/amalgam fillings. Composites come in a variety of shades to match the color of the natural teeth and generally exhibit good support and adaptability to the tooth structure. They are placed inside the tooth just like a pack-able filling and a special light is used to make the filling hard. Once the filling is hard using the special light, the patients can chew and function on the tooth. For teeth that have larger filling areas and/or cracks a material called an Inlay/Onlay may be suggested. Inlay/Onlays are lab made compressed porcelain materials used to fill in the area of the cavity/crack. Inlays/Onlays are very strong and exhibit excellent cosmetic and support characteristics. A process called bonding is required to adapt the Inlay/Onlay to the tooth structure and secure a proper fit.
If plaque and tartar is left on the teeth, it provides the right conditions for bacteria to thrive. The bacteria irritate the gums, which means that they bleed more easily. You may notice this if you are brushing your teeth, or eating, and sometimes your gums may bleed a bit. This is the early stage of gum disease called gingivitis. If you have gingivitis, your dentist or hygienist will clean your teeth by scaling and polishing them. They may also recommend an antiseptic mouthwash containing chlorhexidine and show you how to brush and floss your teeth effectively. Most adults have some degree of gum disease.
If gingivitis not treated and nothing is done about it, the inflammation will work its way down towards the foundations of the tooth causing a "periodontal pocket". Again, within the confines of the pocket, the conditions are such that the bacteria can have a right old party, and cause more damage.
Gum disease can break down the support (bone) structures of the teeth, so that eventually, they will become loose. The problem is that until it gets quite severe, the person often has no symptoms. Sadly, the damage to the support structures of the teeth is irreversible. The good news is that if gum disease is caught in time, its progression can be halted and improved upon, and that is the key.
To stop gum disease from progressing, your dentist may advise periodontal therapy, or deep cleaning. This gets rid of the bacteria in the pocket and provides the necessary conditions for healing to occur.
What is the difference between an ordinary cleaning and deep cleaning?
There is some confusion about the difference between scaling and root planing. Scaling is basically the process of removing dental tartar from the surfaces of the teeth (see dental cleanings). Root planing is the process of smoothening the root surfaces and removing any infected tooth structure. If you have gum disease or gum pocketing, the gum pockets around the teeth will have deepened, thereby allowing tartar deposits to form under the gumline.
The two processes tend to blur together since during the cleaning process, the dental worker scales away tartar and performs any necessary root planing at the same time. Any roughness can be planed away to result in a silky smooth surface.
Gum disease (also called periodontal disease) is an infection of the tissues that support your teeth. It is a major cause of tooth loss in adults. Because gum disease is usually painless, you may not know you have it. At each regular checkup the dentist will measure the depth of the shallow v-shaped crevice (called a sulcus) between your tooth and gums to identify whether you have gum disease.
Signs And Symptoms:
If you notice any of the following signs of gum disease, see the doctor immediately.
• Gums that bleed easily
• Red, swollen, tender gums
• Gums that have pulled away from the teeth
• Persistent bad breath or bad taste
• Pus between your teeth and gums
• Permanent teeth that are loose or separating
• Any change in the way your teeth fit together when you bite
• Any change in the fit of partial dentures
It is possible to have periodontal disease and have no warning signs.
That is one reason why regular dental checkups and periodontal examinations are very important. Treatment methods depend on the type of disease and how far the condition has progressed.
Good oral hygiene at home is essential to keep periodontal disease from becoming more serious or recurring. You don't have to lose teeth to periodontal disease. Brush regularly, clean between your teeth, eat a balanced diet, and schedule regular dental visits for a lifetime of healthy smiles.
Gum disease is caused by plaque, a sticky film of bacteria that constantly forms on the teeth. These bacteria create toxins that can damage the gums.
Periodontal diseases attack just below the gum line in the sulcus, where they cause the attachment of the tooth and supporting tissues to break down. As the tissues are damaged, the sulcus develops into a pocket; generally, the more severe the disease, the greater the depth of the pocket.
Periodontal diseases are classified according to the severity of the disease. The two major stages are gingivitis and periodontitis.
Gingivitis -In the early stage of gum disease, called gingivitis, the gums become red, swollen and bleed easily. At this stage, the disease is still reversible and can usually be eliminated by daily brushing and flossing.
Periodontitis - In the more advanced stages of gum disease, called periodontitis, the gums and bone that support the teeth become seriously damaged. Whereas healthy gums and bone anchor teeth firmly in place, infected gums can cause teeth to become loose, fall out, or have to be removed by a dentist.
Some factors increase the risk of developing periodontal disease:
• Tobacco smoking or chewing
• Systemic diseases such as diabetes
• Some types of medication such as steroids, some types of anti-epilepsy
drugs, cancer therapy drugs, some calcium channel blockers, and
• Bridges that no longer fit properly
• Crooked teeth/malalignment of teeth
• Fillings that have become defective
What is endodontic treatment?
"Endo" is the Greek word for "inside" and "odont" is Greek for "tooth." Endodontic treatment treats the inside of the tooth.
To understand endodontic treatment, it helps to know something about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves, and connective tissue and creates the surrounding hard tissues of the tooth during development.
The pulp extends from the crown of the tooth to the tip of the roots where it connects to the tissues surrounding the root. The pulp is important during a tooth's growth and development. However, once a tooth is fully mature it can survive without the pulp, because the tooth continues to be nourished by the tissues surrounding it.
Why would I need an endodontic procedure?
Endodontic treatment is necessary when the pulp, the soft tissue inside the root canal, becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth. In addition, an injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.
What are the signs of needing endodontic treatment?
Signs to look for include pain, prolonged sensitivity to heat or cold, tenderness to touch and chewing, discoloration of the tooth, and swelling, drainage and tenderness in the lymph nodes as well as nearby bone and gingival tissues. Sometimes, however, there are no symptoms.
How does endodontic treatment save the tooth?
The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the canal, a channel inside the root, then fills and seals the space. Afterwards, you will return to your dentist, who will place a crown or other restoration on the tooth to protect and restore it to full function. After restoration, the tooth continues to function like any other tooth.
Will I feel pain during or after the procedure?
Many endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection. With modern techniques and anesthetics, most patients report that they are comfortable during the procedure.
For the first few days after treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications. Follow your endodontist's instructions carefully.
Your tooth may continue to feel slightly different from your other teeth for some time after your endodontic treatment is completed. However, if you have severe pain or pressure or pain that lasts more than a few days, call your endodontist.
Endodontic treatment can often be performed in one or two visits and involves the following steps:
1. The dentist examines and x-rays the tooth, then administers local anesthesia.
2. After ensuring that the tooth is numb/anesthetisedTh,the dentist makes an opening in the crown of the tooth. Very small instruments are used to clean the pulp from the pulp chamber and root canals and to shape the space for filling.
3. After the space is cleaned and shaped, the endodontist fills the root canals with a biocompatible material, usually a rubber-like material called "gutta-percha." The gutta-percha is placed with an adhesive cement to ensure complete sealing of the root canals. In most cases, a temporary filling is placed to close the opening. The temporary filling will be removed by your dentist before the tooth is restored.
4. After the final visit with your endodontist, you must return to your dentist to have a crown or other restoration placed on the tooth to protect and restore it to full function.
If the tooth lacks sufficient structure to hold the restoration in place, your dentist or endodontist may place a post inside the tooth. Ask your dentist or endodontist for more details about the specific restoration planned for your tooth.
How much will the procedure cost?
The cost varies depending on how complex the problem is and which tooth is affected. Molars are more difficult to treat, the fee is usually more. Most dental insurance policies provide some coverage for endodontic treatment.
Generally, endodontic treatment and restoration of the natural tooth are less expensive than the alternative of having the tooth extracted. An extracted tooth must be replaced with a bridge or implant to restore chewing function and prevent adjacent teeth from shifting. These procedures tend to cost more than endodontic treatment and appropriate restoration. With root canal treatment you save your natural teeth and money.
Will the tooth need any special care or additional treatment after endodontic treatment?
You should not chew or bite on the treated tooth until you have had it restored by your dentist. The unrestored tooth is susceptible to fracture, so you should see your dentist for a full restoration as soon as possible. Otherwise, you need only practice good oral hygiene, including brushing, flossing, and regular checkups and cleanings.
Most endodontically treated teeth last as long as other natural teeth. In a few cases, a tooth that has undergone endodontic treatment does not heal or the pain continues. Occasionally, the tooth may become painful or diseased months or even years after successful treatment. Often when this occurs, redoing the endodontic procedure can save the tooth.
What causes an endodontically treated tooth to need additional treatment?
New trauma, deep decay, or a loose, cracked or broken filling can cause new infection in your tooth. In some cases, the endodontist may discover additional very narrow or curved canals that could not be treated during the initial procedure.
Can all teeth be treated endodontically?
Most teeth can be treated. Occasionally, a tooth can't be saved because the root canals are not accessible, the root is severely fractured, the tooth doesn't have adequate bone support, or the tooth cannot be restored. However, advances in endodontics are making it possible to save teeth that even a few years ago would have been lost. When endodontic treatment is not effective, endodontic surgery may be able to save the tooth.
When teeth are heavily decayed they may be too weak to survive with just a filling. By placing a crown, a tooth may be given a new lease of life. Even when a single tooth is lost a denture may not be required as a bridge can be made which spans the gap with a tooth attached to those next to the space. Sometimes when a single small tooth is lost at the front of the mouth a simple bridge can be made which has 'wings' that are glued to the back of the adjacent teeth. This results in less tooth being damaged by the drill.
When a tooth is heavily decayed it is more likely to fracture and lose considerable tooth substance. The greater risk is that a fracture line may go below the margin of the gum which makes restoration more difficult or near impossible. Crowns may be made from several different materials, gold and porcelain being the most common types.
Gold is usually used on the back teeth, as it has several advantages over porcelain teeth.
• Gold is strong in thin section and less tooth needs to be drilled away before
taking the impression and fitting the crown.
• The lab technician finds it easier to use gold as it shrinks less when cast and
is easier to polish. Crowns of porcelain shrink when cast and the technician
has to estimate this when making the crown.
Porcelain is usually always used for the front teeth but may be used for the back teeth. This material can be made to appear very natural though several factors affect this and are outlined below;
Some porcelain crowns have metal inside which gives strength and support to the porcelain. This acts as a barrier for light and gives the crown a dull colour. On posterior teeth this won't be noticed but in the front of the mouth it can occasionally be a problem as the tooth looks duller than the natural teeth.
A bridge allows the dentist to replace lost teeth without the use of a denture or dental implant. Basically a false tooth is held in place by being attached to a tooth next door. The disadvantage is that the teeth next to the space have to be prepared in a similiar way to a crown in order to accept the bridge. If these teeth already have crowns or big restorations then this is not a problem, the major concern however is when these teeth have small or no restorations (fillings). One compromise is the 'acid etched bridge', with this type a fine ledge is placed on the back of the adjacent teeth.
One disadvantage of a bridge is that the patient should wait three months before placement as the 'gum' shrinks' after a tooth is extracted. If the bridge was fitted early a gap would appear underneath the pontic (the false tooth). At the back of the mouth this may not be a problem, at the front of the mouth however this may appear as a black line along the gum.
When the top of a tooth is lost due to decay there may be very little for the crown to actually hold onto. To gain 'retention' as dentists call it, a post is placed inside the tooth which forms a peg on top of the tooth and acts as a seat for the crown. Post crowns have a shorter lifespan than normal crowns as the roots may be brittle and weaker. Usually a post crown is a better option than having the tooth extracted with a subsequent denture or bridge.
Normally a bridge requires the adjacent teeth to be prepared to accept the abutments of the bridge. This is destructive to these teeth especially if they have small or no fillings in them. A more conservative approach is a 'Maryland bridge' which uses wings that attach to the adjacent teeth. The disadvantage of these systems is that the life expectancy of the bridge is only 4-5 years when compared to the conventional type of 8 years.
As a lot of tooth tissue may need to be removed your dentist will normally give you a local anaesthetic (injection) before starting treatment.
This tooth is heavily decayed and needs a crown to prevent the top part of the tooth beaking down completely. The decay is removed and any holes are filled with amalgam or a white filling material. The tooth is then prepared using the drill. A ledge is made around the tooth and the top is cut down to make space for the gold. After this the dentist will take an impression of the tooth which is then sent to the laboratory. A model of the tooth is made from this and a crown made to fit.
The crown is then fitted. A special cement is used to bond it to the underlying tooth. The dentist may need to adjust it before the patient leaves the surgery so that the bite is just right.
This diagram shows what a tooth looks like after it has been prepared. The notches cut in the side help the crown stay on when its fitted. These are called retention grooves.
A partial denture is a removable dental appliance that replaces multiple missing teeth. It can be attached to the teeth with clasps (clasp or conventional partial) or it can be attached to the teeth with crowns with precision attachments (hidden clasps). Both types have a metal framework and plastic teeth and gum areas. Patients often have questions about Partial Dentures. Call us for more information at 847.697.9900.
Common post extraction instructions / dry sockets Aftercare during the time period beginning 24 hours following your tooth extraction. Your dentist will provide you with a second set of aftercare instructions for the time period beginning 24 hours after your tooth extraction. Usually a dentist's instructions will include directions pertaining to the topics found on this page. Before following any of the aftercare directions that are found here you should print them out and show them to your dentist and ask them if these instructions apply to your specific situation. Your dentist may find reason to revise, add to, or delete from these generalized instructions, depending on your specific needs. In all cases, if you have a concern or feel you have developed a complication associated with your tooth extraction you should contact your dentist.
Addressing swelling that still exists 24 hours after the extraction.
Any swelling caused by the trauma of the tooth extraction process should reach its maximum after 24 to 48 hours. So to bring this swelling down more quickly, apply a warm moist towel to the swollen area for 20 minutes followed by 20 minutes of no application. Repeat this cycle, as you find necessary.
Keeping the extraction site clean.
In general, the cleaner you keep the extraction site (the hole in the bone where the tooth has been removed, also referred to as the tooth's socket) the quicker it will heal. Beginning 24 hours after your tooth extraction, you can gently rinse the socket with warm salt water (1/2 teaspoon of salt in a cup of water) after meals and before bed. Do not use commercial mouth rinses. They may irritate the extraction site.
Stitches (resorbable and non-resorbable).
Your dentist may have found it necessary to place sutures ("stitches") in the extraction site after removing the tooth. Some types of stitches are resorbable (absorbable) and therefore will disintegrate and dissolve away on their own, others are not and will need to be removed by your dentist. If stitches were placed, make sure you know which type have been used. Usually a dentist will want to remove stitches that don't resorb in about a week or so after the extraction. The process of removing stitches is usually very easy and quite painless.
One of the more common complications people experience after a tooth extraction is that of developing a "dry socket." It is thought that dry sockets occur when either a blood clot has failed to form in the tooth socket (the hole left after extracting the tooth), or else the blood clot that did form has been dislodged. Since the formation of a blood clot is an important part of the healing process, the normal healing of the extraction site is interrupted.
Dry sockets are most frequently associated with difficult tooth extractions or extractions that have been traumatic in nature. An extraction that has involved the removal of bone from around a tooth in order for the dentist to access it, which is often the case when lower impacted wisdom teeth are removed, would be considered to be more traumatic in nature than an extraction where this step was not required.
People who follow their dentist's post-extraction recommendations will reduce their chances of developing a dry socket. Dry sockets are found to occur more often with women (even more so with those taking oral contraceptives), people over the age of 30, and smokers.
Typically dry sockets manifest themselves as a dull throbbing pain which doesn't appear until three or four days after the tooth extraction. The pain can be moderate to severe in intensity and often seems to radiate from the area of the extraction site to the ear. Dry sockets typically create a foul odor or bad taste. Visually, if you can see down into the socket, the extraction site appears "dry," in the sense that you just see exposed bone. There is no formation of pus.
Bone sequestra and tooth fragments.
Sometimes small fragments of dead bone (called a "sequestrum" [singular] or "sequestra" [plural]) will come to the surface of an extraction site as they are ejected by the patient's body during the healing process. This is more likely to occur in those cases where the tooth extraction has been relatively difficult or traumatic. Along these same lines, if the tooth broke or splintered during the extraction process you may find that small shards of tooth may come to the surface of the extraction site, even some weeks after the socket seems to have healed. You may be able to remove the smallest of these splinters of bone or tooth on your own, or you may find that you require, or want, your dentist's assistance in removing them.
Completion of the healing process.
Of course after a tooth has been extracted there will be a hole left in your jawbone where the tooth has been removed (the tooth's socket). As time passes the shape of this hole will smooth over and fill in with bone. While it can take many weeks and months for this healing process to occur fully, from a practical standpoint after 1 to 2 weeks enough healing will have occurred that the extraction site should be of only minor inconvenience to you.
There are several options to consider when replacing missing teeth. Dentures and dental implants are the two most common solutions. The two differ in longevity, comfort, confidence while wearing, and effect on your pocket book.
Many people with missing teeth wear conventional upper and lower dentures or partial dentures and many are unhappy with them. Lower dentures never fit or feel like natural teeth. They become loose fitting due to shrinking gum tissue, which then causes irritation to the mouth, sores and pain. Lower dentures also restrict your ability to eat or talk as you had with your natural teeth. The only relief is in using messy dental adhesive to improve the fit.
Upper dentures are a bit different. They are easier to wear because the suction in upper palate (roof of the mouth) helps keep the denture in place. But having the palate covered can also reduce the taste of foods that you are eating. Sores and pain in chewing and talking are quite frequent as the gum tissue shrinks, and many people suffer from having to use dental adhesive with upper dentures as well.
Removable partial dentures might be used when only several teeth are missing. A partial denture anchors to the teeth on either side of the empty area using a metal clasp. This can be very damaging to these teeth. Removable partial dentures can also be hard on the gum tissue when chewing and talking.
The advantage of upper and lower dentures is that they can be constructed quickly and they initially cost less than implants. They may last a lifetime, but over the years with aging, new sets need to be made to fit the changing gum tissue and chewing surfaces of the teeth in the dentures.
Dental Implants – A Better Solution
With the introduction of dental implants, the need to suffer with uncomfortable restorations has been eliminated. As our life span has been increasing, the need for some type of highly functional dental replacement system has become increasingly important. Dental implants are permanent dental replacements that are both natural looking and very functional. Implants look much better and feel better, and offer the same force for biting as natural teeth. If you are a non-smoker with good oral hygiene habits, dental implants should last for a lifetime.
Dental implants are a major investment and the procedure can be time consuming. As with any complex surgery, there is always the risk of complication even after a thorough examination and consultation prior to care. But dental implants are a dependable and life long solution to missing teeth. Compared with dentures, which can be loose and unstable, implants provide a permanent solution that is both functional and natural in appearance, giving you the confidence to smile and show your pearly whites.
Both dentures and dental implants have progressed rapidly over the years. Many people are finding that dental implants are the most desirable solution for missing teeth. Implants allow for a new found confidence while smiling, far exceeding the comfort and confidence found with dentures.
Dental implant bone grafting replaces missing bone lost from previous dental extractions, injuries, accidents, cysts, periodontal disease, infections along with many other causes. Although these procedures increase the cost of dental implants, they also help create more cosmetic and often more durable restorations.
Click on several techniques listed below.
• Block Bone Grafting
• Guided Tissue Regeneration
• Socket Preservation Grafting
In the blossoming world of cosmetic dentistry, teeth whitening reigns supreme. Universally valued by men and women alike, whitening (or bleaching) treatments are available to satisfy every budget, time frame and temperament. Whether in the form of one-hour bleaching sessions at your dentist's office, or home-use bleaching kits purchased at your local drugstore, teeth whitening solutions abound. Yet only 15 percent of the population has tried the cosmetic procedure, and misinformation on the subject is rife. The long and the short of it is that teeth whitening works. Virtually everyone who opts for this cosmetic treatment will see moderate to substantial improvement in the brightness and whiteness of their smile. However, teeth whitening is not a permanent solution and requires maintenance or "touch-ups" for a prolonged effect.