Today’s advanced dental treatments and materials can give you a healthier, more complete smile that can last you a lifetime. Your Pasadena, CA dentist, Dr. Marganian, can help revitalize and maintain your teeth and gums, giving you the smile you’ve always wanted.
We are a mercury-free practice. However, many people still have silver/mercury fillings in their mouths from years past. These fillings are not particularly pleasing to the eye, and we know that by unavoidable design, silver/mercury fillings ultimately result in a weaker tooth structure. Porcelain inlays and Tooth Colored Restorations (onlays) create fillings that are not only beautiful (or unnoticeable) but also add strength to weakened teeth. These restorations are esthetically pleasing and very strong thanks to new bonding technologies.
Disadvantages of Silver Fillings
Silver fillings have many drawbacks. The edges of the silver filling can wear down, become weak or break. This results in the tooth not being protected and lets cavities get started once again. With age, the metal of a silver filling expands, contracts, and can split.
Silver fillings contain 50 percent mercury. They can corrode, leak and cause stains on your teeth and gums.
Fortunately, silver fillings can safely be replaced with Tooth-Colored Restorations.
Advantages of Tooth-Colored Restorations
There are many advantages to tooth-colored restorations. Resin onlays are bonded to the teeth creating a tight, superior fit to the natural tooth. Such restorations can be used in instances where much of the tooth structure has been lost. The tooth remains intact and stronger.
Since the resin used in tooth-colored restorations contain fluoride this can help prevent decay. The resin wears like natural teeth and does not require placement at the gum line, which is healthier for your gums!
The result is a beautiful smile!
Replacing Silver Fillings with a Tooth Colored Restoration
You can have your silver fillings replaced with tooth-colored restorations (onlays). This process requires two appointments.
Your First Appointment:
- The old filling is removed along with any additional decay.
- An impression is made of your teeth. A model of your teeth is made and sent to the lab.
- A temporary onlay is placed on the tooth.
At the Lab: A resin is carefully placed into the model of your teeth. It is then designed to look natural.
Your Second Appointment:
- The temporary onlay is removed.
- A conditioning gel is placed on your tooth to prepare it for the new onlay.
- Bonding cement is placed on the tooth and a high intensity light bonds the resin to the tooth.
- The tooth is then polished.
Your teeth are restored to a natural look and feel, they are stronger and the tooth is protected!
Dental Amalgam is a commonly used dental filling that has been used for over 150 years. It is a mixture of mercury with at least one other metal. Amalgam has many advantages over other restorative material, such as low cost, strength, durability, and bacteriostatic effects.
Amalgam is used in dentistry for a number of reasons. It is relatively easy to use and manipulate during placement; it remains soft for a short time so it can be packed to fill any irregular volume, and then forms a hard compound. Amalgam possesses greater longevity than other direct restorative materials, such as composite. On average, most amalgam restorations serve for 10 to 12 years, whereas resin-based composites serve for about half that time. However, with recent improvements in composite material science and a better understanding of the technique-sensitivity of placement, it should be noted that this difference is decreasing.
There are circumstances in which composite (white fillings) serves better than amalgam; when amalgam is not indicated, or when a more conservative preparation would be beneficial, composite is the recommended restorative material. These situations would include small occlusal restorations, in which amalgam would require the removal of a more sound tooth structure, as well as in “enamel sites beyond the height of contour.”
The American Dental Association Council on Scientific Affairs has concluded that both amalgam and composite materials are considered safe and effective for tooth restoration.
A denture or a complete denture as it is often called, is an appliance that is inserted in the mouth, replaces natural teeth and provides support for the cheeks and lips.
Most dentures are made of acrylic and can be fabricated two different ways.
- A conventional denture is made after all teeth have been extracted and the tissues (gums) have healed.
- An immediate denture is fabricated and inserted immediately after the teeth are extracted and the tissues are allowed to heal under the denture.
- An upper denture has acrylic, usually flesh colored, that covers the palate (roof of the mouth).
- A lower denture is shaped like a horseshoe to leave room for the tongue.
The teeth are made of plastic, porcelain or a combination thereof. Dentures can be fabricated to fit over endodontically treated teeth and a complete denture can be attached to dental implants to allow for a more secure fit of the appliance.
Dentures over a normal course of time will wear and need to be replaced or relined in order to keep the jaw alignment normal. The alignment will slowly change as the bone and gum ridges recede or shrink due to the extraction of the teeth. Regular dental examinations are still important for the denture wearer so that the oral tissues can be checked for disease or change.
All of your teeth play an important role in speaking, chewing and in maintaining proper alignment of other teeth. Tooth loss doesn’t necessarily have to occur as you age, but if you do lose teeth they must be replaced to maintain proper function of your mouth. Fortunately, there are options for correcting tooth loss.
Dental Bridge Options
A bridge — a device used to replace missing teeth — attaches artificial teeth to adjacent natural teeth, called abutment teeth. Bridges are either permanently attached (fixed bridges), or they can be removable.
Fixed bridges are applied by either placing crowns on the abutment teeth or by bonding the artificial teeth directly to the abutment teeth. Removable bridges are attached to the teeth with metal clasps or by precision attachments.
If you’re missing one or more teeth, you may be aware of their importance to your appearance and dental health. Your teeth work together for many daily functions from eating to speaking. With missing teeth, it’s difficult to do these things. Missing teeth can and should be replaced. Fixed bridges are a great way to restore your dental health and appearance.
What exactly is a bridge or fixed partial denture?
A bridge (fixed partial denture) is a device which fills the gap where teeth are absent. Fixed bridges are bonded into place and can only be removed by a dental professional. Removable bridges, as the name implies, can be taken out and cleaned. Fixed bridges offer more stability than their removable counterparts.
Why do I need a bridge?
Oral functionality and appearance are important reasons for wearing a bridge. A bridge helps support your lips and cheeks. The loss of a back tooth may cause your mouth to sink and your face to look older.
Dental health is the most important reason for a bridge. Teeth were designed to complement each other. Unusual stresses are placed on the gums and other oral tissues when teeth are missing, causing a number of potentially harmful disorders.
Increased risk of gum disease has proven to be one of the worst side effects of missing teeth and can be minimized with a bridge.
Missing teeth can cause speech disorders as they are used to make many of the sounds we use to speak clearly.
How is a bridge attached?
The attachment procedure usually takes two or three appointments to complete. At the first appointment Dr. Marganian will prepare the teeth on either side of the gap by removing a portion of the enamel and dentin.
Since the bridge must be fabricated very precisely to ensure correct bite and to match the opposing tooth, impressions of the teeth are taken and sent to a lab where the bridge will be constructed.
Fixed bridges are typically cemented to the natural teeth next to the space left by the missing tooth. A pontic (false tooth) replaces the lost tooth. Crowns, which are cemented onto the natural teeth, provide support for the bridge.
What materials are used?
Bridges can be constructed from gold alloys, non-precious alloys, porcelain, or a combination of these materials. Porcelain is often bonded to either precious or non-precious metal.
How do I take care of my bridge?
A strict regimen of brushing and flossing will keep the bridge and surrounding teeth clean. This is of critical importance as the bridge relies on the neighboring teeth for support.
Dental implants are designed to provide a foundation for replacement teeth that look, feel and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything and can smile with confidence, knowing that teeth appear natural and that facial contours will be preserved. The implants are tiny titanium posts which are placed into the jawbone where teeth are missing. The bone bonds with the titanium, creating a strong foundation for artificial teeth. In addition, dental implants can help preserve facial structure, preventing the bone deterioration which occurs when teeth are missing.
Dental implants are changing the way people live! With them, people are rediscovering the comfort and confidence to eat, speak, laugh and enjoy life.
Evaluation for Dental Implants
If, like many others, you feel implant dentistry is the choice for you, we ask that you undergo a dental/radiographic examination and health history. During these consultation visits, your specific needs and considerations will be addressed by either Dr. Marganian or by an Oral and Maxillofacial Surgeon referred by our practice. Your questions and concerns are important to us and our team will work with you very closely to help make your procedure a success.
Dental Implant Procedure
Dental implants are metal anchors, which act as tooth root substitutes. They are surgically placed into the jawbone. Small posts are then attached to the implant, which protrude through the gums. These posts provide stable anchors for artificial replacement teeth.
For most patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jawbone. For the first three to six months following surgery, the implants are beneath the surface of the gums, gradually bonding with the jawbone. You should be able to wear temporary dentures and eat a soft diet during this time. At the same time, your restorative dentist designs the final bridgework or denture, which will ultimately improve both function and aesthetics.
After the implant has bonded to the jawbone, the second phase begins. The surgeon will uncover the implants and attach a small healing collar. Dr. Marganian can then start making your new teeth. An impression must be taken. Then posts or attachments can be connected to the implants. The replacement teeth are then made over the posts or attachments. The entire procedure usually takes six to eight months. Most patients do not experience any disruption in their daily life.
Most dentistry looks like dentistry. Our goal is to provide dentistry that is undetectable. We replace existing crowns and fillings with restorations that look and feel like your natural teeth.
Where damage to a person’s teeth is extreme, and apparently beyond repair, we can use porcelain or porcelain “pasted on gold” crowns to make the smile appear “as new”. This is an extremely reliable technique for repairing the most severe of dental problems, even permanently replacing missing teeth to offer a complete smile and a functional bite. We are renowned for the quality of our work and the fantastic changes we make for people using this technology. These treatments are used for a long-lasting correction of major dental problems. It is usual for these treatments to last for 20 to 30 years, which is as close to permanent as dental treatment can get.
How long does it take to fit a dental crown?
Fitting a crown requires at least two visits to our office. Initially, we will remove decay, shape the tooth, and fit it with a temporary crown of either plastic or metal.
On the subsequent visit we will remove the temporary crown, and then fit and adjust the final crown. Finally, we will cement the crown into place and you have a new beautiful looking tooth.
Key Benefits of Dental Crowns
- Replaces missing teeth
- Offers support to misshapen teeth or badly broken teeth
- Looks completely natural
- Fixes “smile” and functional chewing problems
What are the capabilities of crowns?
Crown and bridgework is a very reliable solution for major dental problems caused through accidents, diseases or wear and tear. Major problems can usually be corrected using these techniques. Material used in these repairs is either high-grade porcelain, or porcelain bonded to gold. A higher strength of the porcelain and gold materials is recommended to treat the most serious of dental problems. Where accidental damage has occurred, resulting in lost teeth, or where teeth have broken away through excessive wear, or as the result of old fillings breaking, crowns and/or bridges can be used as a long-term solution.
Many people have unexplained pain from filled back teeth, which is usually due to hairline cracks in the chewing part of the tooth. Placing crowns on these teeth relieves the pain and allows a return of full dental function for these teeth. In front teeth, older fillings can both weaken the teeth and cause “appearance” problems due to staining or chipping. Porcelain crowns and bridges are suitable in cases where porcelain veneers are not. In teeth with root canal fillings, crowns can prevent breakage.
You and Dr. Marganian may determine that you need a tooth extraction for any number of reasons. Some teeth are extracted because they are severely decayed; others may have advanced periodontal disease, or have broken in a way that cannot be repaired. Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth), or in preparation for orthodontic treatment.
The removal of a single tooth can lead to problems related to your chewing ability, problems with your jaw joint, and shifting teeth, which can have a major impact on your dental health.
To avoid these complications, in most cases, Dr. Marganian will discuss alternatives to extractions as well as replacement of the extracted tooth.
The Extraction Process
At the time of extraction the doctor will need to numb your tooth, jawbone and gums that surround the area with a local anesthetic.
During the extraction process you will feel a lot of pressure. This is from the process of firmly rocking the tooth in order to widen the socket for removal.
You feel the pressure without pain as the anesthetic has numbed the nerves stopping the transference of pain, yet the nerves that transmit pressure are not profoundly affected.
If you do feel pain at any time during the extraction please let us know right away.
Sectioning a tooth
Some teeth require sectioning. This is a very common procedure done when a tooth is so firmly anchored in its socket or the root is curved and the socket can’t expand enough to remove it. The doctor simply cuts the tooth into sections then removes each section one at a time.
After Tooth Extraction
After tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. Bite on a gauze pad for 30-45 minutes immediately after the appointment. If the bleeding or oozing still persists, place another gauze pad and bite firmly for another 30 minutes. You may have to do this several times to staunch the flow of blood.
After the blood clot forms it is important to not disturb or dislodge the clot. Do not rinse vigorously, suck on straws, smoke, drink alcohol or brush teeth next to the extraction site for 72 hours. These activities may dislodge or dissolve the clot and hinder the healing process. Limit vigorous exercise for the next 24 hours, as this increases blood pressure and may cause more bleeding from the extraction site.
After the tooth is extracted you may feel some pain and experience some swelling. An ice pack or an unopened bag of frozen peas or corn applied to the area will keep swelling to a minimum. Take pain medications as prescribed. The swelling usually subsides after 48 hours.
Use pain medication as directed. Call our office if the medication doesn’t seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time even if signs and symptoms of infection are gone. Drink lots of fluids and eat nutritious, soft food on the day of the extraction. You can eat normally as soon as you are comfortable.
It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean.
After a few days you should feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, continued swelling for 2-3 days, or a reaction to the medication, call our office immediately.
Dr. Marganian is proud to offer the latest technology available for periodontal therapy: laser treatment. There are numerous advantages to using laser therapy as opposed to the traditional methods requiring a scalpel and sutures.
With laser treatment, there is reduced or no bleeding, minimized swelling, no charring, and no drill noise or vibration. The stress and anxiety often associated with dental work is therefore eliminated when you experience quick, effective, and essentially pain-free laser procedures. Also, postoperative sensitivity is greatly limited by laser dentistry, and recovery time is much quicker than with traditional methods. In fact, due to the less-invasive nature of the laser technique, the mouth begins to heal immediately after work is completed!
Reduced Risk of Infection:
The laser’s high-energy light beam acts as a sterilizer on the area it is working, thereby reducing the risk of bacterial infections and relapses.
Anesthesia Limited or Eliminated:
Because laser dentistry is virtually painless, no longer will you suffer with fear of injections and numbness. Often, only a light anesthetic spray is required. Laser treatment eliminates the complications and cost associated with anesthesia.
Dr. Marganian can perform a variety of procedures using laser technology, such as a frenectomy, osseous surgery, and gum grafting. Dr. Marganian is also able to use laser technology as a way to regenerate healthy gums and remove diseases areas in a virtually painless way. This method also encourages healthy gum to regenerate and attach to the teeth. There is a much lower chance of gun disease returning when laser therapy is used as opposed to traditional surgery.
What is a root canal?
A root canal is one of the most common dental procedures performed, well over 14 million every year. This simple treatment can save your natural teeth and prevent the need of dental implants or bridges.
At the center of your tooth is pulp. Pulp is a collection of blood vessels that helps to build the surrounding tooth. Infection of the pulp can be caused by trauma to the tooth, deep decay, cracks and chips, or repeated dental procedures. Symptoms of the infection can be identified as visible injury or swelling of the tooth, sensitivity to temperature or pain in the tooth and gums.
How is a root canal performed?
If you experience any of these symptoms, your dentist will most likely recommend non-surgical treatment to eliminate the diseased pulp. This injured pulp is removed and the root canal system is thoroughly cleaned and sealed. This therapy usually involves local anesthesia and may be completed in one or more visits depending on the treatment required. Success for this type of treatment occurs in about 90% of cases. If your tooth is not amenable to endodontic treatment or the chance of success is unfavorable, you will be informed at the time of consultation or when a complication becomes evident during or after treatment. We use local anesthesia to eliminate discomfort. In addition, we will provide nitrous oxide analgesia if indicated. You will be able to drive home after your treatment, and you probably will be comfortable returning to your normal routine.
What happens after treatment?
When your root canal therapy has been completed, a record of your treatment will be sent to your restorative dentist. You should contact their office for a follow-up restoration within a few weeks of completion at our office. Your restorative dentist will decide on what type of restoration is necessary to protect your tooth. It is rare for endodontic patients to experience complications after routine endodontic treatment or microsurgery. If a problem does occur, however, we are available at all times to respond. To prevent further decay, continue to practice good dental hygiene.
How much will it cost?
The cost associated with this procedure can vary depending on factors such as the severity of damage to the affected tooth and which tooth is affected. In general, endodontic treatment is much less expensive than tooth removal and replacement with an artificial tooth.