Home   Meet the Doctor   Dental Health   Cosmetic Dentistry   Advanced Services   FAQ   Hours   Map and Directions  
Barbara DeLucia, DMD

 ADVANCED PROCEDURES

CROWNS
Crowns are full coverage restorations that are used to cover a tooth that is likely to break, or is too broken down to be restored with a filling.  Crowns are most commonly done after root canal treatment, or when a existing filling becomes so large that the tooth has little structural support. The larger the tooth loss created by  untreated decay, the more likely a crown will be needed. The jaw muscles are the strongest in the human body. Teeth are subjected to tremendous pressures. Crowns are placed over the weakened tooth, providing strength and protecting the tooth against breakage. A broken or cracked tooth can be a more serious matter and may be much more difficult to treat. Crowns help prevent further breakdown of the tooth.

It usually takes two appointments to restore a tooth with a crown. In the first, any existing decay is removed from the tooth and the tooth is shaped for the crown. Then an impression is made of the tooth for use in laboratory fabrication of the crown. Between the two visits the crown is made, usually of high-strength porcelain over a gold alloy or all ceramic material. During this time a temporary crown is placed on the tooth for cosmetics and protection.  At the second visit this temporary is removed, and the permanent crown is adjusted and adhered to the tooth if no further crown alteration is necessary.

IMPLANTS
A dental implant is an option to replace a missing tooth. In this procedure, a small titanium shaft is surgically implanted into the bone. The bone grows around it forming a tight connection, which additionally slows or stops the bone loss that occurs when the root of a natural tooth is missing. Once the implant is firmly adhered to the bone,  a crown is then attached  on the top of the shaft.

Implants can also be used as partial supports to a fixed implant to tooth bridge. This is an alternative to partial dentures, and has several advantages. First, there is no adjustment period for the  the patient as the support for the bridge is not soft tissue which can be irritated by partials. Second, implants slows the naturally occuring bone loss in areas of extracted teeth. Third, there is no discomfort or difficulty in eating. And, best of all, they don't have to be taken out to be brushed, as the fixed bridge is permanently adhered.

ROOT CANAL TREATMENT
Root canal treatment (also referred oo as endodontic therapy) is necessary when either bacteria from decay is transferred to the pulp or the tooth becomes irritated from treatment and becomes 'inflammed'. (Regular cleanings and checkups prevent and detect problems early)  Deep restorations or trauma to a tooth may cause the nerve to be damaged to the point that it needs root canal therapy. Once this occurs the pulp undergoes an inflammatory process and becomes infected. The infection can  pass through the root tip and begin to absorb the bone away in the area of the root.  An abscess can subsequently develop. After  the pulp is infected it must be treated, as it cannot heal on its own. Antiobiotics can only subdue symptoms temporarily and is not a means of permanent treatment .  It is important to remove infections, through treatment to avoid further problems. Symptoms that the pulp has become infected may include sensitivity to hot/cold or sweets, pain, swelling, pain to biting or pressure, and a bad taste in the mouth. In certain cases, no symptoms occur for the patient and the patient is unaware of a dental problem until a checkup and/or xray is taken.

A root canal is then performed to clean out the infected tooth pulp, and disinfect the canals of the tooth. The only other treatment would be to extract the tooth. Once the infection is resolved, the canal(s) are filled in to prevent any further infection. Usually a core build-up and crown is recommended for restoring a tooth that has had root canal therapy.

BRIDGES
This is an option for filling the space created by a missing tooth. It is formed to look like the missing tooth, and it takes its place in the mouth. The sides of a bridge use the two surrounding teeth for support, hence the name. A bridge replaces the missing tooth, both functionally and cosmetically. Bridge work is as much an art as it is an exact science. The materials used may be gold alloys, porcelain bonded to metal alloy, or all ceramic material. The choice of material depends on requirements for strength, wear, and/or esthetics.

It is important that a missing tooth be replaced as soon as possible for several reasons. If not treated the teeth surrounding the gap begin to shift inward, creating a whole chain reaction of bad things. Teeth use their neighbors for support, and, with one missing, they start to "fall." As this worsens the bite changes in response to the pressure. This can eventually result in problems with the entire jaw, e.g. TMJ. The surrounding teeth deteriorate and it is just a matter of time before they, too, are lost. Gum disease becomes a serious problem, with the difficulty of treatment increasing as the neglect continues.

DENTURES
There are different types of dentures, but they share their common function. They replace teeth that have become loose or been lost due to bone loss. When bone loss around the roots of teeth is great enough to loosen them or let them fall out, it's time for dentures. Relax. No one enjoys losing their natural teeth, but you can still eat and talk regularly.

The entire mouth is examined and a determination is made as to which teeth will have to be removed, and which will remain. The loose teeth are then extracted. Dentures are fitted to go over or around whatever teeth remain in the mouth, depending on the type. There is an adjustment period after dentures are placed in the mouth, and it can take some getting used to. But once accustomed to the dentures, all the normal functionality and appearance return and one just carries on as usual. Often implants can used to further stabilize the dentures.

TMJ TREATMENTS
TMJ stands for temporo-mandibular joint. THis is the joint that functions to allow movement of the upper and lower jaws.   Symptoms in this joint may be caused by a misalignment of the teeth, trauma and excess muscle forces due to teeth clinching and grinding.  In addition to  the two bones that meet to allow function of the Temporo-mandibular Joint, there is a disc that buffers their interaction and five muscles that interact in the function and movement of this joint (jaw movement).  

Symptoms in this area can cause:

  • Headaches
  • Earaches
  • Discomfort/soreness in opening and closing the mouth
  • Clicking, popping and grating of the jaw
  • Pain in the jaw muscles
  • Soreness that can extend to the face

Conservative dental treatments for the tempor-mandibular joint disorder can include replacing missing teeth, correcting the alignment of teeth, adjusting the bite and muscle relaxation splint therapy.  Splint therapy is treatment with a labortaory fabricated device that covers the teeth and is worn by the patient to promote relaxation of the over worked muscles and reduction of the bite interferences that can promote the patient to clinch and grind their teeth.  It also reduces the damage of the teeth caused by continual clenching and grinding by transfering the distructive forces to the materials of the splint. If left untreated and the disorder progresses, surgery may be required to repair a badly damaged joint.  After a complete examination of the joint and the supporting structures, a diagnosis and treatment recommendation can be made.




                                            2 CONVENIENT LOCATIONS

PADDOCK PARK PROFESSIONAL CENTER              FRIENDSHIP CENTER (at On Top Of The World)

2701 SW 34th STREET                                                       8441 SW HIGHWAY 200

SUITE 200                                                                            SUITE 115

OCALA,  FL  34474                                                             OCALA,  FL  34481



          > Dental Education
          > Patient Information
          > Refer Our Office