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Dental Health Related Questions, Answered for You

PATIENT EDUCATION

Detailed info on the most common dental procedures, including braces, bleaching, bridges, dentures, dental implants, fillings, root canal.
Provided by: Dentpedia Network

DENTAL BRACES

Dental braces or orthodontic braces are a device used in orthodontics to correct alignment of teeth and their position with regard to bite. Braces are often used to correct malocclusions such as underbites, overbites, cross bites and open bites, or crooked teeth and various other flaws of teeth and jaws, whether cosmetic or structural. Orthodontic braces are often used in conjunction with other orthodontic appliances to widen the palate or jaws, create spaces between teeth, or otherwise shape the teeth and jaws. Most orthodontic patients are children or teenagers, however, recently, more adults have been seeking orthodontic treatment.

ROOT CANALS

Root canals is the commonly used term for the main canals within the dentin of the tooth. These are part of the natural cavity within a tooth that consists of the dental pulp chamber, the main canals, and sometimes more intricate anatomical branches that may connect the root canals to each other or to the root surface of the tooth. Root canals are filled with a highly vascularized, loose connective tissue, the dental pulp. This sometimes becomes infected and inflamed, generally due to caries or tooth fractures that allow microorganisms, mostly bacteria from the oral flora or their byproducts, access to the pulp chamber or the root canals; the infected tissue is removed by a surgical intervention known as endodontic therapy and commonly called 'a root canal'.

FLUORIDE THERAPY

Fluoride therapy is the delivery of fluoride to the teeth topically or systemically, which is designed to prevent tooth decay (dental caries) which results in cavities. Most commonly, fluoride is applied topically to the teeth using gels, varnishes, toothpaste/dentifrices or mouth rinse.

Systemic delivery involves fluoride supplementation using tablets or drops which are swallowed. This type of delivery is rarely used where public water supplies are fluoridated, but is common (along with salt fluoridation) in some European countries.

INLAYS

Sometimes, a tooth is treatment planned to be restored with an intracoronal restoration, but the decay or fracture is so extensive that a direct restoration, such as amalgam or composite, would compromise the structural integrity of the restored tooth by possibly undermining the remaining tooth structure or providing substandard opposition to occlusal (i.e. biting) forces. 
In such situations, an indirect gold restoration may be indicated.
 When gold is used, the tooth-to-restoration margin may be finished and polished to such a super-fine line of contact that recurrent decay will be all but impossible. It is for this reason that some dentists recommend gold as the restorative material of choice for pretty much any and all restorations. 

ONLAYS

When decay or fracture incorporate areas of a tooth that make amalgam or composite restorations essentially inadequate, such as cuspal fracture or remaining tooth structure that undermines perimeter walls of a tooth, a gold onlay might be indicated. Similar to an inlay, a gold onlay is an indirect restoration which incorporates a cusp or cusps by covering or onlaying the missing cusps. All of the benefits of a gold inlay are present in the onlay restoration. The onlay allows for conservation of tooth structure when the alternative is to totally eliminate cusps and perimeter walls for restoration with a crown. Because onlays have a very long margin (i.e. the line of tooth-to-restoration contact is much longer than that of a crown because of the many turns and curves that an onlay makes in contacting the tooth), some dentists feel that an onlay is a fundamentally inferior restoration. This is because it is primarily the marginal adaptation of any dental restoration that will decide whether or not it will successfully remain in the mouth without exhibiting recurrent decay. The increase in marginal length consequently provides a further likelihood of failure.

DENTAL RESTORATIONS

A dental restoration or dental filling is a dental restorative material used artificially to restore the function, integrity and morphology of missing tooth structure. The structural loss typically results from caries or external trauma. It is also lost intentionally during tooth preparation to improve the aesthetics or the physical integrity of the intended restorative material. Dental restoration also refers to the replacement of missing tooth structure by restoring dental implants.

Dental restorations may be fabricated out of a variety of materials.
Common direct restorative materials include dental amalgam, glass ionomer cement and composite resins. Common indirect restorative materials include acrylic, porcelain, gold and other metals.

Dental restorations can be divided into two broad types: direct restorations and indirect restorations. All dental restorations can be further classified by their location and size.

AMALGAM FILLINGS

Used by dentists for more than a century, dental amalgam is the most thoroughly researched and tested restorative material among all those in use. It is durable, easy to use, highly resistant to wear and relatively inexpensive in comparison to other materials. For those reasons, it remains a valued treatment option for dentists and their patients.
   
Dental amalgam is a stable alloy made by combining elemental mercury, silver, tin, copper and other metallic elements. However, the mercury in amalgam combines with other metals to render it stable and safe for use in filling teeth.

COMPOSITE FILLINGS

Composite fillings are a mixture of glass or quartz filler in a resin medium that produces a tooth-colored filling. They are sometimes referred to as composites or filled resins. Composite fillings provide good durability and resistance to fracture in small-to-mid size restorations that need to withstand moderate chewing pressure. Less tooth structure is removed when the dentist prepares the tooth, and this may result in a smaller filling than that of an amalgam. Composites can also be "bonded" or adhesively held in a cavity, often allowing the dentist to make a more conservative repair to the tooth.

IONOMERS

Glass ionomers are translucent, tooth-colored materials made of a mixture of acrylic acids and fine glass powders that are used to fill cavities, particularly those on the root surfaces of teeth. Glass ionomers can release a small amount of fluoride that may be beneficial for patients who are at high risk for decay. When the dentist prepares the tooth for a glass ionomer, less tooth structure can be removed; this may result in a smaller filling than that of an amalgam.
   
Glass ionomers are primarily used in areas not subject to heavy chewing pressure. Because they have a low resistance to fracture, glass ionomers are mostly used in small non-load bearing fillings (those between the teeth) or on the roots of teeth.

DENTAL CROWNS

Crown refers to the restoration of teeth using materials that are fabricated by indirect methods which are cemented into place. A crown is used to cap or completely cover a tooth.

Traditionally, the teeth to be crowned are prepared by a dentist and records are given to a dental technician to fabricate the crown or bridge, which can then be inserted at another dental appointment. The main advantages of the indirect method of tooth restoration include:

DENTAL BRIDGES

A dental bridge, otherwise known as a fixed partial denture, is a prosthesis used to replace missing teeth and is not removable by the patient. A prosthesis that is removable by the patient is called a removable partial denture.

A dental bridge is fabricated by reducing the teeth on either side of the missing tooth or teeth by a preparation pattern determined by the location of the teeth and by the material from which the bridge is fabricated. In other words the abutment teeth are reduced in size to accommodate the material to be used to restore the size and shape of the original teeth in a correct alignment and contact with the opposing teeth. 

LASER USE IN DENTISTRY

Lasers have been used in dentistry since 1994 to treat a number of dental problems. But, despite FDA approval, no laser system has received the American Dental Association's Seal of Acceptance. That seal assures dentists that the product or device meets ADA standards of safety and efficacy, among other things. The ADA, however, states that it is cautiously optimistic about the role of laser technology in the field of dentistry. These lasers are different from the cold lasers used in phototherapy for the relief of headaches, pain, and inflammation.

DENTAL SEALANTS

A sealant is a plastic material that is usually applied to the chewing surfaces of the back teeth: premolars and molars. This plastic resin bonds into the depressions and grooves (pits and fissures) of the chewing surfaces of back teeth. The sealant acts as a barrier, protecting enamel from plaque and acids.

Thorough brushing and flossing help remove food particles and plaque from smooth surfaces of teeth. But toothbrush bristles cannot reach all the way into the depressions and grooves to extract food and plaque. Sealants protect these vulnerable areas by "sealing out" plaque and food.