Dentures

Dentures

A denture is a removable appliance that is inserted in the mouth, replaces some or all of the natural teeth and provides support for the cheeks and lips.  A partial denture can often be used when the remaining natural teeth are healthy and in reasonable alignment.  A full denture may be used when a person has lost all of the upper or all of the lower teeth.

A typical partial denture is attached to the anchor teeth by means of metal or resin clasps, and is supported by a combination of its precise fit over the gum tissue and the attachment to the anchor teeth.  Precision attachments are a means of attaching a partial denture without the use of a visible clasp and also provide enhanced retention.

A full denture sits completely on the underlying gum tissue and is retained by the intimacy of its fit and by the facial muscles and the tongue.  Dentures can also be adapted to work with dental implants to enhance their stability, retention and functionality.  With the right combination of implants and dentures, lost function can be regained, facial support can be restored, and patients previously unable to eat any but the softest foods can resume a normal diet and lifestyle.  Some of Dr Hunting’s happiest patients are those that he has helped to regain lost function with this combination of implants and dentures.

Over a normal course of time, dentures 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.

Extractions

Extractions

You and Dr. Hunting may determine that you need a tooth extracted for any number of reasons.  Some teeth are extracted because they are severely decayed.  Others may have advanced periodontal disease or are 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.  Dr. Hunting can accomplish most routine extractions, but for more complex cases, will recommend the services of a surgical specialist.

The removal of even 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, Dr. Hunting will discuss alternatives to extractions as well as replacement of the extracted tooth.

Root Canals

Root Canals

When the nerve of a tooth dies, whether due to trauma or deep decay, a root canal is often recommended prior to a final restoration as a means to relieve pain and prevent infection.  The process involves the complete cleaning of the hollow space inside the tooth, followed by careful shaping of that space in such a way that a filling can be placed down the entire length of the root.

Front teeth generally have one or possibly two canals which need treatment, but molar teeth frequently have four or more canals. Furthermore, while front teeth generally have straight canals, molars often have curved or bent canals.  It is imperative that all canals be cleaned and filled for the procedure to be successful.  Dr. Hunting can take care of many of your root canal needs, but is also very proficient in identifying those complex cases better treated by specialists.  We work with several excellent board certified Endodontists,  who have specialized equipment and training for handling the most difficult cases.

Dental Implants

Dental Implants

Along with high strength ceramics and composite resins, Dental Implants represent technological advancement that has changed the way modern dentistry is done.  Dental Implants give us options for tooth replacement that did not exist 30 years ago.  In addition, Dental Implants are one of the most predictable procedures in restorative dentistry, with an impressive record of long-term success.

Dental implants are designed to provide a foundation for replacement teeth.  These replacement teeth may be in the form of permanently cemented crowns or bridges, or may be in the form of fixed or fixed detachable full or partial dentures.  The person who has lost teeth regains the ability to eat virtually anything and can smile with confidence, knowing that their teeth appear natural and that their facial contours will be preserved.  The implants themselves are small titanium anchors that are placed into the jawbone where teeth are missing.  The bone bonds with the titanium, creating a strong foundation for artificial teeth.  In addition, implants can help preserve facial structure, preventing the bone deterioration that occurs when teeth are missing.

Dental implants are changing the way people live!  With dental implants, people are rediscovering the comfort and confidence to eat, speak, laugh, and enjoy life.  For most patients, the placement and restoration of dental implants is an uncomplicated and relatively easy procedure.

If, after consulting with Dr Hunting, you feel implant dentistry is the choice for you, you will be referred to an Oral and Maxillofacial Surgeon or Periodontist for consultation.  Dr. Hunting feels that implant dentistry is best performed utilizing a team approach and collaborates with highly experienced surgeons to accomplish the planning and placement phases of the implant process.  Following the placement of the implants, and allowing some time to pass, during which the jawbone will connect to the implant or implants on a microscopic level, Dr. Hunting will complete your restoration with beautiful, natural-looking and functional teeth.  Your questions and concerns are important to us.  Our team will work with you very closely to help make your procedure a success.

Inlay / Onlay

Inlay / Onlay

When over half of the tooth’s biting surface is damaged, Dr. Hunting will often use an inlay or onlay.  Inlays and onlays can be made of porcelain, gold, or composite resin.  These pieces are bonded to the damaged area of the tooth.  An inlay (which is similar to a filling) is used inside the cusp tips of the tooth.  An onlay is a more substantial reconstruction, similar to the inlay, but extending out over one or more of the cusps of the tooth.

Traditionally, gold has been the material of choice for inlays and onlays.  In recent years, however, porcelain has become increasingly popular due to its strength and color that can potentially match the natural color of your teeth.

Inlays and onlays require two appointments to complete.  During the first visit, the filling being replaced or the damaged or decayed area of the tooth is removed, and the tooth is prepared for the inlay or onlay.  An accurate impression of the tooth will be taken so that our lab can construct a model of your tooth on which your restoration will be fabricated.  Dr. Hunting will then apply a temporary restoration for the tooth and schedule the next appointment.

At the second appointment, the temporary restoration is removed.  Dr. Hunting will then make sure that the inlay or onlay fits correctly.  If the fit is satisfactory, the inlay or onlay will be bonded to the tooth with a strong resin and polished to a smooth finish.

As a result of the materials from which they are made, and the techniques by which they are bonded to the tooth, inlays and onlays are much stronger than traditional fillings.  Traditional fillings can reduce the strength of a natural tooth by up to 50 percent.  As an alternative, inlays and onlays can preserve or even enhance the strength of your tooth.  As a result, they can last from 10 to 30 years.  In some cases where the damage to the tooth is not extensive enough to merit a full crown, an onlay can provide a very good and conservative alternative.

Tooth Whitening

Tooth Whitening

Having a beautiful smile may be even easier than you think. Many people achieve the look they’ve been dreaming of with our simple “bleaching” procedure.  It’s safe, quick, and inexpensive. Just let us know at any appointment if you would like to have your teeth whitened.  You can lighten only your upper teeth or both the upper and lower, depending on how much of each shows when you talk and smile.

With simple impressions, we will create models of your teeth.  In just a few days, your custom bleach trays will be ready for you. We provide you with a special bleaching agent that you put into the clear, nearly invisible trays.  Usually worn overnight, for around two weeks, our special bleaching agent bubbles stains right out of your enamel without altering tooth structure or existing dental work in any way. When your teeth reach the brightness you want, only occasional treatment is needed to maintain your new smile.

Dental bleaching can be used to correct many tooth discolorations. These discolorations may have been caused by staining, aging, or chemical damage to teeth. Using the latest in bleaching technology, we can offer a safe method for creating a beautiful, “brilliant” smile. In cases of extreme tooth discoloration, crowns, or veneers may be the only choice.  However, because of the low cost of bleaching treatments, bleaching is nearly always worth a try.

Dental Bridge

Dental Bridge

All of your teeth play an important role in speaking, chewing, and 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. A dental bridge is an option for replacement of missing teeth. A dental bridge attaches artificial teeth to adjacent natural teeth, called abutment teeth. Bridges are permanently attached with dental cement to these abutment teeth. Fixed bridges are applied either by placing crowns on the abutment teeth or by bonding artificial teeth directly to the abutment teeth using retainers called wings. Like crowns, bridges are made of gold, porcelain, or a combination thereof. Also like crowns, the recommended materials used in construction of bridges has evolved over the years. Today, in most applications, all ceramic bridges, made with modern, high-strength ceramics are the material of choice not only for their enhanced esthetic properties, but because they are also much stronger than other options. The advantages and benefits of replacing a missing tooth or teeth with a bridge must be weighed against the pros and cons of other tooth replacement options. Usually, there may be an option to use a dental implant or a removable partial denture to replace a missing tooth. Which is better is largely dependent on an individual situation. Dr. Hunting is highly experienced with all these treatment methods and will thoroughly review your situation and educate you as to your options so that you can make the best choice for yourself.

Dental Crown

Dental Crown

When a tooth needs a restoration more extensive than a filling or an onlay, a crown (also known as a “cap”) is frequently recommended.  Usually a tooth in need of a crown would have extensive decay, a missing cusp as a result of a fracture, a large defective previous restoration, or a recent root canal.  Sometimes, crowns are recommended to prevent the propagation of a crack further into the tooth, or down the root.  Alternatively, crowns are done as a means of restoring proper occlusion to worn teeth, or in the process of cosmetically enhancing the front teeth.

Crowns have undergone some major changes over the years.  In the late 1900s, and very early 2000s we had essentially two options for crown construction.  Gold crowns were a tried and true procedure then, and remains so today, but there are obvious cosmetic limitations associated with them.  PFM (porcelain fused to metal) crowns were the best option we had in a crown that looked somewhat like a tooth.  Although we could do pretty well in matching the color of the crown to the adjacent natural teeth, matching the natural translucency of a tooth was always a problem because of the need to prevent the metal under the porcelain from showing.  In addition, PFM crowns are frequently characterized by a visible line at the margin (the edge adjacent to the gumline), especially in situations where the patient has had some slight recession of the gums.

Even as early as the 1950s, there has been a third option for a crown, namely a “metal-free” porcelain crown.  The problem has been that, until recently, these all ceramic crowns were either very weak and exhibited frequent breakage, or were very limited as to color options.

Dental materials scientists bring us an almost constant stream of new products, many of which are designed to be “easier” though not necessarily “better”.  We have to be very careful in selecting materials that are well tested and founded in solid science.  In the past ten years, we have seen the introduction of “high strength dental ceramics” that have truly revolutionized the practice of restorative and cosmetic dentistry.  With these modern ceramics, our technicians can create beautiful and truly lifelike crowns which are many times stronger than a similar PFM.  These materials also allow us to use ceramic tooth colored crowns in areas where previously we had no choice but to use gold.

Although there are still occasional situations calling for the use of the PFM technique, Dr. Hunting will almost always suggest the use of a “metal-free” crown.  In the past, most dentistry looked 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.

The process for making a crown generally consists of two appointments.  At the first visit, the tooth is prepared for the crown.  This may consist of removal of an old restoration, cleaning out decay, placement of a “buildup” filling to restore the ideal shape of the preparation, and ultimately, shaping the tooth by shaving down the sides and the biting surface to create a smooth peg over which the crown will be cemented.  A mold of the completed preparation will be made and a temporary crown will be placed.  The mold will be sent to the dental laboratory along with detailed instructions from Dr. Hunting for the fabrication of your crown.  After about a week, your crown will be ready.  Your second appointment will be very short.  All we need to do is to remove the temporary crown and cement the permanent crown.  Generally, local anesthesia is not required at cementation.  The cement sets in just a few minutes, and your new crown will be “ready to chew”.

A well made crown can be one of the most beautiful and durable dental restorations.  Though longevity is to a great extent determined by the effectiveness of the home care of the patient, it is not at all uncommon for crowns to last in excess of 15 years.  Dr. Hunting has several patients whom he has treated for nearly 30 years, and many of his original crowns are still providing good service today. 

Porcelain Veneers

Porcelain Veneers

Porcelain veneers are thin shells of ceramic that bond directly to the front of the teeth.  They are frequently an ideal choice for improving your smile and have become increasingly popular due to their conservative nature and their versatility.  Porcelain veneers may be used to correct gaps between teeth, teeth that are stained, broken, worn, poorly shaped, or crooked.  Porcelain veneers placed on your teeth can correct these maladies, simply and quickly and help you achieve a beautiful smile!

When bonded to the teeth, the ultra-thin porcelain veneers are virtually undetectable and highly resistant to coffee, tea, or even cigarette stains.  Well executed porcelain veneers made with modern high strength ceramics are one of the most esthetic and durable restorations available today.  Their resemblance to healthy, white tooth enamel is unsurpassed by other materials.  Because they are thin, light can shine through them and they take on the natural translucency of the underlying tooth.

With proper care, porcelain veneers will brighten your smile for well over a decade.  Dr. Hunting will ensure that your veneers are crafted by the most skilled technicians from the highest quality ceramics, and are bonded with the most advanced and proven materials available.

The placement of porcelain veneers consists of three phases.

Diagnosis and treatment planning
Preparation
Bonding
You will want to take an active role in planning enhancements to your smile.  Dr. Hunting will frequently perform a “cosmetic mock-up” procedure directly on your teeth to assist in your visualization of the possibilities for alteration, and also to demonstrate the corrective limitations of this procedure and help you plan your new smile.  Photographs of your teeth at a younger age or even of someone else whose teeth you wish yours looked more like can be a valuable tool when planning a redesign of your smile.

Although the porcelain veneers are very thin, many cases require a light reduction of the enamel on the front of the teeth to avoid bulkiness in the finished contour.  Usually, about one half millimeter to one millimeter is removed from the front of the tooth.  This may require some local anesthesia.  Following the completion of the shaping or preparation process, a mold is taken of the teeth and sent to the lab for fabrication.  In some cases, temporary veneers will be placed at this time.  The permanent porcelain veneers should be ready in approximately one to two weeks.

When your veneers are ready for bonding, Dr. Hunting will first place the veneer on your teeth with water or glycerin to check the fit and color.  At this point, the color of the veneer can still be adjusted by the shade of the cement used to adhere it.  Once the color is determined and the veneer is ready to be applied, the tooth is cleaned with specific chemicals to achieve a bond.  A special cement is placed between each tooth and veneer and a bright light is used to harden the cement.

When you leave the office, the resin cement will have set completely and your veneers will be strongly bonded and you can resume normal brushing and flossing.  Don’t be afraid that you will damage your veneers by doing so.  Non-abrasive toothpaste is recommended.  A good home care regimen will insure the best aesthetic success of your porcelain veneers.

If you are a known clincher (bruxer), please be sure to let us know. Dr. Hunting may recommend a soft nightguard for you to wear to minimize stress placed upon your teeth while you sleep.

Bonding

Bonding

Bonding is a term for the process by which restorative dental materials are attached to a tooth.  “Bonding” can be used to secure a crown, attach an inlay, onlay, or veneer, or to perform a direct restoration with dental composite.  Frequently, the term “bonding” is used to describe a cosmetic procedure to correct front teeth for conditions such as chipping, cracking, discoloration, and misalignment.  In many cases, though significantly less durable, this type of bonding can be viewed as an alternative to porcelain veneers or more invasive procedures like crowns.  On the plus side though, bonding can be much less costly than veneers.  In certain situations, bonding can be accomplished without the need for reduction of the tooth surface.

The tooth is prepared for the procedure by lightly etching the surface and applying a resin adhesive.  Once the adhesive is cured, Dr. Hunting will layer and sculpt the appropriate shade or shades of dental composite, and cure the material with a bright light.  Once set, the composite is trimmed, smoothed, and polished to a natural appearance.

The bonding procedure can often be completed in a single office visit, and can significantly improve the appearance of a tooth.  However, since the composite resin used is not as strong as your natural tooth enamel, it is more likely to stain, chip, or break than natural teeth.  Bonding typically lasts three to five years before repair is needed.