At Ken Copeland Family Dentistry, we strive to provide the latest in long-lasting and cosmetically pleasing repairs (restorations) to your teeth. Our staff attends continuing education seminars frequently to learn about the newest materials and techniques. We offer options that suit any budget and work with you to create treatment that meets your needs (dental and financial). We go to great lengths to discuss the pros and cons of each type of restoration so that you may make an informed decision regarding your dental treatment and your unique circumstances.
A dental crown is placed over a tooth to improve strength, shape or appearance. Crowns, also known as “caps,” are created from several different materials. Most dentists, including Dr. Ken, recommend all-porcelain dental crowns because they provide the most natural-looking restorations as they closely resemble the color and texture of natural teeth. For restoring molars (back teeth), a gold crown or a porcelain fused to metal (PFM) crown might be recommended.
Crowns are used when more conservative dental restorations cannot be used to improve the strength or appearance of a damaged tooth, to strengthen and improve the appearance and size of a tooth that has been treated for a root canal, to restore a broken or cracked tooth, to cover a misshapen tooth, to serve as the final restoration for dental implants (replacement for the missing tooth), or to hold a dental bridge or partial dentures in place.
Crowns typically require two visits to the office: one to prepare the tooth and place a temporary crown and one to seat the permanent crown once it is received from the laboratory. We use a local lab (Diamond Dental Studios) to fabricate all the crowns Dr. Ken does not design in our office. If same day crowns sound more appealing to you, we also have an option for that. Dr. Ken can create crowns in our office using an E4D machine.
Modern dental technology has allowed for the capability of single visit dental crowns and restorations. Using a chairside computer and milling unit, called the E4D, Dr. Ken can now make porcelain crowns, inlays and onlays quickly in the office and bond them to the tooth in a single appointment. The E4D machine allows us to avoid impressions and dental laboratory wait times. The E4D utilizes digital impressions that are prepared with an infrared camera. The digital impression appears as a 3D model on a computer screen and Dr. Ken is able to design the dental crown on the computer until he is satisfied with the result. Next, the design is sent to the milling unit which creates the restoration out of porcelain block that can then be bonded to the tooth.
Dental inlays and onlays are procedures that are used to restore a decayed or damaged tooth to its original condition and can actually strengthen it. They are a more conservative approach than a crown because they don’t involve the removal of healthy tooth structure. For this reason inlays and onlays are considered minimally invasive. For some patients it can be a much better choice. An inlay fits within the grooves that are within the cusps of your teeth. An onlay, the larger of the two, fits within the grooves but wraps up and over the cusps covering more of the tooth’s surface. An onlay is used when the damage is more extensive and the restoration covers the entire chewing surface including one or more tooth cusps. Inlays and onlays are fabricated in a dental lab and are then fitted and bonded to the damaged tooth by Dr. Ken. This type of restoration is called an indirect filling because unlike a traditional dental filling they are not molded into place during your dental visit. We can also fabricate the inlays and onlays directly in our office for same day visits using the E4D machine.
Dentures are used to replace missing teeth and can be taken out and put back into your mouth. There are generally two types of dentures available: complete dentures and partial dentures. The type that is needed can be determined by your dentist. Typically complete dentures are used to replace all teeth and partial dentures are used when you still have some of your natural teeth in place.
Dentures are employed so that patients who suffer from tooth loss because of periodontal disease (gum disease), tooth decay, or traumatic injury don’t have to suffer the negative effects of not having teeth. Besides the obvious reason of eating, replacement teeth are needed so that remaining teeth do not shift and so that a sagging facial appearance does not give the impression of making one appear older than they are.
Dentures have a brief adjustment period and never feel exactly the same as one’s natural teeth. However they are designed to be comfortable and functional and have a similar appearance to natural teeth, improving the smile and facial appearance. Dentures are custom-made in a dental laboratory from impressions of your mouth that your dentist will take in a preliminary evaluation. Complete dentures contain a flesh-colored acrylic base that fits over your gums. The base of the upper denture covers the palate (roof of your mouth), and the lower denture is horseshoe shaped to accommodate the tongue. Complete dentures can either be “custom” or “immediate.” Custom dentures are made after the teeth have been removed and the gum tissue has begun to heal. This type of denture is ready for use about 3 to 6 months after tooth removal. Immediate dentures are made in advance and can be positioned as soon as the teeth are removed, so that the wearer does not have to be without teeth for the healing period as in conventional dentures. The disadvantage to this is that they must be relined several months after being inserted. Bones and gums shrink over time, especially during the healing period following tooth removal.
A removable partial denture is made of replacement teeth attached to a gum-colored acrylic base, which rests on a metal framework that attaches to your natural teeth. Partial dentures are used when one or more natural teeth remain in the upper or lower jaw. A fixed bridge will replace one or more teeth by placing crowns on the teeth on either side of the space and attaching artificial teeth to them. The partial denture not only fills in the spaces created by missing teeth, it prevents other teeth from changing position. They are removable and have internal attachments rather than clasps that attach to adjacent crowns for a look that is more natural-looking and comfortable.
Dental bridges literally bridge the gap created by one or more missing teeth. A bridge is made up of two crowns for the teeth on either side of the gap — these two anchoring teeth are called abutment teeth — and a false tooth/teeth in between. These false teeth are called pontics and can be made from gold, alloys, porcelain, or a combination of these materials. Dental bridges are supported by natural teeth or implants.
There are many benefits of bridges. They can restore your smile, restore the ability to properly chew and speak, maintain the shape of your face, distribute the forces in your bite properly by replacing missing teeth, and prevent remaining teeth from drifting out of position.
Getting a bridge requires 2-3 visits. During the first visit, the abutment teeth are prepared by removing a portion of enamel to allow room for a crown to be placed over them. Next, impressions of the teeth are made, which serve as a model from which the bridge (pontic and crowns) will be made by a dental lab. Dr. Ken will make a temporary bridge to wear to protect the exposed teeth and gums while the bridge is being made. If the temporary bridge is created on the same date as a tooth has been extracted, you will need to return in 12 weeks to have the impressions taken for the permanent bridge.
During the second (or third) visit, your temporary bridge will be removed and the new permanent bridge will be checked and adjusted, as necessary, to achieve a proper fit.
A dental implant is used to replace missing teeth for a look and feel that is natural. They are surgically placed below the gums over a series of appointments. The procedure involves attaching the implants to the jawbone and gum tissue to become a stable base for one or more custom artificial replacement teeth, called dental crowns. Candidates for dental implants need to have healthy gums and adequate bone to support a secure implant. Implants are frequently the best treatment option for replacing missing teeth because unlike dentures that rest on the gumline or the use of adjacent teeth as anchors, dental implants are long-term replacements that are surgically placed in the jawbone.
The beauty of dental implants is that they are virtually indistinguishable from other teeth. The science behind this lies in the connection between the dental implant and the living bone. Implants can be placed in one sitting but require a period of osseointegration. Osseointegration is the process in which the bone fuses with the implant. In the first step, the implant is surgically placed in the jaw, then a healing process of anywhere from three to six months takes place for it to anchor and heal. Once the implant has anchored with the jawbone, the healed gum tissue is uncovered to reveal the implant and an extension (called a post or abutment) is then attached. After this has been completed, Dr. Ken will then take impressions for a crown, which has a size, shape, color and fit that will blend with your other teeth. When the crown is completed it is attached to the implant post.
Mini-implants are recommended for patients who already have dentures but experience difficulty with their loose fit. This procedure involves a short process that locks the loose dentures into place. Because of the small size of the implants (they are about the diameter of a toothpick) more people can qualify for the option. After the mini-implants are installed, the top of the implant which is shaped like a ball snaps into the metal housing of dentures. The dentures can be removed for cleaning and are easily attached for a tight fit.
Mini Dental Implants have fundamental differences to traditional implants. They are about half the width of traditional implants and require little to no healing time before the final restoration can begin. They are less costly as well.
To treat a cavity Dr. Ken will remove the decayed portion of the tooth and then “fill” the area on the tooth where the decayed material was removed. Fillings are also used to repair cracked or broken teeth and teeth that have been worn down from misuse (such as from nail-biting or tooth grinding).
Filling materials can vary and include amalgam (silver colored) and composite. There are many advantages of composites such as aesthetics (the shade/color of the composite fillings can be closely matched to the color of existing teeth). Composites are particularly well suited for use in front teeth or visible parts of teeth. Composite fillings actually chemically bond to tooth structure, providing further support. In addition to being used to replace teeth due to decay, composite fillings can also be used to repair chipped, broken, or worn teeth. Sometimes less tooth structure needs to be removed compared with amalgam fillings when removing decay and preparing for the filling.
A root canal is a treatment used to repair and save a tooth that is badly decayed or becomes infected. Root canal procedures are performed when the nerve of the tooth becomes infected or the pulp becomes damaged. A tooth’s nerve and pulp can become irritated, inflamed, and infected due to deep decay, repeated dental procedures on a tooth and/or large fillings, a crack or chip in the tooth, or trauma to the face. During a root canal procedure, the nerve and pulp is removed and the inside of the tooth is cleaned and sealed.
Root canal procedures have the reputation of being painful. Actually, most people report that the procedure itself is no more painful than having a filling placed. The discomfort that drives you to seek treatment is truly more painful than the root canal procedure itself.
Symptoms of a tooth needing a root canal vary from person to person but can include severe toothache pain upon chewing or application of pressure, prolonged sensitivity/pain to heat or cold temperatures (after the hot or cold has been removed), discoloration (a darkening) of the tooth, swelling and tenderness in the nearby gums, a persistent or recurring pimple on the gums, or sometimes no symptoms are present.
Following the root canal, the tooth will require further restoration. Because a tooth that needs a root canal often is one that has a large filling or extensive decay or other weakness, a crown, crown and post, or other restoration often needs to be placed on the tooth to protect it, prevent it from breaking and restore it to full function.
Full mouth reconstruction typically involves procedures like crowns, bridges and veneers, and can incorporate dental specialists like periodontists (specializing in the gums), oral surgeons, orthodontists (specializing in tooth movements and positions) and endodontists (specializing in the tooth pulp). Dr. Ken is able to perform the majority (if not all) of the procedures needed right here in our office. The need for full mouth reconstruction may result from teeth that have been lost due to decay or trauma, teeth that have been injured or fractured, teeth that have become severely worn as a result of long-term acid erosion (foods, beverages, acid reflux) or tooth grinding, and ongoing complaints of jaw, muscle and headache pain requiring adjustments to the bite (occlusion).
A full mouth reconstruction differs from smile makeover in that a smile makeover is something that you elect to have performed, while a full mouth reconstruction is something that you need. It is also important to note that a smile makeover – though performed primarily to improve the esthetic appearance of the smile – requires the use of clinically proven dental materials and treatment techniques, as well as exceptional knowledge, training and skill on the part of the dentist. Many of the same techniques and equipment used for full mouth reconstruction are also used to ensure the success and long-term stability of smile makeover treatments.
Most full mouth reconstructions involve multiple phases and office visits. It is not unreasonable to expect treatment to take 12 months or more, depending on your situation. The following procedures may be involved, depending on your needs prophylactic teeth cleaning or treatment for gum infection, crown lengthening to expose healthy, sound tooth structure for possible crowns or bridges, orthognathic surgery to reposition the jaw, contouring of the gum tissue to create balance and harmony in your smile, preparation (reduction) of your natural tooth structure so crowns, bridges or veneers can be placed, placement of temporary restorations so you can become accustomed to your new teeth and the feel of your new mouth or bite alignment, placement of permanent restorations, such as crowns, veneers, inlays/onlays or bridges, made from ceramic, ceramic supported by metal or a combination of both, orthodontics (braces) in order to move your teeth into the optimal position for reconstruction, implant placement and restoration to replace missing teeth and/or anchor bridge restorations, and bone or soft tissue grafting to enhance the stability of your teeth, proposed implants and/or other restorations.