Restorative Services

Even with the most ideal preventive measures in place, teeth can still sometimes need restoration. Accidents and injuries happen, old dental work may need to be replaced, and permanent teeth can sometimes be congenitally missing or malformed. Poor diet habits, pregnancy, chronic health issues, long-term medications, and even stress can also lead to an increased incidence of bacterial plaque. For some people, these higher plaque numbers may result in new decay, gum disease, and even tooth loss. And for those of us who had several cavities and large fillings as children, the restoration process tends to continue on into adulthood, as those filled teeth begin to weaken over time and may sometimes crack or break with age.

Dr. Rich offers a comprehensive array of restorative dental services to address these issues, including cosmetic services. From a simple filling to a full-mouth reconstruction, restorative treatment is designed not only to repair the teeth, but also to identify the underlying contributing factors and to make additional recommendations in home-care and hygiene, if some of those factors are thought to be controllable. When possible, we will always recommend placing the longest lasting restorations currently available to keep future dental needs to a minimum.

Below is a listing of the most common restorative options available within our practice. Every permanent restoration Dr. Rich provides is mercury, nickel, and aluminum-free. For those clients with known or suspected allergies to other dental materials, material-sensitivity testing is also available.

mercury-free laser fillings

More than 20 years ago, Dr. Rich made the decision to stop placing silver amalgam fillings. Not willing to expose her own family to the mercury content anymore, she could no longer in good conscience expose her patients to it either. Over the years, she has seen remarkable improvements in composite resin filling materials, and she now believes that they are not only a safer alternative to silver amalgam, but are also stronger and less likely to promote tooth fracture over time.

Many fillings placed in our office are done so with a Waterlase Dental Laser. For small fillings and preventive resins, this technology often minimizes the amount of anesthetic needed for treatment. But even when anesthetic is used, the laser is an invaluable tool in effectively killing any microscopic bacteria left after the decay is removed. The laser also etches the filling site far more effectively than chemical etchants alone, resulting in superior bonding strength for the final filling.

crown-in-a-day (CEREC CAD/CAM crowns)

The CEREC CAD/CAM technology gives us the ability to custom-fabricate and place a full porcelain crown, or series of crowns, all in one appointment. Using an infrared three-dimensional digital camera to capture pictures of your tooth both before and after preparation, CEREC’s specialized CAD/CAM software allows Dr. Rich to digitally design your crown in three dimensions to match the individual specifics of your bite and tooth shape. Each crown is then milled from a solid block of porcelain, polished, and finally glazed in a high-speed porcelain furnace. Fully cured and ready for placement, the crown can then be bonded into place while the anesthetic is still active. There are no temporary crowns, and your treatment is completed in one appointment.

lab-processed crowns and bridges

While CEREC crowns are strong, durable, and convenient, they are not always the best possible option for restorative treatment. The in-office CEREC system cannot yet fabricate bridges or gold restorations, and for cosmetic cases, the artistry of a skilled dental technician still cannot be replicated. For these cases, we have developed strong relationships with the finest local laboratories to ensure the highest quality of work available. We do not work with dental labs that subcontract their work to foreign markets, and all of our lab-processed restorations are mercury, nickel, and aluminum-free.

implants

Sometimes it’s impossible to avoid the loss of a tooth. Accidents, injuries, and certain types of chronic illness can all lead to unavoidable tooth loss. In rare cases, individuals can also genetically fail to develop all of their permanent teeth. For most of these situations, the best possible restorative option is an implant.

Implants are titanium pegs that insert into the jaw bone to simulate a tooth root. Attachments are then added to the implant to allow for the placement of a beautiful crown or bridge. For significant tooth loss, implants can be used in conjunction with partials and/or dentures to improve both fit and stability.

Dr. Rich performs some types of implant surgery. In cases where the sinuses or other anatomical structures are a concern, however, she will often partner with an oral surgeon or periodontist to ensure the best possible care for her patients.

In most situations, an implant represents the best possible restorative solution to replacing a missing tooth. They are more expensive in the short term than a bridge or a removable partial, but they are stronger, last longer, and look more natural than any other restorative option currently available. Implants also do not jeopardize the long-term health of the adjacent teeth as bridges and partials do.

full-mouth reconstruction

Dr. Rich has spent much of her clinical career dedicated to understanding the complexities of three-dimensional jaw function. Her experience and expertise in neuromuscular dentistry, functional orthodontics, and restorative technique have enabled her to successfully treat those patients whose teeth are so worn, damaged, or ill-fitting that a full reconstruction is necessary to restore proper function and vertical support.

The treatment details of a full-mouth reconstruction vary widely from patient to patient, depending on how the function and support were lost or failed to develop. Multiple crowns, bridges, and/or implants are often involved. In some cases, orthodontics may even be necessary to reposition the teeth before restoration. For every case, Dr. Rich utilizes state-of-the-art diagnostic instrumentation in conjunction with a temporary orthotic appliance to ensure proper repositioning before the final reconstruction takes place.

partials and dentures

Even with all the advancements in dental treatment over the last few decades, significant tooth loss can still happen. And while a full mouth of permanent implant-supported crowns and bridges might be the most ideal solution, it is not always a viable option, clinically or financially. Partials and dentures, however, can still be highly effective treatment options, especially when paired with two or four implant anchors.

Anchoring a partial or denture with implants can allow the wearer a more comfortable and secure fit without the use of adhesives. Rubbing, clicking, and floating can be virtually eliminated. The placement and number of implants necessary for each appliance vary depending upon the wearer’s individual anatomy. Dr. Rich has been designing and placing denture and partial anchoring systems for her patients with significant tooth loss for several years now, and would be happy to evaluate your current needs or those of a loved one.

To schedule a restorative options evaluation,
or to inquire further about Dr. Rich’s treatment philosophy, please call 503-228-6870.

Large restorative cases, particularly full-mouth reconstructions, are complex by nature. A brief email exchange may begin the process of scheduling and evaluation, but ultimately a telephone conversation will be necessary to adequately address all the information needed to schedule the appropriate appointments.