Restorative Dentistry

In dentistry, the term “restorative” refers to broad range of procedures, such as fillings, crowns, bridges or implants, that are intended to stop the progression of dental decay, improve the structural integrity of one or more teeth and prevent the loss of teeth. Dr. Phillip has extensive experience performing a wide range of restorative services, including:

• Conservative Tooth-Colored Fillings

• Porcelain Onlays

• Crowns

• Bridges

• Implants (to learn more about Dr. Phillip’s work with implants, click here)

• Partial and Full Dentures

• Full-Mouth Reconstruction
  
  

Conservative Tooth-Colored Fillings

There are many reasons why a tooth may need to be filled or restored, with decay and chipping being two of the most common ones.

Composite tooth-colored fillings are a more conservative approach compared to their amalgam (“silver”) predecessors. With amalgam fillings, it was typically necessary to remove a significant portion of healthy tooth structure in order to secure the filling in place. With composite fillings, Dr. Phillip only has to remove the damaged or decayed part of your tooth, leaving more of the healthy tooth intact.

A more conservative treatment is not the only benefit, either. Tooth-colored fillings match your natural teeth so that others do not notice your dentistry – just your smile!

Porcelain Onlays

An onlay restoration - sometimes referred to as a “partial crown” - is similar to a tooth-colored filling, but is used in situations where a more significant portion of the tooth is compromised. An onlay may conservatively be used to restore a tooth that is too damaged to repair with a filling but not damaged so badly as to require a crown. Additional reasons Dr. Phillip may recommend an onlay restoration include:

• Certain classes of broken or fractured teeth

• Replacement or repair of large fillings

• Large area of decay

• Cosmetic enhancement

For example, a porcelain onlay can be an effective and affordable means to conservatively restore a back tooth that needs reinforcement from a fracture or decay around a larger old filling.  In such a case, the restoration replaces the existing filling and decay, as well as providing a porcelain veneer over the top of the tooth (an “onlay”), covering one or more cusps of the tooth and providing additional strength and structural integrity.

Porcelain onlays are popular because they resemble your natural tooth.    The process for restoring a tooth with an onlay is similar to that used for a crown. Impressions are taken, a custom onlay is created to match the fit and color of the natural tooth, and then the restoration is permanently bonded or cemented to the underlying tooth. Adjustments are then made by Dr. Phillip to ensure proper bite and function.

Crowns

Not all cases of decay or damage to a tooth can be restored with a filling or an onlay. A dental crown is a restoration that can be used to restore a tooth that is significantly damaged or decayed. The crown is custom-made to fit over the entire tooth in order to restore the tooth to its original shape and size.

There may be other reasons Dr. Phillip recommends a crown instead of an onlay or filling. For example:

• To strengthen a tooth that is fractured or weakened.

• To support a large filling when little natural tooth structure remains.

• To anchor and attach a dental bridge.

• To cover and complete a dental implant.

• For cosmetic applications when a veneer or tooth-colored filling is inadequate

• To improve a misshapen tooth.

• To protect a tooth following endodontic treatment (“root canal”)

Dental crowns can be made of many different types of materials, including gold, porcelain, and porcelain fused to metal. Each of these materials, including a wide range of porcelain systems, has benefits and limitations. Porcelain crowns are popular because they match the natural color and appearance of your teeth. However, not all porcelain crowns are the same. Trade-offs exist in translucency, color and aesthetics, strength, durability, longevity and cost.

Dr. Phillip has extensive experience assessing the relative benefits and drawbacks of different dental crown materials and different restorative approaches. These differences are discussed with you during your appointment to help you make an informed decision regarding your smile and your sustained dental health.
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The process of creating a custom crown involves multiple steps. First, the underlying condition must be treated and the tooth prepared to receive a new crown restoration. In some cases, this may involve creating a “build-up” to provide adequate structure and strength to support the eventual crown.

Next, impressions of your teeth, including the prepared tooth to receive the crown, are taken so that an accurate model of your teeth, gum margins, and bite can be used to ensure your new crown not only looks great but functions properly with your bite. A temporary crown is attached to the tooth being restored to protect it until the permanent crown is ready.

Finally, when the permanent crown is ready, the temporary crown is removed and the permanent crown is inserted and permanently affixed to the underlying tooth structure or implant, completing the restoration.

Dr. Phillip is meticulous to make sure that the crown fits precisely with the tooth and surrounding teeth and that the bite is properly adjusted to be comfortable and functional.

As with any dental procedure, it is important that each patient make an informed decision and to understand the trade-offs involved, particularly for a significant and long-lasting restoration like a crown. Dr. Phillip welcomes your questions and is always happy to discuss a range of appropriate treatment options.

Bridges

When teeth are missing, not only is your smile affected, but your overall appearance, jaw function and dental health can be adversely impacted . The adjacent teeth may start to drift or tilt into the vacant space, and teeth in the opposing jaw may start to shift toward the area of the missing teeth. These changes can impact bone structure, your bite function, and your facial appearance.

It is therefore important to replace the tooth or teeth that have been lost as soon as reasonably possible. Depending on your individual circumstances and needs, a bridge may be recommended as a restoration.

A dental bridge is used to create a lifelike replacement for one or more missing teeth and is supported on the ends by prepared natural teeth or implants. Once fabricated and fitted, a dental bridge will be permanently “fixed,” or cemented into place. Like crowns, bridges can be made of many of the new ceramic materials that have been developed to both provide excellent function and to provide a close match to the appearance of your surrounding teeth.

Like crowns, bridges generally require two to three appointments: the first to prepare the teeth, make the impression, and cement a provisional bridge; and the second to cement or bond the bridge once it's made by the lab.

Partial Dentures

A partial denture is a removable appliance that replaces missing teeth. It is supported by your existing teeth and fills in those unwanted gaps. It will help to regain the aesthetics and chewing and speaking functions that you require.

Partials can restore several areas of missing teeth and can also be combined with implants for added retention and esthetics where needed or preferred.

Dentures

Dentures have many benefits and can greatly improve your quality of life. With today's technology, dentures are created to look natural in appearance and create a beautiful smile. They also provide support for your facial muscles, as well as improve your ability to chew food and speak clearly.

If you are in a situation where you are considering dentures, we would love to work with you to show you the wide range of options available. Dentures no longer have to look artificial - Dr. Phillip loves to work with patients to come up with a personalized solution that creates a smile that not only looks great and natural, but is highly functional, as well. 

For example, some patients want to recreate a younger look from their past, and we work with previous photos and portraits to recreate the desired look. Others want a completely new look. We take the time to listen to your desires and create a smile that you will love for years to come.

Dr. Phillip will do an assessment of your condition and provide you with a list of options tailored to your individual needs. We often can do a trial insert of the denture prior to final processing so that you can be sure you are getting the look that you want, and enabling Dr. Phillip to make any needed adjustments.

Finally, with advances in dental implants in the last twenty years, dentures can often be used in conjunction with implants for enhanced function and comfort. However, for many people dentures alone are a very cost effective solution to the problem of aging teeth and gum disease.

Full-Mouth Reconstruction

Despite the wide range of standalone restorations available, there are some situations where an interdisciplinary approach to utilizing multiple restorative services that potentially affect multiple areas of the mouth is required to achieve the desired outcome. The general term used for these more complex restorative cases is “full-mouth reconstruction”.

Examples when full-mouth reconstruction may be advisable include:

• Major aesthetic or structural changes are desired, often involving multiple quadrants of the mouth

• A significant breakdown or collapse of bite function has occurred

• A loss of vertical dimension of the face is present, often from excessive wear caused by acid erosion or an extended period of time with unrestored missing teeth

• Facial pain, joint pain or headaches in response to functional problems with bite function.

• Significant loss of teeth in multiple locations within the mouth, often accompanied by bone loss

The distinguishing characteristic of full-mouth reconstruction cases, however, is not so much the severity of the problem or the cost of the restoration, but rather the need for an interdisciplinary approach for which the treatment plan must be carefully specified and coordinated by a highly-skilled dentist.

Dr. Phillip has nearly 30 years of experience dealing with complex reconstructive cases, including situations where she acts as “quarterback” to oversee and coordinate the efforts of multiple specialists for her patients. A complex example of such a situation is a procedure referred to as “All-on-4”, where Dr. Phillip, a prosthedontist and a periodontal or oral surgeon join together in a single operatory to do a full reconstruction of an upper arch, lower arch, or full mouth using four implants per arch and the appropriate additional restorations.

In full-mouth reconstruction cases, Dr. Phillip will begin the process by assessing the health of your teeth, jaw, and gum and bone structure, and creating any diagnostic models, as needed, to determine which restorative procedures will best achieve your dental needs and desired outcome. A full-mouth reconstruction requires a customized treatment plan since every case is unique. Once a treatment plan is established, Dr. Phillip works to coordinate her restorative work with any required lab technicians and specialists in other dental disciplines to ensure an efficient implementation of the plan and to help give you the healthy smile you have been seeking.

Dr. Phillip and her staff are always happy to answer questions regarding what is possible, what the most effective solutions might be, and whether an interdisciplinary approach might be appropriate for a given situation or desired outcome.