In more detail, the operation is performed ideally between the 3 and 6 month mark following the loss of the tooth - any earlier and the body may reject the implant, any later and the jaw wont grow as well onto the implant.  The tooth implant operation requires a general aesthetic, after which a screw on plug is inserted into the jaw.  The tooth part of the artificial tooth (essentially a crown) is then attached to the plug some weeks later, when the area has had a chance to heal.

Attack of the Biofilm

How white can your teeth become?
How white your teeth can become from bleaching and whitening is a common question with a very subjective answer. Some whitening procedures claim they can whiten your teeth by up to nine shades, but that is highly unlikely. Just a change of two or three shades will make a significant difference in just about anyone's smile. There is no one standard system in the dental field to measure and determine tooth color. The most often heard about, however, is the Vita shade guide. This guide divides tooth color into four basic shade ranges:

A (reddish brown), B (reddish yellow), C (gray), D (reddish gray).
In the A range there are five levels of darkness. Ranges B, C and D, each have four levels.

Not all of your teeth are the same natural color. Usually your eye teeth tend to be darker than the others, your front teeth are typically the whitest, and molars tend to be a shade between the two. The goal for everyone is to achieve their individual optimum whiteness while still looking natural. During your first consultation for tooth whitening, your dentist will go over what you personally can expect for your specific smile. How white teeth will become from a given procedure will vary from person to person. The structure of your teeth and the type of procedure implemented will affect the outcome.

In-Office Whitening

Why is a bone graft needed?
Bone grafting is performed to reverse the bone loss / destruction caused by periodontal disease, trauma, or ill fitting removable dentures. It is also used to augment bone to permit implant placement, such as augmenting bone in the sinus area for implant placement, or augmenting bone to enhance the fit and comfort of removable prostheses, or to enhance esthetics of a missing tooth site in the smile zone. When one loses a tooth, as in an extraction, the surrounding bone collapses. To preserve this bone for future implant placement or for esthetics, a bone graft is used.

What are the types of bone graft?

1. autogenous - bone taken from one area of the patient and transplanted to another area requiring such grafting
2. allograft - either synthetic bone or bone from a bone bank (cadaver bone)
3. xenograft - bovine /cow bone

Which graft is used and when and why?
Autogenous bone is the "gold standard" and oftentimes has the most predictable results. This is described as the best type of graft because such bone is live bone with live active cellular elements that enhance bone growth, whereas other types of grafts are devoid of any active cellular material.

Allografts and Xenografts both do not require a second surgical site as does the autogenous bone. Ample amounts can be easily obtained.

How long does tooth bonding last?
While the traditional silver fillings last about seven years, these composites should last about seven to eleven years.

I was offered the idea of a bridge when it was clear my crowned tooth could no longer be salvaged from the ravages of a root abscess.  I though about it, but turned the idea down as it means that two perfectly good teeth are being compromised through the crowning procedure.

Denture Bridge

Bridge Decay

Bridge Bone Loss

Composite resin dental fillings were created as an alternative to traditional metal dental fillings. Tooth fillings colored to look like a natural tooth are known as Composite Resin Dental Fillings, are made of a plastic dental resin. Composite Resin Dental Fillings are strong, durable, and make for a very natural looking smile. Many dental insurance plans cover their use.

The dental contouring procedure can even be a substitute for braces under certain circumstances. It is also a procedure of subtle changes. A few millimeters of reduction and a few millimeters of tooth-colored laminate can create a beautiful smile when performed by a cosmetic dentist, with no discomfort to you. Tooth reshaping, or dental contouring, is commonly used to alter the length, shape or position of your teeth.

What is a Cosmetic Dentist?
There is no specialty recognized by the American Dental Association called Cosmetic Dentists. However, dentists whose practices primarily focus on creating beautiful smiles are regarded by the public as Cosmetic Dentists. The type of dental procedure responsible for creating more attractive smiles are called cosmetic dentistry procedures.

The procedure of fitting a crown is somewhat time consuming and is generally NOT an enjoyable experience. The fitting typically occurs over several dental visits. The first dental visit involves a lengthy procedure, in which the tooth is cut down appreciably in width and height, with a cast of the tooth stub and surrounding teeth being taken. The color of the teeth around the tooth is also determined. Often a temporary crown or band is fitted to protect the tooth stub from damage.

The mould and desired color are then sent to a lab that makes crowns and the crown is made to specifically fit over the tooth stub and blend into the rest of the teeth in height, color etc.

The next visit involves the crown being fitted to the tooth. This can also take some time, as the crown may not fit perfectly. If it sits to high, some of the crown may need to be ground down - if the dentist gets the height to high, expect the tooth above or below it to crack as well, as the crown is much harder than tooth, so when you bite, the crown will pound into the opposing tooth, thereby cracking it. If it cracks, you will then need to have that cracked tooth crowned as well - that is what happened to me.

One thing I have found, is that if the tooth is subject to root abscess, getting the tooth crowned may be a pretty dodgy idea.  It may be hard to consider, but having a tooth subject to root abscess removed, is possibly the more practical way to go. To do the root canal work to remove the pulp and clean out the germ and then crown the tooth, could easily cost you about $3,000 - It may sound OK, but there is no guarantee the germ will be gotten rid of, which means that if the root abscess recurs, you will likely loose the tooth anyway.

Who is a candidate for dentures?
If you've lost, or are losing, all of your teeth a Complete Denture is something to discuss with your cosmetic dentist. If some of your teeth remain and are healthy, a partial denture may be your way to a great smile.

This procedure should be thoroughly discussed with your dentist as there are several personal and medical factors to take into consideration. You may instead be a candidate for dental bridges and dental implants as optional procedures.

Reasons for tooth extraction
The most common reason for extraction is tooth damage due to breakage or decay. There are additional reasons for tooth extraction:

Severe tooth decay or infection. Despite the reduction in worldwide prevalence of dental caries, still it is the most common reason for extraction of (non-third molar) teeth with up to two thirds of extractions.

• Extra teeth which are blocking other teeth from coming in.
• Severe gum disease which may affect the supporting tissues and bone structures of teeth.
• In preparation for orthodontic treatment (braces)
• Teeth in the fracture line
• Fractured teeth.
• Insufficient space for wisdom teeth (impacted third molars). Although many dentists remove asymptomatic impacted third molars, American as well as British Health Authorities recommended against this routine procedure, unless there are evidences for disease in the impacted tooth or the near environment. The American Public Health Association, for example, adopted a policy, Opposition to Prophylactic Removal of Third Molars (Wisdom Teeth) because of the large number of injuries resulting from unnecessary extractions.
• Receiving radiation to the head and neck may require extraction of teeth in the field of radiation.

Extraction Premolar

The larger the filling involved, the more likely will be the loss of structural integrity of the tooth and you may be advised to look at having a crown fitted to the tooth.

Flouride is a mineral that helps strengthen teeth enamel, making teeth less susceptible to decay. Fluoride is ingested through food or water, is available in most toothpaste, or can be applied as a gel or liquid to the surface of teeth by a dentist.

Fluoride Treatment

An inlay is done when the tooth structure replaced is within the cusp tips of the tooth. If the damage is more extensive and the new structure covers the entire chewing surface including one or more tooth cusps, the procedure is called an onlay.

What are the most common benefits of this procedure?
Inlays and onlays are ways of repairing relatively extensive tooth decay or damage without having to replace the whole outer portion of the tooth as with a crown. Less tooth material is removed so inlays and onlays tend to be more conservative and esthetic than crowns. Unlike fillings, these procedures strengthen a tooth's structure. They also tend to last longer than a filling, because the inlay or onlay material is custom made and bonded to the tooth.

Inlay

Onlay

How Are Dental Implants Placed?
Dental implant restoration can be completed in only two office visits. In the first visit, the titanium posts are surgically placed in the jawbone. The second visit will take place approximately three to six months later, after the titanium post has been given time to fuse with the jawbone. In the second part of the procedure, the replacement teeth are attached to the titanium posts. In both procedures, sedation dentistry technology is used so that the patient will not feel any pain or discomfort during treatment.

What Are Replacement Teeth Made Of?
The type of replacement teeth that are used in dental implant restoration will depend on the patient's individual needs and goals. If the patient is missing only one tooth, then a dental crown is typically used. Dental bridges may be utilized if more than one tooth is being replaced. In all cases, the implant dentist will strive to provide the most natural-looking and effective dental implant restoration possible.

If you grind your teeth at night, a special mouth guard-type of dental appliance -- called a nocturnal bite plate or bite splint -- may be created to prevent tooth damage.

Who Needs a Mouth Guard?
Mouth guards should be used by anyone -- both children and adults -- who play contact sports such as football, boxing, soccer, ice hockey, basketball, lacrosse, and field hockey. However, even those participating in noncontact sports (for example, gymnastics) and any recreational activity (for example, skateboarding, mountain biking) that might pose a risk of injury to the mouth would benefit from wearing a protective mouth guard.

Adults and children who grind their teeth at night should have a nocturnal bite plate or bite splint made to prevent tooth damage.

Why Use a Mouth Guard When Playing Sports?
Because accidents can happen during any physical activity, the advantage of using a mouth guard during sports is that it can help limit the risk of mouth-related injuries to your lips, tongue, and soft tissues of your mouth. Mouth guards also help you avoid chipped or broken teeth, nerve damage to a tooth, or even tooth loss.

Aside from staining, there are other factors that can affect the color of an individual's teeth. Genetics can play a role. Some people have naturally brighter enamel than others. Disease can also be a factor and certain medications can cause a discoloration of the teeth. If you suspect that there is an underlying medical cause for your teeth discoloration, be sure to inform your cosmetic dentist.

Types of Tooth Veneer Procedures
There are two tooth veneers procedures available that correct discoloration of the teeth by removing the brown and yellow staining. While each work effectively, there are advantages and disadvantages to each procedure dependent upon your objectives and commitment to the processes. The type of procedures available should be discussed with your cosmetic dentist, and a they will recommend the most appropriate tooth veneers procedure for you.

Composite Veneer Procedure:
Composite (direct) veneers are usually performed in a single visit to your cosmetic dentist. The procedure is an application of a bond and enamel directly to the tooth's surface.

Porcelain Veneer Procedure:
Porcelain (indirect) veneers are a very thin porcelain material. Usually porcelain veneers require two visits and also require a dental laboratory to create the final tooth restoration piece.

Scaling and root planing – Scaling and root planing is a deep-cleaning, nonsurgical procedure whereby plaque and tartar from above and below the gum line are scraped away (scaling) and rough spots on the tooth root are made smooth (planing).

Dental Root Canals for Your Teeth
Many of us have heard the comparisons of painful things to the root canal procedure. It's not that bad. There are tiny canals within your tooth that may become infected. This leads to the pulp inside your tooth also becoming diseased. Either your dentist or an endodontist to remove any infection performs the root canal procedure. The canals are then filled and the tooth receives either a filling or a crown. Crowns are more common in most cases as they add strength to the tooth itself.  The procedure itself takes one to two visits.

Types of Root Canals
There are generally two types of root canal procedures. The first (and hopefully only) root canal on a tooth, and the second root canal on the same tooth. Both procedures are the same, other than that if this is the second root canal done on the same tooth it requires more time and expense. This is because your dentist must remove all of the previous filling in the canal and pulp area in order to start again.

Periodontal scaling procedures "include the removal of plaque, calculus and stain from the crown and root surfaces of teeth, whereas root planing is a specific treatment that removes the roughened cementum and surface dentin that is impregnated with calculus, microorganisms and their toxins."

Scaling and root planing are often referred to as deep cleaning, and may be performed using a number of dental tools, including ultrasonic instruments and hand instruments, such as periodontal scalers and curettes.

Removal of adherent plaque and calculus with hand instruments can also be performed on patients without periodontal disease. This treatment would then be referred to as a prophylaxis (a cleaning, although literally it means "prevention") or a prophy for short. Sometimes this device may be electric, known as an ultrasonic or sonic scaler. At present, there is inadequate research evidence to claim that periodic pre-emptive scaling reduces the incidence of periodontal disease.

Sonic and ultrasonic scalers are powered by a system that causes the tip to vibrate. Sonic scalers are typically powered by an air-driven turbine. Ultrasonic scalers typically use either magnetostrictive or piezoelectric systems to create vibration. Magnetostrictive scalers use a stack of metal plates bonded to the tool tip. The stack is induced to vibrate by an external coil connected to an AC source. Many ultrasonic scalers also include a liquid output or lavage, which aids in cooling the tool during use. The lavage can also be used to deliver antimicrobial agents.

There is some debate over whether there is an advantage to sonic or ultrasonic scaling over hand scaling and some issues arise from powered scalers.[citation needed] However, powered scalers tend to create aerosols, which can spread pathogens.

A sealant is a thin, clear or white resin substance that is applied to the biting surfaces of teeth to prevent decay.

Composites or resins were introduced in the 1960’s, and have undergone continual improvements in durability, color stability, material handling qualities, and esthetic properties.

Tooth colored restorations are actually bonded to remaining tooth structure compared to silver/amalgam restorations, which are "locked" into tooth structure. This property of resin restorations makes them a very conservative approach to tooth restoration after caries removal.

How Do They Look?
Tooth colored filling material comes in a great number of colors (shades), and are matched to your individual tooth color. The materials used for front teeth have a high shine; whereas, the materials for back teeth are designed for strength — both look great! It’s nice that if you have a filling it can be virtually undetectable.

How Long Do They Last?
Tooth colored fillings now are harder and more comparable to silver/amalgam restorations. A small filling could conceivably last a lifetime, and larger fillings can be expected to last many years. The factors that determine the lifespan of a particular filling include: the tooth (molars take more force than bicuspids), the size of the filling relative to the tooth (smaller fillings will usually be more durable than larger fillings), and how teeth are cleaned and maintained daily.

How Should They Feel?
A new filling should feel natural, like your own teeth. After the anesthesia has worn away and you can feel your teeth and bite again, you should not notice anything particularly different. It should be smooth and comfortable. There is a period that you might feel some sensitivity to temperature after the restoration is placed. It is temporarily as with any other restorations when they are placed on teeth.

You can eat on tooth colored fillings right away (as soon as anesthesia is gone) compared to silver/ amalgam fillings, which there is a waiting period.

After waxing, the Vivaneer is invested and pressed with an extra high-strength ceramic ingot called Prismatik ThinPress™ . This ceramic is capable of pressing ceramic veneers as thin as 0.3mm! Depending on your shade requirements, Vivaneers also allow for translucent or opaque shading with complete shade flexibility right at the chair. Because of their extra-high strength, Vivaneers can also be used for bonded full crowns.

Vivaneers No-Prep Veneers are the perfect solution to cover stained, discolored or chipped teeth, or as a way to fill in spaces between your teeth. Measuring just 0.3 mm, these ultra-thin Vivaneers will give you the smile you’ve always dreamed of without any shots, drilling or pain.

Custom-made to fit your mouth, each veneer is delicately crafted to exhibit a beautiful, lifelike look. Whether replacing multiple teeth or a few, take comfort in knowing that each Vivaneer will blend naturally with your surrounding teeth. Vivaneers are different from traditional veneers in that traditional veneers require shots to numb the mouth as existing teeth are shaved down with a drill.

Veneer Malformed Tooth