Crowns or "Caps":  
Sometimes, if a tooth is broken, has had a root canal , or has a very large filling, your dentist may recommend a crown or "Cap".  A crown is a full coverage restoration that fits over your existing, natural tooth once the dentist has removed the broken or damaged parts.  The crown protects the tooth from future fractures and wear.  Think of it as armor for your tooth.  Unlike armor, however, crowns today don't need to be big and unsightly.  Recent materials advances have led to some amazing options.  In general there are three types of crowns to choose from:

• All metal (gold) crowns
• Porcelain fused to metal (PFM) - the most popular
• All porcelain

Each has its own strengths and weaknesses:

All metal crowns are very strong and durable.  Not too long ago they were the only real option.  Gold is a great material for the mouth.  It lasts a long time, bacteria hate it and it wears at about the same rate as your natural teeth.  The only downside is that they are metal and most people today want teeth that, well...look like teeth.

The porcelain fused to metal crown (PFM) is composed of an underlying metal substructure on which the tooth colored porcelain is baked.  The result is a crown that looks more like a tooth, but still maintains some of the strength and durability of an all metal crown.

All porcelain crowns are the pinnacle of esthetics.  The porcelain materials mimic natural tooth, allowing natural light to create a lifelike, vibrant appearance.  In general these crowns are less tolerant of the crushing forces found further back in the mouth, but do quite well for front teeth.

Deciding which type of crown is right for you can be difficult.  In addition to the characteristics described here, your dentist must evaluate several other factors including available space for the crown and how your gums will tolerate the material?  It's best to decide which characteristics you desire.  For instance, is it more important for your crown to look good or last for 15 years?  Your dentist should discuss these issues with you so you can choose the crown that best suits your needs.

Root Canals:
Root canals are perhaps the most dreaded of all dental procedures.  The very words can make a person break out in a cold sweat.  Well, root canals today are much different than from years past.  Historically, people have associated root canals with a great deal of pain.  Nothing could be further from the truth. 

During a root canal the doctor will remove the damaged nerve tissue.  A special filling material called gutta percha will then be placed into the root.  This helps prevent future infections.  Depending on the tooth and the complexity of the canal system the whole process can take anywhere from 1-3 visits.  Most cases are completed in 1-2, however. 

Once the root canal is completed the tooth will require a special filling called a post and core and a crown   Root canal treated teeth can become fragile over time and are much more susceptible to fractures. Therefore a crown is recommended to protect the tooth.  Once properly restored, a root canal treated tooth can provide many more years of useful life.

Extractions:
Unfortunately, there are times when removing a tooth is the best option.  Most people refer to this as "pulling a tooth".  The phrase is a bit misleading, however.  In general there is very little "pulling" involved.  During the extraction the tooth is gradually loosened by the dentist until it can be gently removed.  Excessive force, such as a strong pull, can actually complicate the procedure.  Above all though, it is important to note that you should feel no pain.  Extractions generally cause a lot of anxiety and concern.  This is normal and expected.  You should express these concerns to your dentist.  You also talk to your dentist about restoring the space once the tooth has been removed.  Leaving a space following an extraction can have effects on the surrounding teeth.  Your dentist should be able to present you with several options for restoring this area.  Crowns, bridges, implants or dentures are all viable options.

Sealants:
Sealants are preventive in nature.  They are designed to help protect teeth against cavity formation.  Back teeth (molars and pre-molars) have many deep pits and fissures on their surfaces.  Good brushing and flossing alone may not be enough to prevent bacteria from creating cavities at the bottom of these pits.  Sealants "seal" up these pits making it much harder for the cavity causing bacteria to invade the tooth. 

The process itself is simple.  The tooth is cleaned and the sealant material is applied.  The entire procedure is absolutely painless.  Sealants are generally recommended for children at around six years of age when their first adult molars emerge.  While sealants are very beneficial for children they can also be great for adults.  Talk to your dentist to see if you or your children qualify. 

Veneers:
Veneers are thin porcelain coverings which can be placed onto the surface of an existing tooth in order to enhance the shape, size and/ or color.  The results can be dramatic.  Preparation for veneers is minimal compared to fillings and crowns.  The dentist may need to remove some tooth structure to create room for the porcelain, but the amount is usually minimal.  The objective is to preserve as much natural tooth structure as possible and still be able to create a more dynamic smile.  Many dental offices provide free cosmetic consultations to help you decide if veneers are right for you. 

Inlays & Onlays:
Inlays and onlays are very similar to crowns in that the tooth is prepared and a dental laboratory creates a restoration which the dentist "cements" into place.  The differences between an inlay and onlay are Symantec and only convey meaning to a dentist about which parts of the tooth are being restored. 

Restorations of this type are generally used in one or two situations.  Sometimes space or the shape of a tooth can make placing a traditional crown or filling a less than optimal choice.  A lab's ability to shape and contour the restoration means the chances of post operative complications can be reduced.  Inlays/onlays are also perfect when the concern is about esthetics or durability.  Numerous studies show inlays/onlays to be very durable when compared to a traditional filling of equivalent size.  Additionally, regular fillings are hard pressed to match the esthetic results associated with an inlay or onlay. 

Keep in mind that, just like crowns, inlays and onlays come in a variety of materials.  Some offer increased esthetics, while others increase the durability.  Talk to your doctor about your choices.

X-rays (radiographs):
X-rays or radiographs, allow the dentist to see "inside" the teeth.  There are many different types of films which can be taken depending upon the situation.  Bite wing x-rays are the most common and are routinely taken during most patients' hygiene appointment.  Bite wing films allow the dentist to see into the areas between teeth (You know...the places we're all supposed to floss!).  Other films are recommended at various intervals.  Your dentist can explain which films are needed and why.

Whenever radiation is involved, safety is a concern.  Dentists generally use fast exposure film to minimize your radiation exposure.  Newer digital systems can allow for even less exposure.  New digital x-ray systems can allow for even less radiation.  The important thing to remember is that no matter how many x-rays your dentist takes, you still receive a much higher radiation dosage during a single plane trip. 

Dental radiographs are a safe, proven method for detecting decay and other abnormalities in your mouth.  The benefits far outweigh any perceived risks. 

Implants:
One of the most dramatic advancements in dentistry over the past twenty years has been the development of dental implants.  The concept is remarkably simple:  A sterile titanium rod is placed in the site where a tooth was lost.  A cap or crown is then cemented onto the rod.  The result is the closest thing to a natural tooth that your dentist can provide.  Implants are incredibly strong and because they're made of titanium, there's no chance of developing any future cavities like you might with a crown.  Dollar for dollar implants represent the best long term investment.  Studies have repeatedly shown that traditional crown and bridge work needs to be replaced much more often than implants ever do. 

Implants aren't just for restoring a single tooth though.  Implant bridges can be created to restore large spaces.  Loose fitting dentures can also be modified to attach to implants.  Implant supported dentures can change a patient's life.  Denture wearers can now enjoy a much greater degree of function, comfort and confidence.  Your dentist can help you determine if implants are right for you. 

Cleanings:
A "cleaning" is considered a routine hygiene procedure.  It is recommended that you have a cleaning once every six months, though some special cases may require more frequent visits (periodontal cleanings).  The process involves the removal of soft (plaque) and hard (tartar) material from your teeth.  The dentist or hygienist will also floss and polish your teeth to remove stains.  Fluoride therapy is usually recommended at your cleanings as well.  In general a cleaning appointment should be a pleasant experience.  If you find that your routine cleaning visits are uncomfortable or even hurt, notify your dentist immediately.  You may be in need of additional therapy.  Cleanings should not hurt!

Fluoride Therapy:
During a cleaning appointment your dentist may recommend a fluoride treatment. Most people assume that fluoride treatments are for children only, but adults can benefit as well. The topical application of fluoride helps teeth resist future decay, increases the strength of teeth with existing fillings and can even repair or "heal" existing cavities if they are small enough.  Fluoride can even help to reduce sensitivity.  Research by the American Dental Association and independent labs has repeatedly confirmed that fluoride treatments are a safe and effective way to help reduce the formation of cavities. 

Fluorides today come in a variety of great tasting foams and gels.  Children today really enjoy getting their fluoride as compared to the experience 15-20 years ago.  The whole process is even faster.  Most treatments require only 1-2 minutes now. 

P.S. - Adults receive almost no benefit from the fluoride found in public water!