What restorative dentistry covers
Five treatments do most of the work. Which suits you depends on what is left of the tooth, what the bone and gums look like, and what you are willing to live with.
- Dental implants. A titanium post placed in the jawbone to replace the missing root, carrying a crown, a bridge or a denture attachment.
- Crowns and caps. Full coverage for a tooth too cracked, worn or heavily filled to hold a filling.
- Fixed bridges. A cemented replacement that borrows support from the teeth either side of the gap.
- Dentures and partial dentures. Removable replacements for several teeth or a whole arch, including versions that clip onto implants.
- Root canal therapy. Treatment for infection inside a tooth, so you keep a tooth that would otherwise come out.
Smaller repairs are handled with bonded tooth-colored fillings under cosmetic dentistry, and where the tooth shows, see porcelain crowns.
Save the tooth or replace it
Almost every decision here comes down to one question. Is this tooth worth keeping, and if it is, will the repair hold. A natural root in healthy bone, with a ligament around it that senses pressure, is worth real effort to keep. A tooth that has split below the bone, lost most of its support to gum disease, or has canals that cannot be sealed will keep costing you appointments before it comes out anyway.
What we look at: how much sound tooth is left above the gumline, because a crown needs something to grip; whether a crack runs into the root; how much bone holds the tooth; what job it does in your bite; whether you grind; and whether the result can be kept clean. Rebuilding a tooth that was always going to fail costs you the money and some bone, so we will tell you which category yours falls into.
Rebuilding the tooth you have compared with taking it out
A general comparison rather than a rule. The specific tooth decides.
| Consideration | Keep and rebuild | Extract and replace |
|---|---|---|
| What you keep | The natural root and the ligament around it, which senses pressure and lets you feel what you bite. | Nothing of the original tooth. The replacement sits in the bone or rests on top of it. |
| Bone | Bone around a working root stays loaded and holds its shape. | The ridge shrinks after extraction. An implant loads it again; a bridge does not. |
| Time and neighbors | A few weeks, and the teeth either side are untouched. | An implant takes months, most of it healing. A bridge is quicker but means cutting down both neighbors. |
| If it does not work out | Extraction and replacement are still open to you, though you may have lost bone meanwhile. | Far fewer options once the tooth is gone, and the decision is hard to reverse. |
Why a missing tooth is worth replacing
A gap at the back where nobody sees it still causes trouble, and the trouble usually turns up years later in another tooth.
- Neighboring teeth drift. They tip into the space over months and years, opening food traps that are hard to clean.
- The opposing tooth over-erupts. With nothing biting against it, it keeps moving out of the bone until it interferes with the bite, and can be lost though nothing was wrong with it.
- The bone under the gap resorbs. Bone keeps its volume because it is loaded. The ridge shrinks fast at first, which narrows your options later.
- The remaining teeth carry more load. Fewer teeth taking the same force means more cracked cusps and failed fillings. If your jaw is sore, that load matters.
- Chewing and speech change. People missing back teeth quietly stop eating what is hard to chew, and several missing teeth take away lip support.
That is an argument for a plan and a timeline, not for a gap left indefinitely.
The order we do things in
Sequence matters. Building crowns and bridges on active disease wastes the work.
-
Examination and records
A full examination, x-rays, periodontal charting and a look at how your teeth meet. Rebuilding without knowing the bone level and the bite is guesswork.
-
Get out of pain first
Anything acute comes before anything elective. An abscessed tooth is treated with root canal therapy or removed. In pain now, see dental emergencies.
-
Treat the disease before rebuilding
Decay is removed and the gums treated until they stop bleeding. Gum disease is a common reason restorations and implants fail years later, and it is easier to treat first.
-
Rebuild in the order healing allows
Extractions and grafts come first because bone takes months. Implants are placed and left to integrate, and crowns and bridges on natural teeth can be done meanwhile.
-
Fit, adjust the bite, then maintain it
An even bite keeps porcelain from chipping and stops one tooth taking more than its share. New dentistry increases the need for cleanings. See preventive dentistry.
Common questions about restorative dentistry
How do I know whether to save a tooth or replace it?
It depends on how much sound tooth is left, how much bone holds it, whether a crack runs into the root, and whether the result can be kept clean. Borderline teeth are a judgment call, and you get our reasoning and the alternative.
How long does restorative treatment take?
Two visits for a single crown, up to the better part of a year where extractions, grafting and implants are involved. Most of that is healing rather than appointments.
What does a crown or an implant cost in Oakhurst?
Fees depend on the material, whether a build-up or graft is needed first, and how many teeth are involved, so a figure quoted without seeing your mouth is a guess. You get an itemized estimate. See financing.
Can all of this be done in one office?
Most of it. Dr. Brosi is a general dentist and provides crowns, bridges, dentures, root canal therapy and implants. Difficult surgical extractions, unusual canal anatomy and advanced gum surgery are referred to a specialist.
When are you open, and how quickly can I be seen?
Monday to Wednesday from 8:30 am to 5:00 pm and Thursday from 7:30 am to 4:00 pm, closed Friday through Sunday. Call (559) 683-4694 or use the contact page. Urgent problems are fitted in as early as we can.
In this area of treatment
Each of these has its own page with the detail that does not fit here.
-
Dental Implants
A titanium root placed in the jaw to support a crown, bridge or denture without altering neighboring teeth.
-
Dental Crowns and Caps
Full-coverage restorations that hold a cracked or heavily restored tooth together under chewing load.
-
Fixed Dental Bridges
A cemented, non-removable replacement for one or more missing teeth in a row.
-
Dentures and Partial Dentures
Removable replacements for several or all teeth, including implant-retained options that stay put.
-
Root Canal Therapy
Treatment that removes infection from inside a tooth so the tooth can stay rather than be extracted.