Say you want to build something: a chair, a patio, a house. If it’s going to last and serve its intended function, you’ll have to do a lot of evaluating and planning before cutting a piece of wood or hammering a single nail. How will the object be used? In what sort of environment will it be situated? What building materials are most suitable? How much will it cost? Will quality suffer if less expensive materials or even prefab elements are used?
Ignoring these and other issues means that a quality, durable, useful object may only arise by chance. It also increases the odds of the object failing the chair collapsing under weight, the patio deck warping from extremes of weather, the house pulling from its foundation.
No less care must be taken with dental restorations. The conscientious dentist must consider these same sorts of issues in providing you with a healthy, attractive smile. What is the function of the tooth to be restored? What are the surrounding dental conditions? In light of these factors and the patient’s unique biochemical make-up, which restoration materials would be most appropriate?
With a thorough understanding of such factors, the conscientious dentist will talk with you about your restoration options before doing the work. Types of restorations include inlays, onlays, crown, bridges and implants, as well as simple fillings. Acceptable materials for creating them include composite (a tooth-colored material), gold alloys, porcelain and ceramics. And while some metals may be appropriate for certain people in unique cases, mercury is never acceptable.
Indeed, in repairing or restoring broken, decayed or deeply infected teeth, the dentist must be especially careful that the work does not worsen or add to the problems the work is meant to fix. If physically unsuited materials are used, for example, the work may need to be replaced much sooner than anticipated. If the restoration isn’t placed properly, it can throw off the patient’s occlusion (bite), which can lead to chronic pain and discomfort. If biocompatible materials are not chosen, the patient may have a toxic reaction and eventually suffer illness or dysfunction.
But through careful, thorough evaluation and planning, aided by consultation with you, your dentist can do the utmost to provide you with optimal dental restorations.
Function, Strength, Durability, Aesthetics, Economics and Biocompatibility
The type of material used is determined by evaluating several factors, some of which overlap: tooth function, strength and durability, aesthetics, economics and, most important of all, biocompatibility.
Some materials work better in different parts of the mouth. For instance, stronger, more durable materials such as gold alloy or ceramics like Zirconium are needed for crowns and other restorations in the back of a mouth, as the molars take the brunt of force every time we bite down. Composite can be used for minor repairs to the molars, but that brunt force will wear them down rather quickly.
Strength and durability should always be considered when looking to the financial aspect of getting the work done. While it may be cheaper in the short term to fill with composite, for example, you will need to replace the restoration sooner than if the tooth had been fixed with a high quality ceramic. Indeed, many of the newest ceramics are even stronger than natural tooth enamel and more durable than gold. Computer design technology also lets lab technicians create restorations that are almost functionally and aesthetically identical to the teeth they are meant to replace. That is, they both act and look like natural teeth. And because there is no metal, the aesthetics will remain stable for the restoration’s lifetime. You will never see supporting gold or other metal work at the margins should the gums recede over time.
Such an outstanding outcome, while more expensive in the short run, ultimately saves money over time.
While not for everyone, some people find implants an appropriate restoration choice for many of the same reasons others choose ceramic crowns, bridges and the like. The upside is that they are even more functionally and aesthetically identical to the teeth they’re meant to replace. Being situated into the jawbone itself by way of a metal (usually titanium) post, an implant can be practically indistinguishable from a natural tooth. On the other hand, though, some people may have allergic or toxic reactions to the metal, so biochemical suitability should always be checked first. Others have concern with the metal posts interfering with the body’s energetic (acupuncture) meridians and altering the body’s biological terrain in such a way that the patient is more vulnerable to disease and dysfunction.
The choice of implants should thus be very carefully considered, especially if one is chronically ill or has a long history of chemical sensitivity or environmental illness.
Whatever the type of restoration to be done, biocompatibility of materials should always be checked prior to placement. We prefer the serum blood testing provided by Clifford Consulting and Research for its accuracy and thoroughness. Electrodermal screening (EAV) and applied kinesiology may also be used to test.
For those planning on mercury removal, detoxification or who have a history of environmental sensitivities, a serum blood test is essential before having any restorative work done. EAV and applied kinesiology can also be used to verify lab results.
The importance of biocompatibility cannot be stressed enough. It makes no sense to invest your time, money and the physical resources of your body to get beautiful restorations if they wind up harming your health. A person needing a new liver can’t just take any donated liver but one that is biologically matched; otherwise, his or her body will reject the organ. So, too, the person needing a tooth restored needs it to be a biological match. If it is not, systemic illness becomes a likely long-term result.
Getting the Bite Right
Most dental restorations take one to two visits to complete, depending on the type. Composites can be done right here in our office, but ceramic or gold crowns, for example, must be prepared for and then the cases sent to a lab to be created. A second visit is needed for placement and cementation.
The most important thing we check at placement is the occlusion: how your teeth come together. Again, the ideal is to come as close as possible to recreating the natural conditions of the mouth or even improving them. If a restoration is too high or low, the force of biting will be distributed unevenly across the surfaces of the teeth and down into the jaw. Over time, chronic pain can develop. The physical imbalance can also cause some restorations to break down more quickly. Consequently, we test and check and check again to make sure that, once your restorations are in place, your bite feels right and good.
Optimal occlusion lets you enjoy your restorations for a long, long time giving you even more reason to flash your new, healthy, attractive smile.