family & cosmetic dentistry in Waterloo
Dr. Gretzinger believes the best teeth are your own teeth, so he offers many different dental procedures to make sure you keep your teeth.
Dr. Gretzinger may recommend a treatment or procedure to restore or replace a tooth that has been lost or damaged or to improve the appearance, health and function of your teeth. Some of these procedures are straightforward, while others are more involved.
When you go for a dental exam, Dr. Gretzinger checks your fillings and may suggest that you replace any loose or broken ones. He also looks for signs of decay, such as brown or black spots and may want to use X-rays to take a closer look at suspicious spots.
Dental amalgam fillings are sometimes called “silver” fillings. They are the most common type of filling used in Canada today. Because these fillings are silver in colour, they are used to fill back teeth. They are a mix of metals such as mercury, silver, copper and tin.
Cast gold fillings are based on a model (or cast) of your tooth. Cast gold fillings are a mixture of gold with other metals such as silver and copper. These other metals make gold fillings more durable.
A cast gold filling is made in a dental lab and sent back to Dr. Gretzinger, who cements it in place in your mouth. You will need at least two visits to the dentist to get the job done. During the first visit, your dentist cleans out all the decay and makes a mold of your tooth. The hole is filled with a temporary filling.
Meanwhile, in a dental lab, the mold of your tooth is used to make a model. A filling that is the same size and shape as your tooth is built, based on the model. When you go back to Dr. Gretzinger, the gold filling is cemented in place.
Composite fillings are also called white fillings. Composites can be made in a wide range of tooth colors allowing near invisible restoration of teeth
Glass ionomer materials are only used in teeth where you do not bite down hard. There have not been many studies about how long this kind of filling lasts. Newer forms of the filling may be stronger and last longer. Research is underway to evaluate the effectiveness of these materials.
Porcelain materials are the most common type of dental ceramic used by dentists. They are hard and brittle. Porcelain and metal can be combined to make a strong, tooth-coloured crown.
Dental porcelain is made in a dental lab. Unless you have a bad tooth-grinding habit or some other problem, a combination of porcelain and metal can be used anywhere in the mouth.
To fill a cavity, Dr. Gretzinger may first give you “freezing” (or local anesthetic), so you do not feel any pain. He then takes out all traces of decay, shapes the hole and fills it.
Most fillings are done in two ways:
Dental amalgam is the best-known direct material. Cast gold alloy is the most durable indirect material. However, ceramics are gaining in popularity because of their longevity relative to other tooth-coloured materials.
If one or more of your teeth are missing, there are a number of ways to replace them. An alternative to bridges, partials or complete dentures may be dental implants. Implants are used to replace missing roots and support artificial replacement teeth. They are comfortable and look like natural teeth.
A dental implant is an artificial root made of titanium metal. It is inserted into the jawbone to replace the root of the natural tooth. An artificial replacement tooth is attached to the implant. The implant acts as an anchor to hold the replacement tooth in place.
If you are having an implant, your dentist may refer you to a dental specialist who has further training in this area. Specialists who place implants are periodontists or oral and maxillofacial surgeons, also called oral surgeons. Specialists who place crowns, bridges and dentures on implants are called prosthodontists.
If you are in good general health, have healthy gums and have enough bone in the jaw to hold an implant, dental implants might be right for you. If your jawbone has shrunk or if it has not developed normally, you may be able to have a bone graft to build up the bone. A bone graft is a way of adding new bone to your jawbone. Your dentist or dental specialist will tell you if bone grafting can be done.
Because dental implants are placed in the jawbone, artificial replacement teeth attached to implants look and act much like natural teeth. Like natural teeth, implants need to be kept clean using a toothbrush and floss. Your dentist will show you the proper cleaning procedure for implants. Regular dental checkups are important so your dentist can make sure that your bite is right and that your implants are not loose.
If your tooth is damaged but not lost, a crown can be used to restore its shape, appearance and function. You may need a crown if you have a root canal, a large filling in a tooth or a broken tooth.
A crown, also called a cap, is a hollow, artificial tooth used to cover a damaged or decayed tooth. The crown restores the tooth and protects it from further damage. Crowns can also be used to cover a discoloured or misshapen tooth. A tooth that has been fixed with a crown looks and works very much like a natural tooth.
If you need to have a tooth crowned, Dr. Gretzinger may do it, or he may refer you to a prosthodontist. A prosthodontist is a dentist who has completed a university post-graduate specialty program in prosthodontics. Prosthodontics is a specialty of dentistry that deals with restoring and replacing natural teeth and tissues with artificial substitutes.
These are the steps most often used in making a crown, but your tooth may need special care. You may need orthodontic treatment, gum treatment or root canal treatment. It may take more than 2 visits, or your visits may last longer.
Crowns are made from various types of materials. Depending on which tooth needs a crown, Dr. Gretzinger will suggest a material, or combination of materials, that is right for you.
Metal crowns are made of gold. They generally last a long time and won’t chip or break. They tend not to wear down your opposing natural teeth. However, the gold colour does not look natural, particularly on front teeth.
Composite crowns look natural. They won’t chip as easily as porcelain crowns, but they tend to wear more quickly from chewing. Tooth brushing tends to remove the highly polished surface of composite crowns and this causes them to stain more easily.
Porcelain crowns look the most natural. They are more brittle than metal or composite and may chip more easily. Because of this, they are not usually placed on back teeth.
Porcelain-fused-to-metal crowns look natural and are stronger than porcelain or composite crowns. They won’t chip as easily as porcelain or ceramic crowns. However, depending on their design, the metal may show if your gums are thin or shrink.
What else should I know?
Crowns are strong and generally last for about 10 years or longer if you take good care of them. Brush and floss your crown, just like you clean your natural teeth. Crowns may not be as strong as your natural teeth. So like your natural teeth, remember not to bite down on hard objects or use your teeth to open or cut things.
The best teeth are your own natural teeth. But sometimes, a tooth is badly damaged or lost. If a tooth is lost, it is important to replace it with an artificial tooth as soon as possible. This will prevent the teeth that are left from drifting out of line and possibly causing jaw problems. Teeth that are out of line are harder to clean and are more likely to get periodontal disease (gum disease) and cavities. If one or more of your teeth are missing, your dentist may suggest replacing your missing teeth with a bridge or a denture. If you need to have a tooth (or teeth) replaced, your dentist may do it, or he or she may refer you to a prosthodontist. A prosthodontist is a dentist who has completed a university post-graduate specialty program in prosthodontics. Prosthodontics is a specialty of dentistry that deals with restoring and replacing natural teeth and tissues with artificial substitutes.
A bridge, also called a “fixed bridge” or a “fixed dental prosthesis,” is a dental restoration that replaces one or more missing teeth. It extends across an area that has no teeth and is typically made up of an artificial tooth fused between 2 crowns. (A crown is a hollow, artificial tooth that fits over a natural tooth or a dental implant). The bridge is held firmly in place by your own teeth on each side of the missing one(s) or by dental implants. A bridge is permanent and cannot be removed.
There are different types of dental bridges. Your dentist or prosthodontist will recommend the most appropriate one depending on the location of the missing tooth (or teeth) and the condition of your teeth, mouth and gums.
Traditional bridges are used if there are natural teeth on each side of the gap where the tooth is missing. (As an alternative to a bridge, your dentist may suggest a single implant to replace a missing tooth between 2 healthy teeth. An implant will prevent you from having to get your healthy teeth filed down in preparation for the crowns.)
Implant bridges are used if you don’t have healthy teeth or enough teeth to support a bridge, or when several or all teeth are missing. A custom-made bridge is anchored to the dental implants. Your dentist will first determine if dental implants are right for you.
Resin-bonded bridges, also known as “Maryland” bridges, are used when the missing teeth are in the front of the mouth. This type of bridge involves the artificial teeth being fused together to metal bands and cemented to the back of your natural teeth.
Cantilever bridges are used when there are healthy teeth on only one side of the missing tooth or teeth. This procedure involves anchoring the artificial tooth over one or more of your natural adjacent teeth.
If you take good care of your bridge, it should generally last for about 10 years, or perhaps longer. Like natural teeth, bridges need to be brushed and flossed every day. Your dentist will show you how to use a floss threader to floss under and around the artificial tooth (or teeth) in the middle of the bridge. Regular dental visits and professional cleanings are also important. If you have an implant bridge, your dentist will show you how to properly care for them.
Dentures are artificial replacements for your natural teeth and gums. If an accident, a disease or poor oral health care has left you with only a few healthy teeth or none at all, Dr. Gretzinger might suggest dentures to replace your missing teeth. There are 2 types of dentures: partial and complete. For both types of dentures Dr. Gretzinger makes a model of your teeth by taking impressions. The models are used to custom-make your dentures.
Partial dentures are also called “removable partial denture prostheses” or “partials.” They may be used when nearby teeth are not strong enough to hold a bridge, or when more than just a few teeth are missing. Partial dentures are made up of one or more artificial teeth held in place by clasps that fit onto nearby natural teeth. You can take the partial denture out yourself, for cleaning and at night.
Complete dentures are what we most often refer to as “false teeth.” They are also called “full dentures” and are used when all your natural teeth are missing. Complete dentures are removable as they are held in place by suction. They can cause soreness at first and take some time to get used to. There are 2 types of complete dentures: immediate dentures and conventional dentures.
Conventional dentures are made and inserted into your mouth after your teeth have been extracted and the gums and jaw tissues have healed.
Complete and partial dentures need to be cleaned every day just like natural teeth. Otherwise, plaque and tartar can build up on your dentures and cause stains, bad breath and gum problems. Plaque from your dentures can also spread to your natural teeth and gums, causing gum disease and cavities.
To clean your dentures, remove them from your mouth and run them under water to rinse off any loose food particles. Then wet a denture brush or a regular soft-bristle toothbrush and apply denture cleaner or a mild soap. Household cleaners and regular toothpaste are too abrasive and should not be used for cleaning dentures. Gently brush all surfaces of the dentures including under the clasps where bacteria collect. Be careful not to damage the plastic or bend the attachments. Rinse your dentures well in clean water before placing them back in your mouth.
While your dentures are removed, be sure to clean and massage your gums. If your toothbrush hurts your gums, run it under warm water to make it softer or try using a finger wrapped in a clean, damp cloth. If you have partial dentures, brush your natural teeth with a soft-bristled toothbrush and floss.
Always remove your dentures overnight to give your mouth a chance to rest. Soak them in warm water with or without denture cleanser. If your dentures have metal clasps, only use warm water for soaking, as other soaking solutions can tarnish the metal. When you’re not wearing your dentures, keep them in water to stop them from drying out or warping. Never use hot water for soaking.
Look for cracks in your dentures. If you find any, take them to your dentist or specialist for repair. See Dr. Gretzinger regularly and at least once a year. Your mouth is always changing, so your dentures will need adjusting or relining from time to time to make sure they fit well. Poorly fitted dentures may cause denture sores that make oral cancer more difficult to spot. At your dental exam, Dr. Gretzinger will also examine your gums for any signs of disease or oral cancer and any natural teeth you may have for signs of decay or infection.