Cupertino Dentist - Dr. Randall LaFrom serving the San Jose, Cupertino area

RESTORATIVE DENTISTRY - (The repair and replacement of teeth to proper form and function.)

When we speak of restorative dentistry, this is the typical drill-and-fill treatment that we encounter. This, however, is where the similarity stops. Newer technologies have evolved that allow us to produce more aesthetic fillings, more conservative treatment, more accurate margins, stronger and longer lasting treatment for our patients. As these technologies come available, we will investigate them and offer them to you once we have been satisfied that they will be around for several years and that they have proven their durability.

Two of the technologies which we have been using at our practice for the past few years include "air-abrasion micro-dentistry" and "caries detector dye". The air abrasion unit allows us to pin-point stains or decay and very conservatively remove spots of decay without taking away accesive tooth structure. In addition, it has less heat build-up than the drill and is less likely to cause stress cracks that have been associated with the heat and pressure from a drill in the past. The second iten we use is the red caries detector (cavity stain - similar concept to the chewable tablets we had as kids to see where we missed when we brushed). It has been estimated that as much as 20-40% of decay had been left in the tooth by dentists who DON'T use this in the past, because decay may be hiding under a margin or deep in the tooth and be missed. We have been using this at our office for about 15 years now, however, it was one of dentistries hidden secrets until recently and now it is taught in dental schools.

At our office, we are committed to providing the best technology that we can and as a result, we attend well over 50 units of continuing education courses every two years to make sure of that. Most types of restorative procedures fall into five different categories:

Fillings
Crowns
Veneers
Bridges
Dentures

These are covered in greater detail under aesthetic dentistry and prosthetic dentistry in the sections below.

Fillings are basically of two types: either amalgam or composite. We have found that many amalgam fillings can cause problems due to leakage, shrinkage and expansion over time. A large amalgam filling can act as a "wedge" in a tooth and as a result, if it expands and contracts at a different rate than the natural tooth, it puts stress cracks in the tooth and can lead to a fracture in the future. As a result, we have used amalgams only for specific purposes and suggest the composite fillings instead. Composite resins (tooth colored plastic fillings - which typically contain silica crystals for strength) are bonded to the teeth, produce fewer fractured teeth and look better. We can do a more conservative treatment when we use composite filling material generally.

Crowns, are also generally two types: either porcelain or gold. It used to be that gold was done for most back teeth and porcelain is used on the front teeth. Now, we have newer materials that can withstand the heavier stresses that are put on the back teeth, and they don't tend to wear down the opposing teeth as quickly as porcelain, nor do they have the challenging aesthetic problem associated with gold.

Veneers are porcelain facings that (typically) go on the front teeth. They are conservative alternates to full crowns, and are more aesthetic and sturdy than a composite filling. You can think of them like a "fake fingernail", the way they fit over the tooth. Once they are bonded, they are very strong and the color tends to stay the same for a long time. These are great for fractures, spaces between teeth and creating "instant orthodontics" on your front teeth.

Bridges. These are used when you are missing one or more teeth and you wish to not have it affect your health, the spacing of your teeth, and the aesthetics of your mouth. A bridge is used to replace the missing tooth and prevent the adjacent teeth from "falling" in towards the space that was left, as well as prevent the opposing tooth from coming down further than it should causing a mis-alignment of those teeth.

Dentures. These are either full-dentures or partial-dentures. As the name implies, a full denture replaces all of the teeth in an arch, whereas a partial denture will replace one or more teeth in the mouth. They are generaly plastic or porcelain teeth (or a hybrid of both), placed into a plastic tray that has been custom molded to fit the empty space. There are several critical factors involved when creating a denture (or partial). Among these is the size of the teeth, the shape of the teeth, the color of the teeth, the alignment of the teeth, the fit of the teeth and how much wear the teeth will be getting. When we sit down with our patients to create the best possible fitting dentures, often it will take several visits to get it "just right" since the mouth has many uses, including speech, aesthetics, chewing and support.