American Medical Association Family Medical Guide - American Medical Association [795]
Aligners—clear, removable pieces of plastic that are molded to fit over the teeth and that straighten the teeth without using brackets and wires—are an alternative to traditional braces. An aligner moves the teeth a very small amount and is worn day and night for about 2 weeks. You then replace it with the next aligner in the series, and continue this process until all of your teeth have been straightened. Aligners can be removed for eating, brushing, and flossing. The last aligner in the series is usually made of a thicker material, and you can wear it as a retainer to hold your teeth in their new position while the surrounding tissues stabilize. You may need to wear the retainer indefinitely to help ensure that your teeth don’t move.
Dental Treatments
A variety of dental procedures can help keep your teeth and gums strong and healthy. Keeping your teeth and gums in good condition is an essential component of good health.
Cleaning and Polishing
If your teeth are coated with calculus (also called tartar), a chalky mineralized deposit of hardened plaque, the dentist or hygienist will remove the calculus with handheld instruments called scalers. Because they must be used both above and below the gum line, scalers can cause the gums to bleed slightly. After scaling, the dentist or hygienist polishes the teeth, because a smooth surface slows the µformation of calculus.
Cleaning and polishing the teeth
Along with daily brushing and flossing, regular professional cleaning and polishing can help prevent tooth decay and periodontal disease. A dentist or hygienist uses a number of different instruments to remove calculus both above and below the gum line.
Filling a Tooth
The dentist fills a tooth if the enamel has been damaged (left). If the tooth is not filled, bacteria can reach the dentin inside the tooth and destroy it, and then attack the pulp. To prepare a tooth for filling, the dentist drills through the enamel and removes all traces of decay (center). He or she then shapes the hole to prevent the filling from falling out. The hole is then filled with a mixture of silver, tin, and mercury (right). If a filling will be visible, the dentist may use a white filling material made of quartz in a plastic resin.
Fillings
When a tooth is partly decayed or chipped, the dentist replaces the damaged area with a filling (see above). White fillings often are used on front teeth. Silver amalgam—a mixture of silver, tin, and mercury—is generally used on back teeth. If the treatment is likely to cause discomfort, the dentist will inject the gum with a local anesthetic. The dentist removes any decayed area and shapes the hole to retain the filling securely. If a front tooth is chipped, the dentist roughens the surface and bonds the filling to it. If a tooth is badly damaged or discolored, the dentist may use laminate veneers or acrylic resins to restore the appearance of the entire visible surface of the tooth. If the dentist uses a local anesthetic, be careful to avoid biting your lip or tongue while it is still numb.
Crowns
When a tooth is severely decayed, broken, fractured, brittle, or discolored, the dentist usually recommends an artificial crown for it if the base of the tooth and the roots are in good condition. The dentist prepares the damaged tooth by reducing the size of the natural crown so an artificial crown can fit over it. He or she then takes an impression of the prepared tooth and sends the impression to a dental laboratory, where an artificial crown is fabricated.
Generally, a white porcelain crown is fitted on a tooth that can be seen. On back teeth, gold or a less expensive material is used. Porcelain that is fused to metal can also be used for crowns on back teeth. The treatment