Treatments

Fillings/Restorations

We are a mercury-free practice. However, many people still have silver/mercury fillings in their mouths from years past. These fillings are not particularly pleasing to the eye, and we know that by unavoidable design, silver/mercury fillings ultimately result in a weaker tooth structure. Porcelain inlays and tooth colored restorations (onlays) create fillings that are not only beautiful and unnoticeable but also add strength to weakened teeth. These restorations are esthetically pleasing and very strong thanks to new bonding technologies.

Disadvantages of Silver fillings:

Silver fillings have many drawbacks. The edges of the silver filling can wear down, become weak or break. This results in the tooth not being protected and lets cavities get started once again. With age, the metal of a silver filling expands, contracts, and can split.

Silver fillings contain 50 percent mercury. They can corrode, leak and cause stains on your teeth and gums.
Fortunately, silver fillings can safely be replaced with Tooth-Colored Restorations.

Advantages of Tooth-Colored Restorations

There are many advantages to tooth-colored restorations. Resin onlays are bonded to the teeth creating a tight, superior fit to the natural tooth. Such restorations can be used in instances where much of the tooth structure has been lost. The tooth remains intact and stronger.

Since the resin used in tooth-colored restorations contain fluoride this can help prevent decay. The resin wears like natural teeth and does not require placement at the gum line, which is healthier for your gums!
The result is a beautiful smile!

Replacing Silver Fillings with a Tooth Colored Restoration

You can have your silver fillings replaced with tooth-colored restorations (onlays). This process requires two appointments.

Your First Appointment:

The old filling is removed along with any additional decay.
An impression is made of your teeth. A model of your teeth is made and sent to the lab.
A temporary onlay is placed on the tooth.
At the Lab: A resin is carefully placed into the model of your teeth. It is then designed to look natural.

Your Second Appointment:

The temporary onlay is removed.
A conditioning gel is placed on your tooth to prepare it for the new onlay.
Bonding cement is placed on the tooth and a high intensity light bonds the resin to the tooth.
The tooth is then polished.
Your teeth are restored to a natural look and feel, they are stronger and the tooth is protected!

Dental Sealants

Highly effective in preventing decay on the biting surfaces of your chewing teeth, dental sealants are a simple procedure in which a tooth-colored acrylic “coating” is painted onto the surface of the tooth. This effectively “seals” the deep grooves, acting as a barrier and protecting enamel from plaque and acids.
Sealants protect the depressions and grooves of your teeth from food particles and plaque that brushing and flossing can’t reach.

Easy to apply, sealants take only a few minutes to seal each tooth. Sealants hold up well under the force of normal chewing and can last several years before a reapplication is needed.
Children and adults can benefit from sealants in the fight against tooth decay.

Dentures

A denture or a complete denture as it is often called, is an appliance that is inserted in the mouth, replaces natural teeth and provides support for the cheeks and lips.
Most dentures are made of acrylic and can be fabricated two different ways.
A conventional denture is made after all teeth have been extracted and the tissues (gums) have healed.
An immediate denture is fabricated and inserted immediately after the teeth are extracted and the tissues are allowed to heal under the denture.

An upper denture has acrylic, usually flesh colored, that covers the palate (roof of the mouth).
A lower denture is shaped like a horseshoe to leave room for the tongue.
Dentures over a normal course of time will wear and need to be replaced or relined in order to keep the jaw alignment normal. The alignment will slowly change as the bone and gum ridges recede or shrink due to the extraction of the teeth. Regular dentist examinations are still important for the denture wearer so that the oral tissues can be checked for disease or change.

Bridges

All of your teeth play an important role in speaking, chewing and in maintaining proper alignment of other teeth. Tooth loss doesn’t necessarily have to occur as you age, but if you do lose teeth they must be replaced to maintain proper function of your mouth. Fortunately, there are options for correcting tooth loss.

Dental Implants

A bridge — a device used to replace missing teeth — attaches artificial teeth to adjacent natural teeth, called abutment teeth. Bridges are either permanently attached (fixed bridges), or they can be removable.
Fixed bridges are applied by either placing crowns on the abutment teeth or by bonding the artificial teeth directly to the abutment teeth. Removable bridges are attached to the teeth with metal clasps or by precision attachments.
If you’re missing one or more teeth, you may be aware of their importance to your appearance and dental health. Your teeth work together for many daily functions from eating to speaking. With missing teeth, it’s difficult to do these things. Missing teeth can and should be replaced. Fixed bridges are a great way to restore your dental health and appearance.

What exactly is a bridge or fixed partial denture?

A bridge (fixed partial denture) is a device that fills the gap where teeth are absent. Fixed bridges are bonded into place and can only be removed by a dental professional. Removable bridges, as the name implies, can be taken out and cleaned. Fixed bridges offer more stability than their removable counterparts.

Why do I need a bridge?

Oral functionality and appearance are important reasons for wearing a bridge. A bridge helps support your lips and cheeks. The loss of a back tooth may cause your mouth to sink and your face to look older.
Dental health is the most important reason for a bridge. Teeth were designed to complement each other. Unusual stresses are placed on the gums and other oral tissues when teeth are missing, causing a number of potentially harmful disorders.

Increased risk of gum disease has proven to be one of the worst side effects of missing teeth and can be minimized with a bridge.

Missing teeth can cause speech disorders as they are used to make many of the sounds we use to speak clearly.
How is a bridge attached?

The attachment procedure usually takes two or three appointments to complete. At the first appointment Dr. Carolan will prepare the teeth on either side of the gap by removing a portion of the enamel and dentin.
Since the bridge must be fabricated very precisely to ensure correct bite and to match the opposing tooth, impressions of the teeth are taken and sent to a lab where the bridge will be constructed.
Fixed bridges are typically cemented to the natural teeth next to the space left by the missing tooth. A pontic (false tooth) replaces the lost tooth. Crowns, which are cemented onto the natural teeth, provide support for the bridge.

What materials are used?

Bridges can be constructed from gold alloys, non-precious alloys, porcelain, or a combination of these materials. Porcelain is often bonded to either precious or non-precious metal.

How do I take care of my bridge?

A strict regimen of brushing and flossing will keep the bridge and surrounding teeth clean. This is of critical importance as the bridge relies on the neighboring teeth for support.

Dental Crowns

Dental implants are designed to provide a foundation for replacement teeth that look, feel and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything and can smile with confidence, knowing that teeth appear natural and that facial contours will be preserved. The implants are tiny titanium posts, which are placed into the jawbone where teeth are missing. The bone bonds with the titanium, creating a strong foundation for artificial teeth. In addition, dental implants can help preserve facial structure, preventing the bone deterioration that occurs when teeth are missing. Dental implants are changing the way people live! With them, people are rediscovering the comfort and confidence to eat, speak, laugh and enjoy life.

Evaluation for Dental Implants

If, like many others, you feel implant dentistry is the choice for you, we ask that you undergo a dental/radiographic examination and health history. During these consultation visits, your specific needs and considerations will be addressed by either Dr. Carolan or by an Oral and Maxillofacial Surgeon referred by our practice. Your questions and concerns are important to us and our team will work with you very closely to help make your procedure a success.

Dental Implant Procedure

Dental implants are metal anchors, which act as tooth root substitutes. They are surgically placed into the jawbone. Small posts are then attached to the implant, which protrude through the gums. These posts provide stable anchors for artificial replacement teeth.

For most patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jawbone. For the first three to six months following surgery, the implants are beneath the surface of the gums, gradually bonding with the jawbone. You should be able to wear temporary dentures and eat a soft diet during this time. At the same time, your restorative dentist designs the final bridgework or denture, which will ultimately improve both function and aesthetics.

After the implant has bonded to the jawbone, the second phase begins. The surgeon will uncover the implants and attach a small healing collar. Dr. Carolan can then start making your new teeth. An impression must be taken. Then posts or attachments can be connected to the implants. The replacement teeth are then made over the posts or attachments. The entire procedure usually takes six to eight months. Most patients do not experience any disruption in their daily life.

Extractions

You and Dr. Carolan may determine that you need a tooth extraction for any number of reasons. Some teeth are extracted because they are severely decayed; others may have advanced periodontal disease, or have broken in a way that cannot be repaired. Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth), or in preparation for orthodontic treatment.

The removal of a single tooth can lead to problems related to your chewing ability, problems with your jaw joint, and shifting teeth, which can have a major impact on your dental health.

To avoid these complications, in most cases, Dr. Carolan will discuss alternatives to extractions as well replacement of the extracted tooth.

The Extraction Process

At the time of extraction the doctor will need to numb your tooth, jawbone and gums that surround the area with a local anesthetic.

During the extraction process you will feel a lot of pressure. This is from the process of firmly rocking the tooth in order to widen the socket for removal.

You feel the pressure without pain as the anesthetic has numbed the nerves stopping the transference of pain, yet the nerves that transmit pressure are not profoundly affected.
If you do feel pain at any time during the extraction please let us know right away.

Sectioning a tooth

Some teeth require sectioning. This is a very common procedure done when a tooth is so firmly anchored in its socket or the root is curved and the socket can’t expand enough to remove it. The doctor simply cuts the tooth into sections then removes each section one at a time.

After Extraction Home Care
Bleeding

Some bleeding may occur. Placing a piece of moist gauze over the empty tooth socket and biting down firmly for 45 minutes can control this.

Blood clots that form in the empty socket.

This is an important part of the healing process and you must be careful not to dislodge the clot.
Avoid rinsing or spitting for 24 hours after the extraction.
Avoid use of a straw, smoking or hot liquids.

Swelling

If swelling occurs you can place ice on your face for 10 minutes and off for 20 minutes. Repeat this cycle, as you feel necessary for up to 24 hours.

Pain and Medications

If you experience pain you may use non-prescription pain relief medications such as acetaminophen or ibuprofen.

Eating

For most extractions just make sure you do your chewing away from the extraction site. Stay away from hot liquids and alcoholic beverages for 24 hours. A liquid diet may be recommended for 24 hours.
Brushing and Cleaning
After the extraction avoid brushing the teeth near the extraction site for one day. After that you can resume gentle cleaning. Avoid commercial mouth rinses, as they tend to irritate the site. Beginning 24 hours after the extraction you can rinse with salt water (1/2 teaspoon in a cup of water) after meals and before bed.
Dry Socket

Dry socket occurs when a blood clot fails to form in the socket where the tooth has been extracted or the clot has been dislodged, and the healing is significantly delayed.
Following the post extraction instructions will reduce the chances of developing dry socket. Dry sockets manifest themselves as a dull throbbing pain, which doesn’t appear until three or four days after the extraction. The pain can be moderate to severe and radiate from the extraction area. Dry socket may cause a bad taste or bad breath and the extraction site appears dry.
Dr. Carolan will apply a medicated dressing to the dry socket to sooth the pain.

Healing

After a tooth has been extracted there will be a resulting hole in your jawbone where the tooth was. In time, this will smooth and fill in with bone. This process can take many weeks or months. However, after 1-2 weeks you should no longer notice any inconvenience.

Cosmetic Treatments

Bonding

Bonding is an alternative to veneers, and can be used as a restorative procedure for teeth that are chipped, cracked, discolored or misarranged.

How does it work?

The tooth is prepared for the procedure by lightly etching the surface and applying a bonding liquid. Once the liquid sets, a plastic resin is applied and sculpted into the desired shape by the dentist. Once set, the resin is trimmed, smoothed and polished to a natural appearance.

Considerations

The bonding procedure can often be completed in a single office visit, and can improve the appearance of a tooth significantly. However, since the plastic resin used is not as strong as your natural tooth enamel, it is more likely to stain, chip or break than natural teeth. Bonding typically lasts three to five years before need of repair.

Porcelain Veneers

What are porcelain veneers? Porcelain veneers are thin shells of ceramic that bond directly to the front surfaces of the teeth. They are an ideal choice for improving your smile and have become increasingly popular due to their simplicity and versatility.
Placing custom veneers requires a high degree of technical skill as well as attention to cosmetic detail. We place veneers routinely, and design each case individually to match and enhance the characteristics of each patient’s smile.
Will they look like normal teeth?When bonded to the teeth, the ultra-thin porcelain veneers are virtually undetectable and highly resistant to coffee, tea, or even cigarette stains. For strength and appearance, their resemblance to healthy, white tooth enamel is unsurpassed by other restorative options.How durable are porcelain veneers?

With proper care, porcelain veneers will brighten your smile for well over a decade.
Dr. Carolan will ensure that your veneers are crafted from the highest quality porcelains and are bonded with the most advanced and proven materials available.
Refraining from using your veneers as tools to open and cut things will prolong their life, and if accidental breakage or damage occurs, it is usually possible to replace only the veneer involved.

Inlays and Onlays

When more than half of the tooth’s biting surface is damaged a dentist will often use an inlay or onlay.
What are inlays and onlays?

Inlays and onlays can be made of porcelain, gold, or composite resin. These pieces are bonded to the damaged area of the tooth. An inlay, which is similar to a filling, is used inside the cusp tips of the tooth. An onlay is a more substantial reconstruction, similar to the inlay but extending out over one or more of the cusps of the tooth.
Traditionally, gold has been the material of choice for inlays and onlays. In recent years, however, porcelain has become increasingly popular due to its strength and color, which can potentially match the natural color of your teeth.

How are inlays and onlays applied?

Inlays and onlays require two appointments to complete the procedure. During the first visit, the filling being replaced or the damaged or decaying area of the tooth is removed, and the tooth is prepared for the inlay or onlay. To ensure proper fit and bite, an impression of the tooth is made by the dentist, and sent to a lab for fabrication. The dentist will then apply a temporary sealant on the tooth and schedule the next appointment.
At the second appointment, the temporary sealant is removed. Dr. Carolan will then make sure that the inlay or onlay fits correctly. If the fit is satisfactory, the inlay or onlay will be bonded to the tooth with a strong resin and polished to a smooth finish.

Considerations for inlays and onlays

Traditional fillings can reduce the strength of a natural tooth by up to 50 percent. As an alternative, inlays and onlays, which are bonded directly onto the tooth using special high-strength resins, can actually increase the strength of a tooth by up to 75 percent. As a result, they can last from 10 to 30 years. In some cases, where the damage to the tooth is not extensive enough to merit an entire crown, onlays can provide a very good alternative.

Teeth Whitening

Having a beautiful smile may be even easier than you think. Many people achieve the look they’ve been dreaming of with our simple “bleaching” procedure.

What are the details of teeth whitening?

It’s safe, quick, and inexpensive. Just let us know at any appointment if you would like to whiten your teeth. You can lighten only your upper teeth or both the upper and lower, depending on how much you show when you talk and smile.
In only a day or two your custom bleach splints will be ready for you to pick up. We provide you with a special bleaching agent that you put into the clear splints. With only a few hours of wear per day, our special bleaching agent bubbles stains right out of your enamel in a very short time without altering tooth structure or existing dental work in any way. When your teeth reach the desired brightness, only occasional treatment is needed to maintain your new smile. We’ll want to take “after” photos at your next appointment.

Dental bleaching can be used to correct tooth discoloration. Discolorations can be caused by staining, aging, or chemical damage to teeth. Using the latest in bleaching technology, we can offer a safe method for creating a beautiful “brilliant” smile. In cases of extreme tooth discoloration, crowns or veneers may be the only choice, but because of the low cost of bleaching treatments, bleaching is nearly always worth a solid try.

Key Benefits of Teeth Whitening

  • Corrects brown, yellow and spotted tooth staining
  • Works on people of any age
  • Is a near-permanent solution for a “dull” smile, restoring brightness and brings a smile alive

How is teeth whitening done?

An impression is taken to make a specialized “mouth guard” or “stent” to hold the bleach against the teeth. The material is used each night for about 3-4 hours for a week or two, and at the end of this time, significant whitening will occur. In some cases, the change is nothing short of brilliant. For confidence in appearance, bleaching technology allows us to promise improvements in yellowing, aging or stained teeth. For very severely stained teeth, crowns or porcelain veneers may be more appropriate.

Considerations for Teeth Whitening

Over-the-counter bleaching agents are available for purchase at drug stores and pharmacies. However, since these products can cause harm to the gums and teeth, it’s better to use products that our practice recommends.

Zoom! Whitening

If you prefer teeth that are immediately whiter right now or you would rather whiten your teeth over a few nights while you sleep, Dr. Carolan has your answer with Zoom! The Zoom! In-Office Whitening System uses proprietary technology to whiten your teeth an average of eight shades* in a little over an hour while you relax at our office. It’s ideal for anyone who wants immediate results. The Zoom! Take-Home Whitening System uses a revolutionary patent-pending gel to whiten your teeth an average of six shades in three nights*. And you may go even lighter with additional applications. Start on Friday and by Monday you’ll have a whole new smile. Strips or paint-on gels are a waste of time. Get your teeth whiter in a fraction of the time with Zoom.

What is Zoom! tooth whitening?

Zoom! is a bleaching process that lightens discoloration of enamel and dentin.

What can cause tooth discoloration?

There are many causes. The most common include aging and consumption of staining substances such as coffee, tea or tobacco. During tooth formation consumption of tetracycline, certain antibiotics or excessive fluoride may also cause tooth discoloration.

Who may benefit from tooth whitening?

Just about anyone can benefit from tooth whitening. However, treatment may not be as effective for some as it is for others. With an oral exam, Dr. Carolan can determine if you are a candidate for this procedure, including a shade assessment.

Is tooth whitening safe?

Yes, research and clinical studies indicate that whitening teeth under the supervision of a dentist is safe. In fact, many dentists consider whitening the safest cosmetic dental procedure available. As with any tooth whitening product, Zoom! is not recommended for children under 13 years of age and pregnant or lactating women.

Do the results last a long time?

By following some simple post whitening care instructions, your teeth will always be lighter than they were before. We recommend flossing, brushing twice daily with Zoom! Whitening Toothpaste, and touch-ups with Zoom! take-home gel. These are professional formula products designed specifically to keep your teeth their brightest. They are available through our office.

Is there any difference between over-the-counter tooth whiteners and Zoom!

Yes! Consulting Dr. Carolan is always the first step to whitening your teeth safely. Over-the-counter tooth whitening strips, brush-on gels and toothpastes take weeks or months to whiten your teeth just a few shades. Zoom! is clinically proven to whiten your teeth eight shades* in one hour or six shades* in just one weekend.

How does the Zoom! In-Office System work?

The Zoom! light-activated whitening gel’s active ingredient is Hydrogen Peroxide. As Hydrogen Peroxide is broken down, oxygen enters the enamel and dentin, bleaching any colored substance while keeping the structure of the tooth unchanged. The Zoom! light aids in activating the Hydrogen Peroxide and helps it penetrate the surface of the tooth.
Is the Zoom! In-office procedure painful?

No. During the procedure, patients can actually watch television or listen to music. Many fall asleep.

Are there any side effects?

Some people experience temporary increased tooth sensitivity to cold during treatment. These symptoms disappear within 1-3 days after interruption or completion of the treatment.

How long is the procedure?

The entire procedure takes just over one hour. The procedure begins with a preparation period followed by one hour of bleaching. A five-minute fluoride treatment completes the procedure (we recommend a cleaning prior to the actual Zoom! Whitening session).

How long does Zoom! Take-Home Whitening take?

The Zoom! take-home gel is designed to be worn between four and eight hours per application. Dr. Carolan will advise you on how long you should wear each application. A recent study showed that you can achieve an average improvement of six shades* after just three nights of use. Dr. Carolan will help you determine how many applications are right for you.

How is the Zoom! Take-Home System different from the Zoom! In-Office System?

The main difference between the two systems is that you use the Zoom! Take-Home System in the convenience of your own home over a few nights. The Zoom! In-Office System is performed entirely in the office.