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Dental Caries

Dental Caries is also caused by bacteria. Decay starts on the surface of a tooth, but eventually penetrates the enamel (outer layer) of the tooth.
After the enamel is penetrated, the bacteria enter the dentin (inner layer) of the tooth. Here the decay grows and spreads like a cancer, ultimately destroying the tooth. This widespread tooth destruction occurs because the dentin is composed of material that is very vulnerable to the bacteria.
Because dentin is more susceptible to bacteria breakdown, the decay can spread very rapidly. Decay also occurs extensively around old fillings that are deteriorating and allowing leakage to occur. When this leakage occurs between the tooth and the filling, the bacteria are allowed an easy entrance to the underlying tooth structure. This is especially dangerous because the environment around and under the filling is the perfect incubator for growing the germs.
Mercury/silver amalgam fillings are especially susceptible to leakage and decay. Further, the amalgam hides the decay on the x-rays until the decay is advanced.


Decay requires the removal of the infected tooth structure and placement of a dental restoration.

The four basic types to single tooth restorations are:

  • Fillings
  • Inlays
  • Onlays and
  • Crowns


If the tooth decay gets too deep, it can infect the nerve of the tooth cause the tooth to abscess. If this happens, the only treatment options are extraction of the tooth or root canal therapy.

If a tooth is lost, we may recommend replacement with a Fixed Bridge.

A bridge spans a space where one or more teeth have been lost. It is called "fixed" because it is cemented into place and does not come out. The teeth on either end of the span are crowned and called "abutments". The false tooth (teeth) spanning the gap between the crown abutments are "pontics"

When a tooth or teeth are lost, the neighboring teeth are affected. Because the support and chewing forces are altered, the remaining teeth will begin to shift. The tooth opposite the missing tooth will begin to drift out of its socket. This can accelerate gum disease and occlusal disease causing further breakdown in the dental arch. Therefore, we recommend replacing missing teeth to:

  • Restore and maintain the natural bite
  • Prevent unnatural stress on other teeth
  • Keep opposing teeth in their proper place
  • Prevent shifting and tilting of adjacent teeth
  • Help prevent further dental decay and gum disease
  • Maximize your smile, speech and chewing


Fixed bridgework is very predictable, simple, esthetic and proven method to replace missing teeth. Fixed bridges look, feel, and function like natural teeth. If there are multiple missing teeth, missing teeth on both sides of an arch, and/or there is no anchor at one end of the span, a Removable Partial Denture may be recommended.

Partial dentures (partials) use a metal framework to support denture tooth replacements of the missing teeth. Partials are not as well accepted as bridgework by patients, but function acceptably for most patients. While a traditional partial denture is secured by finger-like metal clasps around the outside of the remaining teeth, there are many options for more natural "hidden" methods of retaining the partial denture. The options available depend on the individual custom design of the partial denture.

Unfortunately some patients loose all of there natural teeth and must wear full dentures. Modern esthetic materials combined with thorough knowledge and experience in denture design and the biomechanical functional demands on dentures means that today's dentures can work better than ever.

Unfortunately, many denture patients have lost bone support on the dental ridges causing a loss of lower facial dimension, an increase in facial wrinkles and a patient who looks older than their age. Combined with the loss of bone support often comes excess wear on the old denture teeth. These flat, smooth teeth can not chew properly, often condemning the denture patient to a diet of softer, more refined, less nutritious foods at precisely the time of life when diet is most important. These patient often complain of having "lost" their bite, so there is no natural, comfortable place for the teeth and jaws to fit together.

Fortunately, a patient's bite, facial dimension and function can be restored.