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When your natural teeth are removed, you will face many problems such as the remaining teeth shift, rotate and become crooked. Spaces and gaps between teeth may cause embarrassment, problems with speech, lack of self-esteem and make the difficult to chew food properly.

Moreover, Missing teeth are also can make you look older than you are. Replacing missing teeth can dramatically improve your smile and the shape of your face. This greatly enhances both your dental health and self-esteem.

Dental implants function as "artificial tooth roots" on top of which a dental prosthesis, such as a dental crown , bridge or denture , can be placed .

The fixture is that portion of the implant that is embedded in and becomes anchored to

(osseointegrated with) the jawbone. This portion lies below the gum line.

Implant fixtures are constructed out of titanium and typically have a hollow or solid, cylindrical or screw shaped design.

The dental implant abutment .

The abutment aspect of a tooth implant is its stub portion that lies at and above the gum line or dental bridgework that the implant supports rests on top of the implant's abutment. An abutment is usually attached to (screwed into) the implant fixture 3 to 6 months after it was initially placed.

The dental prosthesis refers to the dental crown or dental bridgework that the implant supports. Depending on how this dental work has been designed, it can either be cemented or screwed into place.

Dental crown ("dental caps" or "tooth caps") can be made from metal (gold or other metal alloys), ceramic materials (such as porcelain), or a combination of both.

The strengthening capability of dental crowns is related to the fact that they cup over and encase the tooth. This means that a crown can act as a splint that binds a tooth together.

In contrast, dental fillings, especially large ones, can have a weakening effect on the teeth in which they are placed.

-These crowns can possess a translucency that makes them the most cosmetically pleasing of all of the different types of dental crowns. They can be an excellent choice for front teeth, however the strength of all-porcelain crowns is less than other types of crowns.

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Full metal dental crowns

- Gold crowns withstand biting and chewing forces well. They probably have the greatest potential for lasting the longest.

- The wear rate of a gold crown is about the same as tooth enamel. This means that a gold dental crown won't create excessive wear on the teeth it opposes.

- Metal dental crowns are usually placed on those teeth that are not overly visible when a person smiles (i.e., molars).

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Porcelain-fused-to-metal dental crowns.

PFM crowns are somewhat of a hybrid between metal crowns and porcelain crowns. A shell of metal that fits over the tooth is made first and then a veneering of porcelain is fused over this metal (in a high heat oven), giving the crown a white tooth-like appearance. These crowns can be a good choice for either front or back teeth and strong enough to withstand biting pressures and at the same time can have an excellent cosmetic appearance. However, there are some disadvantages associated with PFM crowns as follows:

- They often are not as pleasing esthetically as all-porcelain dental crowns.

- The PFM crown's porcelain can chip or break off.

-The porcelain surface of the crown can create wear on those teeth that it bites against.
-The metal that lies underneath a crown's porcelain layer can sometimes be visualized as a dark line found right at the crown's edge.

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Dental bridges

replace missing teeth by "bridging" the gap between two remaining teeth.

The types of bridges

1. Traditional bridges - the dentist creates a pontic, or false tooth with a dental crown on either side. The crowns are fitted over the remaining teeth to hold the false tooth in place.

2. Resin bonded bridges —the pontic tooth is fused to a metal band. The metal band, in turn, is bonded to the back of the remaining teeth with white resin cement.

3. Cantilever bridge —dentists recommend this bridge when there are only teeth on one side of the gap. While traditional bridges have a crown on either side of the pontic, cantilever bridges consist of two side-by-side crowns and only one is connected to the pontic.

To design a bridge, a dentist must first shrink, then reshape the teeth to make room for the crowns. He or she then makes a mold of the teeth. This mold is then sent off to a laboratory, where the actual crowns and bridge are made and you come back to fix the crown or bridge with the dental cement.

It would be reasonable to expect that a dental crown could last between five and fifteen years. Depending on the environment and forces the crown is exposed to (chewing, biting, accidental trauma, tooth grinding) and how well you keep the tooth clean.

Have you ever wished you had better looking teeth without all the hassle of braces or crowns? Veneer is your choice

Dental porcelain laminates are wafer-thin shells of porcelain that are bonded onto the front side of teeth so to create a cosmetic improvement for a tooth.
Though veneers are not suitable for every patient, they are a cosmetic alternative for a variety of dental conditions

         • closing diastema (spaces between the teeth)
         • restoring broken of chipped teeth
         • covering unsightly, stained or washed out fillings
         • whitening permanently stained or discolored teeth
         • correcting uneven or crooked teeth

What are the advantages of porcelain veneers over other types of cosmetic dental bonding procedures?

1) A healthy, natural look. Porcelain veneers create a very life-like tooth appearance.

Because of porcelain veneers are glass-like in nature ( they are translucent ) . When a porcelain veneer is bonded onto a tooth's surface it will closely mimic the light handling characteristics of dental enamel.

3) Only a small amount of natural tooth structure (if any) is removed during the procedure.
4) Veneers are often less expensive than alternative procedures

Veneers can last for many years, depending on how well you take care of them. Because veneers are stronger than simple bonding, they are also mere resistant to stains and
chipping. However, it is important to maintain regular oral hygiene, to avoid bad habits such as biting nails or chewing ice and to visit us regularly for routine cleaning and exams. These precautions will help ensure that your veneers will last a long time and keep looking as good as new.

More conservative than a crown, inlays and onlays are two methods of restoring normal tooth structure after decay or other damage. Inlays and onlays are known as indirect fillings because unlike a standard filling that is done in a dentist's office, both are made in a laboratory and cemented or bonded to the surface of the tooth during a second visit to the dentist. And unlike standard fillings, inlays and onlays do not weaken the tooth structure, but actually strengthens it. After the procedure the tooth can bear up to 50 - 75% more chewing force.

An inlay is done when the tooth structure replaced is within the cusp tips of the tooth. If the damage is more extensive and the new structure covers the entire chewing surface including one or more tooth cusps, the procedure is called and onlay.

Inlays and onlays are ways of repairing relatively extensive tooth decay or damage without having to replace the whole outer portion of the tooth as with a crown. Less tooth material is removed so inlays and onlays tend to be more conservative and esthetic than crowns. Unlike fillings, these procedures strengthen a tooth's structure. They also tend to last longer than a filling, because the inlay or onlay material is custom made and bonded to the tooth .

Inlays and onlays are performed using very similar procedures. Both require two trips to the dentist. At the first appointment, the dentist begins the procedure by numbing the area using a local anesthetic. The decay or damage is removed using a drill, preparing the tooth for its new surface. After all the damage is removed, an impression is made of the prepared tooth so the inlay or onlay material can be cast in a form that will fit the tooth exactly. A temporary restoration is placed on the tooth to protect it until the laboratory makes the new structure and it can be bonded to the tooth. This can take about two to three weeks.

Using the impression, a laboratory prepares the new tooth surface using gold, porcelain or composite resin. Upon return to the dentist's office, the temporary restoration is removed and the surface is cleaned to prepare for the new structure. The dentist will then try in the new restoration to ensure that there is a correct fit that doesn't interfere with your bite. If the fit is good, using special cement or bonding, the inlay or onlay is permanently attached to the tooth. Some minor adjustment may need to be made to the restoration if there are interferences. To finish the procedure, the dentist will polish the cemented or bonded structure and tooth.

Generally, each visit will take about one hour, although the first appointment tends to be longer with an onlay as more tooth structure is removed.The procedure is performed during two visits to the dentist's office.

Tooth-colored fillings are made from durable plastics called resin composite . Similar in color and texture to natural teeth, the fillings are less noticeable, and much more attractive, than other types of fillings

Because composite resins are tooth-colored, they look more natural than other filling materials. You can smile, talk, and eat with confidence. In addition, tooth-colored fillings are compatible with dental sealants. A tooth can be filled and sealed at the same time to prevent further decay.

First, tooth-colored fillings are not for every tooth. They work best in small restorations and low-stress areas. For example, your dentist may not recommend a tooth-colored filling for a large cavity or for the chewing surface of a back tooth. Second, tooth-colored fillings may cost a bit more than silver fillings because they take longer to place.

Take care of a tooth-colored filling the same way you take care of a silver filling: Brush, floss, and visit your dentist at least twice a year. Any filling will last longer with good oral hygiene. Your dentist will regularly check the fillings for color change, leakage, or unusual wear and inform you of the need for repair or replacement.

Root canal treatment is needed for two main reasons: infection or irreversible damage to the pulp. An untreated cavity is a common cause of pulp infection. The decay erodes the enamel and dentin of the tooth until it opens into the root canal system, allowing bacteria to infect the pulp. Infections inside teeth don't respond to antibiotic treatment. The inflammation caused by the infection restricts the tooth's blood supply, so antibiotics in the bloodstream can't reach the infection very well. The reduced blood supply also limits the pulp's ability to heal itself . The pulp also can become damaged from trauma, a fracture or extensive restorative work

Once the pulp becomes infected, the infection can affect the bone around the tooth, causing an abscess to fo rm. The goal of root canal treatment is to save the tooth by removing the infected or damaged pulp, treating any infection, and filling the empty canals with an inert material. If root canal treatment is not done, the tooth may have to be extracted.

It is better to keep your natural teeth if at all possible. If a tooth is missing, neighboring teeth can drift out of line and can be overstressed. Keeping your natural teeth also helps you to avoid more expensive and extensive treatments, such as implants or bridges. If an infected or injured tooth that needs root canal treatment is ignored, not only can you lose the tooth, but also the infection can spread to other parts of your body.

Having endodontic treatment on a tooth does not mean that you'll need to have it pulled out in a few years. The reason for doing root canal treatment is often a large cavity. The tooth often is weakened, but if the tooth is covered with a crown after the root canal or, in some cases, restored with tooth-colored composite filling material, the tooth can last the rest of your life.

If you have an infection of the pulp, you may not feel any pain at first. But if left untreated, the infection will cause pain and swelling. In some cases, an abscess will form. Eventually, the tooth may need to be extracted. Some indications that a tooth may need a root canal are:

To determine whether your tooth needs root canal treatment, your dentist will place hot or cold substances against the tooth, feel surrounding tissues and gently tap on the tooth. He or she also will take X-rays.

If the condition of the pulp isn't clear from these tests, your dentist may use an electric pulp tester. This hand-held device sends a small electric current through the tooth and helps your dentist evaluate whether the pulp is alive. This test does not cause pain or a shock, but a tingling sensation that stops immediately when the tester is removed from the tooth.

Caution: An electric pulp tester should not be used if you have a cardiac pacemaker or any other electronic life-support device

1.Measuring
First, your dentist or endodontist will numb the area around the tooth. He or she will make a hole in the top or back of your tooth to geet to the pulp chamber. He or she will remove some of the diseased pulp. Then the root canals have to be measured.

Your dentist needs to know how long the canals are so he or she can make sure all the diseased tissue is removed and the entire canal is cleaned. Also, the material used to fill the canal after it is cleaned needs to fill the entire canal.

Dentists use X-rays t o determine the length of the canals or use an electric device called an apex locator. In the first procedure, your dentist will place a file into the canal he or she is measuring then take an X-ray to determine how close the file is to the end of the canal. An apex locator makes a calculation based on the resistance to a small electric current. This gives an accurate measurement of a root canal. Often, the two methods are combine.

2.Cleaning
After the canals have been measured, your dentist or endodontist will use the specially designed instruments to clean out the diseased pulp. After the pulp has been removed, the canal is cleaned with an antiseptic solution, which helps to treat the source of the infection.

For root canal treatment to be effective, all the canals within the tooth must be cleaned. Generally, the top front teeth have one canal, the bottom front teeth one or two canals, the premolars one or two, and the molars three or four canals. However, the location and shape of these canals can vary significantly. Some endodontists are now using a microscope to see inside the tooth to make sure all the canals have been located and all the pulp has been removed.

Your tooth may be sore for two to three days after the procedure, and your dentist will tell you to avoid chewing on the affected side. The worse the infection and inflammation was prior to root canal treatment, the sorer the tooth will be after treatment. You can take over-the-counter pain relievers to ease the discomfort.

Once the canals have been thoroughly cleaned and the endodontist or dentist has made sure that the infection has been removed, the roots are filled with the root canal filling. A temporary filling is then placed to cover the new root filling.

The pulp that was removed during root canal treatment is the part that responds to temperature. The tissues and nerves surrounding your tooth remain, however, so your tooth will still respond to pressure and touch.

As with most invasive medical or dental procedures, complications can occur. Here are some possibilities.

Sometimes when a root canal is opened for treatment, the oxygen in the air will trigger some bacteria to start growing, causing inflammation and pain.

This can be treated with painkillers, and sometimes antibiotics, but the site could be painful until it clears up.

A root canal treatment can puncture the side of the tooth. This can happen if the canal is curved or if the canal cannot be located. The instruments are flexible so that they bend as the canal curves, but sometimes the instrument makes a small hole in the side of the tooth. If saliva can get into the hole, the tooth will have to be treated further or extracted. If the hole is far enough under the gum line that saliva can't reach it, it may heal.

A root canal may be missed or an entire canal may not be fully cleaned out. Locating canals within the tooth can be difficult. If a canal or an offshoot of a canal isn't located and cleaned out, the tooth can remain infected and the root canal procedure will have to be repeated. This also can happen if a canal isn't measured correctly and pieces of infected or inflamed pulp are left near the bottom. Occasionally, root canals have branches that are not accessible to traditional treatment.

A file may break. The tip of a file may break off inside the tooth. Usually, it's possible to leave the piece in the tooth and finish the root canal. But if the cleaning of the canal has not been finished, the file piece may have to be removed. Sometimes this can be done from the top of the tooth. However, in some cases, the file can only be removed through a surgical procedure called an apicoectomy. A small incision is made in the gum to access the root of the tooth, and the portion of the root containing the file piece is removed.

The crown of the tooth should then be restored with a permanent filling or crown

Restored with a composite filling material if it is a front tooth and the cavity is small, but back teeth in many cases will need a crown. Because of back teeth are under stress from chewing. A crown will help to restore the tooth's strength and protect it from cracking. A crown should be placed as soon as possible, ideally within a month of the root canal

To prepare the tooth for a crown, your dentist first will have to build up a foundation to strengthen the tooth and support the crown. This buildup is called a core. To help hold the core in place, your dentist may have to use a post. To do this, your dentist will remove some of the root filling material in the root canals to make room for the post, which is a metal rod.

The crown, which is made in a dental laboratory, is composed of porcelain, metal, or a combination of the two. It is cemented onto the foundation.

Your restored tooth could last a lifetime, if you continue to care for your teeth and gums. However, regular checkups are necessary. As long as the root(s) of a treated tooth are nourished by the tissues around it, your tooth will remain healthy.

In the blossoming world of cosmetic dentistry, teeth whitening reigns supreme. Universally valued by men and women alike, whitening (or bleaching) treatments are available to satisfy every budget, time frame and temperament. Whether in the form of one-hour bleaching sessions at your dentist's office, or home-use bleaching kits purchased at your local drugstore, teeth whitening solutions abound. Yet only 15 percent of the population has tried the cosmetic procedure, and misinformation on the subject is rife.

You may feel that your teeth are too discolored to ever be white again, but cosmetic dentists are achieving amazing results with the newest whitening techniques.

The long and the short of it is that teeth whitening works. Virtually everyone who opts for this cosmetic treatment will see moderate to substantial improvement in the brightness and whiteness of their smile. However, teeth whitening is not a permanent solution and requires maintenance or touch-ups for a prolonged effect.

You may want to start by speaking with your dentist. He or she can tell you whether whitening procedures would be effective for you. Whiteners may not correct all types of discoloration. For example, yellow-ish hued teeth will probably bleach well, brownish-colored teeth may bleach less well, and grayish-hued teeth may not bleach well at all. Likewise, bleaching may not enhance your smile if you have had bonding or tooth-colored fillings placed in your front teeth. The whitener will not effect the color of these materials, and they will stand out in your newly whitened smile. In these cases, you may want to investigate other options, like porcelain veneers or dental bonding.

If you are a candidate for bleaching, your dentist may suggest a procedure that can be done in his or her office. This procedure is called chairside bleaching.The visit may take from 30 minutes to one hour.

During chairside bleaching, the dentist will apply either a protective gel to your gums or a rubber shield to protect the oral soft tissues. A bleaching agent is then applied to the teeth, and a special light may be used to enhance the action of the agent. Lasers ,cool light or orther activators have been used during tooth whitening procedures to enhance the action of the whitening agent.

There are several types of products available for use at home, which can either be dispensed by your dentist or purchased over-the-counter.

Bleaching solutions . These products contain peroxide(s), which actually bleach the tooth enamel. These products typically rely on percent carbamide peroxide as the bleaching agent, carbamide peroxide comes in several different concentrations (10%, 15%, 20%).

Peroxide-containing whiteners typically come in a gel and are placed in a mouthguard. Usage regimens vary. Some products are used for about twice a day for 2 weeks, and others are intended for overnight use for 1-2 weeks. If you obtain the bleaching solution from your dentist, he or she can make a custom-fitted mouthguard for you that will fit your teeth precisely.

You also may want to speak with your dentist should any side effects become bothersome. For example, teeth can become sensitive during the period when you are using the bleaching solution. In many cases, this sensitivity is temporary and should lessen once the treatment is finished. Some people also experience soft tissue irritation—either from a tray that doesn't fit properly or from solution that may come in contact with the tissues. If you have concerns about such side effects, you should discuss them with your dentist.

Toothpastes . All toothpastes help remove surface stain through the action of mild abrasives. Unlike bleaches, these products do not alter the intrinsic color of teeth.