But the final filling worked out well. And the patient has had not trouble at all with the tooth. Due to the size and extent of the original cavity the next step for this tooth will be a crown, in 3-5 years.
Here’s something that we’re seeing more and more of…cavities that are tough to diagnose, but still substantial in size. I really think this is due to the hardness of enamel from fluoride use over the years. Don’t misunderstand…I think fluoride is an excellent means to deter cavities. The problem is when the bacteria finally break through the enamel. Let’s start with this case:
Yes, you can see the dark grooves that indicate a cavity. But wait….there’s more!
I opted for the more conservative route. Instead of a bonded-porcelain restoration I suggested a bonded composite filling. Yes, it might chip or break. Yes, it was going to be more ‘upkeep’ and maintenance. But it was SUCH an easy fix and, when it came time to replace it in 5-10 years, THEN we could look to a crown. Needless to say, the patient was elated! So a few short minutes later, this is what we ended up with:
So, in only a few minutes we went from a cracked, unsightly tooth to this. An easy fix and it looks great!!
There are times that bonding doesn’t work, or the patient was told it wouldn’t work. Here’s a tooth that was bonded MANY years ago and the repair fell off. After trying a few more times the dentist just gave up and told the patient it ‘wouldn’t work’ for him. He’s lived with this crack for years now always assuming that it was ‘hopeless’.
I’m really a fanatic for backups. With all the photos I take, I can’t risk losing any of them. So I’m excited about this new service. It has unlimited online backup for one low monthly fee. I’m not going to use it for office photos, but will be looking into it for all my personal images. Read more here….Backblaze.
Here is a tooth that had a large cavity and big silver filling. You can see the dark shadow of the filling through tooth. Because there was so little healthy tooth structure remaining, we decided to place a porcelain crown.
A few more photos of the office, after our renovations. Look at the post below to see the same image during the construction. Big change!!
Let’s get to the bottom line: I felt crowns were WAY too aggressive to replace a little discolored bonding. Veneers were an option, but with this patient in her late teens, I was looking for a more conservative option (leaving veneers for the ‘next step’ down the road in 5-10 years.) We decided on a course of tooth whitening and then simply re-surfacing the existing bonding with a brighter-colored composite. We only had a few weeks, so she quickly finished whitening at home. Here’s what she looked like after the whitening, with the original bonding:
You’re gonna love this one. We recently saw this young lady for a 3rd opinion. She previously had some bonding on a few front teeth that was getting a little older. She was heading to college and hoped to improve the overall esthetics of her front teeth. The options she was initially presented included veneers alone, or veneers and crowns. Here’s what things looked like initially:
