Repairing a decayed tooth may be as simple as removing the damaged tooth material and filling the void. Many filling materials can now match the color of a tooth, so the dental work is hardly noticeable.

Sometimes, though, the decay is too extensive or we've treated the tooth several times and it won't support another filling. If the tooth is still viable, we may be able to cover it with a custom crown.

Also known as a cap, a crown fits over and is securely affixed to the tooth with bonding material or cement. Crowns have been used for decades to restore teeth, but the materials they're made of have changed with time.

The original crowns were made of metal, usually gold or silver. They were strong and could hold up well to the daily forces produced by chewing or biting. They did, however, visually stand out and came to be regarded as unattractive. There were porcelain materials available that could closely mimic the life-likeness of teeth, but they could be weak and brittle.

Dentists came up with a hybrid crown that could supply strength as well as an attractive appearance. These were composed of two parts: an inner metal frame for strength overlaid with porcelain for appearance. These fused crowns were the most popular until the mid-2000s.

About that time, newer forms of porcelain came on the market that were not only attractive, but also durable. Although caution should still be taken when biting something hard, they've proven to stand up well to biting forces. Fused porcelain to metal is still in use, but usually for back teeth where biting forces are higher and the crown won't be as noticeable as on front teeth.

Crowns can also address cosmetic issues with chipped, fractured or excessively worn teeth. But with any crown you should be aware that much of the original tooth material must be removed to accommodate the fit. The altered tooth will require a crown or other restoration from then on. Crowns must also be custom-made by a dental technician in a process that can take weeks.

Still, the process can be well worth it. With proper care and maintenance, a crown could serve you and your smile well for many years to come.

If you would like more information on crowns and other restoration options, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Crowns & Bridgework.”

The chances of contracting an infectious disease from a dental visit are extremely low, thanks to the stringent safety standards practiced by over 170,000 dental care providers across the U.S. Without these standards, you and your family would be at risk for diseases like hepatitis from even a routine office visit.

The main prevention focus centers on blood-borne diseases in which blood from an infected person is introduced into the body of another through a cut, incision or injection site. While HIV/AIDS (autoimmune deficiency syndrome) is perhaps the most well known of blood-borne diseases, a more common and thus a more threatening disease is hepatitis. Caused by a pair of viruses known as HBV and HCV, hepatitis damages the liver, which disrupts normal bodily function and can even cause death.

The spread of hepatitis and similar diseases is a major concern for blood transfusion and surgical centers that commonly use invasive procedures and intravenous (IV) equipment. It’s also a concern in dental offices where even a hygienic cleaning may result in some bleeding. To reduce the risk of disease, the dental profession has several layers of both mandatory and recommended standards for protection against viral or microbial transmission.

The Center for Disease Control, for example, publishes and regularly updates recommended procedures for equipment sterilization and disinfection. State level dental licensing boards also mandate safety procedures and require continuing education for infection control as a requirement for re-licensing, as often as two years. Professional organizations such as the American Dental Association (ADA) also encourage safety protocols among its members.

The vast majority of dentists place infection control among their highest priorities. These care providers institute and practice daily protocols and procedures for hand washing, use of masks, gloves and other biohazard protection, and disinfection. Through effective infection control you and your family can receive the dental care you need without endangering your general health.

If you would like more information on health safety in the dental office, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Infection Control in the Dental Office.”

Your nightly snoring has become a major sleep disturbance for you and other family members. But it may be more than an irritation — it could also be a sign of sleep apnea, a condition that increases your risk for life-threatening illnesses like high blood pressure or heart disease.

Sleep apnea most often occurs when the tongue or other soft tissues block the airway during sleep. The resulting lack of oxygen triggers the brain to wake the body to readjust the airway. This waking may only last a few seconds, but it can occur several times a night. Besides its long-term health effects, this constant waking through the night can result in irritability, drowsiness and brain fog during the day.

One of the best ways to treat sleep apnea is continuous positive airway pressure (CPAP) therapy. This requires an electric pump that supplies constant pressurized air to a face mask worn during sleep to keep the airway open. But although effective, many patients find a CPAP machine clumsy and uncomfortable to wear. That's why you may want to consider an option from your family dentist called oral appliance therapy (OAT).

An OAT device is a custom-made appliance that fits in the mouth like a sports mouthguard or orthodontic retainer. The majority of OAT appliances use tiny metal hinges to move the lower jaw and tongue forward to make the airway larger, thus improving air flow. Another version works by holding the tongue away from the back of the throat, either by holding the tongue forward like a tongue depressor or with a small compartment fitted around the tongue that holds it back with suction.

Before considering an OAT appliance, your dentist may refer you to a sleep specialist to confirm you have sleep apnea through laboratory or home testing. If you do and you meet other criteria, you could benefit from an OAT appliance. There may be other factors to consider, though, so be sure to discuss your options with your dentist or physician to find the right solution for a better night's sleep.

If you would like more information on sleep apnea treatments, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Oral Appliances for Sleep Apnea.”