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The Alphabet Blog: D is for Dentin

The Alphabet Blog: D is for Dentin

Apr 17, 2015 | Auburn WA, Dental blog, Dental Implants, Dentistry, Oral Health, Sensitive Teeth, Women's Health

Dentin is the layer of tooth beneath the outer enamel layer and is important for a few reasons:

The color of dentin shows through the enamel and imparts color to the tooth.

In this photo, the dentin is the darker inner layer:

The next two pictures are great examples of what acid in plaque does as it works its way through the outer enamel into the dentin.  It turns the enamel frosty white, as acid does to glass, and turns the inner dentin dark brown. 

Dentin is flexible and helps prevent fracture of the brittle overlying enamel.

Dentin contains tubules that transmit painful stimuli like cold and sweet.  Are your teeth sensitive?  Blame it on the dentin.

Dentin allows faster spread of bacteria from the outside of the tooth to the inner nerve (pulp).

That’s dentin in a nutshell.

Love your smile,

Dr. Cook

The Alphabet Blog: C is for Composite

The Alphabet Blog: C is for Composite

Jan 8, 2015 | Auburn WA, Dental blog, Dentistry, Oral Health, Women's Health

Composite is tooth-colored filling material.  Composite filling material, a combination of plastic and glass spheres, has been used for over 60 years.  Dentists in the U.S. place more than 122 million dental composites each year.  Many dentists today have stopped placing amalgam (aka silver or mercury) fillings for various reasons.

At Cook Family Dentistry, I no longer place amalgam restorations because in order to do so, I have to remove much more tooth structure and the tooth is left at a higher risk of breakage.

Benefits of composite filling material:

  • They are bonded to the tooth structure:
    • this blocks out bacteria, acids, sugar, saliva from leaking between the filling
      material and the tooth
    • bonding also helps support the remaining walls of the tooth
  • A composite filling can be more narrow and shallow with amalgam/silver fillings because composite is a more flexible material and is bonded into place instead of being held in by mechanical retention only, which undercuts the remaining walls of the tooth.
  • Composite can be repaired because it will bond to itself.  Amalgam does not bond to itself.
  • Composite is tooth-colored, so dark decay that may start to grow in the tooth later can be differentiated from the filling.  Amalgam/silver fillings camouflage new decay in x-rays and also upon visual examination.
  • Esthetics.  Composite fillings are matched to the shade of the natural tooth.

Here are step-by-step photos of the process of removing an old leaking amalgam filling and replacing it with composite:

Before

Before: Old amalgam filling, leaking around the edges. Decay starting in pits and fissures.

Looking under the old filling. The tooth is partially cleaned out here.

Bevel Example

A cleaning solvent removes surface debris, bacteria, and saliva while creating a rough surface to increase the bond strength of the new filling to the tooth surface.

Bonding agent is brushed into the clean surface.

Bevel Example

Tooth-colored composite filling material that matches the tooth shade is injected into the tooth.

The soft composite filling material is packed into place and sculpted before it is hardened with a blue curing light.

Bevel Example

A thin coat of flowable filling material is applied to the filling to better seal the margins of the filling/tooth.

After the filling is hardened, we mark the bite to identify high spots.

Bevel Example

Polishing the filling and removing high spots.

The finished product. Healthy tooth structure, conservatively cleaned and well-sealed. The tooth surface is now smooth and cleansible to a toothbrush. (no narrow grooves for bacteria to hide in).

In this example of a filling we placed in my office, you can see how a silver filling shows through the tooth and makes it look black/grey.

Before:

After:

Before:

After:

Smiles,

Dr. Cook

Implant crown delivery

Oct 25, 2013 | Auburn WA, Dental blog, Dental Implants, Dentistry, Oral Health, Uncategorized, Women's Health

We recently delivered two crowns that are supported by dental implants.  Here are a few pictures of the process:

After the surgeon placed the implants, he attached a healing cap to each one.  The round, silver healing caps cover the implant for a few months after they are placed to allow bone to grow around the implants until they are well-anchored.  The implants, just like fence posts in cement, must be firmly anchored before attaching the crown and applying forces.

Here are the implant crowns in place while we check the fit.  The hole in the center is for the screw that holds the crown securely to the implant.

Once the fit is confirmed, the screws are torqued to 35 Newton/cm, covered, and the access hole restored to a natural look.  The patient can chew with these teeth immediately without restrictions.

Smiles,

Dr. Cook

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