Common Dental Procedures Explained

A common dental procedure seems routine until it gets personal. Any type of dental procedure, no matter how common it is, can be scary when it’s your own mouth. There are several aspects to dental procedures that make people nervous: time, pain, cost, and embarrassment. However, once you know what to expect during these common dental processes, you will surely feel more comfortable in the dentist’s chair.

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Filling Cavities

A cavity filling becomes necessary when there is decay in a tooth. Tooth decay is caused by acid that wears down the tooth’s enamel. If your dentist warns you of the early signs of a cavity, fluoride therapy, dietary changes (less sugary and acidic foods/drinks), and better oral hygiene can help the minerals in the tooth rebuild.

If you do find yourself with a cavity, here’s what you can expect at your appointment.

Getting a Cavity Filled: What to Expect

Tooth decay and dental fillingExpect to be at your dentist’s office for about an hour for a cavity filling. This will give your dentist enough time to take x-rays (if needed), explain the procedure and complete the dental work. The actual dental work only takes a few minutes and begins with your dentist numbing your teeth, gums, and surrounding skin to avoid discomfort during the procedure.

Next, your dentist will remove the decay in your tooth and replace it with a filling. The type of filling you receive will depend on the location and size of your cavity, as well as if your insurance will cover that type of filling. Filling options consist of gold fillings, silver amalgam, or composite resins. Silver amalgam is among the most popular filling types because of its affordability and durability. If your cavity size is small to medium, you may receive a composite resin, or tooth-colored filling.

After the filling has been placed, your mouth will probably remain numb for a few more hours. Follow your dentist’s instructions on eating and drinking after your procedure.

Keep in mind you have the right to discuss cavity treatment with your dentist at any point. Your dentist’s top priority is your health and comfort. You may be concerned about the mercury level in the commonly used metal composite fillings; however, no credible study has shown dental amalgam to have unfavorable health effects except in rare allergic reactions.

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Caring for Cavity Fillings

Your numbness should wear off in 1 to 3 hours after your procedure. Do not chew anything on the numb side of your mouth to make certain you don’t unknowingly injure your cheek, tongue, etc. It’s normal for your tooth to feel sensitive to cold, hot, or pressure - this should cease within one week or so.

You should resume a good oral hygiene routine; however, the affected tooth/teeth may be somewhat sensitive. To prevent future cavities, make certain you're taking the right steps for brushing your teeth.

Problems with filling

Potential Problems With Cavity Fillings

It’s important to be aware of potential problems after your cavity filling so if something does seem unusual, you can visit your dentist promptly to have the filling adjusted or repaired. Potential issues you may have with your filling are:

  • Damage to the filling. Sometimes a cavity filling can be damaged if you bite down too hard on something, or if you get hit in the mouth. As soon as you notice your filling is broken, cracked, or if it has fallen out, contact your dentist.
  • Space between the filling and your tooth. If you notice a space between the filling and your tooth, contact your dentist immediately. This situation gives way to a breeding ground of bacteria in the space, and can easily result in additional decay.
Payment options for fillings

Payment Options for a Cavity Filling

Most dental insurance plans cover the majority or entirety of amalgam (silver) cavity fillings. Although, if you opt towards a composite (tooth-colored) filling, you may have to pay the difference.

Dental Crowns (Caps)

Dental Crowns: What to Expect

Dental crownThe procedure for having a dental crown affixed normally takes two separate dentist visits. The first visit will consist of your dentist examining your tooth and making sure it can support a dental crown. Your dentist will also file down the tooth to prepare for the crown, unless the tooth is severely broken; in this instance the tooth will be filled in to be able to support a crown.

After your tooth has been formed to support a dental crown, your dentist will take impressions of the tooth and those surrounding it to send to the lab. A permanent crown will be ordered, but until then, a temporary cap will be placed to protect the tooth until the final crown can be permanently placed.

Once the permanent crown arrives, you will have the second visit to have it placed. The temporary crown will be removed and the permanent one affixed to your tooth with special adhesive. The crown may feel foreign after your procedure, but before long it will feel and function just like a natural tooth.

Caring for crowns

Caring for Dental Crowns

Normally, a crown lasts five to eight years; however, properly caring for your crown can make it last much longer. After the procedure, you will have some sensitivity, especially to cold, for a few days. Avoid extremely hot or cold foods and beverages for the first few days. Also, you may have some discomfort in the gums and around the tooth after the anesthesia wears off. If your gums are tender, rinse with warm salt water or try taking Tylenol or Ibuprofen to reduce discomfort.

After having a crown placed, avoid chewing hard foods and ice that could break a porcelain cap. If you have a habit of grinding your teeth, talk to your dentist about steps to kick it. Additionally, maintain good oral hygiene by brushing twice a day with a fluoride toothpaste, flossing, and visiting your dentist for a cleaning and exam twice per year.

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Problems with crowns

Potential Problems With Dental Crowns

Inflammation of the tooth’s pulp is normal for a couple of days, and taking NSAIDs (Tylenol, Ibuprofen, etc.) can usually help the discomfort. However, if an unbearable pain in the capped tooth persists after several days of taking NSAIDs, a root canal may be in line to reverse the pain. This sometimes occurs if the tooth’s nerves are traumatized during the procedure, although it’s rare.

Payment options for crowns

Payment Options for Dental Crowns

Since they are considered necessary repair work, dental crowns are normally covered under dental insurance plans. However, it’s possible policy holders will need to pay a deductible before coverage commences. Always check with your insurance provider when receiving a dental procedure.

Root Canal Treatment (Endodontic)

A root canal becomes necessary when a tooth is too infected to save, but can still be preserved. The reason for keeping a dead tooth in your mouth (instead of extracting and administering an implant), is because you can still benefit from the structure of the tooth for chewing food and speaking.

Root Canal Treatment: What to Expect

Root Canal TreatmentOnce your dentist determines that you need a root canal, you will probably be prescribed antibiotics for the meantime, because it is an infection. Also, taking antibiotics before your root canal procedure will make it easier to numb the infected area.

Be prepared to sit in the dental chair for a few hours when you go in for a root canal. Downloading an audiobook or podcast on your phone to listen to during the procedure makes the time go a little faster. During the procedure, your dentist will remove the infected pulp (root); clean out and shape the inside of the tooth; and fill the space so it’s closed off to any more infection.

Throughout the entire procedure you shouldn’t have any pain. As long as your dentist is skilled at administering local anesthesia, you won’t feel a thing. After the root canal, you will need to revisit your dentist to have a crown affixed to the tooth to protect it from normal use.

Post-op care for root canals

Post-op Care for a Root Canal

Until you have the permanent crown placed, avoid biting down or chewing on the treated tooth. It’s advised to have the crown affixed as soon as possible because of the fragility of a root canaled tooth. Maintaining good oral hygiene in the meantime is recommended (brushing and flossing), however be extra careful around the treated area.

You may experience some pain after the root canal, normally peaking 17 to 24 hours after the procedure. Keep your head elevated for the first couple of nights and follow your dentist’s instructions regarding pain medication. It is common to have no pain after a root canal treatment, but still treat the tooth with care.


Potential Problems After a Root Canal

  • Soreness: While it’s uncommon to feel soreness after a root canal, it’s still possible. The theory in this situation is that the infection was so advanced that it may have affected the surrounding jaw bone. In this case, soreness or tenderness may last up to six months after the root canal.
  • Leftover bacteria: If bacteria remains after the tooth canal has been cleaned, it can grow and cause pain in the treated tooth. If the root canaled tooth feels fine, then begins to hurt again, schedule a visit with your dentist.
  • Crack in the root: If a crack in the root goes undetected during your root canal, it will leave the area open to the reintroduction of bacteria, and may require further treatment.
  • Additional problem areas: Sometimes there is more than one root causing you pain, and you consequently need a second root canal procedure. A second root canal within the same vicinity as the last will be more involved due to any of the fillings or crowns that were placed having to be removed.
  • Erosion of materials: If the treated area is not properly cared for after your root canal procedure, the inner seal of your crown can erode and subsequently be reintroduced to bacteria. Contact your dentist if you feel anything irregular after your root canal.
Payment Options for root canals

Payment Options for a Root Canal

Root canal treatment is normally covered under dental insurance plans because it’s considered necessary repair work. The policy holder may be responsible for paying a deductible before coverage kicks in, however. Check with your insurance company to see if your plan covers root canals.

Tooth Extraction

Permanent teeth were meant to last a lifetime, however sometimes decay or damage to a tooth is too significant to preserve the tooth, and it needs to be extracted. Other reasons for having a tooth pulled could include a crowded mouth or the risk of infection on an already compromised immune system.

Tooth Extraction: What to Expect

Tooth extractionPrior to the procedure, your dentist office will obtain all medical and dental history, as well as a list of the medications you take. Then, an x-ray will be taken to determine the best way to extract the affected tooth. Your dentist may prescribe antibiotics before or after the procedure.

The tooth extraction process normally takes 20 - 40 minutes, depending on the condition of the tooth. Before extracting the tooth, your dentist will administer an injection of local anesthetic to numb the area. If you are having more than one tooth extracted, or if the tooth is impacted, your dentist may use a strong general anesthetic that will allow you to sleep through the procedure.

Expect to feel pressure during a simple extraction, for the tooth will need to be rocked back and forth to be loosened from the jaw bone. While there will be some significant pressure, you should not feel any pain whatsoever throughout the procedure.

If you are having a tooth extracted that has not yet broken through to the gum line, your dentist will make a small incision in the gum to reach the tooth, and continue the extraction like described above. Sometimes the tooth may need to be broken into pieces to be more easily removed; however, you still should feel no pain, only pressure.

After the extraction, you’ll be asked to gently bite down on a gauze for 20 - 30 minutes to help form a blood clot.

 

Post-op Care for a Tooth Extraction

  • Medication: Take any narcotics as directed by your dentist. If you are prescribed a pain medication, it’s recommended to alternate with an anti-inflammatory such as Ibuprofen.
    *NOTE: If you are taking Plavix or Coumadin, do NOT take Ibuprofen or Aspirin products.
  • Diet: Start with liquids, especially if you were administered general anesthetic or an I.V. Avoid really hot or cold foods while you are still numb. Once the numbness has started to wear off, progress to solid foods, but still avoid chewing on the treated side. Avoid foods like popcorn, sunflower seeds, and other nuts that can get stuck in socket areas.
  • Diet while still numb:
    • Water
    • Sports drinks
    • Juice
    • Applesauce
    • Pudding
    • Yogurt
    • Jell-O
  • Foods for after numbness:
    • Pasta
    • Mashed potatoes
    • Eggs
    • Pancakes
    • Oatmeal (not too hot)
    • Soups (not too hot)
  • Increase solid foods as tolerated
  • Oral hygiene: Maintain good oral hygiene habits after the extraction. Use a soft bristle toothbrush twice a day and continue flossing. If bleeding continues, repeat the use of a gauze.
Problems with tooth extraction

Potential Problems With a Tooth Extraction

  • Bleeding: If bleeding persists after your tooth extraction, fold two pieces of damp gauze over the extraction site and bite down gently for 30 - 60 minutes. Rest with your head elevated. Bleeding may continue for several hours after your procedure.
  • Swelling: Swelling normally doesn’t appear until one day after the extraction, and won’t peak until 2 -3 days after. Swelling can be treated by applying an ice pack to the outside of the face for 20 minutes on, and 20 minutes off, for the first 24 hours. After 48 hours, it’s recommended to use a warm, moist compress to the cheek.
  • Dry sockets: Symptoms of dry sockets don’t usually appear until 3 days after the procedure. Contact your dentist if the discomfort does not subside within a few days.
Payment options for extraction

Payment Options for a Tooth Extraction

Most dental insurance plans cover some level of routine dental extractions, if not all. However, if your dentist classifies your tooth extraction as a “surgical” procedure, you will need to include it in the insurance claim as such.

Dental Bridges

Tooth replacements have come a long way on the road to fighting infection and improving smiles. If you’ve had a tooth damaged severely or extracted, you may be discussing the differences between dental bridges and implants with your dentist.

Simply put, if the surrounding teeth will need caps in the future, or the tooth/teeth have been missing for a long time, a dental bridge will be your best option. A dental implant is administered when the surrounding teeth are in good condition and the affected tooth has recently been lost or extracted. Additionally, a dental bridge will initially cost less, but will not endure as long as a dental implant, and will need to be replaced.

A missing tooth/teeth need to be replaced to avoid the other teeth shifting to fill the gap. Shifting teeth can cause your natural bite to be distorted, gum disease, or even temporomandibular joint (TMJ).

Dental Bridges: What to Expect

Dental bridgeA dental bridge is a prosthetic piece used to cover any span of missing teeth. The bridge is held in place by a crown (cap) on each end. Once you and your dentist decide on the best type of dental bridge, you will probably need to schedule two different visits to have the bridge placed.

Your first visit will consist of your dentist using a local anesthetic on the affected area. Your dentist will then reshape the adjacent teeth to properly support the bridge. Impressions will be taken of the space and treated teeth to send to the lab for a custom dental bridge to be made. Until then, your dentist will administer a temporary bridge.

The permanent bridge will take a few weeks to be delivered to your dentist’s office, at which time you will have your second visit. Your dentist will simply replace the temporary bridge with the new one, and make certain that it fits your mouth comfortably.

 

Post-op Care for a Dental Bridge

Temporary bridge: Avoid chewing sticky foods like gum and caramels. Use your toothbrush on the temporary bridge just as you would your natural teeth. When flossing, do not pull up on the temporary bridge - this could loosen the cement.

Permanent bridge: Maintain oral hygiene by regularly brushing and flossing. It may take a few days to get used to the bridge, but if your bite is unbalanced, make an appointment to have it adjusted. Regulate your sugar intake to ensure your dental bridge lasts as long as possible.

Problems with dental bridges

Potential Problems With a Dental Bridge

  • Bridgework loosens: If the temporary bridge comes loose at any time, put it back in its place and make an appointment with your dentist to have it reattached.
  • Sensitivity: Your teeth may be sensitive to extreme hot and cold. Avoid really hot or cold beverages and foods for the first few days after treatment. If your gums are sensitive, rinse with warm salt water and take analgesics as directed by your dentist.
  • Bridgework fails: Dental bridges - when well-maintained - provide a long-term solution, but will eventually need repair. Contact your dentist if your bridge feels compromised in any way.
Payment options for dental bridges

Payment Options for Dental Bridgework

Coverage for dental bridges will depend on your specific plan. Sometimes insurance carriers will only offer coverage for bridgework if you had that plan when your tooth/teeth was/were extracted. Check with your insurance company to determine the best route of payment.

Implants

Dental implants are a durable option for teeth replacement. Implants initially cost more than bridgework, but will last longer and function more naturally.

Implants: What to Expect

Dental implantsDental implant surgery involves replacing tooth roots with screw-like posts, and replacing damaged or missing teeth with an artificial structure that looks and performs just like your natural teeth. Because the titanium fuses with your jaw bone, dental implants won’t slip, make noise or cause bone damage like a bridge or dentures might.

Similar to the previously discussed procedures, having a dental implant placed may require several visits. A dental implant is more durable than bridgework, so the entire process may take a few months because of the healing that will have to occur before the next step.

If the replaceable tooth is still in your mouth, your dentist will extract it before any more further action. At the following visit, you will have x-rays and an impression taken of your teeth for the lab to prepare the implant(s). Since dental implant surgery happens in stages, you and your dentist will discuss the best treatment plan for your situation.

The next steps go as follows:

  • Your jawbone is prepared for the implant. You will be sent home to allow the bone to heal.
  • You will revisit your dentist once your jawbone has healed, and the metal post will be placed in the bone.
  • Either you will go home to heal after the post has been placed, or - if your dentist feels you’re ready - the implant extension (abutment) can be attached.
  • Once the soft tissue has healed, your dentist will make additional impressions of the treated area.
  • You will revisit your dentist to have the final “tooth” or “teeth” placed on the implant(s).
Caring for implants

Post-op Care for Dental Implants

After general anesthetic or I.V. sedation, start with a liquid diet. Progress to soft foods and add solid foods as tolerated. Take care to chew on the opposite side of your dental implant for the 10 - 12 week integration stage. Continue good dental hygiene, otherwise leave the implant alone for at least two weeks after the procedure.

Problems with dental implants

Potential Problems With Dental Implants

Bleeding: Minimal bleeding is normal after implant surgery. The best way to stop bleeding is to dampen two pieces of gauze and place them over the treated area. Gently bite down on the gauze for 30 - 60 minutes.

Swelling: Swelling normally doesn’t appear until one day after implant surgery, and won’t peak until 2 -3 days after. Swelling can be treated by applying an ice pack to the outside of the face for 20 minutes on, and 20 minutes off for the first 24 hours. After 48 hours, it’s recommended to use a warm, moist compress to the cheek.

Micromovement of the implant: The dental implant must be immobile long enough for the metal and bone to fuse together. If the implant is moved during the first 10 - 12 weeks, soft tissue will grow on the side of the implant and will result in a loose and possibly painful implant.

Payment options for dental implants

Payment Options for a Dental Implant

Coverage for dental implants will depend on your specific insurance plan. Some companies exclude dental implant surgery as a covered benefit because the plans are designed to cover routine, emergency, and basic care. Check with your insurance company to determine the best route of payment.

Teeth Whitening

Coffee, red wine, aging, smoking. While life is happening, our teeth can become dull in color, so we look to a professional to get our luminous smile back. Professional teeth whitening involves the use of powerful bleaching agents administered by your dentist in a safe and controlled environment. Professional teeth whitening will lead to faster and safer results than over-the-counter whitening treatments.

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Teeth Whitening: What to Expect

Teeth whiteningBefore the whitening commences, you will need to have a mandatory cleaning to prepare your teeth. Then, your dentist will examine your teeth to make sure there won’t be anything causing discomfort during the bleaching process. Also, your dentist will probably take an image of the initial color of your teeth to compare with the end result.

To begin the whitening, your dentist will place a cheek retractor into your mouth to expose the teeth that are visible when you smile. Next, your dentist will either put a hardening resin or liquid rubber dam onto the gums to avoid irritation once the bleach is administered. The bleaching gel will then be applied onto the teeth. The actual bleaching process will take around 15 - 20 minutes.

Once the last layer of bleaching gel is administered, the cheek retractor will be removed and you will be able to rinse your mouth. The true color of your teeth won’t appear until a few days after the treatment.

Problems with whitening

Potential Problems With Teeth Whitening

  • Not the desired shade of white: If the professional teeth whitening did not result in the shade of white you were hoping for, a follow-up visit should be arranged.
  • Sensitivity: Sensitive teeth usually occur after an in-office whitening treatment as opposed to an at-home treatment because of the concentration of the bleach. Whitening sensitivity should not last longer than a couple of days after treatment.
Payment options for whitening

Payment Options for Professional Teeth Whitening

Teeth whitening is not normally covered by dental insurance because it’s not considered a routine, emergency, or basic treatment.

Needing one of these dental procedures done can bring up questions about pain, time, and cost. By familiarizing yourself with the procedure you’re having done, it should give you peace of mind knowing the steps that will come next, and the fact that any dental procedure is ultimately painless. Your dentist has your best interest in mind, and is willing to answer any further questions about your dental procedure.

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