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Adam Bellingham DDS

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Adam Bellingham DDS

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05/03/2022

Today, lets talk about crowns and what types there are. Prepare for some nerdy content!!!!

What is a Dental Crown?

A dental crown is one of our more common procedures to restore a tooth that needs more than just a filling. The purpose of a crown is to hold a tooth together and prevent it from breaking. This is needed when you either have a large cavity, a large filling, or a large part of the tooth is missing due to breakage. When there is not enough tooth to hold a filling, then you need to cover it with a crown to hold it all together. Think of a dental crown as a new outside layer for the tooth. It is cemented over your existing tooth to give it back its shape and strength.

What is the procedure?

The dental crown procedure involves removing a set amount of tooth structure from the top and sides of the tooth. We are creating a shape that lets us slide the crown over the existing tooth. Once your tooth has been appropriately shaped, we will then take an impression of that prepared tooth. This impression, or mold, of your tooth is what the lab will use to fabricate your new crown. We will then make you a temporary crown to wear until we receive your permanent crown from our lab. Once your crown is back, we take off the temporary, make any adjustments to your new crown to make sure it fits properly, then permanently cement it on.

Types of Dental Crowns

While all dental crowns serve the same purpose, there are a few different types of materials they can be made of. Each one has its own set of strengths and weaknesses. The main types of crowns used today are Full Zirconia, Veneered Zirconia, Lithium Disilicate, and Porcelain Fused to Metal.

Full Zirconia (BruxZir)
Full Zirconia is an all Ceramic/Metal free crown. It is currently one of the strongest crown materials we have and is mostly used on back molars and back tooth bridges. It only needs a minimal amount of tooth to be removed and its esthetics are good, but there are better looking options.

Lithium Disilicate (Emax)
This is another all Ceramic/Metal free crown. It has very good strength but is not as resilient as full Zirconia restorations. It is used for premolars and front teeth and short bridges in the front. It has very good esthetics.

Layered Restorations
Another type of all Ceramic/Metal free crown. The inner core is either Emax or Zirconia with traditional feldspathic porcelain layered on the outside. This gives you excellent esthetics for difficult to match front teeth. Strength is good due to its core material, but the esthetic layer of traditional porcelain has a higher chance of chipping or breaking, especially along the edge of front teeth.

Porcelain fused to metal
This type of dental crown has a metal core with a traditional feldspathic porcelain outer layer. This type of dental crown has been used for decades in dentistry. It has good strength with good esthetics and is best for long bridges due to the strength of its metal core. Its largest downfall is gum recession. If you experience any gum recession the metal layer will become visible. When this metal layer starts to show it causes a visible gray line along the gums. Another problem is the traditional porcelain layer can chip allowing that grey metal to show through.

Dental Crown Cost

The question of how much does a dental crown cost can vary depending on your insurance coverage. If you have insurance, your out-of-pocket cost can range anywhere from about $600 to $800 depending on your particular plan. Without insurance, the cost of a crown can range anywhere from $1000 to $1800. At The Grapevine Dentist we take most major PPO insurances and have an in-house discount plan to help those without insurance.

04/21/2022

I get asked this question a lot, so let's talk about gingivitis vs periodontitis, AKA gum disease in all it's forms.

What is Gum Disease

Gum disease typically comes in 2 forms, Gingivitis and Periodontitis. Gingivitis is an inflammation of the gum tissue due to plaque or calculus (tartar) build up. This is what most people have when they aren’t brushing and flossing as well as they should be. The second form of gum disease is Periodontitis, and it is considerably more serious. Periodontitis is characterized by the loss of jawbone and tissue attachment levels. In regular terms this means recession of the gums and destruction of the bone that holds your teeth in. When not properly and regularly removed, plaque and calculus start to form below the gum line. This plaque and calculus is full of bacteria and keeps your gums constantly irritated and inflamed. This long-term inflammation is destructive and will start to dissolve away the bone that holds your teeth in. This lets your gums recede away from the buildup. Unfortunately, as your gums recede, the buildup continues to form on this newly exposed root structure. This leads to a cycle of continued bone loss and gum recession. Eventually this destruction will approach the end of the tooth root and, just like digging the dirt out from around a fence post, things start to get loose. If left untreated this will lead to the loss of teeth.

Gum Disease Symptoms

The signs of gum disease, whether gingivitis or periodontitis, can be similar. Both are characterized by red and puffy gums, along with bleeding when you eat, brush or floss. Periodontitis goes a step farther with receding gums and mobility, or loosening, of teeth. Periodontal disease is usually painless until a tooth becomes so loose that it hurts to chew on. Untreated periodontitis also causes a particularly strong type of bad breath.

How to treat Gum Disease

To effectively treat gum disease, we first must determine the type. This is typically done with periodontal probing and a comprehensive set of x-ray. When probing, we use a measuring device called a periodontal probe to determine if you have any loss of bone/attachment. X-ray are also used to measure your current level of bone and the extent of bone loss, if any.
If you only have inflammation, or gingivitis, then the treatment is a Prophy. This is what most people know as a regular cleaning. This involves removing plaque and calculus above the gumline. Insurance typically covers 2 of these a year.
If you have bone or attachment loss, then you have Periodontitis. To treat this, you need SCRP (scaling and root planing), often called a deep cleaning. SCRP involves cleaning above and below the gums to remove the calculus buildup and the use of medicated irrigation to reduce the bacteria in the pockets. Once the bone loss associated with periodontitis has started it cannot be reversed, it can only be halted. The bone that is lost cannot be grown back. Once the deep cleaning is done, we place you on a periodontal maintenance schedule. This involves cleaning, irrigation, and possible re-scaling of problem areas, every 3-4 months. This is done to try and prevent the need for subsequent rounds of SCRP or deep cleaning. Insurance only covers a percentage of SCRPs and perio maintenance, so you will have an out-of-pocket cost. Once you are a deep cleaning patient you typically cannot go back to just a prophy. Insurance will typically not cover a prophy once you have a diagnosis of periodontal disease.

04/06/2022

Lets answer the most common questions I get about root canals.

What is a root canal?
A root canal procedure is what is done to remove the dead or dying pulp tissue from a tooth. A root canal treatment is needed when you have a tooth that is causing pain when you chew, is very sensitive to cold, is causing swelling, or has radiographic evidence of infection at the tip of the tooth root. The tooth pulp is the nerve and blood supply that gives a tooth feeling. The pulp comes up from the jawbone, through small hollow canals in the tooth roots, into a chamber or box in the center of the tooth. It also has tiny little extensions that go all throughout the underlying layer of the tooth.

The reason you need a root canal is because the pulp tissue is dying or has died inside the tooth. Pulp tissue dies when it is exposed to bacteria or trauma. This can happen a few ways. The most common is from cavities. If a cavity gets large enough, the bacteria from the cavity invade the pulp and begin the process of killing it off. Another way is from a cracked or broken tooth. If the crack is large or deep enough, this can provide a path for bacteria to make it into the pulp. There are also some unusual times where we find a tooth has died and we just don’t know why.

Why does my tooth hurt?
As the pulp dies the tooth becomes very temperature sensitive and aches and throbs. Once that pulp tissue dies it starts to rot. Then this bacteria and byproducts from that rotting tissue leak out of the chamber and down the canals in the roots to your jawbone. This causes inflammation and infection in the bone leading to pain, swelling, and eventually an abscess.

How do we treat it?
The only way to treat a dead or dying tooth is to remove all the dead and dying pulp tissue. We then must clean and seal the canal and pulp chamber.
The typical process starts with get the tooth numb. We then make a small hole in the tooth to access the pulp chamber (box it sits in) and use a series of instruments and medications to remove and clean out all the dead material and bacteria from inside the tooth. We then seal and fill the roots and chamber. Finally, we close the access hole in the tooth with a filling. Depending on the size of the access hole and amount of decay the tooth had, we often need to cover the tooth with a crown to keep it from breaking when you chew.

How long do root canals take?
A root canal can take anywhere from 45 minutes to 2 hours depending on the anatomy of the tooth and the severity of the infection.

Root canal recovery: What to expect afterwards.
It is normal to have some pain after a root canal. The tooth will be a little sore from all that work. This typically can be a dull ache for a few days and some tenderness if you bite on it. Depending on the severity of the infection, we may prescribe some antibiotics to make sure any lingering bacteria are taken care of. After some healing time, the tooth will return to feeling just like any other tooth.

Root canal cost
The cost of a root canal varies on what tooth is being treated and if you have insurance. The average cost of a root canal is anywhere from around $400 up to $1500 depending on the tooth, if you have insurance, and what your particular insurance fee schedule is.

04/05/2022

It’s prom season!! This is the perfect time to start your Opalescent GO trays. Get that perfect white smile on the GO! No impressions needed, will fit ANY mouth 🤩 Call our office at 817.251.4888 for more details

Address

1600 W Northwest Highway #200
Grapevine, TX
76051

Opening Hours

Monday	8am - 5pm
Tuesday	8am - 5pm
Wednesday	8am - 5pm
Thursday	8am - 5pm

Website

https://thegrapevinedentist.com/

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