Handle With Care: A Gentle Guide to Caring for Your Restorations

Restorative dentistry isn’t just about fixing what’s broken—it’s about preserving what’s still remains.  When I place a restoration—whether it’s a filling, crown, bridge, or implant—my goal is always the same: long-term health, comfort, and confidence.  Every restoration deserves thoughtful design, precise placement, and ongoing care.  Here’s what I want my patients to understand about the life of their restorations—and how to make them last.

Fillings—Small But Significant

Fillings replace areas of decay, but even the smallest one means part of your natural tooth is gone forever. I only use composite resin to restore small and moderate-sized restorations.  I stopped using amalgam materials 35 years ago.  While amalgam is a very durable material, the fact that it is 40% mercury and the fact that it expands and contracts under hot and cold temperatures at a different rate than the tooth structure means that the tooth is far more likely to fracture during chewing and clenching.  Composite materials are tooth-colored, mercury-free, and bond directly to the enamel, helping strengthen the remaining structure.

Crowns—Strength, Beauty, and Fit

A crown acts like a custom-fitted helmet for a tooth that’s been compromised by fracture, decay, or a large restoration.  It encases the visible portion of the tooth to restore strength and function.  But not all crowns are created equal.

Most crowns today consist of a porcelain layer over a substrate—this is the 'foundation' of the crown.  Common substrate materials include:
- **Gold**: Extremely durable and gentle on opposing teeth
- **Metal alloys (silver-colored)**: Strong, but may be visible at the gum line
- **Zirconia**: White, very strong, often used for back teeth
- **Lithium disilicate (e.g., E.max)**: Highly aesthetic, best for front teeth

The crown must fit precisely at the gum line to prevent leakage, decay, and irritation.  Teeth are not static—they shift slightly over time.  If the bite isn’t balanced or the crown contacts the opposint tooth prematurely, it can cause rocking, loosen the tooth, or damage adjacent structures.

Crowns can fail due to:
- Recurrent decay under the crown margin
- Fracture of the crown or underlying tooth
- Clenching/grinding forces
- Poor hygiene or inflammation at the gum line
That’s why regular check-ups and perfecting the bite are so important.

Bridges—More Than a Pretty Fix

A dental bridge fills the space of a missing tooth by anchoring to neighboring teeth.  It comprises two crowns on either side of the gap, with a false tooth (pontic) suspended between them.

Bridges look natural, restore chewing function, and keep surrounding teeth from drifting.  But they require diligent care, especially underneath.  I teach my patients how to use floss threaders or water flossers to clean under the pontic, where food and bacteria tend to collect.  Neglecting this area can lead to decay under the anchor crowns or inflammation of the gum tissue. If the abutment teeth on either side of the extracted tooth are in pristine condition, I do not believe it is wise to remove enamel to shape them so they can receive crowns to retain the bridge.  I prefer an implant or a removable bridge that does not require eliminating enamel from perfectly good teeth.  This is why I am a tooth-conserving dentist.

Well-cared-for bridges can last 10–15 years or more, but like all restorations, they rely on strong hygiene and maintenance habits.

Implants—A Rooted, Long-Term Solution

Dental implants are the closest thing we have to a natural tooth.  They consist of a titanium post placed in the jawbone, topped with an abutment and crown. I use **BICON implants**, which are known for their short, wide design and excellent long-term success rates.

Some holistic dentists prefer zirconia implants, and while zirconia has aesthetic advantages, I’ve found that it may not be as strong or predictable over time as titanium.  In fact, several studies comparing zirconia and titanium show that titanium consistently outperforms in load resistance and longevity.

The process of getting an implant usually involves:
- Initial consultation and imaging
- Surgical placement of the implant
- Healing and integration with the bone (osseointegration)
- Placement of the crown for full function and appearance

With proper care, implants can last a lifetime. But like teeth, they need brushing, flossing, and professional monitoring to stay healthy.

What About Removable Appliances and Dentures?

Removable options include full dentures, partial dentures, and appliances like flippers or retainers with artificial teeth.  These deserve their own detailed article, but here’s the short version:

- **Partial dentures** replace a few missing teeth and attach to existing ones.
- **Full dentures** replace all teeth on the upper or lower arch.
- **Flippers** are temporary removable devices often used during healing.

These solutions must be cleaned daily—never with toothpaste, which is too abrasive—and checked regularly to ensure proper fit and no irritation to the underlying tissue.  Even without natural teeth, your oral health still needs professional support.

Every Restoration Deserves a Relationship

Whether it’s a tiny filling or a full-mouth reconstruction, your restorations are part of your story—and part of your health.  Let’s care for them together.  I’ll bring the experience and the gentle hand.  You bring your questions, your smile, and your commitment to keeping it strong.