Restorative Services...

While Dr. McMurtry and his staff's main focus is prevention, if a tooth does need treatment, he does offer a number of different options for treating whatever problem may occur. With the addition of using the Waterlase MD all-tissue dental laser, many procedures can be done without the need of a shot.

Restorative services offered in our office include:

  • Tooth-colored Fillings
  • Crowns (Caps) and Bridges
  • Implants
  • Full Dentures
  • Partial Dentures

Please click on any of the "+" marks on the right to expand the
Restorative topics listed below.

What is a Composite Resin (White Fillings)? []

A composite filling is a tooth-colored plastic and glass mixture used to restore decayed teeth. Composites are also used for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth.

How is a composite placed?

Following preparation, Charlotte dentist Dr. Brian A. McMurtry places the composite in layers, using a specialized light to harden each layer. When the process is finished, Dr. McMurtry will shape the composite to fit the tooth. Charlotte dentist Dr. McMurtry then polishes the composite to prevent staining and early wear.

What is the cost?

Prices vary depending on the size of the filling. Most dental insurance plans cover the cost of the composite up to the price of a silver filling, with the patient paying the difference. As composites continue to improve, insurance companies are more likely to increase their coverage of composites. Our experience is showing that composites are usually now covered at the same fee as a silver filling. However, each individual insurance plan differ.

What are the advantages of composites?

Aesthetics are the main advantage of composites, since Dr. McMurtry can blend shades to create a color nearly identical to that of the actual tooth. Composites bond to the tooth to support the remaining tooth structure, which helps to prevent breakage and insulate the tooth from excessive temperature changes.

What are the disadvantages?

After receiving a composite, a patient may experience postoperative sensitivity. Also, the shade of the composite can change slightly if the patient drinks tea, coffee or other staining foods. The dentist can put a clear plastic coating over the composite to prevent the color from changing if a patient is particularly concerned about tooth color. Composites tend to wear out sooner than silver fillings in larger cavities, although they hold up as well in small cavities.

What is Dental Amalgam (Silver Fillings) and do we use it? []

This is for informational purposes only. Our office does not use dental amalgam anymore for a number of different reasons, mainly because of esthetics. Patients do not want the look of silver in their mouth. They want their teeth to look like, well, teeth.

Most people recognize dental amalgams as silver fillings. Dental amalgam is a mixture of mercury, silver, tin and copper. Mercury, which makes up about 50 percent of the compound, is used to bind the metals together and to provide a strong, hard, durable filling. After years of research, mercury has been found to be the only element that will bind these metals together in such a way that can be easily manipulated into a tooth cavity.

Is mercury in dental amalgam safe?

Mercury in dental amalgam is not poisonous. When mercury is combined with other materials in dental amalgam, its chemical nature changes, so it is essentially harmless. The amount of mercury released in the mouth under the pressure of chewing and grinding is extremely small and no cause for alarm. In fact, it is less than what patients are exposed to in food, air and water.

Ongoing scientific studies conducted over the past 100 years continue to prove that amalgam is not harmful. Claims of diseases caused by mercury in amalgam are anecdotal, as are claims of miraculous cures achieved by removing amalgam. These claims have not been proven scientifically.

Why do other dentists use dental amalgam?

Dental amalgam has withstood the test of time, which is why it is the material of choice for some dentists. It has a 150-year proven track record and is still one of the safest, durable and least expensive materials used to a fill a cavity. It is estimated that more than 1 billion amalgam restorations (fillings) are placed annually. Dentists use dental amalgam because it is easier to work with than other alternatives. Some patients prefer dental amalgam to other alternatives because of its safety, cost-effectiveness and ability to be placed in the tooth cavity quickly.

Why don't dentists use alternatives to amalgam?

Alternatives to amalgam, such as cast gold restorations, porcelain and composite resins are more costly. Gold and porcelain restorations take longer to make and can require two dental appointments. Composite resins, or white fillings, are aesthetically appealing but require a longer time to place the restoration. It should also be known that these materials, with the exception of gold, are not as durable as amalgam.

What about patients allergic to mercury?

The incidence of allergy to mercury is far less than one percent of the population. People suspected of having an allergy to mercury should be tested by qualified physicians, and, when necessary, seek appropriate alternatives. Should patients have amalgam removed? No. To do so, without need, would result in unnecessary expense and potential injury to teeth.

Are dental staff occupationally exposed?

Dentists use premixed capsules, which reduce the chance of mercury spills. And newer, more advanced dental amalgams are containing smaller amounts of mercury than before. An interesting factor can be brought into this: Because dental staff are exposed to mercury more often, one would expect dental personnel to have higher rates of neurological diseases, such as multiple sclerosis. They, in fact, do not.

What are other sources of mercury?

Mercury can be found in air, food and water. We are exposed to higher levels of mercury from these sources than from a mouthful of amalgam.

What are Crowns? []

A crown is a restoration that covers, or "caps," a tooth to restore it to its normal shape and size, strengthening and improving the appearance of a tooth. Crowns are necessary when a tooth is generally broken down and fillings won't solve the problem. If a tooth is cracked, a crown holds the tooth together to seal the cracks so the damage doesn't get worse. Crowns are also used to restore a tooth when there isn't enough of the tooth remaining to provide support for a large filling, attach a bridge, protect weak teeth from fracturing, restore fractured teeth or cover badly shaped or discolored teeth.

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How is a crown placed?

To prepare the tooth for a crown, it is reduced so the crown can fit over it. An impression of the teeth and gums is made and sent to the lab for the crown fabrication. A temporary crown is fitted over the tooth until the permanent crown is made. On the next visit, Dr. Brian McMurtry removes the temporary crown and cements the permanent crown onto the tooth.

Will it look natural?

Yes. Dr. McMurtry's main goal is to create a crown that looks like a natural tooth. That is why he takes an impression. To achieve a certain look, a number of factors are considered, such as the color, bite, shape and length of your natural teeth. Any one of these factors alone can affect your appearance.

If you have a certain cosmetic look in mind for your crown, discuss it with Charlotte dentist Dr. Brian A. McMurtry at your initial visit. When the procedure is complete, your teeth will not only be stronger, but they may be more attractive.

Why crowns and not veneers?

Crowns require more tooth structure removal, hence they cover more of the tooth than veneers. Crowns are customarily indicated for teeth that have sustained significant loss of structure or to replace missing teeth. Crowns may be placed on natural teeth or dental implants.

What is the difference between a cap and a crown?

There is no difference between a cap and a crown. They are the same thing.

How long do crowns last?

Crowns should last approximately five to eight years. However, with good oral hygiene and supervision, most crowns will last for a much longer period of time. Some damaging habits like grinding your teeth, chewing ice or fingernail biting may cause this period of time to decrease significantly.

How should I take care of my crown?

To prevent damaging or fracturing the crown, avoid chewing hard foods, ice or other hard objects. You also want to avoid teeth grinding. Besides visiting Dr. McMurtry and brushing twice a day, cleaning between your teeth is vital with crowns. Floss or interdental cleaners (specially shaped brushes and sticks) are important tools to remove plaque from the crown area where the gum meets the tooth. Plaque in that area can cause dental decay and gum disease.

What is a Dental Implant? []

charlotte dentistA dental implant is an artificial tooth root that is surgically anchored into your jaw to hold a replacement tooth or bridge in place. The benefit of using implants is that they don't rely on neighboring teeth for support and they are permanent and stable. Implants are a good solution to tooth loss because they look and feel like natural teeth.

 

Implant material is made from different types of metallic and bone-like ceramic materials that are compatible with body tissue. There are different types of dental implants: the first is placed directly into the jaw bone, like natural tooth roots; the second is used when the jaw structure is limited, therefore, a custom-made metal framework fits directly on the existing bone.

How do they work?

Strategically placed, implants can now be used to support permanently cemented bridges, eliminating the need for a denture. The cost tends to be greater, but the implants and bridges more closely resemble real teeth.

Can anyone receive dental implants?

Talk with Charlotte dentist Dr. Brian McMurtry about whether you are an implant candidate. You must be in good health and have the proper bone structure and healthy gums for the implant to stay in place. People who are unable to wear dentures may also be good candidates. If you suffer from chronic problems, such as clenching or bruxism, or systemic diseases, such as diabetes, the success rate for implants decreases dramatically. Additionally, people who smoke or drink alcohol may not be good candidates.

What can I expect during this procedure?

charlotte dentistThe dentist must perform surgery to anchor the "artificial root" into or on your jaw bone. The procedure is done in the dental office with local anesthesia. The gum is then secured over the implant, which will remain covered until it fuses with the bone. The dentist then uncovers the implant and attaches an extension, or post, to the implant. With some implants, the implant and post are a single unit placed in the mouth during the initial surgery. Finally, the dentist makes an artificial tooth, or crown, that is attached to the implant post.

How long does the process take?

The process can take up to six to nine months to complete. Each patient heals differently, so times will vary. After the implant and posts are placed surgically, the healing process can take up to four months and the fitting of replacement teeth no more than a few weeks. Sometimes, if a patient has good bone quality, posts can be placed and replacement teeth fitted in one appointment.

What is the success rate of implants?

The success rate for implants depends on the tooth's purpose and location in the mouth, as well as a patient’s overall health.

How do I care for implants?

Poor oral hygiene is a big reason why some implants fail. It is important to floss and brush around the fixtures at least twice a day. Dr. McMurtry will give you specific instructions on how to care for your new implants. Additional cleanings of up to four times per year may be necessary to ensure that you retain healthy gums.

What is the cost of implants?

Since implants involve surgery and are more involved, they cost more than traditional bridgework. However, some dental procedures and portions of the restoration may be covered by dental and medical insurance policies. Dr. McMurtry and his outstanding staff can help you with this process.

Crown Crazes: Are You a Candidate? []

Yellow teeth, gum disease and tooth loss may conjure up images of aging, yet many people are unaware that as they age, they are more likely to develop crown crazes – unsightly hairline cracks in tooth enamel.

"Crown craze candidates are usually in their mid-thirties," says Academy of General Dentistry spokesperson Barbara A. Rich, DDS, FAGD. "Years of wear and tear and bad chewing habits create extra pressure and cause crazes to form, especially in teeth with older, large fillings."

This condition develops over time to all teeth, but crazes are more apparent on the front upper teeth, where staining is more likely, and shows up as a thin brown line.

"It's not just a cosmetic problem," warns Dr. Rich. If the craze is deep enough in the enamel, the tooth may develop some sensitivity.

To avoid developing crazes that may instigate dental accidents, Dr. Rich advises her patients to stop chewing on popcorn kernels, hard candy or ice cubes. "It's quite common to develop a craze when repeatedly chewing hard objects."

Many patients are not aware of this problem until their dentist points it out with a mirror or intraoral camera, says Dr. Rich.

If a craze does not cause discomfort or pain, Dr. McMurtry will monitor the tooth at each dental visit and have you keep a watchful eye on the tooth and report changes. If the crack goes to the inner surface of the tooth, you may want to consider a crown in order to restore tooth strength.

What is a Dental Bridge? []

charlotte laser dentistA Dental Bridge is similar to a crown but consists of more than one crown. They literally bridge the gap created by one or more missing teeth.

A bridge is made up of at least two crowns for the teeth on either side of the gap, called abutment teeth, and one or more false teeth in between. These false teeth are called pontics and can be made from gold, alloys, porcelain or a combination of these materials. Dental bridges are supported by natural teeth or implants.

 

 

What Are the Benefits of Dental Bridges?

  • Restore your smile
  • Restore your ability to properly chew and speak
  • Maintain the shape of your face
  • Distribute the forces in your bite properly by replacing missing teeth
  • Prevent remaining teeth from drifting out of position

What Types of Dental Bridges Are Available?

  • Traditional bridges involve creating a crown for the tooth or implant on either side of the missing tooth, with a pontic in between. Traditional bridges are the most common type of bridge and are made of either porcelain fused to metal, all-ceramics, or all-metal.
  • Cantilever bridges are used when there are adjacent teeth on only one side of the missing tooth or teeth. These types of bridges are not usually recommended due to the type of unwanted forces placed on them.
  • Maryland bonded bridges (also called a resin-bonded bridge or a Maryland bridge) are made of plastic teeth and gums supported by a metal framework. Metal or ceramic wings on each side of the bridge are bonded to your existing teeth. These can be good long term temporaries when finances may be an issue. They usually will not last as long as a traditional bridge but can be more conservative until an implant may be an option for the patient.

 

What is a Denture? []

A denture is a removable replacement for missing teeth and adjacent tissues. It is made of acrylic resin, sometimes in combination with various metals. Complete dentures replace all the teeth, while a partial denture fills in the spaces created by missing teeth and prevents other teeth from changing position. Complete dentures are either "conventional" or "immediate." A conventional denture is placed in the mouth about a month after all the teeth are removed to allow for proper healing, whereas an immediate denture is placed as soon as the teeth are removed. The drawback behind an immediate denture is that it may require more adjustments after the healing has taken place.

Who needs a denture?

Candidates for complete dentures have lost most or all of their teeth. A partial denture is suitable for those who have some natural teeth remaining. A denture improves chewing ability and speech and provides support for facial muscles. It will greatly enhance the facial appearance and smile.

What happens when you get a denture?

Charlotte dentist Dr. Brian McMurtry can make a full conventional denture when all teeth have been lost or all extraction sites have healed (up to eight weeks or longer.) The denture process takes about one month and five appointments: the initial diagnosis is made; an impression and a wax bite are made to determine vertical dimensions and proper jaw position; a "try-in" is placed to assure proper color, shape and fit; and the patient's final denture is placed, following any minor adjustments.

New denture wearers need time to get accustomed to their new "teeth," because even the best-fitting dentures will feel awkward at first. While most patients can begin to speak normally within a few hours, many patients report discomfort with eating for several days to a few weeks. To get accustomed to chewing with a new denture, start with soft, easy-to-chew foods. In addition, denture wearers often notice a slight change in facial appearance, increased salivary flow or minor irritation or discomfort.

How do you care for a denture?

A denture is fragile, so it is important to handle it with care. Remove and brush the denture daily, preferably with a brush designed specifically for cleaning dentures, using either a denture cleanser or toothpaste. Never use harsh, abrasive cleansers, including abrasive toothpastes, because they may scratch the surface of the denture. Don't soak your denture in boiling water because it will cause it to become warped. If you wear a partial denture, be sure to remove it before brushing your natural teeth. When not in use, soak it in a cleanser solution or in water. Get in the habit of keeping the denture in the same safe and handy place to reduce the likelihood of misplacement.

Should a denture be worn at night?

While you may be advised to wear your denture almost constantly during the first two weeks – even while you sleep – under normal circumstances it is considered best to remove it at night and soak the denture in cleansing solution or water. Research has shown that removing the denture for at least eight hours during either the day or night allows the gum tissue to rest and allows normal stimulation and cleansing by the tongue and saliva. This promotes better long-term health of the gums.

Continue seeing your dentist regularly

It is important to continue having regular dental checkups so that Dr. McMurtry can examine oral tissues for signs of disease or cancer. With age, your mouth will continue to change as the bone under your denture shrinks or recedes. To maintain a proper fit over time, it may be necessary to adjust your denture or possibly remake your denture. Never attempt to adjust a denture yourself, and do not use denture adhesives for a prolonged period because this can contribute to bone loss. When in doubt, consult your dentist.

Are there any alternatives to dentures? 

Dentures are no longer the only way to restore a mouth that has little or no non-restorable teeth. Strategically placed support, or implants, can now be used to support permanently cemented bridges, eliminating the need for a denture. The cost tends to be greater, but the implants and bridges more closely resemble the "feel" of real teeth. Dental implants are becoming the alternative of choice to dentures, but not everyone is a candidate for implants. Speak with Dr. McMurtry for advice.
 

What is a Partial Denture? []

A partial denture is a removable appliance that replaces missing teeth. A partial denture is made up of one or more artificial replacement teeth and is anchored in your mouth on your natural teeth with either metal clasps or precision clasps. The artificial acrylic teeth are attached to a pink colored plastic that is attached to a metal framework.

Adjusting to the Partial

Several visits to the office are usually needed to make sure the partial fits properly ans to relieve any sore spots caused by pressure. Since the partial is a foreign object in your mouth, it may feel awkward for a few weeks while your mouth adapts to it.

At first, you will need to eat soft foods that are cut into small pieces. You will eventually feel more comfortable eating a lot of foods, but it is important to remember that a partial is removable and the teeth are acrylic and you are limited in what you can eat. We recommend avoiding sticky or hard foods.

Advantages of a Removable Partial Denture

  • Less costly than permanent bridework or implants
  • Treatment time is short
  • Less expensive to repair if there are any problems
  • Less expensive to replace

Disadvantages of a Removable Partial Denture

  • Clasps can cause excess wear and tear on the supporting teeth
  • Food stuck under partial
  • Reduction in chewing efficiency
  • Food sticking to partial
  • Soreness underneath partial from bone loss