Adrian Pulkrabek DDS PLLC
18205 N 51st Ave Suite 137 Glendale, AZ 85308

Services

Dental Fillings, Bondings, Sealants and Dental Cleanings

Dental fillings typically are done with a white composite material sometimes called bonding. Other older "silver fillings" use an amalgam material. Fewer offices use the amalgam fillings. More offices use the composite material because of the aesthetics and overall longevity.

A composite (tooth colored) filling is used to repair a tooth that is affected by decay, cracks, fractures, etc. The decayed or affected portion of the tooth will be removed and then filled with a composite filling.

There are many types of filling materials available, each with their own advantages and disadvantages. You and your dentist can discuss the best options for restoring your teeth. Composite fillings, along with silver amalgam fillings, are the most widely used today. Because composite fillings are tooth colored, they can be closely matched to the color of existing teeth, and are more aesthetically suited for use in front teeth or the more visible areas of the teeth.

As with most dental restorations, composite fillings are not permanent and may someday have to be replaced. They are very durable, and will last many years, giving you a long lasting, beautiful smile.

Reasons for composite fillings:
Chipped teeth.
Closing space between two teeth.
Cracked or broken teeth.
Decayed teeth.
Worn teeth.
How are composite fillings placed?
Composite fillings are usually placed in one appointment. While the tooth is numb, your dentist will remove decay as necessary. The space will then be thoroughly cleaned and carefully prepared before the new filling is placed. If the decay was near the nerve of the tooth, a special medication will be applied for added protection. The composite filling will then be precisely placed, shaped, and polished, restoring your tooth to its original shape and function.

It is normal to experience sensitivity to hot and cold when composite fillings are first placed, however this will subside shortly after your tooth acclimates to the new filling.
You will be given care instructions at the conclusion of your treatment. Good oral hygiene practices, eating habits, and regular dental visits will aid in the life of your new fillings.

Sealants are a protective material that fills in the grooves of the teeth. These Sealants help minimize the potential for cavities to develop in common grooves of the teeth.
A sealant is a thin, plastic coating applied to the chewing surface of molars, premolars and any deep grooves (called pits and fissures) of teeth. More than 75% of dental decay begins in these deep grooves. Teeth with these conditions are hard to clean and are very susceptible to decay. A sealant protects the tooth by sealing deep grooves, creating a smooth, easy to clean surface. Sealants can protect teeth from decay for many years, but need to be checked for wear and chipping at regular dental visits.

Reasons for sealants:
Children and teenagers - As soon as the six-year molars (the first permanent back teeth) appear or any time throughout the cavity prone years of 6-16.
Adults - Tooth surfaces without decay that have deep grooves or depressions.
Baby teeth - Occasionally done if teeth have deep grooves or depressions and child is cavity prone.

What do sealants involve?
Sealants are easily applied by your dentist or dental hygienist and the process takes only a couple of minutes per tooth. The teeth to be sealed are thoroughly cleaned and then surrounded with cotton to keep the area dry. A special solution is applied to the enamel surface to help the sealant bond to the teeth. The teeth are then rinsed and dried. Sealant material is carefully painted onto the enamel surface to cover the deep grooves or depressions. Depending on the type of sealant used, the material will either harden automatically or with a special curing light.

Proper home care, a balanced diet, and regular dental visits will aid in the life of your new sealants.

Dental cleanings are an important procedure for the health of the mouth, including the teeth and gums. It is recommended that the average child and adult have professional dental cleanings 2 times year. Patients with periodontal disease may require deep cleanings or gum surgery. Periodontal maintenance cleanings 4 times/year.
Medications may be used with treatment that includes scaling and root planning, but they cannot always take the place of surgery. Depending on how far the disease has progressed, the dentist or periodontist may still suggest surgical treatment. Long-term studies are needed to find out if using medications reduces the need for surgery and whether they are effective over a long period of time. Listed on the next page are some medications that are currently used.

Crowns and Root canals

A crown (or cap) is a covering that encases the entire tooth surface restoring it to its original shape and size. A crown protects and strengthens tooth structure that cannot be restored with fillings other types of restorations.
Crowns are tooth coverings that are commonly placed on and around teeth to protect and strengthen them after a trauma fracture or severely damaged from tooth decay.

Although there are several types of crowns, porcelain, Zirconia and gold. The Zirconia and Porcelain are the most popular, because they resemble your natural teeth. They are highly durable and will last many years, but like most dental restorations, they may eventually need to be replaced. Porcelain crowns are made to match the shape, size, and color or your teeth giving you a natural, long-lasting beautiful smile.

Reasons for crowns:
Broken or fractured teeth.
Cosmetic enhancement.
Decayed teeth.
Fractured fillings.
Large fillings.
Tooth has a root canal.
What does getting a crown involve?
A crown procedure usually requires two appointments. Your first appointment will include taking several highly accurate molds (or impressions) that will be used to create your custom crown. A mold will also be used to create a temporary crown which will stay on your tooth for approximately two weeks until your new crown is fabricated by a dental laboratory.

While the tooth is numb, the dentist will prepare the tooth by removing any decay and shaping the surface to properly fit the crown. Once these details are accomplished, your temporary crown will be placed with temporary cement and your bite will be checked to ensure you are biting properly.

At your second appointment your temporary crown will be removed, the tooth will be cleaned, and your new crown will be carefully placed to ensure the spacing and bite is accurate.

You will be given care instructions and encouraged to have regular dental visits to check your new crown.
Root Canals are a dental procedure that is preformed to alleviate infections or severe tooth aches caused by bacterial decay, and other nerve damage as a result of trauma. Essentially the nerves and bacterial infection are removed and a rubberized cemented gutta percha is filled into it. Most all teeth that have had root canals will require a crown afterwards.

Root Canal Therapy

Root canal therapy is needed when the nerve of a tooth is affected by decay or infection. In order to save the tooth, the pulp (the living tissue inside the tooth), nerves, bacteria, and any decay are removed and the resulting space is filled with special, medicated, dental materials, which restore the tooth to its full function.

Having a root canal done on a tooth is the treatment of choice to save a tooth that otherwise would die and have to be removed. Many patients believe that removing a tooth that has problems is the solution, but what is not realized is that extracting (pulling) a tooth will ultimately be more costly and cause significant problems for adjacent teeth.

Root canal treatment is highly successful and usually lasts a lifetime, although on occasion, a tooth will have to be retreated due to new infections.

Signs and symptoms for possible root canal therapy:
An abscess (or pimple) on the gums.
Sensitivity to hot and cold.
Severe toothache pain.
Sometimes no symptoms are present.
Swelling and/or tenderness.
Reasons for root canal therapy:
Decay has reached the tooth pulp (the living tissue inside the tooth).
Infection or abscess have developed inside the tooth or at the root tip.
Injury or trauma to the tooth.
What does root canal therapy involve?
A root canal procedure requires one or more appointments and can be performed by a dentist or endodontist (a root canal specialist). While the tooth is numb, a rubber dam (a sheet of rubber) will be placed around the tooth to keep it dry and free of saliva. An access opening is made on top of the tooth and a series of root canal files are placed into the opening, one at a time, removing the pulp, nerve tissue, and bacteria. If tooth decay is present, it will also be removed with special dental instruments.

Once the tooth is thoroughly cleaned, it will be sealed with either a permanent filling or, if additional appointments are needed, a temporary filling will be placed.

At the next appointment, usually a week later, the roots and the inside cavity of the tooth will be filled and sealed with special dental materials. A filling will be placed to cover the opening on top of the tooth. In addition, all teeth that have root canal treatment should have a crown (cap) placed. This will protect the tooth and prevent it from breaking, and restore it to its full function. After treatment, your tooth may still be sensitive, but this will subside as the inflammation diminishes and the tooth has healed. You will be given care instructions after each appointment. Good oral hygiene practices and regular dental visits will aid in the life of your root canal treatment.

Dental Implants

Dental implants are a great way to replace missing teeth and also provide a fixed solution to having removable partial or complete dentures. Implants provide excellent support and stability for these dental appliances.

Dental implants are artificial roots and teeth (usually titanium) that are surgically placed into the upper or lower jaw bone by a dentist or Periodontist - a specialist of the gums and supporting bone. The teeth attached to implants are very natural looking and often enhance or restore a patient's smile!

Dental implants are very strong, stable, and durable and will last many years, but on occasion, they will have to be re-tightened or replaced due to normal wear.

Reasons for dental implants:
Replace one or more missing teeth without affecting adjacent teeth.
Resolve joint pain or bite problems caused by teeth shifting into missing tooth space.
Restore a patient's confident smile.
Restore chewing, speech, and digestion.
Restore or enhance facial tissues.
Support a bridge or denture, making them more secure and comfortable.
What does getting dental implants involve?
The process of getting implants requires a number of visits over several months.
X-rays and impressions (molds) are taken of the jaw and teeth to determine bone, gum tissue, and spacing available for an implant. While the area is numb, the implant will be surgically placed into the bone and allowed to heal and integrate itself onto the bone for up to six months. Depending on the type of implant, a second surgery may be required in order to place the "post" that will hold the artificial tooth in place. With other implants the post and anchor are already attached and placed at the same time.

After several weeks of healing the artificial teeth are made and fitted to the post portion of the anchor. Because several fittings may be required, this step may take one to two months to complete. After a healing period, the artificial teeth are securely attached to the implant, providing excellent stability and comfort to the patient.

Dental Extractions

Extractions
A dental extraction (also referred to as exodontia) is the removal of a tooth from the mouth. Extractions are performed for a wide variety of reasons, including tooth decay that has destroyed enough tooth structure to prevent restoration. Extractions of impacted or problematic wisdom teeth are routinely performed, as are extractions of some permanent teeth to make space for orthodontic treatment.

Reasons for tooth extraction
The most common reason for extraction is tooth damage due to breakage or decay. There are additional reasons for tooth extraction:
Severe tooth decay or infection. Despite the reduction in world-wide prevalence of dental caries, it still is the most common reason for extraction of (non-third molar) teeth with up to two thirds of extractions.
Extra teeth which are blocking other teeth from coming in. This is common when a patient is also undergoing orthodontic treatment.
Severe gum disease which may affect the supporting tissues and bone structures of teeth.
In preparation for orthodontic treatment, using removable and/or fixed appliances such as braces
Teeth in the fracture line
Fractured teeth
Insufficient space for wisdom teeth (impacted third molars).
Receiving radiation to the head and neck may require extraction of teeth in the field of radiation.
Types of extraction
An extracted 3rd molar that was horizontally impacted. Extractions are often categorized as "simple" or "surgical".

Simple extractions are performed on teeth that are visible in the mouth, usually under local anesthetic, and require only the use of instruments to elevate and/or grasp the visible portion of the tooth.

Typically the tooth is lifted using an elevator, and using dental forceps, rocked back and forth until the Periodontal ligament has been sufficiently broken and the supporting alveolar bone has been adequately widened to make the tooth loose enough to remove. Typically, when teeth are removed with forceps, slow, steady pressure is applied with controlled force. Bleeding is far less prominent compared to surgical extractions, as no incisions in the gums are needed to remove the tooth.

Surgical extractions involve the removal of teeth that cannot be easily accessed, either because they have broken under the gum line or because they have not erupted fully. Surgical extractions almost always require an incision. In a surgical extraction the doctor may elevate the soft tissues covering the tooth and bone and may also remove some of the overlying and/or surrounding bone tissue with a drill. Frequently, the tooth may be split into multiple pieces to facilitate its removal.

Dental Veneers

Veneers are very thin pieces of durable, tooth shaped porcelain that are custom made (for shape and color) by a professional dental laboratory. They are bonded onto the front of teeth to create a beautiful and attractive smile.



Veneers can completely reshape your teeth and smile. They can often be alternatives to crowns and the ideal solution in treating many dental conditions.

As with most dental restorations, veneers are not permanent and may someday need replacement. They are very durable and will last many years, giving you a beautiful long lasting smile.

Reasons for porcelain veneers:
Cosmetically, to create a uniform, white, beautiful smile.
Crooked teeth.
Misshapen teeth.
Severely discolored or stained teeth.
Teeth that are too small or large.
Unwanted or uneven spaces.
Worn or chipped teeth.
What does getting porcelain veneers involve?
Getting veneers usually requires two visits to complete the process, with little or no anesthesia required during the procedure. The teeth are prepared by lightly buffing and shaping the surface to allow for the thickness of the veneer. A mold or impression of the teeth is taken and a shade (color) will then be chosen by you and the dentist.

On the second visit the teeth will be cleansed with special liquids to achieve a durable bond. Bonding cement is then placed between the tooth and veneer and a special light beam is used to harden and set the bond.

You will receive care instructions for veneers. Proper brushing, flossing and regular dental visits will aid in the life of your new veneers.