• 450 Grand Blvd, Deer Park, NY 11729, USA
  • (631) 667-4080
  • smile@RaphaelsonDDS.com
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Restorative Dentistry

Restorative dentistry aims to treat the teeth and their supporting structures. Many conditions and their consequences may be assessed and treated by a restorative dentist. Restorative dentistry is the study, diagnosis and integrated management of diseases of the teeth and their supporting structures and the rehabilitation of the dentition to functional and aesthetic requirements of the individual.

Early Dental Care

Teething

Normally the first tooth erupts between ages 6 to 12 months. Gums are sore, tender and sometimes irritable until the age of 3. Rubbing sore gums gently with a clean finger, the back of a cold spoon or a cold, wet cloth helps soothe the gums. Teething rings work well, but avoid teething biscuits—they contain sugar that is not good for baby teeth.

While your baby is teething, it is important to monitor the teeth for signs of baby bottle decay. Examine the teeth, especially on the inside or the tongue side, every two weeks for dull spots (whiter than the tooth surface) or lines. A bottle containing anything other than water and left in an infant’s mouth while sleeping can cause decay. This happens because sugar in the liquid mixes with bacteria in dental plaque, forming acids that attack the tooth enamel. Each time a child drinks liquids containing sugar, acids attack the teeth for about 20 minutes. When awake, saliva carries away the liquid. During sleep, the saliva flow significantly decreases and liquids pool around the child’s teeth for long periods, covering the teeth in acids.

Infant's New Teeth

The primary, or “baby,” teeth play a crucial role in dental development. Without them, a child cannot chew food properly and has difficulty speaking clearly. Primary teeth are vital to development of the jaws and for guiding the permanent (secondary) teeth into place when they replace the primary teeth around age 6.

Since primary teeth guide the permanent teeth into place, infants with missing primary teeth or infants who prematurely lose primary teeth may require a space maintainer, a device used to hold the natural space open. Without a maintainer, the teeth can tilt toward the empty space and cause permanent teeth to come in crooked. Missing teeth should always be mentioned to your family dentist. The way your child cares for his/her primary teeth plays a critical role in how he/she treats the permanent teeth. Children and adults are equally susceptible to plaque and gum problems—hence, the need for regular care and dental check-ups.

A Child’s First Dental Visit

A child’s first dental visit should be scheduled around his/her first birthday. The most important part of the visit is getting to know and becoming comfortable with a doctor and his staff. A pleasant, comfortable first visit builds trust and helps put the child at ease during future dental visits. If possible, allow the child to sit in a parent’s lap in the exam room. Children should be encouraged to discuss any fears or anxiety they feel.

Why Primary Teeth Are Important

Primary teeth are important for several reasons. Foremost, good teeth allow a child to eat and maintain good nutrition. Healthy teeth allow for clear pronunciation and speech habits. The self-image that healthy teeth give a child is immeasurable. Primary teeth also guide eruption of the permanent teeth.

Good Diet and Healthy Teeth

The teeth, bones and soft tissue of the mouth require a healthy, well-balanced diet. A variety of foods from the five food groups helps minimize (and avoid) cavities and other dental problems. Most snacks that children eat cause cavities, so children should only receive healthy foods like vegetables, low-fat yogurt and cheeses, which promote strong teeth.

Infant Tooth Eruption

A child’s teeth actually start forming before birth. As early as 4 months of age, the primary or “baby” teeth push through the gums—the lower central incisors are first, then the upper central incisors. The remainder of the 20 primary teeth typically erupt by age 3, but the place and order varies.

Permanent teeth begin eruption around age 6, starting with the first molars and lower central incisors. This process continues until around age 21. Adults have 28 secondary (permanent) teeth—32 including the third molars (wisdom teeth).

Preventing Baby Bottle Tooth Decay

Tooth decay in infants can be minimized or totally prevented by not allowing sleeping infants to breast or bottle-feed. Infants that need a bottle to comfortably fall asleep should be given a water-filled bottle or a pacifier. Our office is dedicated to fighting baby bottle tooth decay. Let us know if you notice any signs of decay or anything unusual in your child’s mouth.

Dental Sealants

Sealants are a thin coating painted on the chewing surfaces of teeth typically place on the the back teeth (the premolars and molars) to prevent tooth decay. It bonds into the grooves of the teeth, forming a protective shield over the enamel of each tooth.

Due to the likelihood of developing decay in the grooves of the premolars and molars, children are great candidates for sealants.

FILLINGS

The concept of a “filling” is replacing and restoring your tooth structure that is damaged due to decay or fracture with a material. We will replace old, broken-down amalgam/metal fillings that contain traces of mercury with white fillings (composites) to restore your smile and teeth to a more natural look and feel.

With today’s advancements, no longer will you have to suffer the embarrassment of unsightly and unhealthy silver/mercury fillings or metal margins of the past. Eliminate the dark, black appearance in your teeth with new-age, state-of-the-art, tooth-colored resin or porcelain materials.

Comparing White Fillings versus Silver Amalgam Fillings:

White fillings bond to the tooth; they strengthen the tooth by restoring most of its original shape. Silver amalgams, on the other hand, weaken the teeth and make them more susceptible to breaking. Broken teeth can be very expensive to replace; white amalgam can actually save time and money in the long run.
White filling composites are preferred by most patients. This is due to the natural color, strength and overall appearance and feel. Composites are naturally more comfortable. Hot and cold sensitivity is greatly reduced with composite material compared to the silver/mercury amalgams. Restorations with composites require less removal of tooth, less structure to place than those with amalgams and especially with new cavities. Dramatically smaller holes are needed with a composite. White fillings are healthier because no traces of mercury are used, unlike silver amalgams.

COMPOSITE BONDINGS

Bonding is a common solution for:

  • Fixing or repairing chipped or cracked teeth
  • Reducing unsightly gaps or spaces between teeth
  • Hiding discoloration or faded areas on the tooth’s surface
  • Often used to improve the appearance of your teeth and enhance your smile. As the name indicates, composite material, either a plastic or resin, is bonded to an existing tooth. Unlike veneers or crowns, composite bonding removes little, if any, of the original tooth.

Composite bonding has many advantages:

  • It is a quick process, which typically lasts less than one hour.
  • It does not reduce the tooth’s original structure and is relatively inexpensive.
  • Composite resins come in many different shades and provide better matching of shades to the natural color of your teeth.
  • Composite bonds, however, are not as durable and long-lasting as veneers and crowns and may need to be re-touched or replaced in the future.
  • Composite bonds stain more easily and therefore require proper care and regular cleaning. In order to ensure the longest possible duration of the bonding, composites should be brushed and flossed daily.
  • Common staining elements include coffee, tea, tobacco, foods and candy.

CROWNS AND BRIDGES

Crowns

A crown is a permanent covering that fits over an original tooth that is either decayed, damaged or cracked. Crowns are made of a variety of different materials such as porcelain, gold, acrylic resin or a mix of these materials. Porcelain generally has the most natural appearance, although it is often less durable.

The treatment plan for a patient receiving a crown involves:

  • Numbing the tooth to remove the decay in or around it.
  • Re-sculpturing the tooth to provide an ideal fit for the crown.
  • Making an impression of your teeth in order to create a custom-made crown (usually takes one to two weeks
  • Making a temporary crown out of acrylic resin and fitting it onto the tooth during the interim period when the permanent custom-made crown is being created.
  • Applying the permanent crown (when received from the lab) by removing the temporary crown and fitting the permanent one onto the tooth.
  • After ensuring that the crown has the proper look and fit, the dentist cements it into place.
  • This process generally consists of a minimum of 2-3 visits over a three to four week period. Once the procedure is completed, proper dental hygiene, including daily brushing and flossing, is required to maintain healthy, bacteria-free teeth, gums and crowns. This helps in the prevention of gum disease. Given proper care, your crowns can last a lifetime.

Bridges

A bridge is a dental device that fills a space that a tooth previously occupied. A bridge may be necessary to prevent:

Shifting of the teeth that can lead to bite problems (occlusion) and/or jaw problems and resultant periodontal disease.
Bridges safeguard the integrity of existing teeth and help maintain a healthy, vibrant smile.

There are three main types of bridges, namely:

Fixed bridge – this is the most popular and consists of a filler tooth that is attached to two crowns, which fit over the existing teeth and hold the bridge in place.

The “Maryland” bridge is commonly used to replace missing front teeth and consists of a filler that is attached to metal bands that are bonded to the abutment teeth. The metal bands consist of a white-colored composite resin that matches existing tooth color.

The “Cantilever” bridge is often used when there are teeth on only one side of the span. A typical three-unit cantilever bridge consists of two crowned teeth positioned next to each other on the same side of the missing tooth space. The filler tooth is then connected to the two crowned teeth, which extend into the missing tooth space or end.

WHITE FILLINGS

We are able to provide functional, tooth-colored fillings using composite bonding. Bonding is a common solution for:

  • Fixing or repairing chipped or cracked teeth
  • Reducing unsightly gaps or spaces between teeth
  • Hiding discoloration or faded areas on the tooth’s surface

Often used to improve the appearance of your teeth and enhance your smile. As the name indicates, composite material, either a plastic or resin, is bonded to an existing tooth. Unlike veneers or crowns, composite bonding removes little, if any, of the original tooth.

Composite bonding has many advantages:

  • It is a quick process, which typically lasts less than one hour.
    It does not reduce the tooth’s original structure and is relatively inexpensive.
  • Composite resins come in many different shades and provide better matching of shades to the natural color of your teeth.

Composite bonds, however, are not as durable and long-lasting as veneers and crowns and may need to be re-touched or replaced in the future.

  • Composite bonds stain more easily and therefore require proper care and regular cleaning. In order to ensure the longest possible duration of the bonding, composites should be brushed and flossed daily. Common staining elements include coffee, tea, tobacco, foods and candy.

TMJ AND TMD

The “Temporomandibular Joint,” more commonly referred to as the “jaw joint,” assists in the basic opening and closing movements of the jaw. Unfortunately, this joint is a common area for recurring pain. Although conventional wisdom suggests that “popping” sounds in the jaw indicates a TMJ dysfunction, this is not always true. Many times, your jaw is functioning properly even if a “popping” sound is present when chewing or talking.

We offer a TMJ exam that evaluates the joint tissue in the “hinge” of the jaw. Possible problems include swelling, deterioration of the joint tissue or damaged joint tissue (which cushions the jaw bones during the opening and closing movement of the mouth). Common pain relievers and cold compresses can provide temporary relief for most cases of TMJ.

For more serious cases of TMJ, we will recommend alternate treatments. Often, we will suggest using a mouthguard to relieve teeth grinding. In some cases, we will instruct you to use orthodontic appliances or retainers to alleviate discomfort or redirect positioning of the TMJ joint. For the most severe cases of TMJ, we may recommend certain invasive procedures.