Restorative Dentistry in Miami

Restorative dentistry repairs teeth that are decayed, broken or worn, and replaces the ones that are missing: fillings, crowns, bridges, implants, dentures and, when most of the mouth is involved, full-mouth rehabilitation. At Vizcaya Dental Arts the starting principle is to keep as much of the natural tooth as possible for as long as possible, and to recommend the least invasive treatment that will last.

Minimally invasive by default

Every restoration removes some tooth, and a tooth can only be restored so many times in a lifetime before there is not enough left. So the least invasive treatment that will last is the one we recommend. Where a tooth can be saved, that is preferable to replacing it, and we do not recommend replacing a tooth unless it is necessary.

The same principle applies to the start of a problem. Shallow decay that is still confined to the enamel often does not need a filling. With better cleaning between the teeth and fluoride, those spots can stay stable for years, and we watch them at each visit rather than drill them. Decay that has reached the dentin underneath generally does need to be restored, because it rarely stops on its own. We do not recommend a preventive filling on a shallow lesion, with one exception: a visible spot on a front tooth that bothers you is a legitimate cosmetic reason to treat.

Two patterns come up often:

• A teenager or young adult arrives with ten or twelve small spots between the teeth on the X-rays, most of them shallow; one or two need filling now, and the rest need floss, fluoride and a recheck.
• Someone who has been away from the dentist for five or ten years arrives with several cavities that have had time to grow, and needs more fillings at once.

Setting priorities

Not everything happens at once. The order we use:

1. Pain, infection and urgent appearance. A toothache, an abscess or a broken front tooth comes first, often on the day you first come in.
2. Teeth likely to get worse soon. A cavity close to the nerve will need a root canal if it waits; that tooth is next.
3. Smaller, slower problems. A small cavity or a worn filling that is not likely to change quickly can be scheduled in turn.
4. Optional and cosmetic treatment waits for you.

You always get more than one option. We tell you what we would recommend for our own family, and if you prefer a different reasonable choice, we accommodate it. A filling instead of a crown may be acceptable as a medium-term solution, as long as you understand that is what it is. Where a choice would endanger the tooth, we say that.

The treatments, briefly

Tooth-colored fillings. Composite resin bonded into a cleaned cavity or a chipped corner, matched to the tooth, placed under a rubber dam so the bond is made dry. The right repair for smaller damage. More about tooth-colored fillings.

Crowns. A ceramic cap over a tooth that is cracked, broken, heavily filled or has had a root canal. Two visits and a laboratory-made crown. More about dental crowns.

Bridges. A fixed false tooth anchored to crowns on the teeth either side of a gap. Quick, surgery-free, and often the right choice when an implant would need grafting. More about dental bridges.

Dental implants. A titanium post in the jaw carrying a crown, for a missing tooth, with the neighbors left untouched. Planned on a 3D scan, placed and restored here. More about dental implants.

Dentures. Removable replacement for several or all teeth, including implant-supported designs that stop a denture moving. More about dentures.

Inlays and onlays. Laboratory-made partial crowns that sit between a filling and a crown. Many dentists use them; we do not, and we explain why. More about inlays and onlays.

Full-mouth rehabilitation. When wear, damage or bite problems involve most of the teeth, the treatments above are combined into one coordinated plan. More about full-mouth rehabilitation.

• Bone Grafting

  Preserving bone when a tooth comes out, and rebuilding it when an implant needs more support.

• Dental Bridges

  A fixed replacement for one or two missing teeth, anchored to crowns on the teeth either side.

• Dental Crowns

  A ceramic cap for a tooth that is cracked, broken, heavily filled or has had a root canal.

• Dental Implants

  A replacement tooth on a titanium root, for one missing tooth or several, planned, placed and restored in the office.

• Dentures

  Complete and partial dentures, how they are made and fitted, and how to adapt to them.

• Full-Mouth Rehabilitation

  Rebuilding a worn, broken-down or collapsed bite as a whole, in planned stages.

• Implant-Supported Dentures

  A removable denture that snaps onto two or four implants, made and placed in the office.

• Inlays and Onlays

  Partial crowns, and why we usually recommend a filling or a crown instead.

What to expect from good work

A filling or a crown should feel like your own tooth:

• The bite should be even.
• The surface should be smooth to the tongue.
• Floss should pass without catching.
• Any sensitivity should settle within days.

If the tooth does not feel completely normal, have it looked at, because a small problem is easy to fix now and expensive later.

Your part

Restorative work lasts as long as the tooth around it stays healthy.

• Floss or clean between the teeth daily.
• Brush well.
• Use a water flosser if you have bridges or implants.
• Keep your regular cleanings.

These protect the edges where restorations meet teeth, which is where they fail. We show you what works for your mouth.

Frequently asked questions

Do I really need all these fillings?

Possibly not. Shallow spots of decay that are still in the enamel can often be halted with better cleaning and fluoride, and we watch them rather than fill them. We see young patients with ten small spots on an X-ray and perhaps one or two that need treatment now. Decay that has reached the dentin underneath generally does need to be restored.

Filling or crown?

Size and position. A smaller cavity above the gum is a filling. When the restoration would cover most of the chewing surface or reach below the gum, a crown protects the tooth better in the long run. We will tell you if a filling would be a short-term fix, and let you choose with that knowledge.

Will it feel normal afterward?

It should. Properly done restorative work, a filling or a crown, should feel like a natural tooth: almost forgettable. If anything feels off, high, rough or sensitive beyond the first couple of weeks, come back and let us look, because something may need adjusting.

How do you decide what to do first?

Pain, infection and anything urgent about a visible front tooth come first, often the same day. Then the teeth most likely to get worse soon, such as a cavity close to the nerve. Smaller or slower problems can wait their turn, and purely optional or cosmetic treatment waits for you.

My old fillings are breaking down. Do they all need crowns?

Not necessarily. Many can be replaced with new fillings. Some teeth that have been filled and refilled over the years have too little left and are better served by a crown. We look at each one and tell you which is which.

Do you offer inlays and onlays?

No. We explain what they are on their own page, because many dentists recommend them, but in our experience patients are better served by a well-placed filling or a crown.