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Advanced Services

Advanced Services – from Implants to Root Canals and Crowns

At Advanced Dental, we offer many advanced services that many general dental practices refer out to specialists. From Root Canals and Crowns to Dentures, Dr. Gambetta prefers to treat his patients himself. Of course, if he determines that a patient would be better served by a specialist, he will gladly refer them. Let us tell you about some of the Advanced Services we offer.


Crowns are full-coverage restorations that are used to cover a tooth that is likely to break or is too broken down to be restored with a filling. We do them most commonly after a root canal treatment or when a large filling wears out. The large the hole made by a cavity, the more likely a crown will be needed. Even after a tooth with a large cavity is filled, the tooth is more likely to break. Keep in mind that the jaw muscles are the strongest in the human body. Teeth are subjected to tremendous pressures. Crowns cover the weakened tooth, providing strength and protecting the tooth against breakage. A broken or cracked tooth is a far more serious matter and much more difficult to treat. Crowns prevent this, as well as creating a nice smile.

It takes two appointments to restore a tooth with a crown. In the first appointment, we remove any decay from the tooth and shape it to accept the crown. Then we make an impression, either digitally or with impression material, for the lab to use in creating the crown. We will create a temporary crown to wear until the permanent crown is back from the laboratory.

During the two to three weeks between the first and second appointments, the laboratory makes a crown, usually of high-strength porcelain over gold alloy, all ceramic material, or gold. At the second appointment, the temporary crown is removed. We place the permanent crown, adjust it as needed, and cement it in place.

Root Canal Treatment

Root canal treatment (also known as root canal therapy or endodontic therapy) is needed when a cavity reaches all the way to the pulp of the tooth. (Regular cleanings and checkups prevent and detect problems early.) Sometimes due to extensive decay or occlusal trauma, the nerve may be damaged to the point that it needs root canal therapy, also. Once this happens, the pulp may become infected and can even extend through the root tip and begin eating away at the surrounding bone (this is an abscess). By the time the pulp is infected, it must be treated and cannot heal on its own. It can even weaken the entire immune system. This is dangerous, not to mention, very painful. Symptoms of an infected pulp may include sensitivity to hot/cold or sweets, pain, swelling, pain with biting or pressure, and a bad taste in the mouth. Sometimes, however, no symptoms are apparent, and the person is unaware of any problem until a checkup when x-rays reveal what is brewing underneath the gum.

Then a root canal is performed to clean out the infected tooth pulp and disinfect the canals of the tooth. The only other option besides a root canal would be to extract the tooth, and that is only as a last resort. Once the infection is resolved, the canals are filled in to prevent any further infection. Usually a core build-up (or a post and core) and crown is recommended for restoring a tooth that has had root canal therapy.


The root of a tooth anchors the bone. Once that tooth is gone, the bone will resorb over time. A dental implant is an option to replace the missing tooth root. In this procedure, a small titanium shaft is surgically implanted into the bone and allowed to set. The bone grows around it, forming a tight connection, which also serves to slow or stop bone loss that occurs when the root of a natural tooth is missing. Once the implant is firmly set in the mouth, we then work to attach an abutment and the replacement tooth (a crown) on to the top of the implant. This permanent solution has the advantage over a bridge in that it does not stress the surrounding teeth for support. Additionally, should the tooth wear out, the crown can simply be replaced on the implant.

Implants can also be used to support an implant bridge. This is a good alternative to partial dentures and has several advantages. First, there is no adjustment period to acclimatize the patient. Once the work is done, they feel only teeth, not metal supports intruding into the mouth. Second, an implant can slow the bone loss that comes from missing teeth. Third, there is no discomfort or difficulty in eating. Best of all, of course, they don’t have to be removed daily.


There are different types of dentures, but they share a common function: they are a removable appliance that replaces teeth that have been lost.

Partial dentures are fitted to go over or around whatever teeth remain in the mouth. Complete dentures replace the entire dentition.
There is an adjustment period after dentures are placed in the mouth, and it can take some getting used to. Once a patient is accustomed to the dentures, all the normal functionality and appearance return, and they carry on as usual. Oftentimes, implants can be used to further stabilize the dentures.

After tooth loss, bone loss will occur. This will result in the denture eventually not fitting well and having to be replaced. This typically occurs every 5 to 10 years.


A bridge is an option for filling the space created by a missing tooth. It is shaped to look like the missing tooth, and it takes its place in the mouth. The sides of a bridge use the two surrounding teeth for support. A bridge replaces the missing tooth, both functionally and cosmetically. Bridgework is as much an art as it is an exact science. The materials used may be gold alloys, porcelain bonded to metal alloy, or all-ceramic material. The choice of material depends on requirements for strength, wear, and or aesthetics.

It is important that a missing tooth be replaced as soon as possible for several reasons. If not treated, the teeth surrounding the gap begin to shift inward, creating a chain reaction of negative consequences. Teeth use their neighbors for support, and, with one missing, they start to “fall.” As this worsens, the bite changes in response to the pressure. This can eventually result in problems with the entire jaw, e.g. TMJ. The surrounding teeth deteriorate, and it is a matter of time before they, too, are lost.

Occlusal Guards

An occlusal guard, also known as a night guard or bite guard, is a dental appliance that is worn over the teeth to prevent teeth grinding and clenching, especially during sleep. It helps protect the teeth from the harmful effects of bruxism, such as wear and damage to the tooth enamel and damage to the tooth root, which could result in needing root canals and crowns.

The guard creates a barrier between the upper and lower teeth, preventing them from coming into direct contact and reducing the impact of grinding forces. Occlusal guards are typically custom-made. They can be made of various materials, including soft or hard acrylic, or a combination of both.

If you suspect that you grind your teeth or are experiencing symptoms related to jaw clenching (headaches or TMJ disorders, for example), please consult Dr. Gambetta. He can assess your situation and recommend appropriate treatment, which may include the use of an occlusal guard if deemed necessary.