Dr Centrella
(781) 322-8951
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Preventive & General Dentistry

Our professional and courteous dental team specializes in preventing, diagnosing, and treating various dental conditions. Our highly trained dentists and dental hygienists provide preventative dental dentistry, such as routine dental exams, cleanings, and more complex dental services.

We believe that maintaining quality dental health involves more than just general cleaning, such as brushing and flossing your teeth — it consists in caring for your smile with regular preventative visits. 

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Advanced Procedures

CROWNS
Crowns are full coverage restorations used to cover a tooth that is likely to break or is too broken down to be restored with a filling. They are most commonly done after root canal treatment or when a large filling wears out. The larger the hole made by a cavity that has to be treated, the more likely a crown will be needed. A tooth is more likely to break even after a filling is put in a large cavity. Remember that the jaw muscles are the strongest in the human body. Teeth are subjected to tremendous pressure. Crowns ride over the weakened tooth, providing strength and protecting the tooth against breakage. A broken or cracked tooth is a much more severe matter and much more challenging to treat. Crowns prevent this, as well as make for a friendly smile.

Crowns are full coverage restorations used to cover a tooth that is likely to break or is too broken down to be restored with a filling. They are most commonly done after root canal treatment or when a large filling wears out. The larger the hole made by a cavity that has to be treated, the more likely a crown will be needed. A tooth is more likely to break even after a filling is put in a large cavity. Remember that the jaw muscles are the strongest in the human body. Teeth are subjected to tremendous pressure. Crowns ride over the weakened tooth, providing strength and protecting the tooth against breakage. A broken or cracked tooth is a much more severe matter and much more challenging to treat. Crowns prevent this, as well as make for a friendly smile.

It takes two appointments to restore a tooth with a crown. At first, any decay is removed from the tooth and is shaped to accept the crown. Then an impression is made of the tooth for use in fabricating a crown. Between the two visits, the crown is made, usually of high-strength porcelain over gold alloy, all ceramic material, or gold. During this time, a temporary crown is worn. In the second visit, this temporary is removed. Then the permanent crown is adjusted as needed and then cemented in place.

DENTURES 
There are different types of dentures, but they share their common function. They replace teeth that have become loose or been lost due to bone loss. When bone loss around the roots of teeth is significant enough to loosen them or let them fall out, it's time for dentures. Relax. No one enjoys losing their natural teeth, but you can still eat and talk regularly.

The entire mouth is examined, and a determination is made as to which teeth will have to be removed and which will remain. The loose teeth are then extracted. Dentures are fitted to go over or around whatever teeth remain in the mouth, depending on the type. There is an adjustment period after dentures are placed in the mouth, and it can take some getting used to. But once accustomed to the dentures, all the standard functionality and appearance return, and one just carries on as usual. Often implants can be used to further stabilize the dentures.

IMPLANTS 
A dental implant is an option to replace a missing tooth. In this procedure, a small titanium shaft is surgically implanted into the bone and allowed to be set. The bone grows around it, forming a tight connection, which slows or stops the bone loss that occurs when the root of a natural tooth is missing. Once the implant is firmly set in the mouth, the dentist then works to attach the replacement tooth onto the top of the shaft. This permanent solution has advantages over bridge work: it does not stress the surrounding teeth for support, and, should the tooth wear out, another can simply be replaced on the shaft.

Implants can also be used as support as part of an implant bridge. This is an alternative to partial dentures and has several advantages. First, there is no adjustment period to acclimatize the patient who, once the work is done, only feels teeth, not metal supports intruding into the mouth. Second, this slows the bone loss occasioned by missing teeth. Third, there is no discomfort or difficulty in eating. And, best of all, they don't have to be taken out all the time.

We also offer mini dental implants. These implants are about half the diameter of traditional implants and stabilize lower dentures. These implants can be placed in one appointment and be immediately used. The cost is 50-70% of standard dental implants. Call for a free consult.

ROOT CANAL TREATMENT 
Root canal treatment (also referred to as root canal therapy or endodontic therapy) is made necessary when a cavity is allowed, through neglect, to reach all the way to this pulp. (Regular cleanings and checkups prevent and detect problems early) Sometimes deep restorations or trauma to a tooth may cause the nerve to be damaged to the point it needs root canal therapy. Once this occurs, the pulp becomes infected and can even extend through the root tip and begin to eat away at the surrounding bone (this is an abscess). When the pulp is infected, it must be treated and cannot heal independently. It can even weaken the entire immune system. This is dangerous, not to mention very painful. Symptoms that the pulp has become infected may include sensitivity to hot/cold or sweets, pain, swelling, 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.

A root canal is then performed to clean out the infected tooth pulp and disinfect the tooth channels. The only other treatment would be to extract the tooth. Once the infection is resolved, the canal(s) are filled in to prevent further disease. Usually, a core build-up and crown are recommended for restoring a tooth that has had root canal therapy.

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

A missing tooth must be replaced as soon as possible for several reasons. If not treated, the teeth surrounding the gap shift inward, creating a chain reaction of bad things. 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 which is just a matter of time before they are lost. Gum disease has become a severe problem, with the difficulty of treatment increasing as the neglect continues.

TMJ TREATMENTS 
TMJ stands for temporal-mandibular joint. Temporal as in the temple area of the skull; mandibular as in the mandible or lower jaw; joint as in the head and jaw meet. Problems in this joint may be caused by a misalignment of the teeth, trauma, or excess muscle tension. Aside from the two bones that meet there, cartilage buffers them, and five muscles are involved in the area. If something goes wrong, a good deal of trouble can result.

Problems in this area can cause:

Headaches
Earaches
Trouble/soreness in opening and closing the mouth
Clicking or popping the jaw
Pain in the jaw muscles
Soreness in the area, sometimes extending to the face
Dental treatments for the condition can include replacing missing teeth, moving teeth, adjusting the bite, filling gaps between teeth, etc. No one solution is suitable for all cases. Sometimes a plastic mouthpiece is used to prevent clenching or grinding, contributing to the problem. If untreated and taken to extremes, surgery may be required to repair a badly damaged joint.

Member Massachusetts Dental Society
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Gerard A. Centrella D.M.D.
738 Salem Street
Malden, MA 02148

781-322-8951
Member American Dental Association
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