Anca Vladescu DDS

Phone: (408) 268-5531

Preventive, Family and Aesthetic Dentistry


I need a filling, what are my treatment options?

There are several options for restoring a tooth that requires a filling. Each option has its advantages and disadvantages. SILVER FILLINGS are one of the choices available. Amalgam (silver) fillings have been around for a long time and have long term studies to support their use (we always like that when it comes to our health). They are strong restorations and are able to withstand chewing forces successfully for a long time. They are also well tolerated by the gums and oral tissues in general. In addition, I like that over time they seal the gap between the filling and the tooth structure through the process of corrosion. They are not a cosmetic choice and are therefore best used on molar teeth. COMPOSITE FILLINGS have two main advantages. They are aesthetically pleasing and allow the dentist to be conservative. Their cost is higher than silver fillings but lower than inlays or onlays. They are not as strong as inlays or onlays and they need to be replaced more often than other filling materials. Bear in mind that every time a filling is replaced more tooth structure is taken away. Composite fillings work very well for very small cavities and for fillings on front teeth. CERAMIC INLAYS/ONLAYS are a more expensive method for restoring teeth but they are stronger and seal better than composite fillings. They also require two appointments, one to prepare the tooth, and another to place the restoration once it has been made in the lab.

I am unhappy with the shape and color of my front teeth, what can I do to improve my smile?

VENEERS are an excellent choice for enhancing chipped, discolored front teeth. Veneers are thin shells of ceramic that bond to tooth enamel and can create the look of flawless tooth structure. They can also change the shape, color and size of the teeth to obtain the result the patient is looking for. We start with the SMILE DESIGN appointment where we show you what you can expect even before we begin treatment.

What do you think about gold restorations?

GOLD RESTORATIONS are called “Lifetime Restorations” because they can last 40-50 years. Gold is the only material that expands and contracts the same as tooth enamel (as we drink hot or cold liquids). It is also the smoothest man made material used in the mouth. It simply means that gaps are less likely to form between tooth structure and the restoration, leading to longevity. Gold does not attract plaque easily due to its smoothness, will not corrode and the gums remain healthier around gold restorations. While not an aesthetic choice, gold is a healthy choice. Placing gold restorations requires an appointment to prepare the tooth and one place the restoration.

I have been told I need a crown, what are my options?

Crowns are recommended when there is a significant loss of tooth structure or when a tooth is cracked. Most often, we use tooth colored crowns, either made from porcelain fused to metal or all porcelain. All porcelain crowns provide excellent aesthetic results and are therefore used when possible, primarily on front teeth where aesthetics are important and there is not a lot of stress on the crown. On back teeth, porcelain fused to metal allows a tooth colored restoration to be placed while providing strength where chewing forces are high. Gold is another excellent choice for a crown on a back tooth. While not as aesthetically pleasing, gold usually provides the best longevity for the restoration.

I have heard people talk about dental implants, what are they?

IMPLANTS are used to replace one or more missing teeth. There is research data to support implants as a long term solution for replacement of missing teeth. They are more cost effective than a bridge (in the long term) and preserve the health of the adjacent teeth (by not grinding them to place a fixed bridge). An implant is easier to maintain and easier to floss. They also provide unsurpassed comfort. This option requires appointments with a specialist as well as the restoring dentist.

If I can’t have an implant to replace a missing tooth (teeth), what are my options?

FIXED DENTAL BRIDGES are recommended to replace missing teeth when an implant is not possible. The teeth next to the missing one(s) are shaped to accommodate crowns that connect with the pontic which replaces the missing tooth. The two teeth take the load of the missing one. A fixed bridge may be made from porcelain fused metal, all porcelain or gold. Fixed bridges require a minimum of two appointments. REMOVABLE PARTIAL DENTURES are another option for replacing missing teeth. They are less like natural teeth in terms on how they feel in the mouth. Partial Dentures are relatively inexpensive in the short term and are usually used when multiple teeth are missing in one arch. They require several appointments with the restoring dentist. REMOVABLE PARTIAL DENTURES SUPPORTED BY IMPLANTS are another option available now to replace multiple missing teeth in an arch. They offer a more secure fit as well as a better aesthetic result. They are also more comfortable and more like natural teeth than a conventional removable partial denture. The forces are more optimally distributed on the bone, causing less potential stress on the remaining teeth. In the long term, they are a cost effective option due to their longevity. They require multiple appointments, both with a specialist and a restoring dentist.

I would like to have whiter teeth. There are so many products and ads for whiteners, what do you recommend?

In this aesthetic driven society, we are all eager to look and feel our best. We provide reliable options for teeth whitening that are backed by research. The best results are obtained with a session of In-Office Whitening followed by custom tray whitening at home for at least two weeks. This combination extends the rebound in color in comparison with other methods or just one of the above. Our office recommends Opalescence products whose results are sustained by research in the Operative Dentistry Journal. As a less costly alternative, we also provide other options such as Crest White Strips Professional. While they will not provide the same result, they can still make an improvement in the whiteness and brightness of the teeth.