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General Dentistry
In the absence of gum disease, a cleaning and checkup is recommended every 6 months. Tartar (calculus) may build up on the teeth, and can only be removed by instruments used by your hygienist. This buildup, which is formed when plaque on the teeth combines with components of saliva, provides a collection point for more plaque to accumulate. This can lead to inflamed gums and the initial stages of gum disease, as well as cavities.
At the cleaning appointment, you will also have a complete exam to determine the health of the teeth, gums, and surrounding soft tissues and bone. The doctor will even complete an oral cancer screening.
Your initial visit as a new patient involves a comprehensive exam, unless you are being seen for a specific concern, in which case a “Limited, Problem-focused Exam” will be completed. A comprehensive exam is always recommended over a limited exam to be sure that all potential conditions are treated effectively. Focusing on only one tooth, or one specific area of the mouth can lead to a domino effect of more significant conditions that may have been prevented if a complete exam had been performed.
A “Limited, Problem-Focused Exam” is the approach taken typically when you are experiencing pain, or something happens in between your checkups that needs attention. When in pain, we clearly want to address that concern before anything else. Damage to front teeth can also lead to very critical aesthetic concerns. These can be addressed at a limited exam in order to get that presentable smile back intact as quickly as possible.
After the decay has been removed, fillings are put in place to help replace the infected tooth structure. It is called a filling because new materials fill the hole that decay has left. It is more common for teeth to be treated with bonded tooth-colored composite resin fillings. If caught early enough, cavities can be handled quickly and painlessly. If not treated, decay can lead to tooth pain and/or infection, and the tooth would need root canal treatment or extraction.
When a tooth is damaged from decay or fracture so severely that it can not be restored (saved), it may have to be extracted (pulled). Simple extractions mean the tooth can be elevated and removed without removing bone. Surgical extractions are needed when teeth are more difficult to remove, and involve removing a small amount of bone around the tooth in order to successfully remove all of the root structure of the tooth.
A sealant is used to fill narrow grooves in a tooth that cannot be adequately cleaned by brushing. In some cases, the tooth structure has fine grooves or pits which accumulate plaque, not because the person doesn’t brush, but because they’re too narrow to allow any bristles in between them. These will develop cavities over time, and you don’t want that. So the dentist will brush on a coating that seals the grooves and pits, making it possible to brush off all the plaque and keep your teeth healthy.
The gums, ligaments, and bone around the teeth form the foundation for one’s teeth. All these structures are referred to as the periodontium. When the periodontium is not healthy, it jeopardizes the teeth just as a bad foundation would threaten a house’s stability. Signs of unhealthy periodontium (gum disease) may be as follows: gums that are red and bleed easily, persistent bad breath, gums that have pulled away from the tooth, loose teeth, and changes in the position or bite of the teeth. Any of these signs may mean something is wrong. With the proper care, however, it may be possible to return them to a healthy state. This is where appropriate gum treatments come in. If you’re having a problem, come in and see us so we can take care of it immediately. The procedure usually involves a deep cleaning or root planing done under a local anesthetic. If the gum disease gets too severe, surgery or extraction may need to be used to treat this. It is essential to get it treated at the first sign of a problem.
Custom athletic mouth-guards can be fabricated in our office. A custom mouth-guard insures that your teeth are better protected due to the fact that an impression is taken to ensure an exact fit. Various forms of protective night guards can be fabricated to protect your teeth from the effects of grinding/clenching habits while you sleep.
Bonding involves adhering a tooth-colored composite resin material to the remaining tooth structure. Bonding can be used to repair the damage done to the tooth by decay, to alter the tooth’s alignment, close gaps between the teeth, or for cosmetic purposes. First, the surface of the tooth is roughened to accept the bonding and hold it. A gel is applied to micro etch the tooth surface, and a primer/bond agent is then applied, so the material adheres to the surface. Then the material itself is placed on the tooth and hardened with intense light. The composite resin material is shaped and polished to get a lustrous finish as a last step.
Advanced Procedures
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. After a root canal treatment or when a large filling wears out, a crown is put in place. There is a higher chance that a crown will be needed if the hole made by a cavity is large. Even after a filling is put in a large cavity, a tooth is more likely to break. Keep in mind that the jaw muscles are the strongest in the human body, and teeth must withstand tremendous pressures. Crowns ride over the weakened tooth, providing strength and protecting the tooth against breakage. A broken or cracked tooth is a severe matter and much more challenging to treat. Crowns prevent this, as well as making for a beautiful smile.
It takes two appointments to restore a tooth with a crown. Decay is removed from the tooth, and then the tooth is shaped to receive the crown. An impression is then taken of the tooth for use in fabricating a crown. Between the two visits, a crown is made from various materials like Zirconia (a ceramic with metal-like properties), Lithium Disilicate (A ceramic material), or Gold. During this time, a temporary crown is worn. In the second visit, the temporary crown is removed. The permanent crown is adjusted as needed and then cemented in place.
Bridges are an option for filling the space created by a missing tooth. To look like the missing tooth bridges are formed, and it 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. 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 esthetics.
A missing tooth must be replaced as soon as possible for several reasons. If not treated, the teeth surrounding the gap begin to shift inward, creating a whole chain reaction of bad things. Teeth use their neighbors for support, and, with one missing, they start to “fall.” A missing tooth worsens the bite changes in response to the pressure. Missing teeth can eventually result in problems with the entire jaw, e.g., temporomandibular joint. The surrounding teeth deteriorate, and it is just a matter of time before they are lost. Gum disease becomes a serious problem, with the difficulty of treatment increasing as the neglect continues.
Implants also can be used as support as part of an implant bridge. Implants are an alternative to partial dentures and have several advantages. One advantage of this is not having an adjustment period to acclimatize the patient who only feels teeth; not metal supports intruding into the mouth. This procedure also slows the bone loss that would happen when you have missing teeth. Another advantage is no discomfort or difficulty in eating. Best of all, of course, they don’t have to be taken out all the time.
Implants also can be used as support as part of an implant bridge. Implants are an alternative to partial dentures and have several advantages. One advantage of this is not having an adjustment period to acclimatize the patient who only feels teeth; not metal supports intruding into the mouth. This procedure also slows the bone loss that would happen when you have missing teeth. Another advantage is no discomfort or difficulty in eating. Best of all, of course, they don’t have to be taken out all the time.
Root canal treatment (also referred to as root canal therapy or endodontic therapy) is necessary when a cavity reaches the tooth’s inner pulp (nerve and blood supply). Sometimes deep restorations or trauma to a tooth may also cause nerve damage 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). By the time the pulp is infected, it must be treated, and cannot heal independently. It can even weaken the entire immune system. The infected pulp is dangerous, not to mention very painful. Symptoms that the pulp has become infected may include sensitivity to hot/cold or sweets, pain, swelling, pain to biting or pressure, and a bad taste in the mouth. Sometimes, no symptoms are apparent, and the person is unaware of any problem until a checkup.
A root canal will be performed to clean out the infected tooth pulp and disinfect the tooth’s canals. The only other treatment would be to extract the tooth. A filling is put in the canal(s) to resolve the infection and prevent any further infection. For restoring a tooth with root canal therapy, usually, a core build-up and crown are used.
There are different types of dentures, but they share a standard function. They replace teeth that have become loose or due to bone loss have fallen out. When bone loss around the roots of teeth is significant enough to loosen or let them fall out, it’s time for dentures. Relax. No one enjoys losing their natural teeth, but you can still regain the ability to speak and eat at a satisfactory level. It is important to remember that dentures are not a replacement for natural teeth; they are just a replacement for missing or broken teeth. Nothing will ever be the same as the original, natural tooth.
An examination of the mouth must be performed to determine which teeth are to be removed. After loose teeth are extracted, dentures get fitted to go over or around the mouth’s remaining teeth. There is an adjustment period after getting the dentures, and it can take some awhile to get used to this. But once accustomed to the dentures, they can be very comfortable. Often implants can be used to stabilize the dentures further.
Invisalign straightens your teeth with a series of clear, virtually invisible custom-molded aligners. Using a series of clear, removable aligners, Invisalign straightens your teeth with results that you’ll notice sooner than you think. The course of treatment involves changing aligners approximately every two weeks, moving your teeth into a straighter position, until you have a more beautiful smile. And unlike braces, these clear aligners can be removed while you eat and brush your teeth as usual.
Cosmetic Dentistry
Whitening is the procedure of making teeth whiter, and therefore more attractive. We use several methods:
1) In-office, professional-strength whitening with 38% hydrogen peroxide for “instant” results
2) Prescription-strength, passive tray whitening at home
3) Over the counter-strength whitening strips at home
Veneers are a dental procedure in which a covering is placed over the tooth’s outside (visible area). Veneers are usually only used on the part of the teeth that are visible when talking or smiling. The procedure can be direct or indirect.
The direct technique usually involves placing composite resin on the outside of the tooth using bonding.
The indirect technique usually involves two appointments because the veneers are made at a dental laboratory. At the first appointment, the teeth are prepared, impressions taken, and the teeth are given a temporary covering. In two to three weeks, the veneers are back from the laboratory, the temporaries are removed, and the veneers are bonded to the teeth. The laboratory fabricated veneers are usually made using porcelain or pressed ceramic, and are very aesthetic.
The advantage of veneers versus crowns is that much less tooth material is removed. Veneers are not recommended for teeth that have large fillings or have little tooth structure remaining.
Health/Well Being
Many people do not know that dentists actually screen for oral cancer during exams in addition to evaluating your teeth and gums. For many types of oral cancer, early detection is the key to a good long-term prognosis. In most cases the dentist will not be able to diagnose oral cancer, but is able to refer you to the proper provider that can perform the proper diagnostic testing.
Dentists are trained to help you quit smoking. This is done through proper evaluation and education, as well as prescribing medications that are available to assist with cessation.
At every dental cleaning, our hygienists discuss proper oral hygiene. We evaluate nutrition, brushing, flossing, and habits that may be either beneficial or detrimental to your teeth and gums. We work with you to make positive choices in these areas wherever possible.
Pain associated with the jaw joint is known as Temporomandibular Joint Disorder (TMJD). There are many causes of TMJD. If a specific cause can be identified, treatments can be recommended. This commonly includes an appliance or mouth-guard. Physical Therapy can also be a very useful method of treatment.
TECHNOLOGY
In each of our dental treatment rooms, there are two televisions. They are conveniently positioned on the wall in front of the patient chair as well as on the ceiling! Watch your favorite channel for a pleasant distraction during your appointment. We also have the ability to display x-rays and pictures on the screens.
For more information regarding the types of X-Rays click HERE.
For those that wish to participate in this service, we have the ability to send text message reminders prior to your scheduled appointment. We can also communicate with you via text message in certain situations to ensure that you are able to respond at a convenient time for you.
Intraoral cameras allow for us to take pictures of the inside of your mouth to better explain conditions and recommended treatment. Being able to show you a visual aid on the screen in front of you, allows for a much more effective explanation that leads to a better understanding of what we are talking about.
We keep electronic records