Dental Exam and X-rays
We recommend a dental exam and a full set of x-rays to diagnose any possible health problems with your teeth, jaw, or gums. In the exam, the doctor will evaluate your oral health and check for gum disease known as gingivitis or periodontitis. He will screen for oral cancer and do a head and neck exam. He will check your TMJ joint to check for signs of TMD. He will check for infection in your teeth and gums and for xerostomia (dry mouth), missing teeth, loose teeth, cold sores, and inflammation of tonsils. He will check the bone levels around your teeth on bite-wing x-rays and will look for caries (cavities) in your teeth on the x-rays and in your mouth. Bitewing x-rays show decay between the teeth. Periapical x-rays show the entire tooth and are used to diagnose problems with your teeth roots. Panoramic x-rays show the entire jawbone and show the wisdom teeth and maxillary sinuses. He will check development of your teeth if you are a child or teen-ager and will check the alignment of your teeth and jaws to see when or if you might be a candidate for orthodontic treatment.
Many dental problems arise without pain for a period of time including decay, gum disease, cracked teeth around old fillings. Your dentist will encourage treatment that is pro-active to help you avoid dental emergencies. Remember that just because you are not in pain does not mean your mouth is perfectly healthy. Many dental treatments help prevent future more extensive treatment. If we treat prudently, we can prevent future treatments that are more complicated and can often save your teeth before they decay or crack beyond repair.
Your dentist is trained to preserve your teeth and gums and to replace missing teeth He and is team treat conditions that lead to loss of teeth. If you have any dental health issues, your dentist will discuss them with you upon doing the exam. If you have bleeding gums or other signs of gum disease, he will discuss treatment. Likewise, if you have missing teeth, cavities, cracked teeth, decay around old fillings or crowns, etc., he will discuss treatment and options. If you grind your teeth severely, a condition, called bruxism, he will discuss treatment.
Many times, there are several treatment options for a given condition and your dentist will discuss your treatment options with you to help you in making an informed decision.
We recommend routine cleanings (dental prophylaxis) every three to six months depending on the condition of your gums. If you have heavy plaque build-up and gingivitis, we may recommend more frequent visits. Most people do well on a six-month recall. If you have periodontal disease, you may require treatment beyond simple cleaning visits. These visits include a doctor’s exam and x-rays if needed. Hand scaling and ultrasonic instruments are used as needed and your teeth are buffed with prophy paste to make them shiny and smooth.
Home Care Tips
We recommend Sonicare electric toothbrushes, waxed dental floss such as Reach or Glide, Crest Pro Health mouthwash (non-alcoholic, doesn’t burn), a toothpaste with fluoride in it, and the Waterpik to help clean between teeth especially if you have braces, a history of cavities, or dental crowns and bridges. Brush and floss after eating and avoid sugary drinks.
Scaling and Root Planing
If you have periodontal disease and tartar buildup below the gum line, we will need to get you numb and clean your teeth and their roots by quadrant of your mouth. Usually this takes two visits of one and a half to two hours each. The hygienist uses ultrasonic scaling to remove the tartar (calculus) and stain on your teeth.
Non-surgical Periodontal Therapy
After you have had scaling and root planing we may place you on periodontal maintenance to keep your teeth and gums as healthy as possible. At these visits, we will take probing measurements of your teeth to check on bone level.
Fillings go into cavities in your teeth. We prefer to use composite resin, a tooth colored restorative material, to fill your cavities. If you get a cavity in your tooth, it can lead into your tooth’s nerve and result in pain and infection. Our goal is to stop the decay before it gets too deep and thus to keep our fillings small. Sometimes if we catch the decay early, enough you will not even need a shot for treatment. If the decay is deeper or between your teeth, you will receive numbing to make the procedure comfortable. It is important that you be careful to avoid breaking your fillings. This means avoiding crunchy foods and chewing ice. You can prevent decay by avoiding sugars and by practicing good home care.
We do not use amalgam (silver colored) fillings unless necessary or unless a patient specifically requests their use. These restorations are durable but are not the same flexibility as your enamel. This rigidity lead to cracks in your teeth and often must be replaced with crowns if they cause too much damage to your teeth over time.
A crown covers the part of the tooth that you see and strengthens it against fracture. Because it covers the tooth, it allows you to chew confidently without wondering when that old filling might break. We place crowns if old fillings break down or if the corner of a tooth fractures. Often we can see fractures around old silver fillings before the tooth actually fractures catastrophically. If you wait for the tooth to break in half, we will usually be forced to remove the entire tooth or do a root canal. If you get a crown when the dentist recommends it, you will be saving yourself money and pain and possibly the loss of a tooth due to fracture or decay. A crown should last many years if properly cared for but may need to be replaced if you develop decay underneath it on your root or if your gums or bone recedes.
Crowns are placed in two steps. The first visit involves removing decay and placing a temporary crown. The second visit occurs about two weeks later when we deliver the crown made at the lab.
We use porcelain crowns, porcelain with metal underneath and all metal crowns depending on the situation. Generally, all porcelain crowns look the most like your tooth and metal crowns are the strongest.
A porcelain veneer covers the front of your tooth. It requires the removal of a small amount of enamel and is not a reversible procedure. Veneers are considered cosmetic and can be used to close spaces, repair a chipped tooth, or change the color of your teeth. A good indication for veneers is a patient with tetracycline stain on their front teeth or peg laterals (small upper lateral incisors)
Composite Bonding Procedures
If you have spaces between your teeth or want to change the shape of your teeth without removing enamel, composite bonding can be a useful treatment. The dentist bonds tooth-colored composite resin to your teeth to shape and color them until you are pleased with the result. This treatment can enhance you appearance without any grinding on your teeth and is reversible.
Bridges (Fixed Partial Dentures)
A dental bridge is a cemented appliance that is used to replace a missing tooth. It spans the gap where the tooth is missing and connects to the adjacent teeth. You must floss under the bridge and the adjacent teeth are prepared for crowns. You can think of a bridge as three crowns that are connected. Bridges are a good replacement of missing teeth.
Every tooth is composed of enamel, dentin, and pulp. The pulp is in the middle of the tooth. If a cavity reaches the pulp or if you develop a bad toothache or abscessed tooth, you may need a root canal. A root canal procedure removes the pulp portion of your tooth along with infection and seals the tooth off at its tip with a material called gutta percha. A successful root canal can save your tooth to function for years to come. After a root canal is performed, a crown is generally placed to protect the tooth.
Dental implants are the best way to replace missing teeth if you have enough bone to anchor the implant. An implant is simply a surgical screw that is inserted into your jawbone by a dental surgeon to replace a missing tooth. Once the implant heals in place (usually two to three months) and the implant has become one with your jawbone, your general dentist places a crown on top of it. The implant process requires teamwork between your oral surgeon and dentist to give you the best functioning and appearing tooth replacement on the market. You may still floss around it, unlike a bridge that connects your teeth. Implants are not always covered by insurance and are one of the most expensive procedures you can receive at a dental office because of the time involved. They should last longer than a bridge so the initial cost is usually recovered over time.
Cracked Tooth Treatment
A cracked tooth may be sensitive to temperature or may bother you when you eat crunchy food. We will diagnose the cracked tooth and treat it according. The treatment depends on the extent of the fracture. If a tooth is cracked superficially, no treatment may be indicated. Sometimes a change in habits, a mouthguard, or a filling may be indicated. A more extensive crack could require a crown, root canal, or even extraction.
We can extract teeth if they become loose or break off at the gumline. When a tooth is removed, the entire root must also be removed to prevent future infection and pain. We also remove third molars if they are not impacted in your jawbone.
Removable Partial Dentures
A removable partial denture, or RPD, is a removable appliance that is used to replace missing teeth. It attaches to your remaining teeth. A partial is a good option if you do not desire implants or bridges but are missing teeth and would like to chew and smile again efficiently. Impressions are taken of your remaining teeth and gums and after two or three fitting appointments, your new teeth will be ready to use. We match the color and shape of your natural teeth and make sure the appliance is comfortable so you can use it.
We make RPDs with metal framework and use Valplast flexible partials with no metal. RPDs need to be replaced periodically if your teeth shift, the appliance breaks or you lose it.
If you need all of your teeth removed due to periodontal disease, infection, or decay, or are missing all of your teeth, we can make you a set of dentures to replace them, and get you chewing and smiling again. We make immediate dentures, which go in place the day that your teeth are removed.
If you have been missing your teeth for years or just need a new set of dentures because your old set is loose, we can make you a new set according to the shape of your mouth. Old dentures tend to get loose when your gums shrink over time and they need to be replaced periodically.
We can work with an oral surgeon who can place implants to hold your dentures in place if you would like to eat a steak again.
Denture and Partial Denture Repairs
We can repair your dentures and partial dentures and often prevent you from having to buy a new set by adding a new tooth or clasp to your appliance.
Emergency Dental Care
When you need us quickly, we will try to bring you in quickly to get you out of pain and resolve your problems. Sometime this means placing an emergency filling, re-cementing a crown, extracting a tooth, prescribing antibiotics, repairing a denture or starting a root canal.
Invisalign is a great technology that allows us to align your crowded teeth, enhancing your health and appearance. You will wear clear trays day and night and put in a new set every two weeks until the teeth are in the correct position.
Many dentists and orthodontists are using Invisalign as an alternative to metal braces. Invisalign is not indicated for all orthodontic cases but for the correct patients it is a simple way to achieve a healthy and beautiful smile.
Crowded teeth lead to periodontal disease and gum recession because they are hard to floss. If your bite is off it can lead to gum and jaw problems. Ask your dentist about the health benefits of straight teeth and a good bite.
After orthodontic therapy, retainers keep your teeth from shifting back into their original positions. We make clear retainers and traditional Hawley-type retainers with metal retention.
Teeth Whitening Procedures
We use a home whitening system that allows you to control the pace of your treatment until you get to the shade you desire. We will take impressions of your teeth and make clear bleaching trays for you to wear at home. Many of our patients have achieved great results with our system, which uses a bleaching agent that is safe and effective.
Sensitive Teeth Treatments
We offer several products for sensitive teeth including high fluoride toothpaste, a fluoride gel, and a special mouthwash that will fight gingivitis and sensitivity.
Night Guards / Occlusal Guards
Occlusal guards can be used to treat bruxism, a condition of teeth grinding. Bruxism destroys your teeth gradually. Severe grinding can ruin your enamel and reduce your teeth to nubs of their former selves. A night guard is an acrylic over-lay that separates your teeth at night. If you keep grinding, you will be grinding the night guard, and your teeth will be protected. It is important to recognize that bruxism can lead to tooth loss just as much as cavities or periodontal disease because it wears away your teeth and sometimes also leads to cracked roots and thus extractions.