General Dentistry

A dental prophylaxis is a cleaning treatment performed to thoroughly clean the teeth and gums. It is an important preventative dental treatment for stopping the progression of gingivitis and periodontal disease.

Periodontal disease and gingivitis occur when bacteria from plaque colonize on the teeth, either above or below the gum line. These bacteria colonies cause serious inflammation and irritation, which in turn produce a chronic inflammatory response in the body. As a result, the body begins to systematically destroy gum and bone tissue, making the teeth shift, become unstable, or completely fall out. The pockets between the gums and teeth become deeper and house more bacteria, which may travel via the bloodstream and infect other parts of the body.

Periodontal Prophylaxis is recommended twice a year as a preventive care. Prophylaxis is an effective procedure in keeping the oral cavity in proper health and halting the progression of gum disease. The benefits include: plaque and tarter removal, a healthier looking smile and fresher breath.

Scaling and root planing is the most common and conservative form of treatment for periodontal (gum) disease. The procedure is done when gums have either started to pull away from the teeth or the roots of the teeth have hard mineral deposits (tartar) on them. The objective of these non-surgical procedures is to remove etiologic agents such as dental plaque and tartar, or calculus, which cause periodontal inflammation and disease. Scaling and root planing is a simple procedure and considers the first step to resolve periodontal infection.

Plaque is a sticky substance, full of bacteria that forms on teeth. When plaque hardens over time, it is called calculus. Plaque is more likely to stick to rough surfaces. When scaling is performed, calculus and plaque that attaches to the tooth surfaces is removed. The root planing process especially targets the area below the gum line, along the root. During root planing, the root of the tooth is literally smoothed, which promotes healing, and also helps prevent bacteria from easily colonizing in the future. Root planing removes any remaining calculus and smoothens irregular areas of the root surface.

A local anesthetic may be used to numb the portion of your mouth that is being worked on. Scaling and root planing are done with a combination of ultrasonic scalers and hand instruments. For two to three days after the treatment, you may have some bleeding, soreness and be sensitive to hot and cold temperatures. Over-the-counter pain relievers can help.

When a tooth is exposed to acid frequently, for example, if you eat food that containing sugar and starch or drink liquid that containing sugar and acid, the repeated cycles of acid attacks cause the enamel to continue to lose minerals. A white spot may appear where minerals have been lost. This is a sign of early decay. But if the tooth decay process continues, more minerals are lost. Over time, the enamel is weakened and destroyed, forming a cavity. A cavity is permanent damage that a dentist has to repair with a filling.

In the past, teeth were filled with a mixture or amalgam of different metals. Today that is changing as more natural-looking and metal-free fillings are becoming the preferred approach.

Dentists use more tooth-like materials (composite resins and porcelains) that are both safe and predictable. The most important feature is that they look and react more like natural teeth. Composite resin is restorative material to fill into cavities resulting from decay. Following preparation, the dentist places the composite in layers, which are instantly set with special light. When the process is finished, the dentist will shape the composite to fit the tooth. Composite resins are becoming the preferred approach, as they are more natural looking, safe (mercury free), strong and durable. Composites are also used for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth.

Advantages of tooth colored composites:

• Aesthetics – the shade/color of the composite fillings can be closely matched to the color of existing teeth. Composites are particularly well suited for use in front teeth or visible parts of teeth.
• Bonding to tooth structure – composite fillings actually chemically bond to tooth structure, providing further support and restores 85% to 95% of the original strength of the tooth.
• Versatility – in addition to use as a filling material for decay, composite fillings can also be used to repair chipped, broken, or worn teeth.
• Tooth sparing preparation – sometimes less tooth structure needs to be removed when removing decay and preparing for the filling. If damaged they can be repaired.
• Sensitivity – Tooth sensitivity, if any, due to composite resin use is minimal and brief.

A dental crown, sometimes called a cap, completely covers your damaged tooth. It is cemented into place and offers a strong, solid, good-looking replacement for a natural tooth. A crown is created in a lab based on models dentist makes with impressions. To place a crown, dentist will need to shape your tooth so that the crown can fit over it and sit naturally among your other teeth.

A dental crown can be used,

• To replace a large filling that no longer has enough tooth structure to continue to fill the cavity
• To cover a poorly shaped tooth or discolored tooth
• To protect a weak tooth from further chipping, breaking or fracturing
• To attach a dental bridge
• To restore a fractured/cracked tooth
• To protect and restore a tooth that has had a root canal
• To cover a dental implant

A dental bridge covers or “bridges” the gap between missing teeth. After you lose a tooth, dentist may suggest that you get a bridge. A bridge can keep your other teeth from moving out of place. Once a bridge is placed, it works just like your natural teeth. Bridges are cemented to the teeth adjacent to the empty space. The adjacent teeth serve as the anchors for the bridge. The adjacent teeth are trimmed down and capped with a crown, and then a replacement tooth, called a pontic, is attached to those crowns to form the bridge. The unit is securely cemented to your teeth and your smile and ability to chew food is improved.

Dental bridges help you:

• To prevent remaining teeth from shifting out of position and into the gap
• To restore the ability to chew and speak properly
• To maintain the shape of your face, preventing lip or face collapse
• To distribute the forces in your bite to alleviate stress on other teeth

Dental inlays and onlays are porcelain or metal materials used to repair moderately damaged or decayed teeth. In certain cases, inlays and onlays are a conservative alternative to full coverage dental crowns. Dentists may use dental inlays and onlays to restore a tooth that is too damaged to repair with a filling but not damaged enough to need a crown. Dental inlays and onlays help to save a healthy portion of a damaged tooth and provide strength and stability for normal chewing. These restorations are beneficial from both an esthetic and functional point of view.

A dental inlay is placed in the center area of the tooth. A dental onlay is placed on the inside and outside areas of a tooth. Dental inlays and onlays are also called indirect fillings or partial crowns. They are a less aggressive and usually less expensive treatment option than full crowns.

A denture is a removable replacement for missing teeth and surrounding tissues. Two types of dentures are available – complete and partial dentures. Complete dentures are used when all the teeth are missing, while partial dentures are used when some natural teeth remain.

Dentures, also known as false teeth, are prosthetic devices constructed to replace missing teeth. Dentures fill the gaps created by lost teeth, and also help the facial and jaw muscles continue to work in the fashion they are supposed to. So you can eat properly, speak properly, and feel less pain when doing both. Dentures are made out of a plastic base that supports fabricated teeth. It’s shaded to match your gum tissue, and the teeth are usually made of acrylic or porcelain. Conventional dentures are removable (partial or complete). Dentures are custom made in a lab, molded and shaped to exact proportions based on your … custom impressions of your mouth. However, there are many different denture designs. There are two main categories of dentures, the distinction being whether they are used to replace missing teeth on the lower jaw arch or on the upper jaw arch.

Dentures are custom made in a lab, molded and shaped to exact proportions based on your dentist’s prescription and custom impressions of your mouth.

Dentures can help patients through:

• Mastication – as chewing ability is improved by replacing edentulous areas with denture teeth.
• Aesthetics – because the presence of teeth gives a natural appearance to the face, and wearing a denture to replace missing teeth provides support for the lips and cheeks and corrects the collapsed appearance that results from the loss of teeth.
• Pronunciation – because replacing missing teeth, especially the front teeth, enables patients to speak better.
• Self-esteem – because improved looks and speech boost confidence in the ability to interact socially.

To understand a root canal procedure, it helps to know about the anatomy of the tooth. Inside the tooth, a hard layer of enamel and dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves and soft lymph tissues, and helps to nourish the root of your tooth during development. In a fully developed tooth, the tooth can survive without the pulp because the tooth continues to be nourished by the tissues surrounding it.

If these tissues become damaged or infected due to a deep cavity, a cracked or broken tooth, or a failing restoration, root canal therapy may be the best option to relieve your pain and avoid losing the tooth entirely. Often you will have a toothache, or it hurts to chew or sensitive to drink cold and hot liquids, or your gum is swollen because of inflammation, frayed nerves, and bacteria caused by infection. If pulp inflammation or infection is left untreated, it can lead to an abscess running even deeper beyond the tooth roots.

During root canal treatment, the inflamed or infected pulp is removed and the inside of the tooth is carefully cleaned and disinfected, then filled and sealed with a rubber-like material called gutta-percha. The reason the entire canal needs to be cleaned is to prevent the infection from running even deeper beyond the tooth roots. When nerve tissue or pulp is damaged, it breaks down and bacteria begin to multiply inside the canal. If not treated promptly and accurately, the bacteria can cause an infection of the mouth, face, jaw, or throat. Afterwards, the tooth is restored with a crown or filling for protection. After restoration, the tooth continues to function like any other tooth. Root canal alternatives include extracting the damaged tooth and replacing it with a dental implant, bridge or removable partial denture.

Most of the time, root canal therapy takes place in one appointment. The pain of not having a root canal performed is far worse than having root canal therapy. With dental advances and local anesthetics, most people have little if any pain with a root canal. And in cases where the nerves are already dead, there really is no pain from the procedure.

If a tooth has been broken or badly damaged by decay, your dentist will try to fix it with a filling, crown or other treatment. Sometimes, though, there is too much damage for the tooth to be repaired. In this case, the tooth needs to be extracted. Tooth extraction is the removal of a tooth from its socket in the bone. Besides decay and damaged tooth, there are other reasons tooth needs to be extracted as well.

The root portion of a tooth is firmly attached in bone socket and it is tightly bound into place in this socket by a ligament. During the extraction process the dentist needs to expand the socket (widen and enlarge) and separate the tooth from its ligament to a point where the tooth is loose and free to come out. Sometimes a tooth is so firmly anchored in its socket, or else the tooth roots are so curved, that the dentist cut the tooth into pieces and then remove each portion individually. You should expect to feel a lot of pressure but not pain.

The socket preservation graft is simple and important bone graft procedure. This procedure must be performed at the time of tooth extraction. It helps to preserve bone at an extraction site. The area of the jawbone that holds a tooth in socket is called an alveolar bone. Preservation of bone volume and shape is crucial for implant stability and esthetics. After a tooth has been extracted, the tooth supporting bone begins to rapidly resorb. Post-extraction bone resorption tends to be particularly severe in sockets with thin walls of bone. A socket preservation graft placed immediately after tooth extraction helps to preserve bone volume and architecture by minimizing post-extraction bone resorption. In some cases, due to severe inflammation at the extraction site, a low maxillary sinus, extensive preexisting bone loss and/or diseased tissue at the extraction site, it is not possible to provide enough bone volume for implant placement with this procedure alone. In these cases additional bone grafting may be required either at the time of implant placement, or as a staged procedure prior to implant placement. Depending on the condition of the tooth that was extracted, the ridge graft requires to heal three to six months before an implant can be placed.

If you’ve been living with persistent jaw pain, ear pain and headaches, you could have TMJ – Temporo-mandibular jaw disorder. TMJ can often be traced back to an improper bite, misaligned jaw joints, or an injury to the jaw or face.

Teeth Grinding (Bruxism)

Most people probably grind and clench their teeth from time to time. Occasional teeth grinding does not usually cause harm, but when teeth grinding occurs on a regular basis the teeth can be damaged and other oral structure can be compromised. Teeth grinding can be caused by habit, stress or anxiety, it often occurs during sleep. It can also be caused by a sleep disorder such as sleep apnea. Because you can grind your teeth at night and not even know it until complications develop, it’s important to learn the warning signs and to seek routine dental care. Several symptoms are commonly associated with bruxism, including hypersensitive teeth, aching jaw muscles, and headaches. Bruxism may cause tooth wear, and even damage or break teeth and dental restorations such as crowns and fillings.

There are a few different dental approaches to bruxism treatment. The first is a bruxism mouth guard or night guard. Night Guard can play a very important role in protecting your teeth and restorations from grinding and clenching. Dentist can make a custom bruxism guard called a night guard specially designed to fit your mouth. Another dental appliance used for bruxism treatment is called NTI appliance. This type of bruxism guard is a custom-made piece of hard plastic that fits over your top or bottom teeth. This bruxism guard fits over just the front teeth to prevent clenching of the back molars. The NTI protects teeth, muscles and joints by suppressing undesired muscle contraction by almost 70%.

Snore Guard

During sleep, muscles and soft tissues in the throat and mouth relax, shrinking the airway. This increases the velocity of airflow during breathing. As the velocity of required air is increased, soft tissues like the soft palate and uvula vibrate. The vibrations of these tissues result in noisy breathing or snoring. Snoring can be a real problem, not only for the person who snores, but also for the partner and other family members who live with the snorer. Your doctor will also examine your throat and nasal passages for any signs of nasal, mouth, dental, jaw, or throat deformities that may contribute to snoring.

For the majority of snorers, the most affordable, non-invasive, comfortable, effective snoring solution is dentist-prescribed snoring preventative device such as Silent Nite. Silent Nite is a custom-fabricated dental device that moves the lower jaw into a forward position, increasing space in the airway tube and reducing air velocity and soft tissue vibration. This affordable device is flexible, thin and comfortable, and it helps to prevent the disruptive, unhealthy effects of snoring and sleep apnea

Inhalation Sedation (Nitrous Oxide Gas)

This is the mildest form of sedation. Nitrous oxide is a safe and effective sedative agent that is mixed with oxygen and inhaled through a small mask that fits over your nose to help you relax.

Nitrous oxide, sometimes called “laughing gas,” is one option your dentist may offer to help make you more comfortable during certain procedures. It is not intended to put you to sleep. You can still respond to your dentist’s requests and answer questions. Your dentist will ask you to breathe normally through your nose, and within a few short minutes you should start to feel the effects of the nitrous oxide.

Use of Nitrous oxide provides safe, comfortable dental treatment for patients with dental fear, anxiety or nervousness. Your dentist may want to talk to your medical doctor before giving you nitrous oxide if you have certain conditions.

Oral Sedation

Oral sedation dentistry is more moderate form of sedation with use of medicine prior to the procedure to achieve an appropriate level of relaxation. The objective is to control anxiety during the procedure.

We will advise you as to when you should take the medication prior to your dental procedure. Accompanied by a responsible friend or family member, you will arrive at our office more rested and relaxed. Your friend or family member will accompany you home once your dental work is complete. The effects of the sedative should subside by the following day. It is wise to have a friend or relative stay with you until the medication wears off. Sedation medications have an amnesic effect, so you will have few, if any, memories of the visit. You can immediately enjoy your improved smile.