A preventive program is a cooperative effort by the patient, dentist, and dental staff to preserve the natural dentition and supporting structures by preventing the onset, progress, and recurrence of dental diseases and conditions.

Preventing dental disease starts at home with good oral hygiene and a balanced diet.  It is continued in the dental office by the efforts of your dentist and dental hygienist to promote, restore, and maintain your oral health.

Prevention also includes regular dental exams, cleanings, and x-rays. Sealants and fluoride are also great preventive treatments that help protect the teeth.

Prevention helps avoid serious and costly dental problems and is the key to having a healthy, confident, beautiful smile.

It’s great news that the incidence of tooth decay has significantly diminished over the years due to the use of fluorides and an increase in patient awareness.  However, teeth are still susceptible to decay, infection, and breakage and sometimes need to be restored back to health.  Through improved techniques and modern technology, we are now able to offer more options for restoring a tooth back to its normal shape, appearance and function.

Should your teeth ever require a restorative treatment, you can rest assured knowing we will always discuss with you the available options, and recommend what we believe to be the most comfortable and least invasive treatment.  Providing you with excellent care is our number one priority when creating your beautiful smile.

Reasons for restorative dentistry:

• Enhance your smile.
• Fill in unattractive spaces between teeth.
• Improve or correct an improper bite.
• Prevent the loss of a tooth.
• Relieve dental pain.
• Repair damaged and decayed teeth.
• Replace missing teeth.
• Replace old, unattractive dental treatments.
• Restore normal eating and chewing.

Remember to give your teeth the attention they need today!

Wisdom Teeth Extractions

Third molars, commonly referred to as wisdom teeth, are usually the last four of 32 teeth to erupt (surface) in the mouth, generally making their appearance between the ages of 17 to 25. They are located at the back of the mouth (top and bottom), near the entrance to the throat. The term “wisdom” stems from the idea that the molars surface at a time typically associated with increased maturity or “wisdom”.

In most cases, inadequate space in the mouth does not allow the wisdom teeth to erupt properly and become fully functional. When this happens, the tooth can become impacted (stuck) in an undesirable or potentially harmful position. If left untreated, impacted wisdom teeth can contribute to infection, damage to other teeth, and possibly cysts or tumors.

There are several types, or degrees, of impaction based on the actual depth of the teeth within the jaw:

• Soft Tissue Impaction: The upper portion of the tooth (the crown) has penetrated through the bone, but the gingiva (gum) is covering part or all of the tooth’s crown and has not positioned properly around the tooth. Because it is difficult to keep the area clean, food can become trapped below the gum and cause an infection and/or tooth decay, resulting in pain and swelling.
• Partial Bony Impaction: The tooth has partially erupted, but a portion of the crown remains submerged below the gum and surrounding jawbone. Again, because it is difficult to keep the area clean, infection will commonly occur.
• Complete Bony Impaction: The tooth is completely encased by jawbone. This will require more complex removal techniques.

Reasons to remove wisdom teeth

While not all wisdom teeth require removal, wisdom teeth extractions are most often performed because of an active problem such as pain, swelling, decay or infection, or as a preventative measure to avoid serious problems in the future. If impaction of one or more wisdom teeth is present, and left untreated, a number of potentially harmful outcomes can occur, including:

Damage to nearby teeth: Second molars (the teeth directly in front of the wisdom teeth) can be adversely affected by impacted wisdom teeth, resulting in tooth decay (cavities), periodontal disease (gum disease) and possible bone loss.

• Disease: Although uncommon, cysts and tumors can occur in the areas surrounding impacted wisdom teeth.
• Infection: Bacteria and food can become trapped under the gum tissue, resulting in an infection. The infection can cause considerable pain and danger.
• Tooth Crowding: It has been theorized that impacted wisdom teeth can put pressure on other teeth and cause them to become misaligned (crowded or twisted). This theory isn’t universally accepted by all dental professionals, and it has never been validated by any scientific studies.
• Wisdom teeth examination

 As with any dental procedure, your dentist will want to initially conduct a thorough examination of the wisdom and surrounding teeth. Panoramic or digital X-rays will be taken in order for your dentist to evaluate the position of the wisdom teeth and determine if a current problem exists, or the likelihood of any potential future problems.  The X-rays can also expose additional risk factors, such as deterioration or decay of nearby teeth.  Early evaluation and treatment (typically in the mid-teen years) is recommended in order to identify potential problems and to improve the results for patients requiring wisdom teeth extractions. Only after a thorough examination can your dentist provide you with the best options for your particular case.

What does the removal of wisdom teeth involve?

 Wisdom teeth removal is a common procedure, generally performed under local anesthesia, intravenous (IV) sedation, or general anesthesia by a specially trained dentist in an office surgery suite. The surgery does not require an overnight stay, and you will be released with post-operative instructions and medication (if necessary), to help manage any swelling or discomfort.

Composite fillings are also called plastic or white fillings. Getting this kind of filling depends on where the tooth is in your mouth. We bite down hard on our back teeth (molars), so a plastic filling may not be a good choice. Talk to your dentist about other options.

To place this filling, your dentist cleans all decay from the tooth and puts a glue (or bonding material) on the inside of the hole. Composite resin is put into the hole in thin layers. Each layer gets hard with the help of a special light that your dentist holds over the tooth. When the last layer of the filling is hard, your dentist shapes the filling so it looks and feels natural.

What does a CEREC® restoration procedure involve?

The first step in the procedure is to prepare the tooth. The dentist removes all tooth decay and creates a divergent occlusal axial wall, to make the opening of the tooth wider than the base. Next, an impression is made using a covering of titanium dust. This dust allows the camera to take a highly detailed picture of the tooth. Images are formulated with the CEREC® camera. CEREC® optical imaging utilizes an infrared wavelength.

The image is transposed onto the computer screen. It is here that the dentist is able to view the tooth from every angle and design the final restoration. When the design is complete, it is transmitted to the milling unit. The dentist chooses a block of ceramic that matches the color of the teeth. This ensures that the restoration will be almost invisible.

Within 15 minutes, the full crown, onlay, overlay or veneer is complete. The restoration is made of compressed, rather than laboratory-layered porcelain. This enhances strength and durability.

Before affixing the restoration to the tooth, the dentist will place it dry to ensure it fits perfectly. It is then polished and affixed to the tooth with dental cement. The procedure is now complete, and all without the need for a second visit! The quality of the results is the same as the laboratory-generated restoration, but a great deal of time and money has been saved.

If you have questions or concerns about CEREC®, please contact us.

What does getting a crown involve?

A crown procedure usually requires two appointments.  Your first appointment will include taking several highly accurate molds (or impressions) that will be used to create your custom crown.  A mold will also be used to create a temporary crown which will stay on your tooth for approximately two weeks until your new crown is fabricated by a dental laboratory.

While the tooth is numb, the dentist will prepare the tooth by removing any decay and shaping the surface to properly fit the crown.  Once these details are accomplished, your temporary crown will be placed with temporary cement and your bite will be checked to ensure you are biting properly.

At your second appointment your temporary crown will be removed, the tooth will be cleaned, and your new crown will be carefully placed to ensure the spacing and bite are accurate.

You will be given care instructions and encouraged to have regular dental visits to check your new crown.

A dental bridge is a fixed (non-removable) appliance and is an excellent way to replace missing teeth.

There are several types of bridges. You and your dentist will discuss the best options for your particular case. The “traditional bridge” is the most popular type and is usually made of porcelain fused to metal. Porcelain fixed bridges are most popular because they resemble your natural teeth. This type of bridge consists to two crowns that go over two anchoring teeth (abutment teeth) and are attached to pontics (artificial teeth), filling the gap created by one or more missing teeth.

Dental bridges are highly durable and will last many years, however they may need replacement or need to be re-cemented due to normal wear.

Reasons for a fixed bridge:

• Fill space of missing teeth
• Maintain facial shape
• Prevent remaining teeth from drifting out of position
• Restore chewing and speaking ability
• Restore your smile
• Upgrade from a removable partial denture to a permanent dental appliance

What does getting a fixed bridge involve?

Getting a bridge usually requires two or more visits. While the teeth are numb, the two anchoring teeth are prepared by removing a portion of enamel to allow for a crown. Next, a highly accurate impression (mold) is made which will be sent to a dental laboratory where the bridge will be fabricated. In addition, a temporary bridge will be made and worn for several weeks until your next appointment.

At the second visit, you permanent bridge will be carefully checked, adjusted, and cemented to achieve a proper fit. Occasionally your dentist may only temporarily cement the bridge, allowing your teeth and tissue time to get used to the new bridge. The new bridge will be permanently cemented at a later time.

You will receive care instructions at the conclusion of your treatment. Proper brushing, flossing and regular dental visits will aid in the life of your new permanent bridge.

Reasons for root canal therapy

• Decay has reached the tooth pulp (the living tissue inside the tooth).
• Infection or abscess have developed inside the tooth or at the root tip.
• Injury or trauma to the tooth.

What does root canal therapy involve?

A root canal procedure requires one or more appointments and can be performed by a dentist or endodontist (a root canal specialist).

While the tooth is numb, a rubber dam (a sheet of rubber) will be placed around the tooth to keep it dry and free of saliva.  An access opening is made on top of the tooth and a series of root canal files are placed into the opening, one at a time, removing the pulp, nerve tissue, and bacteria.  If tooth decay is present, it will also be removed with special dental instruments.

Once the tooth is thoroughly cleaned, it will be sealed with either a permanent filling or, if additional appointments are needed, a temporary filling will be placed.

At the next appointment, usually a week later, the roots and the inside cavity of the tooth will be filled and sealed with special dental materials.  A filling will be placed to cover the opening on top of the tooth.  In addition, all teeth that have root canal treatment should have a crown (cap) placed.  This will protect the tooth and prevent it from breaking, and restore it to its full function.

After treatment, your tooth may still be sensitive, but this will subside as the inflammation diminishes and the tooth has healed.

You will be given care instructions after each appointment.  Good oral hygiene practices and regular dental visits will aid in the life of your root canal treatment.

What does getting dental implants involve?

The process of getting implants requires a number of visits over several months.

X-rays and impressions (molds) are taken of the jaw and teeth to determine bone, gum tissue, and spacing available for an implant.  While the area is numb, the implant will be surgically placed into the bone and allowed to heal and integrate itself onto the bone for up to six months.  Depending on the type of implant, a second surgery may be required in order to place the “post” that will hold the artificial tooth in place.  With other implants the post and anchor are already attached and placed at the same time.

After several weeks of healing the artificial teeth are made and fitted to the post portion of the anchor.  Because several fittings may be required, this step may take one to two months to complete.  After a healing period, the artificial teeth are securely attached to the implant, providing excellent stability and comfort to the patient.

You will receive care instructions when your treatment is completed.  Good oral hygiene, eating habits, and regular dental visits will aid in the life of your new implant.

What does Invisalign® treatment involve?

First, the dentist needs to devise an initial treatment plan before creating the special aligning trays.  Three-dimensional digital images are taken of the entire jaw.  These images allow the dentist to move specific teeth on the screen, view the jaw from different angles, and also foresee what the face might look like in years to come.  In essence, this technology can show how Invisalign® trays will change the facial aesthetics.

Once planning is complete, a unique set of aligners is made.  The total amount of aligners required varies with each individual case, but 20-29 sets per arch is typical.

What are some considerations when wearing Invisalign® trays?

Life with Invisalign® aligning trays may take several weeks to get used to.  The trays should be worn constantly, except when eating and drinking.  It is important to remove the trays when consuming food or drink because food can become trapped between the tray and the teeth, causing tooth decay.

Usually, new trays are necessary every two weeks, and progress between appointments can be seen with the naked eye. There is no doubt that Invisalign® aligning trays have revolutionized orthodontics.  Invisalign® is renowned for being both comfortable and effective.

If you have questions about Invisalign®, please contact our office.

Teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel and is an ideal way to enhance the beauty of your smile.

Because having whiter teeth has now become the number one aesthetic concern of most patients, there are a number of ways to whiten teeth.  The most popular method is using a home teeth whitening system that will whiten teeth dramatically.  Since teeth whitening only works on natural tooth enamel, it is important to evaluate replacement of any old fillings, crowns, etc.  Replacement of any restorations will be done after bleaching so they will match the newly bleached teeth.

Teeth whitening is not permanent.  A touch-up may be needed every several years, and more often if you smoke, drink coffee, tea, or wine.

 Reasons for teeth whitening:

• Fluorosis (excessive fluoridation during tooth development).
• Normal wear of outer tooth layer.
• Stained teeth due to medications (tetracycline, etc.).
• Yellow, brown stained teeth.
• What does teeth whitening involve?

This type of teeth whitening usually requires two visits.  At the first appointment, impressions (molds) will be made of your teeth to fabricate custom, clear plastic, trays.

At your second appointment, you will try on the trays for proper fit, and adjustments will be made if necessary.  The trays are worn with special whitening solution either twice a day for 30 minutes or overnight for a couple of weeks depending on the degree of staining and desired level of whitening.  It is normal to experience tooth sensitivity during the time you are whitening your teeth, but it will subside shortly after you have stopped bleaching.

You will receive care instructions for your teeth and trays, and be encouraged to visit your dentist regularly to help maintain a beautiful, healthy, white smile.

Dental cone beam computed tomography is a special type of x-ray equipment used when regular dental or facial x-rays are not sufficient. Your dentist may use this technology to produce three dimensional (3-D) images of your teeth, soft tissues, nerve pathways and bone in a single scan.

In the past decade there has been a dramatic interest in cosmetic dentistry.  We all realize that having a healthy, bright, beautiful smile enhances our appearance and allows us to smile with confidence.  Thanks to the advances in modern cosmetic dentistry, we are able to improve our teeth and smiles with quick, painless and surprisingly affordable treatments.

Cosmetic dental treatments can:

• Change the size, shape, and alignment of certain teeth.

• Fill in unattractive spaces between teeth.

• Improve or correct bites.

• Lighten or brighten the color of teeth.

• Repair decayed, broken, cracked, or chipped teeth.

• Replace missing teeth.

• Replace old, unattractive dental treatments.

• Remember, your smile speaks before you even say a word 

Dental emergencies are quite frightening and often painful.  Prompt treatment is almost always required to alleviate pain and to ensure the teeth have the best possible chance of survival.

Sometimes teeth become fractured by trauma, grinding or biting on hard objects.  In other cases, fillings, crowns and other restorative devices can be damaged or fall out of the mouth completely.  If there is severe pain, it is essential to make an appointment with the dentist as quickly as possible.  The pain caused by dental emergencies almost always gets worse without treatment, and dental issues can seriously jeopardize physical health.

Types of dental Emergencies and how to deal with them

Avulsed tooth (tooth knocked out)

If a tooth has been knocked clean out of the mouth, it is essential to see a dentist immediately.  When a tooth exits the mouth, tissues, nerves and blood vessels become damaged.  If the tooth can be placed back into its socket within an hour, there is a chance the tissues will grow to support the tooth once again.

Here are some steps to take:

• Call the dentist
• Pick up the tooth by the crown and rinse it under warm water. DO NOT touch the root.
• If possible, place it back into its socket – if not tuck it into the cheek pouch.
• If the tooth cannot be placed in the mouth, put the tooth into a cup of milk, saliva, or water as a last resort. It is important to keep the tooth from drying out.
• Get to the dentist, quickly and safely.
• The dentist will try to replace the tooth in its natural socket. In some cases, the tooth will reattach, but if the inner mechanisms of the teeth are seriously damaged, root canal therapy may be necessary.

Lost filling or crown

Usually, a crown or filling comes loose while eating.  Once it is out of the mouth, the affected tooth may be incredibly sensitive to temperature changes and pressure.  Crowns generally become loose because the tooth beneath is decaying.  The decay causes shape changes in the teeth – meaning that the crown no longer fits.

If a crown has dropped out of the mouth, make a dental appointment as soon as possible.  Keep the crown in a cool, safe place because there is a possibility that the dentist can reinsert it.  If the crown is out of the mouth for a long period of time, the teeth may shift or sustain further damage.

When the dentist is not immediately accessible, here are the steps to take:

• Apply clove oil to the tooth to alleviate pain.
• Clean the crown and affix it onto the tooth with dental cement. This can be purchased at the local pharmacy.
• If the crown is lost, smear the top of the tooth with dental cement to alleviate discomfort
• DO NOT use any kind of glue to affix the crown.
• The dentist will check the crown to see if it still fits. If it does, it will be reattached to the tooth. Where decay is noted, this will be treated and a new crown will be made.

Cracked or broken teeth

The teeth are strong, but they are still prone to fractures, cracks and breaks.  Sometimes fractures are fairly painless, but if the crack extends down into the root, it is likely that the pain will be extreme.  Fractures, cracks and breaks can take several different forms, but are generally caused by trauma, grinding and biting.  If a tooth has been fractured or cracked, there is no alternative but to see the dentist as quickly as possible.

Where a segment of tooth has been broken off, here are some steps that can be taken at home:

• Call the dentist
• Rinse the tooth fragment and the mouth with lukewarm water
• Apply gauze to the area for ten minutes if there is bleeding
• Place a cold, damp dishtowel on the cheek to minimize swelling and pain
• Cover the affected area with over-the-counter dental cement if there is no way to see the dentist immediately.
• Take a topical pain reliever.
• The nature of the break or fracture will limit what the dentist is able to do. If a fracture or crack extends into the root, root canal therapy may be the only effective way to retain the tooth.  In the case of a complete break, the dentist will usually affix the fragment back onto the tooth as a temporary measure.

Dislodged/loose teeth

When a tooth has been dislodged or loosened from its socket by trauma or decay, it might be possible to save it.  If the tooth remains in the mouth and attached to the blood vessels and nerves, there is a good chance root canal therapy will not be necessary.

It is important to call the dentist immediately to make an appointment.  In the meantime, use a cold compress and over-the-counter medications to relieve pain.  The dentist will reposition the tooth and add splints to stabilize it.  If the tooth fails to heal, root canal therapy may be required.