Our office strives to give our patients quality aesthetic dental care. We opt not to use amalgam (silver) restorative material and offer tooth colored restorations for our patients. We are equipped to care for most dental needs for adults as well as children including the following:
Comprehensive Oral Evaluation – A complete and comprehensive evaluation of oral health. The logical beginning of any dental treatment with the goal of developing a plan of treatment that will feel good, look good, and last a long time.
Review of Dental and Medical History – Certain health problems can modify dental treatment, or even make some things dangerous.
Panoramic X-ray – a circular, full range view of the jaws.
Bitewing and Periapical X-rays – smaller x-rays of individual or groups of teeth.
Oral Cancer Screening – thorough evaluation of the soft tissue of the head and neck, as recommended by the American Cancer Society.
Complete dental charting – evaluation and documentation of present conditions, including missing, restored, diseased, fractured, or traumatized teeth.
Periodontal evaluation – recording present conditions of the gums and supporting structures of the teeth, as well as an evaluation of oral hygiene status.
Dental Imaging – Visualization of the teeth and the smile using intra oral video camera as well as 35 mm close up intra oral photography.
Pit and Fissure Exploration – Laser diagnosis of these tiny places where 90% of decay begins. A laser is used which measures the integrity of dental enamel.
Occlusal analysis – study of the bite, noting signs of wear and/or trauma, includes plaster casts of the jaws that may be mounted on an instrument to duplicate movement.
TMJ evaluation – evaluation of jaw joint discrepancies, including pain, clicking, deviation, limitations of movement to assure the health of these unique structures.
Non-surgical Periodontal Therapy – Gum disease affects more than 98% of Americans and is the number one cause of tooth loss. Several protocols are available depending on the type of gum disease.
Type I – Gingivitis – This gum condition is treated by cleaning and polishing the teeth. Removing plaque and tarter results in the return of health to the gums. Requires at least two visits with our hygienists, and includes home care instructions.
Types II, III, & IV – Periodontitis (early, moderate, advanced) – Gum disease progressively destroys the underlying bone and attachment mechanisms of the teeth. Treatment consists of removal of the toxic bacterial products from affected root surfaces beneath the gums. Called scaling and root planing, this is accomplished with multiple visits, using local anesthesia. When indicated, antibacterial medication is applied. A follow-up visit four to six weeks following treatment measures progress.
Maintenance Procedures – Gum disease frequently recurs, due to the rapid return of bacterial growth in the mouth. To keep it under control it is necessary to return regularly to the hygienist for removal of this bacterial growth. Following scaling and root planing, these visits are necessary every three months for at least one year.
Periodontal Surgery – There are several surgical procedures that involve treating the supporting tissues of teeth. These would almost always require a post operative visit, for suture and/or dressing removal.
Crown Lengthening Procedures – performed to obtain adequate tooth structure in order to properly restore a tooth.
Gingival Grafting Procedures – performed when inadequate attachment of the gum to the tooth might jeopardize that tooth — 2 types: Pedicle – sliding flap graft, Free Gingival – graft from a donor site.
Pocket elimination Procedures – performed when non-surgical methods fail to eliminate a periodontal pocket.
Mucogingival surgery – performed to modify the relationship of the gums to the surrounding mucous membrane (skin that covers most of the inside of the mouth.
Removal of Teeth – Even though we believe in keeping teeth for a lifetime, sometimes it is necessary to remove them. Due to decay, to gum disease, because they’re in the way of another dental procedure, or because they can’t properly erupt, there are several oral surgical procedures that can be performed.
- Hard Tissue Replacement – Filling the socket space of an extracted tooth with synthetic bone. When a tooth is extracted, approximately 60-80% of supporting bone can be lost to resorption. This technology prevents that.
- Alveolopasty – another way of treating the devastation of tooth loss is to surgically shape the remaining bone to better support whatever will replace the teeth. Can be done in conjunction with the extractions, or after the sockets have healed.
Impacted Teeth – removal of impacted teeth (usually 3rd molars – wisdom teeth) can be simple or complex. The more complex cases will generally be referred to an oral and maxillofacial surgeon.
Endodontics (Root Canal Fillings) – When the pulp (nerve) of a tooth is infected, dying, or otherwise needs removing to save the tooth, a root canal filling is necessary. Endodontics consists of three steps:
- Disinfection – irrigation of the canal with a disinfecting agent
- Obturation – filling canal usually with rubber-like gutta percha material.
- Step3 – Root Canal
At times it is necessary for teeth requiring root canal therapy are referred to an Endodontist (a specialist in treating pulpal disease). Referral is based on the particular tooth as well as the planned restoration of that tooth. Endodontists do not place the final restoration, and all teeth treated endodontically must be restored in some fashion, usually with a crown.
There are three different types of root canals, based primarily on tooth location:
- Anterior – teeth in the front of the mouth, usually only one canal .
- Premolar – teeth in the middle will have one or two roots
- Molar – back teeth which have two or more roots, and multiple canals.
Pain management – It is certainly reasonable to expect modern dentistry to be pain free. We do all that we can to assure freedom from pain and anxiety:
- Nitrous Oxide Analgesia – “Laughing gas” will diminish perception of pain and create a mild euphoria (happy feeling) that significantly reduces anxiety. It is safe and effective and has no after effects.
- Topical Anesthesia – An ointment placed on an injection site to prevent any sensation from penetrating.
- Local Anesthesia – A medicine that stops a nerve from transmitting pain signals. Several choices of varying duration, including one that is almost imperceptible when injected.
- P O Sedation – Prescription medicine to sedate a patient for difficult procedures, used to alleviate anxiety.
Restorative Dentistry – A restoration is a filling (either direct or indirect) , or any other procedure that restores form and function. Cavities come in all shapes and sizes. They can involve from one to five surfaces of a tooth. Some are small enough that they can be restored without anesthesia. Some are so deep that they may involve the nerve of the tooth. Some are so wide that they undermine the remaining tooth support, requiring indirect restoration. Good dentistry demands a restorative material that is compatible with the hard and soft tissues of the mouth, that can withstand the forces to which it will be subjected, that will seal the sensitive structures inside the tooth from further assault by bacteria or anything else, and that will look and feel natural.
Types of restorations are:
Sealant – A preventive restoration, a tough resin coating is bonded into the enamel, sealing the pits and fissures from attack by decay acids. Recommended for all newly erupted permanent molars. Can be placed by hygienist.
Direct Composite Resin – A tooth colored resin that is bonded directly to tooth structure, creating nearly invisible fillings. Used with cavities so small that decay can be removed with air abrasion technology, as well as for large build-ups of teeth that require crowns. Also used for closing open spaces and lightening discolored teeth, and to replace broken, corroded, unsightly silver fillings.
Indirect Inlays/Onlays – A ceramic restoration, processed in the laboratory, that restores defective portions of a tooth. This ceramic material approximates dental enamel in physical properties and is used when the biting points (cusps) of a tooth must be restored, and full coverage (a crown) would destroy too much tooth structure.
Crowns – Often called a cap, this restoration covers the entire tooth. Frequently requires a post (in endodontically treated teeth) and/or a core to replace tooth structure for support, can be made of several materials. The most common are:
- Stainless steel – used only for primary teeth.
- Cast Gold – when the patient prefers gold
- Porcelain-fused-to-metal – most common
- All Porcelain – several forms, most natural
Laminates – This is a restoration that involves minimal reduction of a tooth. It is a very thin processed veneer (made of porcelain or resin, or even gold) bonded over a tooth–changing the shape, size or color, usually for cosmetic purposes.
Replacing missing teeth – The bones and muscles of the adult human face are designed to work with a full complement of at least twenty-eight teeth. When one or more of these teeth are lost, replacement is required for natural function. This is probably the most difficult job that a dentist faces: replacing a missing part of the body so that proper form and function is restored.
There are three ways that missing teeth can be replaced: removable, fixed, or a combination of the two. Removable prostheses include:
Complete Dentures – Prosthesis made when all teeth are missing in one arch.
It must restore function to the bite, to speech, to appearance. Can be made prior to the loss of the natural teeth with the advantage of maintaining the proper muscle tone. This is an Immediate Denture. Can also be made to cover existing tooth roots, properly restored, with attachment mechanisms to secure the removable part of the prosthesis. This is an Overdenture.
Partial Dentures – These prostheses can be either supported by the tissues or by the teeth. When they are supported only by the soft tissue, the adjacent teeth are jeopardized, so these appliances should be considered temporary only. To avoid this, the supporting teeth must be modified to properly distribute the load of the appliance. This modification can vary from very slight to a full coverage crown with a precision attachment.
Missing teeth can also be replaced with a fixed prosthesis. When possible, fixed is almost always better than removable. The most common type of fixed replacement is called a bridge.
Fixed Bridge – A restoration which spans the space where one or more teeth have been lost. It is cemented onto natural teeth, called abutments, and consists of two types of units: Retainers (the crowns or other restoration on the supporting abutment teeth) and Pontics (the replacement or dummy teeth that fill the space).
Sometimes the necessary abutment support for a fixed bridge is absent or weak. When this is the case, it is probably a good idea to consider implants.
Implant – A special fixture that is surgically placed into the bone to support a fixed or removable replacement of teeth. A surgical template is constructed to guide the surgeon in placing the fixtures. A period of several months follows the surgery, during which the fixtures integrate into the bone. Then they can be made into an abutment to support either a fixed or a removable prosthesis.
Mini Implant – consists of a miniature titanium implant that acts like the root of your tooth and a retaining fixture that is incorporated into the base of your denture, The head of the implant is shaped like a ball and the retaining fixture acts like a socket that contains a rubber O-ring. The O-ring snaps over the ball when the denture is seated and holds the denture at a predetermined level of force. When seated, the denture gently rests on the gum tissue. More information.
Invisalign – A tooth straightening method using clear removable aligners. For more information see Invisalign.com
