All too often, we take the health of our teeth for granted. It wasn't that long ago that part of adulthood many times included having all of your teeth removed and dentures made. Thankfully, dental care has come a long way in a short period of time. Now, by combining new advances in treatment with routine preventive care, we are able to help our patients keep their natural teeth for their entire lives.
We will help you learn about the condition of your teeth and gums. If any treatment is required, we will discuss your options with you so you can decide which treatment is right for you. Most treatments can be completed in our office including cleanings, tooth colored fillings, crowns, and cosmetic work. If a specialist is needed, we can make recommendations and help arrange appointments if necessary. We look forward to working with you to achieve and maintain a healthy smile!
When you come to our office as a new patient, we'll address your primary concerns regarding your dental health. We recommend that our patients have a dental exam every six months. Typically, your oral exam is completed by the dentist in conjunction with the dental cleaning, usually completed by the dental hygienist. As part of your comprehensive oral evaluation, we will examine and record the condition of your teeth, carefully looking for any signs of decay, cracks, or other problems. We evaluate the condition of your gums and the underlying bone that supports your teeth. A head and neck exam and an oral cancer screening will be done.
The oral exam is comprehensive:
- All teeth are checked for areas of decay, wear, or fracture
- Surrounding gum tissue is evaluated for signs of periodontal disease
- An oral cancer screening is performed
- Your face and the neck are examined for any abnormalities
- Recent images (radiographs) are evaluated
Most importantly, we discuss any concerns you may have with regard to symptoms you may be experiencing. This additional information, along with the oral exam, is necessary to diagnose and to formulate a treatment plan. In addition, it is likely that we will discuss your overall health, diet, habits, and the effectiveness of your oral hygiene routine (see home care). It is our goal to provide comprehensive treatment for our patients at every visit.
Tooth Colored Fillings
Fillings are used to restore decayed or broken teeth. We generally recommend using tooth-colored resin filling material due to its strength, durability, and aesthetics.
Since the nineteenth century, silver amalgam filling material was often the only choice dentists had to repair decayed or broken teeth. It served its purpose well for all those years, but is now considered outdated by many dental practitioners.
Tooth colored resin-filling materials (composites) have been available for many years and have proven to quite natural looking, comfortable, and durable. The material has the ability to bond to tooth structure and actually strengthen thin weak areas of enamel helping to prevent cracks and fractures.
Crowns are durable, long lasting restorations used to rebuild broken, decayed or heavily filled teeth. They can be made of porcelain or gold. Crowns strengthen weak teeth, making it possible to chew comfortably without concern. Porcelain crowns are beautiful as well as durable and can improve the appearance of a smile.
Bridges are used to replace missing teeth. In a conventional bridge, the natural teeth adjacent to the space of the missing tooth are prepared for crowns and a false tooth is securely attached to these crowns. Another type of bridge, commonly known as a “Maryland bridge”, uses wings attached to the inside surface of the adjacent teeth to support the false tooth. In both cases the entire unit is cemented into place and is not removable. Bridges look, feel, and function much like natural teeth.
Dental implants replace missing teeth. They act as replacement "roots" and can be used to support individual crowns, multiple tooth bridges, or help anchor dentures. Since their initial development over 30 years ago, the design and placement techniques of implants have been continually improved. Treatments using implants today enjoy a success rate greater than 99%. We have an excellent working relationship with specialists in the area to place implants for our patients. Our job is to coordinate the treatment and fabricate the restorations that are supported by implants to replace the missing teeth.
This is a treatment option for those patients who are missing some or all of their teeth. Complete dentures are used in cases where all the natural teeth are missing. Partial dentures are used when some natural teeth remain. Both are made of acrylic, although a partial denture may also have a metal component that rests or holds onto existing teeth to stabilize it. Partial and complete dentures are removable, however, while in place they act to greatly improve appearance, speech, and function.
For many patients, the placement of two or more dental implants has been found to be highly effective in improving the retention of complete dentures. In this case, the implant-supported denture has special attachments that connect directly to the dental implant. As with a traditional denture, the patient is still able to remove the implant-supported denture to maintain good oral hygiene. However, the retention and stability of the implant-supported denture is typically far superior to that of a traditional denture.
Teeth are supported by bone and the surrounding overlying gum tissue. In order to maintain teeth for a lifetime, it is important to keep these structures healthy with regular removal of dental plaque, the sticky film that is always forming on teeth. In its most mature form, plaque is referred to as 'calculus' or 'tartar' and is laden with bacteria. In instances of periodontal (gum) disease, the gum tissue can be severely inflamed or infected due to the presence of this unwanted bacteria. This may eventually lead to destruction of the supporting bone structure, and ultimately to the loss of teeth.
Treating periodontal disease in the early stages can therefore help to prevent tooth loss. Periodontal therapy often consists of a deep cleaning, called scaling and root planing, in order to eliminate the causes of the inflammation (tartar) and to keep the gums and underlying bone healthy. We make every effort to keep the patient comfortable during periodontal therapy. Treatment often includes the application of anesthetic gel to numb the gum tissue, or even local anesthesia to numb the teeth if they are sensitive.
We encourage routine dental cleanings and check-ups because the symptoms of periodontal disease are not always apparent to the patient. Also, it is well documented that there is a link between periodontal disease and cardiovascular disease (heart disease and stroke).
Endodontic (Root Canal) Treatment
Endodontic therapy is used to treat infected teeth that have become abscessed and painful due to a cavity, fracture or trauma. Infected nerve tissue is removed from inside the tooth and replaced with a rubbery filling material. This seals the area to prevent the infection from returning. Endodontic techniques have improved greatly in recent years resulting in much greater patient comfort and an extremely high success rate.
Bite Guards & Bruxism
Bruxism is a habit of either clenching or grinding the teeth, typically while you are sleeping. Clenching is when the top and bottom teeth are simply held together very tightly. Therefore, clenching is often a silent condition. Grinding is when the bottom teeth slide back and forth, or side-to-side, against the upper teeth. Not surprisingly, grinding is often associated with a loud noise that may wake a bed partner. Parents may even hear their child grinding his or her teeth. Unfortunately, the causes for bruxism are not known for certain. However, it is well documented that stress, an abnormal bite relationship, or even sleep disorders may be contributing factors to this behavior. People who suffer from bruxism may report the following symptoms:
- Sore jaw
- Facial pain
- Headache or earache
- Difficulty sleeping
- Frequent toothaches
- Excessive wear of the teeth
- Worn or cracked fillings or teeth
If you are exhibiting any of the above symptoms, we may recommend fabrication of a bite guard for you to wear while sleeping. For that reason, the appliance is often referred to as a night guard. This type of appliance is custom-made for you and therefore fits comfortably over your upper teeth. As a result, we can be certain that your teeth will be protected from excessive wear and damaging biting forces, and you will likely sleep more soundly.
The abbreviation, TMJ, stands for temporal-mandibular joint. These are the jaw joints found on both sides of your head, just in front of your ears, that allow you to open and close your mouth. These joints are complex in that they are made up of muscles, ligaments, bones, and a cartilage disc that allows for smooth, uninterrupted movement of the joints. Needless to say, keeping these joints healthy is critical to allow comfortable jaw movement during eating and speaking. Possible causes for improper functioning of the TMJ include arthritis, injury, teeth clenching or grinding, or tooth/jaw misalignment. Jaw joint problems, along with problems of the muscles that open and close your jaws, can therefore cause a multitude of symptoms.
- Jaw joint pain
- Facial pain
- Difficulty in chewing comfortably
- Difficulty opening or closing your jaw comfortably
Treatment starts with attempting to pinpoint the origin of the pain and careful analysis of any dental issues that may be contributing to the problem.
Solutions may include:
- Bite guard therapy (See Bite Guards and Bruxism)
- Alteration of diet
- Replacement of missing teeth
- Bite adjustment
Obstructive Sleep Apnea (OSA) is a condition in which interruptions in breathing occur during sleep due to a narrowing or collapse of the airway. Patients suffering from OSA feel fatigued and sleepy during the day. OSA can also lead to more serious medical conditions such as high blood pressure, heart disease, irregular heartbeat, stroke and sudden nocturnal death.
A physician diagnoses Obstructive Sleep Apnea with the information provided by an overnight sleep test called a polysomnogram, known more commonly as a sleep study. The treatment of choice for those diagnosed with OSA is a CPAP (continuous positive airway pressure) machine. Through the use of a mask and tubing, this device provides enough pressure to keep the patient's airway open.
Unfortunately, many patients cannot tolerate CPAP treatment for a variety of reasons.
As an alternative, we offer oral appliance therapy. A custom-fit appliance (similar to an orthodontic retainer) can help to position the lower jaw slightly forward during sleep. This keeps the airway open and allows for a restful night's sleep.