From prevention to restorative dentistry: We offer the entire range of modern dentistry to keep your teeth healthy and beautiful for your entire life. Get an overview here of the types of treatments we offer.
Prevention: Keeping teeth healthy:
We need teeth cleanings for two reasons:
• To prevent diseases in the rest of the body like heart disease, dementia, and complications of diabetes
• To prevent tooth loss
The mouth is an area that’s completely different from the entire body, and it takes quite a beating from the food we eat and the talking we do all day long. And this unique environment requires special care.
Teeth cleanings remove the buildup of plaque and tartar. This buildup is for the most part natural — kind of like how a boat picks up barnacles just by being in the ocean. But too much buildup leads to gum disease. The reason tartar needs to be removed is because your body sees it as a foreign invader. As with any other foreign invader, like a flu bug or an infection, your body “sends in the troops” using the immune system to fight off the infection. There is a battle in your mouth at all times, and the war is never over. Teeth cleanings level the playing field by keeping things in check. Gum disease is when your body’s immune system is responding to this tartar buildup with inflamed and bleeding gums. The immune system response is successful at killing off invaders like infection and flu bugs, but at a cost: like a war, there are innocent bystanders that get slaughtered. As gum disease progresses, so does the destruction to your bone and tissues in your mouth. Your immune system is meant only to fight off infection for a short period of time — chronic activation of the immune system means it can get worn out and it won’t be as strong to fight off an illness. Chronic activation of the immune system can lead to diseases in the rest of your body. That’s why preventing gum disease reduces risk of stroke, heart disease, and dementia.
At a certain stage, this damage is irreversible, so prevention is the best way to maintain overall health and keep beautiful teeth for a lifetime — and teeth cleanings are a critical piece of this prevention.
What Is a Teeth Cleaning?
A professional teeth cleaning is done by the hygienist at a dentist’s office. The hygienist uses tools to remove tartar from your teeth — both above and below where the gum meets the tooth.
Your hygienist should explain what work is being done, why it’s being done, and why your teeth may be sensitive or why your gums are bleeding. You can ask for a mirror or an intra-oral
camera (a more hi-tech version of the mirror) which will allow you to watch your hygienist working and understand what’s being done to your teeth. It’s one thing to hear your hygienist say,
“You really need to pay more attention to your back molars.” But it’s quite another thing to actually see your hygienist scraping tartar from your back molars so you can following up with proper
brushing and flossing at home.
Your dentist or hygienist should give you an updated primer on proper brushing and flossing technique. Follow through after a teeth cleaning is everything, so use this opportunity to get a full demo of what you should be doing at home to keep your mouth disease-free and healthy.
What to Ask For
While you’re there for your teeth cleaning, ask your dentist for a diagnosis for stage of gum disease. This will give you some idea of where to go from here. You can have direction until you know where you’re starting from.
You can ask: “Am I type I, II, III, IV, or V for gum disease?”
Understand What Gum Disease Is
Imagine when you’ve cut your hand — it swells up. The same thing happens to gums that are inflamed by the buildup of tartar, even more so than swelling in other parts of the body because gums have an incredibly rich blood supply.
Discuss this with your dentist and make sure to talk about your own status when it comes to gum disease.
Know Why a Pocket Reading Is So Important For Overall Health
Where the gum and the tooth meet isn’t actually where they attach — they are attached further down. This creates a small pocket, which you can picture like a moat all the way around your tooth.
The size of this little pocket can change in two ways:
1. At the bottom of the pocket are ligaments that hold the gum and tooth together. These ligaments are eaten away by the enzyme produced by the body produces when the body feels it’s under attack. This makes the pocket deeper.
2. The top flap of the pocket can grow in size due to inflammation.
Pockets can get deeper from the top or the bottom — but however it happens, it’s not good for your health.
That’s why a “pocket reading” is an important indicator of your health. A pocket reading is a measurement of the size of your pockets.
Deeper pockets are indicators of disease. Ideally, you’re preventing your pockets from deepening with proper oral hygiene at home and regular teeth cleanings, which will prevent your gums from being inflamed.
Ask For Your Pocket Reading
Ask to hold a mirror so you can watch your dentist measure your pocket — you’ll see a little probe with ruler lines on it being inserted into your pocket.
Ask your dentist for your pocket reading. Again, this is good to know. Just as you want to know what your blood pressure is, you want to know what your pocket reading is and be aware of how it’s changing.
Know the Different Types of Teeth Cleanings
There are different types of teeth cleanings, depending on how healthy your gums are. Make sure you’re not over-treated or under-treated.
No Gum Disease
This is the best and what you should aim for at each teeth cleaning. There’s no bleeding when the dentist flosses your gums or puts the probe inside your pockets to measure them.
Treatment: Maintain, maintain, maintain. It is infinitely easier (and healthier) to maintain good health and prevent disease than it is to become unhealthy and to have to seek treatment. Ask your dentist how to maintain this good health. You will still need regular teeth cleanings, but in exceptional cases, you might be able to get a cleaning once per year, and this is perfectly fine.
Having no gum disease for a lifetime will reduce your risk of heart disease, dementia. If you have diabetes, it will reduce complications. The reduced inflammation in your body will make you better at fighting infection and maybe even make it easier to lose weight. Keep up the good work!
Type I: Gingivitis
Gingivitis is very common. Around 80% of people in the United States have gingivitis.
If you have gingivitis, your gums bleed when you floss them or when the dentist measures your pockets. There might be some redness along the edge of the gum where it meets the tooth.
Gingivitis means your gums are reacting to an infection and they’re diseased. Healthy gums don’t bleed when touched.
Treatment: you’ll need to be doing better at home with flossing and brushing and you might need to increase your frequency. Ask your dentist or hygienist for a demo of proper brushing and flossing technique. You might also need different instruments — gum disease can be aggravated by a toothbrush that is too old.
Type II: Early Periodontitis
At this stage, you’ve had gingivitis for some time and it has progressed to something more serious. Your dentist might tell you that you have deep pockets. Your gums are bleeding when flossed or probed. It’s possible you may even have some ligament damage to the place where your gums attach to your teeth.
Gum recession is also common at this stage. Gum recession is when gums pull down, away from the tooth, after healing from inflammation. Receding gums aren’t pretty and they lead to tooth sensitivity because the root of the tooth starts to become exposed as the gum pulls down. Gum recession is 100% irreversible. It’s permanent and no surgery can fix it.
Treatment: Early periodontitis is the beginning of a very dangerous path. If you’re at this stage, I would recommend a deep cleaning, called a scale and root planing.
A root planing is required at this stage because there’s so much tartar buildup that brushing and flossing on your own will be inadequate now. With this much tartar buildup, it’s impossible to clean down to the surface of the tooth — until it’s removed by a professional in a deep cleaning.
Ask your dentist which sections of your mouth are affected because you might not need the deep cleaning everywhere. Scale and root planings are done in quarters — upper right, upper left, lower right, and lower left. You will need a deep cleaning in one, two, three, or all four of these quadrants.
A scale and root planing gives you the chance to prevent the tartar from building up and taking hold again. This is why follow through is critical after the deep cleaning. Ask your dentist for a demo of the proper flossing and brushing technique you’ll need to use at home.
Type III, IV, and V: Moderate to Severe Periodontitis
At this stage, you also have deeper pockets and bleeding gums. As the severity increases, it gets more and more difficult to get healthy again. In these severe stages of periodontitis, you begin to tempt your fate with a point of no return — as in, the point where your gums will no longer respond to treatment. Surgery is frequently required in these stages.
Treatment: You’ll need multiple scale and root planings (read the section about Type II: Early Periodontitis above for information on the scale and root planing procedure). I would recommend considering a second opinion from a periodontist as well, who specializes in these more advanced and serious stages of gum disease.
After your root planing procedures, your follow through at home with proper brushing and flossing is imperative to be able to reverse the disease. Everything done at the dentist will be reversed without your taking care of your teeth every day and after every meal.
Ask your dentist: “How am I brushing and flossing?” By asking this, you are verifying the efficacy of how you take care of your teeth at home.
Gum disease is a very complicated, multi-factor disease, and no matter what stage you’re at, and even if you don’t have gum disease, you have to monitor it your whole life — kind of like blood pressure. The mouth is never static — it is always changing depending on the foods we eat, how we brush and floss, and the chemicals we expose it to.
The treatment guidelines above are for gum disease that is caused by plaque. But gum disease can also occur due to hormonal changes from a pregnancy, medications you’re taking, grinding your teeth, poor dentistry, or root canals, you could get gum disease that way.
Summary of Questions to Ask During the Appointment
• What classification of gum disease do I have?
• How deep are my pockets?
• Do you notice any gum recession?
• Am I over-brushing?
• Am I grinding my teeth?
• May I have a demo of how I should floss and brush my teeth?
After the Teeth Cleaning
No matter whether you have gum disease or not, or what stage gum disease you have, your oral hygiene at home is critical. Follow through after your teeth cleaning is everything.
Make sure you are:
• Brushing and flossing after meals, or at least twice per day.
• Eating a diet rich in vegetables
• Making an appointment for every three months if you have gum disease, or every six months if you don’t have gum disease and are just maintaining good health.
Gum disease is easy to prevent, but a hard disease to get rid of. Home care is essential — your dentist and hygienist can’t do it all for you at these appointments.
Restorations-fillings, crowns, and bridge work:
What are Dental Crowns and Tooth Bridges?
Both crowns and most bridges are fixed prosthetic devices. Unlike removable devices such as dentures, which you can take out and clean daily, crowns and bridges are cemented onto existing teeth or implants, and can only be removed by a dentist.
How do Crowns Work?
A crown is used to entirely cover or "cap" a damaged tooth. Besides strengthening a damaged tooth, a crown can be used to improve its appearance, shape or alignment. A crown can also be placed on top of an implant to provide a tooth-like shape and structure for function. Porcelain or ceramic crowns can be matched to the color of your natural teeth. Other materials include gold and metal alloys, acrylic and ceramic. These alloys are generally stronger than porcelain and may be recommended for back teeth. Porcelain bonded to a metal shell is often used because it is both strong and attractive.
Your dentist may recommend a crown to:
Replace a large filling when there isn't enough tooth remaining
Protect a weak tooth from fracturing
Restore a fractured tooth
Attach a bridge
Cover a dental implant
Cover a discolored or poorly shaped tooth
Cover a tooth that has had root canal treatment
How do Bridges Work?
A bridge may be recommended if you're missing one or more teeth. Gaps left by missing teeth eventually cause the remaining teeth to rotate or shift into the empty spaces, resulting in a bad bite. The imbalance caused by missing teeth can also lead to gum disease and temporomandibular joint (TMJ) disorders.
Bridges are commonly used to replace one or more missing teeth. They span the space where the teeth are missing. Bridges are cemented to the natural teeth or implants surrounding the empty space. These teeth, called abutments, serve as anchors for the bridge. A replacement tooth, called a pontic, is attached to the crowns that cover the abutments. As with crowns, you have a choice of materials for bridges. Your dentist can help you decide which to use, based on the location of the missing tooth (or teeth), its function, aesthetic considerations and cost. Porcelain or ceramic bridges can be matched to the color of your natural teeth.
How are Crowns and Bridges Made?
Before either a crown or a bridge can be made, the tooth (or teeth) must be reduced in size so that the crown or bridge will fit over it properly. After reducing the tooth/teeth, your dentist will take an impression to provide an exact mold for the crown or bridge. If porcelain is to be used, your dentist will determine the correct shade for the crown or bridge to match the color of your existing teeth.
Using this impression, a dental lab then makes your crown or bridge, in the material your dentist specifies. A temporary crown or bridge will be put in place to cover the prepared tooth while the permanent crown or bridge is being made. When the permanent crown or bridge is ready, the temporary crown or bridge is removed, and the new crown or bridge is cemented over your prepared tooth or teeth.
How Long do Crowns and Bridges Last?
While crowns and bridges can last a lifetime, they do sometimes come loose or fall out. The most important step you can take to ensure the longevity of your crown or bridge is to practice good oral hygiene. A bridge can lose its support if the teeth or bone holding it in place are damaged by dental disease. Keep your gums and teeth healthy by Brushing with fluoride toothpaste twice a day and flossing daily. Also see your dentist and hygienist regularly for checkups and professional cleanings.
To prevent damage to your new crown or bridge, avoid chewing hard foods, ice or other hard objects.
Removable partial dentures and complete dentures:
Removable partial dentures usually consist of replacement teeth attached to pink or gum-colored plastic bases. Depending on your needs, your dentist will design a partial denture for you. A partial denture may have a metal framework and clasps that connect to your teeth, or they can have other connectors that are more natural looking. In some cases, a removable partial denture is made to attach to your natural teeth with devices called precision attachments. Precision attachments are generally more esthetic than clasps. Crowns on your natural teeth are sometimes needed to improve the fit of a removable partial denture and they are usually required with attachments. Partial dentures with precision attachments generally cost more than those with clasps. Consult with your dentist to find out which type is right for you.
Complete dentures can be either "conventional" or "immediate." Made after the teeth have been removed and the gum tissue has begun to heal, a conventional denture is ready for placement in the mouth about eight to 12 weeks after the teeth have been removed. Unlike conventional dentures, immediate dentures are made in advance and can be positioned as soon as the teeth are removed. As a result, the wearer does not have to be without teeth during the healing period. However, bones and gums shrink over time, especially during the healing period following tooth removal. Therefore a disadvantage of immediate dentures compared with conventional dentures is that they require more adjustments to fit properly during the healing process and generally should only be considered a temporary solution until conventional dentures can be made.
Thinking about teeth whitening? Get the facts first. Here are five of the most commonly asked questions about the process.
Why Did My Teeth Change Color?
Over time, your teeth can go from white to not-so-bright for a number of reasons:
Food and Drink
Coffee, tea and red wine are some major staining culprits. What do they have in common? Intense color pigments called chromogens that attach to the white, outer part of your tooth (enamel).
Two chemicals found in tobacco create stubborn stains: Tar and nicotine. Tar is naturally dark. Nicotine is colorless until it’s mixed with oxygen. Then, it turns into a yellowish, surface-staining substance.
Below the hard, white outer shell of your teeth (enamel) is a softer area called dentin. Over time, the outer enamel layer gets thinner with brushing and more of the yellowish dentin shows through.
If you’ve been hit in the mouth, your tooth may change color because it reacts to an injury by laying down more dentin, which is a darker layer under the enamel.
Tooth darkening can be a side effect of certain antihistamines, antipsychotics and high blood pressure medications. Young children who are exposed to antibiotics like tetracycline and doxycycline when their teeth are forming (either in the womb or as a baby) may have discoloration of their adult teeth later in life. Chemotherapy and head and neck radiation can also darken teeth.
How Does Teeth Whitening Work?
Teeth whitening is a simple process. Whitening products contain one of two tooth bleaches (hydrogen peroxide or carbamide peroxide). These bleaches break stains into smaller pieces, which makes the color less concentrated and your teeth brighter.
Does Whitening Work on All Teeth?
No, which is why it’s important to talk to your dentist before deciding to whiten your teeth, as whiteners may not correct all types of discoloration. For example, yellow teeth will probably bleach well, brown teeth may not respond as well and teeth with gray tones may not bleach at all. Whitening will not work on caps, veneers, crowns or fillings. It also won’t be effective if your tooth discoloration is caused by medications or a tooth injury.
What Are My Whitening Options?
Talk to your dentist before starting. If you are a candidate, there are three ways to put the shine back in your smile:
All toothpastes help remove surface stain through the action of mild abrasives that scrub the teeth. Look for the ADA Seal for safe whitening toothpastes that have special chemical or polishing agents to provide additional stain removal effectiveness. Unlike bleaches, these types of ADA Accepted products do not change the color of teeth because they can only remove stains on the surface.
This procedure is called chairside bleaching and usually requires only one office visit. The dentist will apply either a protective gel to your gums or a rubber shield to protect your gums. Bleach is then applied to the teeth.
Peroxide-containing whiteners actually bleach the tooth enamel. They typically come in a gel and are placed in a tray that fits on your teeth. You may also use a whitening strip that sticks to your teeth. The concentration of the bleaching agent is lower than what your dentist would use in the office. If you are thinking about using an over-the-counter bleaching kit, discuss options with your dentist and look for one with the ADA Seal of Acceptance. That means it has been tested to be safe and effective for teeth whitening. Get a list of all ADA-Accepted at-home bleaching products.
Are There Any Side Effects from Teeth Whitening?
Some people who use teeth whiteners may experience tooth sensitivity. That happens when the peroxide in the whitener gets through the enamel to the soft layer of dentin and irritates the nerve of
your tooth. In most cases the sensitivity is temporary. You can delay treatment, then try again.
Overuse of whiteners can also damage the tooth enamel or gums, so be sure to follow directions and talk to your dentist.
Porcelain and composite veneers:
Choosing to have dental veneers placed is the first step to improving the aesthetics of your teeth and getting that winning smile you’ve longed for. Determining what material to go with is the second.
veneer materials. Composite resin and porcelain are the most commonly used materials in the veneer fabrication process. In the hands of an experienced cosmetic dentist, both materials can beautifully transform your smile. But how do you know which type is right for you? This comes down to your specific needs and which factors are most important to you (cost, treatment time, etc.). Let’s evaluate some of the differences between composite and porcelain veneers.
Advantages of Composite Veneers
Composite veneers have a number of advantages over porcelain, chief among which is cost. On average, porcelain veneers are twice as expensive as composites, which is very important for some people given that most treatments are not covered by insurance, meaning you are likely paying out-of-pocket for treatment. The cost of veneers varies based on a number of factors, but composites cost on average between $250 and $1,500 per tooth. This can add up quickly in a smile makeover.
Another advantage that composite veneers have over porcelain is the fact that composites can typically be fabricated while you wait, making it a same-day treatment. Direct composite veneers (also referred to as composite bonding) are actually sculpted on your teeth rather than in an offsite lab. The tooth-shaded resin is applied to teeth directly (hence the name) where it can be shaped and sculpted by the dentist. The shaped resin is hardened using a high-intensity light, after which additional layers of resin can be applied and sculpted as needed to elicit the desired aesthetic outcome. Once finished, the resin must be polished in order to elicit a more natural, tooth-like appearance. The composite procedure therefore tends to be much less invasive and noticeably quicker than porcelain.
Arguably the biggest advantage that composite veneers have over porcelain is reversibility. Porcelain requires reshaping of your natural teeth in order to fit the veneer. When it comes to composites, minimal prep work is required on your natural teeth, meaning that they are not permanently altered to such an extent that the composite material cannot be removed and replaced as needed.
Advantages of Porcelain Veneers
Although composite veneers have a number of advantages, there is one area in which they cannot compete with porcelain: durability. Porcelain is a far stronger material than composite resin (even with the improvements in resin materials over the years). Well-maintained porcelain veneers can last 10 to 15 years, compared to the five- to seven-year average lifespan of composites. It’s important to consider this tradeoff if you’re thinking of having veneers placed. That is, while composites may cost half as much as porcelain, they last only half as long. So which is the better value?
Most dentists agree that porcelain veneers offer the most natural, tooth-like aesthetics. Porcelain has a translucent quality that is quite similar to tooth enamel. It is also highly resistant to staining and chipping due to the strength of the material and the glaze that is applied after treatment. On the other hand, composite veneers are more porous and therefore susceptible to staining, meaning that you may need to adjust your diet in order to avoid certain stain-causing foods. Composite also needs to be polished in order to achieve a tooth-like esthetic. And even then it doesn’t quite compare.
The porcelain veneer procedure is more involved, and often requires temporaries be worn while you wait for the veneers to be sculpted in a lab. However more and more dentists are embracing chairside CAD/CAM technologies that help to speed up the process by allowing for on-site fabrication. If you are looking for a porcelain veneers solution, it’s important to evaluate the sort of technologies that your dentist has available. You could end up drastically reducing the overall treatment time. Lastly, porcelain veneers offer a viable treatment solution for all cases of worn enamel, wear and tear, genetic defects, uneven teeth, etc. Composites may not be a viable option for severe concerns. For example, significant discoloration or spacing issues may not be adequately treatable with composite veneers, making porcelain your only option. Your dentist will conduct a thorough oral health evaluation as part of your consultation to determine your options.
Composite or Porcelain… What’s the Verdict?
At the end of the day, the only way to determine whether a composite or porcelain veneer solution is right for you is to speak with your dentist about your aesthetic goals and to weigh your personal considerations. In other words, what is most important to you? If you’re looking for the most cost-effective solution, then a composite veneers treatment plan will probably be a good fit. However, if you have a severe aesthetic concern, or you’re looking for the most natural and durable treatment solution (and cost is not a consideration), then porcelain veneers will give you a fantastic result.
Regardless of which material you opt for in the end, you can rest assured that both offer fantastic smile enhancement.
Root canal therapy:
In the past, if you had a damaged or diseased tooth, it usually was pulled. But today, injured or diseased teeth often can be saved with endodontic therapy, also known as root canal treatment.
Endodontics is a specialized type of dentistry that deals with abnormal tooth pulp; the causes/origins, diagnosis, prevention and treatment of diseases and injuries to the pulp; and other conditions affecting the tissues surrounding the pulp and canal (channel inside the tooth root). Tooth pulp, the soft tissue that contains nerves, blood vessels and connective tissues, runs through the hard tissue inside the tooth (dentin) and extends from the crown (top) of the tooth down to the tip of the root in the jaw bone.
Endodontic procedures are used in the diagnosis and treatment of oral pain involving the pulp and periradicular area (just outside or around the root of the tooth origin). Pulp therapy, such as pulpotomy, is a common procedure in which dental pulp is removed from the pulp chamber. The nonsurgical treatment of root canals, especially in difficult cases such as teeth with blocked, narrow or unusually positioned canals, also is a major part of endodontic therapy. Endodontic treatment may also be required for surgical removal of diseased or abnormal (pathologic) tissues, repair procedures associated with the surgical removal of pathologic tissues, repair of cracked teeth or the replacement (replantation) of teeth knocked out (avulsed) by injury.
Additional procedures include:
Surgical removal of tooth structure, such as an apicoectomy, or root-end resection (the removal of the root tip and the surrounding infected tissue of an abscessed tooth), hemisection (the process
of cutting a tooth with two roots in half) and bicuspidization (procedure to change tricuspid valve into a functioning bicuspid valve)
Endodontic implants, which extend through the root canal into the periapical bone structure (tip or apex of the root of a tooth), whereas other types of tooth implants are anchored directly in the gums or jawbones.
Bleaching of dentin and enamel
Retreatment of teeth previously treated endodontically
Placement of posts and/or cores to save and strengthen teeth
Signs and Symptoms-
Significant tooth discomfort or pain
Prolonged tooth sensitivity to hot and cold
Gum tenderness to the touch and when chewing
Drainage and tenderness in the lymph nodes, jaw bone and gingival tissues
If a root canal procedure is not performed, an abscess (infected pus pocket) can form at the tip of the tooth root that can be painful. Even if there is no pain, the bone holding the tooth in the jaw can be damaged.
When is Treatment Appropriate?
Endodontic treatment is necessary when the dental pulp becomes inflamed or infected as a result of deep tooth decay, repeated dental procedures on the tooth or a crack, chip or other injury to the tooth.
Tooth extraction is not necessary unless:
Roots are severely fractured
The tooth does not have adequate bone support
The tooth cannot be restored
Root canals are not accessible
Do you have questions about our services?
Contact us by phone at 843.554.4545.