Dental Services

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Emergency Dental Treatment

We can treat a variety of traumatic dental injuries, including teeth that have been chipped, moved, or knocked out entirely. Please call our office for assistance.

Regular dental visits are essential to make sure oral health problems — from tooth decay to oral cancer — are detected and treated in a timely manner. At our office, your oral health is our paramount concern. We want to make sure your teeth stay healthy, function well and look great! From regular cleanings and exams to advanced restorative treatments, all of your routine dental needs can be met right here.

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Bonding

 

Bonding uses tooth-colored materials to replace missing tooth structure or hide chips, discoloration, and even minor spacing issues. The tooth-colored material actually bonds, or becomes one, with the rest of the tooth, and blends seamlessly with your natural tooth. 

 

 

 

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Crowns & Bridge

Dentistry is an art as well as a science; dental crowns offer a perfect example of this. A dental crown is a covering that fits over a damaged, decayed or unattractive tooth.

Crowns strengthen damaged teeth, allowing them to function normally again. When crafted from today's high-tech porcelains (dental ceramics), crowns are virtually indistinguishable from natural teeth. They can even be designed to improve upon a tooth's original appearance.

Crowning a Tooth

Crowning a tooth will usually take two to three visits. At the first visit, your tooth is prepared to receive its new crown. First, it is shaped to fit inside the new covering. After the tooth is prepared, impressions of your teeth are taken and sent to the lab.  We will make a temporary crown to protect your tooth until your permanent crown comes in.

At the second visit, your permanent crown will be attached to your tooth.

Bridges

Crowns can also be used to create a lifelike replacement for a missing tooth. This is done with bridgework, which spans the space of the missing tooth and requires at least three crowns. Two of those crowns will be placed over healthy teeth on either side of the missing tooth. The two crowned teeth become support for a third crown placed in between them.

 

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Implant Dentistry

Of all the ways modern dentistry has to replace missing teeth, dental implants are by far the best. Implants help preserve tooth-supporting bone that naturally deteriorates when a tooth is lost. Loss of bone is one of the major hidden consequences of losing teeth.

Tooth Replacement Options Using Dental Implants

Implants can replace missing teeth in a variety of ways. They can be used to:

Replace One Tooth — When you have one tooth missing, a single implant is inserted into the bone to replace the root part of that tooth; a crown then goes on top to replace your missing tooth. This treatment choice has the highest success rate, making it the best long-term investment for replacing a single missing tooth. Even if the initial cost is slightly higher than other options, it is the most cost-effective solution over time.


Replace Multiple Teeth — When you have more than one tooth missing, implants are, again, by far the best treatment option. You don't even need one implant for every missing tooth. Implants can be used for bridges as well. For example, if you are missing three teeth in a row, we can place two implants, one on either side of the gap, and a crown in between that has no implant underneath. That way, you won't need to use any of your remaining natural teeth as bridge supports, which could weaken them and make them more susceptible to decay.

Replace All Teeth Permanently — Implants can support an entire arch of upper or lower replacement teeth that are fixed into the mouth and are never removed. It's the next best thing to natural teeth.

Support Removable Dentures — Implants can even make removable dentures more comfortable, effective and healthier to wear. Without implants, dentures can slip and make it hard to eat and speak. Implants "anchor" the dentures in place, making eating easier; it is also better for your jawbone because the implant slows bone loss.

Implant Care and Maintenance

There are only two ways an implant can lose attachment to the bone and fail once it has successfully fused: poor oral hygiene or excessive biting forces. Poor oral hygiene and/or a lack of regular cleanings can lead to a destructive bacterial infection called peri-implantitis. Flossing and brushing your teeth on a daily basis, along with regular professional cleanings, can prevent this. Excessive biting forces can come from the habit of clenching or grinding your teeth. If you are like so many of us, and have an issue with clenching/grinding, an NTI or night guard should be worn to help protect your investment.

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Fillings

About 78% of us have had at least one cavity by the time we reach age 17, according to a 2000 report by the U.S. Surgeon General. Fortunately, if treated early enough, there is a simple solution. Fillings. 

The decay will be removed from your tooth, and a tooth colored material (composite) will be placed in the hole to replace the tooth structure.

 

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Oral Cancer Screening

 

Although oral cancer may not get as much attention as some more widely-known types of cancer, that doesn't mean it's any less deadly. In fact, it is estimated that in the United States, oral cancer is responsible for killing one person every hour, every day. While it accounts for a relatively small percentage of all cancers, oral cancer is dangerous because it isn't usually detected until it has reached an advanced stage. At that point, the odds aren't great: only about 6 in 10 people will survive after five years of treatment.

 

If there was a simple test that could give you an early warning about whether you're likely to have this disease, would you take it? The good news is — there is! Since early detection has been shown to increase the survival rate of oral cancer to 80% or better, this test can truly save lives. And best of all, having an oral cancer screening is part of something you should be doing anyway: getting regular dental checkups.

 

An oral cancer examination is fast and painless. Its objective is to identify small changes in the lining tissues of the mouth, lips and tongue that may signify the early stages of this type of cancer. The screening is primarily a visual and tactile (touch) examination. If any abnormalities are noted, a small tissue sample can be retrieved for further testing in a laboratory.

 

Who's At Risk for Developing Oral Cancer?

 


The answer might surprise you. Oral cancer used to be thought of as an older person's disease, and it still mostly affects those over 40. But today, younger people form the fastest-growing segment among oral cancer patients. This is primarily due to the spread of the sexually-transmitted Human Papilloma Virus (HPV16).

 

Of course, the other major risk factors still apply: If you're middle aged or older, a moderate to heavy drinker or a long-time tobacco user, you have a greater chance of developing oral cancer. Chronic exposure to the sun, long known to cause skin cancer, is also associated with cancers of the lips. Genetic factors are thought to have a major impact on who gets the disease as well.

 

Detecting Oral Cancer

 


Oral cancer screening.A thorough screening for oral cancer is part of your routine dental checkup — another reason why you should be examined regularly. The screening includes a visual assessment of your lips, tongue, and the inside of your mouth, including a check for red or white patches or unusual sores. You may be palpated (pressed with fingers) to detect the presence of lumps and swellings, and your tongue may be gently pulled aside for an even better view. A special light, dye, or other procedure may also be used to help check any suspect areas. If anything appears to be out of the ordinary, a biopsy can be easily performed.

 

If you notice abnormal sores or color changes in the tissue of your mouth, lips and tongue, they may be a symptom of oral cancer — most, however, are completely benign. But sores or other unusual changes that haven't gone away by themselves after 2-3 weeks should be examined. Remember, the only way to accurately diagnose oral cancer is through a laboratory report. Early diagnosis, aided by thorough screenings at your regular dental checkups, is one of the best defenses against oral cancer.

 

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6 Month Smiles

Straight Teeth. Less Time. Clear Braces for Adults.

Are you uncomfortable when you smile? Chances are. if you're reading this, your smile isn't something that you are proud of. Regardless of age or gender, EVERYONE, should be able to smile with confidence. Using a revolutionary orthodontic technology, Six Month Smiles provides an efficient and economical way to get the smile you have always dreamed of. 

Conventional metal braces are usually worn for 2-4 years and can often times be embarrassing for adults. Six Month Smiles treatment is completed, on average, in just six months and are barely noticeable. 

Imagine having straight teeth before your next cleaning appointment!

Call today to set up a FREE consultation! 

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Periodontal Therapy - Treatment of Gum Disease

It is not a given that we must lose teeth as we age. If we maintain good oral hygiene and have regular professional cleanings and oral examinations, chances are we can keep our natural teeth for life. That involves not only caring for the teeth themselves, but also the structures that surround them: the gums and tooth-supporting bone. Gum disease, which is a bacterial infection, threatens these supporting tissues. That is why dental professionals are always on the lookout for early signs that patients may not notice. When signs of trouble become apparent, periodontal therapy may be suggested.

Periodontal therapy can take various forms, but the goal is always to restore diseased tissues to health. Gum (periodontal) disease can spread from the gums to the bone that supports the teeth, and may even cause tooth loss in the most severe cases. There are very effective therapies to combat this, ranging from scalings (deep cleanings) that remove plaque and calculus (tartar) from beneath the gum line, to surgical repair of lost gum and bone tissue.

Periodontal Therapy Procedures

Periodontal therapy includes both surgical and non-surgical techniques to restore health to the tissues that support the teeth (gums and bone) and prevent tooth loss. They include:

Scaling and Root Planing. These deep-cleaning techniques are the best starting point to control gum disease. Plaque and calculus (tartar) are removed from beneath the gum tissues, using hand scalers and/or ultrasonic instruments.

Your Role in Periodontal Health

Dental plaque is the main cause of periodontal disease, so it's essential to remove it every day with effective brushing and flossing. This doesn't mean scrubbing, which can actually cause your gums to recede. Proper techniques can be demonstrated for you, if you have any questions.

Of course, there are some areas of the mouth that a toothbrush and floss just can't reach, which is why it's so important to have regular professional cleanings at the dental office. Your regular dental exam is also a time when early signs of gum disease can be detected — before they become apparent even to you.

Eating a nutritious diet low in sugar, and staying away from tobacco in all forms, will also increase your periodontal health — and your chances of keeping your teeth for life.

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Porcelain Veneers

You may already know that a veneer is a thin covering over another surface. In dentistry, a veneer is a wafer-thin layer of super-strong porcelain that convincingly substitutes for natural tooth enamel. When bonded to your teeth, veneers can create a natural-looking, beautiful new surface. That's because dental porcelain, like natural tooth enamel, is translucent and tough. But it doesn't stain like tooth enamel does.

Recent years have brought remarkable advances in dental porcelain technology. These days, veneers can be made so thin that they can sometimes be bonded directly onto your existing tooth surface. In other cases, a very thin layer of tooth enamel — as thin as the veneer itself — needs to be removed to fit the new porcelain surface and make it look as lifelike as possible. Either way, the results are sure to make you smile.

Versatility of Porcelain Veneers

Veneers can be used to improve any of the following characteristics of your teeth:
Color — Teeth can become stained by the foods and drinks we like, from smoking, and even normal aging. Veneers are available in numerous shades, from the most natural to the brightest Hollywood white.
Size & Shape — Teeth can become worn down from grinding habits, or may not have the shape or size you want to begin with. For example, some people consider rounder teeth more feminine and squarer teeth more masculine. Veneers can be shaped and sized in whichever way is most flattering to your face.
Alignment & Spacing — Veneers can be used to close small gaps between teeth or make slight corrections in alignment while improving tooth color and shape.

Limitations of Porcelain Veneers

There are some situations in which veneers would be inappropriate. For example, if you have significantly misaligned teeth or a large gap, orthodontics might be a more appropriate solution than veneers. And if you have lost a lot of tooth structure from decay or trauma (or a particularly severe grinding habit), it might be better to restore your teeth with porcelain crowns that cover the entire tooth.

Creating a New Smile with Porcelain Veneers

The first step in creating a new smile with porcelain veneers is to communicate exactly what you don't like about your smile as it is now. It's a great idea to bring in pictures of smiles you do like, as a starting point for discussion. It's possible to see how veneers would look on your teeth in one of several ways. A model of your teeth can be created over which wax “veneers” can be placed; sometimes acrylic (plastic) or tooth-colored filling material can be placed directly onto your teeth to demonstrate the effect veneers would have on them.

Once the plan has been agreed upon, your teeth will be prepared by removing a small amount of enamel, if this step is necessary. Molds of your teeth will be taken and used by a skilled dental laboratory to create your veneers, and you will receive a temporary set of veneers to wear during the few weeks it will take to create your permanent veneers. When the veneers come back from the lab, they will be cemented onto your teeth.

Caring for Your Veneers

Just like the teeth nature gave you, teeth restored with veneers need gentle brushing and flossing every day. This will remove dental plaque and ensure good gum tissue health around the veneers. Regular checkups at the dental office will remain as important as always to your oral and general health. And keep in mind that as tough as veneers are, they may not be able to withstand forces that come from using your teeth as tools (to open packages, for example) or biting into very hard foods like candy apples — which isn't good for your natural teeth, either! And if you grind or clench your teeth at night, you might be advised to get a custom-made nightguard to protect your veneers — and your investment.

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Professional Teeth Cleanings

Even if you brush and floss your teeth faithfully, it is important that you have your teeth professionally cleaned on a regular basis. (Of course, if you aren't quite so meticulous about your oral hygiene, it's even more important!) After a thorough cleaning, your teeth will feel smooth and squeaky-clean, and they will probably look a lot brighter too. But professional teeth cleanings aren't done for looks alone.

Why do your teeth need this kind of attention? Essentially, it's because over time they tend to build up a layer of plaque (a sticky, bacteria-rich film) and hard deposits (called tartar, or calculus) that are very difficult to remove without special tools. When these deposits are allowed to remain on the tooth surfaces or below the gum line, they provide ideal conditions for bacteria to grow and multiply. The acids produced by some bacteria cause tooth decay and gum disease; if left uncontrolled, this can lead to inflammation and infection of the gums, and possibly influence systemic (whole body) diseases.

Dentists have a special term for preventive procedures like tooth cleaning: prophylaxis, from the Greek word meaning to protect or guard against. In this case, the focus is on preventing tooth decay and gum disease. Performed in conjunction with a routine dental examination, a professional cleaning can go a long way toward controlling these two common maladies. While your teeth are being cleaned, it's also a good opportunity to take a close look at your oral health in general and check for a few specific problems.

The Professional Cleaning Procedure

Teeth cleaning is often performed by a dental hygienist — a highly trained technician who uses a special set of tools designed just for this purpose. Because everyone's teeth are a little different, your cleaning will be tailored to your particular needs. However, many cleanings follow a similar pattern.

First, the dental hygienist will do an oral examination to evaluate the health of your oral tissues. Then the cleaning will take place using either an ultrasonic scaler or metal instruments referred to as curettes to remove the plaque and calculus from the tooth surfaces. The ultrasonic scaler is a hand-held tool with a tiny tip that vibrates at a very high frequency. Hardened deposits are broken up by the rapid movement of the tip, which does not damage the tooth. A constant stream of liquid (called lavage) serves to cool the tip and aid in plaque removal; at the same time, it also washes away the debris.

Some hygienists prefer curettes, which are hand-held instruments that are curved and tapered to fit around and in between the teeth. If your teeth are sensitive, using hand-held instruments may be more comfortable for a professional cleaning. In the capable hands of a hygienist or dentist, it takes only moderate pressure to remove any stubborn buildup and scrub the teeth clean, regardless of which instruments are used.

Finally, your teeth are polished with a low-speed rotary brush fitted with a soft rubber tip. A slightly gritty, toothpaste-like gel is applied, and the tip spins around and polishes the teeth, making them smooth and shiny.

A Requirement for Good Oral Health

Most people don't feel any noticeable discomfort during dental cleanings; some even report they enjoy the experience — especially the dramatic results when it's done! If you haven't had a cleaning in a while, however, it may take you a few moments to get used to getting your teeth cleaned. If you experience any discomfort, however, it may be possible to apply a topical numbing gel or another type of anesthetic.

If your gums are irritated due to bacterial buildup, they may become sore or bleed slightly during the cleaning. It may be possible to prevent this from occuring in the future with oral hygiene measures you can perform at home (such as improved flossing techniques or special mouthrinses); it might also indicate that you need more frequent in-office cleanings. This type of regular maintenance will help you avoid more involved dental procedures down the road — and it will give you the best chance of keeping your teeth for life!

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Removable Dentures

Full or partial tooth loss, if left untreated, doesn't just affect a person's self-image — it can also increase the risk of developing nutritional problems and other systemic health disorders. Fortunately, there's a reliable and time-tested method for treating this condition: full or partial dentures.

Dentures are just one option for replacing missing teeth; some of the others include fixed bridgework and dental implants. Each method has its particular pluses and minuses, which should be carefully considered. There are also several varieties of dentures available to address specific issues, from partial dentures to implant-supported overdentures. The best option for you will depend on your individual situation.

How Do Removable Dentures Work?

Full or partial dentures consist of a gum-colored base made of plastic resin, which fits over the remaining alveolar (bone) ridge that formerly held the teeth. The prosthetic teeth projecting from the base are designed to look and function just like your natural teeth. Dentures are held in place primarily by the suctioning effect of their close fit against the alveolar ridges — that's why it's so important that they are fitted properly. The upper denture also gets extra support from the large surface area of the roof of the mouth (palate), which generally makes it extremely stable.

At first, wearing dentures may require some getting used to in terms of talking and eating, as the dentures become “balanced” in the space formerly occupied by the teeth. But over time, the muscles, nerves and ligaments of the mouth learn to work in new ways, which allows these functions to occur normally. Dentures also help support the facial skeleton and the soft tissues of the lips and cheeks, which can help create a more youthful appearance.

Types of Full Dentures

Removable denture types.Immediate Dentures: These are usually a temporary means of helping you transition to successful denture wearing. Because of the muscular readjustment required, as well as the natural shrinkage of gums, the dentures which are placed immediately after tooth extraction won't fit as well as permanent dentures made when the healing is complete. They do, however, provide you with new teeth right away, and give you time to adjust.

Conventional Full Dentures: After a period of time, permanent dentures that conform to your mouth with near-perfect accuracy can be fabricated. These are carefully crafted to look as much like your own natural teeth as possible, and are able to function properly in your mouth for a long time.

Implant-Supported Overdentures: To increase the stability of a lower or upper denture, it's possible for it to be securely anchored using two or more dental implants. The upper jaw requires more implants (generally three or more) than the lower jaw due to a lesser bone density. Many people find this option offers a great balance of comfort, functionality and value.

Types of Partial Dentures

Transitional Partial Dentures: These relatively inexpensive removable plastic dentures serve as a temporary tooth replacement and space maintainer as you wait for your mouth to heal from tooth extraction, for example. Once the healing process is complete, dental implants can be placed.

Removable Partial Dentures (RPDs): Usually made of cast vitallium, these well-constructed, metal-based removable partial dentures are much lighter and less obtrusive than those made of plastic. They are a little more expensive than plastic dentures but will fit better. They are, however, much less expensive than implants or fixed bridgework.

How Dentures Are Made and Fitted

Lab making denture.Making quality dentures is a blend of science and art. First, an accurate impression (mold) is made of the alveolar ridges on the top and bottom of your mouth. The base of the denture is made from this mold in a dental laboratory. Working together, the dentist and lab technician choose from among many different sizes and shapes of prosthetic teeth to re-create a natural-looking smile. When everyone is satisfied with the result, the temporary dentures are made in permanent form.

To enable normal speech and eating, it's crucial to balance your bite. This means that the upper and lower dentures come together and properly stabilize each other. The form and function of the dentures are carefully checked to ensure that they are working and fitting properly.

What to Expect After You Get Dentures

If you've recently lost your teeth and received an immediate denture, it's normal to find some tissue shrinkage and bone loss occurring. Therefore, in several months you may find that your immediate dentures no longer fit well. You will have two choices at this point: You can have your immediate (temporary) dentures re-lined. This means that material is added under the denture's base to better conform to the new contours of your alveolar ridge. A better option is to move to a set of conventional full dentures, which will last longer and fit better. With proper care, dentures offer a functional, aesthetic and economical solution to the problem of tooth loss.

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Root Canal Treatment

Healthy Tooth.Root canal treatment — also called endodontics (“endo” – inside, “dont” – tooth) — is a set of specialized procedures designed to treat problems of the soft pulp (nerve) tissue inside the tooth. While some mistakenly think of it as an unusually painful treatment, in most cases the procedure is no more uncomfortable than getting a filling. It's actually one of the most effective ways of relieving some kinds of tooth pain.

A root canal procedure becomes necessary when infection or inflammation develops in the pulp tissue of the tooth. Pulp tissue consists of blood vessels, connective tissue and nerve cells — which explains why a problem here may cause you to feel intense pain. In time, the pain may go away... at least temporarily. Without treatment, however, the infection won't. It can lead to a dental abscess, and may even contribute to systemic problems in other parts of the body.

Root Canal Treatment Is Your Friend

We've all heard the gag: “I'd rather have a root canal...” This comedy line, comparing the procedure to something truly undesirable, may be funny — but putting off needed endodontic treatment is no joke. The idea that a root canal procedure invariably comes with complications and pain is a shopworn myth. It's certainly true that infection or inflammation in the tooth's pulp can be excruciatingly painful. But you should remember that having a root canal results in eliminating this acute pain and is not the cause of the pain.

Need another reason not to delay root canal treatment? How about this: A natural tooth that's saved via root canal treatment and restoration helps you avoid the problems that commonly occur when teeth must be removed. These include unwanted tooth migration or shifting, which can lead to difficulties in chewing; the need for bridgework or dental implants, which may be costly and complicated; and even the eventual loss of bone structure from the area of the missing tooth.

Causes of Root Canal Problems

Root canal problems stem from infection and inflammation of the tooth's pulp tissue. One potential cause of infection is deep tooth decay. Untreated dental cavities eventually allow bacteria to work their way down to the center of the tooth, where they may infect the pulp tissue. Another path by which bacteria may come into contact with pulp is via chipped or cracked teeth. Any opening in the protective enamel coating has the potential to allow bacteria access to the tooth's pulp.

Trauma to the tooth — the kind that might result from a sports injury or automobile accident, for example — is also a major cause of pulp tissue damage. In this case, it's essential to seek treatment immediately, both to try and save the tooth, and to prevent future problems.

In some cases, extensive dental work itself may cause damage to the pulp tissue that will need to be treated via a root canal. Having multiple fillings or restorations on the same tooth increases the chances of this type of injury. Occasionally, common procedures like crown preparation or orthodontics may eventually lead to root canal problems.

What to Expect During Root Canal Therapy

If an examination shows that you do need root canal therapy, don't worry — it's one of the most routine and effective procedures in the arsenal of dental treatments and can often be accomplished in just one visit.

The root canal process generally begins the same way as a filling does, and with no greater discomfort: an anesthetic is administered to numb the tooth and the surrounding area. For many patients, the worst is already over.

Tooth after root canal treatment.

Next, a small opening is made in the surface of the affected tooth to give access to the pulp chamber and root canals. Tiny instruments are used, sometimes with the aid of a microscope, to remove the dead and dying pulp tissue from inside these narrow passageways. The chamber and empty canals are then cleaned, disinfected, and prepared to receive a filling of inert, biocompatible material. Finally, adhesive cement is used to seal the opening in the tooth, preventing future infection.

Following root canal treatment, your tooth may feel some sensitivity or tenderness for a few days. Over-the-counter pain relievers like ibuprofen are generally effective in relieving discomfort, but prescription medications may also be given if needed. During this period, it may help to avoid biting hard on the affected tooth. All of these symptoms, however, should be temporary.

To further protect the tooth and restore it to full function, it's usually necessary to have a crown or other restoration placed on it. Restorations can take many forms, from traditional gold crowns to tooth replicas made of high-tech tooth-colored material. In any case, you will have made an investment in preserving your dental health for years to come.

Signs and Symptoms of Root Canal Problems

How do you know when you need a root canal? Sometimes, it's painfully obvious. If you feel constant and severe pain and pressure in your mouth, or noticeable swelling and extreme sensitivity in your gums, then it's clear you need an evaluation and treatment right away. Another telltale symptom of pulp tissue damage is sharp pain when you bite down on food. Lingering pain after eating hot or cold foods is also an indication of potential trouble. If you notice any of these symptoms, you need to have an examination as soon as possible.

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Sealants

The most likely location for a cavity to develop in your child's mouth is on the chewing surfaces of the back teeth. Run your tongue over this area in your mouth, and you will feel the reason why: These surfaces are not smooth, as other areas of your teeth are. Instead, they are filled with tiny grooves referred to as “pits and fissures,” which trap bacteria and food particles. The bristles on a toothbrush can't always reach all the way into these dark, moist little crevices. This creates the perfect conditions for tooth decay.

What's more, a child's newly erupted permanent teeth are not as resistant to decay as adult teeth are. The hard enamel coating that protects the teeth changes as it ages to become stronger. Fluoride, which is found in toothpaste and some drinking water — and in treatments provided at the dental office — can strengthen enamel, but, again, it's hard to get fluoride into those pits and fissures on a regular basis. Fortunately, there is a good solution to this problem: dental sealants.

Dental sealants are invisible plastic resin coatings that smooth out the chewing surfaces of the back teeth, making them resistant to decay. A sealed tooth is far less likely to develop a cavity, require more expensive dental treatment later on, or, most importantly, cause your child pain.

How Sealants Are Placed

You can think of a sealant as a mini plastic filling, though please reassure your child that it doesn't “count” as having a cavity filled. Because tooth enamel does not contain any nerves, placing a sealant is painless and does not routinely require numbing shots. First, the tooth or teeth to be sealed are examined, and if any minimal decay is found, it will be gently removed. The tooth will then be cleaned and dried. Then a solution that will slightly roughen or “etch” the surface is applied, to make the sealing material adhere better. The tooth is then rinsed and dried again. The sealant is then painted on the tooth in liquid form and hardens in about a minute, sometimes with the help of a special curing light. That's all there is to it!

A note about BPA: A 2012 study that received wide press coverage raised concerns that trace amounts of the chemical bisphenol-A (BPA) found in some (but not all) dental resins might contribute to behavioral problems in children. The study authors noted that while they had found an association, they had not actually proven that BPA in dental sealants causes these problems. In fact, BPA is far more prevalent in food and beverage packaging than in dental restorative materials. The American Academy of Pediatric Dentistry and the American Dental Association have since reaffirmed their support for the use of sealants.

Taking Care of Sealants

Sealed teeth require the same conscientious dental hygiene as unsealed teeth. Your child should continue to brush and floss his or her teeth daily and have regular professional cleanings. Checking for wear and tear on the sealants is important, though they should last for up to 10 years. During this time, your child will benefit from a preventive treatment proven to reduce decay by more than 70 percent.

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Teeth Whitening

It's hard to imagine anything more appealing than a sparkling, white smile. Yet our teeth rarely stay as white as we'd like them to without a little help. Fortunately, that help is available at the dental office.

Teeth whitening done in a professional dental setting is a safe, effective way to brighten your smile. It's also perhaps the most economical cosmetic dental procedure. Depending on the whitening method you choose, results can be dramatic: in-office whitening, for example, can lighten teeth three to eight shades in a single hour.

Professionally supervised whitening will work faster, and protect sensitive gums and tooth-root surfaces better, than over-the-counter whitening products. Having an oral exam before you begin any whitening process is an important first step to make sure your tooth discoloration is not the result of a dental condition in need of treatment. Also, please be aware that it can be risky to have whitening solutions applied to your teeth by untrained personnel in shopping malls. If you have any questions about which whitening method would be best for you, talk to us first.

Professional Whitening Methods

Professional whitening makes use of high-concentration bleaching gels that are not available over the counter.

In-Office Whitening — This technique offers the fastest results with the most powerful whitening solutions available. First, your gums and tooth-root surfaces will be covered with a protective barrier to ensure your safety. A thin plastic device known as a retractor will hold your lips and cheeks away from your teeth as a professional-strength hydrogen peroxide gel is applied. The gel will be left on for about an hour. When it is removed, the results will be obvious immediately.

Take-Home Whitening — This is another effective way to whiten your teeth, though you will play a greater role in ensuring the best possible results and several weeks may be needed to achieve your desired level of whiteness. First, a mold of your teeth will be taken and then two thin, flexible plastic mouth trays will be custom-made for you — one for the top teeth and one for the bottom. You will fill the trays with whitening gel and then position the trays over your teeth. The trays are left in usually for about an hour at a time.


Caring for Your Whitened Smile

There are lots of things you can do to make sure your whitening results last as long as possible, and this will vary from person to person (six months to two years or even longer). First of all, please maintain your usual, conscientious routine of brushing and flossing every day, and keep up with your regular schedule of professional cleanings at the dental office. Avoid foods and beverages that stain, including red wine, tea and coffee. If you smoke, use your newly whitened teeth as an impetus to quit — a good idea in any event! A minor touch-up every so often, either at home or at the dental office, can keep your smile bright and beautiful for years.

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TMJ/TMD Treatment

If you experience ongoing pain in the area near your ear, your jaw or the muscles on the side of your face, possibly accompanied by a clicking or popping sound or restricted jaw movement, you may be suffering from TMD — an abbreviation for Temporomandibular disorders. Sometimes people incorrectly use the term TMJ to refer to these problems, when in fact TMJ is the abbreviation for the temporomandibular joint — or jaw joint — itself. So while you definitely have a TMJ (two of them in fact), you may or may not have TMD.

TMD, then, describes a group of conditions characterized by pain and dysfunction of the TMJ and/or the muscles surrounding it. It's not always so easy to figure out exactly what's causing these symptoms, but the good news is that most TMD cases resolve themselves with the help of conservative remedies that you can try at home. In fact, it's important to exhaust all such reversible remedies before moving on to anything irreversible, such as bridgework or surgery.

The two TMJs that connect your lower jaw, the mandible, to the temporal bone of the skull on either side, are actually very complex joints that allow movement in three dimensions. The lower jaw and temporal bone fit together as a ball and socket, with a cushioning disk in between. Large pairs of muscles in the cheeks and temples move the lower jaw. Any of these parts — the disk, the muscles or the joint itself — can become the source of a TMD problem. If you are in pain, or are having difficulty opening or closing your jaw, a thorough examination can help pinpoint the problem area; then an appropriate remedy can be recommended.

Causes of TMD

As with any other joint, the TMJ can be subject to orthopedic problems including inflammation, sore muscles, strained tendons and ligaments, and disk problems. TMD is also influenced by genes, gender (women appear to be more prone to it), and age. Physical and psychological stress can also be a factor. In some cases, jaw pain may be related to a more widespread, pain-inducing medical condition such as fibromyalgia (“fibro” – connective tissues; “myo” – muscle; “algia” – pain).

Signs and Symptoms of TMD

Clicking Sounds — Some people with TMD hear a clicking, popping or grating sound coming from the TMJ when opening or closing the mouth. This is usually caused by a shifting of the disk inside the joint. Someone standing next to you might even be able to hear it. Clicking by itself is actually not a significant symptom because one third of all people have jaw joints that click, studies show. However, if the clicking is accompanied by pain or limited jaw function — the jaw getting “stuck” in an open or closed position, for example — this would indicate TMD.

Muscle Pain — This can be felt in the cheeks (masseter muscles) and temples (temporalis muscles), where the two big pairs of jaw-closing muscles are located. If you feel soreness and stiffness upon waking up in the morning, it's often related to habits such as clenching and/or grinding the teeth at night. If you have this type of nocturnal habit, a custom-made nightguard should be very helpful in decreasing the force applied to your teeth, which will in turn allow your muscles to relax and relieve pressure on your jaw joints. Other self-care remedies are discussed below (please see Relieving the Pain).

Joint Pain — Pain that's actually coming from one or both jaw joints technically would be described as arthritis (“arth” – joint; “itis” – inflammation) of the TMJ. Radiographs (x-ray pictures) show that some people have arthritic-looking TMJs but no symptoms of pain or dysfunction; others have significant symptoms of pain and dysfunction but their joints look normal on radiographs. There is no cure for arthritis anywhere in the body, but medication can sometimes help relieve arthritic symptoms.

Relieving the Pain

Once you have been examined, a strategy for treating your condition and managing your pain can be developed. Sometimes a temporary change to a softer diet can reduce stress on the muscles and joints. Ice and/or moist heat can help relieve soreness and inflammation. Muscles in spasm can also be helped with gentle stretching exercises. Non-steroidal anti-inflammatory medications and muscle relaxants can also provide relief.

Other Treatment Options

Severe TMD cases may require more complex forms of treatment, which might include orthodontics, dental restorations like bridgework, or minor procedures inside the joint such as cortisone injections or lavage (flushing) of the joint. It's rare for major surgery ever to be necessary in a case of TMD. Again, it's important to try the wide range of conservative, reversible treatments available, and give them enough time to work as they almost always prove effective. The first step is an examination at the dental office. To learn more about available treatment options, view this Chart on TMD Therapy

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Extractions

The main goal of dentistry is to preserve your natural teeth and keep them healthy for as long as possible. There are times, however, when it is in your best interest (or your child's) to have a tooth extracted (removed). This could be the case for a variety of reasons. Perhaps you have a tooth that has been severely damaged by trauma or decay; or an impacted wisdom tooth that may cause trouble for you later on. Maybe your teenager will soon undergo orthodontic treatment and has insignificant space for his adult teeth, referred to as crowding. Or your younger child has a baby tooth that's stubbornly adhering, even though it's past time for it to go.

Whatever the reason, tooth extraction is more often than not a very routine procedure. How straightforward this minor surgery is will depend on where the tooth to be extracted is located in the mouth, and what its roots are like. For example, a front tooth with a single straight root is easier to remove than a molar with multiple roots. This is especially true when that molar is a wisdom tooth that is impacted, meaning it is below the surface surrounded by gum tissue and bone. Often, a wisdom tooth is blocked from fully erupting (growing in) by other teeth in its path.

Still, tooth extraction is nothing to be feared when done by an experienced hand. Keep in mind that a tooth is not rigidly fixed in its surrounding bone, though that's how some may picture it. In fact, it is attached to the bone via a network of fibers that form what's known as the periodontal ligament. By carefully manipulating the tooth, these fibers can be detached and the tooth freed without much trouble.

Reasons for Extracting a Tooth

As mentioned above, there can be a variety of reasons for extracting a tooth. Be sure to ask questions about the pros and cons of any dental treatment, including extraction.

Trauma or Disease — In both of these situations, there are several ways to try and save the tooth. The damaged tooth might need a full-coverage crown, a root canal treatment, or both. But sometimes even these methods are not enough to keep the tooth functioning well and looking good; it might be better to remove the tooth and replace it with a strong and lifelike dental implant.

Orthodontic Treatment — Teeth are sometimes extracted when there are too many of them for the size of the dental arches (jaws), a situation known as crowding. After an adequate amount of space is opened up through the extraction of one or more teeth, the remaining teeth can be aligned properly. The teeth most frequently removed for orthodontic reasons are the first premolars, which are right next to the eyeteeth (canines).

Impacted Wisdom Teeth — Early removal of impacted wisdom teeth can prevent damage to neighboring healthy teeth, bone, gum tissue, even nerves and blood vessels. If an impacted wisdom tooth is in a bad position, it's best to remove it before its roots are fully formed.

Baby Teeth — If a baby tooth is out of position or not lost in the right sequence, the permanent tooth underneath it might not erupt normally. In this case, removing the baby tooth could prevent a need for orthodontic treatment later on.

The Process of Extracting a Tooth

The first step in any extraction is a radiographic (x-ray) examination to assess the position of the tooth roots and the condition of the surrounding bone. This will allow any possible complications to be anticipated. A thorough medical and drug history is taken, to ensure that you are healthy enough to undergo the procedure, and your options for anesthesia will be discussed.

Tooth extraction is usually carried out with local anesthesia, which will numb the teeth to be removed, and the surrounding bone and gum tissues. Additional sedatives might also be used, including oral sedatives (taken in pill form), nitrous oxide (which is inhaled) and/or conscious sedation, which is given intravenously (into a vein). The latter is usually required for more complicated (or multiple) tooth extractions. By the time the sedation medication has worn off, you won't even be aware that the surgery was done.

As your tooth is being removed, steps are taken to ensure the bone that surrounds it isn't damaged. Sometimes, in the process of removing a tooth, a small amount of lab-processed bone-grafting material is placed into the socket to help preserve the bone volume there. This is particularly important when the extraction is going to be followed at some point by the placement of a dental implant, which needs to fuse to existing bone, or orthodontics, which gently moves teeth through bone.

What to Expect After Tooth Extraction

Immediately after your tooth is extracted, the socket will be covered with sterile gauze; gentle pressure will be applied for 10-20 minutes to control any bleeding. Small sutures (stitches) might also be used for this purpose. It's normal to experience some mild to moderate post-operative discomfort and/or swelling. Taking non-steroidal, anti-inflammatory drugs such as ibuprofen and/or aspirin the day of surgery should control most symptoms. Antibiotics may also be prescribed to ensure infection-free healing. Using ice packs on the outside of your jaw, and eating softer foods until you feel more comfortable can also be helpful. Within a few days, all should be back to normal.

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