A preventive program is a cooperative effort by the patient, dentist, and dental staff to preserve the natural dentition and supporting structures by preventing the onset, progress, and recurrence of dental diseases and conditions. Preventing dental disease starts at home with good oral hygiene and a balanced diet. It is continued in the dental office by the efforts of your dentist and dental hygienist to promote, restore, and maintain your oral health.

Prevention also includes regular dental exams, cleanings, and x-rays. Sealants and fluoride are also great preventive treatments that help protect the teeth. Prevention helps avoid serious and costly dental problems and is the key to having a healthy, confident, beautiful smile.

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

Cosmetic dental treatments can:

• Change the size, shape, and alignment of certain teeth.
• Fill in unattractive spaces between teeth.
• Improve or correct bites.
• Lighten or brighten the color of teeth.
• Repair decayed, broken, cracked, or chipped teeth.
• Replace missing teeth.
• Replace old, unattractive dental treatments.

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

The word periodontal means “around the tooth”. Periodontal disease attacks the gums and the bone that support the teeth. Plaque is a sticky film of food debris, bacteria, and saliva. If plaque is not removed, it turns into calculus (tartar). When plaque and calculus are not removed, they begin to destroy the gums and bone. Periodontal disease is characterized by red, swollen, and bleeding gums.

Four out of five people have periodontal disease and don’t know it! Most people are not aware of it because the disease is usually painless in the early stages.

Not only is it the number one reason for tooth loss, research suggests that there may be a link between periodontal disease and other diseases such as, stroke, bacterial pneumonia, diabetes, cardiovascular disease, and increased risk during pregnancy. Researchers are determining if inflammation and bacteria associated with periodontal disease affects these systemic diseases and conditions. Smoking also increases the risk of periodontal disease.

Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.

Signs and symptoms of periodontal disease:

• Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.
• Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).
• New spacing between teeth – Caused by bone loss.
• Persistent bad breath – Caused by bacteria in the mouth.
• Pus around the teeth and gums – Sign that there is an infection present.
• Receding gums – Loss of gum around a tooth.
• Red and puffy gums – Gums should never be red or swollen.
• Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.

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

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

Reasons for restorative dentistry:

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

Remember to give your teeth the attention they need today!

Orthodontics is a branch of dentistry specializing in the diagnosis, prevention, and treatment of jaw, face and bite irregularities (malocclusions*). Orthodontic treatment is provided by an oral health care provider known as an orthodontist, who has completed two to three years of additional training beyond dental school.

Recent years have brought about many changes within the dental industry, specifically with regards to orthodontic treatment and care. Now more than ever patients are experiencing fewer incidences of cavities and missing teeth due to the heightened awareness of fluoride use and preventative dentistry. This increasing awareness on the health and look of a patient’s smile has fueled the desire for many to seek out orthodontia not only as a medical necessity, but for cosmetic reasons as well.

Whether it’s traditional braces or custom made removable appliances, orthodontics can help you have the healthy, straight, beautiful smile you’ve been waiting for!

*Malocclusion is the technical term for teeth that don’t fit together correctly. Malocclusions not only affect the teeth, but also the appearance of the face. Most malocclusions are inherited; however some are due to acquired habits such as thumb sucking and tongue thrusting. The spacing left from an adult tooth being extracted or an early loss of a baby tooth can also contribute to a malocclusion.

Oral and maxillofacial surgeons are specialists with advanced training and expertise in the diagnosis and treatment of various head and neck conditions and injuries. After four years of dental school, an oral and maxillofacial surgeon completes four to six years of additional formal training in treating the craniomaxillofacial complex. This specialty is one of 9 dental specialties recognized internationally and by the American Dental Association (ADA).

An oral and maxillofacial surgeon can diagnose and treat a wide variety conditions. The following are just some of the many conditions, treatments and procedures oral and maxillofacial surgeon deal with on a daily basis:

• TMJ, Facial Pain, & Facial Reconstruction
• Dental Implants
• Tooth Extractions & Impacted Teeth
• Wisdom Teeth
• Misaligned Jaws
• Cleft Lip & Palate
• Apicoectomy
• Oral Cancers , Tumors, Cysts, & Biopsies
• Sleep Apnea
• Facial Cosmetic Surgery

Whether your dentist refers you to our office, you have pain or symptoms causing you concern, or you simply have questions you would like answered, please contact our office today to schedule an appointment. We are here to answer your questions and provide the treatment you deserve!

The term “periodontics” refers to the dental specialty that pertains to the prevention, diagnosis and treatment of periodontal disease that affects the gums and jawbone. The gum tissues serve to surround and support the teeth and the underlying jawbone anchors teeth firmly in place. Periodontists have completed several years of extra dental training and are concerned with maintaining the function, health and aesthetics of the jawbone and tissues.

Reasons for periodontal treatment

Periodontal disease is a progressive condition which begins with mild gum inflammation called gingivitis. It is the leading cause of tooth loss in adults living in the developed world, and should be taken very seriously. Periodontal disease (often called gum disease) is typically signified by red, swollen, painful, or bleeding gums, but in some cases has no noticeable symptoms.

Periodontal disease generally begins when the bacteria living in plaque cause an infection in the surrounding tissues of the teeth, causing them to become irritated and painful. Eventually, this infection will cause the jawbone to recede and the tooth to become loose.

There are several reasons why periodontal treatment may be necessary:

• Moderate / advanced gum disease – This occurs when the gums are bleeding, swollen or red around most teeth and the jawbone has begun to recede.
• Localized gum recession – The infection which propagates moderate or advanced gum disease often begins in one area. Gum recession may also be caused due to over brushing with a hard bristle brush, or due to a tooth that is not positioned properly. Immediate treatment is required to prevent further spreading.
• Before crown lengthening – The periodontist may lengthen the crown of the tooth by removing surrounding soft tissue to provide more tooth exposure.
• Ridge augmentation – This procedure, often called “recontouring” may be required to correct an uneven gum line. Before embarking on treatment, a periodontist needs to treat any bacterial infections and periodontitis.

In the case of mild/moderate periodontal problems, the focus of the periodontist will be on curing the underlying bacterial infection and then providing advice on the most appropriate home cleaning methods.

Sometimes a deep scaling is needed to remove the bacterial plaque and calculus (tartar) from the teeth and tissues. Where periodontal disease is advanced and the jawbone has regressed significantly, more intensive cleaning may be recommended and loose teeth that cannot be saved will be removed.

The periodontist is trained in all aspects of dental implant procedures, which can restore functionality to the mouth when teeth have been affected by periodontitis.

Because periodontal disease is progressive, it is essential to remove the bacteria and calculus build up to halt the spread of the infection. Your dentist will be happy to advise you on effective cleaning methods and treatment options.

Endodontics is a specialized branch of dentistry that deals with the complex structures found inside the teeth. The Greek word “Endodontics” literally means “inside the tooth” and relates to the tooth pulp, tissues, nerves, and arterioles. Endodontists receive additional dental training after completing dental school to enable them to perform both complex and simple procedures, including root canal therapy.

Historically, a tooth with a diseased nerve would be removed immediately, but endodontists are now able to save the natural tooth in most cases. Generally, extracting the inner tooth structures, then sealing the resulting gap with a crown restores health and functionality to damaged teeth.

Signs and symptoms of endodontic problems:

• Inflammation and tenderness in the gums.
• Teeth that are sensitive to hot and cold foods.
• Tenderness when chewing and biting.
• Tooth discoloration.
• Unexplained pain in the nearby lymph nodes.

Reasons for endodontic treatment:

Endodontic treatment (or root canal therapy) is performed to save the natural tooth. In spite of the many advanced restorations available, most dentists agree that there is no substitute for healthy, natural teeth.

Here are some of the main causes of inner tooth damage:

• Bacterial infections – Oral bacteria is the most common cause of endodontic problems. Bacteria invade the tooth pulp through tiny fissures in the teeth caused by tooth decay or injury. The resulting inflammation and bacterial infection jeopardize the affected tooth and may cause an abscess to form.
• Fractures and chips – When a large part of the surface or crown of the tooth has become completely detached, root canal therapy may be required. The removal of the crown portion leaves the pulp exposed, which can be debilitating painful and problematic.
• Injuries – Injuries to the teeth can be caused by a direct or indirect blow to the mouth area. Some injuries cause a tooth to become luxated or dislodged from its socket. Root canal therapy is often needed after the endodontist has successfully stabilized the injured tooth.
• Removals – If a tooth has been knocked clean out of the socket, it is important to rinse it and place it back into the socket as quickly as possible. If this is impossible, place the tooth in special dental solution (available at pharmacies) or in milk. These steps will keep the inner mechanisms of the tooth moist and alive while emergency dental treatment is sought. The tooth will be affixed in its socket using a special splint, and the endodontist will then perform root canal therapy to save the tooth.

What does an endodontic procedure invlove?

Root canal therapy usually takes between one and three visits to complete. Complete X-rays of the teeth will be taken and examined before the treatment begins.

Initially, a local anesthetic will be administered, and a dental dam (protective sheet) will be placed to ensure that the surgical area remains free of saliva during the treatment. An opening will be created in the surface of the tooth, and the pulp will be completely removed using small handheld instruments.

The space will then be shaped, cleaned, and filled with gutta-percha. Gutta-percha is a biocompatible material that is somewhat similar to rubber. Cement will be applied on top to ensure that the root canals are completely sealed off. Usually, a temporary filling will be placed to restore functionality to the tooth prior to the permanent restoration procedure. During the final visit, a permanent restoration or crown will be placed.

If you have questions or concerns about endodontic procedures, please contact our office.

Prosthodontics is the specialized field of dentistry concerned with diagnosing, planning and executing restorative and cosmetic treatments. Dentists who choose to specialize in prosthodontics must complete three or four more years of dedicated training following dental school.

A prosthodontist is in essence an architect, who formulates a comprehensive treatment plan and informs the patient as to what is possible. Missing or defective teeth can be extremely detrimental to self-esteem and self-confidence. Using the latest technology, a prosthodontist is able to fill these gaps with functional, natural-looking teeth that boost confidence and enhance the smile.

There are many reasons why a prosthodontist may be consulted, including (but not limited to):

• Creation of partial or full sets of dentures.
• Desire to whiten the teeth or improve the aesthetics of the smile.
• Filling gaps created by one or more missing teeth.
• Interest in dental implants.

What treatments can the prosthodontist perform?

Prosthodontic treatments are designed to be functional, long lasting and pleasing to the eye. These procedures can only be completed on generally healthy teeth. Issues like gum disease need to be controlled before prosthodontic treatments can begin.

There are an ever-increasing number of hi-tech prosthodontic treatments available including the following:

• Dental Implants – Implants are designed to replace the natural teeth in the best possible way. Titanium roots are implanted in the jawbone in the same way as natural tooth roots. Implants look and feel the same as natural teeth.
• Dental Veneers – Veneers are porcelain/ceramic covers that are bonded to the natural teeth. Veneers can instantly solve problems like uneven teeth, stained teeth, and chips and damage caused by general wear and tear.
• Dental Crowns – Prosthetic crowns are generally made from porcelain, metal or a combination of the two. They have been designed to mimic the natural crown (surface of the tooth) and can last for up to a decade, and possibly longer.
• Dental Bridges – Conventional and cantilever bridges are used to support a prosthetic tooth. The natural teeth can support the bridge if they are in good condition, or dental implants may be used as anchors.
• Complete Dentures – A complete set of dentures can be created for people who have no teeth due to gum disease or trauma. Complete dentures restore functionality to the mouth and make chewing and speaking easier.
• Partial Dentures – Where many teeth have been lost, removable or fixed partial dentures can prove to be an excellent option. They enhance the aesthetics of the smile in addition to improving chewing abilities.

What other problems can a prosthodontist treat?

In addition to performing the treatments described above, the prosthodontist is also adept at treating problems with the jaw (TMJ), alleviating severe snoring, managing sleep apnea, and reconstructing the teeth following oral cancer treatments. Generally, the prosthodontist works in combination with other dental health professionals to ensure the best possible restorative results are achieved.

If you have questions or concerns about prosthodontics, please contact your prosthodontist.

Wisdom teeth are a third set of adult molars located in the back of your mouth. They usually come in between the ages of 17 and 25. Some people never develop wisdom teeth, while others have them come in with no issues. However, for many people, wisdom teeth can create problems and need to be removed.

Why should I have my wisdom teeth removed?

Wisdom tooth extraction is a surgical procedure to remove one or more wisdom teeth. If a wisdom tooth does not have the proper room to grow, it can result in pain, infection, or other dental problems. Most people have wisdom teeth removed for one of these reasons:

• They are impacted. Since wisdom teeth are at the very back of your mouth, they may not develop properly. They can get trapped in the jawbone or underneath the gum.
• They erupt at the wrong angle. Wisdom teeth may come in at a slanted angle, pressing against your other teeth or towards the back of your mouth.
• Your jaw isn’t big enough. Your mouth may have no room for another set of molars to come in.

What to expect with wisdom tooth extraction

During the procedure

The surgery procedure should take around 45 minutes. Depending on the complexity of the wisdom tooth extraction and your comfort level, you will be administered one of three types of anesthesia.

• Local: With local anesthesia, you will receive one or more injections near the area of each extraction to numb your mouth. You will be awake during the procedure and feel some slight pressure and movement but should experience no pain.
• Sedation: Sedation anesthesia is administered through an IV line in your arm. During the procedure, you will have limited consciousness and feel no pain.
• General: In some situations, you will be given general anesthesia. This is administered by inhaling medication through the nose and mouth, an IV in your arm, or both. You will be unconscious during the procedure and experience no pain or memory of the surgery.

After the procedure

Day of surgery

Wisdom tooth extraction is an outpatient surgery, meaning you will arrive and leave the same day. With sedation or general anesthesia, you will be taken to a recovery room after the procedure.

After surgery, you will slowly begin to regain feeling in your mouth. Some pain and swelling is normal. You can eat very soft foods after surgery, but should avoid caffeine, alcohol, smoking, or drinking with a straw.

Recovery

Most people fully recover from wisdom teeth surgery in three to four days. For those with wisdom teeth that were impacted or erupted at a slanted angle, it could take a week to recover.

The day after surgery, you can resume normal activities but should avoid any activity that could dislodge the stitches or blood clots. This includes strenuous exercise, spitting, smoking, or drinking from a straw.

By the third day after surgery, symptoms should be significantly improved. All pain and bleeding should be gone after a week. The wound will not be fully healed until after several months, so it is important to practice proper oral care to avoid any infection.

Some complications could be a sign of infection or possible nerve damage. Seek help if any of these symptoms occur:

• fever
• medication not dulling pain
• swelling that gets worse over time
• trouble swallowing or breathing
• numbness
• bleeding that won’t stop when applying pressure

Pediatric dentistry (formerly Pedodontics/Paedodontics) primarily focuses on children from birth through adolescence. The American Dental Association (ADA), recognizes pediatric dentistry as a specialty, and therefore requires dentists to undertake two or three years of additional training after completing a general dentistry degree. At the end of this training, the American Board of Pediatric Dentistry issues a unique diploma (Diplomate ABPD). Some pediatric dentists (pedodontists) opt to specialize in oral care for children with special needs, specifically children with autism, varying levels of mental retardation, or cerebral palsy.

One of the most important components of pediatric dentistry is child psychology. Pediatric dentists are trained to create a friendly, fun, social atmosphere for visiting children, and always avoid threatening words like “drill,” “needle,” and “injection.” Dental phobias beginning in childhood often continue into adulthood, so it is of paramount importance that children have positive experiences and find their “dental home” as early as possible.

What Does a Pediatric Dentist Do?

Pediatric dentists fulfill many important functions pertaining to the child’s overall oral health and hygiene. They place particular emphasis on the proper maintenance and care of deciduous (baby) teeth, which are instrumental in facilitating good chewing habits, proper speech production, and also hold space for permanent teeth.

Other important functions include:

• Education – Pediatric dentists educate the child using models, computer technology, and child-friendly terminology, thus emphasizing the importance of keeping teeth strong and healthy. In addition, they advise parents on disease prevention, trauma prevention, good eating habits, and other aspects of the home hygiene routine.
• Monitoring growth – By continuously tracking growth and development, pediatric dentists are able to anticipate dental issues and quickly intervene before they worsen. Also, working towards earlier corrective treatment preserves the child’s self-esteem and fosters a more positive self-image.
• Prevention – Helping parents and children establish sound eating and oral care habits reduces the chances of later tooth decay. In addition to providing check ups and dental cleanings, pediatric dentists are also able to apply dental sealants and topical fluoride to young teeth, advise parents on thumb- sucking/pacifier/smoking cessation, and provide good demonstrations of brushing and flossing.
• Intervention – In some cases, pediatric dentists may discuss the possibility of early oral treatments with parents. In the case of oral injury, malocclusion (bad bite), or bruxism (grinding), space maintainers may be fitted, a nighttime mouth guard may be recommended, or reconstructive surgery may be scheduled.

If you have questions or concerns about pediatric dentistry, please contact our office.

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

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

Types of dental emergency and how to deal with them

Avulsed tooth (tooth knocked out)

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

Here are some steps to take:

1. Call our office.
2. Pick up the tooth by the crown and rinse it under warm water. DO NOT touch the root.
3. If possible, place it back into its socket – if not tuck it into the cheek pouch.
4. If the tooth cannot be placed in the mouth, put the tooth into a cup of milk, saliva, or water as a last resort. It is important to keep the tooth from drying out.
5. Get to our office, quickly and safely.

We will try to replace the tooth in its natural socket. In some cases, the tooth will reattach, but if the inner mechanisms of the teeth are seriously damaged, root canal therapy might be necessary.

Lost filling or crown

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

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

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

1. Apply clove oil to the tooth to alleviate pain.
2. Clean the crown, and affix it onto the tooth with dental cement. This can be purchased at a local pharmacy.
3. If the crown is lost, smear the top of the tooth with dental cement to alleviate discomfort.
4. DO NOT use any kind of glue to affix the crown.

We will check the crown to see if it still fits. If it does, it will be reattached to the tooth. Where decay is noted, this will be treated and a new crown will be made.

Cracked or broken teeth

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

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

1. Call our office.
2. Rinse the tooth fragment and the mouth with lukewarm water.
3. Apply gauze to the area for ten minutes if there is bleeding.
4. Place a cold, damp dishtowel on the cheek to minimize swelling and pain.
5. Cover the affected area with over-the-counter dental cement if you cannot see us immediately.
6. Take a topical pain reliever.

The nature of the break or fracture will limit what we are able to do. If a fracture or crack extends into the root, root canal therapy is often the most effective way to retain the tooth. In the case of a complete break, your dentist will usually affix the fragment back onto the tooth as a temporary measure.

Dislodged/loose teeth

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

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

If you have questions or concerns about dental emergencies, please contact our office.