Services

What are porcelain fixed bridges?

Porcelain fixed bridges are non-removable appliances that are placed on teeth to replace a tooth that is missing. Porcelain bridges are made to match the natural color of your teeth and help fill in the gap where a tooth is missing. Bridges are essentially two crowns that that anchor an artificial tooth in between. The two crowns are cemented onto the teeth surrounding the missing tooth to help anchor the artificial tooth into place (abutment). The artificial tooth (pontic) is in place of the missing tooth to fill in the gap and allow your teeth to look natural.

The process of getting a porcelain fixed bridge

When you and your dentist decide that a porcelain fixed bridge is the right option for you, the dentist will begin preparing the two teeth that surround the missing tooth. The teeth are prepared so that two crowns can be placed in order to support the artificial tooth. Several impressions will be taken in order for the dentist to determine the size of the crowns and artificial tooth. Once the impressions are taken, they are sent to a dental laboratory where your bridge will be made. Setting a bridge generally takes two dental visits to complete. Once the dental laboratory has made your bridge, the dentist will cement the crowns into place.

Porcelain fixed bridges are very durable and can last a very long time when they are well taken care of. Your dentist will give you special instructions on how you can keep your bridge clean through brushing and flossing.

What is a porcelain dental crown?

A porcelain dental crown is a tooth shaped cap that is used to help replaced teeth that cannot be restored using the traditional filling. They are generally suggested for patients who have had severely decayed or damaged teeth. Porcelain dental crowns match the color of teeth to give a natural appearance. There are many other types of crowns such as gold or silver, but porcelain crowns are most popular because they give the most natural look.

How are porcelain crowns placed?

When you and your dentist decide that getting a crown is the right option for you, the dentist will shape the tooth in a shape that enables him or her to place a crown. Depending on the damage of the tooth and how much tooth structure is present, the dentist will either shape the tooth or build up the tooth in order to support the crown. Several impressions will be taken so that a dental laboratory can custom make a cap for your tooth. While you wait for the dental laboratory to create your crown, your dentist will create a temporary crown for you that will be replaced when your final crown is finished. When the crown is finished by the dental laboratory, the dentist will try on the crown to ensure that the fit and bite are correct. The porcelain crown is then cemented to your tooth to give you a beautiful and natural appearance.

With care, porcelain dental crowns can be very durable and have the ability to last a long time. Your dentist will give you special instructions on how you can keep your crown clean with brushing and flossing so that you can help your crown last for years.

Although receiving a crown can take two visits to complete, if your dentist uses CAD-CAM technology such as CEREC^®, they may be able to offer you a crown in one visit. Consult with your dentist to see if this is an option for you.

Taking dental x-rays or radiographs is essential for diagnosing dental disease and concerns. These radiographs show teeth, bones and soft tissue to help dentists determine if there are caries or hidden dental problems such as bone loss that cannot be seen when looking into a mouth. Taking dental x-rays can also help catch dental disease early to prevent pain and expensive dental treatment.

Dental x-rays use very small amounts of radiation and exposure to this small amount of radiation is safe. When a patient receives a full mouth series of x-rays, this is equivalent to radiation exposure in everyday life.

What are composite fillings?

Mouth fillings are the most popular method of restoring teeth. There are many types of materials that can be used for fillings such as amalgam and gold. Composites fillings are a popular choice because they match the color of teeth and look natural. Composites are not only used to restore decayed teeth, but they may also be used for crack or broken teeth, stained teeth, and teeth that have been worn down.

How are fillings placed?

Fillings are very common and can be done in one visit to the dentist. Once anesthesia is applied, the dentist will begin removing decay from the tooth using a dental drill and clean out the decay area. When all the decay is removed, the dentist will prepare and shape the area so that the filling material, such as composite, can be placed. Once the filling has been placed, the filling will be shaped and the tooth will be polished so it can look as natural as possible.

After first receiving a filling, many patients become temporarily sensitive to hot and cold foods. When the tooth becomes used to having the filling, the sensitivity will subside.

What are Porcelain Inlays and Onlays?

Porcelain Inlays and Onlays are restorative fillings that are made using different materials such as porcelain, gold or composite. Porcelain is often the most popular because it mimics natural tooth color. The porcelain is custom created to fit into the prepared tooth cavity and cemented in. Porcelain on its own can be very brittle, but when porcelain is bonded to tooth structure, it becomes very strong and durable.

Due to the durability of porcelain inlays and onlays, they may be recommended for patients who have more severe decay that cannot be repaired by a traditional filling. Generally, teeth that are broken, have severe decay or have fractured fillings are recommended to receive a porcelain inlay or onlay.

What is the difference between inlays and onlays?

Inlays and onlays are both made at dental laboratories. Therefore, the process generally takes two visits to complete. Porcelain inlays are used in place on traditional silver or composite fillings. They are placed into the prepared tooth where a filling would be placed. Onlays are also known as “partial crowns” and they are caps that help protect the chewing surface of the tooth that has been damaged. Both inlays and onlays last for a very long time and provide patients with beautiful results, but they may eventually need to be replaced.

Tooth Whitening is a popular procedure done to brighten your smile. First, speak with your dentist to see if whitening is a good option for you. Depending on the type of discoloration that is present on your teeth, whitening may or may not be effective. Common reasons for teeth discoloration result from using tobacco, staining from food or drinks and poor oral hygiene. Tooth whitening is most effective on surface stains. Although whitening is helpful for the appearance of teeth, it is not permanent and stains may recur over time.

There are many types of whitening that can be done and the most common type is a gel-solution that can be applied directly to the surface of the teeth. This type of whitening can be done at a dental office or at home. At a dental office, the dentist will put a whitening agent on the teeth that is activated by a light or laser. For whitening at home, the dentist may recommend that you wear a whitening tray containing the whitening agent for several hours a day till you reach the shade you desire. Whitening toothpaste may also be purchased to help remove staining on the enamel.

Contact your dentist to see if tooth whitening is right for you.

What are dental implants?

Dental implants are recommended for those seeking a permanent solution to missing teeth. They are designed to look natural while also giving you the ability to have stable function of natural teeth. Dental implants are surgically placed into the mouth by inserting a titanium anchor into your jaw. After the anchor is placed, the bone will heal (about 6 months) around the titanium and hold it into place. When your dentist thinks you are ready, they will place your custom made artificial tooth into the anchor.

Dental implants are not recommended for everyone. In order to be eligible to receive implants, you must have enough bone structure to support the implant, free of chronic illnesses and must ensure that you will maintain proper oral hygiene to care for a new implant.

What is a root canal?

Root canal therapy is a treatment used to save a tooth when the tissue, blood vessels and nerves inside of a tooth have become inflamed. In order to save the tooth and remove the pain, the dentist will need to remove infected and diseased tissue to help clean out the infected area. The canal inside is then medicated to allow the surrounding area to heal.

Reasons a root canal may be performed

• Deep decay
• Infections at the tip of the root or inside the tooth canal
• Cracked, broken or injured teeth

Generally, but not always, a crown will need to be placed after the root canal treatment is complete in order to protect the tooth from any further damage. Sensitivity after the procedure is generally experienced by many patients and subside when the tooth has healed. When your treatment has been completed, your dentist will provide you with special instructions on how to care for your newly treated tooth.

On your first visit, the dentist will perform a comprehensive dental exam to assess the current condition of your teeth and their supporting dental structures. You will then be asked to return for regular check-up exams to help implement and maintain your individualized dental health plan. Regular check-up exams cover three primary areas:

1. Professional Dental Cleanings.
2. Screenings for General Dental Health
3. Periodic X-Rays & Regular Diagnostic Evaluations of X-Rays

There are many things that you can do away from the dental office to help control bacteria and plaque to keep your mouth healthy. Brushing, flossing, mouth rinses and maintaining good nutrition can help keep your mouth healthy in between dental visits.

Brushing

Brushing your teeth is something that you should do everyday! Using a soft-bristled brush can help remove food particles, plaque and other debris from your teeth. If you choose not to use a soft-bristled brush, electric toothbrushes have become an option for many. Choosing a proper toothbrush will help you brush those hard to reach places. It is important to brush twice a day, once in the morning and once before you go to bed for two minutes each time.

To properly brush, use about a pea size about of toothpaste. There are many types of toothpaste and choosing the right one for you is important. Toothpaste varieties range from those designed for sensitivity to those used for tartar protection. Begin by placing the toothbrush at a 45 degree angles to the gums. Use small and gentle circular motions so you are cleaning the surface of the teeth and gently massaging your gums. Proper brushing takes two minutes, so set a timer, stopwatch or even sing a song to ensure that you are brushing for a long enough time. For hard to reach areas in the back and inside surfaces of the teeth, use the tip of the toothbrush. Brushing your tongue can also help remove bacteria and leave your breath smelling fresher.

Replacement of your toothbrush should occur every 2-3 months or when your toothbrush bristles start showing signs of wear. Toothbrushes should also be replaced after illness to prevent from reinfecting yourself.

Flossing

Brushing alone does not reach all areas of the mouth. The areas in between teeth cannot be accessed with a toothbrush and therefore flossing is needed. Flossing helps clean and prevent the formation of plaque in between teeth and underneath the gum line.

To properly floss, use about 15 inches of floss and wrap it around your middle finger and leave about 2 inches of floss to work with. Use your thumbs and index fingers to help guide the floss in between the teeth and slide it between the gum and teeth, forming a V motion. The floss should clean underneath the gum line, but avoid forcing it down further, which causes damage to the gum tissue.

Mouthrinses

Mouthrinses are another way to keep your teeth healthy and your breath fresh. Though it does not replace brushing and flossing, rinsing can help after meals when a toothbrush is not readily available.

What is periodontal disease?

Periodontal disease is a very serious dental disease that affects many people. It is caused by bacteria from plaque formations on the teeth. In the mouth, there are constant plaque formations on the teeth, but when the plaque formations become severe, the body’s immune system will try to fight the bacteria from plaque. This causes inflammation in the gums that results in swelling and bleeding, which are early signs of periodontal disease called gingivitis. In severe forms of periodontal disease, the bacteria will go under the gums are begin to damage the bone that supports the teeth and cause the teeth to become loose.

Other health risks of periodontal disease

There have now been studies that have shown a connection between periodontal disease and other health concerns. These include:

• Diabetes
• Cardiovascular disease
• Respiratory problems
• Increase risk of stroke
• Premature births in pregnant women

What can you do?

If you suspect that you may have early signs of periodontal disease such as gum disease due to inflammation and bleeding gums, many an appointment to consult with your dentist. At early stages, the process of the disease can be reversed through a cleaning or deep cleaning and proper oral hygiene maintenance. Maintaining good oral hygiene through brushing and flossing and regular visits to the dentist can help periodontal disease from occurring.

Wisdom teeth are the third and final set of molars that most people get in their late teens or early twenties. Sometimes these teeth can be a valuable asset to the mouth when healthy and properly aligned, but more often, they are misaligned and require removal.

When wisdom teeth are misaligned, they may position themselves horizontally, be angled toward or away from the second molars, or be angled inward or outward. Poor alignment of wisdom teeth can crowd or damage adjacent teeth, the jawbone, or nerves.

Anatomy of the Teeth

The teeth are the hardest substances in the human body. Besides being essential for chewing, the teeth play an important role in speech. Parts of the teeth include:

• Enamel: The hardest, white outer part of the tooth. Enamel is mostly made of calcium phosphate, a rock-hard mineral.
• Dentin: A layer underlying the enamel. Dentin is made of living cells, which secrete a hard mineral substance.
• Pulp: The softer, living inner structure of teeth. Blood vessels and nerves run through the pulp of the teeth.

Wisdom teeth also can be impacted — they are enclosed within the soft tissue and/or the jawbone or only partially break through or erupt through the gum. Partial eruption of the wisdom teeth allows an opening for bacteria to enter around the tooth and cause an infection, which results in pain, swelling, jaw stiffness, and general illness. Partially erupted teeth are also more prone to tooth decay and gum diseas,e because their hard-to-reach location and awkward positioning makes brushing and flossing difficult.

How Do I Know if I Have Wisdom Teeth?

Ask your dentist about the positioning of your wisdom teeth. He or she may take an X-ray periodically to evaluate for the presence and alignment of your wisdom teeth. Your dentist may also decide to send you to an oral surgeon for further evaluation.

Your dentist or oral surgeon may recommend that your wisdom teeth be extracted even before problems develop. This is done to avoid a more painful or more complicated extraction that might have to be done a few years later. Removal is easier in young people, when the wisdom teeth roots are not yet fully developed and the bone is less dense. In older people, recovery and healing time tend to be longer.

How Are Wisdom Teeth Removed?

The relative ease at which your dentist or oral surgeon can extract your wisdom teeth depends on their position and stage of development. Your oral health care provider will be able to give you an idea of what to expect during your pre-extraction exam. A wisdom tooth that is fully erupted through the gum can be extracted as easily as any other tooth. However, a wisdom tooth that is underneath the gums and embedded in the jawbone will require an incision into the gums and then removal of the portion of bone that lies over the tooth. Often, for a tooth in this situation, the tooth will be extracted in small sections rather than removed in one piece to minimize the amount of bone that needs to be removed to get the tooth out.

What Happens During Wisdom Teeth Removal?

Before your wisdom teeth are pulled, the teeth and the surrounding tissue will be numbed with a local anesthetic — the same type used to numb a tooth prior to having a cavity filled. In addition to the local anesthetic to numb the pain, you and your dentist or oral surgeon may decide that a sedative is desired to control any anxiety. Sedating medications that could be selected include: nitrous oxide (otherwise known as “laughing gas”), an oral sedative (for example, Valium), or an intravenous sedative (administered via an injection into your veins). If nitrous oxide is given, you will be able to drive yourself home. If any of the other medications is selected, you will need someone to drive you both to and from the appointment.

What are sealants?

Dental sealants are a form of preventative treatment that is used to help prevent or slow down the development of caries. The plastic coatings are placed on the chewing surface of the teeth, which are generally the molars or premolars. These teeth are the most susceptible to caries because due to the anatomy of the tooth, food particles get stuck in the fissures of the tooth. When food accumulates in these areas, plaque forms and attacks the enamel, causing a cavity to form. The plastic coating of the dental sealant helps prevent the food from being stuck in the fissures of the tooth.

When are sealants placed?

Dental sealants are first placed when the first permanent molar is erupted. The dental sealant will help protect the permanent teeth of children to help prevent the formation of cavities. These sealants can also be placed on adults that are at high risk for forming dental caries. Sealants last for many years, but new ones can be placed when the old sealants have worn down.

Fluoride is a mineral used to help prevent caries and help harden enamel. Fluoride is found naturally in water and in many foods, and it is also used to help with the remineralization process to prevent breakdown of the tooth and tooth decay. Today, studies have shown that drinking fluoridated water has decreased dental caries by two-thirds. Brushing with fluoridated toothpaste and using community fluoridated water is considered to be helpful is decreasing decay. In areas where the water supply is not fluoridated, fluoride tablets may be prescribed to children.

According to research conducted by the American Cancer society, more than 30,000 cases of oral cancer are diagnosed each year. More than 7,000 of these cases result in the death of the patient. The good news is that oral cancer can easily be diagnosed with an annual oral cancer exam, and effectively treated when caught in its earliest stages.

Oral cancer is a pathologic process which begins with an asymptomatic stage during which the usual cancer signs may not be readily noticeable. This makes the oral cancer examinations performed by the dentist critically important.  The most common type of oral cancer is the malignant squamous cell carcinoma. This oral cancer type usually originates in lip and mouth tissues.

There are many different places in the oral cavity and maxillofacial region in which oral cancers commonly occur, including:

• Lips
• Mouth
• Tongue
• Salivary Glands
• Oropharyngeal Region (throat)
• Gums
• Face

Reasons for oral cancer examinations

It is important to note that around 75 percent of oral cancers are linked with modifiable behaviors such as smoking, tobacco use and excessive alcohol consumption. Your dentist can provide literature and education on making lifestyle changes and smoking cessation.

When oral cancer is diagnosed in its earliest stages, treatment is generally very effective. Any noticeable abnormalities in the tongue, gums, mouth or surrounding area should be evaluated by a health professional as quickly as possible. During the oral cancer exam, the dentist and dental hygienist will be scrutinizing the maxillofacial and oral regions carefully for signs of pathologic changes.

Oral cancer exams, diagnosis and treatment

The oral cancer examination is a completely painless process. During the visual part of the examination, the dentist will look for abnormality and feel the face, glands and neck for unusual bumps. Die procedures which can highlight pathologic changes are also a wonderful tool for oral cancer checks. We offer this procedure and recommend once a year to “look” below the surface for abnormal signs and lesions which would be invisible to the naked eye. We offer Visalite”, a simple application of a liquid die and then the oral mucosa is examined with a high intensity light.

During bi-annual check-ups, the dentist and hygienist will thoroughly look for changes and lesions in the mouth, but a dedicated comprehensive oral cancer screening should be performed at least once each year.

You and our doctors may determine that you need a tooth extraction for any number of reasons. Some teeth are extracted because they are severely decayed; others may have advanced periodontal disease, or have broken in a way that cannot be repaired. Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth), or in preparation for orthodontic treatment. Teeth can be removed with local anesthetic, or you may choose to go to sleep for the procedure. In either case, tooth removal should not be a traumatic experience, and we will do our best to ensure that you are comfortable during the entire procedure.

During the extraction process you will feel a lot of pressure. This is from the process of firmly rocking the tooth in order to widen the socket for removal. You feel the pressure without pain as the anesthetic has numbed the nerves that transfer pain, yet the nerves that transmit pressure are not profoundly affected. If you do feel pain at any time during the extraction please let us know right away.

Many teeth are simply extracted with elevators and forceps. Some teeth, however, may be broken off below the gumline or too big to remove in one piece. When this occurs incisions may be made in the gums in order to expose the tooth to be extracted. It may also require the removal of some of the surrounding bone or sectioning the tooth into several pieces. This is a very common procedure that is performed when a tooth is firmly anchored in its socket or the root is curved and the socket can’t expand enough to remove it. The doctor uses a surgical handpiece to remove bone and cut the tooth into smaller sections. He then removes each section one at a time.

The removal of a single tooth can lead to problems related to your chewing ability, problems with your jaw joint, and shifting teeth, which can have a major impact on your dental health. To avoid these complications, in most cases, our doctors will discuss alternatives to extractions as well replacement of the extracted tooth.

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 make an appointment with the dentist as quickly as possible. The pain caused by dental emergencies almost always gets worse without treatment, and dental issues can seriously jeopardize physical health.

Types of Dental Emergencies and How to Deal with Them

Avulsed (knocked out) tooth

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 the dentist.
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 the dentist, quickly and safely.

The dentist 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 may 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 the dentist 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 the dentist is 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 the 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.

The dentist 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 see the dentist 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 the dentist.
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 there is no way to see the dentist immediately.
6. Take a topical pain reliever.

The nature of the break or fracture will limit what the dentist is able to do. If a fracture or crack extends into the root, root canal therapy may be the only effective way to retain the tooth. In the case of a complete break, the 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 and attached to the blood vessels and nerves, there is a good chance root canal therapy will not be necessary.

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

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