Our Services

Whether your dental needs are a complete exam and cleaning, a full-mouth restoration, or anything in between, we promise to provide you with exceptional care as we enhance the natural beauty of your smile. Below are just some of the many procedures and services we regularly provide to our patients – with a gentle touch, and stunning results. Your smile is our first priority, and we’ll give you something to smile about.

If you have any questions, concerns, or would like to schedule an appointment, please contact us today. We look forward to providing you with the personal care you deserve.

Cleanings & Prevention

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.

Digital Radiographs

Digital radiographs (x-rays) are an important diagnostic tool for dental professionals. While traditional film radiographs provide critical insight into the oral and physical health of the patient, hi-tech digital radiographs allow dentists to view and enhance dental images on a large computer screen.

Dentists can also copy or print digital radiographs with ease. This allows for effective comparison of new results to previous images and insight on how treatments have impacted dental conditions. If the dentist refers the patient to a specialist, digital radiographs can be transmitted via computer – eliminating the need for a second set of x-rays in most cases.

Why Use Digital Radiographs?

One of the most significant advantages of utilizing digital radiographs is reduction of radiation exposure. Digital radiographs also eliminate the use of film and required chemicals for processing, making the overall procedure much less harmful to the environment.

The larger computer screen used to display digital radiographs allows dentists to view any problems or irregularities with added clarity. The potential for early detection of decay or periodontal problems and reducing complicated conditions later is vastly increased.

Here are some of the main conditions that digital radiographs can better expose:

Small areas of decay
Bone recession
Tumors
Fractures and trauma
Positioning of the teeth
Developmental irregularities
Tooth positioning

How Are Digital Radiographs Taken?

The technique for capturing digital radiographs is similar to that of the traditional-style radiographs, but the digital variety uses a small electronic sensor to capture intraoral images, as opposed to film bitewings.

Generally, a full mouth series of digital x-rays includes eighteen different views of the teeth and underlying jawbone. The two standard views dentists use are: periapical and bitewing. The periapical view is used to inspect the root tips for decay, disease or damage, while the bitewing view allows for close inspection and measurement of the mandible and maxilla (upper and lower jawbones).

After exposure, the digital image is either transferred wirelessly to a computer, or the dentist takes the plate from the mouth, and scans it with a specialized reader. Processing traditional film can take up to five minutes, but a digital image takes mere seconds. Once the image is apparent on the screen, the contrast, color and brightness can be altered to produce a much clearer image.

If you have questions or concerns about getting a digital radiograph, please contact your dentist.

Intraoral Cameras

Intraoral cameras are changing the face of routine dental appointments. The intraoral camera gives the patient a unique view of each tooth – enabling them to understand diagnoses and make informed treatment decisions.

The intraoral camera is connected to a computing unit at the side of the dental chair. A pen-sized wand is inserted into the mouth, and a movie of the inner mouth is created. This movie can be magnified more than 30x to allow every aspect of the teeth to be viewed in full color. The intraoral camera is an incredibly valuable tool, which brings dentistry to life.

How can the intraoral camera help?

Utilizing intraoral cameras is a completely comfortable process for patients, and provides an honest assessment of the teeth. Here are some of an intraoral camera’s main uses:

Dental education – Education and preventive care are highly important in dentistry. The intraoral camera can expose areas where home hygiene may be deficient. Any problems can then be resolved before complicated treatments are required.
Exposing hidden problems – Conditions like gum disease and oral cancer may display easy-to-miss symptoms in their earliest stages. The intraoral camera can more clearly highlight these issues to the dentist and the patient.
Treatment planning – No matter how well a dentist might describe a condition, it is easier to understand the issue if it can be seen. Seeing tooth decay and problem teeth helps patients understand why certain treatments are recommended for maximum health benefit and aesthetics.
Assessing progress – Some treatments impact the teeth slowly. The intraoral camera allows treatment to be modified along the way, if necessary, to ensure the desired results are achieved.
Eliminating uncertainty – One of the most common patient fears is that a dentist is performing unnecessary treatments. The intraoral camera highlights problem areas, so that individuals are less likely to refuse necessary treatment.
Referrals to specialists – On occasion, a patient may need to be referred to a specialist for complex treatment. If this specialist is able to view clear images of the teeth in advance, consultation times and costs can be reduced.

How will the intraoral camera be used?

The intraoral camera is the size and shape of a pen. It is covered with a disposable sheath, to ensure that no germs are transmitted from patient-to-patient. The slim wand is inserted into the mouth and rotated until clear pictures of every tooth can be recorded. The images are transmitted onto a television screen in movie format. The movie can be paused, and images of individual teeth can be magnified to allow the dentist to explain and explore any noticeable problems. One of the biggest advantages of the intraoral camera is tit does not expose patients to radiation. The intraoral camera is one of the most useful and versatile diagnostic tools available.

If you have any questions or concerns about the intraoral camera, please contact your dentist.

Dental Exams & Cleanings

Dental Exam

A comprehensive dental exam will be performed by your dentist at your initial dental visit. At regular check-up exams, your dentist and hygienist will perform the following:

Examination of diagnostic X-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
Examination of existing restorations: Check current fillings, crowns, etc.

Professional Dental Cleaning

Professional dental cleanings (dental prophylaxis) are usually performed by Registered Dental Hygienists. Your cleaning appointment will include a dental exam and the following:

Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments.
Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.

Dental X-Rays

Dental radiographs (X-rays) are essential, preventative, diagnostic tools that provide valuable information not visible during a regular dental exam. Dentists and dental hygienists use this information to safely and accurately detect hidden dental abnormalities and complete an accurate treatment plan. Without X-rays, problem areas may go undetected.

Dental X-rays may reveal:

Abscesses or cysts.
Bone loss.
Cancerous and non-cancerous tumors.
Decay between the teeth.
Developmental abnormalities.
Poor tooth and root positions.
Problems inside a tooth or below the gum line.

Detecting and treating dental problems at an early stage can save you time, money, unnecessary discomfort, and your teeth!

Are dental X-rays safe?

We are all exposed to natural radiation in our environment. The amount of radiation exposure from a full mouth series of X-rays is equal to the amount a person receives in a single day from natural sources.

Dental X-rays produce a low level of radiation and are considered safe. Dentists take necessary precautions to limit the patient’s exposure to radiation when taking dental X-rays. These precautions include using lead apron shields to protect the body and using modern, fast film that cuts down the exposure time of each X-ray.

How often should dental X-rays be taken?

The need for dental X-rays depends on each patient’s individual dental health needs. Your dentist and dental hygienist will recommend necessary x-rays based on the review of your medical and dental history, dental exam, signs and symptoms, age consideration, and risk for disease.

A full mouth series of dental X-rays is recommended for new patients. A full series is usually good for three to five years. Bite-wing X-rays (X-rays of top and bottom teeth biting together) are taken at recall (check-up) visits and are recommended once or twice a year to detect new dental problems.

Diagnodent®

Tooth decay can be extremely painful and puts the teeth at risk. Many extractions and restorative treatments are performed every single day because tooth decay has become too severe for the tooth to be saved. Diagnodent® is a safe fluorescent laser that detects hidden tooth decay accurately, quickly, and in its earliest stages.

All dentists are advocates for healthy, natural teeth. Restoration devices like crowns and bridges are popular because they allow the natural tooth to remain in the mouth. Diagnodent® accurately exposes areas of tooth decay without scratching, probing, or “opening up the tooth.” This provides a greater chance of identifying, treating, and retaining a natural tooth without the need for expensive and time-consuming restorations.

How can Diagnodent® help me?

Diagnodent® accurately exposes more caries than X-rays and examinations. In fact, this revolutionary diagnostic tool is over 90% accurate. Sometimes, caries “go underground” due to fluoridation. This essentially means that lesions that once lay on the surface of the tooth bed down, and remain invisible to the naked eye. Because Diagnodent® exposes caries earlier, more treatment options are possible.

Here are some of the other benefits associated with Diagnodent®:

Allows dentists to perform treatment with greater confidence.
Allows for the investigation of suspicious areas.
Completely safe.
Cost effective.
Empirically measurable results.
Helps reduce future dental procedures.
More accurate than any other diagnostic tool.
No exposure to X-rays.
No need for invasive investigations.
No pain or scratching.

What does the Diagnodent® process involve?

The Diagnodent® process is performed within the scope of a regular dental checkup. It is strikingly similar to having a laser pointer aimed at the teeth. Diagnodent® is a hi-tech tool, which first scans a clean tooth surface with a laser beam. This scanning procedure serves to calibrate the instrument by providing information about the tooth structure.

The Diagnodent® System is actually measuring the amount of laser fluorescence within the tooth. As each tooth is scanned, the amount of reflected laser light is recorded to produce a digital readout. If the tooth contains little or no decay, little or no laser light will be reflected back to the instrument. However, if a tooth contains caries of any significance, more laser light is reflected back. High readings (compared to the tooth originally scanned) indicate that caries are present within the structure of a particular tooth. The amount of laser light reflected back correlates with the amount of decay within the tooth.

Once we determine which teeth are suffering from decay, a plan can be formulated and treatment options can be discussed. In most cases, the early detection of caries means more treatment options and a greater chance of saving the affected tooth.

If you have any questions about Diagnodent®, please contact our office.

Digital X-Rays

Digital radiography (digital X-ray) is the latest technology used to take dental X-rays. This technique uses an electronic sensor (instead of X-ray film) that captures and stores the digital image on a computer. This image can be instantly viewed and enlarged, helping the dentist and dental hygienist detect problems more easily. Digital X-rays reduce radiation 80-90% compared to the already low exposure of traditional dental X-rays.

Dental X-rays are essential, preventative, diagnostic tools that provide valuable information not visible during a regular dental exam. Dentists and dental hygienists use this information to safely and accurately detect hidden dental abnormalities and complete an accurate treatment plan. Without X-rays, problem areas can go undetected.

Dental X-rays may reveal:

Abscesses or cysts.
Bone loss.
Cancerous and non-cancerous tumors.
Decay between the teeth.
Developmental abnormalities.
Poor tooth and root positions.
Problems inside a tooth or below the gum line.

Detecting and treating dental problems at an early stage can save you time, money, unnecessary discomfort, and your teeth!

Are dental X-rays safe?

We are all exposed to natural radiation in our environment. Digital X-rays produce a significantly lower level of radiation compared to traditional dental x-rays. Not only are digital X-rays better for the health and safety of the patient, they are faster and more comfortable to take, which reduces your time in the dental office. Also, since the digital image is captured electronically, there is no need to develop the X-rays, thus eliminating the disposal of harmful waste and chemicals into the environment.

Even though digital X-rays produce a low level of radiation and are considered very safe, dentists still take necessary precautions to limit the patient’s exposure to radiation. These precautions include only taking those X-rays that are necessary, and using lead apron shields to protect the body.

How often should dental X-rays be taken?

The need for dental X-rays depends on each patient’s individual dental health needs. Your dentist and dental hygienist will recommend necessary X-rays based upon the review of your medical and dental history, a dental exam, signs and symptoms, your age, and risk of disease.

A full mouth series of dental X-rays is recommended for new patients. A full series is usually good for three to five years. Bite-wing X-rays (X-rays of top and bottom teeth biting together) are taken at recall (check-up) visits and are recommended once or twice a year to detect new dental problems.

Fluoride Treatment

Fluoride is the most effective agent available to help prevent tooth decay. It is a mineral that is naturally present in varying amounts in almost all foods and water supplies. The benefits of fluoride have been well known for over 50 years and are supported by many health and professional organizations.

Fluoride works in two ways:

Topical fluoride strengthens the teeth once they have erupted by seeping into the outer surface of the tooth enamel, making the teeth more resistant to decay. We gain topical fluoride by using fluoride containing dental products such as toothpaste, mouth rinses, and gels. Dentists and dental hygienists generally recommend that children have a professional application of fluoride twice a year during dental check-ups.

Systemic fluoride strengthens the teeth that have erupted as well as those that are developing under the gums. We gain systemic fluoride from most foods and our community water supplies. It is also available as a supplement in drop or gel form and can be prescribed by your dentist or physician. Generally, fluoride drops are recommended for infants, and tablets are best suited for children up through the teen years. It is very important to monitor the amounts of fluoride a child ingests. If too much fluoride is consumed while the teeth are developing, a condition called fluorosis (white spots on the teeth) may result.

Although most people receive fluoride from food and water, sometimes it is not enough to help prevent decay. Your dentist or dental hygienist may recommend the use of home and/or professional fluoride treatments for the following reasons:

Deep pits and fissures on the chewing surfaces of teeth.
Exposed and sensitive root surfaces.
Fair to poor oral hygiene habits.
Frequent sugar and carbohydrate intake.
Inadequate exposure to fluorides.
Inadequate saliva flow due to medical conditions, medical treatments or medications.
Recent history of dental decay.

Remember, fluoride alone will not prevent tooth decay! It is important to brush at least twice a day, floss regularly, eat balanced meals, reduce sugary snacks, and visit your dentist on a regular basis.

Home Care

A beautiful, healthy smile that lasts a lifetime is our ultimate goal when treating patients. Your personal home care plays an important role in achieving that goal. Your personal home care starts by eating balanced meals, reducing the number of snacks you eat, and correctly using the various dental aids that help control the plaque and bacteria that cause dental disease.

Tooth brushing – Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste.

Place the brush at a 45 degree angle to the gums and gently brush using a small, circular motion, ensuring that you always feel the bristles on the gums.
Brush the outer, inner, and biting surfaces of each tooth.
Use the tip of the brush to clean the inside of the front teeth.
Brush your tongue to remove bacteria and freshen your breath.

Electric toothbrushes are also recommended. They are easy to use and can remove plaque efficiently. Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.

Flossing – Daily flossing is the best way to clean between the teeth and under the gumline. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.

Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
Curve the floss into a “C” shape around each tooth and under the gumline. Gently move the floss up and down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Rinsing – It is important to rinse your mouth with water after brushing and after meals if you are unable to brush. If you are using an over-the-counter product for rinsing, it’s a good idea to consult with your dentist or dental hygienist on its appropriateness for you.

Use other dental aids as recommended by your dentist or dental hygienist: interdental brushes, rubber tip stimulators, tongue cleaners, irrigation devices, fluoride, medicated rinses, etc., can all play a role in good dental home care.

How to Properly Brush & Floss

Brushing and flossing are of paramount importance to oral hygiene. Though bi-annual professional dental cleanings remove plaque, tartar, and debris, excellent homecare methods are equally valuable. Proper brushing and flossing can enhance the health of the mouth, make the smile sparkle, and prevent serious diseases.

Reasons why proper brushing and flossing are essential:

Prevention of tooth decay – Tooth decay is one of the leading causes of tooth loss, and its treatment often requires complex dental procedures. Tooth decay occurs when the acids found in plaque erode the natural enamel found on the teeth. This phenomenon can easily be prevented by using proper home hygiene methods.
Prevention of periodontal disease – Periodontal disease is a serious, progressive condition which can cause tooth loss, gum recession, and jawbone recession. Periodontal disease is caused by the toxins found in plaque and can lead to serious health problems in other parts of the body. Removing plaque and calculus (tartar) from the surface of the tooth using a toothbrush and from the interdental areas using dental floss, is an excellent way to stave off periodontal problems.
Prevention of halitosis – Bad breath or halitosis is usually caused by old food particles on or between the teeth. These food particles can be removed with regular brushing and flossing, leaving the mouth healthier, and breath smelling fresher.
Prevention of staining – Staining, or yellowing, of teeth can be caused by a wide variety of factors such as smoking, coffee, and tea. The more regularly these staining agents are removed from the teeth using brushing and flossing techniques, the less likely it is that the stains will become permanent.

The Proper Way to Brush

The teeth should be brushed at least twice a day, ideally in the morning and before bed. The perfect toothbrush is small in size with soft, rounded-end bristles, and is no more than three months old. The head of the brush needs to be small enough to access all areas of the mouth, and the bristles should be soft enough so as not to cause undue damage to the gum tissue. The American Dental Association (ADA) has given electric toothbrushes their seal of approval, stating that those with rotating or oscillating heads are more effective than other toothbrushes.

Here is a basic guide to proper brushing:

Place the toothbrush at a 45-degree angle where the gums and teeth meet.
Use small circular motions to gently brush the gumline and teeth.
Do not scrub or apply too much pressure to the teeth, as this can damage the gums and tooth enamel.
Brush every surface of every tooth, cheek-side, tongue-side, and chewing surfaces. Place special emphasis on the surfaces of the back teeth.
Use back and forth strokes to brush the chewing surfaces.
Brush the tongue to remove fungi, food, and debris.

The Proper Way to Floss

Flossing is a great way to remove plaque from the interdental regions (between the teeth). Flossing is an especially important tool for preventing periodontal disease and limiting the depth of the gum pockets. The interdental regions are difficult to reach with a toothbrush and should be cleansed with dental floss on a daily basis. The flavor and type of floss are unimportant; choose floss that will be easy and pleasant to use.

Here is a basic guide to proper flossing:

Cut a piece of floss to around 18 inches long.
Wrap one end of the floss around the middle finger of the left hand and the other end around the middle finger of the right hand until the hands are 2-3 inches apart.
Work the floss gently between the teeth toward the gum line.
Curve the floss in a U-shape around each individual tooth and carefully slide it beneath the gum line.
Carefully move the floss up and down several times to remove interdental plaque and debris.
Do not pop the floss in and out between the teeth as this will inflame and cut the gums.

If you have any questions about the correct way to brush or floss, please contact our office.

Oral Hygiene Aids

Regular dental check ups are essential for maintaining excellent oral hygiene and diagnosing potential problems, but they are not a “fix-all” solution. Thorough oral homecare routines should be practiced on a daily basis to avoid future dental problems.

Periodontal disease (also called gum disease and periodontitis) is the leading cause of tooth loss in the developed world, and is completely preventable in the vast majority of cases. Professional cleanings twice a year combined with daily self-cleaning can remove a high percentage of disease-causing bacteria and plaque. In addition, teeth that are well cared for make for a sparkling white smile.

There are numerous types of oral hygiene aids on the supermarket shelves, and it can be difficult to determine which will provide the best benefit to your teeth.

Here are some of the most common oral hygiene aids for homecare:

Dental Flosses

Dental floss is the most common interdental and subgingival (below the gum) cleaner and comes in a variety of types and flavors. The floss itself is made from either thin nylon filaments or polyethylene ribbons, and can help remove food particles and plaque from between the teeth. Vigorous flossing with a floss holder can cause soft tissue damage and bleeding, so great care should be taken. Floss should normally be used twice daily after brushing.

Interdental Cleaners

Many hygienists and periodontists recommend interdental brushes in addition to dental floss. These tiny brushes are gentle on the gums and very effective in cleaning the contours of teeth in between the gums. Interdental brushes come in various shapes and sizes.

Mouth Rinses

There are two basic types of mouth rinse available: cosmetic rinses which are sold over the counter and temporarily suppress bad breath, and therapeutic rinses which may or may not require a prescription. Most dentists are skeptical about the benefits of cosmetic rinses because several studies have shown that their effectiveness against plaque is minimal. Therapeutic rinses however, are regulated by the FDA and contain active ingredients that can help reduce bad breath, plaque, and cavities. Mouth rinses should generally be used after brushing.

Oral Irrigators

Oral irrigators, like Water Jets and Waterpiks have been created to clean debris from below the gum line. Water is continuously sprayed from tiny jets into the gum pockets which can help remove harmful bacteria and food particles. Overall, oral irrigators have proven effective in lowering the risk of gum disease and should not be used instead of brushing and flossing. Professional cleanings are recommended at least twice annually to remove deeper debris.

Rubber Tip Stimulators

The rubber tip stimulator is an excellent tool for removing plaque from around the gum line and also for stimulating blood flow to the gums. The rubber tip stimulator should be traced gently along the outer and inner gum line at least once each day. Any plaque on the tip can be rinsed off with tap water. It is important to replace the tip as soon as it starts to appear worn, and to store the stimulator in a cool, dry place.

Tongue Cleaners

Tongue cleaners are special devices which have been designed to remove the buildup of bacteria, fungi and food debris from the tongue surface. The fungi and bacteria that colonize on the tongue have been related to halitosis (bad breath) and a great many systemic diseases like diabetes, heart disease, respiratory disease and stroke. Tongue cleaners can be made from metal, wood or plastic and shaped in accordance with the contours of the tongue. Tongue cleaning should be done prior to brushing to prevent the ingestion of fungi and bacteria.

Toothbrushes

There are a great many toothbrush types available. Electric toothbrushes are generally recommended by dentists because electric brushes are much more effective than manual brushes. The vibrating or rotary motion helps to easily dislodge plaque and remove food particles from around the gums and teeth. The same results can be obtained using a manual brush, but much more effort is needed to do so.

Manual toothbrushes should be replaced every three months because worn bristles become ineffective over time. Soft bristle toothbrushes are far less damaging to gum tissue than the medium and hard bristle varieties. In addition, an appropriate sized ADA approved toothbrush should be chosen to allow proper cleaning to all the teeth. Teeth should ideally be brushed after each meal, or minimally twice each day.

If you have any questions about oral hygiene aids, please contact our practice.

Panoramic X-rays

Panoramic X-rays (also known as Panorex^® or orthopantomograms) are wraparound photographs of the face and teeth. They offer a view that would otherwise be invisible to the naked eye. X-rays in general, expose hidden structures, such as wisdom teeth, reveal preliminary signs of cavities, and also show fractures and bone loss.

Panoramic X-rays are extraoral and simple to perform. Usually, dental X-rays involve the film being placed inside the mouth, but panoramic film is hidden inside a mechanism that rotates around the outside of the head.

Unlike bitewing X-rays that need to be taken every few years, panoramic X-rays are generally only taken on an as-needed basis. A panoramic X-ray is not conducted to give a detailed view of each tooth, but rather to provide a better view of the sinus areas, nasal areas and mandibular nerve. Panoramic X-rays are preferable to bitewing X-rays when a patient is in extreme pain, and when a sinus problem is suspected to have caused dental problems.

Panoramic X-rays are extremely versatile in dentistry, and are used to:

Assess patients with an extreme gag reflex.
Evaluate the progression of TMJ.
Expose cysts and abnormalities.
Expose impacted teeth.
Expose jawbone fractures.
Plan treatment (full and partial dentures, braces and implants).
Reveal gum disease and cavities.

How are panoramic X-rays taken?

The panoramic X-ray provides the dentist with an ear-to-ear two-dimensional view of both the upper and lower jaw. The most common uses for panoramic X-rays are to reveal the positioning of wisdom teeth and to check whether dental implants will affect the mandibular nerve (the nerve extending toward the lower lip).

The Panorex equipment consists of a rotating arm that holds the X-ray generator, and a moving film attachment that holds the pictures. The head is positioned between these two devices. The X-ray generator moves around the head taking pictures as orthogonally as possible. The positioning of the head and body is what determines how sharp, clear and useful the X-rays will be to the dentist. The pictures are magnified by as much as 30% to ensure that even the minutest detail will be noted.

Panoramic X-rays are an important diagnostic tool and are also valuable for planning future treatment. They are safer than other types of X-rays because less radiation enters the body.

If you have questions or concerns about panoramic X-rays, please contact our practice.

Sealants

A sealant is a thin, plastic coating applied to the chewing surface of molars, premolars and any deep grooves (called pits and fissures) of teeth. More than 75% of dental decay begins in these deep grooves. Teeth with these conditions are hard to clean and are very susceptible to decay. A sealant protects the tooth by sealing deep grooves, creating a smooth, easy to clean surface.

Sealants can protect teeth from decay for many years, but need to be checked for wear and chipping at regular dental visits.

Reasons for sealants:

Children and teenagers – As soon as the six-year molars (the first permanent back teeth) appear or any time throughout the cavity prone years of 6-16.

Adults – Tooth surfaces without decay that have deep grooves or depressions.

Baby teeth – Occasionally done if teeth have deep grooves or depressions and child is cavity prone.

What do sealants involve?

Sealants are easily applied by your dentist or dental hygienist and the process takes only a couple of minutes per tooth.

The teeth to be sealed are thoroughly cleaned and then surrounded with cotton to keep the area dry. A special solution is applied to the enamel surface to help the sealant bond to the teeth. The teeth are then rinsed and dried. Sealant material is carefully painted onto the enamel surface to cover the deep grooves or depressions. Depending on the type of sealant used, the material will either harden automatically or with a special curing light.

Proper home care, a balanced diet, and regular dental visits will aid in the life of your new sealants.

Cosmetic Dentistry

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!

Bonding

Bonding is a cosmetic procedure that allows the dentist to reshape or repair your smile using composite resin. Cosmetic bonding is particularly ideal if you’re insecure about the appearance of your smile or want an affordable alternative to invasive and more costly procedures such as orthodontics or veneers. With bonding, chipped or uneven teeth can be repaired easily and affordably, restoring your self-confidence. Additionally, bonding is often completed in a single visit and doesn’t require any anesthetic!

As with most cosmetic procedures, bonding will wear and discolor over time, eventually needing to be replaced; however, bonding is very durable and typically lasts many years.

Reasons for cosmetic bonding:

Closing spaces or gaps
Fixing chipped teeth
Fixing decayed teeth (teeth with cavities)
Lengthening uneven teeth
Protecting roots exposed by receding gums
Restoring badly discolored teeth

What does dental bonding involve?

To begin, the dentist will isolate the teeth included in the procedure, etching them in preparation for bonding. After applying the etching conditioning liquid, the surface of the teeth will have small crevices that allow the tooth stronger adhesion with the bonding agent.

The dentist will then apply a bonding resin which cements the composite in place. After several layers of tooth-colored composite are applied, the composite and bonding resin are shaped and hardened with a specially calibrated light. Once the composite is fully set, the bonded areas are smoothed, buffed, and polished to blend in naturally with the surrounding teeth.

If you want to regain confidence in your smile, contact our practice to learn more about bonding.

Composite Fillings

A composite (tooth colored) filling is used to repair a tooth that is affected by decay, cracks, fractures, etc. The decayed or affected portion of the tooth will be removed and then filled with a composite filling.

There are many types of filling materials available, each with their own advantages and disadvantages. You and your dentist can discuss the best options for restoring your teeth. Composite fillings, along with silver amalgam fillings, are the most widely used today. Because composite fillings are tooth colored, they can be closely matched to the color of existing teeth, and are more aesthetically suited for use in front teeth or more visible areas of the mouth.

As with most dental restorations, composite fillings are not permanent and may someday have to be replaced. They are very durable and will last many years, giving you a long lasting, beautiful smile.

Reasons for composite fillings:

Chipped teeth.
Closing space between two teeth.
Cracked or broken teeth.
Decayed teeth.
Worn teeth.

How are composite fillings placed?

Composite fillings are usually placed in one appointment. While the tooth is numb, your dentist will remove decay as needed. The space will then be thoroughly cleaned and carefully prepared before the new filling is placed. If the decay was near the nerve of the tooth, a special medication will be applied for added protection. The composite filling will then be precisely placed, shaped, and polished, restoring your tooth to its original shape and function.

It is normal to experience sensitivity to hot and cold when composite fillings are first placed, however this will subside shortly after your tooth acclimates to the new filling.

You will be given care instructions at the conclusion of your treatment. Good oral hygiene practices, eating habits, and regular dental visits will aid in the life of your new fillings.

Porcelain Veneers

Veneers are very thin pieces of durable, tooth shaped porcelain that are custom made (for shape and color) by a professional dental laboratory. They are bonded onto the front of teeth to create a beautiful and attractive smile.

Veneers can completely reshape your teeth and smile. They can often be alternatives to crowns and the ideal solution in treating many dental conditions.

As with most dental restorations, veneers are not permanent and may someday need replacement. They are very durable and will last many years, giving you a beautiful long lasting smile.

Reasons for porcelain veneers:

Cosmetically, to create a uniform, white, beautiful smile.
Crooked teeth.
Misshapen teeth.
Severely discolored or stained teeth.
Teeth that are too small or large.
Unwanted or uneven spaces.
Worn or chipped teeth.

What does getting porcelain veneers involve?

Getting veneers usually requires two visits to complete the process, with little or no anesthesia required during the procedure. The teeth are prepared by lightly buffing and shaping the surface to allow for the thickness of the veneer. A mold or impression of the teeth is taken and a shade (color) will then be chosen by you and the dentist.

On the second visit the teeth will be cleansed with special liquids to achieve a durable bond. Bonding cement is then placed between the tooth and veneer and a special light beam is used to harden and set the bond.

You will receive care instructions for veneers. Proper brushing, flossing and regular dental visits will aid in the life of your new veneers.

Teeth Whitening

Teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel and is an ideal way to enhance the beauty of your smile.

Because having whiter teeth has now become the number one aesthetic concern of most patients, there are a number of ways to whiten teeth. The most popular method is using a home teeth whitening system that will whiten teeth dramatically. Since teeth whitening only works on natural tooth enamel, it is important to evaluate replacement of any old fillings, crowns, etc. Replacement of any restorations will be done after bleaching so they will match the newly bleached teeth.

Teeth whitening is not permanent. A touch-up may be needed every several years, and more often if you smoke, drink coffee, tea, or wine.

Reasons for teeth whitening:

Fluorosis (excessive fluoridation during tooth development).
Normal wear of outer tooth layer.
Stained teeth due to medications (tetracycline, etc.).
Yellow, brown stained teeth.

What does teeth whitening involve?

This type of teeth whitening usually requires two visits. At the first appointment, impressions (molds) will be made of your teeth to fabricate custom, clear, plastic, trays.

At your second appointment, you will try on the trays for proper fit, and adjustments will be made if necessary. The trays are worn with special whitening solution either twice a day for 30 minutes or overnight for a couple of weeks depending on the degree of staining and desired level of whitening. It is normal to experience tooth sensitivity during the time you are whitening your teeth, but it will subside shortly after you have stopped bleaching.

You will receive care instructions for your teeth and trays, and be encouraged to visit your dentist regularly to help maintain a beautiful, healthy, white smile.

Opalescence® Teeth Whitening

Opalescence ^® is a proven teeth whitening treatment that eliminates organic stains on the teeth and significantly brightens the smile. Opalescence ^® can be used with or without light activation of the gel provided at the discretion of the dentist. Opalescence ^® is an exceptionally quick and simple treatment. Bleaching gel is applied to the teeth for around 45 minutes. Opalescence ^® is completely safe and helps to protect dental enamel during treatment with added potassium nitrate and fluoride.

Why should I consider Opalescence ^®?

Opalescence ^® combines hydrogen peroxide that serves to whiten the teeth, with potassium nitrate that reduces sensitivity and strengthens enamel. This treatment can only be used on generally healthy teeth that are free from disease and decay.

There are a great many reasons why Opalescence ^® is often preferred over other brands, including:

Minimizes tooth sensitivity
Promotes strong tooth enamel
Quick treatment times
Reduces risk of tooth dehydration
Proven results

How is the Opalescence ^® treatment performed?

Opalescence ^® whitening gel contains 38% hydrogen peroxide and potassium nitrate. After in-office treatment, gel and toothpaste containing lower concentrations of the whitening formula may be prescribed for use at home. The Opalescence ^® whitening gel is thick, which reduces mess during application.

Here is how the procedure will be performed:

A thorough cleaning will remove debris from the surfaces of the teeth
Photographs will be taken to record the current color of the teeth
A cheek retractor will be inserted to expose the surfaces of key teeth
A resin will be painted onto the gums to protect them
The first covering of Opalescence ^® whitening gel will be applied to the teeth for 15 minutes
The dentist will suction off the gel and check the whitening progress
More gel will be applied for a further 15 minutes
Again, the gel will be removed
The mouth will be rinsed and the final round of whitening gel will be applied.
The mouth will be cleaned and photographs of teeth color post-treatment will be taken

If the dentist chooses to expedite the whitening process with a specialized light, the light will be applied for approximately 30 seconds per gel application. The entire procedure, including the initial cleaning should take no more than 90 minutes.

If you have questions or concerns about Opalescence ^® or any other whitening treatment, please contact your dentist.

Zoom!®

A pearly-white smile is beautiful to look at and can greatly improve self-confidence. Many people are opting for the Zoom!^® Chairside Whitening System (Zoom!^®) for fast, safe and effective teeth whitening. Zoom!^® combines the newest advances in dental technology with proven chemical formulas. This ensures that the bleaching experience is painless, and the results are satisfying.

There are many reasons why teeth become stained or discolored, including tobacco use, and drinking dark liquids such as red wine, coffee, tea and cola. However, the natural aging process and prescription medication use can also cause yellowing and graying.

There are literally hundreds of whitening treatments available in the marketplace, including take-home strips, bleaching toothpastes and take-home whitening gels. Many take-home gels are ineffective and may not elicit the desired results.

Zoom!^® has many advantages over these other treatments, including:

All teeth treated simultaneously.
Faster treatment times.
Longer lasting results.
Reduced sensitivity.
Removal of stains on crowns, veneers and other restorations.
Safe procedure and treatment.
Treatments are performed by an experienced professional.

It is important to seek advice from the dentist prior to beginning a bleaching regime. Women who are pregnant or lactating should not seek bleaching treatment.

How does Zoom!^® whiten the teeth?

Zoom!^® is a bleaching process that lightens the dentin and enamel of the teeth. Zoom!^® contains a hydrogen peroxide component (25%), which is the active ingredient in the gel. When hydrogen peroxide is applied to the teeth, the peroxide component breaks down into tiny oxygen bubbles. It is these bubbles that eliminate yellowing and staining.

A mercury metal halide light is used to activate the gel and expedite the whitening process. This specialized light contains a unique infrared filter that works to reduce the amount of heat (and therefore sensitivity) on the surface of the teeth during the procedure. The internal structure of the teeth remains completely healthy and intact during and after the treatment.

As with any whitening system, the post-treatment results can vary according to the degree of staining and the condition of the teeth. A consultation with the dentist prior to treatment will provide information as to what kind of results Zoom!^® can provide in specific instances. Zoom!^® is only applied to healthy teeth and gums. If tooth decay or gum disease is an issue, these need to be controlled before the bleaching treatment is performed.

How is the Zoom!^® treatment performed?

Prior to treatment, there will be a consultation where the dentist will outline the exact procedure. On treatment day, a deep cleaning (prophylaxis) will be performed to rid the teeth of any debris and plaque. Then, special eyewear will be provided to protect the eyes from the halide light, and splashguards to protect the clothing from the bleaching agent.

Here is a brief overview of the Zoom!^® procedure:

Cheek retractors will be placed to expose the entire surface of the teeth.
The gums will be painted or covered to reduce sensitivity.
The dentist will apply the whitening gel to the teeth.
The halide light will then be applied to activate the gel. This specialized Zoom!^® light can be positioned to work on all the teeth simultaneously.
After 15 minutes, gel will be removed from the teeth and the mouth will be rinsed.
More gel will be applied for another 15 minutes.
Again, the gel will be removed and the mouth will be thoroughly cleansed.
The final treatment of gel will be applied for 15 minutes.
The gel will be removed for the final time.

What happens after treatment?

The same external factors that caused the discoloration in the first place can quickly work their way back onto the teeth. For this reason, the dentist recommends flossing once a day, thorough cleaning with anti-sensitivity toothpaste twice a day, and occasional retreatment with Zoom!^® Weekender. These post-treatment measures will ensure that the smile stays at its whitest for a long time.

If you have questions about the Zoom!^® Chairside System, please ask your dentist.

Restorations

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!

Crowns (Caps)

A crown (or cap) is a covering that encases the entire tooth surface, restoring it to its original shape and size. A crown protects and strengthens tooth structure that cannot be restored with fillings or other types of restorations.

Although there are several types of crowns, porcelain (tooth colored crown) are the most popular. They are highly durable and will last many years, but like most dental restorations, they may eventually need to be replaced. Porcelain crowns are made to match the shape, size, and color of your teeth, giving you a long-lasting, beautiful smile.

Reasons for crowns:

Broken or fractured teeth.
Cosmetic enhancement.
Decayed teeth.
Fractured fillings.
Large fillings.
Tooth has a root canal.

What does getting a crown involve?

A crown procedure usually requires two appointments. Your first appointment will include taking several highly accurate molds (or impressions) that will be used to create your custom crown. A mold will also be used to create a temporary crown which will stay on your tooth for approximately two weeks until your new crown is fabricated by a dental laboratory.

While the tooth is numb, the dentist will prepare the tooth by removing any decay and shaping the surface to properly fit the crown. Once these details are accomplished, your temporary crown will be placed with temporary cement and your bite will be checked to ensure you are biting properly.

At your second appointment, your temporary crown will be removed, the tooth will be cleaned, and your new crown will be carefully placed to ensure the spacing and bite are accurate.

You will be given care instructions and encouraged to have regular dental visits to check your new crown.

Dental Implants

Dental implants are a great way to replace missing teeth and also provide a fixed solution to having removable partial or complete dentures. Implants provide excellent support and stability for these dental appliances.

Dental implants are artificial roots and teeth (usually titanium) that are surgically placed into the upper or lower jaw bone by a dentist or Periodontist – a specialist of the gums and supporting bone. The teeth attached to implants are very natural looking and often enhance or restore a patient’s smile!

Dental implants are strong and durable and will last many years. On occasion, they will have to be re-tightened or replaced due to normal wear.

Reasons for dental implants:

Replace one or more missing teeth without affecting adjacent teeth.
Resolve joint pain or bite problems caused by teeth shifting into missing tooth space.
Restore a patient’s confident smile.
Restore chewing, speech, and digestion.
Restore or enhance facial tissues.
Support a bridge or denture, making it more secure and comfortable.

What does getting dental implants involve?

The process of getting implants requires a number of visits over several months.

X-rays and impressions (molds) are taken of the jaw and teeth to determine bone, gum tissue, and spacing available for an implant. While the area is numb, the implant will be surgically placed into the bone and allowed to heal and integrate itself for up to six months. Depending on the type of implant, a second surgery may be required in order to place the “post” that will hold the artificial tooth in place. With other implants the post and anchor are already attached and placed at the same time.

After several weeks of healing the artificial teeth are made and fitted to the post portion of the anchor. Because several fittings may be required, this step may take one to two months to complete. After a healing period, the artificial teeth are securely attached to the implant, providing excellent stability and comfort to the patient.

You will receive care instructions when your treatment is completed. Good oral hygiene and eating habits, alongside regular dental visits, will aid in the life of your new implant.

If you have questions about dental implants or would like to schedule a consultation, please contact our office.

Dentures & Partial Dentures

A denture is a removable dental appliance and a replacement for missing teeth and surrounding tissue. They are made to closely resemble your natural teeth and may even enhance your smile.

There are two types of dentures – complete and partial dentures. Complete dentures are used when all of the teeth are missing, while partial dentures are used when some natural teeth remain. A partial denture not only fills in the spaces created by missing teeth, it prevents other teeth from shifting.

A complete denture can be either “conventional” or “immediate.” A conventional type is made after the teeth have been removed and the gum tissue has healed (usually takes 4 to 6 weeks). During this time, the patient will go without teeth. Immediate dentures are made in advance and immediately placed after the teeth are removed, thus preventing the patient from having to be without teeth during the healing process. Once the tissues shrink and heal, adjustments will have to be made.

Dentures are very durable appliances and will last many years but may have to be remade, repaired, or readjusted due to normal wear.

Reasons for dentures:

Complete Denture – Loss of all teeth in an arch.
Partial Denture – Loss of several teeth in an arch.
Enhancing smile and facial tissues.
Improving chewing, speech, and digestion.

What does getting dentures involve?

The process of getting dentures requires several appointments, usually over a period of several weeks. Highly accurate impressions (molds) and measurements are taken and used to create your custom denture. Several “try-in” appointments may be necessary to ensure proper shape, color, and fit. At the final appointment, your dentist will precisely adjust and place the completed denture, ensuring a natural and comfortable fit.

It is normal to experience increased saliva flow, some soreness, and possible speech and chewing difficulty, however this will subside as your muscles and tissues get used to the new dentures.

You will be given care instructions for your new dentures. Proper cleaning of your new dental appliance, good oral hygiene, and regular dental visits will aid in the life of your new dentures.

Fixed Bridges

A dental bridge is a fixed (non-removable) appliance and is an excellent way to replace missing teeth.

There are several types of bridges. You and your dentist will discuss the best options for your particular case. The “traditional bridge” is the most popular type and is usually made of porcelain fused to metal. This type of bridge consists of two crowns that go over two anchoring teeth (abutment teeth) and are attached to pontics (artificial teeth), filling the gap created by one or more missing teeth.

Dental bridges are highly durable and will last many years; however, they may need replacement or need to be re-cemented due to normal wear.

Reasons for a fixed bridge:

Fill space of missing teeth.
Maintain facial shape.
Prevent remaining teeth from drifting out of position.
Restore chewing and speaking ability.
Restore your smile.
Upgrade from a removable partial denture to a permanent dental appliance.

What does getting a fixed bridge involve?

Getting a bridge usually requires two or more visits. While the teeth are numb, the two anchoring teeth are prepared by removing a portion of enamel to allow for a crown. Next, a highly accurate impression (mold) is made which will be sent to a dental laboratory where the bridge will be fabricated. In addition, a temporary bridge will be made and worn for several weeks until your next appointment.

At the second visit, your permanent bridge will be carefully checked, adjusted, and cemented to achieve a proper fit. Occasionally your dentist may only temporarily cement the bridge, allowing your teeth and tissue time to get used to the new bridge. The new bridge will be permanently cemented at a later time.

You will receive care instructions at the conclusion of the procedure. Proper brushing, flossing, and regular dental visits will aid in the life of your new, permanent bridge.

Empress® Restorations

Dental veneers, crowns, onlays, inlays, and bridges are important restorations which enhance the health and functionality of the natural teeth. A sparkling smile can be an enormous confidence-booster and have a dramatic effect on a person’s appearance. Empress® has been dedicated to creating natural-looking restorations for almost two decades and is one of the world leaders in dental ceramics.

Empress® veneers, crowns, onlays, overlays, and dental bridges are renowned for their strength, durability, and exceptional optical properties. Empress® restorations are completely metal-free, and are constructed from inorganic material which is baked and cured at high temperatures.

Why should I choose Empress® restorations?

Empress® is continually refining and enhancing restorations to ensure that they look natural and restore complete functionality to the teeth.

Traditional ceramic restorations were known for being brittle and expensive to repair after sustaining damage. However, Empress® has developed a heat-pressed glass ceramic that is immensely strong and durable. There are several reasons for this, including the high shrinkage of leucite crystals. This shrinkage means that compressive stress is created during the vitreous stage, thus preventing breakage and cracking.

The unique veneer glaze and stain also increases strength by as much as 50%. These elements combined establish a thicker restoration that is fracture resistant. Empress® crowns have a 100% chance of surviving the first three years. This means less dental visits, less expense, and a sensational, comfortable smile.

Here are some of the advantages associated with Empress® restorations:

Biocompatible.
Do not affect other dentition.
Ease of application.
Excellent polishing properties.
Many levels of translucency available.
Metal-free.
Natural-looking.
Shades match the other teeth.

What restorations can be done using Empress® products?

Empress® has created many natural-looking restorations, including:

Empress® Veneers – These veneers are wafer-thin porcelain and ceramic covers which fit permanently over natural teeth. Empress® veneers are perfect for covering disfigured and stained teeth. They are stain and bacteria-resistant, strong, and can be manufactured to match the natural tooth shade.

Empress® Crowns – These crowns are generally placed after root canal therapy or after the removal of tooth decay. Empress® crowns are proven to last longer than many types of crowns, and again, can be matched exactly to the natural tooth shade. There is no visible, ugly metal edge, just a sensational end result.

Empress® Inlays/Onlays – Inlays and onlays are currently being used to replace the traditional amalgam fillings. Amalgam is unpleasant to view and unhealthy for the body. Empress® ceramic inlays and overlays are strong, healthy, and usually invisible to onlookers.

Empress® Bridges – As with all Empress® products, Empress® bridges are a completely natural-looking way to replace missing teeth. Metal bridges are often highly visible and make the teeth look shorter. Empress® bridges are almost impossible to spot and restore symmetry and sparkle to the smile.

If you have questions about any of the Empress® restorations, please contact our office.

3i Dental Implants

Dental implants offer a natural looking replacement for adult teeth. In addition, implants restore functionality to the jaw, making speaking, eating, and chewing easier. Most implants are comprised of a screw that is embedded into the bone and a post to which the prosthesis is attached.

Biomet 3i implants are unique because the microsurface of the cone-shaped screw contains an innovative bone-bonding component. This means that implants can be placed in areas with low bone density, sparing the patient the mess and misery of wearing poorly fitting dentures. Additionally, the bone-bonding component means quicker recovery time after the implant is placed.

Why should I choose 3i dental implants?

There are a wide variety of dental implants in the marketplace, but 3i have an almost unparalleled success rate. Almost 98% of 3i implants are fitted successfully and last for a lifetime. 3i implants contain a unique feature, which is embedded in the surface of the screw. Implant screws made by other companies are sprayed with calcium phosphate to enhance the bone integration process. However, 3i screws actually contain calcium phosphate, which means that delamination is less likely to occur.

Additionally, the cone-shaped 3i screw adds precision to the placement of implants and ensures that the final prosthesis is comfortable and can withstand pressure.

Here are some of the other benefits associated with 3i implants:

Better oral health.
Higher success rate.
Improved self-esteem.
Long-lasting results.
Multiple 3i implants can be placed during a visit.
Natural-looking implants.
No adhesives or mess.
Prevention of bone loss and gum recession.
Sturdy, functional prosthetic teeth.

How are 3i dental implants placed?

The procedure for placing 3i dental implants is similar to many other implant procedures. It is usually performed in two short visits, the first visit being typically an hour in length and the second taking around thirty minutes.

After the dentist has analyzed the X-rays and diagnostic results, the implant root can be inserted. This procedure will be performed under local anesthetic, unless another type of sedation is preferred.

Here is a step-by-step process for the first stage of a 3i dental implant placement:

An incision will be made in the gum tissue to expose the jawbone.
A tiny hole will be drilled into the jawbone to insert the implant into.
The implant will be screwed or tapped into the designated position.
A small temporary stop-cap is placed to cover the implant, and the surgical site is sutured closed.
After approximately 10 days, the sutures will be removed and the dentist will assess the healing process.

Generally, 3i dental implants enhance the healing process, which means that the second treatment phase can be completed around 10-12 weeks after the first.

Here is a brief overview of can be expected at the second appointment:

A local anesthetic will be administered, and a tiny incision will be made to expose the prosthetic root. The temporary stop-cap will be removed and a small post or abutment will be attached to the implant.

When the healing process is complete, the new dental prosthesis (usually a crown) will be created from bite impressions. A tiny screw will be used to secure the prosthesis onto the abutment. Any necessary adjustments will be made to ensure the prosthesis is comfortable, and the 3i dental implant will be secure for a lifetime.

If you have any questions about 3i dental implants, please ask your dentist.

Straumann® Implants

Straumann ^® implants offer an effective way to replace missing teeth. These medical-grade titanium implants are highly compatible with the body and have proven to last for many years. Straumann ^® implants are one of the most popular types of implants in the world and restore full dental functionality.

Dental implants are a preferable alternative to other restorations, like dental bridges, because they do not require consistent replacement over their lifetime. Implants also enhance the smile aesthetically and feel exactly like natural teeth.

Here are some of the main benefits associated with dental implants:

Reduce bone loss
Do not compromise or affect adjacent teeth
Create stability and balance in the jaw
Can be used to replace a single tooth or multiple teeth
Can be used to anchor partial or full dentures

How can Straumann ^® dental implants help me?

Straumann ^® dental implants differ from other brands in a variety of ways. Straumann ^® has developed a unique technology that promotes faster healing and osseointegration (bone growth around the implant). These implants can also be of benefit for patients with problems related to bone density. Here are some of the main advantages associated with Straumann ^® implants:

99% success rate in patients with an otherwise healthy mouth
Hi-tech implant surface, which vastly reduces healing time
More than 3 million implants successfully placed
30 years of clinical research and experience
Implant types suitable for reduced bone quality

What types of Straumann ^® implants are available?

Straumann ^® offers three main types of implants andeach type comes in a variety of sizes. Though many patients are suitable candidates for Straumann ^® implants, different needs require different styles of implant. Here is a brief overview of the some different Straumann ^® implants:

Straumann ^® Standard Implants – These implants promote fast healing when placed through the gums and have the SLActive surface for quicker osseointegration.

Straumann ^® Standard Plus Implants – These implants have been designed for semi-, trans-, and subgingival use in the anterior (front-facing) region of the mouth. They have the specialized SLActive surface and are designed for use where the teeth are most noticeable.

Straumann ^® Tapered Effect Implants – These implants can be loaded immediately with a temporary prosthetic and have been developed specifically for early implantation.

How are Straumann ^® dental implants placed?

Generally, Straumann ^® implants require three dental visits. During the first visit, a plan will be constructed for the forthcoming procedures. To develop this plan, thorough examinations need to be performed, along with three-dimensional x-rays. These tools help your oral health professional to determine exactly where to place the implant to support the greatest possible benefit.

During the second visit, the implant is placed under local anesthetic. Your doctor makes an incision into gum tissue to expose the jawbone at the placement site. The Straumann ^® implant is inserted into the bone by screwing or tapping.A cap is then placed on the top of the implant and the surgical site is sutured closed. In some methods, the implants can be placed directly through the gingival tissue, with no additional incisions needed.

After this visit, osseointegration occurs. This stabilizes the implant in the jawbone and usually takes 3-4 weeks, instead of many months with other types of implant. The third appointment is generally of shorter duration, where the custom-created dental crown or restoration is permanently placed. In certain cases, the restoration can be placed immediately with the implant on the second visit.

If you have any questions or concern about Straumann ^® implants, please contact your oral health professional.

Zimmer Implants

Zimmer Biomet Dental provides a popular brand of implants to restore comfort and dental functionality for patients with missing teeth. Traditionally, bridges and crowns would fill the gaps left by absent teeth, but Zimmer Biomet Dental implants are preferable for a number of reasons.

Zimmer Biomet Dental implants come in a variety of shapes and sizes. Each different design has been created to ensure that as many patients as possible can benefit from dental implant placement.

Why should I choose Zimmer Biomet Dental implants?

Zimmer Biomet Dental implants are technologically advanced and exceptionally versatile. With arrange of implant types suited to unique patient needs, greater stability and treatment precision can be achieved. With these implants, less time is spent in the dentist’s chair, which substantially reduces the cost and time investment associated with implant procedures.

These implants are exceptionally easy for oral health professionals to place and can support many implantation techniques, whether in single or multiple stages. Zimmer Biomet Dental not only designs the prosthetic root of the implant, but the titanium abutment as well, which serves as an intermediary between the implant and the custom-created prosthesis.

Here are some of the other key advantages associated with Zimmer Biomet Dental implants:

Cost-effective
High precision levels for patients of varying dental health
Minimized preparation and steps required
Reduced treatment and healing time
Greater comfort
Secure, stable prosthesis for restorations in any area of the mouth
Beautiful, natural end result

What is involved in getting Zimmer Biomet Dental implants?

Before implanting prosthetic tooth roots, your oral health professional formulates a plan from diagnostics achieved through-rays, bite impressions and examinations. When the plan is complete, the first stage of implant placement can begin.

Initially, a local anesthetic is administered to the surgical site. After an incision is made to reveal bone at the treatment site, a precision drill is used to make a tiny hole. The Zimmer Biomet Dental implant is then tapped or screwed into place. In some cases, initial incisions may not be necessary and the implant can be placed directly through soft tissue.

For patients whose treatment plan involves two-step implant care, the second stage is completed when the implant has been integrated into and stabilized by the jawbone.

During the second visit, another local anesthetic will be administered so the implant post can be accessed and the abutment can be attached to the implant. Zimmer Biomet Dental also manufactures an implant with a pre-attached abutment, which can negate this step of treatment for some patients.

The dental prosthesis is created within a week of taking post-healing bite impressions. The primary concern of your oral health professional is ensuring that you experience a lifetime of comfort and stability when your final restoration is placed.

If you have any questions or concerns about Zimmer Biomet Dental implants, please contact your dental professional.

Endodontics

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.

Root Canal Therapy

Root canal therapy is needed when the nerve of a tooth is affected by decay or infection. In order to save the tooth, the pulp (the living tissue inside the tooth), nerves, bacteria, and any decay are removed and the resulting space is filled with special, medicated, dental materials, which restore the tooth to its full function.

Having a root canal done on a tooth is the treatment of choice to save a tooth that otherwise would die and have to be removed. Many patients believe that removing a tooth that has problems is the solution, but what is not realized is that extracting (pulling) a tooth will ultimately be more costly and cause significant problems for adjacent teeth.

Root canal treatment is highly successful and usually lasts a lifetime, although on occasion, a tooth will have to be retreated due to new infections.

Signs and symptoms for possible root canal therapy:

An abscess (or pimple) on the gums.
Sensitivity to hot and cold.
Severe toothache pain.
Sometimes no symptoms are present.
Swelling and/or tenderness.

Reasons for root canal therapy:

Decay has reached the tooth pulp (the living tissue inside the tooth).
Infection or abscess have developed inside the tooth or at the root tip.
Injury or trauma to the tooth.

What does root canal therapy involve?

A root canal procedure requires one or more appointments and can be performed by a dentist or endodontist (a root canal specialist).

While the tooth is numb, a rubber dam (a sheet of rubber) will be placed around the tooth to keep it dry and free of saliva. An access opening is made on top of the tooth and a series of root canal files are placed into the opening, one at a time, removing the pulp, nerve tissue, and bacteria. If tooth decay is present, it will also be removed with special dental instruments.

Once the tooth is thoroughly cleaned, it will be sealed with either a permanent filling or, if additional appointments are needed, a temporary filling will be placed.

At the next appointment, usually a week later, the roots and the inside cavity of the tooth will be filled and sealed with special dental materials. A filling will be placed to cover the opening on top of the tooth. In addition, all teeth that have root canal treatment should have a crown (cap) placed. This will protect the tooth and prevent it from breaking, and restore it to its full function.

After treatment, your tooth may still be sensitive, but this will subside as the inflammation diminishes and the tooth has healed.

You will be given care instructions after each appointment. Good oral hygiene practices and regular dental visits will aid in the life of your root canal treatment.

Periodontal Disease

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.

What is Periodontal (Gum) Disease?

The term “periodontal” means “around the tooth.” Periodontal disease (also known as periodontitis and gum disease) is a common inflammatory condition that affects the supporting and surrounding soft tissues of the tooth, eventually affecting the jawbone itself in the disease’s most advanced stages.

Periodontal disease is most often preceded by gingivitis which is a bacterial infection of the gum tissue. A bacterial infection affects the gums when the toxins contained in plaque begin to irritate and inflame the gum tissues. Once this bacterial infection colonizes in the gum pockets between the teeth, it becomes much more difficult to remove and treat. Periodontal disease is a progressive condition that eventually leads to the destruction of the connective tissue and jawbone. If left untreated, it can cause shifting teeth, loose teeth, and eventually tooth loss.

Periodontal disease is the leading cause of tooth loss among adults in the developed world and should always be promptly treated.

Types of Periodontal Disease

When left untreated, gingivitis (mild gum inflammation) can spread to below the gum line. When the gums become irritated by the toxins contained in plaque, a chronic inflammatory response causes the body to break down and destroy its own bone and soft tissue. There may be little or no symptoms as periodontal disease causes the teeth to separate from the infected gum tissue. Deepening pockets between the gums and teeth are generally indicative that soft tissue and bone is being destroyed by periodontal disease.

Here are some of the most common types of periodontal disease:

Chronic periodontitis – Inflammation within supporting tissues cause deep pockets and gum recession. It may appear the teeth are lengthening, but in actuality, the gums (gingiva) are receding. This is the most common form of periodontal disease and is characterized by progressive loss of attachment, interspersed with periods of rapid progression.
Aggressive periodontitis – This form of gum disease occurs in an otherwise clinically healthy individual. It is characterized by rapid loss of gum attachment, chronic bone destruction and familial aggregation.
Necrotizing periodontitis – This form of periodontal disease most often occurs in individuals suffering from systemic conditions such as HIV, immunosuppression and malnutrition. Necrosis (tissue death) occurs in the periodontal ligament, alveolar bone and gingival tissues.
Periodontitis caused by systemic disease – This form of gum disease often begins at an early age. Medical condition such as respiratory disease, diabetes and heart disease are common cofactors.

Treatment for Periodontal Disease

There are many surgical and nonsurgical treatments the periodontist may choose to perform, depending upon the exact condition of the teeth, gums and jawbone. A complete periodontal exam of the mouth will be done before any treatment is performed or recommended.

Here are some of the more common treatments for periodontal disease:

Scaling and root planing – In order to preserve the health of the gum tissue, the bacteria and calculus (tartar) which initially caused the infection, must be removed. The gum pockets will be cleaned and treated with antibiotics as necessary to help alleviate the infection. A prescription mouthwash may be incorporated into daily cleaning routines.
Tissue regeneration – When the bone and gum tissues have been destroyed, regrowth can be actively encouraged using grafting procedures. A membrane may be inserted into the affected areas to assist in the regeneration process.
Pocket elimination surgery – Pocket elimination surgery (also known as flap surgery) is a surgical treatment which can be performed to reduce the pocket size between the teeth and gums. Surgery on the jawbone is another option which serves to eliminate indentations in the bone which foster the colonization of bacteria.
Dental implants – When teeth have been lost due to periodontal disease, the aesthetics and functionality of the mouth can be restored by implanting prosthetic teeth into the jawbone. Tissue regeneration procedures may be required prior to the placement of a dental implant in order to strengthen the bone.

Please contact our office if you have questions or concerns about periodontal disease, periodontal treatment, or dental implants.

Diagnosis

Periodontal disease is diagnosed by your dentist or dental hygienist during a periodontal examination. This type of exam should always be part of your regular dental check-up.

A periodontal probe (small dental instrument) is gently used to measure the sulcus (pocket or space) between the tooth and the gums. The depth of a healthy sulcus measures three millimeters or less and does not bleed. The periodontal probe helps indicate if pockets are deeper than three millimeters. As periodontal disease progresses, the pockets usually get deeper.

Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category below:

Gingivitis

Gingivitis is the first stage of periodontal disease. Plaque and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed.

Periodontitis

Plaque hardens into calculus (tartar). As calculus and plaque continue to build up, the gums begin to recede from the teeth. Deeper pockets form between the gums and teeth and become filled with bacteria and pus. The gums become very irritated, inflamed, and bleed easily. Slight to moderate bone loss may be present.

Advanced Periodontitis

The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed. Unless treated, the affected teeth will become very loose and may be lost. Generalized moderate to severe bone loss may be present.

Treatment

Periodontal treatment methods depend upon the type and severity of the disease. Your dentist and dental hygienist will evaluate for periodontal disease and recommend the appropriate treatment.

Periodontal disease progresses as the sulcus (pocket or space) between the tooth and gums gets filled with bacteria, plaque, and tartar, causing irritation to the surrounding tissues. When these irritants remain in the pocket space, they can cause damage to the gums and eventually, the bone that supports the teeth!

If the disease is caught in the early stages of gingivitis, and no damage has been done, one to two regular cleanings will be recommended. You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings.

If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planing (deep cleaning) will be recommended. It is usually done one quadrant of the mouth at a time while the area is numb. In this procedure, tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planing). This procedure helps gum tissue to heal and pockets to shrink. Medications, special medicated mouth rinses, and an electric tooth brush may be recommended to help control infection and healing.

If the pockets do not heal after scaling and root planing, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean. Your dentist may also recommend that you see a periodontist (specialist of the gums and supporting bone).

Maintenance

It only takes twenty four hours for plaque that is not removed from your teeth to turn into calculus (tartar)! Daily home cleaning helps control plaque and tartar formation, but those hard to reach areas will always need special attention.

Once your periodontal treatment has been completed, your dentist and dental hygienist will recommend that you have regular maintenance cleanings (periodontal cleanings), usually four times a year. At these cleaning appointments, the pocket depths will be carefully checked to ensure that they are healthy. Plaque and calculus that is difficult for you to remove on a daily basis will be removed from above and below the gum line.

In addition to your periodontal cleaning and evaluation, your appointment will usually include:

Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss.X-rays also help determine tooth and root positions.

Examination of existing restorations: Check current fillings, crowns, etc.

Examination of tooth decay: Check all tooth surfaces for decay.

Oral cancer screening: Check the face, neck, lips, tongue, throat, cheek tissues, and gums for any signs of oral cancer.

Oral hygiene recommendations: Review and recommend oral hygiene aids as needed. (Electric toothbrushes, special periodontal brushes, fluorides, rinses, etc.)

Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.

Good oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control!

Mouth - Body Connection

Research studies have shown that there is a strong association between periodontal disease and other chronic conditions such as diabetes, heart disease, pregnancy complications and respiratory disease.

Periodontal disease is characterized by chronic inflammation of the gum tissue, periodontal infection below the gum line and a presence of disease-causing bacteria in the oral region. Halting the progression of periodontal disease and maintaining excellent standards of oral hygiene will not only reduce the risk of gum disease and bone loss, but also reduce the chances of developing other serious illnesses.

Common cofactors associated with periodontal disease:

Diabetes

A research study has shown that individuals with pre-existing diabetic conditions are more likely to either have, or be more susceptible to periodontal disease. Periodontal disease can increase blood sugar levels which makes controlling the amount of glucose in the blood difficult. This factor alone can increase the risk of serious diabetic complications. Conversely, diabetes thickens blood vessels and therefore makes it harder for the mouth to rid itself of excess sugar. Excess sugar in the mouth creates a breeding ground for the types of oral bacteria that cause gum disease.

Heart Disease

There are several theories which explain the link between heart disease and periodontitis. One such theory is that the oral bacteria strains which exacerbate periodontal disease attach themselves to the coronary arteries when they enter the bloodstream. This in turn contributes to both blood clot formation and the narrowing of the coronary arteries, possibly leading to a heart attack.

A second possibility is that the inflammation caused by periodontal disease causes a significant plaque build up. This can swell the arteries and worsen pre-existing heart conditions. An article published by the American Academy of Periodontology suggests that patients whose bodies react to periodontal bacteria have an increased risk of developing heart disease.

Pregnancy Complications

Women in general are at increased risk of developing periodontal disease because of hormone fluctuations that occur during puberty, pregnancy and menopause. Research suggests that pregnant women suffering from periodontal disease are more at risk of preeclampsia and delivering underweight, premature babies.

Periodontitis increases levels of prostaglandin, which is one of the labor-inducing chemicals. Elevated levels prostaglandin may trigger premature labor, and increase the chances of delivering an underweight baby. Periodontal disease also elevates C-reactive proteins (which have previously been linked to heart disease). Heightened levels of these proteins can amplify the inflammatory response of the body and increase the chances of preeclampsia and low birth weight babies.

Respiratory Disease

Oral bacterium linked with gum disease has been shown to possibly cause or worsen conditions such as emphysema, pneumonia and Chronic Obstructive Pulmonary Disease (COPD). Oral bacteria can be drawn into the lower respiratory tract during the course of normal inhalation and colonize, causing bacterial infections. Studies have shown that the repeated infections which characterize COPD may be linked with periodontitis.

In addition to the bacterial risk, inflammation in gum tissue can lead to severe inflammation in the lining of the lungs, which aggravates pneumonia. Individuals who suffer from chronic or persistent respiratory issues generally have low immunity. This means that bacteria can readily colonize beneath the gum line unchallenged by body’s immune system.

If you have questions or concerns about periodontal disease and the mouth-body connection, please contact our office. We care about your overall health and your smile!

Orthodontics

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!

Give us a call today and schedule your orthodontic consultation!

*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.

Invisalign

One of the primary concerns people often have about dental braces is the aesthetic impact of the metalwork on their smile. Especially for adults, the prospect of wearing unattractive metal braces for long periods of time can be very discouraging. Invisalign® offers an almost invisible aligning system that straightens teeth fast and contains no metal.

Invisalign® treatment consists of a series of custom-made aligning trays. The dentist changes the trays every several weeks to fit the new tooth configuration. In addition to the reduced visual impact, Invisalign® aligning trays can be temporarily removed for important occasions – meaning that treatment duration is patient-controlled. A great number of people report complete satisfaction with both the Invisalign® treatment and the stunning results.

What kind of bite problems can Invisalign® correct?

Invisalign® corrects the same dental problems as traditional metal braces; the only difference is that Invisalign® trays are almost invisible to the naked eye, and can be removed at will.

Here are some problems that are commonly corrected with Invisalign®:

Overcrowding – This occurs when there is too little space for the teeth to align normally in the mouth. Overcrowding can cause tooth decay and increase the likelihood of gum disease.
Large gaps between teeth – This can sometimes occur because teeth are missing or because the jaw continues to grow abnormally.
Crossbite – This common dental problem occurs when one or multiple upper teeth bite inside the lower teeth. As a consequence, uneven wear can lead to bone erosion and gum disease.
Overbite – This problem occurs when the upper teeth project further than, or completely cover, the lower teeth. Eventually, jaw pain and TMJ may occur.
Underbite – This is the inverse of the overbite; the lower teeth project further than, or completely cover, the upper teeth. Eventually, jaw pain and TMJ can occur.

What advantages does Invisalign® offer over traditional braces and veneers?

Traditional dental braces, Invisalign® aligning trays, and dental veneers are three different ways to perfect the alignment of the teeth. There are many different considerations to make when deciding which treatment will be best, and each of these options works better in certain situations.

Invisalign® differs from traditional braces in that the aligning trays are fully removable. This means that more discipline and commitment is required from the patient. This is not usually a problem since the trays are comfortable and nearly invisible. Almost identical results can be obtained by using either treatment.

Invisalign® is preferable to veneers in many cases because unlike veneers, Invisalign® actually straightens the teeth. Veneers are thin covers that the dentist permanently affixes to the teeth. Teeth must be etched beforehand, meaning that to remove dental veneers, an alternative covering must be constructed. In addition to being somewhat expensive, veneers can break and often last for less than 20 years.

What does Invisalign® treatment involve?

First, the dentist needs to devise an initial treatment plan before creating the special aligning trays. Three-dimensional digital images are taken of the entire jaw. These images allow the dentist to move specific teeth on the screen, view the jaw from different angles, and also foresee what the face might look like in years to come. In essence, this technology can show how Invisalign® trays will change the facial aesthetics.

Once planning is complete, a unique set of aligners is made. The total amount of aligners required varies with each individual case, but 20-29 sets per arch is typical.

What are some considerations when wearing Invisalign® trays?

Life with Invisalign® aligning trays may take several weeks to get used to. The trays should be worn constantly, except when eating and drinking. It is important to remove the trays when consuming food or drink because food can become trapped between the tray and the teeth, causing tooth decay.

Usually, new trays are necessary every two weeks, and progress between appointments can be seen with the naked eye. There is no doubt that Invisalign® aligning trays have revolutionized orthodontics. Invisalign® is renowned for being both comfortable and effective.

If you have questions about Invisalign®, please contact our office.

Care During Orthodontic Treatment

Taking care of braces properly and being committed ideal results is an important part of orthodontic treatment. Orthodontic braces contain many parts and should be protected from damage to ensure ideal results. It is essential to strictly adhere to the instructions provided by your orthodontist to ensure excellent at-home care.

Foods to Avoid

Stick to softer foods for the first few days following the placement of braces to optimize comfort. Throughout the course of treatment, there are types of foods that should be avoided entirely. These foods can snap archwires, displace orthodontic bands and loosen brackets. Your orthodontist will offer a complete list of foods to steer clear of, but here are some general examples:

Hard Foods – Ice cubes, popcorn kernels, and potato chips
Sticky Foods – Taffy, gum, bagels, jerky and caramel
Sugary Foods – Candy, jam, jelly, chocolate, breath mints and soda
On The Bone Foods – Chicken wings, barbecue ribs and corn on the cob

Cleaning Around Braces

Orthodontic braces create spots where oral bacteria can stick and promote tooth decay. It is crucial to brush your teeth after every meal or snack to rid the teeth of debris and plaque. Flossing is also an essential part of everyday braces care. All sides of each tooth should be carefully cleaned twice a day. Your orthodontist will be able to provide advice on home hygiene techniques with braces.

Preventing Damage During Athletics

Sports are one of the major causes of dislodged and broken orthodontic appliances. Special mouth guards that protect braces should be worn every time a sport is played. Though contact sports, such as football, put orthodontic patients at higher risk for to injury, players of non-contact sports like soccer are also at susceptible to lip lacerations and snapped archwires.

Braces can be rendered ineffective from loose bands, brackets and broken archwires. An appointment should be made with your orthodontist as promptly as possible so appliances can be fixed for maximum function. A broken orthodontic appliance prolongs total treatment time when not corrected.

Commitment to Best Results

Braces require a significant commitment from the wearer to work effectively. It is essential to attend scheduled orthodontic adjustment appointments and follow instructions diligently. Remember: the result of effective treatment is a perfect smile!

If you have any questions or concerns about orthodontic care, please contact your orthodontist.

When Should My Child Get An Orthodontic Evaluation?

Orthodontists aim to prevent and treat irregularities in the jaw and misalignment of the teeth that are the result of genetics, or develop in accordance with a child’s habits. The best way to achieve these goals is to have your child evaluated by an orthodontist as early as age seven; however, children with noticeable facial irregularities may benefit from preventive orthodontic treatment several years earlier.

Orthodontists are highly trained to notice minute problems with emerging teeth and jaw growth – even if a mixture of baby teeth and permanent teeth are present. While the untrained eye might fail to spot these irregularities, an orthodontic check-up allows for early detection of problems and development of efficient treatment plans.

Some of the key signs that an orthodontic problem is present are as follows:

Difficulty chewing and biting
Jaws that click, shift or make noise as they move
Asymmetry in the face due to disproportionate jaws
Finger and thumb sucking
Bite misalignment (arches of teeth that do not meet properly)

Common Orthodontic Problems for Children

Children often experience overcrowding, jaw growth irregularities, protruding teeth and teeth that are too widely spaced. While some problems are inherited, main causes of acquired orthodontic irregularities are:

Inadequate nutrition or dental hygiene problems
Medical problems, such as birth defects
Habits such as thumb or finger sucking
Breathing through the mouth
Earlier or later loss of baby teeth than is considered normal

How Can an Orthodontist Help my Child?

The orthodontist may take one of several approaches when dealing with children. In some cases, malocclusions or irregularities are carefully monitored and are addressed at a later date. The ideal time to initiate treatment varies with each individual child and is based on their unique diagnosis.

Early orthodontic treatment is beneficial to reduce the amount and duration of later treatment, preventing more complex conditions from occurring. Through early intervention, the orthodontist is able to correct habits that lead to acquired irregularities, increase the confidence of the child, guide the growth of the jawbone, and decrease the risk of injury to protruding teeth.

If you have any further questions about when your child should visit the orthodontist, please contact our office.

What Does Orthodontic Treatment Involve?

Orthodontics is a highly-specialized branch of dentistry that deals with facial and jaw irregularities. As proper alignment of the teeth and jaw arches affects coherent speech, chewing and biting abilities, orthodontic treatment is vital for health and comfort.

What Problems Do Orthodontic Treatments Solve?

There is a wide range of orthodontic treatments available to successfully and expediently alter the alignment of teeth. The type of treatment provided depends on the exact nature of the malocclusion or teeth misalignment. Here is a brief overview of the main classifications of bite and teeth positioning problems:

Overcrowding – The non-eruption of adult teeth and the overcrowding of arch space can lead to misalignment. Additionally, overcrowding may cause twisting and complete displacement of teeth.

Negative Underjet – An underbite is characterized by a pronounced lower jaw, which protrudes further than the upper jaw. This malocclusion causes the chin to look large or pointed.

Overbite – Overbite is a result of a protruding maxilla (upper jaw) in relation to the mandible (lower jaw). This type of malocclusion makes the chin look like it has receded.

What Does Orthodontic Treatment Involve?

The first step in developing a treatment plan is completion of a thorough visual examination of a patient’s smile. After completing this, your care provider creates diagnostic records which include panoramic x-rays, bite impressions and additional imaging of the jaw joints in some cases. If treatment is needed to realign the teeth, this is discussed extensively.

Examining diagnostic records allows for the development of a predictable treatment plan. Your dental professional can also work with an oral surgeon if the symmetry of the face needs to be altered. In the case of an overcrowded mouth, one or several teeth may need to be extracted to prepare for the realignment process. Once the diagnosis and preparation phases are complete, a fixed or removable orthodontic appliance is used to move the teeth and jaw arches into ideal alignment.

Fixed Appliances

There are several types of fixed orthodontic appliances, of which traditional metal braces are the most common. Ceramic, clear or metal brackets are fixed onto each individual tooth for the duration of the treatment, and an arch wire is threaded through each one to connect them.

The wire is tightened slightly every few weeks until the desired results are achieved. Typically the fixed brackets are removed after 18-30 months.

Removable Devices

Removable devices come in many shapes and sizes and are popular because of their convenience and versatility. Removable devices include headgear, which corrects malocclusions due to developmental problems; retainers, which maintain the correct alignment of the teeth after orthodontic treatment; and Invisalign® trays, which are used for several weeks at a time to correct common teeth alignment problems.

It is important to note that a dental professional creates a custom treatment plan or each individual case. The time-span for corrections with removable devices can greatly vary in accordance with the severity of the original malocclusion.

If you have questions about orthodontic care and procedures, please be sure to ask your dental office.

Types of Braces

There are many different types of orthodontic braces available. Each type, though made of varying components, realigns the teeth to enhance chewing, biting, and aesthetics. Available styles of orthodontic appliances allow the wearer a great amount of flexibility, control and convenience.

The two main types of braces available are removable and fixed devices. As the names suggest, removable devices can be moved into and out of the mouth at any time, while fixed devices are both applied and removed by the orthodontist. Though fixed dental braces are often used to correct severe alignment issues, removable devices are popular because they afford the wearer more control over their treatment.

Traditional Fixed Braces

Traditional braces are often more affordable and expedient than any other kind of braces – particularly in the case of a severe malocclusion (bad bite). During application of fixed braces, individual brackets are glued to each tooth on the arch and a thin wire connects the brackets. Traditional fixed braces work on the premise that consistent pressure is applied to the teeth. The appliances must modified by an orthodontist at routine appointments to continue exerting appropriate pressure.

There are several different types of brackets available, including metal, ceramic and clear. The metal brackets tend to be the least problematic structurally, but they are also the most visible. Ceramic brackets are equally effective and less visible, but they have a tendency to stain if not cared for properly. Clear brackets are the least visible, but generally cost more and are prone to damage.
The following treatment options are available for patients who choose fixed orthodontics:

Lingual Braces

Lingual braces are almost invisible, as they are bonded to the back of the teeth, but the initial affixation is slightly more complex. Lingual braces are comprised of special custom-made brackets, which are connected by a wire. Many wearers prefer the reduced aesthetic impact with these braces, but some report an initial impairment in speech.

Damon System

The Damon System is a more discreet alternative to traditional fixed braces. Light wires are initially used to align the teeth, and are replaced with heavier wires as the teeth become straighter. Traditional braces use elastic rings to hold the wires in place, whereas the creators of the Damon System have replaced these rings with tiny sliding doors.

The biggest advantage of this replacement is the reduction of friction and discomfort. A reduced amount of friction allows this system of self-ligating braces to correct malocclusions quickly, and the lighter wires cause less stress to the periodontal ligaments. The Damon System is less noticeable and quicker, but can be costlier than traditional fixed systems.

SureSmile

SureSmile is a hi-tech system that claims to straighten teeth in a far shorter time than traditional braces. To determine the precise position and angle of each tooth, an OraScanner and/or Cone Beam Computed Tomography (CBCT) is used to take a three dimensional picture of the teeth. The archwire for the braces is created by a computer system and used to link the orthodontic brackets. The archwire is activated by body heat. The result is quicker treatment and more precise alignment. The SureSmile system is technologically advanced and effective, but can be among the more expensive forms of fixed braces.

Six Month Smiles

Six Month Smiles is designed to greatly impact aesthetics, as opposed to function. Instead of moving every tooth into alignment, this system focuses mainly on the teeth that are visible when smiling and speaking. Six Month Smiles utilizes small archwires and tooth-colored brackets to make the braces as unobtrusive as possible. Contrary to popular belief, more pressure is not added to move the teeth quickly. These cosmetic braces are popular, effective and can cost less than other technologically advanced systems.

Removable Devices

Invisalign® Clear Braces

The Invisalign system is a series of removable aligning trays, which gradually reposition the teeth into the correct alignment. Generally, aligning trays are worn for two weeks before they are discarded for trays which fit the new positioning of the teeth. Invisalign trays can be easily removed for eating and social functions, but must be worn as much as possible for expedient results. Invisalign is a convenient type of orthodontics, but requires commitment from the wearer.

Clear, removable braces are generally recommended for minor to moderate alignment problems. Other popular brands of removable orthodontics include ClearCorrect and MTM® Clear Aligner.

If you have questions or concerns about any type of braces, please contact your dental care provider.

Orthodontic Treatment Phases

Orthodontic irregularities are extremely common andvary in their complexity. In the case of a severe irregularity, the orthodontist may work in conjunction with a maxillofacial surgeon or another dental professional to correctly realign the teeth and underlying jawbone. Malocclusions, or misaligned bites, however, are usually treated by the orthodontist alone. Orthodontic treatment for malocclusion typically occurs in two or three main stages:

Phase 1: Planning

The goal of the first several visits to the orthodontist is to determine an exact diagnosis and plan expedient treatment. The orthodontic evaluation usually includes:

A complete dental and medical history review
Castings or bite impressions of the teeth
Panoramic x-rays of the jaws and teeth
Additional imaging of the face, teeth and jaw joints
Computer-generated images of the head, face and neck

Phase 2: Active Treatment

Once a specific diagnosis has been made, the orthodontist applies a device to realign the teeth, which is either fixed or removable. The best known type of fixed device is traditional dental braces, which use brackets interconnected by an archwire. Continual gentle pressure is applied on teeth by the gradual tightening of the archwire. Regular orthodontic adjustments are necessary to continue the straightening process.

Removable devices include the Invisalign® system and headgear. These devices should be worn for a specified number of hours each day. The success of these removable appliances largely depends on the motivation of the wearer. The orthodontist monitors and adjusts the device at regular appointments.

Phase 3: Retention

When treatment is complete, the braces and appliances are removed. The orthodontist then creates a retainer. The retainer ensures that the teeth do not regress back to their original positioning. The retainer is worn for a specified number of hours each day to allow the bone to reform and stabilize the teeth in their new, correct alignment.If you have questions or concerns about the progression of orthodontic treatment, please contact your dental professional.

Orthodontic Exams

The planning stage is the most crucial phase in orthodontic treatment. During this phase, the orthodontist pinpoints a diagnosis and plans the most effective treatment. The planning phase includes conducting thorough examinations, taking x-rays and keeping meticulous dental and medical records.

Orthodontic treatment is highly predictable, successful and beneficial when planned appropriately. Not only does a straight smile look attractive, but it also helps stave off a wide range of dental and physical problems, which include:

Tooth Decay – Improper alignment can reduce the effectiveness of oral hygiene at home. Hard-to-reach places created by crooked teeth can become breeding grounds for harmful bacteria.
Gum Disease – Periodontal disease is a result of a bacterial infection within the gums. Poor oral hygiene resulting from misalignment can cause gum recession, jawbone deterioration and tooth loss.
Digestive Disorders – Misalignment commonly impairs chewing function. This leads to improperly chewed food working its way through the digestive system, contributing to digestive discomforts and disorders.

What Types of Orthodontic Exams Will Be Conducted?

The first visit to the orthodontist can involve different examinations to determine what treatments are required and how they will impact the teeth and jaws. It is highly beneficial for the orthodontist to create treatment plans with as much information as possible.

Here is an overview of the types of orthodontic examinations and records that the orthodontist uses to plan treatment:

Medical and Dental History Evaluation

Orthodontic treatments cannot begin until other existing medical and dental issues are resolved or are at least under control. Gum disease, for example, is often exacerbated by fixed braces and must be treated prior to orthodontic treatment. Dental health greatly impacts physical health and vice versa. Certain prescription medications can affect teeth and gums, so great care must be taken to evaluate the whole picture of medical and dental concerns.

Bite Impressions

Bite impressions or molds are invaluable tools in determining the exact nature of the malocclusion. Molds allow a closer look at how the upper and lower jaws fit together. Alginate, a soft material that hardens on the teeth, is poured into a horseshoe-shaped tray, producing an imprint. Plaster is then poured into the impressions, resulting in a model of the teeth.

Photographs of the Face and Mouth

The orthodontist takes regular photographs of the face and mouth. This shows how the treatment is progressing and impacting overall facial appearance. Facial photographs also allow for the measurement of facial proportions.

Computer-Generated Pictures of the Head and Neck

Computer-generated pictures of the head and neck allow the orthodontist to measure facial proportions and to determine ideal facial aesthetic. Facial appearance is an important consideration to make when planning treatment.

Panoramic X-rays of the Jaws and Teeth

Panoramic x-rays offer excellent insight into the general health of the teeth, gums and jawbone. X-rays show precise root structures of the teeth and inform the orthodontist as to how the upper and lower jaws fit together. X-rays of the temporomandibular jaw joint may also be taken, as necessary.

If you have any questions about orthodontic examinations or records, please ask your dental professional.

Orthodontic Appliances

Orthodontic appliances are not just limited to fixed and removable braces. There are many devices available to correct jaw alignment irregularities and reposition the teeth. In some cases, traditional fixed or removable braces are used in conjunction with another type of orthodontic appliance, which serves to fulfill one of the following functions:

Expanding the palate to create space
Closing large gaps between the teeth
Correcting irregularities, such as an elongated mandible (lower jaw) bone or a short maxilla (upper jaw) bone
Alleviating crowding in the upper or lower jaw

Types of Orthodontic Appliances

Most types of orthodontic appliances treat a specific irregularity. The nature of your diagnosis points your dental professional towards the most effective treatment.

Here is a brief overview of some of the most commonly used orthodontic appliances:

Palatal Expanders

Palatal expanders come in two styles: the bonded appliance and the banded appliance. These devices widen the upper arch to create room for the eruption of permanent teeth and are used to correct a narrow bite or crossbite. Palate expanders are fairly discreet and work effectively as long as the device is adjusted at the designated intervals. Some individuals experience slight difficulty speaking and eating until they have fully acclimated to the device.

Facemasks (Reverse Headgear)

Facemasks are designed to combat growth discrepancies between upper and lower jaw arches. In the case of a class III malocclusion, where the upper jaw grows faster than the lower jaw, the upper arch can look more prominent. Facemasks pull the lower arch forward and encourage its growth relative to the upper arch. This appliance consists of a frame, which fits around the headand elastics, which are directly applied to the teeth. Facemasks are removable, but must be worn for 12-20 hours a day to expedite treatment.

Headgear

Headgear works to correct class II malocclusion, more commonly known as an overbite. In this case the maxilla or lower jaw is growing faster than the mandible or upper jaw. Headgear restricts lower jaw growth and allows the mandible to catch up. Headgear consists of a frame which fits around the head and is attached to braces and bands. In some cases, headgear is used to create space to move the front teeth backwards. As with facemasks, it is typically recommended to ear headgear for wear 12-20 hours each day.

Other types of orthodontic appliances include the Andresen appliance to reduce overbite, Biobloc, which works to posture the lower jaw forward, and Bass Dynamax, which also corrects malocclusion.

If you have any questions or concerns about orthodontic appliances, please contact your dental professional.

Repositioning Teeth with Orthodontic Appliances

Malocclusion (or bad bite) and teeth misalignment are extremely common and treatable problems for many individuals. Failure to seek care for the improper alignment of the teeth and jaws can result in poor aesthetic and impaired chewing, biting and speaking functions. Malocclusion can also cause a wide range of dental and physical problems including:

Tooth Loss and Decay – Periodontal disease (gum disease) is a common, progressive condition which eventually results in severe tooth decay, bone erosion and tooth loss. If teeth are crowded and your hygiene routine is impaired, you are at higher risk for decay and soft tissue infection.

TMJ – Temporomandibular joint disorder is the overstraining of the jaw joint due to the improper alignment of arches. Symptoms of this disorder include neck pain, jaw pain, earache and grinding teeth. Jaw alignment can be improved with the application of orthodontic treatments.

Uneven Tooth Wear – Malocclusion can cause the teeth to wear in an unusual pattern. Instead of sharing the wear evenly, some teeth are forced to perform additional rigorous chewing and biting functions. Not only do these worn teeth look unappealing, they may need to be restored with dental prosthetics.

How Teeth are Properly Repositioned

There are many orthodontic treatment methods that can be employed to move and realign the teeth. Orthodontic devices that correct irregularities are generally divided into two categories: fixed and removable appliances.

Fixed Appliances

The most common type of fixed appliance is traditional dental braces. These appliances utilize brackets made from a variety of materials, including metal and tooth-colored ceramic, which are bonded to individual teeth and linked by an archwire. Orthodontic elastic bands may also be applied to the braces to add additional pressure to specific teeth.

At every orthodontic adjustment appointment, the elastic bands and wires are gently tightened until the teeth have moved into ideal alignment. In the case of overcrowding, a tooth or several teeth may need to be extracted prior to placement of braces, in order to maximize available jawbone space.

Removable Devices

There are several different types of removable devices an orthodontist may recommend, based on a thorough examination, bite impressions and a diagnosis of current conditions.

Invisalign® – Invisalign braces use a series of clear plastic trays to gently move the teeth. Every few weeks, new trays are provided to ensure that continual gentle pressure is exerted on the teeth.

Headgear – Headgear is a dental appliance attached to a metal framework and is most commonly used to correct growth and developmental problems. When upper jaw growth is significantly slower than lower jaw growth, reverse pull headgear may be needed. Conversely, when lower jaw growth is delayed, high pull headgear may be used to properly align the teeth.

Retainers – Retainers are usually used after braces to maintain the proper alignment. Retainers ensure that the jawbone forms into the desired position and helps straight teeth remain that way over time.

If you have questions or concerns about the realignment of your teeth, please contact your dental professional.

Does My Child Need Early Orthodontics?

Orthodontic treatments are most commonly associated with pre-teens and teenagers. However, the American Association of Orthodontists (AAO) recommends children receive their first orthodontic check-up around the age of seven. In cases where obvious irregularities are noted, treatment may be sought at an earlier age.

Most orthodontists agree that there is an optimal time for treating malocclusions (bad bites) and irregularities in the face and jaw. While an early orthodontic check-up does not mean that treatment will begin immediately, or even that it will become necessary, some irregularities are more easily corrected before jaw growth is complete, making it imperative to have problems detected early.

Irregularities in Pediatric Dental Development

Orthodontic problems can sometimes be invisible to the untrained eye. An orthodontist is highly skilled at detecting the smallest clues of irregularities and misalignment. Irregularities are most often a result of genetic factors, but can be exacerbated by poor nutrition, poor oral hygiene and thumb sucking.

There is no substitute for an orthodontic examination, but here are some common signs that irregularity may become a possibility:

Finger or thumb sucking
Chewing or biting problems
Teeth that do not meet or that meet irregularly
Disproportionate jaws
Clicking or shifting jaws
Later or earlier loss of baby teeth than normal

Types of Early Orthodontic Intervention

The goal of early intervention and treatment is to ensure that more serious problems do not develop in the future. If an irregularity is allowed to progress, there is a chance that later treatment will be more complicated. Your oral health professional can improve the appearance of your child’s teeth and jaw, guide jaw growth, and provide advice and support on correcting poor oral habits.

Early intervention tends to fall into three main categories: preventive, interceptive and comprehensive. Here is a brief overview of each type of treatment to better exemplify how complicated problems can be avoided:

Preventive Treatments

The goal of preventive treatment is to avoid the development of malocclusion in a normally developing mouth. Your dental professional may remove a baby tooth to create space for the corresponding adult tooth to erupt. Conversely, if a baby tooth has been lost too early, a space retainer appliance will hold that space for the corresponding adult tooth.

Interceptive Treatments

Interceptive treatments aim to reduce the complexity of a developing problem and eliminate the cause where possible. The ideal candidate for interceptive treatment usually has a mixture of adult and baby teeth. Your dental provider is able to alter the size of the teeth, remove longstanding baby teeth and create space for erupting adult teeth.

Comprehensive Treatments

Comprehensive treatments are commonly used to correct growth irregularities. When the teeth are completely misaligned or the jaws are functioning poorly, orthodontic treatment may be combined with jaw surgery, tooth extractions or restorative surgery. Comprehensive treatment can begin prior to the loss of baby teeth, with several phases of such treatment required to optimize benefits.

If you have any questions or concerns about early orthodontic treatment, please contact your dental care provider.

Brushing and Flossing with Braces

Adjusting to proper oral hygiene with a smile full of brackets, including cleaning around bands and wires, is incredibly important. Effectively cleaning orthodontic appliances ensures that plaque is not allowed to build up around the braces. Typically, if a proper oral hygiene routine is not strictly adhered to, gum inflammation and tooth decay can occur.

The key to brushing and flossing effectively with orthodontic braces is learning the best technique. Though everyone has different preferences, here are some excellent tips on how to get started:

Brushing

Regular, proper brushing is especially important when braces have been applied to the teeth. If possible, brush teeth after every snack to eliminate plaque buildup. If this isn’t practical, aim to brush four times daily, including:

After breakfast
After lunch
After dinner
Right before bedtime

It is important to choose an appropriate toothbrush and to inspect the bristles routinely for signs of wear. The orthodontic braces will wear and fray the bristles, so replacement brushes will be needed more often than usual.

A soft bristled toothbrush is best because it will not damage the archwire or brackets. Apply a small strip of toothpaste, preferably a brand with fluoride, to the brush. Keep in mind that every tooth has several sides that need to be thoroughly cleaned: the outside, the sides facing each other and the chewing side.

When brushing front-facing sides of the teeth, create a 45 degree angle between the brush and the gum line. Brush in gentle circular motions from the top of the tooth to the bottom and then from bottom to top. Try not to exert too much force on either the wire or the brackets. When brushing the inside angles of teeth, work methodically creating the same 45 degree angle with the brush. The back surfaces of the teeth should pose no additional problems and should be brushed in the regular way.

Next, use a specially-designed proxabrush (Christmas tree brush) to brush between two brackets at a time. Insert the proxabrush and use downward and upward motion. Continue until all the spaces between the braces are plaque-free. As a last step, use mouthwash to flush out remaining bacteria.

Flossing

Flossing is also of paramount importance. Plaque and food particles can quickly provide fuel for the formation of bacteria colonies that cause gum disease and tooth loss. Though flossing between braces can be more time-consuming, it should still be completed several times per day.

Floss threaders can be used or the floss can be wrapped around fingers in the standard method. First, thread a piece of floss underneath the arch wire of the braces. Slide the floss in an up-and-down motion against the large surface of the tooth. Exercise great care around the bracket and archwire, as they can easily be damaged by excess pressure.

Next, guide the floss to the interdental area (between the teeth) and use gentle sawing motions to move down from the gum line toward the bottom of the tooth. Repeat this motion several times. Then, using the same sawing motion, work the floss from the bottom of the tooth toward the gum line several times.

In some cases, flossing around orthodontic braces can cause mild bleeding, which should go away. If this bleeding persists for several days, be sure to inform your oral health professional.

If you have any questions or concerns about brushing and flossing with braces, please contact your dental office.

At-Home Care for Orthodontic Soreness

When braces are first applied, it can take several days to get used to the new appliances. During this time, the mouth may feel tender or sore. While soreness is rarely problematic enough to warrant additional dental care, contact your orthodontist if soreness becomes highly uncomfortable.

Causes of Orthodontic Soreness

When braces are initially applied or the archwire is changed during an orthodontic adjustment appointment, teeth start to gradually shift toward their new destination. This initial movement causes adjacent tissue to become inflamed. This inflammation causes fibers that join the teeth to the jawbone and gums (periodontal ligaments) to swell. The swelling in turn leads to compressed nerve fibers, which are the true cause of orthodontic soreness.

What Can Be Done to Ease Soreness?

It is important to remember that orthodontic discomfort generally decreases within a few days. After the initial affixation of braces, it can take between one and two weeks for the tissues of the tongue, cheek and lips to adapt to the new orthodontic device. There are several home remedies, however, that will help ease initial discomfort:

Wax Application

Orthodontic relief wax is usually provided at your appointment and can be applied to the braces as required. If the soreness is being caused by braces rubbing on the cheek, lip or tongue, the wax provides a smooth, effective buffer between the two. Roll a pea-sized amount of wax into a ball and place it the protruding and bothersome part of the appliance. Press the wax into place to efficiently cover any irritating wires.

Salt Water Rinses

Warm salty water is an excellent remedy for sore lips, gums and cheeks. The salt water mixture actually extracts excess fluid in inflamed tissue by way of osmosis, alleviating pressure on the nerves and easing soreness. To utilize this remedy, add a teaspoon of salt to around half a cup of lukewarm water. Swish the water around the mouth without gargling for one minute before spitting it out.

Chewing on Soft Foods

To further ensure comfort, you can also chewing on soft foods that won’t damage your braces. Apple and cheese slices work nicely, as do small celery slices. The chewing action compresses the fibers that fix the teeth and gums together (periodontal ligaments), thus pumping out the fluid accumulation that causes soreness.

Eat Berries

Not only do berries contain high levels of antioxidants, they can also substantially reduce intraoral swelling. Cherries, blackberries, blueberries and raspberries all contain natural anti-inflammatory properties which reduce soreness. Cherries are preferable because they are soft enough not to damage the braces and do not contain small seeds which tend to stick between the braces.

Pain Medication

While it is unlikely that orthodontic soreness will warrant over-the-counter pain medications, some patients choose to alleviate soreness this way.

If you have any questions or concerns about orthodontic soreness, please contact your oral health provider.

Eating While Wearing Braces

Traditional braces consist of bands, brackets and wires, which are easily dislodged or damaged while eating. When orthodontic braces sustain damage, they cease to work in the intended way. For this reason, it is essential to take good care of your braces and follow guidelines for eating as provided by your orthodontist.

Certain types of foods should either be completely avoided or eaten with extreme care. Here are some general guidelines to follow when eating with braces:

Do Not Eat Hard Foods Whole

Hard foods pose the biggest threat to braces. They can dislodge the brackets and snap the wires. Here are some foods which must never be eaten whole:

Hard candy
Popcorn (the kernels can cause breakage or inflammation if they get stuck between teeth)
Ice cubes
Unsliced hard fruits and vegetables
Hard potato chips
Gumballs

Slice Fruits and Vegetables Before Consumption

There are many hard, healthy foods such as fruits and vegetables that should still be consumed, but need to be prepared first. The best way to eat fruits and vegetables, such as carrots and apples, without damaging braces is to slice or dice them into small pieces. This will make them easier to eat and reduce the chance of dislodging braces.

Do Not Eat Sticky Foods

Sticky foods can quickly dislodge braces and tend to wrap around brackets, making them look stained and unattractive. Examples of sticky foods to be avoided include:

Gum
Taffy
Jerky
Caramel
Chocolate bars containing caramel

Similarly, foods which are generally eaten off the bone or the cob must be must be completely stripped from the bone, and then cut into tiny pieces which will not dislodge or break appliances.

Do Not Chew On Inedible Items

Chewing on pencils, crayons, pens or fingernails can easily damage braces. Always keep in mind that your orthodontic appliances are fragile. Some habits and activities require a change in routine to ensure effective treatment.

Avoid Sugary Foods and Drinks

It is no secret that high sugar levels lead to tooth decay. As orthodontic appliances can exacerbate the decay process, it is even more crucial to think about the sugar content in foods. It is also essential to thoroughly brush teeth (including in-between the brackets) a minimum of four times each day. If brushing is not an option after every meal, try to rinse with water to remove food particles captured on brackets and between teeth.

Always remember to remove retainers before drinking beverages. The sugary liquid can become trapped between the device and teeth, which expedites the decay process.

Here are some sugary foods and beverages to avoid (the sugarless versions are acceptable):

Milk
Soda
Breath mints
Iced tea
Jam and jelly
Cereals
Fruit juice

If you have any questions or concerns about what foods to eat while wearing braces, please contact your orthodontist.

An Introduction to Braces

Orthodontic braces are commonly used to correct malocclusion (bad bite) and misalignment of the teeth. Braces are typically recommended for children and teenagers, but an increasing number of adults are now seeking orthodontic treatments. Dental braces owe their success to technology that supports predictable results. Braces are tailored to the wearer’s unique needs and create beautifully straight smiles.

There are several common alignment problems that dental braces can fix:

Underbite – The lower jaw projects further than the upper jaw
Overbite – The upper jaw projects further than the lower jaw
Overcrowding –The teeth twist or are misaligned due to insufficient space in arches
Crossbite – Teeth on the upper arch bite down inside or outside of the corresponding teeth on the lower arch and vice versa

Why Choose Braces?

Crooked, twisted or poorly spaced teeth can be an aesthetic issue, but malocclusion and dental misalignment impact far more than appearance. In fact, malocclusion has been linked to other dental problems, as well as uncomfortable physical issues. Even a single improperly positioned tooth can cause difficulties in hygiene routines and make patients feel self-conscious.

Braces offer many benefits, including:

Improved Oral Hygiene – Poorly aligned teeth can make maintaining excellent oral hygiene difficult. Hard-to-reach places between overlapped and tight teeth can become breeding grounds for oral bacteria.
Better Digestion – Serious digestive disorders can result from improper chewing created by significant bite misalignment. Realigning the teeth and jaw using braces restores optimal functionality.
Improved Confidence – Dental patients with properly aligned teeth enjoy a positive self-image and do not feel worried about displaying their smiles in social and professional situations.

What Are Some Common Types Of Braces?

There are two categories of dental braces: fixed appliances and removable appliances.

Fixed braces – These braces are used when the malocclusion is severe or when treatment needs to be expedient. After the initial fitting of the braces by bonding brackets to teeth and threading archwires, routine adjustments are required to ensure that continuous pressure is being applied to the teeth.

Removable braces – With modern orthodontic technology, removable trays can be utilized when malocclusion is less severe or in situations where fixed braces would be impractical. The most common types of removable braces include Invisalign® and other clear tray orthodontics. Removable dental braces are preferred by many patients, as they are versatile, convenient and discreet.

If you have any questions or concerns about orthodontic braces, please contact your oral health professional.

What is Orthodontics?

Orthodontics is one of many dental specialties. The word “orthodontics” is derived from the Greek words orthos, meaning proper or straight and odons meaning teeth. Orthodontics is specifically concerned with diagnosing and treating tooth misalignment and irregularity in the jaw area. Initially, orthodontic treatments were geared toward the treatment of teens and pre-teens, but these days around 30 percent of orthodontic patients are adults.

There are many advantages to well-aligned teeth, including easier cleaning, better oral hygiene, clearer speech and a more pleasant smile. Though orthodontic treatment can be effective at any age, the American Dental Association suggests that an orthodontic assessment should be performed around the age of seven. The earlier orthodontic treatment begins, the more quickly the problem can be successfully resolved.

What problems can be treated with orthodontics?

Orthodontics is a versatile branch of dentistry that can be used alone, or in combination with maxillofacial or cosmetic dentistry.

Here are some of the common conditions treated with orthodontics:

Anteroposterior deviations – The discrepancy between a pair of closed jaws is known as an anteroposterior discrepancy or deviation. An example of such a discrepancy would be an overbite (where the upper teeth are further forward than the lower teeth), or an underbite (where the lower teeth are further forward then the upper teeth).
Overcrowding – Overcrowding is a common orthodontic problem. It occurs when there is an insufficient space for the normal growth and development of adult teeth.
Aesthetic problems – A beautiful straight smile may be marred by a single misaligned tooth. This tooth can be realigned with ease and accuracy by the orthodontist. Alternatively, orthodontists can also work to reshape and restructure the lips, jaw or the face.

Orthodontic Solutions

Orthodontics is a technologically advanced field which offers many sophisticated solutions to malocclusions and other cosmetic problems. The orthodontist will generally perform a visual examination, panoramic X-rays, and study models (bite impressions) in order to assess the exact nature of the discrepancy.

When a diagnosis has been made, there are a variety of orthodontic treatment options available.

Here is an overview of some of the most common treatments:

Fixed orthodontic braces – A metal or ceramic dental base is affixed to each tooth, and a dental wire is inserted through each base. The orthodontist is able to gradually train the teeth into proper alignment by regularly adjusting the wire. When the desired results are achieved, the fixed dental braces are completely removed.
Removable appliances – There are a wide range of removable appliances commonly used in orthodontics, including headgear that correct overbites, Hawley retainers that improve the position of the teeth even as the jawbone reforms, and facemasks which are used to correct an underbite.
Invisalign^® – This is a newer, removable type of dental aligner that is completely transparent. Invisalign^® does not interfere with eating because of its removable nature, and mechanically works in the same way as the traditional metal dental braces. Not all patients are candidates for Invisalign^®.

If you have any questions or concerns about orthodontics, please contact our office.

What is a Malocclusion?

A malocclusion is an incorrect relationship between the maxilla (upper arch) and the mandible (lower arch), or a general misalignment of the teeth. Malocclusions are so common that most individuals experience one, to some degree. The poor alignment of the teeth is thought to be a result of genetic factors combined with poor oral habits, or other factors in the early years.

Moderate malocclusion commonly requires treatment by an orthodontist. Orthodontists are dentists who specialize in the treatment of malocclusions and other facial irregularities.

The following are three main classifications of malocclusion:

Class I – The occlusion is typical, but there are spacing or overcrowding problems with the other teeth.
Class II – The malocclusion is an overbite (the upper teeth are positioned further forward than the lower teeth). This can be caused by the protrusion of anterior teeth or the overlapping of the central teeth by the lateral teeth.
Class III – Prognathism (also known as “underbite”) is a malocclusion caused by the lower teeth being positioned further forward than the upper teeth. An underbite usually occurs when the jawbone is large or the maxillary bone is short.

Reasons for treating a malocclusion

A severe malocclusion may lead to skeletal disharmony of the lower face. In a more extreme case, the orthodontist may work in combination with a maxillofacial dentist to reconstruct the jaw. It is never too late to seek treatment for a malocclusion. Children and adults alike have completed orthodontic realignment procedures and have been delighted with the resulting even, straight smile.

Here are some of the main reasons to seek orthodontic treatment for a malocclusion:

Reduced risk of tooth decay – A malocclusion often causes an uneven wear pattern on the teeth. The constant wearing of the same teeth can lead to tooth erosion and decay.
Better oral hygiene – A malocclusion can be caused by overcrowding. When too many teeth are competing for too little space, it can be difficult to clean the teeth and gums effectively. It is much easier to clean straight teeth that are properly aligned.
Reduced risk of TMJ – Temporomandibular jaw syndrome (TMJ) is thought to be caused by a malocclusion. Headaches, facial pains and grinding teeth during sleep all result from the excessive pressure to the temporomandibular joint. Realigning the teeth reduces pressure, and eliminates these symptoms.

How is a malocclusion treated?

A malocclusion is usually treated with dental braces. The orthodontist takes panoramic X-rays, conducts visual examinations, and takes bite impressions of the whole mouth before deciding on the best course of treatment. If a malocclusion is obviously caused by overcrowding, the orthodontist may decide an extraction is the only way to create enough space for the realignment. However, in the case of an underbite, crossbite or overbite, there are several different orthodontic appliances available, such as:

Fixed multibracket braces – This type of dental braces consists of brackets cemented to each tooth, and an archwire that connects each one. The orthodontist adjusts or changes the wire on a regular basis to train the teeth into proper alignment.
Removable devices – There are many non-fixed dental braces available to treat a malocclusion. Retainers, headgear and palate expanders are amongst the most common. Retainers are generally used to hold the teeth in the correct position while the jawbone grows properly around them.
Invisalign^® – These dental aligners are removable and invisible to the naked eye. Invisalign^® works similarly to fixed dental braces but does not impact the aesthetics of the smile.

If you have any questions about malocclusions, please contact our office.

Who Can Benefit From Orthodontics?

Orthodontics is a specialized branch of dentistry that is concerned with diagnosing, treating and preventing malocclusions (bad bites) and other irregularities in the jaw region and face. Orthodontists are specially trained to correct these problems and to restore health, functionality and a beautiful aesthetic appearance to the smile. Though orthodontics was originally aimed at treating children and teenagers, almost one third of orthodontic patients are now adults. A person of any age can be successfully treated by an orthodontist.

A malocclusion (improper bite) can affect anyone at any age, and can significantly impact the individual’s clarity of speech, chewing ability and facial symmetry. In addition, a severe malocclusion can also contribute to several serious dental and physical conditions such as digestive difficulties, TMJ, periodontal disease and severe tooth decay. It is important to seek orthodontic treatment early to avoid expensive restorative procedures in the future.

What problems can orthodontics treat?

Orthodontics can treat a wide range of dental problems and in most cases, completely realign the teeth. Orthodontists may work alone, or in combination with a maxillofacial surgeon.

The typical irregularities requiring orthodontic treatment are as follows:

Overcrowding – An overcrowded mouth means there is insufficient space within the jaw for all of the adult teeth to fit naturally. Overcrowding may lead to displaced, rotated or completely misaligned teeth.
Overbite – An overbite refers to the protrusion of the maxilla (upper jaw) relative to the mandible (lower jaw). An overbite gives the smile a “toothy” appearance and the chin looks like it has receded.
Underbite – An underbite, also known as a negative underjet, refers to the protrusion of the mandible (lower jaw) in relation to the maxilla (upper jaw). An underbite makes the chin look overly prominent. Developmental delays and genetic factors generally cause underbites and overbites.

How can orthodontics help?

Orthodontic dentistry offers techniques which will realign the teeth and revitalize the smile. There are several treatments the orthodontist may use, depending on the results of panoramic X-rays, study models (bite impressions), and a thorough visual examination.

Fixed dental braces can be used to expediently correct even the most severe case of misalignment. These braces consist of metal or ceramic brackets which are affixed to each tooth and an archwire which is used to gradually move the teeth through the duration of the treatment.

Removable appliances include headgear (which consists of a metal wire device attached to customized braces), retainers, Invisalign^® aligners (which are almost invisible to the naked eye), palate expanders and tooth movers. Faceguards are generally used to correct developmental delays in both the upper and lower jaw, and palate expanders are used to combat overcrowding.

Whatever the dental irregularity or the age of the individual, orthodontic appliances can properly realign the teeth and create a beautiful smile.

If you have any questions or concerns about orthodontic treatments or how they can benefit you, please contact our office.

Orthodontic Treatment (Braces)

The benefits of orthodontic treatment often go beyond the obvious physical changes of an improved bite and straighter teeth; it’s also a great way to improve a person’s overall self-image. While having beautiful straight teeth is important, even more important is the need to alleviate any potential health problems associated with the teeth or jaw. Crooked teeth or jaw problems may contribute to improper cleaning of teeth, leading to tooth decay and, possibly, gum disease or total tooth loss. Orthodontic problems that go untreated can lead to chewing and digestion difficulties, speech impairments, and abnormal wear of tooth surfaces. Over time, excessive strain on gum tissue and the bone that supports the teeth can affect the jaw joints leading to problems such as headaches or face and neck pain.

The American Association of Orthodontics recommends that children get an orthodontic evaluation no later than age 7. Though orthodontic treatment can be done at any age, timely treatment ensures maximum dental health.

With all of the recent advancements in orthodontics, wearing braces has never been easier. State-of-the-art appliances and treatments are now available, from traditional metal braces, to clear and tooth colored brackets, to NASA type wires that are heat activated and require fewer adjustments! Some patients may even be candidates for treatment with Invisalign, a revolutionary way to straighten teeth using clear, retainer type aligners that require no braces or wires!

If treatment is necessary, we will thoroughly discuss which treatment option is best suited for you!

Reasons for orthodontic treatment (braces) adults & children:

Breathing or swallowing problems – Mouth breathing can lead to snoring and sleep apnea.
Crossbite – One or more upper teeth bite inside the lower teeth (towards the tongue).
Crowding – Involving extra teeth or malpositioned teeth.
Deep Overbite – The lower front teeth bite into the upper tissue of the upper teeth.
Disfiguring of the face & mouth – Affects the development of the jaw and position of the teeth.
Jaw & jaw joint pain
Missing or extra teeth – Due to tooth decay, injuries, or inherited problems.
Overjet (protruding upper teeth) – Upper teeth that protrude beyond normal and are usually associated with a short lower jaw.
Self-image – An attractive smile can boost a person’s self-image and confidence.
Spacing between teeth – Teeth are missing or may be too small or too large.
Speech, chewing or biting problems
Underbite (lower jaw protrusion) – Lower jaw is longer than the upper jaw.

Specific to children:

Finger or thumb sucking – These habits can cause protrusion of the upper incisor teeth, and mouth breathing.
Teeth erupting out of position – Can be guided to proper alignment.

What does orthodontic treatment involve?

Orthodontic treatment involves three phases:

1. Planning Phase – Your first couple of visits may include the following:

A medical and dental history evaluation.
Castings or “molds” of your teeth.
Computer generated photograph of the head and neck that will aid in planning.
Photographs of your face and mouth.
X-rays of the teeth and jaws.

After careful planning, your orthodontist will design and apply braces or fabricate custom-made appliances for you.

2. Active Phase – Active treatment involves visiting your orthodontist on a regular basis for adjustments and following specific treatment requirements to ensure successful treatment.

3. Retention Phase – When treatment is completed, the braces and/or appliances are removed and a new appliance is made. Usually these retainers are removable and will maintain the changes made to your teeth if worn continuously until the teeth and bone are stabilized in their new positions.

Treatment and retention times vary depending on each individual case. Your orthodontist will ensure you have a successful treatment for a beautiful smile that can last a lifetime.

Orthodontics can not only help straighten your teeth, giving you an appealing smile, but can greatly contribute to the health of your jaw, teeth and sometimes your overall health.

Orthodontic Treatment Phases

Orthodontic treatment is highly predictable and immensely successful. Depending on the severity of the malocclusion (bad bite) or irregularity, orthodontic treatments may occur in either two or three distinct phases.

The benefits of correcting misaligned teeth are many. Straight teeth are pleasing to look at and greatly boost confidence and self esteem. More importantly, properly aligned teeth enhance the biting, chewing and speaking functions of the jaw. There are several types of irregularities, including:

Overbite – The upper teeth protrude further than or completely cover the lower teeth.
Underbite – The lower teeth protrude further than the upper teeth causing the chin to look prominent.
Crossbite – Some of the upper teeth may close inside the lower teeth rather than on the outside.
Overcrowding – Insufficient room on the arch causes some adult teeth to erupt incorrectly and become rotated.

The Phases of Orthodontic Treatment

Generally, orthodontic treatment takes between six and thirty months to complete. The treatment time will largely depend on the classification of the malocclusion, the type of dental devices used to correct it and the perseverance of the patient.

Here is a general overview of the three major stages of treatment:

Phase 1 – The Planning Stage

The orthodontist makes an exact diagnosis in order to realign the teeth in the most effective and expedient way. The first several visits may comprise of some of the following evaluations:

Medical and dental evaluations – Dental and physical problems tend to go hand in hand. Problems in the oral cavity can lead to (or be caused by) medical problems. The goal of this evaluation is to ensure that prior medical and dental issues are completely under control before treatment begins.
Study model (castings/bite impressions) – The patient is asked to bite down into a dental tray filled with a gel substance that hardens around the teeth. The trays are removed from the teeth and filled with plaster to create models of the patient’s teeth. Study models enable the orthodontist to scrutinize the position of each tooth, and how it relates to the other teeth.
Panoramic X-rays – X-rays are fantastic tools for viewing potential complications or pre-existing damage to the jaw joint. X-rays also allow the orthodontist to see the exact position of each tooth and its corresponding root(s).
Computer generated images – Such images allow the orthodontist to treatment plan and examine how specific treatments may affect the shape of the face and symmetry of the jaw.
Photographs – Many orthodontists like to take “before, during and after” photographs of the face and teeth to assess how treatment is progressing, and the impact the treatment is having on the patient’s face shape.

Phase 2 – The Active Phase

All of the above diagnostic tools will be used to diagnosis and develop a customized treatment plan for the patient. Next, the orthodontist will recommend custom orthodontic device(s) to gently move the teeth into proper alignment. This orthodontic appliance may be fixed or removable. Most commonly, traditional fixed braces are affixed, which utilizes individual dental brackets connected by an archwire. Lingual braces are also fixed, but fit on the inside (tongue side) of the teeth to make them less visible.

Removable devices are an alternative to fixed braces. Examples of removable devices include the Invisalign system, headgear and facemask. These devices are designed to be worn for a specified amount of hours each day to expedite treatment.

Whatever the orthodontic device, the orthodontist will regularly adjust it to ensure adequate and continual pressure is being applied to the teeth. It is essential to visit the orthodontist at the designated intervals and to call if part of the device breaks or becomes damaged.

Phase 3: The Retention Phase

When the teeth have been correctly aligned, fixed braces and removable devices will be removed and discontinued. The most cumbersome part of the orthodontic treatment is now over. The orthodontist will next create a custom retainer. The goal of the retainer is to ensure that the teeth do not begin to shift back to their original positions. Retainers need to be worn for a specified amount of time per day for a specified time period. During the retention phase, the jawbone will reform around the realigned teeth to fully stabilize them in the correct alignment.

If you have any questions about orthodontic treatments, please contact our office.

Braces for Children

Many children are ambivalent about getting braces. On one hand, they like the idea of perfect teeth, but on the other hand, they are nervous about whether the braces will cause pain and discomfort. The good news is that the placement of orthodontic braces is not at all painful, and the end result will be a beautiful straight smile.

Although patients of any age can benefit from orthodontic braces, they tend to work much quicker on pre-teens and teenagers since they are still experiencing jaw growth. The American Association of Orthodontists (AAO) recommends that children should first see an orthodontist around the age of seven years-old. An orthodontic examination may be beneficial before age seven if facial or oral irregularities are noted.

What Causes misalignment of teeth?

Poorly aligned teeth often cause problems speaking, biting and chewing. Most irregularities are genetic or occur as a result of developmental issues. Conversely, some irregularities are acquired or greatly exacerbated by certain habits and behaviors such as:

Mouth breathing
Thumb or finger sucking
Prolonged pacifier use
Poor oral hygiene
Poor nutrition

What’s involved when a child gets braces?

The orthodontist initially conducts a visual examination of the child’s teeth. This will be accompanied by panoramic X-rays, study models (bite impressions), and computer generated images of the head and neck. These preliminary assessments are sometimes known as the “planning phase” because they aid the orthodontist in making a diagnosis and planning the most effective treatment.

In many cases, the orthodontist will recommend “fixed” orthodontic braces for a child. Fixed braces cannot be lost, forgotten or removed at will, which means that treatment is completed more quickly. Removable appliances may also be utilized, which are less intrusive and are generally used to treat various types of defects.

Here is a brief overview of some of the main types of orthodontic appliances used on children:

Fixed braces – Braces are comprised of brackets that are affixed to each individual tooth and an archwire that connects the brackets. The brackets are usually made of metal, ceramic, or a clear synthetic material which is less noticeable to the naked eye. After braces have been applied, the child will have regular appointments to have the braces adjusted by the orthodontist. Orthodontic elastic bands are often added to the braces to aid in the movement of specific teeth.
Headgear – This type of appliance is most useful to treat developmental irregularities. A headgear is a custom-made appliance attached to wire that aids in tooth movement. A headgear is intended to be worn for 12-20 hours each day and must be worn as recommended to achieve the intended result.
Retainers – Retainers are typically utilized in the third phase (retention phase). When the original malocclusion has been treated with braces, it is essential that the teeth do not regress back to the original misalignment. Wearing a retainer ensures that teeth maintain their proper alignment and gives the jawbone around the teeth a chance to stabilize.

If you have questions about braces for children, please contact our office.

Braces for Adults

Orthodontic braces were historically associated with teenagers. Today, an increasing number of adults are choosing to wear braces to straighten their teeth and correct malocclusions (bad bites). In fact, it is now estimated that almost one third of all current orthodontic patients are adults.

Orthodontic braces are predictable, versatile, and incredibly successful at realigning the teeth. Braces work in the same way regardless of the age of the patient, but the treatment time is greatly reduced in patients who are still experiencing jaw growth and have not been affected by gum disease. In short, an adult can experience the same beautiful end results as a teenager, but treatment often takes longer.

Can adults benefit from orthodontic braces?

Absolutely! Crooked or misaligned teeth look unsightly, which can cause a low self-esteem and a lack of self confidence. Aside from poor aesthetics, improperly aligned teeth can also cause difficulties biting, chewing, and articulating clearly. Generally speaking, orthodontists agree that straight teeth tend to be healthier teeth.

Straight teeth offer a multitude of health and dental benefits including:

Reduction in general tooth decay
Decreased likelihood of developing periodontal disease
Decreased likelihood of tooth injury
Reduction in digestive disorders

Fortunately, orthodontic braces have been adapted and modified to make them more convenient for adults. There are now a wide range of fixed and removable orthodontic devices available, depending on the precise classification of the malocclusion.

The most common types of malocclusion are underbite (lower teeth protrude further than upper teeth), overbite (upper teeth protrude further than lower teeth), and overcrowding where there is insufficient space on the arches to accommodate the full complement of adult teeth.

Prior to recommending specific orthodontic treatment, the orthodontist will recommend treatment of any pre-existing dental conditions such as gum disease, excess plaque, and tooth decay. Orthodontic braces can greatly exacerbate any or all of these conditions.

What are the main types of orthodontic braces?

The following are some of the most popular orthodontic braces:

Traditional braces – These braces are strong and tend not to stain the teeth. They are comprised of individual brackets which are cemented to each tooth and accompanied by an archwire which constantly asserts gentle pressure on the teeth. Traditional braces are generally metal but are also available in a clear synthetic material and “tooth colored” ceramic. The ceramic brackets are usually more comfortable than the metal alternative, but can become discolored by coffee, wine, smoking, and certain foods.

Invisalign® – Invisalign® aligners are clear trays and should be worn for the recommended amount of time each day for the quickest results. Invisalign® aligners are clear trays, and should be worn for the recommended amount of time each day for the quickest results. Invisalign® aligners are more comfortable and less obtrusive than traditional braces but also tend to be more costly. Not all patients are candidates for Invisalign®.

Lingual braces – These appliances are usually metal and fixed on the tongue side of the teeth, therefore cannot be seen when a patient smiles. Lingual braces tend to be moderately expensive and can interfere with normal speech.

If you have any questions about orthodontic braces, please contact our office.

Do Braces Hurt?

One of the most commonly asked questions about dental braces is whether placing them causes any pain or discomfort. The honest answer is that braces do not hurt at all when they are applied to the teeth, so there is no reason to be anxious. In most cases, there is mild soreness or discomfort after the orthodontic wire is engaged into the brackets, which may last for a few days.

There are two common types of fixed dental braces used to realign the teeth: ceramic fixed braces and metal fixed braces. Both types of fixed appliances include brackets which are affixed to each individual tooth and an archwire the orthodontist fits into the bracket slot to gently move the teeth into proper alignment. Elastic or wire ties will be applied to hold the wire in place. Some orthodontists may use self-ligating brackets which do not require a rubber or wire tie to secure the wire.

Fixed dental braces are used to treat a wide variety of malocclusions, including overbite, underbite, crossbite, and overcrowding. If the orthodontist has determined that the malocclusion has been caused by overcrowding, it is possible that teeth may need to be extracted to increase the amount of available space to properly align the teeth.

What to expect when getting braces

Here is an overview of what you can expect when getting braces:

Placement day – The placement of braces will not be painful in the slightest. It may take longer to eat meals, but this is largely because it takes some time to adjust to wearing the braces. In some cases, the teeth may feel more sensitive than usual. Hard, difficult to chew foods should be avoided in favor of a softer, more liquid-based diet for the first few days after placement of braces.
Two days after placement – The first several days after placement of braces can be slightly uncomfortable. This is because the teeth are beginning the realignment process and are not used to the pressure of the archwire and orthodontic elastic bands. The orthodontist will provide relief wax to apply over the braces as necessary. Wax helps provide a smooth surface and alleviates irritation on the inner cheeks and lips. Additionally, over-the-counter pain medication (e.g., Motrin^® and Advil^®) may be taken as directed to relieve mild soreness.
Five days after placement – After five days, any initial discomfort associated with the braces should be completely gone. The teeth will have gradually acclimated to the braces, and eating should be much easier. Certain hard foods may still pose a challenge to the wearer, but normal eating may be resumed at this point.
Orthodontic appointments – Regular orthodontic appointments are necessary to allow the orthodontist to change the archwire, change the rubber or metal ties, and make adjustments to the braces. Fixed braces work by gradually moving the teeth into a new and proper alignment, so gentle pressure needs to be applied constantly. The first several days after an orthodontic adjustment may be slightly uncomfortable, but remember that this discomfort will quickly fade.
Dealing with discomfort – Over-the-counter pain medication and orthodontic relief wax will help alleviate any mild soreness and discomfort following placement of braces and orthodontic adjustments. Another effective remedy is to chew sugar-free gum, as this increases blood flow which helps reduces discomfort and can also encourage the teeth to align quicker.

If you have any questions or concerns about orthodontic treatment, please contact our office.

Care Following Orthodontics – Retainers

When braces are finally removed, the “retention” phase begins for most individuals. The objective of this phase is to ensure the teeth do not regress back to their previous position. A retainer will be used to maintain the improved position of the teeth. A retainer is a fixed or removable dental appliance which has been custom-made by the orthodontist to fit the teeth. Retainers are generally made from transparent plastic and thin wires to optimize the comfort of the patient.

Retainers are worn for varying amounts of time, depending on the type of orthodontic treatment and the age of the patient. Perseverance and commitment are required to make this final stage of treatment successful. If the retainer is not worn as directed, treatment can fail or take much longer than anticipated.

What types of retainer are available?

There are a variety of retainers available, each one geared towards treating a different kind of dental problem. The orthodontist will make a retainer recommendation depending on the nature of the original diagnosis and the orthodontic treatment plan.

The following are some of the most common types of retainers:

Hawley retainer – The Hawley retainer consists of a metal wire on an acrylic arch. The metal wire may be periodically adjusted by the orthodontist to ensure the teeth stay in the desired position. The acrylic arch is designed to fit comfortably on the lingual walls or palate of the mouth.
Essix – The Essix retainer is the most commonly used vacuum formed retainer (VFR). A mold is initially made of the teeth in their new alignment, and then clear PVC trays are created to fit over the arch in its entirety. VFR’s are much cheaper than many other types of retainers and also do not affect the aesthetic appearance of the smile in the same way as the Hawley retainer. The disadvantage of VFR’s is that they break and scratch more easily than other types of retainers.
Fixed retainers – A fixed retainer is somewhat similar to a lingual brace in that it is affixed to the tongue side of a few teeth. Usually, a fixed retainer is used in cases where there has been either rapid or substantial movement of the teeth. It usually consists of a single wire. The inclination of the teeth to move rapidly means they are also more likely to regress back to their previous position if a fixed retainer is not placed.

What do I need to consider when using a retainer?

There are a few basic things to consider for proper use and maintenance of your retainer.

Don’t lose the appliance – Removable retainers are very easy to lose. It is advisable to place your retainer in the case it came in while eating, drinking, and brushing. Leaving a retainer folded in a napkin at a restaurant or in a public restroom can be very costly if lost because a replacement must be created. A brightly colored case serves as a great reminder.

Don’t drink while wearing a retainer – It is tempting to drink while wearing a retainer because of the unobtrusive nature of the device. However, excess liquid trapped under the trays can vastly intensify acid exposure to teeth, increasing the probability of tooth decay.

Don’t eat while wearing a retainer – It can be difficult and awkward to eat while wearing a removable retainer and it can also damage the device. Food can get trapped around a Hawley retainer wire or underneath the palate, causing bad breath. When worn on the upper and lower arches simultaneously, VFR retainers do not allow the teeth to meet. This means that chewing is almost impossible.

Clean the retainer properly – Removable retainers can become breeding grounds for calculus and bacteria. It is essential to clean the inside and outside thoroughly as often as possible. Hawley retainers can be cleaned with a toothbrush. Because harsh bristles can damage the PVC surface of a VFR, denture cleaner or a specialized retainer cleaner is recommended for this type of device.

Wear the retainer as directed – This phase of treatment is critical. The hard work has been done; the braces are off, and now it is tempting not to wear the retainer as often as the orthodontist recommends. Retainers are needed to give the muscles, tissues, and bones time to stabilize the teeth in their new alignment. Failure to wear the retainer as directed can have regrettable consequences, such as teeth returning to their original position, added expense, and lost time.

If you have any questions or concerns about retainers, please contact our office.

Why Straighten Teeth?

Straighter teeth perform chewing, biting and speaking functions more effectively than crooked teeth. In addition, a straight smile boosts confidence, is aesthetically pleasing to look at, and can help stave off a wide variety of dental ailments.

There are several types of malocclusion including overbite, underbite, crossbite, and overcrowding. Each of these alignment problems negatively impacts the functionality and cosmetic appearance of the teeth.

Here is a brief overview of some of the main disorders associated with crooked teeth:

Periodontitis – Periodontitis or gum disease begins with a bacterial infection. The bacterial infection is caused by inadequate oral hygiene. Crooked teeth are hard to clean effectively, which means that debris, plaque and bacteria can build up in hard-to-reach areas. Straight teeth are much easier to clean and are at less risk of contracting gum disease.

Temporomandibular Disorder (TMJ) – Crooked teeth can lead to improper jaw alignment, which in turn causes a painful condition known as TMJ. Severe headaches, jaw pain, lockjaw and the grinding of teeth characterize this debilitating disorder.

Tooth injury – Straight teeth creates a strong wall, which means injuries are less likely to occur. Crooked teeth are weaker and often protrude, making them far more vulnerable to external injury.

Uneven wear – Crooked teeth cause some of the teeth to work harder than others when biting and chewing. Straight teeth share the workload evenly, meaning less risk of injury and better aesthetics.

Teeth can be straightened using either orthodontic braces or customized aligning trays. Orthodontic braces are usually affixed to the teeth for a set duration. The brackets and archwires are tightened regularly by the orthodontist and removed when treatment is complete. Fixed braces can be placed on the front side or back side of the teeth and are effective for most types of malocclusion.

Aligning trays are fully removable and are used where the malocclusion is less severe, and the teeth need to move a shorter distance. These trays are replaced every few weeks for the duration of the treatment, and have proven to be equally effective for straightening teeth.

If you have questions about orthodontics and straightening teeth, please ask your orthodontist.

Orthodontic Dictionary

The following are the most commonly used terms in orthodontics. If you have any questions about orthodontics or would like to schedule an appointment, please contact our office.

Anterior Teeth: The upper and lower six front teeth on each arch.

Appliance: Any orthodontic device which moves or retains teeth. Appliances may also alter the positioning of the jaw.

Arch: The entire upper or lower jaw.

Archwire: The metal wire that connects orthodontic brackets. This wire guides the teeth into their new alignment.

Band with bracket: Metal bands (rings) that are generally cemented around the back teeth.

Braces: Fixed orthodontic appliances designed to align teeth.

Brackets: The tiny metal, ceramic or clear brackets that are affixed to each individual tooth on the arch.

Brushing: This is a crucial part of home dental care. Orthodontists recommend those wearing braces to brush after every meal and snack to eliminate bacteria and plaque.

Buccal: The outer (cheek) side of posterior teeth in the lower and upper arches.

Cephalometric Radiograph: A side X-ray of the face and head used to show growth and development.

Chain: Elastics connected together and placed around the brackets to stabilize the archwire and gently close spaces.

Class I Malocclusion: Molars are correctly aligned, but there is an anterior/posterior crossbite, an openbite or overcrowding on the arches.

Class II Malocclusion: Also known as an overbite. The upper front teeth are positioned further forward than the lower teeth.

Class III Malocclusion: Also known as an underbite. The lower front teeth are positioned further forward than the upper front teeth.

Closed Bite: The upper front teeth completely overlap the bottom teeth causing a deep overbite.

Congenitally Missing Teeth: Some permanent teeth fail to develop and erupt due to genetic factors.

Crossbite: A malocclusion in which the upper back teeth bite inside or outside the lower back teeth, or the lower front teeth bite in front of the upper front teeth.

De-banding: The removal of orthodontic bands from the teeth.

De-bonding: The removal of affixed orthodontic brackets from the teeth.

Diagnostic Records: Records used to assess, plan and implement treatments. These records usually include medical and dental history, radiographs, panoramic radiographs, bite molds and intraoral/extraoral photographs.

Digital Radiograph: Digital X-rays of the teeth which can be viewed, stored, and transmitted via computer.

Elastics: Some braces may require that elastic rubber bands be attached to exert additional pressure to an individual tooth or a group of teeth.

Eruption: The way in which teeth surface through the gums inside the mouth.

Fixed Orthodontic Appliances: Orthodontic appliances which are affixed to the teeth by the orthodontist and cannot be removed by the patient.

Flossing: An essential part of home care that removes debris and plaque from above and below the gumline.

Functional Appliances: Orthodontic appliances that use the muscle movement created by swallowing, eating and speaking to gently move and align the teeth and jaws.

Gingiva: The gums and soft tissue around the teeth.

Headgear: A removable appliance comprised of a brace and external archwire. This device modifies growth and promotes tooth movement.

Impressions: Teeth impressions are taken to allow the orthodontist to see exactly how a patient’s teeth fit together.

Interceptive Treatment: Treatment performed on children who have a mixture of adult and baby teeth. Early treatment can help reduce the need for major orthodontic treatment in the future.

Invisalign^®: A newer, removable type of dental aligner that is completely transparent and doesn’t interfere with eating because it’s removable. Not all patients are candidates for Invisalign^®.

Ligating Modules: An elastic donut-shaped ring which helps secure the archwire to the bracket.

Ligation: Securing the archwire to the brackets.

Lingual Side: The side of the teeth (in both arches) that is closest to the tongue.

Malocclusion: Literally means “bad bite” in Latin, and refers to teeth that do not fit together correctly.

Mandible: The lower jaw.

Maxilla: The upper jaw.

Mouthguard: A removable plastic or rubber device that protects teeth and braces from sporting injuries.

Open Bite: Upper and lower teeth fail to make contact with each other. This malocclusion is generally classified as anterior or posterior.

Orthodontics: The unique branch of dentistry concerned with diagnosing, preventing and correcting malocclusions and jaw irregularities.

Orthodontist: A dental specialist who prevents, diagnoses and treats jaw irregularities and malocclusions. Orthodontists must complete two or three additional years of college after dental school and complete a residency program.

Palatal Expander: A removable or fixed device designed to expand the palate in order create room on either the upper or lower arch.

Panoramic Radiograph: An extraoral (external) X-ray that shows the teeth and jaws.

Plaque: The sticky film of saliva, food particles and bacteria that contributes to gum disease and tooth decay.

Posterior Teeth: Back teeth.

Removable Appliance: An orthodontic brace or device that can be removed at will by the patient. It must be worn for the designated amount of time each day to be effective.

Separators: A wire loop or elastic ring placed between the teeth to create room for the subsequent placement of bands or orthodontic appliance.

Space Maintainer: A fixed appliance used to hold space for permanent (adult) tooth. This is usually used when a baby tooth has been lost earlier than anticipated.

Wax: Orthodontic relief wax is a home care remedy used to alleviate irritations caused by braces.

Wires: Attached to the brackets to gently move the teeth into proper alignment.

Oral & Maxillofacial Surgery

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!

Tooth Extractions

Tooth extractions, or the removal of one or more teeth, are usually used as a last resort in dentistry, as keeping the natural tooth in the mouth is ideal. There are many reasons why single or multiple extractions may be performed, including pervasive tooth decay, the impaction of wisdom teeth, or the need to create space for orthodontic devices.

The most significant short-term benefit associated with tooth extraction is the elimination of pain. If a tooth is severely decayed or an infection is present, removing the affected tooth almost immediately alleviates discomfort. However, it should be noted that further procedures are necessary to replace the extracted tooth. Leaving a gap is not a viable option as the other teeth tend to twist out of alignment to fill the space.

Why might I need to have a tooth extraction?

Tooth extractions are incredibly common procedures. It should be reiterated that an extraction is used as a procedure of last resort, when nothing more can be done to save the tooth.

Here is a brief overview of some of the main reasons for tooth extraction:

Deep decay – This is easily the most common reason for tooth extraction, accounting for around two-thirds of all extraction procedures performed. When decay affects the surface of the tooth as well as the pulp, root canal procedures cannot be performed. Root canal therapy is only viable where the general structure of the tooth is in stable condition.

Extra teeth –There are a variety of explanations associated with extra teeth, but most commonly they are baby teeth that do not shed. Extra teeth take up space on the arch, causing nearby teeth to twist out of place. A tooth extraction is necessary in this case to provide enough space for the teeth to properly realign.

Periodontal disease – Often teeth have to be extracted because the gums and underlying bone are so severely eroded that they can no longer hold the tooth in place securely. The cause of bone and gum recession is almost always advanced periodontal disease (gum disease). Poor bone density means that the chance of restoring the natural tooth is minimal.

Prior to braces – Traditional orthodontic braces require enough space to for the teeth to move into ideal alignment. If space cannot be created naturally, a tooth may be extracted as an alternative.

Fractured teeth – Fortunately, dentists are able to save injured teeth in most circumstances with the aid of root canal therapy. However, there are some instances where the tooth has become fractured in a way that makes repair impossible. Your oral health professional will remove the tooth and use a prosthetic replacement in most cases.

How is the extraction procedure performed?

Generally, tooth extraction can be simple in nature or involve more complex surgical processes. Simple extractions are performed on fully emerged teeth after applying local anesthetic to the treatment site. Instruments are used to elevate the tooth and then sever the periodontal ligament. The tooth is then carefully removed with dental forceps.

Surgical extractions are performed on teeth that are either invisible or inaccessible, like un-erupted wisdom teeth. An incision is usually made in the gum tissue and a drill is used to precisely remove some of the adjacent bone tissue. Sometimes, the tooth has to be split into several pieces to completely remove it.

If you have any questions or concerns about tooth extraction, please contact your oral health care provider.

Bone Grafting

Bone grafting is often closely associated with dental restorations such as bridge work and dental implants. In the majority of cases, the success of a restoration procedure can hinge on the height, depth, and width of the jawbone at the implant site. When the jawbone has receded or sustained significant damage, the implant(s) cannot be supported on this unstable foundation and bone grafting is usually recommended for the ensuing restoration.

There are several major factors that affect jaw bone volume:

Periodontal Disease – Periodontal disease can affect and permanently damage the jaw bone that supports the teeth. Affected areas progressively worsen until the teeth become unstable.
Tooth Extraction – Studies have shown that patients who have experienced a tooth extraction subsequently lose 40-60% of the bone surrounding the extraction site during the following three years. Loss of bone results in what is called a “bone defect”.
Injuries and Infections – Dental injuries and other physical injuries resulting from a blow to the jaw can cause the bone to recede. Infections can also cause the jaw bone to recede in a similar way.

Reasons for bone grafts

Bone grafting is a highly successful procedure in most cases. It is also a preferable alternative to having missing teeth, diseased teeth, or tooth deformities. Bone grafting can increase the height or width of the jawbone and fill in voids and defects in the bone.

There are essentially two basic ways in which bone grafting can positively impact the health and stability of the teeth:

Jaw Stabilization – Bone grafting stabilizes and helps restore the jaw foundation for restorative or implant surgery. Deformities can also be corrected and the restructuring of the bone can provide added support.

Preservation – Bone grafting can be used to limit or prevent bone recession following a tooth extraction, periodontal disease, or other invasive processes.

Oral Examination

Initially, the dentist will thoroughly examine the affected area in order to assess the general condition of the teeth and gums. If periodontal disease is present or the adjacent teeth are in poor condition, these factors will be fully addressed before the bone grafting procedure can begin. The dentist will also recommend panoramic x-rays in order to assess the precise depth and width of the existing bone. On occasion, a CAT scan may be recommended to determine the bone condition. Depending on these results, the dentist may also anesthetize the area and explore into the gum in order to determine what kind and how much bone is required.

What Does Bone Grafting Involve?

There are several types of bone grafts. Your dentist will determine the best type for your particular condition.

Autogenous Bone Graft – Harvested from the patient’s own body (usually from the posterior part of the lower jaw or the chin). This method is usually preferred because it produces the most predictable results.

Allograft Bone Graft – Cadaver or synthetic bone is used in this type of graft.

Xenograft – Cow bone is used in this type of graft.

The bone grafting procedure can often take several months to complete. Bone is typically harvested from your own body (or on rare occasions obtained from a “bone bank”) and added to the affected site. This bone will fuse with the existing bone and the migration of cells will cause firm adhesion and cell growth. Supplementing the jaw with bone will result in greater bone mass to help support and anchor the implant(s).

During the surgery, the dentist will numb the grafting and extraction sites using local anesthetic. A small incision will be made to prepare the site for the new bone and it will be anchored into place. On occasion, a synthetic membrane may be used to cover the new bone. This membrane prevents soft tissue and bacterial invasions, and encourages new bone growth. The surgery does not require an overnight stay, and you will be provided with comprehensive instructions for your post-operative care. The dentist will prescribe medications to help manage infection, discomfort and swelling.

TMJ (Temporomandibular Joint Dysfunction)

Temporomandibular Joint Dysfunction Syndrome (TMJ) is a common condition affecting a wide variety of people. TMJ is characterized by severe headaches, jaw pain of varying degrees, grinding teeth, and an intermittent ringing in the ears. The vast majority of TMJ sufferers are unaware that the root cause of these problems is something that a dentist can effectively treat.

The symptoms of TMJ are debilitating and can greatly interfere with every day life. The comfort and general well being of the patient is at the heart of the dental practice, so pain relief is the first consideration of the dentist. The dentist is able to test, diagnose, and devise an immediate plan to treat the underlying causes of the TMJ disorder.

Reasons for treating TMJ

TMJ sufferers report that their symptoms generally worsen during periods of prolonged or unexpected stress, and that intense outbreaks of the condition can lead to neck pain and dizziness.

The most common cause of TMJ is the misalignment of the teeth, often called “bad bite.” It is possible for the dentist to realign or adjust the teeth without the need for painful or expensive surgeries. The realignment/adjustment will stop the pounding headaches, the jaw pain, and the dizziness.

The grinding teeth symptom is particularly common and usually occurs at night. The grinding will eventually erode the structure of the teeth and lead to much more severe dental problems in the future. Untreated TMJ is one of the prime underlying factors in eroded jawbones and loose teeth.

It is important for anyone experiencing the symptoms of TMJ to visit the dentist for an exact diagnosis.

What does treating TMJ involve?

TMJ could be a result of several different problems. Bad bite is the most common, but an injury resulting from a blow to the meniscus cartilage is also a possibility. Initially, the dentist will thoroughly examine the jaw area, the patient’s bite, take X-rays, and review the patient’s history in order to make an accurate diagnosis and recommend necessary treatment.

Once a firm diagnosis is attained, there are several ways in which relief can be provided. A specially molded bite guard can be created to stop teeth grinding during the night. A bite relationship analysis may be recommended by the dentist. The dentist can also provide advice on relaxation techniques which will lessen the effects of stress. As a last alternative, the dentist is also able to prescribe muscle relaxants.

A better option is to change the shape of the teeth and get rid of the bad bite completely, often called “realignment.” This is especially useful because it alleviates TMJ symptoms and may improve the aesthetic appearance of the teeth as well. Realignment involves adjusting the relationship between how the upper teeth come together with the lower teeth. This may require new restorations and/or adjusting the natural teeth as well. It is not a painful procedure, and it is one the dentist has performed with great success numerous times. As with any procedure, the dentist will be happy to answer questions and discuss symptoms, options, and treatments.

If you are experiencing any symptoms of TMJ, we encourage you to contact our office today to schedule an appointment.

Periodontics

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.

What is a Periodontist?

A periodontist is a dentist who specializes in the soft tissues of the mouth and the underlying jawbone which supports the teeth. A dentist must first graduate from an accredited dental school before undertaking an additional three years of study within a periodontology residency training program, in order to qualify as a periodontist.

The primary focus of this residency training is on both surgical and non surgical management of periodontal disease and the placement of dental implants.

Conditions Treated by a Periodontist

The periodontist is mainly concerned with: preventing the onset of gum disease (periodontal disease); diagnosing conditions affecting the gums and jawbone; and treating gingivitis, periodontitis, and bone loss. Periodontal disease is a progressive condition and the leading cause of tooth loss among adults in the developed world.

The periodontist is able to treat mild, moderate and advanced gum disease by first addressing the bacterial infection at the root of the problem, providing periodontal treatment, then providing information and education on good oral hygiene and the effective cleaning of the teeth.

The most common conditions treated by a periodontist are:

Gingivitis – This is the mild inflammation of the gums which may or may not be signified by pain and bleeding.
Mild/moderate periodontitis – When the pockets between the teeth and the soft tissues are measured to be between 4-6mm it is classified as moderate periodontitis (gum disease).
Advanced periodontitis – When the pockets between the teeth and the soft tissues in general exceed 6mm in depth, significant bone loss may occur; causing shifting or loss of teeth.
Missing teeth – When teeth are missing as a result of bone loss, the periodontist can implant prosthetic teeth. These teeth are anchored to the jawbone and restore functionality to the mouth.

Treatments Performed by a Periodontist

The periodontist is able to perform a wide range of treatments to halt the progression of gum disease, replace missing teeth and make the appearance of the smile more aesthetically pleasing.

Here are some of the treatments commonly performed by the periodontist:

Implant placement – When a tooth or several teeth are missing, the periodontist is able to create a natural-looking replacement by anchoring a prosthetic tooth to the jawbone.
Osteoplasty (hard tissue recontouring) – Once periodontitis has been treated, the periodontist can recontour the hard tissue to make the smile both natural-looking and aesthetically pleasing.
Gingivoplasty (soft tissue recontouring) – As gums recede due to periodontitis, the teeth may appear longer; causing a “toothy” smile. The periodontist can remove tissues or straighten the gum line to make the teeth look more even.
Bone grafting – Dental implants can only be positioned if there is sufficient bone to attach the prosthetic tooth to. If bone loss has occurred, bone grafting is an excellent way to add or “grow” bone so that an implant may be properly secured.
Deep pocket cleanings – As gingivitis and periodontitis progress, it becomes more difficult to cleanse the pockets between the soft tissues and the teeth. The periodontist can scale and root plane the teeth (sometimes under local anesthetic) to remove debris and infection-causing bacteria.
Crown lengthening – In order to expose more of the natural tooth, the periodontist can remove some of the surrounding gingival tissue.

The periodontist is a highly skilled dental health professional who is able to diagnose and treat many commonly occurring soft tissue and bone problems in the oral cavity.

Please contact our office if you have any questions or concerns.

When to See a Periodontist

A periodontist is a dentist specializing in the prevention, diagnosis and treatment of infections and diseases in the soft tissues surrounding the teeth, and the jawbone to which the teeth are anchored. Periodontists have to train an additional three years beyond the four years of regular dental school, and are familiar with the most advanced techniques necessary to treat periodontal disease and place dental implants. Periodontists also perform a vast range of cosmetic procedures to enhance the smile to its fullest extent.

Periodontal disease begins when the toxins found in plaque start to attack the soft or gingival tissue surrounding the teeth. This bacterium embeds itself in the gum and rapidly breeds, causing a bacterial infection. As the infection progresses, it starts to burrow deeper into the tissue causing inflammation or irritation between the teeth and gums. The response of the body is to destroy the infected tissue, which is why the gums appear to recede. The resulting pockets between the teeth deepen and if no treatment is sought, the tissue which makes up the jawbone also recedes causing unstable teeth and tooth loss.

Referrals from General Dentists and Self Referral

There are several ways treatment from a periodontist may be sought. In the course of a regular dental check up, if the general dentist or hygienist finds symptoms of gingivitis or rapidly progressing periodontal disease, a consultation with a periodontist may be recommended. However, a referral is not necessary for a periodontal consultation.

If you experience any of these signs and symptoms, it is important that you schedule an appointment with a periodontist without delay:

Bleeding while eating or brushing – Unexplained bleeding while consuming food or during the course of daily cleaning is one of the most common signs of periodontal infection.
Bad breath – Continued halitosis (bad breath) which persists even when a rigorous oral hygiene program is in place, can be indicative of periodontitis, gingivitis or the beginnings of an infection in the gum tissues.
Loose teeth and gum recession – Longer looking teeth can signal recession of the gums and bone loss due to periodontal disease. As this disease progresses and attacks the jawbone, (the anchor holding the teeth in place) the teeth may become loose or be lost altogether.
Gangrene in the tissues – Gangrene is hard to self diagnose but the general dentist and periodontist will check for its presence in the soft tissues, alveolar bone and periodontal ligament.
Related health conditions – Heart disease, diabetes, osteopenia and osteoporosis are highly correlated with periodontitis and periodontal infections. The bacteria infection can spread through the blood stream and affect other parts of the body.

Diagnosis and Treatment

Before initiating any dental treatment, the periodontist must extensively examine the gums, jawbone and general condition of the teeth. When gingivitis or periodontal disease is officially diagnosed, the periodontist has a number of surgical and non surgical options available to treat the underlying infection, halt the recession of the soft tissue, and restructure or replace teeth which may be missing.

Gingivitis/mild periodontal disease – When the gum pockets exceed 4mm in depth, the periodontist or hygienist may perform scaling and root planing to remove debris from the pockets and allow them to heal. Education and advice will be provided on an effective cleaning regime thereafter.
Moderate periodontal disease – If the gum pockets reach 4-6mm in length, a more extensive scaling and root planing cleaning might be required. This cleaning is usually performed under local anesthetic.
Advanced periodontal disease – Gum pockets in excess of 6-7mm are usually accompanied by bone loss and gum recession. Scaling and root planing will always be performed as the initial nonsurgical treatment. In addition to tose nonsurgical treatments, the periodontist may recommend surgical treatment to reduce pocket depth.
Tooth loss – Where one or several teeth are missing due to periodontal disease, dental implants are an effective option. If the bone is strong enough to provide a suitable anchor for the prosthetic tooth, the implant can be placed. However, if the bone is severely eroded, bone grafts may be performed by the periodontist to provide a suitable anchor for the new tooth/teeth.

Ask your periodontist if you have questions about periodontal disease, periodontal treatment or dental implants.

Antibiotic Treatment

Periodontal disease is a progressive condition that leads to severe inflammation and tooth loss if left untreated. Antibiotic treatments can be used in combination with scaling and root planing, curettage, surgery, or as a stand-alone treatment to help reduce bacteria before and/or after many common periodontal procedures.

Antibiotic treatments come in several different types, including oral forms and topical gels which are applied directly into the gum pockets. Research has shown that in the case of acute periodontal infection, refractory periodontal disease, prepubertal periodontal disease and juvenile periodontal disease, antibiotic treatments have been incredibly effective.

Antibiotics can be prescribed at a low dose for longer term use or as a short term medication to deter bacteria from re-colonizing.

Oral Antibiotics

Oral antibiotics tend to affect the whole body and are less commonly prescribed than topical gel. Here are some specific details about several different types of oral antibiotics:

Tetracycline antibiotics – Antibiotics which include tetracycline hydrochloride, doxycycline, and minocycline are the primary drugs used in periodontal treatment. They have antibacterial properties, reduce inflammation and block collagenase (a protein which destroys the connective tissue).
Macrolide antibiotics – This group of antibiotics has proven effective at reducing inflammation and can also reduce bacterial growth associated with periodontitis.
Metronidazole – This antibiotic is generally used in combination with amoxicillin or tetracycline to combat inflammation and bacterial growth in severe or chronic periodontitis.

Topical Gels and Strips

The biggest advantage of directly delivering antibiotics to the surface of the gums is not affecting the entire body. Topical gels and direct delivery methods tend to be preferred over their oral counterparts and are extremely effective when used after scaling and root planing procedures. Here are some of the most commonly used direct delivery antibiotics:

Atridox^® – This doxycycline gel conforms to the contours of gum surfaces and solidifies over them. Over several days, this gel gradually releases the antibiotic medication.
PerioChip^® – This chip is placed into the actual gum pocket after a root planing procedure. PerioChip® slowly releases Chlorhexidine, a powerful antibacterial antiseptic. PerioChip® reduces pocket depth in most periodontitis cases.
Actisite^® – This thin strip is similar to dental floss and contains tetracycline hydrochloride. The thread is temporarily placed between the tooth and gum to kill bacteria and reduce pocket depth. Several threads are sometimes placed for around 10 days to enhance the antibiotic effect.
Elyzol^® – This metronidazole antibiotic comes in gel and strip form. It is unique because it is able to destroy parasites as well as oral bacteria.
Arestin^® – This Minocycline antibiotic comes in mini capsules which are delivered into the gums after scaling and root planing.

Noticeable periodontal improvements are usually seen after systemic or oral antibiotic treatment. We will incorporate antibiotic treatments as necessary for the healing of your periodontal condition.

If you have any questions about periodontal disease or antibiotic treatments, contact our practice at your convenience.

Bruxism

Bruxism refers to an oral parafunctional activity that occurs in most humans at some point in their lives. Grinding of the teeth and clenching of the jaw are the two main characteristics of this condition, which can occur during the day or at night.

Bruxism is one of the most common known sleep disorders and causes most of its damage during sleeping hours. The clenching and grinding which accompanies bruxism is symptomatic of a malfunctioning chewing reflex, which is turned off in non-sufferers when sleeping. For sufferers, deep sleep or even naps cause the reflex nerve control center in the brain to turn off and the reflex pathways to become active.

Typically, the incisors and canines (front 6 upper and lower teeth) of opposing arches grind against each other laterally. This side to side action puts undue strain on the medial pterygoid muscles and the temporomandibular joints. Earache, depression, headaches, eating disorders, and anxiety are among the most common symptoms of bruxism; these symptoms also accompany health issues such as chronic stress, Alzheimer’s disease, and alcohol abuse.

Bruxism is frequently misdiagnosed or not diagnosed at all, because it is only one of several potential causes of tooth wear. Only a trained professional can tell the difference between bruxing wear and wear caused by overly aggressive brushing, acidic soft drinks, and abrasive foods.

A BiteStrip® is an economical device used to diagnose bruxism at home. The device itself is a small electromyography which senses and monitors any activity in the jaw muscles during sleep. The frequency and severity of the condition can then be assessed and the best treatment plan can be formulated.

Reasons for the treatment of bruxism

Here are some of the main reasons why bruxism should be promptly treated:

Gum recession and tooth loss – Bruxism is one of the leading causes of gum recession and tooth loss. It damages the soft tissue directly and leads to loose teeth and deep pockets, where bacteria can colonize and destroy the supporting bone.
Occlusal trauma – The abnormal wear patterns on the occlusal (chewing) surfaces can lead to fractures in the teeth, which may require restorative treatment.
Arthritis – In severe and chronic cases, bruxing can eventually lead to painful arthritis in the temporomandibular (TMJ) joints (the joints that allow the jaw to open smoothly).
Myofascial pain – The grinding associated with bruxism can eventually shorten and blunt the teeth. This can lead to debilitating headaches and muscle pain in the myofascial region.

Treatment options for bruxism

There is no single cure for bruxism, though a variety of helpful devices and tools are available. Here are some common ways in which bruxism is treated:

Mouthguards – An acrylic mouthguard can be designed from tooth impressions to minimize the abrasive action of tooth surfaces during normal sleep. Mouthguards should be worn on a long-term basis to help to stabilize the occlusion as well as prevent damage to teeth and to the temporomandibular joint.
NTI-tss device – This device is fitted by a health professional and only covers the front teeth. The goal of the NTI-tss is to prevent the grinding of the rear molars by limiting the contraction of the temporalis muscle.
Botox® – Botox® can be injected into the muscles to relax and weaken them. Botox® is an excellent treatment for bruxism because it weakens the muscles enough to prevent grinding but not enough to interfere with everyday functions like chewing and speaking.

Other methods of treatment include relaxation exercises, stress management education, and biofeedback mechanisms. When the bruxing is under control, there are a variety of dental procedures such as crowns, gum grafts, and crown lengthening that can restore a pleasant aesthetic appearance to the smile.

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

Oral Cancer Exam

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. Oral cancers can be of varied histologic types such as teratoma, adenocarcinoma and melanoma. 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.

The following signs will be investigated during a routine oral cancer exam:

Red patches and sores – Red patches on the floor of the mouth, the front and sides of the tongue, white or pink patches which fail to heal and slow healing sores that bleed easily can be indicative of pathologic (cancerous) changes.
Leukoplakia – This is a hardened white or gray, slightly raised lesion that can appear anywhere inside the mouth. Leukoplakia can be cancerous, or may become cancerous if treatment is not sought.
Lumps – Soreness, lumps or the general thickening of tissue anywhere in the throat or mouth can signal pathological problems.

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. Lasers which can highlight pathologic changes are also a wonderful tool for oral cancer checks. The laser can “look” below the surface for abnormal signs and lesions which would be invisible to the naked eye.

If abnormalities, lesions, leukoplakia or lumps are apparent, the dentist will implement a diagnostic impression and treatment plan. In the event that the initial treatment plan is ineffective, a biopsy of the area will be performed. The biopsy includes a clinical evaluation which will identify the precise stage and grade of the oral lesion.

Oral cancer is deemed to be present when the basement membrane of the epithelium has been broken. Malignant types of cancer can readily spread to other places in the oral and maxillofacial regions, posing additional secondary threats. Treatment methods vary according to the precise diagnosis, but may include excision, radiation therapy and chemotherapy.

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.

If you have any questions or concerns about oral cancer, please contact our practice.

Periodontal Scaling & Root Planning

The objective of scaling and root planing is to remove etiologic agents which cause inflammation to the gingival (gum) tissue and surrounding bone. Common etiologic agents removed by this conventional periodontal therapy include dental plaque and tartar (calculus).

These non-surgical procedures which completely cleanse the periodontium, work very effectively for individuals suffering from gingivitis (mild gum inflammation) and moderate/severe periodontal disease.

Reasons for scaling and root planing

Scaling and root planing can be used both as a preventative measure and as a stand-alone treatment. These procedures are performed as a preventative measure for a periodontitis sufferer.

Here are some reasons why these dental procedures may be necessary:

Disease prevention – The oral bacteria which cause periodontal infections can travel via the bloodstream to other parts of the body. Research has shown that lung infections and heart disease have been linked to periodontal bacteria. Scaling and root planing remove bacteria and halts periodontal disease from progressing, thus preventing the bacteria from traveling to other parts of the body.
Tooth protection – When gum pockets exceed 3mm in depth, there is a greater risk of periodontal disease. As pockets deepen, they tend to house more colonies of dangerous bacteria. Eventually, a chronic inflammatory response by the body begins to destroy gingival and bone tissue which may lead to tooth loss. Periodontal disease is the number one cause of tooth loss in the developed world.
Aesthetic effects – Scaling and root planing help remove tartar and plaque from the teeth and below the gumline. As an added bonus, if superficial stains are present on the teeth, they will be removed in the process of the scaling and root planing procedure.
Better breath – One of the most common signs of periodontal disease is halitosis (bad breath). Food particles and bacteria can cause a persistent bad odor in the oral cavity which is alleviated with cleaning procedures such as scaling and root planing.

What do scaling and root planing treatments involve?

Scaling and root planing treatments are only performed after a thorough examination of the mouth. The dentist will take X-rays, conduct visual examinations and make a diagnosis before recommending or beginning these procedures.

Depending on the current condition of the gums, the amount of calculus (tartar) present, the depth of the pockets and the progression of the periodontitis, local anesthetic may be used.

Scaling – This procedure is usually performed with special dental instruments and may include an ultrasonic scaling tool. The scaling tool removes calculus and plaque from the surface of the crown and root surfaces. In many cases, the scaling tool includes an irrigation process that can also be used to deliver an antimicrobial agent below the gums that can help reduce oral bacteria.

Root Planing – This procedure is a specific treatment which serves to remove cementum and surface dentin that is embedded with unwanted microorganisms, toxins and tartar. The root of the tooth is literally smoothed in order to promote good healing. Having clean, smooth root surfaces helps bacteria from easily colonizing in future.

Following these deep cleaning procedures, the gum pockets may be treated with antibiotics. This will soothe irritation and help the gum tissues to heal quickly.

During the next appointment, the dentist or hygienist will thoroughly examine the gums again to see how well the pockets have healed. If the gum pockets still measure more than 3mm in depth, additional and more intensive treatments may be recommended.

If you have any concerns or questions about scaling and root planing, or periodontal disease, please ask your dentist.

Pocket Irrigation

Periodontal disease is a progressive condition which leads to gum inflammation, the recession of bone and gum tissue, and tooth loss if left untreated. There are a variety of effective treatments and procedures available, including pocket irrigation, which can assist in treating the progression of the disease.

Pocket irrigation aims to cleanse plaque from the interdental (between teeth) and subgingival (under the gumline) regions of the mouth in order to prevent the colonization of harmful oral bacteria. This procedure is also used to deliver antibacterials to the subgingival areas.

Reasons for pocket irrigation

Pocket irrigation, which is also known as oral irrigation, is a versatile dental treatment used for several different preventative purposes. Pocket irrigation may be performed as part of a professional dental cleaning, or at home with a specially modified oral irrigator.

Here are the main ways in which pocket irrigation can be beneficial:

Interdental cleaning – Pocket irrigators blast plaque, food particles and other debris from between the teeth. The removal of harmful materials and bacteria keep the gum pockets cleaner and shallower, helping the gum tissue remain healthy.
Halitosis prevention – Halitosis (or bad breath) is generally a result of old food particles between the teeth, and tooth decay. A toothbrush or dental scraper alone may not be able to reach into the depths of the gum pockets, but water jets can flush out food particles and help clean above and below the gumline.
Subgingival cleaning – Pocket irrigators have a rounded tip which eliminates the risk of tissue damage while cleaning under the gumline. The side port opening facilitates extensive cleansing by flushing out bacteria, particles and toxins from below the gumline.
Antimicrobial application – Antimicrobial substances have proven effective for eliminating and preventing some strains of harmful oral bacteria. Antimicrobial substances can be combined with water, or used as a stand-alone treatment for successful pocket irrigation.

What does pocket irrigation treatment involve?

Pocket irrigation is generally performed in combination with other dental treatments, such as professional dental cleaning or pocket reduction surgery.

In the case of a pocket reduction surgery, the tartar and subgingival plaque will be removed with special scaling and root planing instruments. When the pockets are free of debris, an antimicrobial agent may be applied using an oral irrigator. This will help reduce harmful oral bacteria which still remain in the pockets.

During a deep cleaning procedure, a pocket irrigator may be used after scaling and root planing to cleanse the pockets. Again, an antimicrobial agent may be applied to help reduce subgingival oral bacteria.

Pocket irrigation can be performed at home as part of the daily oral routine using a water jet or water pick. Flushing the interdental area with water is less harmful to soft tissue than dental floss, but should not be used as a substitute for professional dental cleaning.

If you have any questions about pocket irrigation, cleaning your teeth, periodontal disease and treatment, please contact our practice.

Prophylaxis (Teeth Cleaning)

A dental prophylaxis is a cleaning procedure performed to thoroughly clean the teeth. Prophylaxis is an important dental treatment for halting the progression of periodontal disease and gingivitis.

Periodontal disease and gingivitis occur when bacteria from plaque colonize on the gingival (gum) tissue – either above or below the gum line. These bacteria colonies cause serious inflammation and irritation which in turn produce a chronic inflammatory response in the body. As a result, the body begins to systematically destroy gum and bone tissue, making the teeth shift, become unstable, or completely fall out. The pockets between the gums and teeth become deeper and house more bacteria which may travel via the bloodstream and infect other parts of the body.

Reasons for prophylaxis/teeth cleaning

Prophylaxis is an excellent procedure to help keep the oral cavity in good health and also halt the progression of gum disease.

Here are some of the benefits of prophylaxis:

Tartar removal – Tartar (calculus) and plaque buildup, both above and below the gum line, can cause serious periodontal problems if left untreated. Even using the best brushing and flossing homecare techniques, it can be impossible to remove debris, bacteria and deposits from gum pockets. The experienced eye of a dentist using specialized dental equipment is needed in order to spot and treat problems such as tartar and plaque buildup.
Aesthetics – It’s hard to feel confident about a smile marred by yellowing, stained teeth. Prophylaxis can rid the teeth of unsightly stains and return the smile to its former glory.
Fresher breath – Periodontal disease is often signified by persistent bad breath (halitosis). Bad breath is generally caused by a combination of rotting food particles below the gum line, possible gangrene stemming from gum infection, and periodontal problems. The removal of plaque, calculus and bacteria noticeably improves breath and alleviates irritation.
Identification of health issues – Many health problems first present themselves to the dentist. Since prophylaxis involves a thorough examination of the entire oral cavity, the dentist is able to screen for oral cancer, evaluate the risk of periodontitis and often spot signs of medical problems like diabetes and kidney problems. Recommendations can also be provided for altering the home care regimen.

What does prophylaxis treatment involve?

Prophylaxis can either be performed in the course of a regular dental visit or, if necessary, under general anesthetic. The latter is particularly common where severe periodontal disease is suspected or has been diagnosed by the dentist. An endotracheal tube is sometimes placed in the throat to protect the lungs from harmful bacteria which will be removed from the mouth.

Prophylaxis is generally performed in several stages:

Supragingival cleaning – The dentist will thoroughly clean the area above the gum line with scaling tools to rid them of plaque and calculus.
Subgingival cleaning – This is the most important step for patients with periodontal disease because the dentist is able to remove calculus from the gum pockets and beneath the gum line.
Root planing – This is the smoothing of the tooth root by the dentist to eliminate any remaining bacteria. These bacteria are extremely dangerous to periodontitis sufferers, so eliminating them is one of the top priorities of the dentist.
Medication – Following scaling and root planing, an antibiotic or antimicrobial cream is often placed in the gum pockets. These creams promote fast and healthy healing in the pockets and help ease discomfort.
X-ray and examination – Routine X-rays can be extremely revealing when it comes to periodontal disease. X-rays show the extent of bone and gum recession, and also aid the dentist in identifying areas which may need future attention.

Prophylaxis is recommended twice annually as a preventative measure, but should be performed every 3-4 months on periodontitis sufferers. Though gum disease cannot be completely reversed, prophylaxis is one of the tools the dentist can use to effectively halt its destructive progress.

If you have questions or concerns about prophylaxis or periodontal disease, please contact our practice.

Tips and Information

Dental Anxiety and Fear

The overwhelming fear of dental appointments can be a common cause of anxiety. Many people visualize a drill-wielding man in a white coat just waiting to cause pain and remove teeth. The reality, however, is very different. The comfort, relaxation, and happiness of the patient are the primary focus of any good dental practice. The staff at the practice will do whatever they can to reduce anxiety, allay fears, and provide painless, quick treatments.

Recent technological advancements have meant that in many cases, dentists are able to replace noisy drills with painless laser beams. There are also a wide variety of safe anesthetics available to eliminate pain and reduce anxiety during routine appointments.

Here is a list of some of the most common dental fears:

Fear of embarrassment about the condition of teeth.
Fear of gagging.
Fear of injections.
Fear of loss of control.
Fear of not becoming numb when injected with Novocain.
Fear of pain.
Fear of the dentist as a person.
Fear of the hand piece (or the drill).

How can one overcome dental anxiety?

Dental anxiety and fear can become completely overwhelming. It is estimated that as many as 35 million people do not visit the dental office at all because they are too afraid. Receiving regular dental check-ups and cleanings is incredibly important. Having regular routine check-ups is the easiest way to maintain excellent oral hygiene and reduce the need for more complex treatments.

Here are some tips to help reduce dental fear and anxiety:

Talk to us – We can’t read minds. Though it can be hard to talk about irrational fears with a stranger, we can take extra precautions during visits if fears and anxiety are communicated.

Bring a portable music player – Music acts as a relaxant and also drowns out any fear-producing noises. Listening to calming music throughout the appointment will help to reduce anxiety.

Agree on a signal – Many people are afraid that the dentist will not know they are in significant pain during the appointment and will continue with the procedure regardless. The best way to solve this problem is to agree on a “stop” hand signal. Both parties can easily understand signals like raising the hand or tapping on the chair.

Spray the throat – Throat sprays (for example, Vicks^® Chloraseptic^® Throat Spray) can actually control the gag reflex. Two or three sprays will usually keep the reflex under control for about an hour.

Take a mirror – Not being able to see what is happening can increase anxiety and make the imagination run wild. Watching the procedure can help keep reality at the forefront of the mind.

Sedation – If there is no other way to cope, sedation offers an excellent option for many people. There are several types of sedation, but the general premise behind them is the same: the patient regains their faculties after treatment is complete.

Ask about alternatives – Advances in technology mean that dental microsurgery is now an option. Lasers can be used to prepare teeth for fillings, whiten teeth, and remove staining. Discuss all the options with us and decide on one that is effective and produces minimal anxiety.

If you have questions or concerns about how we can help you overcome anxiety and fear, please contact our office.

Laser Dentistry

In recent years, laser dentistry has superseded many traditional dentistry practices, making treatments more precise and less painful. This newer style of dentistry utilizes intense beams of light projected by a dental laser. Dental lasers can be used to perform a wide variety of treatments, including soft tissue shaping and removal.

The FDA deemed laser dentistry to be safe for public usage in 1990. Since then, many dentists have incorporated dental lasers into everyday procedures – reducing bleeding, anxiety and post-treatment recovery times. The beauty of dental lasers is that they damage far less of the surrounding tissue than traditional techniques – which means less discomfort and pain.

Here are some of the other benefits associated with laser dentistry:

Faster healing and tissue regeneration.
Preservation of more of the natural tooth.
Reduced bleeding during and after treatment.
Reduced need for anesthesia.
Reduced need for stitches and sutures.
Reduced risk of bacterial infections after procedures.

How can laser dentistry help me?

Laser dentistry is incredibly versatile and plays an important role in a growing number of common dental procedures. Though laser dentistry is most notably associated with cosmetic treatments, it is equally effective for preventative purposes.

Here are some of the ways that dental lasers can be used:

Tooth preparation – Prior to laser dentistry, a drill would be required to prepare the tooth for a filling. Lasers can now completely eliminate the need for drilling and anesthesia. Lasers also successfully kill oral bacteria around the surgical site.
Reshaping soft tissue – Dental lasers can dissolve soft tissue to expose more of the natural tooth (crown lengthening), reshape soft tissue to make “gummy smiles” more attractive, and remove uncomfortable soft tissue folds caused by denture wear.
Frenectomy – Lasers can improve speech and the feeding habits of babies, children and adults by untying the tongue.
Tumor removal – When benign tumors have formed in the soft tissue areas of the mouth, a dental laser can completely remove them without causing pain.
Whitening – Lasers can greatly expedite the tooth whitening process by increasing the activity of the particles in the peroxide bleaching solution.
Biopsy – Lasers are sometimes used to perform a biopsy on suspicious areas of soft tissue. This biopsy procedure can be performed instantly and with great precision.

How are laser procedures performed?

Different types of dental laser have been created to treat different conditions. Each laser uses a different wavelength of light, which predicates its best use. The most common types of dental laser are carbon dioxide lasers and diode lasers, which are usually employed to treat soft tissue problems. The dentist will decide which type of laser is best to use after conducting X-rays and a thorough examination.

The laser beam is extremely bright, and special glasses will be provided to protect the eyes. The dentist will then direct the beam at the affected area and carefully dissolve the soft tissue, harden the filling or whiten the teeth.

The procedure will take far less time than conventional methods, and cause far less anxiety and discomfort. The only real disadvantage of laser dentistry is that it can prove to be more expensive.

If you have questions or concerns about laser dentistry, please ask your dentist.

Dental Emergencies

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:

Call our office.
Pick up the tooth by the crown and rinse it under warm water. DO NOT touch the root.
If possible, place it back into its socket – if not tuck it into the cheek pouch.
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.
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:

Apply clove oil to the tooth to alleviate pain.
Clean the crown, and affix it onto the tooth with dental cement. This can be purchased at a local pharmacy.
If the crown is lost, smear the top of the tooth with dental cement to alleviate discomfort.
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:

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

Prosthodontics

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.

Pediatric Dentistry

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.

Care for Your Child’s Teeth

Pediatric oral care has two main components: preventative care at the pediatric dentist’s office and preventative care at home. Though infant and toddler caries (cavities) and tooth decay have become increasingly prevalent in recent years, a good dental strategy will eradicate the risk of both.

The goal of preventative oral care is to evaluate and preserve the health of the child’s teeth. Beginning at the age of twelve months, the American Dental Association (ADA) recommends that children begin to visit the pediatric dentist for “well baby” checkups. In general, most children should continue to visit the dentist every six months, unless instructed otherwise.

How can a pediatric dentist care for my child’s teeth?

The pediatric dentist examines the teeth for signs of early decay, monitors orthodontic concerns, tracks jaw and tooth development, and provides a good resource for parents. In addition, the pediatric dentist has several tools at hand to further reduce the child’s risk for dental problems, such as topical fluoride and dental sealants.

During a routine visit to the dentist: the child’s mouth will be fully examined; the teeth will be professionally cleaned; topical fluoride might be coated onto the teeth to protect tooth enamel, and any parental concerns can be addressed. The pediatric dentist can demonstrate good brushing and flossing techniques, advise parents on dietary issues, provide strategies for thumb sucking and pacifier cessation, and communicate with the child on his or her level.

When molars emerge (usually between the ages of two and three), the pediatric dentist may coat them with dental sealant. This sealant covers the hard-to-reach fissures on the molars, sealing out bacteria, food particles, and acid. Dental sealant may last for many months or many years, depending on the oral habits of the child. Dental sealant is an important tool in the fight against tooth decay.

How can I help at home?

Though most parents primarily think of brushing and flossing when they hear the words “oral care,” good preventative care includes many more factors, such as:

Diet – Parents should provide children with a nourishing, well-balanced diet. Very sugary diets should be modified and continuous snacking should be discouraged. Oral bacteria ingest leftover sugar particles in the child’s mouth after each helping of food, emitting harmful acids that erode tooth enamel, gum tissue, and bone. Space out snacks when possible, and provide the child with non-sugary alternatives like celery sticks, carrot sticks, and low-fat yogurt.

Oral habits – Though pacifier use and thumb sucking generally cease over time, both can cause the teeth to misalign. If the child must use a pacifier, choose an “orthodontically” correct model. This will minimize the risk of developmental problems like narrow roof arches and crowding. The pediatric dentist can suggest a strategy (or provide a dental appliance) for thumb sucking cessation.

General oral hygiene – Sometimes, parents clean pacifiers and teething toys by sucking on them. Parents may also share eating utensils with the child. By performing these acts, parents transfer harmful oral bacteria to their child, increasing the risk of early cavities and tooth decay. Instead, rinse toys and pacifiers with warm water, and avoid spoon-sharing whenever possible.

Sippy cup use – Sippy cups are an excellent transitional aid when transferring from a baby bottle to an adult drinking glass. However, sippy cups filled with milk, breast milk, soda, juice, and sweetened water cause small amounts of sugary fluid to continually swill around young teeth – meaning acid continually attacks tooth enamel. Sippy cup use should be terminated between the ages of twelve and fourteen months or as soon as the child has the motor skills to hold a drinking glass.

Brushing – Children’s teeth should be brushed a minimum of two times per day using a soft bristled brush and a pea-sized amount of toothpaste. Parents should help with the brushing process until the child reaches the age of seven and is capable of reaching all areas of the mouth. Parents should always opt for ADA approved toothpaste (non-fluoridated before the age of two, and fluoridated thereafter). For babies, parents should rub the gum area with a clean cloth after each feeding.

Flossing – Cavities and tooth decay form more easily between teeth. Therefore, the child is at risk for between-teeth cavities wherever two teeth grow adjacent to each other. The pediatric dentist can help demonstrate correct head positioning during the flossing process and suggest tips for making flossing more fun!

Fluoride – Fluoride helps prevent mineral loss and simultaneously promotes the remineralization of tooth enamel. Too much fluoride can result in fluorosis, a condition where white specks appear on the permanent teeth, and too little can result in tooth decay. It is important to get the fluoride balance correct. The pediatric dentist can evaluate how much the child is currently receiving and prescribe supplements if necessary.

If you have questions or concerns about how to care for your child’s teeth, please ask your pediatric dentist.

Dental Radiographs (X-Rays)

Dental radiographs, also known as dental X-rays, are important diagnostic tools in pediatric dentistry. Dental radiographs allow the dentist to see and treat problems like childhood cavities, tooth decay, orthodontic misalignment, bone injuries, and bone diseases before they worsen. These issues would be difficult (in some cases impossible) to see with the naked eye during a clinical examination.

The American Academy of Pediatric Dentistry (AAPD) approves the use of dental radiographs for diagnostic purposes in children and teenagers. Although radiographs only emit tiny amounts of radiation and are safe to use on an occasional basis, the AAPD guidelines aim to protect young people from unnecessary X-ray exposure.

What are dental X-rays used for?

Dental x-rays are extremely versatile diagnostic tools. Some of their main uses in pediatric dentistry include:

Assessing the amount of space available for incoming teeth.
Checking whether primary teeth are being shed in good time for adult teeth to emerge.
Evaluating the progression of bone disease.
Monitoring and diagnosing tooth decay.
Planning treatment (especially orthodontic treatment).
Revealing bone injuries, abscesses, and tumors.
Revealing impacted wisdom teeth.

When will my child need dental X-rays?

Individual circumstances dictate how often a child needs to have dental radiographs taken. Children at higher-than-average risk of childhood tooth decay (as determined by the pediatric dentist) may need biannual radiographs to monitor changes in the condition of the teeth. Likewise, children who are at high risk for orthodontic problems, for example, malocclusion, may also need sets of radiographs taken more frequently for monitoring purposes.

Children at average or below average risk for tooth decay and orthodontic problems should have a set of dental X-rays taken every one to two years. Even in cases where the pediatric dentist suspects no decay at all, it is still important to periodically monitor tooth and jaw growth – primarily to ensure there is sufficient space available for incoming permanent teeth.

If the oral region has been subject to trauma or injury, the pediatric dentist may want to X-ray the mouth immediately. Developments in X-ray technology mean that specific areas of the mouth can be targeted and X-rayed separately, reducing the amount of unnecessary X-ray exposure.

What precautions will be taken to ensure my child’s safety?

Though dental radiographs are perfectly safe for use on children, the pediatric dentist will take several precautions to ensure the X-ray process does not unduly damage the child’s cells and bodily tissues.

First, the child will be covered in a lead apron to protect the body from unnecessary exposure. Second, the dentist will use shields to protect the parts of the face that are not being X-rayed. Finally, the pediatric dentist will use high-speed film to reduce radiation exposure as much as possible.

If you have questions or concerns about dental radiographs or X-rays, please contact your pediatric dentist.

Does Your Child Grind His or Her Teeth at Night?

Bruxism, or the grinding of teeth, is remarkably common in children and adults. For some children, this tooth grinding is limited to daytime hours, but nighttime grinding (during sleep) is most prevalent. Bruxism can lead to a wide range of dental problems, depending on the frequency of the behavior, the intensity of the grinding, and the underlying causes of the grinding.

A wide range of psychological, physiological, and physical factors may lead children to brux. In particular, jaw misalignment (bad bite), stress, and traumatic brain injury are all thought to contribute to bruxism, although grinding can also occur as a side effect of certain medications.

What are some symptoms of bruxism?

In general, parents can usually hear intense grinding – especially when it occurs at nighttime. Subtle daytime jaw clenching and grinding, however, can be difficult to pinpoint. Oftentimes, general symptoms provide clues as to whether or not the child is bruxing, including:

Frequent complaints of headache.
Injured teeth and gums.
Loud grinding or clicking sounds.
Rhythmic tightening or clenching of the jaw muscles.
Unusual complaints about painful jaw muscles – especially in the morning.
Unusual tooth sensitivity to hot and cold foods.

How can bruxism damage my child’s teeth?

Bruxism is characterized by the grinding of the upper jaw against the lower jaw. Especially in cases where there is vigorous grinding, the child may experience moderate to severe jaw discomfort, headaches, and ear pain. Even if the child is completely unaware of nighttime bruxing (and parents are unable to hear it), the condition of the teeth provides your pediatric dentist with important clues.

First, chronic grinders usually show an excessive wear pattern on the teeth. If jaw misalignment is the cause, tooth enamel may be worn down in specific areas. In addition, children who brux are more susceptible to chipped teeth, facial pain, gum injury, and temperature sensitivity. In extreme cases, frequent, harsh grinding can lead to the early onset of temporomandibular joint disorder (TMJ).

What causes bruxism?

Bruxism can be caused by several different factors. Most commonly, “bad bite” or jaw misalignment promotes grinding. Pediatric dentists also notice that children tend to brux more frequently in response to life stressors. If the child is going through a particularly stressful exam period or is relocating to a new school for example, nighttime bruxing may either begin or intensify.

Children with certain developmental disorders and brain injuries may be at particular risk for grinding. In such cases, your pediatric dentist may suggest botulism injections to calm the facial muscles, or provide a protective nighttime mouthpiece. If the onset of bruxing is sudden, current medications need to be evaluated. Though bruxing is a rare side effect of specific medications, the medication itself may need to be switched for an alternate brand.

How is bruxism treated?

Bruxing spontaneously ceases by the age of thirteen in the majority of children. In the meantime however, your pediatric dentist will continually monitor its effect on the child’s teeth and may provide an interventional strategy.

In general, the cause of the grinding dictates the treatment approach. If the child’s teeth are badly misaligned, your pediatric dentist may take steps to correct this. Some of the available options include: altering the biting surface of teeth with crowns, and beginning occlusal treatment.

If bruxing seems to be exacerbated by stress, your pediatric dentist may recommend relaxation classes, professional therapy, or special exercises. The child’s pediatrician may also provide muscle relaxants to alleviate jaw clenching and reduce jaw spasms.

In cases where young teeth are sustaining significant damage, your pediatric dentist may suggest a specialized nighttime dental appliance such as a nighttime mouth guard. Mouth guards stop tooth surfaces from grinding against each other, and look similar to a mouthpiece a person might wear during sports. Bite splints or bite plates fulfill the same function and are almost universally successful in preventing grinding damage.

If you have questions or concerns about bruxism or grinding teeth, please contact our office.

Early Orthodontic Treatment

Orthodontic treatment is primarily used to prevent and correct “bite” irregularities. Several factors may contribute to such irregularities, including genetic factors, the early loss of primary (baby) teeth, and damaging oral habits (such as thumb sucking and developmental problems).

Orthodontic irregularities may be present at birth or develop during toddlerhood or early childhood. Crooked teeth hamper self-esteem and make good oral homecare difficult, whereas straight teeth help minimize the risk of tooth decay and childhood periodontal disease.

During biannual preventative visits, your pediatric dentist is able to utilize many diagnostic tools to monitor orthodontic irregularities and, if necessary, implement early intervention strategies. Children should have an initial orthodontic evaluation before the age of eight.

Why does early orthodontic treatment make sense?

Some children display early signs of minor orthodontic irregularities. In such cases, your pediatric dentist might choose to monitor the situation over time without providing intervention. However, for children who display severe orthodontic irregularities, early orthodontic treatment can provide many benefits, including:

Enhanced self-confidence and aesthetic appearance.
Increased likelihood of proper jaw growth.
Increased likelihood of properly aligned and spaced adult teeth.
Reduced risk of bruxing (grinding of teeth).
Reduced risk of childhood cavities, periodontal disease, and tooth decay.
Reduced risk of impacted adult teeth.
Reduced risk of protracted orthodontic treatments in later years.
Reduced risk of speech problems.
Reduced risk of tooth, gum, and jawbone injury.

When can my child begin early orthodontic treatment?

Pediatric dentists recognize three age-related stages of orthodontic treatment. These stages are described in detail below.

Stage 1: Early treatment (2-6 years old)

Early orthodontic treatment aims to guide and regulate the width of both dental arches. The main goal of early treatment is to provide enough space for the permanent teeth to erupt correctly. Good candidates for early treatment include: children who have difficulty biting properly, children who lose baby teeth early, children whose jaws click or grind during movement, bruxers, and children who use the mouth (as opposed to the nose AND mouth) to breathe.

During the early treatment phase, your pediatric dentist works with parents and children to eliminate orthodontically harmful habits, like excessive pacifier use and thumb sucking. The dentist may also provide one of a variety of dental appliances to promote jaw growth, hold space for adult teeth (space maintainers), or to prevent the teeth from “shifting” into undesired areas.

Stage 2: Middle dentition (6-12 years old)

The goals of middle dentition treatments are to realign wayward jaws, to start to correct crossbites, and to begin the process of gently straightening misaligned permanent teeth. Middle dentition marks a developmental period when the soft and hard tissues are extremely pliable. In some ways therefore, it marks an optimal time to begin to correct a severe malocclusion.

Again, the dentist may provide the child with a dental appliance. Some appliances (like braces) are fixed and others are removable. Regardless of the appliance, the child will still be able to speak, eat, and chew in a normal fashion. However, children who are fitted with fixed dental appliances should take extra care to clean the entire oral region each day in order to reduce the risk of staining, decay, and later cosmetic damage.

Stage 3: Adolescent dentition (13+ years old)

Adolescent dentition is what springs to most parents’ minds when they think of orthodontic treatment. Some of the main goals of adolescent dentition include straightening the permanent teeth and improving the aesthetic appearance of the smile.

Most commonly during this period, the dentist will provide fixed or removable “braces” to gradually straighten the teeth. Upon completion of the orthodontic treatment, the adolescent may be required to wear a retainer in order to prevent the regression of the teeth to their original alignment.

If you have questions or concerns about orthodontic treatment, please contact our office.

Eruption of Your Child’s Teeth

The eruption of primary teeth (also known as deciduous or baby teeth) follows a similar developmental timeline for most children. A full set of primary teeth begins to grow beneath the gums during the fourth month of pregnancy. For this reason, a nourishing prenatal diet is of paramount importance to the infant’s teeth, gums, and bones.

Generally, the first primary tooth breaks through the gums between the ages of six months and one year. By the age of three years old most children have a “full” set of twenty primary teeth. The American Dental Association (ADA) encourages parents to make a “well-baby” appointment with a pediatric dentist approximately six months after the first tooth emerges. Pediatric dentists communicate with parents and children about prevention strategies, emphasizing the importance of a sound, “no tears” daily home care plan.

Although primary teeth are deciduous, they facilitate speech production, proper jaw development, good chewing habits, and the proper spacing and alignment of adult teeth. Caring properly for primary teeth helps defend against painful tooth decay, premature tooth loss, malnutrition, and childhood periodontal disease.

In what order do primary teeth emerge?

As a general rule-of-thumb, the first teeth to emerge are the central incisors (very front teeth) on the lower and upper jaws (6-12 months). These (and any other primary teeth) can be cleaned gently with a soft, clean cloth to reduce the risk of bacterial infection. The central incisors are the first teeth to be lost, usually between 6 and 7 years of age.

Next, the lateral incisors (immediately adjacent to the central incisors) emerge on the upper and lower jaws (9-16 months). These teeth are lost next, usually between 7 and 8 years of age. First molars, the large flat teeth towards the rear of the mouth, then emerge on the upper and lower jaws (13-19 months). The eruption of molars can be painful. Clean fingers, cool gauzes, and teething rings are all useful in soothing discomfort and soreness. First molars are generally lost between 9 and 11 years of age.

Canine (cuspid) teeth then tend to emerge on the upper and lower jaws (16-23 months). Canine teeth can be found next to the lateral incisors and are lost during preadolescence (10-12 years old). Finally, second molars complete the primary set on the lower and upper jaw (23-33 months). Second molars can be found at the very back of the mouth and are lost between the ages of 10 and 12 years old.

What else is known about primary teeth?

Though each child is unique, baby girls generally have a head start on baby boys when it comes to primary tooth eruption. Lower teeth usually erupt before opposing upper teeth in both sexes.

Teeth usually erupt in pairs – meaning that there may be months with no new activity and months where two or more teeth emerge at once. Due to smaller jaw size, primary teeth are smaller than permanent teeth, and appear to have a whiter tone. Finally, an interesting mixture of primary and permanent teeth is the norm for most school-age children.

If you have questions or concerns about primary teeth, please contact our office.

First Visit

According to AAPD (American Academy of Pediatric Dentistry) guidelines, infants should initially visit the pediatric dentist around the time of their first birthday. First visits can be stressful for parents, especially for parents who have dental phobias themselves.

It is imperative for parents to continually communicate positive messages about dental visits (especially the first one), and to help the child feel as happy as possible about visiting the dentist.

How can I prepare for my child’s first dental visit?

Pediatric dentists are required to undergo extensive training in child psychology. Their dental offices are generally colorful, child-friendly, and boast a selection of games, toys, and educational tools. Pediatric dentists (and all dental staff) aim to make the child feel as welcome as possible during all visits.

There are several things parents can do to make the first visit enjoyable. Some helpful tips are listed below:

Take another adult along for the visit – Sometimes infants become fussy when having their mouths examined. Having another adult along to soothe the infant allows the parent to ask questions and to attend to any advice the dentist may have.

Leave other children at home – Other children can distract the parent and cause the infant to fuss. Leaving other children at home (when possible) makes the first visit less stressful for all concerned.

Avoid threatening language – Pediatric dentists and staff are trained to avoid the use of threatening language like “drills,” “needles,” “injections,” and “bleeding.” It is imperative for parents to use positive language when speaking about dental treatment with their child.

Provide positive explanations – It is important to explain the purposes of the dental visit in a positive way. Explaining that the dentist “helps keep teeth healthy” is far better than explaining that the dentist “is checking for tooth decay and might have to drill the tooth if decay is found.”

Explain what will happen – Anxiety can be vastly reduced if the child knows what to expect. Age-appropriate books about visiting the dentist can be very helpful in making the visit seem fun. Here is a list of parent and dentist-approved books:

The Berenstain Bears Visit the Dentist – by Stan and Jan Berenstain.
Show Me Your Smile: A Visit to the Dentist – Part of the “Dora the Explorer” Series.
Going to the Dentist – by Anne Civardi.
Elmo Visits the Dentist – Part of the “Sesame Street” Series.

What will happen during the first visit?

There are several goals for the first dental visit. First, the pediatric dentist and the child need to get properly acquainted. Second, the dentist needs to monitor tooth and jaw development to get an idea of the child’s overall health history. Third, the dentist needs to evaluate the health of the existing teeth and gums. Finally, the dentist aims to answer questions and advise parents on how to implement a good oral care regimen.

The following sequence of events is typical of an initial “well baby checkup”:

Dental staff will greet the child and parents.
The infant/family health history will be reviewed (this may include questionnaires).
The pediatric dentist will address parental questions and concerns.
More questions will be asked, generally pertaining to the child’s oral habits, pacifier use, general development, tooth alignment, tooth development, and diet.
The dentist will provide advice on good oral care, how to prevent oral injury, fluoride intake, and sippy cup use.
The infant’s teeth will be examined. Generally, the dentist and parent sit facing each other. The infant is positioned so that his or her head is cradled in the dentist’s lap. This position allows the infant to look at the parent during the examination.
Good brushing and flossing demonstrations will be provided.
The state of the child’s oral health will be described in detail, and specific recommendations will be made. Recommendations usually relate to oral habits, appropriate toothpastes and toothbrushes for the child, orthodontically correct pacifiers, and diet.
The dentist will detail which teeth may appear in the following months.
The dentist will outline an appointment schedule and describe what will happen during the next appointment.

If you have questions or concerns about your child’s first dental visit, please contact our office.

Fluoride

Fluorine, a natural element in the fluoride compound, has proven to be effective in minimizing childhood cavities and tooth decay. Fluoride is a key ingredient in many popular brands of toothpaste, oral gel, and mouthwash, and can also be found in most community water supplies. Though fluoride is an important part of any good oral care routine, overconsumption can result in a condition known as fluorosis. The pediatric dentist is able to monitor fluoride levels, and check that children are receiving the appropriate amount.

How can fluoride prevent tooth decay?

Fluoride fulfills two important dental functions. First, it helps staunch mineral loss from tooth enamel, and second, it promotes the remineralization of tooth enamel.

When carbohydrates (sugars) are consumed, oral bacteria feed on them and produce harmful acids. These acids attack tooth enamel – especially in children who take medications or produce less saliva. Repeated acid attacks result in cavities, tooth decay, and childhood periodontal disease. Fluoride protects tooth enamel from acid attacks and reduces the risk of childhood tooth decay.

Fluoride is especially effective when used as part of a good oral hygiene regimen. Reducing the consumption of sugary foods, brushing and flossing regularly, and visiting the pediatric dentist biannually, all supplement the work of fluoride and keep young teeth healthy.

How much fluoride is enough?

Since community water supplies and toothpastes usually contain fluoride, it is essential that children do not ingest too much. For this reason, children under the age of two should use an ADA-approved, non-fluoridated brand of toothpaste. Children between the ages of two and five years old should use a pea-sized amount of ADA-approved fluoridated toothpaste, on a clean toothbrush, twice each day. They should be encouraged to spit out any extra fluid after brushing. This part might take time, encouragement, and practice.

The amount of fluoride children ingest between the ages of one and four years old determines whether or not fluorosis occurs later. The most common symptom of fluorosis is white specks on the permanent teeth. Children over the age of eight years old are not considered to be at-risk for fluorosis, but should still use an ADA-approved brand of toothpaste.

Does my child need fluoride supplements?

The pediatric dentist is the best person to decide whether a child needs fluoride supplements. First, the dentist will ask questions in order to determine how much fluoride the child is currently receiving, gain a general health history, and evaluate the sugar content in the child’s diet. If a child is not receiving enough fluoride and is determined to be at high-risk for tooth decay, an at-home fluoride supplement might be recommended.

Topical fluoride can also be applied to the tooth enamel quickly and painlessly during a regular office visit. There are many convenient forms of topical fluoride, including foam, liquids, varnishes, and gels. Depending on the age of the child and their willingness to cooperate, topical fluoride can either be held on the teeth for several minutes in specialized trays or painted on with a brush.

If you have questions or concerns about fluoride or fluorosis, please contact our office.

Good Diet

A child’s general level of health often dictates his or her oral health, and vice versa. Therefore, supplying children with a well-balanced diet is more likely to produce healthier teeth and gums. A good diet provides the child with the many different nutrients he or she needs to grow. These nutrients are necessary for gum tissue development, strong bones, and protection against certain illnesses.

According to the food pyramid, children need vegetables, fruits, meat, grains, beans, and dairy products to grow properly. These different food groups should be eaten in balance for optimal results.

How does my child’s diet affect his or her teeth?

Almost every snack contains at least one type of sugar. Most often, parents are tempted to throw away candy and chocolate snacks – without realizing that many fruit snacks contain one (if not several) types of sugar or carbohydrate. When sugar-rich snacks are eaten, the sugar content attracts oral bacteria. The bacteria feast on food remnants left on or around the teeth. Eventually, feasting bacteria produce enamel-attacking acids.

When tooth enamel is constantly exposed to acid, it begins to erode – the result is childhood tooth decay. If tooth decay is left untreated for prolonged periods, acids begin to attack the soft tissue (gums) and even the underlying jawbone. Eventually, the teeth become prematurely loose or fall out, causing problems for emerging adult teeth – a condition known as childhood periodontal disease.

Regular checkups and cleanings at the pediatric dentist’s office are an important line of defense against tooth decay. However, implementing good dietary habits and minimizing sugary food and drink intake as part of the “home care routine” are equally important.

How can I alter my child’s diet?

The pediatric dentist is able to offer advice and dietary counseling for children and parents. Most often, parents are advised to opt for healthier snacks, for example, carrot sticks, reduced fat yoghurt, and cottage cheese. In addition, pediatric dentists may recommend a fluoride supplement to protect tooth enamel – especially if the child lives in an area where fluoride is not routinely added to community water.

Parents should also ensure that children are not continuously snacking – even in a healthy manner. Lots of snacking means that sugars are constantly attaching themselves to teeth, and tooth enamel is constantly under attack. It is also impractical to try to clean the teeth after every snack, if “every snack” means every ten minutes!

Finally, parents are advised to opt for faster snacks. Mints and hard candies remain in the mouth for a long period of time – meaning that sugar is coating the teeth for longer. If candy is necessary, opt for a sugar-free variety or a variety that can be eaten expediently.

Should my child eat starch-rich foods?

It is important for the child to eat a balanced diet, so some carbohydrates and starches are necessary. Starch-rich foods generally include pretzels, chips, and peanut butter and jelly sandwiches. Since starches and carbohydrates break down to form sugar, it is best that they are eaten as part of a meal (when saliva production is higher), than as a standalone snack. Provide plenty of water at mealtimes (rather than soda) to help the child rinse sugary food particles off the teeth.

As a final dietary note, avoid feeding your child sticky foods if possible. It is incredibly difficult to remove stickiness from the teeth – especially in younger children who tend not to be as patient during brushing.

If you have questions or concerns about your child’s general or oral health, please contact our office.

How Often Should Children Have Dental

The American Academy of Pediatric Dentists (AAPD) advises parents to make biannual dental appointments for children, beginning approximately six months after the first tooth emerges.

These two important yearly visits allow the pediatric dentist to monitor new developments in the child’s mouth, evaluate changes in the condition of teeth and gums, and continue to advise parents on good oral care strategies.

The pediatric dentist may schedule additional visits for children who are particularly susceptible to tooth decay or who show early signs of orthodontic problems.

What is the purpose of dental checkups?

First, the pediatric dentist aims to provide a “good dental home” for the child. If a dental emergency does arise, parents can take the child for treatment at a familiar, comfortable location.

Second, the pediatric dentist keeps meticulous records of the child’s ongoing dental health and jaw development. In general, painful dental conditions do not arise overnight. If the pediatric dentist understands the child’s dental health history, it becomes easier to anticipate future issues and intervene before they arise.

Third, the pediatric dentist is able to educate parents and children during the visit. Sometimes the pediatric dentist wants to introduce one or several factors to enhance tooth health – for example, sealants, fluoride supplements, or xylitol. Other times, the pediatric dentist asks parents to change the child’s dietary or oral behavior – for example, reducing sugar in the child’s diet, removing an intraoral piercing, or even transitioning the child from sippy cups to adult-sized drinking glasses.

Finally, dental X-rays are often the only way to identify tiny cavities in primary (baby) teeth. Though the child may not be feeling any pain, left unchecked, these tiny cavities can rapidly turn into large cavities, tooth decay, and eventually, childhood periodontal disease. Dental X-rays are only used when the pediatric dentist suspects cavities or orthodontic irregularities.

Are checkups necessary if my child has healthy teeth?

The condition of a child’s teeth can change fairly rapidly. Even if the child’s teeth were evaluated as healthy just six months prior, changes in diet or oral habits (for example, thumb sucking) can quickly render them vulnerable to decay or misalignment.

In addition to visual examinations, the pediatric dentist provides thorough dental cleanings during each visit. These cleanings eradicate the plaque and debris that can build up between teeth and in other hard to reach places. Though a good homecare routine is especially important, these professional cleanings provide an additional tool to keep smiles healthy.

The pediatric dentist is also able to monitor the child’s fluoride levels during routine visits. Oftentimes, a topical fluoride gel or varnish is applied to teeth after the cleaning. Topical fluoride remineralizes the teeth and staunches mineral loss, protecting tooth enamel from oral acid attacks. Some children are also given take-home fluoride supplements (especially those residing in areas where fluoride is not routinely added to the community water supply).

Finally, the pediatric dentist may apply dental sealants to the child’s back teeth (molars). This impenetrable liquid plastic substance is brushed onto the molars to seal out harmful debris, bacteria, and acid.

If you have questions or concerns about when to schedule your child’s dental checkups please contact your pediatric dentist.

How to Prevent Cavities

Childhood cavities, also known as childhood tooth decay and childhood caries, are common in children all over the world. There are two main causes of cavities: poor dental hygiene and sugary diets.

Cavities can be incredibly painful and often lead to tooth decay and childhood periodontitis if left untreated. Ensuring that children eat a balanced diet, embarking on a sound home oral care routine, and visiting the pediatric dentist biannually are all crucial factors for both cavity prevention and excellent oral health.

What causes cavities?

Cavities form when children’s teeth are exposed to sugary foods on a regular basis. Sugars and carbohydrates (like the ones found in white bread) collect on and around the teeth after eating. A sticky film (plaque) then forms on the tooth enamel. The oral bacteria within the plaque continually ingest sugar particles and emit acid. Initially, the acid attacks the tooth enamel, weakening it and leaving it vulnerable to tooth decay. If conditions are allowed to worsen, the acid begins to penetrate the tooth enamel and erodes the inner workings of the tooth.

Although primary (baby) teeth are eventually lost, they fulfill several important functions and should be protected. It is essential that children brush and floss twice per day (ideally more), and visit the dentist for biannual cleanings. Sometimes the pediatric dentist coats teeth with a sealant and provides fluoride supplements to further bolster the mouth’s defenses.

How will I know if my child has a cavity?

Large cavities can be excruciatingly painful, whereas tiny cavities may not be felt at all. Making matters even trickier, cavities sometimes form between the teeth, making them invisible to the naked eye. Dental X-rays and the dentist’s trained eyes help pinpoint even the tiniest of cavities so they can be treated before they worsen.

Some of the major symptoms of cavities include:

Heightened sensitivity to cool or warm foods
Nighttime waking and crying
Pain
Sensitivity to spicy foods
Toothache

If a child is experiencing any of these symptoms, it is important to visit the pediatric dentist. Failure to do so will make the problem worse, leave the child in pain, and possibly jeopardize a tooth that could have been treated.

How can I prevent cavities at home?

Biannual visits with the pediatric dentist are only part of the battle against cavities. Here are some helpful guidelines for cavity prevention:

Analyze the diet – Too many sugary or starchy snacks can expedite cavity formation. Replace sugary snacks like candy with natural foods where possible, and similarly, replace soda with water.
Cut the snacks – Snacking too frequently can unnecessarily expose teeth to sugars. Save the sugar and starch for mealtimes, when the child is producing more saliva, and drinking water. Make sure they consume enough water to cleanse the teeth.
Lose the sippy cup – Sippy cups are thought to cause “baby bottle tooth decay” when they are used beyond the intended age (approximately twelve months). The small amount of liquid emitted with each sip causes sugary liquid to continually swill around the teeth.
Avoid stickiness – Sticky foods (like toffee) form plaque quickly and are extremely difficult to pry off the teeth. Avoid them when possible.
Rinse the pacifier – Oral bacteria can be transmitted from mother or father to baby. Rinse a dirty pacifier with running water as opposed to sucking on it to avoid contaminating the baby’s mouth.
Drinks at bedtime – Sending a child to bed with a bottle or sippy cup is bad news. The milk, formula, juice, or sweetened water basically sits on the teeth all night – attacking enamel and maximizing the risk of cavities. Ensure the child has a last drink before bedtime, and then brush the teeth.
Don’t sweeten the pacifier – Parents sometimes dip pacifiers in honey to calm a cranky child. Do not be tempted to do this. Use a blanket, toy, or hug to calm the child instead.
Brush and floss – Parents should brush and floss their child’s teeth twice each day until the child reaches the age of seven years old. Before this time, children struggle to brush every area of the mouth effectively.
Check on fluoride –When used correctly, fluoride can strengthen tooth enamel and help stave off cavities. Too much or too little fluoride can actually harm the teeth, so ask the pediatric dentist for a fluoride assessment.
Keep to appointments – The child’s first dental visit should be scheduled around his or her first birthday, as per the American Academy of Pediatric Dentistry (AAPD) guidelines. Keep to a regular appointment schedule to create healthy smiles!

If you have questions or concerns about cavity prevention, please contact our office.

Pacifiers and Thumb Sucking

For most infants, the sucking of thumbs and pacifiers is a happy, everyday part of life. Since sucking is a natural, instinctual baby habit, infants derive a sense of comfort, relaxation, and security from using a thumb or pacifier as a sucking aid.

According to research from the American Academy of Pediatric Dentistry (AAPD), the vast majority of children will cease using a pacifier before the age of four years old. Thumb sucking can be a harder habit to break and tends to persist for longer without intervention. Children who continue to suck thumbs or pacifiers after the age of five (and particularly those who continue after permanent teeth begin to emerge) are at high-risk for developing dental complications.

How can thumb sucking and pacifier use damage children’s teeth?

Pacifier and thumb sucking damage can be quite insidious. Both can be difficult to assess with the naked eye, and both tend to occur over a prolonged period of time. Below is an overview of some of the risks associated with prolonged thumb sucking and pacifier use:

Jaw misalignment – Pacifiers come in a wide range of shapes and sizes, most of which are completely unnatural for the mouth to hold. Over time, pacifiers and thumbs can guide the developing jaws out of correct alignment.

Tooth decay – Many parents attempt to soothe infants by dipping pacifiers in honey, or some other sugary substance. Oral bacteria feed on sugar and emit harmful acids. The acids attack tooth enamel and can lead to pediatric tooth decay and childhood caries.

Roof narrowing – The structures in the mouth are extremely pliable during childhood. Prolonged, repeated exposure to thumb and pacifier sucking actually cause the roof of the mouth to narrow (as if molding around the sucking device). This can cause later problems with developing teeth.

Slanting teeth – Growing teeth can be caused to slant or protrude by thumb and pacifier sucking, leading to poor esthetic results. In addition, thumb sucking and pacifier use in later childhood increases the need for extensive orthodontic treatments.

Mouth sores – Passive sucking is much less harmful than aggressive sucking. Aggressive sucking (popping sounds when the child sucks) may cause sores or ulcers to develop.

If you do intend to purchase a pacifier:

Buy a one-piece pacifier to reduce the risk of choking.
Buy an “orthodontically correct” model.
Do not dip it in honey or any other sugary liquid.
Rinse with water (as opposed to cleansing with your mouth) to prevent bacterial transmissions.

How can I encourage my child to stop thumb or pacifier sucking?

In most cases, children naturally relinquish the pacifier or thumb over time. As children grow, they develop new ways to self-soothe, relax, and entertain themselves. When thumb sucking or pacifier use persists past the age of five, a gentle intervention may be required.

Here are some helpful suggestions to help encourage the child to cease thumb sucking or pacifier use:

Ask the pediatric dentist to speak with the child about stopping. Often, the message is heard more clearly when delivered by a health professional.
Buy an ADA recommended specialized dental appliance to make it difficult for the child to engage in sucking behaviors.
Implement a reward system (not a punishment), whereby the child can earn tokens or points towards a desirable reward for not thumb sucking or using a pacifier.
Wrap thumbs in soft cloths or mittens at nighttime.

If the above suggestions do not seem to be working, your pediatric dentist can provide more guidance. Remember: the breaking of a habit takes time, patience, and plenty of encouragement!

Perinatal and Infant Oral Health

Pregnancy is an exciting time. It is also a crucially important time for the unborn child’s oral and overall health. The “perinatal” period begins approximately 20-28 weeks into the pregnancy, and ends 1-4 weeks after the infant is born. With so much to do to prepare for the new arrival, a dental checkup is often the last thing on an expectant mother’s mind.

Research shows, however, that there are links between maternal periodontal disease (gum disease) and premature babies, babies with low birth weight, maternal preeclampsia, and gestational diabetes. It is of paramount importance therefore, for mothers to maintain excellent oral health throughout the entire pregnancy.

Why are perinatal dental checkups important?

Maternal cariogenic bacteria is linked with a wide range of adverse outcomes for infants and young children. For this reason, the American Academy of Pediatric Dentistry (AAPD) advises expectant mothers to get dental checkups and counseling regularly, for the purposes of prevention, intervention, and treatment.

Here are some perinatal oral care tips for expectant mothers:

Brush and floss – Be sure to use an ADA approved, fluoridated toothpaste at least twice each day, and floss at least once each day, to eliminate harmful oral bacteria. In addition, an alcohol-free mouthwash should be used on a daily basis.
Chew gum – Xylitol, a natural substance, has been shown to reduce infant and toddler caries (cavities) when chewed 3-5 times daily by the expectant mother. When choosing gum, check for the “xylitol” ingredient – no other sugar substitute has proven to be beneficial in clinical studies.
Diet evaluation – Maintaining a balanced, nourishing diet is always important, but particularly so during pregnancy. Make a food eating diary and look for ways to cut down on sugary and starchy foods. Sugars and starches provide food for oral bacteria, and also increase the risk of tooth decay.
Make regular dental appointments – When seen regularly, the dentist can bolster homecare preventative efforts and provide excellent advice. The dentist is able to check the general condition of teeth and provide strategies for reducing oral bacteria.

How can I care for my infant’s gums and teeth?

Many parents do not realize that cavity-causing (cariogenic) bacteria can be transmitted from the mother or father to the child. This transmission happens via the sharing of eating utensils and the “cleaning” of pacifiers in the parent’s mouth. Parents should endeavor to use different eating utensils from their infants and to rinse pacifiers with warm water as opposed to sucking them.

Parents should also adhere to the following guidelines to enhance infant oral health:

Brush – Using a soft-bristled toothbrush and a tiny sliver of ADA approved non-fluoridated toothpaste (for children under two), gently brush the teeth twice each day.
Floss – As soon as two adjacent teeth appear in the infant’s mouth, cavities can form between the teeth. Ask the pediatric dentist for advice on the best way to floss the infant’s teeth.
Pacifier use – Pacifiers are a soothing tool for infants. If you decide to purchase a pacifier, choose an orthodontically correct model (you can ask the pediatric dentist for recommendations). Be sure not to dip pacifiers in honey or any other sweet liquid.
Use drinking glasses – Baby bottles and sippy cups are largely responsible for infant and toddler tooth decay. Both permit a small amount of liquid to repeatedly enter the mouth. Consequently, sugary liquid (milk, soda, juice, formula, breast milk or sweetened water) is constantly swilling around in the infant’s mouth, fostering bacterial growth and expediting tooth decay. Only offer water in sippy cups, and discontinue their use after the infant’s first birthday.
Visit the pediatric dentist – Around the age of one, the infant should visit a pediatric dentist for a “well baby” appointment. The pediatric dentist will examine tooth and jaw development, and provide strategies for future oral care.
Wipe gums – The infant is at risk for early cavities as soon as the first tooth emerges. For young infants, wipe the gums with a damp cloth after every feeding. This reduces oral bacteria and minimizes the risk of early cavities.

If you have further questions about perinatal or infant oral care, please contact your pediatric dentist.

Sealing Out Tooth Decay

Tooth decay has become increasingly prevalent in preschoolers. Not only is tooth decay unpleasant and painful, it can also lead to more serious problems like premature tooth loss and childhood periodontal disease.

Dental sealants are an important tool in preventing childhood caries (cavities) and tooth decay. Especially when used in combination with other preventative measures, like biannual checkups and an excellent daily home care routine, sealants can bolster the mouth’s natural defenses, and keep smiles healthy.

How do sealants protect children’s teeth?

In general, dental sealants are used to protect molars from oral bacteria and harmful oral acids. These larger, flatter teeth reside toward the back of the mouth and can be difficult to clean. Molars mark the site of four out of five instances of tooth decay. Decay-causing bacteria often inhabit the nooks and crannies (pits and fissures) found on the chewing surfaces of the molars. These areas are extremely difficult to access with a regular toothbrush.

If the pediatric dentist evaluates a child to be at high risk for tooth decay, he or she may choose to coat additional teeth (for example, bicuspid teeth). The sealant acts as a barrier, ensuring that food particles and oral bacteria cannot access vulnerable tooth enamel.

Dental sealants do not enhance the health of the teeth directly, and should not be used as a substitute for fluoride supplements (if the dentist has recommended them) or general oral care. In general however, sealants are less costly, less uncomfortable, and more aesthetically pleasing than dental fillings.

How are sealants applied?

Though there are many different types of dental sealant, most are comprised of liquid plastic. Initially, the pediatric dentist must thoroughly clean and prepare the molars, before painting sealant on the targeted teeth. Some sealants are bright pink when wet and clear when dry. This bright pink coloring enables the dentist to see that all pits and fissures have been thoroughly coated.

When every targeted tooth is coated to the dentist’s satisfaction, the sealant is either left to self-harden or exposed to blue spectrum natural light for several seconds (depending on the chemical composition of the specific brand). This specialized light works to harden the sealant and cure the plastic. The final result is a clear (or whitish) layer of thin, hard, durable sealant.

It should be noted that the “sealing” procedure is easily completed in one office visit, and is entirely painless.

When should sealants be applied?

Sealants are usually applied when the primary (baby) molars first emerge. Depending on the oral habits of the child, the sealants may last for the life of the primary tooth, or need replacing several times. Essentially, sealant durability depends on the oral habits of the individual child.

Pediatric dentists recommend that permanent molars be sealed as soon as they emerge. In some cases, sealant can be applied before the permanent molar is full grown.

The health of the sealant must be monitored at biannual appointments. If the seal begins to lift off, food particles may become trapped against the tooth enamel, actually causing tooth decay.

If you have questions or concerns about dental sealants, please contact your pediatric dentist.

What is Pulp Therapy?

The “pulp” of a tooth cannot be seen with the naked eye. Pulp is found at the center of each tooth, and is comprised of nerves, tissue, and many blood vessels, which work to channel vital nutrients and oxygen. There are several ways in which pulp can be damaged. Most commonly in children, tooth decay or traumatic injury lead to painful pulp exposure and inflammation.

Pediatric pulp therapy is known by several other names, including: root canal, pulpotomy, pulpectomy, and nerve treatment. The primary goal of pulp therapy is to treat, restore, and save the affected tooth.

Pediatric dentists perform pulp therapy on both primary (baby) teeth and permanent teeth. Though primary teeth are eventually shed, they are needed for speech production, proper chewing, and to guide the proper alignment and spacing of permanent teeth.

What are the signs of pulp injury and infection?

Inflamed or injured pulp is exceptionally painful. Even if the source of the pain isn’t visible, it will quickly become obvious that the child needs to see the pediatric dentist.

Here are some of the other signs to look for:

Constant unexplained pain.
Nighttime pain.
Sensitivity to warm and cool food temperatures.
Swelling or redness around the affected tooth.
Unexpected looseness or mobility of the affected tooth.

When should a child undergo pulp therapy?

Every situation is unique. The pediatric dentist assesses the age of the child, the positioning of the tooth, and the general health of the child before making a recommendation to extract the tooth or to save it via pulp therapy.

Some of the undesirable consequences of prematurely extracted/missing teeth are listed below:

Arch length may shorten.
In the case of primary tooth loss, permanent teeth may lack sufficient space to emerge.
Opposing teeth may grow in a protruding or undesirable way.
Premolars may become painfully impacted.
Remaining teeth may “move” to fill the gap.
The tongue may posture abnormally.

How is pulp therapy performed?

Initially, the pediatric dentist will perform visual examinations and evaluate X-rays of the affected areas. The amount and location of pulp damage dictates the nature of the treatment. Although there are several other treatments available, the pediatric pulpotomy and pulpectomy procedures are among the most common performed.

Pulpotomy – If the pulp root remains unaffected by injury or decay, meaning that the problem is isolated in the pulp tip, the pediatric dentist may leave the healthy part alone and only remove the affected pulp and surrounding tooth decay. The resulting gap is then filled with a biocompatible, therapeutic material, which prevents infection and soothes the pulp root. Most commonly, a crown is placed on the tooth after treatment. The crown strengthens the tooth structure, minimizing the risk of future fractures.

Pulpotomy treatment is extremely versatile. It can be performed as a standalone treatment on baby teeth and growing permanent teeth, or as the initial step in a full root canal treatment.

Pulpectomy – In the case of severe tooth decay or trauma, the entire tooth pulp (including the root canals) may be affected. In these circumstances, the pediatric dentist must remove the pulp, cleanse the root canals, and then pack the area with biocompatible material. This usually takes several office visits.

In general, reabsorbable material is used to fill primary teeth, and non-reabsorbable material is used to fill permanent teeth. Either way, the final treatment step is to place a crown on the tooth to add strength and provide structural support. The crown can be disguised with a natural-colored covering, if the child prefers.

If you have questions or concerns about the pediatric pulp therapy procedure, please contact your pediatric dentist.

What’s the Best Toothpaste for My Child?

Evaluating the many brands of oral products claiming to be “best for children” can be an overwhelming task. Selecting an appropriately sized toothbrush and a nourishing, cleansing brand of children’s toothpaste is of paramount importance for maintaining excellent oral health.

Why brush primary teeth?

The importance of maintaining the health of primary (baby) teeth is often understated. Primary teeth are essential for speech production, chewing, jaw development, and they also facilitate the proper alignment and spacing of permanent adult teeth. Brushing primary teeth prevents bad breath and tooth decay, and also removes the plaque bacteria associated with childhood periodontal disease.

What differences are there among toothpaste brands?

Though all toothpastes are not created equal, most brands generally contain abrasive ingredients to remove stains, soapy ingredients to eliminate plaque, fluorides to strengthen tooth enamel, and some type of pleasant-tasting flavoring.

The major differences between brands are the thickness of the paste, the level of fluoride content, and the type of flavoring. Although fluoride strengthens enamel and repels plaque bacteria, too much of it can actually harm young teeth – a condition known as dental fluorosis. Children between the ages of one and four years old are most at risk for this condition, so fluoride levels should be carefully monitored during this time.

Be aware that adult and non-ADA approved brands of toothpaste often contain harsher abrasives, which remove tooth enamel and weaken primary teeth. In addition, some popular toothpaste brands contain sodium lauryl sulfate (shown as “SLS” on the package), which cause painful mouth ulcers in some children.

So which toothpaste brand should I choose?

The most important considerations to make before implementing an oral care plan and choosing a toothpaste brand is the age of the child. Home oral care should begin before the emergence of the first tooth. A cool clean cloth should be gently rubbed along the gums after feeding to remove food particles and bacteria.

Prior to the age of two, the child will have many teeth and brushing should begin. Initially, select fluoride-free “baby” toothpaste and softly brush the teeth twice per day. Flavoring is largely unimportant, so the child can play an integral role in choosing whatever type of toothpaste tastes most pleasant.

Between the middle and the end of the third year, select an American Dental Association (ADA) accepted brand of toothpaste containing fluoride. The ADA logo is clear and present on toothpaste packaging, so be sure to check for it. Use only a tiny pea or rice-sized amount of fluoride toothpaste, and encourage the child to spit out the excess after brushing. Eliminating the toothpaste takes practice, patience, and motivation – especially if the child finds the flavoring tasty. If the child does ingest tiny amounts of toothpaste, don’t worry; this is perfectly normal and will cease with time and encouragement.

Dental fluorosis is not a risk factor for children over the age of eight, but an ADA accepted toothpaste is always the recommended choice for children of any age.

If you have questions or concerns about choosing an appropriate brand of toothpaste for your child, your pediatric dentist will be happy to make recommendations.

When Should Children Have Their First Dental Visit?

The American Academy of Pediatric Dentistry (AAPD) suggests that parents should make an initial “well-baby” appointment with a pediatric dentist approximately six months after the emergence of the first tooth, or no later than the child’s first birthday.

Although this may seem surprisingly early, the incidence of infant and toddler tooth decay has been rising in recent years. Tooth decay and early cavities can be exceptionally painful if they are not attended to immediately, and can also set the scene for poor oral health in later childhood.

The pediatric dentist is a specialist in child psychology and child behavior, and should be viewed as an important source of information, help, and guidance. Oftentimes, the pediatric dentist can provide strategies for eliminating unwanted oral habits (for example, pacifier use and thumb sucking) and can also help parents in establishing a sound daily oral routine for the child.

What potential dental problems can babies experience?

A baby is at risk for tooth decay as soon as the first tooth emerges. During the first visit, the pediatric dentist will help parents implement a preventative strategy to protect the teeth from harm, and also demonstrate how infant teeth should be brushed and flossed.

In particular, infants who drink breast milk, juice, baby formula, soda, or sweetened water from a baby bottle or sippy cup are at high-risk for early childhood caries (cavities). To counteract this threat, the pediatric dentist discourages parents from filling cups with sugary fluids, dipping pacifiers in honey, and transmitting oral bacteria to the child via shared spoons and/or cleaning pacifiers in their own mouths.

Importantly, the pediatric dentist can also assess and balance the infant’s fluoride intake. Too much fluoride ingestion between the ages of one and four years old may lead to a condition known as fluorosis in later childhood. Conversely, too little fluoride may render young tooth enamel susceptible to tooth decay.

What happens during the first visit?

Pediatric dentists have fun-filled, stimulating dental offices. All dental personnel are fully trained to communicate with infants and young children.

During the initial visit, the pediatric dentist will advise parents to implement a good oral care routine, ask questions about the child’s oral habits, and examine the child’s emerging teeth. The pediatric dentist and parent sit knee-to-knee for this examination to enable the child to view the parent at all times. If the infant’s teeth appear stained, the dentist may clean them. Oftentimes, a topical fluoride treatment will be applied to the teeth after this cleaning.

What questions may the pediatric dentist ask during the first visit?

The pediatric dentist will ask questions about current oral care, diet, the general health of the child, the child’s oral habits, and the child’s current fluoride intake.

Once answers to these questions have been established, the pediatric dentist can advise parents on the following issues:

Accident prevention.
Adding xylitol and fluoride to the infant’s diet.
Choosing an ADA approved, non-fluoridated brand of toothpaste for the infant.
Choosing an appropriate toothbrush.
Choosing an orthodontically correct pacifier.
Correct positioning of the head during tooth brushing.
Easing the transition from sippy cup to adult-sized drinking glasses (12-14 months).
Eliminating fussing during the oral care routine.
Establishing a drink-free bedtime routine.
Maintaining good dietary habits.
Minimizing the risk of tooth decay.
Reducing sugar and carbohydrate intake.
Teething and developmental milestones.

If you have further questions or concerns about the timing or nature of your child’s first oral checkup, please ask your pediatric dentist.

When Will My Baby Start Getting Teeth?

The initial growth period for primary (baby) teeth begins in the second trimester of pregnancy (around 16-20 weeks). During this time, it is especially important for expectant mothers to eat a healthy, nutritious diet, since nutrients are needed for bone and soft tissue development.

Though there are some individual differences in the timing of tooth eruption, primary teeth usually begin to emerge when the infant is between six and eight months old. Altogether, a set of twenty primary teeth will emerge by the age of three.

The American Academy of Pediatric Dentistry (AAPD) recommends a first “well-baby” dental visit around the age of twelve months (or six months after the first tooth emerges). This visit acquaints the infant with the dental office, allows the pediatric dentist to monitor development, and provides a great opportunity for parents to ask questions.

Which teeth emerge first?

In general, teeth emerge in pairs, starting at the front of the infant’s mouth. Between the ages of six and ten months, the two lower central incisors break through. Remember that cavities may develop between two adjacent teeth, so flossing should begin at this point.

Next (and sometimes simultaneously), the two upper central incisors emerge – usually between the ages of eight and twelve months. Teething can be quite an uncomfortable process for the infant. Clean teething rings and cold damp cloths can help ease the irritation and discomfort.

Between the ages of nine and sixteen months the upper lateral incisors emerge – one on either side of the central incisors. Around the same time, the lower lateral incisors emerge, meaning that the infant has four adjacent teeth on the lower and upper arches. Pediatric dentists suggest that sippy cup usage should end when the toddler reaches the age of fourteen months. This minimizes the risk of “baby bottle tooth decay.”

Eight more teeth break through between the ages of thirteen and twenty three months. On each arch, a cuspid or canine tooth will appear immediately adjacent to each lateral incisor. Immediately behind (looking towards the back of the child’s mouth), first molars will emerge on either side of the canine teeth on both jaws.

Finally, a second set of molars emerges on each arch – usually beginning on the lower arch. Most children have a complete set of twenty primary teeth before the age of thirty-three months. The pediatric dentist generally applies dental sealant to the molars, to lock out food particles, bacteria, and enamel-attacking acids.

How can I reduce the risk of early caries (cavities)?

Primary teeth preserve space for permanent teeth and guide their later alignment. In addition, primary teeth help with speech production, prevent the tongue from posturing abnormally, and play an important role in the chewing of food. For these reasons, it is critically important to learn how to care for the child’s emerging teeth.

Here are some helpful tips:

Brush twice each day – The AAPD recommends a pea-sized amount of ADA approved (non-fluoridated) toothpaste for children under two years old, and the same amount of an ADA approved (fluoridated) toothpaste for children over this age. The toothbrush should be soft-bristled and appropriate for infants.
Start flossing – Flossing an infant’s teeth can be difficult but the process should begin when two adjacent teeth emerge. The pediatric dentist will happily demonstrate good flossing techniques.
Provide a balanced diet – Sugars and starches feed oral bacteria, which produce harmful acids and attack tooth enamel. Ensure that the child is eating a balanced diet and work to reduce sugary and starchy snacks.
Set a good example – Children who see parents brushing and flossing are often more likely to follow suit. Explain the importance of good oral care to the child; age-appropriate books often help with this.
Visit the dentist – The pediatric dentist monitors oral development, provides professional cleanings, applies topical fluoride to the teeth, and coats molars with sealants. Biannual trips to the dental office can help to prevent a wide range of painful conditions later.

If you have questions or concerns about the emergence of your child’s teeth, please contact your pediatric dentist.

Why Are Primary Teeth Important?

Primary teeth, also known as “baby teeth” or “deciduous teeth,” begin to develop beneath the gums during the second trimester of pregnancy. Teeth begin to emerge above the gums approximately six months to one year after birth. Typically, preschool children have a complete set of 20 baby teeth – including four molars on each arch.

One of the most common misconceptions about primary teeth is that they are irrelevant to the child’s future oral health. However, their importance is emphasized by the American Dental Association (ADA), which urges parents to schedule a “baby checkup” with a pediatric dentist within six months of the first tooth emerges.

What are the functions of primary teeth?

Primary teeth can be painful to acquire. To soothe tender gums, biting on chewing rings, wet gauze pads, and clean fingers can be helpful. Though most three-year-old children have a complete set of primary teeth, eruption happens gradually – usually starting at the front of the mouth.

The major functions of primary teeth are described below:

Speech production and development – Learning to speak clearly is crucial for cognitive, social, and emotional development. The proper positioning of primary teeth facilitates correct syllable pronunciation and prevents the tongue from straying during speech formation.

Eating and nutrition – Children with malformed or severely decayed primary teeth are more likely to experience dietary deficiencies, malnourishment, and to be underweight. Proper chewing motions are acquired over time and with extensive practice. Healthy primary teeth promote good chewing habits and facilitate nutritious eating.

Self-confidence – Even very young children can be quick to point out ugly teeth and crooked smiles. Taking good care of primary teeth can make social interactions more pleasant, reduce the risk of bad breath, and promote confident smiles and positive social interactions.

Straighter smiles – One of the major functions of primary teeth is to hold an appropriate amount of space for developing adult teeth. In addition, these spacers facilitate the proper alignment of adult teeth and also promote jaw development. Left untreated, missing primary teeth cause the remaining teeth to “shift” and fill spaces improperly. For this reason, pediatric dentists often recommend space-maintaining devices.

Excellent oral health – Badly decayed primary teeth can promote the onset of childhood periodontal disease. As a result of this condition, oral bacteria invade and erode gums, ligaments, and eventually bone. If left untreated, primary teeth can drop out completely – causing health and spacing problems for emerging permanent teeth. To avoid periodontal disease, children should practice an adult-guided oral care routine each day, and infant gums should be rubbed gently with a clean, damp cloth after meals.

If you have questions or concerns about primary teeth, please contact your pediatric dentist.

Why See a Pediatric Dentist?

Pediatric dentists (or pedodontists) are qualified to meet the dental needs of infants, toddlers, school-age children, and adolescents. Pediatric dentists are required to undertake an additional two or three years of child-specific training after fulfilling dental school requirements.

In addition to dental training, pediatric dentists specifically study child psychology. This enables them to communicate with children in an effective, gentle, and non-threatening manner.

The American Academy of Pediatric Dentistry (AAPD) recommends that children see a pediatric dentist before the age of one (or approximately six months after the emergence of the first primary tooth). Though this might seem early, biannual preventative dental appointments are imperative for excellent oral health.

Parents should take children to see a pediatric dentist for the following reasons:

To ask questions about new or ongoing issues.
To discover how to begin a “no tears” oral care program in the home.
To find out how to implement oral injury prevention strategies in the home.
To find out whether the child is at risk for developing caries (cavities).
To receive information about extinguishing unwanted oral habits (e.g., finger-sucking, etc.).
To receive preventative treatments (fluorides and sealants).
To receive reports about how the child’s teeth and jaws are growing and developing.

What does a pediatric dentist do?

Pediatric dentistry offices are colorful, fun, and child-friendly. Dental phobias are often rooted in childhood, so it is essential that the child feel comfortable, safe, and trusting of the dentist from the outset.

The pediatric dentist focuses on several different forms of oral care:

Prevention – Tooth decay is the most prevalent childhood ailment. Fortunately, it is almost completely preventable. Aside from providing advice and guidance relating to home care, the pediatric dentist can apply sealants and fluoride treatments to protect tooth enamel and minimize the risk of cavities.

Early detection – Examinations, X-rays, and computer modeling allow the pediatric dentist to predict future oral problems. Examples include malocclusion (bad bite), attrition due to grinding (bruxism), and jaw irregularities. In some cases, optimal outcomes are best achieved by starting treatment early.

Treatment – Pediatric dentists offer a wide range of treatments. Aside from preventative treatments (fluoride and sealant applications), the pediatric dentist also performs pulp therapy and treats oral trauma. If primary teeth are lost too soon, space maintainers may be provided to ensure the teeth do not become misaligned.

Education – Education is a major part of any pediatric practice. Not only can the pediatric dentist help the child understand the importance of daily oral care, but parents can also get advice on toothpaste selection, diet, thumb-sucking cessation, and a wide range of related topics.

Updates – Pediatric dentists are well informed about the latest advances in the dentistry field. For example, Xylitol (a naturally occurring sugar substitute) has recently been shown to protect young teeth against cavities, tooth decay, and harmful bacteria. Children who do not see the dentist regularly may miss out on both beneficial information and information about new diagnostic procedures.

If you have questions or concerns about when to see a pediatric dentist, please contact our office.

Xylitol – Reducing Cavities

Tooth decay is a common, yet preventable childhood problem. Left untreated, cavities in primary (baby) and permanent (adult) teeth become painful and negatively impact the esthetics and functionality of the teeth.

Some children are particularly susceptible to tooth decay, even after receiving regular dental examinations and oral care at home. The American Academy of Pediatric Dentistry (AAPD) has recently recognized the benefits of a substance called Xylitol for reducing childhood tooth decay.

What is Xylitol?

Xylitol is a natural substance that can be found in a variety of fruits and vegetables. Some of the most common Xylitol- rich foods include: berries, mushrooms, corns, and lettuces. Study results indicate that 4-20 grams of Xylitol each day, divided into three or more helpings, can reduce tooth decay and cavities by as much as 70%. As a point of reference, a single cup of berries contains a little less than one gram of Xylitol.

It can be difficult to encourage children (especially toddlers) to consistently eat four or more cups of fruit or vegetables each day. For this reason, Xylitol is also available as a sugar substitute, a gum, and as a concentrate in numerous health foods. No other sugar substitute has been shown to benefit young teeth in the same way.

It should be noted that excessive Xylitol consumption does not provide “more” tooth protection. Sticking to the recommended daily amount is enough to enhance other cavity-reduction efforts, and the effects will last well into the future.

How does Xylitol work?

The combination of many factors increases susceptibility to childhood tooth decay and cavities. These factors include: oral care habits, diet, carbohydrate consumption, sucrose consumption, salivary flow rate, and tooth resistance to plaque.

More specifically, harmful oral bacteria feed on sugars and carbohydrates, producing acids. When sugary foods are consumed, these acids attack and destroy vulnerable tooth enamel. Xylitol works to neutralize the acids, reducing enamel destruction, and minimizing the threat of cavities in the process. Xylitol also stimulates saliva production, meaning that food particles, plaque and bacteria are continually removed from the teeth. When used in combination with fluoride, Xylitol works to remineralize teeth, protecting tooth enamel and minimizing new cavity formation.

When should my child start using Xylitol?

Although Xylitol gum is not suitable for very young children, infants actually benefit from maternal chewing! Mothers of children between three months and two years old who used Xylitol gum several times each day, protected their child from tooth decay until the age of five years old. In this case, Xylitol reduced the amount of microorganisms transmitted from mother to child.

Once the child reaches toddlerhood, Xylitol can be consumed as a sugar substitute, or as a natural byproduct of eating fruit and vegetables. Older children can reduce the threat of new cavities by chewing Xylitol gum.

If you have questions or concerns about Xylitol or tooth decay, please contact our practice.

Surgical Instructions

While most dental surgery is performed on an out-patient basis, it remains an involved procedure that requires specific preparation and aftercare. In an effort to provide safe, comfortable care, we encourage you to review our pre- and post-operative instructions, which are intended to facilitate a smooth operation and safer recovery.

If you have any questions or concerns about your surgery, please contact our practice today.

After Dental Implant Surgery

Following dental implant surgery, patients must take detailed care of the area surrounding their new implant. For the first month the dental implant is still integrating with the bone and tissues so the patient’s care routine will be slightly more involved during this initial period. Above all, do not disturb the wound in the initial days that follow surgery. Avoid rinsing, spitting, and touching the mouth for 24 hours after surgery to avoid contaminating or irritating the surgical site. After dental implant surgery it’s important to follow these care instructions:

Antibiotics – Patients should take all prescribed antibiotics to prevent infection at the surgical site. Twenty-four hours after the surgery, patients should begin using the prescribed oral rinse twice daily alongside a warm saltwater rinse 4-5 times daily (preferably after every meal/snack).
Bleeding – Blood in the patients’ saliva is normal during the first 24 hours following surgery. We suggest biting on gauze pads to help control and lessen blood flow. Gently bite down on the gauze pad and try to maintain constant pressure, repeating as often as needed, or until bleeding lessens.
Dealing with pain – Shortly after your dental implant surgery the anesthetic will wear off. You should begin taking pain medication before this happens. Any over-the-counter pain medication can be taken (e.g., Tylenol^®, Aleve^®, ibuprofen, etc.).
Diet – We recommend an initial diet of soft foods, but patients can resume a normal diet as soon as they feel capable of doing so. Stay hydrated. It is critical that you are drinking plenty of fluids.
Hygiene – In order for the dental implants to heal properly, the surgical site must be kept clean. Continue to brush your teeth as you normally would, but avoid any sutures and do not brush the implant. The antibiotic and saltwater rinses will disinfect the implant itself.
Swelling – After dental implant surgery some amount of swelling is to be expected. To help minimize swelling, try to keep your head elevated and lower your activity level as much as possible. Use ice packs for the first 48 hours and apply continuously, or as frequently as possible to minimize facial swelling.
Wearing your prosthesis or night guard – Partial dentures, flippers, full dentures, retainers, or night guards should not be used for at least 10 days following surgery. If there are any special circumstances, our practice will discuss those with you during your pre-operative consultation.
Smoking – Smoking after dental implant surgery has an increased risk of infection which also increases the risk of dental implants failing to integrate. We recommend that patients do not smoke for a minimum of 2 weeks after dental implant surgery.

What does recovery involve?

While each patient’s case is different, recovery after dental implant surgery happens in a series of phases. With your new dental implants, maintaining proper oral hygiene should be your primary focus. In order for the implant to properly fuse with the jawbone, it must remain clean. Also keep in mind that when properly cared for, a dental implant can serve its owner for life.

When maintaining proper hygiene, oral discomfort should gradually lessen. Swelling, bruising, and minor bleeding may still occur. If any pain does continue, feel free to continue using the pain medications.

Healing time differs depending on whether a patient receives immediate crown placement, or waits for the implant to fuse with the jawbone. Your recovery timeframe will depend on your individual case and treatment plan; follow-up appointments will be scheduled accordingly.

If you have any questions, please feel free to contact our office.

After Tooth Extractions

There are a number of reasons that your dentist might recommend a tooth extraction. Some dental patients suffer from tooth decay; others need to remove teeth hindering orthodontic treatment, whereas various patients simply need wisdom teeth removal. While a tooth extraction can be a serious dental procedure, aftercare is just as critical as the procedure itself. As the dental patient, it is important to understand that pain and the risk of infection can be lessened with proper care.

Care immediately following surgery:

Keep pressure on the gauze pad that your doctor placed over the surgical area by gently biting down. Dampen the gauze sponge with water if it begins to dry out. Try to maintain constant pressure in intervals of 45-60 minutes, repeating as often as needed, or until bleeding lessens. Change the gauze as needed.
Keep your head elevated and try to lower your activity level as much as possible.
48 hours after surgery, rinse mouth with warm salt water every 1-2 hours. Avoid using any mouthwash containing alcohol as it can irritate the wound.
Keep your mouth clean by brushing areas around the surgical site, but be sure to avoid sutures. Touching the wounded area in any fashion should be prevented.
Use ice packs to control swelling by placing them on facial areas near extraction.
Take all prescribed medications accordingly. If any itching or swelling occurs, contact the practice immediately, or go to the nearest emergency room.
Try to eat softer foods, preferably high in protein.
Keep your body hydrated by drinking plenty of fluids, but do not drink through a straw for the next 5-7 days.
If you are a regular tobacco user refrain from smoking for the next 3-4 days as smoking increases your chances of getting a dry socket as well as an infection.

After your tooth has been extracted, healing will take some time. Within 3 to 14 days, your sutures should fall out or dissolve. For sutures that are non-resorbable, your doctor will schedule a follow-up appointment to remove the stitches for you. Your tooth’s empty socket will gradually fill in with bone over time and smooth over with adjacent tissues.

Possible complications after a tooth extraction

Bleeding – Bleeding after a tooth extraction is entirely normal. A pinkish tinted saliva and subtle oozing is fairly common during the first 36 hours. If bleeding gets excessive, control it by using dampened gauze pads and biting down to keep pressure on the area. As an alternative to gauze pads, a moistened tea bag can be used, as the tannic acid helps blood vessels contract. Apply pressure to the gauze or tea bag by gently biting down for 30 minutes. Please remember that raised tempers, sitting upright, and exercise can all increase blood flow to the head, which can cause excess bleeding. Try to avoid these as much as possible. If your bleeding does not reduce after 48 hours, please call the practice.

Bone sequestra (dead tooth fragments) – Some patients have small sharp tooth fragments that were unable to be completely removed during surgery. During the recovery period, these dead bone fragments, or bone sequestra, slowly work themselves through the gums as a natural healing process. This can be a little painful until the sequestra are removed so please call our practice immediately if you notice any sharp fragments poking through the surgery site.

Dry socket – In the days that follow your tooth extraction, pain should gradually subside. Rarely, patients report that pain increases to a throbbing unbearable pain that shoots up towards the ear. Often this is a case of dry socket. Dry socket occurs when the blood clot becomes irritated and ousted before healing is complete. Food and debris can then get into the socket causing irritation. Tobacco users and women taking oral contraceptives are at a higher risk of getting dry socket. Dry socket is not an infection but does require a visit to our office. If you think you may be suffering from dry socket, please contact the practice immediately.

Lightheadedness – Because you may have been fasting prior to surgery, your blood sugar levels may be lower than normal. Until your body has had the chance to catch up and process some sugars, you should remember to stand up slowly when getting up from a relaxed position. For somewhat immediate relief, try eating something soft and sugary, stay in a relaxed position, and reduce the elevation of your head.

Numbness – Many patients report still feeling numb hours after their tooth extraction procedure. An extended lack of feeling around the mouth is normal and can last 10-12 hours after surgery.

Swelling – Swelling should subside almost entirely within 10 days after surgery. Immediately following your tooth extraction, apply an ice pack to the facial areas near the extraction. Continue using the ice in 15 minute intervals for the first 36 hours. After 36 hours, ice will no longer be beneficial in reducing swelling and moist heat should be used instead. To decrease swelling, apply a warm damp cloth to the sides of your face.

Trismus (difficulty opening and closing mouth) – If you experience a sore jaw and difficulty chewing or swallowing, do not be alarmed. Occasionally patients’ chewing muscles and jaw joints remain sore 3-5 days after surgery. This soreness can also make it difficult to open and close your mouth. Soreness should eventually subside.

If you have any worries, or are experiencing any complications not mentioned, please contact our practice immediately so that we may address your concerns.

LIEN K. LY, DDS
LIEN K. LY, DDS
FAMILY AND CONSMETIC DENTISTRY

SKY CANYON DENTAL

Lien K. Ly, DDS

Family and Cosmetic Dentistry

Call

Map

Contact

Appointment