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Preventive & Basic

Exam & Cleaning

 

The initial and recall exams are the backbone of maintaining good oral health. During your exam, a variety of procedures are performed which include a detailed medical history, looking for cavities, defects in current restorations, periodontal (gum) health, developmental issues, oral cancer, grinding/clenching habits and more.
When a diagnosis is needed to be made digital radiographs (x-rays) are also taken to help confirm a diagnosis. We do not believe in indiscriminately taking radiographs and our practice model follows that as outlined by the ADA.
For many patients a regular cleaning (adult prophylaxis) is sufficient to get rid of plaque and tartar build up. We stress 6 month intervals for most patients, but often-times more frequent visits are needed for those with advanced stages of gum disease.

Fillings

 

Upon examination, if we detect a cavity or tooth decay, we will perform a filling to stop the progression of the decay and restore it back to function. The type of material used depends on the patient and clinical scenario. These include materials such as composite resin, glass ionomer, and more.
Fillings can be done directly in the mouth (as shown to the right) or can be done indirectly with a laboratory. These indirect fillings include procedures such as inlays and onlays that typically restore more missing tooth structure than is traditionally done in office. Cavities left untreated will progress until they reach the nerve of the tooth which can no longer be treated by a simple filling.

Root Canal Therapy & Emergency

 

The most common causes of dental emergencies are endodontic in nature, meaning they are related to pain felt from the nerve of the tooth. Endodontic treatment can be done for a variety of reasons including dental decay, aggressive orthodontic treatment, iatrogenic damage to the nerve, and more. Untreated cavities often progress to the pulp chamber which is the center of the tooth that contains blood, nerves, etc. Your doctor will determine if the tooth is restorable first and the severity of the infection. The purpose of the root canal is to disinfect, clean, shape and ultimately fill the roots to prepare the tooth for a permanent restoration. This can be either with a filling in conservative cases or a crown in more advanced cases. Not all root canal treated teeth are restored with a crown nor are they all restored with a filling. This is case dependent and will be reviewed at the appropriate time of treatment.
Teeth with chronic infections often report of common symptoms including pain in the middle of the night, persistent pain, sensitivity to hot things and more. We prefer to treat teeth with a root canal before they become symptomatic since the success rate decreases even when done at the highest level possible.

Crown & Bridge

 

Certain teeth require a crown (“cap”) that encompasses the entire tooth. Often times these reasons include large pre-existing fillings that have weakened the tooth making it prone to fracture, root canal treatment, extensive decay, full mouth rehabilitation and more. Crowns are made out of a variety of materials and their use depends on the location and indication for each patient. Traditionally, crowns have been made out of all gold or a combination of porcelain layered on top of a metal foundation (porcelain fused to metal or PFM).
Currently in dentistry there have been major advances in materials that have allowed us to use different types of crowns made from non-metallic substances such as zirconia and lithium disilicate. These are stronger and more predictable clinically. To the right you will see a case where two back teeth with large fillings were failing, causing discomfort. They were then prepared (top) and fitted for two all zirconia crowns that were delivered (bottom image). We aim to give ourselves the highest level of success to keep the teeth we already have. While dental implants have been a major advancement in dentistry, our philosophy is to try to keep our natural teeth and implants are an option when they are deemed more predictable than conventional restorative treatment.

Periodontal & Gum Disease

 

The health of the gums and bone that support our teeth is crucial and most important for establishing excellent oral health. This branch of dentistry is called periodontics. During your initial and recall hygiene exams, your gums and teeth will be checked for a variety of things that will check the stability and overall health of the gums, teeth, and bone that supports the teeth.
Periodontal disease is a condition that affects the bony support around the teeth that is accompanied by inflammation of the gums. This will not go away on its own and its diagnosis is crucial during your exams. Patients with gingivitis have only inflammation of the gums which is easily treated by a professional cleaning and good home care. Patients with periodontal disease require advanced treatment such as scaling and root planing that aims to get rid of the cause of disease.
Other advanced periodontal treatments and their necessity will be determined in your treatment plan. We stress regular 6 month intervals for healthy patients and those with gingivitis. We stress more frequent visits as determined by your provider for those patients with periodontal disease.

Sports Dentistry

 

One of the most overlooked aspects of those involved in contact sports is proper mouth protection. Frequently we see patients come in with traditional “boil and bite” mouthguards which provide severely inadequate protection compared to those made by a dentist. Sports that should consider a dentist fabricated mouth guard include, but are not limited to, football, basketball, hockey, rugby, lacrosse, boxing, martial arts, combat sports, wrestling, and soccer. Have you ever seen a mouthguard knocked out of an athlete’s mouth upon contact? This is most often due to an improper fit of the mouth guard made by non-professional means.
This prosthesis can help protect against broken teeth, damage to the jaw (TMJ), cuts on the lips, tongue and more. It should be worn whenever the athlete is actively participating in the sport and is recommended during training to get used to wearing it. A properly made mouthguard assures you the highest percentage of protection in addition to being the most comfortable type available.
Mouthguards are custom made and vary in thickness depending on the sport. We can add custom colors or images and will consult with you to make sure they meet the requirement for the sport you are participating in.

Oral Surgery

 

Procedures such as extractions (including wisdom teeth), bone grafting, soft tissue grafts, and more fall under the category of oral surgery. We extract teeth that are impacted (i.e. will not grow into the mouth properly), infected, broken, or in some instances, to gain space for braces. These teeth are considered “non-restorable” and serve no purpose functionally or aesthetically.
The figure to the right shows what different types of “impacted” teeth can look like under the gums. They are prone to irritation, infection, and damage to the surrounding teeth. While this does not happen in all cases, when you consult with your dentist they will be able to evaluate it clinically and with x-rays. Often, patients can complain of localized pain, radiating pain, pain felt in the ear or jaw joint, swelling, and other symptoms. We typically recommend to have teeth extracted before they cause such problems since it makes the procedure more difficult and can affect the success rate.
Dental surgical procedures can be used to supplement common restorative procedures and are necessary for some patients. Consult with us to see if these would fit your treatment plan.

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