Our practice is dedicated to providing our patients with the safest and most advanced dental technology, this is why we utilize digital x-ray technology in our office. The x-ray is captured by placing a small electronic sensor in your mouth and the image is immediately available for viewing on the computer screen. The amount of radiation exposure to you is cut by as much as 80%. The images can be magnified and the contrast can be increased or decreased to better diagnose areas of concern.
Comprehensive Examination and Treatment Planning
A complete exam where the surfaces of each tooth, bone, and gums are examined to detect cavities, periodontal disease, and gingivitis. If you have fillings, crowns, bridges, or other restorations, those will be examined to make sure they are sound and without decay. Your head, neck, and temporomandibular joint (jaw), lymph nodes, and the soft tissues of the inside of the mouth will also be checked for any abnormalities. Your bite (or occlusion) will also be examined. The findings will be discussed with the patient and written in your chart. A treatment plan is determined and discussed with the patient. Any necessary work is then scheduled.
Emergency Dental Examination
An exam that is needed if you are having a dental emergency or pain. We do our best to respond to your needs promptly. If an emergency arises when our office is closed and you are already a patient with us, please call the office and follow the instructions on the answering machine.
Routine cleaning and examination
A cleaning is done on a 3, 4, or 6 month schedule. Ultrasonics, hand instrumentations, and polishing are used to clean teeth of buildup, plaque, and stains. If it is determined you require more than 2 cleanings a year, your hygienist and dentist will make that recommendation. At this time an exam will also be done to determine any changes with your teeth or oral tissues since your last visit. It is important to keep these appointments for healthy teeth, bone, gums, and oral cancer screenings so that any changes can be noted and needed treatment is promptly completed.
A cleaning is usually done 3-4 times a year after your initial periodontal treatment has been completed. This is for patients with periodontal disease or bone loss. These cleanings help keep your bone and gums healthier and help prevent further bone loss around teeth by removing any calculus and plaque.
Oral Cancer Screenings
Your face, neck, lips, tongue, throat, oral mucosa, and gums will be checked for any signs of oral cancer. Most cases of oral cancer are linked to cigarette smoking and heavy alcohol use, but using both poses a much higher risk. HPV (human papillomavirus sexually transmitted HPV 16 type), age (over 40), sun exposure (on your lips), and a diet low in fruits and vegetables can all play a role in oral cancer development. We check every patient at their initial exam and recall examinations for oral cancer.
Fluoride is the most effective agent for prevention of cavities. We recommend children get a fluoride application during their routine cleaning appointments. Although most people receive fluoride from drinking water, it is still recommended to have topical application. Fluoride applications are recommended for those with deep pits and fissures on the chewing surfaces of teeth, poor oral hygiene, frequent sugar and carbohydrate intake, inadequate saliva flow, and a history of dental caries or cavities, or inadequate exposure to fluoride in water.
This is a thin, plastic coating applied to the chewing surfaces of teeth with deep pits and grooves. They protect the decay-prone areas from plaque and bacteria that cause cavities. They can protect the teeth for many years, but they will need to be checked for chipping and wear at regular dental visits. Proper home care, a balanced diet, and regular dental visits will aid in the life of your sealants.
Oral Hygiene Instructions—
Tooth Brushing: Brush your teeth at least twice a day, morning and night. Place the brush at a 45 degree angle on the tooth and use a small, circular motion. Brush the outer, inner, and biting surfaces of each tooth. You should brush for a minimum of 2 minutes each time. Brush your tongue to remove bacteria and buildup that may cause bad breath.
Flossing: The best way to clean between the teeth is to floss daily. It helps to disrupt plaque that cause cavities, gingivitis, and bone disease. Take some floss and wrap it around your fingers, leaving about 2 inches of floss between the fingers. Use your thumbs and forefingers to guide the floss, inserting it between your teeth, curving it into a “C” shape around each tooth and under the gumline. Move the floss gently up and down, cleaning the side of each tooth. It is important to rinse with water thoroughly after brushing and flossing.
Most commonly known as laughing gas, patients who receive nitrous oxide are able to maintain their airway and are aware of their surroundings, however they are much more relaxed for their procedures. Nitrous Oxide is administered via a nasal mask and is quickly cleared from the patients system once their procedure is over. Patients are able to drive home and resume normal activities.
For patients with very high anxiety, your dentist may recommend oral sedation with or without Nitrous Oxide Sedation. Patients are still able to maintain their own airway and are conscious, however, they are more relaxed for their procedures. Patients who receive oral sedation will require a driver to and from their appointment and will need to wait several hours before returning to normal activities. A patient’s medical history, along with their doctor’s approval, is needed prior to oral sedation.
Diagnostic and Preventative Services starting at age 1
The American Academy of Pediatric Dentistry recommends that your child’s first dental visit be scheduled by his/her 1st birthday. It is important for your child to become familiar with the dentist and the staff to build trust, making it easier and more relaxing on their future dental appointments. We want to make their first appointment a pleasurable experience, where they will discover new things about their teeth and oral health. While we encourage parents to accompany their child during their examination appointment, we promote self-independence and encourage that you allow our staff to guide your child through their dental treatment. Parent/caregiver education is also essential at your child’s dental visit.
Baby Oral Health Program
bOHP, was founded at the University of Chapel Hill in 2005 and its goal is to educate dentists on the delivery of oral health to infants and children. It also has a “parent portal” to help parents with any questions they may have regarding the care and development of their child’s teeth. It also helps parents locate a pediatric dentist in their area.
Fluoride exposure is important for infants and children between the ages of 6 months and 16 years because the primary (baby teeth) and permanent (adult teeth) teeth are coming in during this time frame. New research shows that topical fluoride from toothpastes, mouth rinses, and fluoride treatments are important to help fight decay and to strengthen the development of teeth.
Four out of five cavities are found on back teeth in children. To protect them from decay, shortly after eruption, sealants are placed. The sealant acts as a barrier to plague, acid, and food. It is applied to the chewing surfaces of back teeth as clear plastic coatine.
Oral Hygiene Instructions
Caring for your child’s teeth starts at birth. Use a small wet washcloth to wipe their gums. As their teeth start to come in, you should use a small, soft-bristled toothbrush to brush them. Do not use toothpaste with fluoride until your child turns 2, after this age you should only use a pea-sized dab of toothpaste on their brush and encourage them to spit out excess toothpaste after brushing. It is recommended that you stand behind your child and cradle their head to help them brush their teeth until the age of 4 or 5, by this age they should be able to begin brushing their teeth alone.
It is never too early to start flossing, it is believed to be the single most important factor in reducing plaque. Daily flossing and brushing should become a routine for your child to prevent cavities, periodontal disease, and other dental problems later in life.
There are several types of filling materials available. Options will be discussed and recommended for each patient. The most widely used are composite (tooth colored) fillings and amalgam (silver) fillings. The composite material is usually placed on front teeth for aesthetics to match the shade of your natural tooth and the amalgam fillings are placed on back teeth where it is not very noticeable and it is stronger material that’s needed for molars. The decay or affected area of the tooth will be removed and it will be filled with a filling material. Good oral hygiene practices, regular dental visits, and good eating habits will aid in the life of your new fillings.
Crown and Bridge
Crowns, tooth colored or gold, cover the entire tooth surface, restoring it back to its original shape and size. Most crowns are made of porcelain, gold, or a mixture of different metals with porcelain overlay. Due to heavy function and limited space, gold crowns are usually placed on second molars because they are less susceptible to breaking or chipping. Porcelain crowns (PFM-porcelain fused to metal) or all porcelain crowns are placed on front teeth and some molars. These are fabricated to match your natural teeth in shape, size, and shade.
Removable Dentures and Partials
A denture is a dental appliance that is made to replace missing teeth and to resemble your natural teeth. There are two types of dentures-complete and partial-both can be either “conventional” or “immediate”.
A complete denture is fabricated when all your teeth are missing and a partial denture is fabricated when you only have some teeth that are missing.
The conventional method requires for the patient to have their teeth removed and to heal for several weeks prior to making a denture or partial denture. The patient will go without teeth during this time. The immediate method is the most popular option. Their appliance is made prior to having their teeth removed and inserted the day of their extractions, thus preventing the patient from having to go without teeth during the healing process.
Implants are both a permanent and appealing solution. Dental implants will fit, feel, and look like a natural tooth. They are a great alternative to bridges because teeth on either side of the implant are not involved. The dental implant process takes a couple of months, allowing for the bone to integrate around the implant screw that has been placed. Once the implant has healed and is firmly in place, an abutment is placed over the top, and will serve as a base for the new tooth. The implant is placed by a specialist and can be restored by our office. The crown is made to fit precisely. This creates a natural looking tooth that blends seamlessly with your own teeth.
Extractions (Tooth Removal)
Extractions are required on teeth that are determined non-restorable or for other reasons. There are two types of extractions-simple and surgical. A simple extraction is done without any incisions or having to tie any sutures. The tooth comes out fairly easy.
A surgical extraction is more involved, usually having to move the tissue back to expose more of the tooth, the tooth may need to be sectioned to remove more easily. This usually requires sutures to close the wound. Some extractions will be referred to a specialist. These usually include the impacted wisdom teeth, the patient whose medical history is compromised, and extremely nervous patients that would prefer to be sedated (put to sleep).
Periodontal Treatment and Maintenance
Scaling and Root Planning (deep cleanings)
Periodontal disease is bone loss and attachment loss around teeth. It progresses as the bacteria, plaque, and tartar build up and cause bone to recede. If these irritants are not removed they can cause damage to the gums and eventually the bone that supports the teeth. In the early stages (gingivitis), no permanent damage is done and one or two cleanings will be recommended to control it. However, if you have bone loss, scaling and root planning will be recommended, which is a deeper cleaning of the teeth and roots. One or two quadrants (upper right and lower right side) of the mouth are treated at a time. The tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planning). Special medicated mouth rinses, special toothpaste, and an electric tooth brush may be recommended to help control infection and healing. Periodontal surgery may be recommended if your bone loss is sever or does not respond to conventional therapy. We will refer you to a periodontist (specialist).
Once your periodontal treatment has been completed, we recommend that you have regular maintenance cleanings, usually 3-4 times a year. During these appointments, your bone loss will be checked to ensure that your periodontal disease is not worsening. Plaque and calculus will be removed, and your teeth will be polished. A thorough exam will be done to check existing fillings and crowns to make sure new decay is not present, oral hygiene recommendations will be made, and x-rays will be taken, if needed. Our goal is to help you keep the periodontal disease under control by encouraging good oral hygiene practices and having you come in for your periodontal maintenance cleanings. The success of your maintenance treatment depends on you. Brushing and flossing daily as well as using any other cleaning brushes that have been given to you by our office, is very important.
Arestin placement (subgingival antibiotic therapy)
There are times when scaling and root planning will not be enough to treat your periodontal disease. Arestin, an antibiotic in powder form, will be recommended in some cases to help in fighting this disease. It is placed directly into the infected areas by your dentist. It is made up of 100,000 tiny microspheres containing the drug minocycline, which release slowly over time into the infected area. Arestin keeps working long after you have left the dental office. After this antibiotic has been placed, you will be asked to refrain from brushing the area for 24 hours and flossing for a few days. This time period could change depending on the doctor’s recommendation.
Treatment of Aphthous Ulcers and Cold Sores
Lasers have revolutionized the way dentist perform some procedures. Aphthous ulcers, more commonly known as canker sores, affect 10% of the population. Topical steroid agents or chemical cauterizing agents have been used to treat these lesions, but studies show that patients’ benefit more from having laser therapy treatments. One study showed that 75% of the patients reported a reduction in the pain in the same session after laser treatment and total healing after 4 days. It usually takes 5-7 days for it to heal with steroid treatment.
Herpetic Simplex Lesions (cold sores): are caused by the HSV-1 strain. They usually breakout in the non-movable parts of the mouth including gums, lips, and hard palate. These lesions usually crust over and heal within 10-14 days. They are very contagious and care should be taken to ensure you do not spread it. Dentists usually use Acyclovir in ointments to speed up healing and in pill form to help prevent recurrence. Studies have found that 100% of the lesions in the prodromal (first sign of lesion, tingling, itching, inflammation) stage, 95% in the vesicular stage (small blisters), and 91% of the crust stage were able to cure during the first 48 hours with laser treatment.
Gingival Sculpting (gum contouring)
The process of contouring or reshaping your gums/tissues can benefit a patient for cosmetic or health reasons. Cosmetically, the procedure involves removing and re-sculpting uneven or excessive gingival tissue. The health benefit of eliminating harmful bacteria by reducing gum pockets is greater. The procedure typically requires about an hour with minor discomfort afterwards.
Injuries to the mouth while playing sports can harm your teeth, lips, tongue, and cheeks. A mouth guard is recommended to protect your teeth and smile. There are three types of mouth guards: stock, boil-n-bite, and custom made. Dentist recommend the custom made mouth guard because it confirms to your teeth specifically and it can be adjusted to your bite. An impression is taken of your upper and lower teeth, it is sent to the lab for fabrication, then you return to our office for delivery and adjustment.
Clenching and grinding your teeth can cause wearing and cracking of the teeth, and jaw discomfort. Patients will grind their teeth occasionally, but when it happens on a regular basis, it is called bruxism. There is no cure for bruxism, but it can be managed through treatment. One of those treatments is to have a biteguard made. A biteguard is recommended to protect your teeth from the force that is inflicted from clenching and grinding. It also protects your jaw and helps treat or prevent muscles tenderness and pain associated with parafunctional habits. An impression is taken of your upper and lower teeth, it is sent to the lab for fabrication, then you return to our office for delivery and adjustment.