Anesthesia
Local anesthetic is used to numb the tooth and gums in procedures that might cause discomfort. Anesthetic is placed by injection after a topical gel is used to numb the injection site. In early dentistry an anesthetic called Novocain was used. However, in current dentistry Lidocaine, Carbocaine, Septocaine, and Marcaine are now commonly used due to their effectiveness with little side affect or allergic reactions common to Novocain use. Some of these drugs are combined with a vasoconstrictor to lessen bleeding during procedures. However, a patient’s health will determine if a vasoconstrictor is appropriate.
Athletic Mouth Guards
Athletic mouth guards also known as sport guards are used to prevent injury to the teeth during athletic activities. Injury to the teeth and mouth are often common in people who bike, or play sports such as football, wrestling, basketball, and volleyball. The athletic guard is made from dental impressions that make an exact replica of your teeth. An acrylic material is then used from those models to make a guard to fit your teeth. This hard material prevents teeth from being pushed backward or broken if impact occurs. We can make athletic guards in many colors to suit our patients and teams.
Bleaching
Bleaching is a cosmetic procedure used to whiten the teeth. Although this is sometimes done internally to a tooth following an injury, the most common type of bleaching is externally done to enhance the color of the teeth. This type of bleaching is accomplished using a peroxide or carbomide gel that is placed into a tray made specifically to replicate your teeth. The tray with bleaching gel is then worn for approximately one hour a day until the desired results are achieved. Most patients see results within a week with the desired results within 2 to 3 weeks. However results vary with each patient depending on the current shade and thickness of the dentin layer (second layer of the tooth which determines tooth color), and the results desired. Sensitivity to cold is the most common side affect to occur during the bleaching process, but in most patients the sensitivity disappears once bleaching is completed.
Bone Grafting
Bone grafting is a procedure done to replace missing bone after it has disappeared following the loss of a tooth, injury or disease. Adequate bone is important to maintain health of existing teeth or to allow enough structure for an artificial root or tooth (called an implant) to be placed. Bone grafting can be done using your own bone taken from another site, synthetic bone, or donated bone (both human or animal). A specialist dealing in gum and bone called a periodontist, or an oral surgeon typically does bone grafting.
Bridge
A bridge is fixed unit that replaces a tooth. In order to replace a missing tooth using a bridge, two teeth on the surrounding sides of the missing tooth must be crowned creating an anchor for the replacement tooth. The replacement tooth is a crown that is affixed to both of the anchor crowns. Cosmetically it will appear as a normal row of teeth. However, with a bridge one or two teeth will not have a root and the crowns that replace missing teeth will be placed against the gum tissue. Bridges are typically used to replace only one or two missing teeth in the same area of the mouth.
Build Up
A build up is often done when a large filling needs to be removed due to surrounding decay, or a root canal has been completed. Both of these circumstances leave the tooth weakened and susceptible to breakage. The build up helps to make the remaining tooth strong enough to prepare it for further restoration.
Crowns
Crowns are done when a tooth has had a root canal, a fracture, or cavity that encompasses a large enough area leaving the tooth structure weak or susceptible to breakage. Crowns can be made out of gold, porcelain, zirconia, or a mixture of both metal and porcelain. To prepare for a crown an impression of the tooth is taken. The tooth is then prepared by removing a few millimeters of enamel all the way around the tooth. Once the tooth has been prepared another impression is taken and a temporary crown is placed. The impressions are sent to a lab where the crown is custom made to fit on top of your prepared tooth exactly as if it were your own natural tooth. This includes all the natural grooves and contours that existed in your tooth prior to preparation. Crowns can also be used for cosmetic purposes to fix defects in existing teeth.
Crown Lengthening
This procedure involves removing gum tissue or bone to expose more of the tooth structure needed to repair a tooth.
Dental Implants
Dental implants are used to replace an entire tooth and root, or to provide retention for a denture. Once a tooth is lost either due to disease, genetics or injury, the bone in that area starts to disappear as well. This is known as bone resorption and occurs because the bone no longer has a purpose to be there. Bone resorption can happen quickly in some cases after the loss of a tooth, or over a period of years. Even though the rate of resorption varies with each patient, studies show it will occur. The disadvantage of losing bone in an area where a tooth should be include the shifting of surrounding teeth which can affect occlusion and chewing. It can also make it more difficult or impossible to replace a missing tooth if too much bone is lost.
The procedure of placing a dental implant involves placing a titanium post/screw underneath the gum tissue, into the bone where a root once was. The titanium screw mimics the tooth root and gives the bone a purpose and keep the bone from resorption. The implant is left to heal for a few months so that the surrounding bone and blood supply can adhere to the implant. Once the implant is solid in the bone, it is ready to have an implant crown or denture placed. The new restoration crown will look, and function as a natural tooth. Implants can be done singularly or several at a time. A specialist such as a periodontist or oral surgeon places the implant. The restorative crown or denture will then be placed in our office.
Dentures
Dentures are used to replace several missing teeth in an arch either upper or lower teeth which is called a complete denture, or just a few teeth called a partial denture. Often dentures are used when several teeth are affected and cannot be saved. Dentures are removable but can be anchored by the use of implants for better retention. Dentures often include not only artificial teeth, but usually include artificial gums as well.
Diagnostic Casts
Diagnostic casts are often used to visualize what the end result of treatment will look like. Impressions are taken of the teeth that are then poured in stone to create an exact replica of your mouth. This model can then be sent to our lab where a technician will make teeth in wax to show how a new tooth or teeth will look following restorations. Diagnostic casts are often done when a patient would like crowns or veneers in the front part of the mouth, however there are many procedures that can benefit from having diagnostic casts. After a diagnostic cast is created the patient and Dr. will sit down for a consultation to discuss what the patient likes or dislikes about the possible results. This is a great way to see how your teeth may look prior to spending time and money on the actual procedure.
Extractions
Extractions involve removing the entire crown and root of the tooth. This might be necessary for orthodontic procedures, or when a fracture or decay involves too much of the tooth structure preventing further restoration. If necessary extracted teeth can be replaced with dental implants, bridges, or removable appliances such as partials or dentures.
Fillings
Fillings are done to replace missing tooth structure that has been lost due to decay, cracks or grinding. Fillings can be an amalgam material that are silver colored or a composite resin that matches your tooth shade. Amalgam fillings are rarely used anymore, however sometimes if isolating saliva is difficult such as in children with baby teeth, an amalgam filling might be a better choice. However, composite fillings are the ideal choice in our office. The composite resin fillings are not only more esthetic; they are etched and bonded to the tooth. Unlike the amalgam fillings, this allows the filling to expand and contract along with the tooth during temperature changes. This helps to prevent leakage around the filling where unwanted bacteria can harbor.
Full Mouth Debridement
This procedure is done to remove hard mineral deposits known as calculus above and/or below the gum tissue. Removal of these mineral deposits is necessary to evaluate the patient’s supporting bone structure. In a sense it is like “vacuuming the carpet before having it cleaned”. Once the calculus is removed more accurate measurements of the bone and gum can be completed. Often this procedure is done when it has been many years since a patient as received a dental cleaning. This procedure can precede a scaling and root planning procedure or a prophylaxis.
Gingival Grafts
Gingival grafts are done when gum tissue has been lost around a tooth. This is referred to as recession. Recession of the gums can cause root exposure and sensitivity. In addition, root exposure can lead to root decay. A gingival graft is used to cover the root exposure and is typically done using gum tissue from the roof of your mouth (palate). A specialist called a periodontist typically does this procedure.
Inlays and Onlays
Inlays and onlays are used when a filling restoration might not provide the strength needed for remaining tooth structure once decay or fractures are removed. Once decay or a fracture is removed an impression is taken of the tooth. This impression is sent to the lab where a gold or porcelain inlay or onlay is fabricated. Once returned from the lab it is then cemented into the tooth. Inlays and Onlays differ only in the surface area they cover. Onlays involve a cusp of the tooth while inlays do not. Although inlays and onlays can be more expensive than a filling, they have increased strength to biting forces, and finer margins than fillings which decreases the risk of recurrent decay.
Orthodontics
Orthodontic procedures involve the use of various appliances to move teeth to their proper position in order to correct a patient’s occlusion or bite. Orthodontics can also be used to cosmetically straighten teeth. The newest type of orthodontics known as Invisalign uses removable trays that are invisible to the naked eye. Trays are made in sets and our switched periodically to shift teeth into their desired position.
Periodontal Maintenance Cleaning
This type of cleaning is a maintenance cleaning following a scaling and root planning procedure. This is for patients who have been diagnosed with periodontal disease. It should be done every 3 to 4 months in order to help maintain remaining bone heights and to keep infection from reoccurring.
Prophylaxis Cleaning
Commonly referred to as prophy, this procedure is a dental cleaning on a person who has normal bone height surrounding the teeth, little to no bleeding when gums are measured, and very little hard mineral deposits called calculus. It is considered a preventive cleaning and is typically completed every 6 months.
Root Canal
A root canal is done when a tooth has an infection affecting the nerve of a tooth, or decay that is close to or into the nerve canal. The nerve of the tooth is removed and replaced with a filling material and sealed over. Following a root canal treatment for most teeth it is necessary to build the tooth structure back up (build up) and then place a crown on the tooth to prevent breakage.
Scaling and Root Planing
This procedure is sometimes called a periodontal cleaning or “deep cleaning”. It is performed when a person has bone loss around the teeth (periodontal disease), moderate to heavy mineral deposits (called calculus) above and below the gum tissue. Typically, heavy bleeding occurs upon measuring and an odor is present. Scaling and root planning is typically done in two to four appointments. The patient receives local anesthetic to alleviate discomfort since the root of the tooth is being cleaned.
Scaling and Root Planing Before and After Pictures
Sealants
Sealants are used to fill the deep grooves in teeth to prevent decay. Typically they are placed on 6 year and 12 year molars soon after erupting. The tooth is first cleaned, and then etched slightly for retention before the resin material is painted on the chewing surface of the tooth. The resin is then light cured onto the tooth to make it permanent.
Subgingival Antibiotic Therapy
This procedure is used to decrease inflammation and help regain some attachment of the gum tissue and tooth. The antibiotic is typically used in patients who have bleeding and 5mm or greater pockets of the gums upon measuring. The drug is dispensed into the pocket where it adheres to the tissue to kill off bacteria over a 6 week period.
Veneers
Veneers are a cosmetic procedure that can cover defects of the teeth. The procedure involves removing a very slight amount of the enamel from the edges and front of the tooth. An impression is taken and sent to the lab where porcelain veneers are custom made. The veneers are then cemented over the existing tooth. It is similar to placing a fake nail over the top of your natural nail. This procedure can be used to cosmetically straighten teeth without orthodontics, or to fill in small gaps between teeth.
X-rays
X-rays (radiographs) are used to diagnose problems of the bone and teeth. Many problems may not be visible simply by looking. Decay occurring in between the teeth, or infection at the root tip is often diagnosed using x-rays. There are many different types of x-rays used to diagnose.
Bitewing x-rays are taken once a year. These x-rays show the crowns of the premolar and molar teeth which are most affected by decay. These x-rays are used to find decay in between the teeth.
Periapical x-rays are taken during new patient exams and when a patient might be having pain. This x-ray will show the root tip and help diagnose infection.
Panograph x-rays are used to see the entire dentition, jawbone, and sinus cavity. This x-ray is taken approximately every five years and is used to diagnose growths and other pathology that might be present. In addition, the panograph is used to ensure the proper eruption and position of permanent teeth including 3rd molars (wisdom teeth).
*Note that new patients may receive a combination of some or all of the above listed x-rays. It is our job to be extremely thorough so that problems can be diagnosed when small to avoid bigger and more expensive procedures later. We use digital x-rays to keep radiation exposure to a minimum.