Posts for: April, 2014
While you may most associate professional dental cleanings with that “squeaky” clean feeling you have afterward, there is a much higher goal. What is also referred to as “non-surgical periodontal therapy,” these cleanings seek to remove bacterial plaque and tartar (hard deposits) not only from the visible portions of the tooth but also the root surfaces (scaling), so as to reduce the risk and occurrence of periodontal gum disease.
For generations, this was primarily achieved by dental hygienists using hand-held instruments specially designed to manually remove plaque from tooth surfaces. Since the 1950s, though, a new technology known as ultrasonic or power scaling has become more prevalent in use. Initially only used in the outer most portions of the gum tissue (the supra-gingival area) power scaling is increasingly employed to clean the sub-gingival area, much closer to the tooth roots. As this technology has developed, it’s been shown to be just as effective, if not superior in some cases, to manual scaling for removing plaque and tartar.
Ultrasonic or power scalers work by emitting high vibration energy that crushes and removes plaque and calculus (tartar). The resulting shockwaves also tend to disrupt bacterial cell function. The hygienist uses water to flush away the dislodged calculus. They have a number of advantages over manual scaling: they’re quite effective on deep gum pockets, especially when specially designed tips are used; they require less time than manual scaling; and when used correctly power scalers are gentler to tooth structures.
However, they do have a few drawbacks. Because they produce an aerosol effect, power scalers can project contaminants from the patient’s mouth into the atmosphere, requiring special protective equipment for the hygienist. They’re not recommended for patients with hypersensitive teeth, especially regarding temperature change, or for teeth with areas of de-mineralization (the loss of mineral content in the enamel). Care should be taken when they’re used with implants or porcelain or composite crowns — specially designed tips are necessary to avoid scratching the restoration. They may also have an effect on cardiac pacemakers.
In the end, the best approach is a combination of both power and manual scaling techniques. Depending on your individual needs, ultrasonic scaling can do an effective job in removing plaque and tartar and help you avoid gum disease.
If you would like more information on ultrasonic cleaning techniques, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Cleanings Using Ultrasonic Scalers.”
Regardless of culture, the smile is a universal gesture of friendship and openness, and an important communication tool in your social and career relationships. But what if you’re not comfortable with your smile because of misaligned, damaged or missing teeth? That could have a dampening effect on your interactions with people and your own self-confidence.
Cosmetic dentistry can change all that — we have an arsenal of treatments that can rejuvenate your smile. We must first, though, develop a design plan, often involving multiple dental disciplines. It will definitely involve you — your desires, expectations and choices.
It begins with a thought-provoking discussion with our office. Generalities — “I want a beautiful smile” — aren’t enough. Effective planning begins with a clear perspective about your teeth: What do you like or dislike about them? If you could change anything, what would it be? These initial discussions help us specify your expectations.
While the initial discussion envisions the future, the next step focuses on the present — the current condition of your teeth, mouth and entire facial structure. This requires a comprehensive examination to identify any health issues like tooth decay, periodontal gum disease or bone loss. We must also take in the “big picture,” like the shape of your face, out-of-balance features (asymmetries), skin complexion, eye shape and color, or the form and posture of your lips.
Considering all these factors, we then develop a treatment plan with specifics on how to achieve the desired transformation. We will offer our prognosis for what we believe is achievable and maintainable for your specific situation. Here we provide various models, perhaps even including computer simulation, to depict your future smile. In the end, we create a workable plan that meets both reality and your expectations.
With the design plan completed, we can then harness all the techniques and materials available to achieve it. These range from less invasive procedures like whitening, tooth reshaping, cosmetic bonding or porcelain veneers, to more involved restorations like crowns, bridgework or dental implants. In some cases, orthodontics may be necessary to correct bad bites or other malformations of your oral structures.
Smile design ensures we’re employing the right techniques for your particular situation. It all serves the end goal — a new smile that can transform your life.
If you would like more information on smile design, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Beautiful Smiles by Design.”
One of the great benefits that patients with implants enjoy is their imperviousness to decay: unlike a natural tooth, bacteria have no effect on the materials in an implant’s construction. That doesn’t mean, however, you can become lax in your hygiene habits — although the implants may not be susceptible to disease, the surrounding gum tissue and bone are. If those tissues become infected you could start to lose the implant attachment and, as it progresses, the implant itself.
In fact, the gum tissue that surrounds the implant may be more susceptible to infection than those around natural teeth. Teeth maintain a connection with the jawbone through the periodontal ligament. Besides securing the tooth, the gum tissue has fibrous attachments to the tooth to help the gum tissue endure a lot of wear and tear and resist the invasion of bacteria and food particles. Implants are anchored directly into the jawbone (where bone eventually grows and attaches to the titanium implant surface) and don’t develop an attachment with the ligament. Implants, therefore, don’t have the benefit of resistance to bacteria and food particles that natural teeth receive through these fibrous attachments.
As a result, patients with implants need to establish a conscientious habit of effective oral hygiene. Daily removal of bacterial plaque from teeth surfaces through brushing and flossing (and semi-annual office cleanings and checkups) greatly reduce the risk of infection and subsequent inflammation. It’s also important to monitor the condition of your gums, especially around implants. If you begin to notice bleeding, red or swollen gums, or other signs of possible gum disease, you should contact us as soon as possible for an assessment.
Proper care for implants and their supporting tissues is just as necessary, and perhaps more so, than it is for natural teeth. By providing that care, you’ll help ensure years of effective service from your implants.
If you would like more information on hygiene practices with implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Infections Around Implants.”
When it comes to dental procedures, not everybody has the same comfort level; what’s easily tolerated by some can be a major source of anxiety and stress for others. In fact, by some estimates perhaps 10 to 15 percent of Americans avoid visiting the dentist entirely because of the fear factor — and this applies to kids as well as adults. So what should you do if your child needs dental work but is seriously scared of the chair? Here are the top five reasons for considering conscious sedation to relieve your child's dental anxiety.
- It allows dentists to treat children and teens who would otherwise be too fearful to come in. This can be especially useful when invasive treatments like root canals or extractions are needed. When problems are treated at an early stage, it’s often possible to prevent more extensive work from being required later; this can reduce the overall cost of treatment — and also help to preserve the natural teeth!
- Dentists who use pediatric conscious sedation are specially qualified to do so. Advanced training and continuing education are part of the qualification process. In addition, emergency life support equipment is kept on hand, and practitioners are familiar with its use.
- The medications used are safe and effective. New, fast-acting drugs get the job done and then leave the body quickly. They are commonly administered by mouth (orally), so there is no need to fear the needle. While any type of sedation comes with a slight risk, minimal conscious sedation is a lower-risk alternative to deeper levels of sedation, or general anesthesia.
- A designated staff member monitors your child at all times. Vital signs such as heart rate, blood oxygen level, respiration rate, blood pressure and temperature are constantly under observation. This helps ensure that the level of sedation remains effective, yet safe.
- It can form a foundation for stress-free dental treatment in the years to come. No one wants to put their child through a terrifying experience — especially when the fearful memories could prevent them from getting necessary treatment in the future. With conscious sedation, that’s not an issue. In fact, with many of the medications currently in use, your child may not even remember the procedure when it’s over.
Dental anxiety can be a serious problem — but it’s good to know there are ways to control it. If you would like more information, call our office to arrange a consultation. You can learn more in the Dear Doctor magazine article “Sedation Dentistry for Kids.”
There’s more to tooth loss than you might think. Because teeth are part of a larger system that facilitates speaking, eating and digestion, a lost tooth could eventually affect your overall health.
Tooth loss is actually about bone loss. As living tissue, bone continually reforms in response to stimuli it receives from the body. The alveolar bone (which surrounds and supports the teeth) receives such stimuli as the teeth chew and bite, as well as when they contact each other. All these stresses — hundreds a day — transmit through the periodontal ligament to the bone, stimulating it to grow and remodel.
A lost tooth reduces this stimulation and causes the alveolar bone to resorb (dissolve) — as much as 25% of its width the first year alone. Unless the process is stopped, the underlying basal bone and the periodontal (gum) tissue will begin to resorb too. Without this structural support the facial height shrinks and the front teeth begin to push forward, making chewing and speaking more difficult. These teeth begin performing functions outside their normal range, leading to damage and possible loss.
The primary goal of oral hygiene and dental care is to prevent tooth loss. When tooth loss does occur, however, it’s then important to restore the lost tooth with an artificial replacement if at all possible — not only to regain form and function, but to also stop further bone loss.
While the fixed partial denture (FPD), also known as a fixed bridge, has been the restoration of choice for many decades, dental implants may be the better long-term option. Although more expensive initially, implants can achieve a life-like restoration without involving or altering adjacent teeth as with FPDs. Plaque retention and tartar accumulations are much less likely with an implant, and the bone-loving quality of titanium, the metal used for implants, actually encourages bone growth. As a result, implants have a much higher longevity rate than FPDs.
Taking care of your teeth through effective hygiene practices and regular checkups may help you avoid tooth loss altogether. But if it can’t be avoided, restoring lost teeth is the single most important thing you can do to prevent even greater problems down the road.
If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”