Veneers

What Are Porcelain Veneers?

Porcelain veneers are thin shells of ceramic that bond directly to the front and top surfaces of the teeth. They are an ideal choice for improving your smile and have become increasingly popular due to their simplicity and versatility. With veneers as an alternative, there is no reason to put up with gaps between your teeth, teeth that are stained, badly shaped, or crooked. A veneer placed on top of your teeth can correct these maladies, simply and quickly and help you achieve a beautiful smile!

Will They Look Like Normal Teeth?

When bonded to the teeth, the ultra-thin porcelain veneers are virtually undetectable and highly resistant to coffee, tea, or even cigarette stains. For strength and appearance, their resemblance to healthy, white tooth enamel is unsurpassed by other restorative options. Because they are thin, light can shine through them and they take on the natural color of the underlying tooth.

How Durable Are Porcelain Veneers?

With proper care, porcelain veneers will brighten your smile for well over a decade. Your doctor will ensure that your veneers are crafted from the highest quality porcelains and are bonded with the most advanced and proven materials available.

The Procedure

This procedure will require three appointments:

• Diagnosis and treatment planning
• Preparation
• Bonding

Diagnosis & Treatment Planning

You will want to take an active role in planning your smile design. Your doctor will review the corrective limitations of this procedure and help you plan your new smile.

Preparation

The second appointment will take one to two hours. Although the porcelain veneer is very thin, the teeth are lightly buffed to allow for the added thickness. Approximately one half of a millimeter of tooth is removed. This may require little or no local anesthesia.
Then a mold is taken of the teeth and sent to the lab for fabrication. In some cases, temporary veneer will be placed at this time. The permanent veneer should be ready in approximately one to two weeks.

Bonding

At the time of your third appointment, your doctor will first place the veneer on your teeth with water or glycerin to check the fit and color. At this point, the color of the veneer can still be adjusted by the shade of the cement used to adhere it. Once the color is determined and the veneer is ready to be applied, the tooth is cleaned with specific chemicals to achieve a bond. A special cement is placed between the teeth and the veneer and a visible light beam is used to harden the cement. This appointment takes approximately one to two hours.

Care & Follow-Up

Brush and floss daily. Return for a follow-up visit after one to two weeks.

Maintenance Of Your New Veneers

Brush and floss as you normally would. Don’t be afraid that you will damage your veneers by doing so. Non-abrasive toothpaste is recommended. A good home care regimen will insure the best aesthetic success of your veneer.
You may experience some sensitivity to hot and cold after placement of your veneer. This is due to the amount of enamel left on the tooth after preparation. Sensitivity is totally normal and should dissipate in one to two weeks. If sensitivity persists, please call the office.
If you are a known clencher (bruxer), please be sure to let us know. Your doctor may recommend a soft nightguard for you to wear to minimize stress placed upon your teeth while you sleep.
We hope that your new veneers fulfill your esthetic goal. With proper home care and scheduled visits, they are sure to provide you with a beautiful smile for years to come.

Sealants

Highly effective in preventing decay on the biting surfaces of your chewing teeth, sealants are a simple procedure in which a tooth-colored acrylic "coating" is painted onto the surface of the tooth. This effectively "seals" the deep grooves acting as a barrier, protecting enamel from plaque and acids.
Sealants protect the depressions and grooves of your teeth from food particles and plaque that brushing and flossing can't reach.
Easy to apply, sealants take only a few minutes to seal each tooth. Sealants hold up well under the force of normal chewing and can last several years before a reapplication is needed.
Children and adults can benefit from sealants in the fight against tooth decay.

Fillings

A dental restoration or dental filling is a dental restorative material used artificially to restore the function, integrity and morphology of missing tooth structure. The structural loss typically results from caries or external trauma. Dental restorations may be fabricated out of a variety of materials:

Dental Amalgam

Dental Amalgam is a commonly used dental filling that has been used for over 150 years. It is a mixture of mercury with at least one other metal. Amalgam has many advantages over other restorative material, such as low cost, strength, durability, and bacteriostatic effects.
Amalgam is used in dentistry for a number of reasons. It is relatively easy to use and manipulate during placement; it remains soft for a short time so it can be packed to fill any irregular volume, and then forms a hard compound. Amalgam possesses greater longevity than other direct restorative materials, such as composite. On average, most amalgam restorations serve for 10 to 12 years, whereas resin-based composites serve for about half that time. However, with recent improvements in composite material science and a better understanding of the technique-sensitivity of placement, it should be noted that this difference is decreasing.
There are circumstances in which composite (white fillings) serves better than amalgam; when amalgam is not indicated, or when a more conservative preparation would be beneficial, composite is the recommended restorative material. These situations would include small occlusal restorations, in which amalgam would require the removal of a more sound tooth structure, as well as in "enamel sites beyond the height of contour."
The American Dental Association Council on Scientific Affairs has concluded that both amalgam and composite materials are considered safe and effective for tooth restoration.

Dental Composites

Dental composites are also called white fillings. Crowns and in-lays can also be made in the laboratory from dental composites. These materials are similar to those used in direct fillings and are tooth colored. Their strength and durability is not as high as porcelain or metal restorations and they are more prone to wear and discoloration.
Many people still have silver/mercury fillings in their mouths from years past. These fillings are not particularly pleasing to the eye, and we know that by unavoidable design, silver/mercury fillings ultimately result in a weaker tooth structure. Porcelain inlays and tooth-colored restorations (onlays) create fillings that are not only beautiful (or unnoticeable), but also add strength to weakened teeth. These restorations are aesthetically pleasing and very strong thanks to new bonding technologies.

Disadvantages Of Silver Fillings

Silver fillings have many drawbacks. The edges of the silver filling can wear down, become weak or break. This results in the tooth not being protected and creates an environment where cavities get started once again. With age, the metal of a silver filling expands, contracts, and can split.
Silver fillings contain 50 percent mercury. They can corrode, leak, and cause stains on your teeth and gums.
Fortunately, silver fillings can safely be replaced with tooth-colored restorations.

Advantages of Tooth-Colored Restorations

There are many advantages to tooth-colored restorations. Resin onlays are bonded to the teeth creating a tight, superior fit to the natural tooth. Such restorations can be used in instances where much of the tooth structure has been lost. The tooth remains intact and stronger.
Since the resin used in tooth-colored restorations contain fluoride this can help prevent decay. The resin wears like natural teeth and does not require placement at the gum line, which is healthier for your gums!
The result is a beautiful smile!

Replacing Silver Fillings With A Tooth-Colored Restoration

You can have your silver fillings replaced with tooth-colored restorations (onlays). This process requires two appointments.

Your First Appointment

• The old filling is removed and any additional decay.
• An impression is made of your teeth. A model of your teeth is made and sent to the lab.
• A temporary onlay is placed on the tooth.

At The Lab

A resin is carefully placed into the model of your teeth. It is then designed to look like your natural tooth.

Your Second Appointment

• The temporary onlay is removed.
• A conditioning gel is placed on your tooth to prepare it for the new onlay.
• Bonding cement is placed on the tooth and a high intensity light bonds the resin to the tooth.
• The tooth is then polished.

Your teeth are restored to a natural look and feel, they are stronger and the tooth is protected!

Our program consists of:

• Dental Wellness Days
• Health Awareness Events
• Brown Bag Seminars


• Health Fair Coordination
• Complimentary Brochures
• Payroll Stuffer Program


• Dental Health Screenings
• Newsletter Service

Smile Finders is Often requested to participate in other company events such as:

• Blood Drives
• Safety Meetings
• Company Picnics
• Health Fairs


• Open Enrollment
• Ride Share Events
• Employee Appreciation Days

Cosmetic Periodontal Surgery

These procedures are a predictable way to cover unsightly, sensitive, or exposed root surfaces and to prevent future gum recession. If you are unhappy with the appearance of short unsightly teeth this can be greatly improved by a combination of periodontal procedures by your doctor and cosmetic dentistry by your dentist.
Although your teeth appear short, they may actually be the proper length. The teeth may be covered with too much gum tissue. We can correct this by performing the periodontal plastic surgery procedure, crown lengthening.
During this procedure, excess gum and bone tissue are reshaped to expose more of the natural tooth. This can be done to more than one tooth, to even your gum line, and to create a beautiful smile.
Another cosmetic procedure is the soft tissue graft. It is used to cover unattractive tooth roots, reduce gum recession, and protect the roots from decay and eventual loss.
Tooth loss causes the jawbone to recede and can lead to an unnatural looking indentation in your gums and jaw, an appearance of a general aging. The original look of your mouth may not be recaptured because of spaces remaining under and between replacement teeth. They may appear too long compared to nearby teeth.
Bone grafting following tooth loss can preserve the socket/ridge and minimize gum and bone collapse. There is less shrinkage and a more aesthetic tooth replacement for either an implant crown or fixed bridge around the replacement teeth.

Guided Tissue Bone Regeneration

Traditionally, eliminating the gum pockets by trimming away the infected gum tissue and by re-contouring the uneven bone tissue treats gum disease. Although this is still an effective way of treating gum disease, new and more sophisticated procedures are used routinely today.
Guided tissue bone regeneration regenerates the previously lost gum and bone tissue. Most techniques utilize membranes that are inserted over the bone defects. Some of these membranes are bio-absorbable and some require removal. Other regenerative procedures involve the use of bioactive gels.

Crown lengthening

Crown lengthening (or crown exposure) is required when your tooth needs a new crown or other restoration. The edge of that restoration is deep below the gum tissue and not accessible. It is also usually too close to the bone or below the bone.
The procedure involves adjusting the level of the gum tissue and bone around the tooth in question to create a new gum-to–tooth relationship. This allows us to reach the edge of the restoration, ensuring a proper fit to the tooth. It should also provide enough tooth structure so the new restoration will not come loose in the future. This allows you to clean the edge of the restoration when you brush and floss to prevent decay and gum disease. The procedure takes approximately one hour.
When the procedure is completed, sutures, and a protective bandage are placed to help secure the new gum-to-tooth relationship. You will need to be seen in one or two weeks to remove the sutures and evaluate your healing.

Gum Grafting

When recession of the gingiva occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem, gum reconstruction using grafting techniques is an option.
When there is only minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the mucosa, the first line of defense against bacterial penetration is lost.
In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance of the gum and tooth. When significant, gum recession can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to root caries and root gouging.
A gingival graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth or gently moved over from adjacent areas to provide a stable band of attached gingiva around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root.
The gingival graft procedure is highly predictable and results in a stable healthy band of attached tissue around the tooth.

Osseous Surgery

One of the most common surgical procedures, incisions are made around the tooth, and the gum tissue is pulled back slightly. This provides access to thoroughly remove all plaque and calculus. Irregularities of the bone caused by the disease are smoothed over and the tissue placed at a higher level around the tooth, closer to the bone. When the procedure is completed, “dissolving” sutures are used. A protective dressing often is placed around the necks of the teeth to cover the surgical area and to help secure the new gum-to-tooth relationship.  You will need to be seen in 10-14 days to remove any remaining sutures and evaluate your healing.
By moving the gum closer to the bone, the pockets will be reduced or eliminated. However, the tooth will appear longer and the spaces between the teeth will be larger. In cosmetic areas, other treatment options may be considered depending on how much gum tissue is exposed (“Smile Line”).

Oral Pathology

The inside of the mouth is normally lined with a special type of skin (mucosa) that is smooth and coral pink in color. Any alteration in this appearance could be a warning sign for a pathological process. The most serious of these is oral cancer. The following can be signs at the beginning of a pathologic process or cancerous growth:

• Reddish patches (erythroplasia) or whitish patches (leukoplakia) in the mouth.
• A sore that fails to heal and bleeds easily.
• A lump or thickening on the skin lining the inside of the mouth.
• Chronic sore throat or hoarseness.
• Difficulty in chewing or swallowing.

These changes can be detected on the lips, cheeks, palate, and gum tissue around the teeth, tongue, face, and/or neck. Pain does not always occur with pathology and, curiously, is not often associated with oral cancer. However, any patient with facial and/or oral pain without an obvious cause or reason may also be at risk for oral cancer. We would recommend performing an oral cancer self-examination monthly and remember that your mouth is one of your body's most important warning systems. Do not ignore suspicious lumps or sores. Please contact us so we may help.

Oral Hygiene

While brushing the outside surfaces of your teeth, position the brush at a 45-degree angle where your gums and teeth meet. Gently move the brush in a circular motion several times using small, gentle strokes. Use light pressure while putting the bristles between the teeth, but not so much pressure that you feel any discomfort.
When you are done cleaning the outside surfaces of all your teeth, follow the same directions while cleaning the inside of the back teeth.
To clean the inside surfaces of the upper and lower front teeth, hold the brush vertically. Make several gentle back-and-forth strokes over each tooth. Don't forget to gently brush the surrounding gum tissue.
Next you will clean the biting surfaces of your teeth. To do this use short, gentle strokes. Change the position of the brush as often as necessary to reach and clean all surfaces. Try to watch yourself in the mirror to make sure you clean each surface. After you are done, rinse vigorously to remove any plaque you might have loosened while brushing.
If you have any pain while brushing or have any questions about how to brush properly, please be sure to call the office.

How to Floss

Periodontal disease usually appears between the teeth where your toothbrush cannot reach. Flossing is a very effective way to remove plaque from those surfaces. However, it is important to develop the proper technique. The following instructions will help you, but remember it takes time and practice.
Start with a piece of floss (waxed is easier) about 18" long. Lightly wrap most of the floss around the middle finger of one hand. Wrap the rest of the floss around the middle finger of the other hand.
To clean the upper teeth, hold the floss tightly between the thumb and forefinger of each hand. Gently insert the floss tightly between the teeth using a back-and-forth motion. Do not force the floss or try to snap it in to place. Bring the floss to the gum line then curve it into a C-shape against one tooth. Slide it into the space between the gum and the tooth until you feel light resistance. Move the floss up and down on the side of one tooth. Remember there are two tooth surfaces that need to be cleaned in each space. Continue to floss each side of all the upper teeth. Be careful not to cut the gum tissue between the teeth. As the floss becomes soiled, turn from one finger to the other to get a fresh section.
To clean between the bottom teeth, guide the floss using the forefinger of both hands. Do not forget the back side of the last tooth on both sides, upper and lower.
When you are done, rinse vigorously with water to remove plaque and food particles. Do not be alarmed if during the first week of flossing your gums bleed or are a little sore. If your gums hurt while flossing you could be doing it too hard or pinching the gum. As you floss daily and remove the plaque your gums will heal and the bleeding should stop.

Caring For Sensitive Teeth

Sometimes after dental treatment, teeth are sensitive to hot and cold. This should not last long, but only if the mouth is kept clean. If the mouth is not kept clean the sensitivity will remain and could become more severe. If your teeth are especially sensitive, consult with your doctor. They may recommend a medicated toothpaste or mouth rinse made especially for sensitive teeth.

Choosing Oral Hygiene Products

There are so many products on the market it can become confusing and choosing between all the products can be difficult. Here are some suggestions for choosing dental care products that will work for most patients.
Automatic and "high-tech" electronic toothbrushes are safe and effective for the majority of the patients. Oral irrigators (water spraying devices) will rinse your mouth thoroughly, but will not remove plaque. You need to brush and floss in conjunction with the irrigator. We see excellent results with electric toothbrushes called Rotadent and Interplak.
Some toothbrushes have a rubber tip on the handle, this is used to massage the gums after brushing. There are also tiny brushes (interproximal toothbrushes) that clean between your teeth. If these are used improperly you could injure the gums, so discuss proper use with your doctor.
If used in conjunction with brushing and flossing, fluoride toothpastes and mouth rinses can reduce tooth decay as much as 40 percent. Remember, these rinses are not recommended for children under six years of age. Tartar control toothpastes will reduce tartar above the gum line, but gum disease starts below the gum line so these products have not been proven to reduce the early stage of gum disease.
Anti-plaque rinses, approved by the American Dental Association, contain agents that may help bring early gum disease under control. Use these in conjunction with brushing and flossing.
Your periodontist is the best person to help you select the right products that are best for you.

Professional Cleaning

Daily brushing and flossing will keep dental calculus to a minimum, but a professional cleaning will remove calculus in places your toothbrush and floss have missed. Visit your periodontist, as he or she is an important part of your program to prevent gum disease. Keep your teeth for your lifetime.

Invisalign

The invisible way to straighten your teeth without braces. To discuss Invisalign® please feel free to contact us to schedule an appointment.
For more information on Invisalign, please visit www.invisalign.com.

• Invisalign® uses a series of clear removable aligners to straighten your teeth without metal wires or brackets.
• The aligners are made through a combination of your doctor's expertise and 3-D computer imaging technology.
• You wear each set of aligners for about 2 weeks, removing them only to eat, drink, brush, and floss.
• As you replace each aligner with the next in the series, your teeth will move - little by little, week by week - until they have straightened to the final position your doctor has prescribed.
• You'll visit your doctor about once every 6 weeks to ensure that your treatment is progressing as planned.

Total treatment time averages 9 - 15 months and the average number of aligners worn during treatment is between 18 and 30, but both will vary from case to case.

Headgear

Orthodontic headgear is a very important part of the treatment for some patients. Headgear creates forces that guide the growth of the face and jaws. It also is used to move teeth into better positions or to prevent teeth from moving.
Maintaining constant use of your headgear will achieve the best results. If instructions on usage are not followed, treatment will take longer and our treatment plan may have to change.

• Always be careful when removing your headgear. If the headgear is removed carelessly, the part that fits in your mouth and attaches to your teeth could injure your lips, cheeks, face and possibly your eyes.
• Never remove the headgear until the straps have been disconnected.
• Never lift the headgear over your face.
• Never wear the headgear when running or playing sports.

Take your headgear with you to every appointment. If it becomes soiled, your doctor will tell you how it should be cleaned.
Your teeth may be tender for the first few days of wearing your headgear. This tenderness will disappear as you adjust to the new pressures.
Let your doctor know if you continue to be uncomfortable for more than a few days. Wearing headgear is necessary for your treatment. Follow the instructions exactly, and you will complete your treatment without any changes in your treatment plan.

Different Types of Braces

Metal braces are the most popular with kids and teenagers. They love using different colors of ligature ties. These braces are much smaller than ever before.
Gold braces are the newest addition to our line of brackets. They are stainless steel braces coated with 24 karat gold. They have the strength of metal, but blend in with the color of the teeth much better. That is because most teeth have a natural yellow tint. Quite often, we will put ceramic braces on the top teeth and gold braces on the bottom.
Translucent clear ceramic braces are the most popular with adults. You have to be very close to someone to be able to see them. Yet, because they are a ceramic material, they are more fragile.

How do braces straighten crooked teeth?

Braces use constant, gentle pressure, which over time, move teeth into their proper positions. Your braces are at work every moment of your orthodontic treatment. The two main components of your braces are: the brackets that are placed on your teeth and the main archwire that connects them. The bracket is a piece of shaped metal or ceramic that we affix to each tooth. The archwire is bent to reflect your "ideal" bite. In other words, it reflects the way we want you to look after treatment.
The wire threads through the brackets and, as the wire tries to return to its original shape, it applies pressure to move your teeth. Picture your tooth resting in your jaw bone. With pressure on one side from the archwire, the bone on the other side gives way. The tooth moves. New bone grows in behind.

Attached to your braces, elastics (rubber bands) exert the proper force that creates the right amount of pressure to move teeth. In order for this force to remain constant, elastics must be worn all the time and changed every day.

Dental Implants

Dental implants are changing the way people live. They are designed to provide a foundation for replacement teeth that look, feel, and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything, knowing that teeth appear natural and that facial contours will be preserved. Patients with dental implants can smile with confidence.

What Are Dental Implants?

The implants themselves are tiny titanium posts that are surgically placed into the jawbone where teeth are missing. These metal anchors act as tooth root substitutes. The bone bonds with the titanium, creating a strong foundation for artificial teeth. Small posts that protrude through the gums are then attached to the implant. These posts provide stable anchors for artificial replacement teeth.
Implants also help preserve facial structure, preventing bone deterioration that occurs when teeth are missing.

The Surgical Procedure

For most patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jawbone. For the first three to six months following surgery, the implants are beneath the surface of the gums gradually bonding with the jawbone. You should be able to wear temporary dentures and eat a soft diet during this time. At the same time, your dentist is forming new replacement teeth.
After the implant has bonded to the jawbone, the second phase begins. Your doctor will uncover the implants and attach small posts that protrude through the gums and will act as anchors for the artificial teeth. When the artificial teeth are placed, these posts will not be seen. The entire procedure usually takes six to eight months. Most patients experience minimal disruption in their daily life.

Surgical Advances

Using the most recent advances in dental implant technology, your doctor is able to place single stage implants. These implants do not require a second procedure to uncover them, but do require a minimum of six weeks of healing time before artificial teeth are placed. There are even situations where the implants can be placed at the same time as a tooth extraction – further minimizing the number of surgical procedures. Advances in dental implant technology have made it possible, in select cases, to extract teeth and place implants with crowns at one visit. This procedure, called “immediate loading”, actually performs the implant placement?
Implants are a team effort between an oral and maxillofacial surgeon and a restorative dentist. While your doctor performs the actual implant surgery, initial tooth extractions, and bone grafting if necessary, the restorative dentist (your dentist) fits and makes the permanent prosthesis. Your dentist will also make any temporary prosthesis needed during the implant process.

Dental Implant Presentation

To provide you with a better understanding of dental implants, we have provided the following multimedia presentation. Many common questions pertaining to dental implants are discussed.

Having trouble? Please make sure you have version 9 of the Flash browser plugin in order to correctly view this presentation. This software is available as a free download.

What Types Of Prosthesis Are Available?

A single prosthesis (crown) is used to replace one missing tooth – each prosthetic tooth attaches to its own implant. A partial prosthesis (fixed bridge) can replace two or more teeth and may require only two or three implants. A complete dental prosthesis (fixed bridge) replaces all the teeth in your upper or lower jaw. The number of implants varies depending upon which type of complete prosthesis (removable or fixed) is recommended. A removable prosthesis (over denture) attaches to a bar or ball in socket attachments, whereas a fixed prosthesis is permanent and removable only by the dentist.
Your doctor performs in-office implant surgery in a hospital-style operating suite, thus optimizing the level of sterility. Inpatient hospital implant surgery is for patients who have special medical or anesthetic needs or for those who need extensive bone grafting from the jaw, hip or tibia.

Why Dental Implants?

Once you learn about dental implants, you finally realize there is a way to improve you life. When you lose several teeth – whether it’s a new situation or something you have lived with for years – chances are you have never become fully accustomed to losing such a vital part of yourself.
Dental implants can be your doorway to renewed self-confidence and peace of mind.
A Swedish scientist and orthopedic surgeon, Dr. Per-Ingvar Branemark, developed this concept for oral rehabilitation more than 35 years ago.  With his pioneering research, Dr. Branemark opened the door to a lifetime of renewed comfort and self-confidence for millions of individuals facing the frustration and embarrassment of tooth loss.

Why Select Dental Implants Over More Traditional Types Of Restorations?

There are several reasons: Why sacrifice the structure of surrounding good teeth to bridge a space? In addition, removing a denture or a “partial” at night may be inconvenient, not to mention that dentures that slip can be uncomfortable and rather embarrassing.

Are You A Candidate For Implants?

If you are considering implants, your mouth must be examined thoroughly and your medical and dental history reviewed. If you mouth is not ideal for implants, ways of improving outcome, such as bone grafting, may be recommended.

What Type Of Anesthesia Is Used?

The majority of dental implants and bone graft can be performed in the office under local anesthesia, with or without general anesthesia.

Do Implants Need Special Care?

Once the implants are in place, they will serve you well for many years if you take care of them and keep your mouth healthy. This means taking the time for good oral hygiene (brushing and flossing) and keeping regular appointments with your dental specialists.

Teeth-In-An-Hour™

TEETH-IN-AN-HOUR™ is a revolutionary concept providing patients with fully functioning teeth on dental implants in one single procedure that lasts about an hour. This technology was recently developed by Nobel Biocare and allows for collaboration between both the restorative doctor and the surgeon. This merging of knowledge and experience achieves not only increased safety, but also a more precise implant placement. In addition, the fabrication of a final prosthesis is completed prior to the surgery. The computer-guided implant surgery is done in an arthroscopic fashion without requiring any flap reflection. This benefits the patient in that there is less postoperative discomfort, less swelling and less bruising. Patients can often resume their normal activities the next day.
The process starts when a CAT scan is taken of the patient's jawbone. This CAT scan allows for the generation of a three-dimensional model of the jawbone that can then be used in virtual reality software to plan the implant placement without the presence of the patient. The results are more accurate implant placement, and less chair time for the patient at the surgery office.

Facial Trauma

The dental specialist performs the proper treatment of facial injuries. These professionals must be well versed in emergency care, acute treatment and long-term reconstruction and rehabilitation – not just for physical reasons but emotional as well. Oral and maxillofacial surgeons are trained, skilled and uniquely qualified to manage and treat facial trauma. Injuries to the face, by their very nature, impart a high degree of emotional, as well as physical trauma to patients. The science and art of treating these injuries requires special training involving a “hands on” experience and an understanding of how the treatment provided will influence the patient’s long term function and appearance.
Your doctor meets and exceeds these modern standards. They are trained, skilled, and uniquely qualified to manage and treat facial trauma. They are on staff at local hospitals and deliver emergency room coverage for facial injuries, which include the following conditions:

• Facial lacerations
• Intra oral lacerations
• Avulsed (knocked out) teeth
• Fractured facial bones (cheek, nose or eye socket)
• Fractured jaws (upper and lower jaw)

The Nature Of Maxillofacial Trauma

There are a number of possible causes of facial trauma such as motor vehicle accidents, accidental falls, sports injuries, interpersonal violence, and work-related injuries. Types of facial injuries can range from injuries of teeth to extremely severe injuries of the skin and bones of the face. Typically, facial injuries are classified as either soft tissue injuries (skin and gums), bone injuries (fractures), or injuries to special regions (such as the eyes, facial nerves or the salivary glands).

Soft Tissue Injuries Of The Maxillofacial Region

When soft tissue injuries such as lacerations occur on the face, they are repaired by suturing. In addition to the obvious concern of providing a repair that yields the best cosmetic result possible, care is taken to inspect for and treat injuries to structures such as facial nerves, salivary glands, and salivary ducts (or outflow channels). Your doctor is a well-trained oral and maxillofacial surgeon and is proficient at diagnosing and treating all types of facial lacerations.

Bone Injuries Of The Maxillofacial Region

Fractures of the bones of the face are treated in a manner similar to the fractures in other parts of the body. The specific form of treatment is determined by various factors, which include the location of the fracture, the severity of the fracture, the age, and general health of the patient. When an arm or a leg is fractured, a cast is often applied to stabilize the bone to allow for proper healing. Since a cast cannot be placed on the face, other means have been developed to stabilize facial fractures.
One of these options involves wiring the jaws together for certain fractures of the upper and/or lower jaw. Certain other types of fractures of the jaw are best treated and stabilized by the surgical placement of small plates and screws at the involved site. This technique of treatment can often allow for healing and obviates the necessity of having the jaws wired together. This technique is called "rigid fixation" of a fracture. The relatively recent development and use of rigid fixation has profoundly improved the recovery period for many patients, allowing them to return to normal function more quickly.
The treatment of facial fractures should be accomplished in a thorough and predictable manner. More importantly, the patient's facial appearance should be minimally affected. An attempt at accessing the facial bones through the fewest incisions necessary is always made. At the same time, the incisions that become necessary, are designed to be small and, whenever possible, are placed so that the resultant scar is hidden.

Injuries To The Teeth & Surrounding Dental Structures

Isolated injuries to teeth are quite common and may require the expertise of various dental specialists. Oral surgeons usually are involved in treating fractures in the supporting bone or in replanting teeth that have been displaced or knocked out. These types of injuries are treated by one of a number of forms of splinting (stabilizing by wiring or bonding teeth together). If a tooth is knocked out, it should be placed in salt water or milk. The sooner the tooth is re-inserted into the dental socket, the better chance it will survive. Therefore, the patient should see a dentist or oral surgeon as soon as possible. Never attempt to wipe the tooth off, since remnants of the ligament that hold the tooth in the jaw are attached and are vital to the success of replanting the tooth. Other dental specialists may be called upon such as endodontists, who may be asked to perform root canal therapy, and/or restorative dentists who may need to repair or rebuild fractured teeth. In the event that injured teeth cannot be saved or repaired, dental implants are often now utilized as replacements for missing teeth.
The proper treatment of facial injuries is now the realm of specialists who are well versed in emergency care, acute treatment, long-term reconstruction, and rehabilitation of the patient.

Orthognathic Surgery

Orthognathic surgery is needed when jaws don't meet correctly and/or teeth don't seem to fit with jaws. Teeth are straightened with orthodontics and corrective jaw surgery repositions a misaligned jaw. This not only improves facial appearance, but also ensures that teeth meet correctly and function properly.

Who Needs Orthognathic Surgery?

People who can benefit from orthognathic surgery include those with an improper bite or jaws that are positioned incorrectly. Jaw growth is a gradual process and in some instances, the upper and lower jaws may grow at different rates. The result can be a host of problems that can affect chewing function, speech, long-term oral health and appearance. Injury to the jaw and birth defects can also affect jaw alignment. Orthodontics alone can correct bite problems when only the teeth are involved. Orthognathic surgery may be required for the jaws when repositioning in necessary.
Difficulty in the following areas should be evaluated:

• Difficulty in chewing, biting or swallowing
• Speech problems
• Chronic jaw or TMJ pain
• Open bite
• Protruding jaw
• Breathing problems

Any of these symptoms can exist at birth, be acquired after birth as a result of hereditary or environmental influences, or as a result of trauma to the face. Before any treatment begins, a consultation will be held to perform a complete examination with x-rays. During the pre-treatment consultation process, feel free to ask any questions that you have regarding your treatment. When you are fully informed about the aspects of your care, you and your dental team can make the decision to proceed with treatment together.

Technology & Orthognathic Surgery

Your doctor uses modern computer techniques and three-dimensional models to show you exactly how your surgery will be approached. Using comprehensive facial x-rays and computer video imaging, we can show you how your bite will be improved and even give you an idea of how you'll look after surgery. This helps you understand the surgical process and the extent of the treatment prescribed. Our goal is to help you understand the benefits of orthognathic surgery.
If you are a candidate for corrective jaw surgery, your doctor will work closely with your dentist and orthodontist during your treatment. The actual surgery can move your teeth and jaws into a new position that results in a more attractive, functional, and healthy dental-facial relationship.

Oral Surgery: Wisdom Teeth

By the age of 18, the average adult has 32 teeth; 16 teeth on the top and 16 teeth on the bottom. Each tooth in the mouth has a specific name and function. The teeth in the front of the mouth (incisors, canine, and bicuspid teeth) are ideal for grasping and biting food into smaller pieces. The back teeth (molar teeth) are used to grind food up into a consistency suitable for swallowing.
The average mouth is made to hold only 28 teeth. It can be painful when 32 teeth try to fit in a mouth that holds only 28 teeth. These four other teeth are your third molars, also known as "wisdom teeth."

Why Should I Have My Wisdom Teeth Removed?

Wisdom teeth are the last teeth to erupt within the mouth. When they align properly and gum tissue is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen. The extraction of wisdom teeth is necessary when they are prevented from properly erupting within the mouth. They may grow sideways, partially emerge from the gum, and even remain trapped beneath the gum and bone. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to successfully erupt.
These poorly positioned impacted teeth can cause many problems. When they are partially erupted, the opening around the teeth allows bacteria to grow and will eventually cause an infection. The result: swelling, stiffness, pain, and illness. The pressure from the erupting wisdom teeth may move other teeth and disrupt the orthodontic or natural alignment of teeth. The most serious problem occurs when tumors or cysts form around the impacted wisdom teeth, resulting in the destruction of the jawbone and healthy teeth. Removal of the offending impacted teeth usually resolves these problems. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure.

Oral Examination

With an oral examination and x-rays of the mouth, your doctor can evaluate the position of the wisdom teeth and predict if there are present or may be future problems. Studies have shown that early evaluation and treatment result in a superior outcome for the patient. Patients are generally first evaluated in the mid-teenage years by their dentist, orthodontist or by an oral and maxillofacial surgeon.
All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort. Your doctor has the training, license and experience to provide various types of anesthesia for patients to select the best alternative.

Removal

In most cases, the removal of wisdom teeth is performed under local anesthesia, laughing gas (nitrous oxide/oxygen analgesia) or general anesthesia. These options, as well as the surgical risks (i.e., sensory nerve damage, sinus complications), will be discussed with you before the procedure is performed. Once the teeth are removed, the gum is sutured. To help control bleeding, bite down on the gauze placed in your mouth. You will rest under our supervision in the office until you are ready to be taken home. Upon discharge, your postoperative kit will include postoperative instructions, a prescription for pain medication, antibiotics, and a follow-up appointment in one week for suture removal. If you have any questions, please do not hesitate to call us.
Our services are provided in an environment of optimum safety that utilizes modern monitoring equipment and staff who are experienced in anesthesia techniques.

Pedontics

Children’s Dentistry

Your Child's First Visit

The first "regular" dental visit should be just after your child's third birthday. The first dental visit is usually short and involves very little treatment. We may ask the parent to sit in the dental chair and hold their child during the examination. The parent may also be asked to wait in the reception area during part of the visit so that a relationship can be built between your child and your dentist.
We will gently examine your child's teeth and gums. X-rays may be taken (to reveal decay and check on the progress of your child's permanent teeth under the gums). We may clean your child's teeth and apply topical fluoride to help protect the teeth against decay. We will make sure your child is receiving adequate fluoride at home. Most important of all, we will review with you how to clean and care for your child's teeth.

What Should I Tell My Child About Their First Dental Visit?

We are asked this question many times. We suggest you prepare your child the same way that you would before their first haircut or trip to the shoe store. Your child's reaction to his first visit to the dentist may surprise you.

Some First Visit Tips

• Take your child for a "preview" or online tour of the office.
• Read books with them about going to the dentist.
• Review with them what the dentist will be doing at the time of the first visit.
• Speak positively about your own dental experiences

What Will Happen During The First Visit With Your Dentist?

• Examination of your child’s mouth, teeth, and gums.
• Evaluate adverse habits like thumb sucking
• Check to see if your child need fluoride
• Teach you about cleaning your child’s teeth and gums.
• Suggest a schedule for regular dental visits.

What About Preventive Care?

Tooth decay and children no longer have to go hand-in-hand. At our office, we are most concerned with all aspects of preventive care. We use the latest in sealant technology to protect your child's teeth. Sealants are space-age plastics that are bonded to the chewing surfaces of decay prone back teeth. This is just one of the ways we will set the foundation for your child's lifetime of good oral health.

Cavity Prevention

Most of the time cavities are due to a diet high in sugary foods and a lack of brushing. Limiting sugar intake and brushing regularly, of course, can help. The longer it takes your child to chew their foods the longer the residue stays on their teeth, the greater the chances of getting cavities.
Every time someone eats, an acid reaction occurs inside their mouth as the bacteria digests the sugars. This reaction lasts approximately 20 minutes. During this time the acid environment can destroy the tooth structure, eventually leading to cavities.
Consistency of a person's saliva also makes a difference. Thinner saliva breaks up and washes away food more quickly. When a person eats diets high in carbohydrates and sugars, they tend to have thicker saliva that allows more acid-producing bacteria that can cause cavities.

Tips For Cavity Prevention

• Limit frequency of meals and snacks.
• Encourage brushing, flossing, and rinsing.
• Watch what you drink.
• Avoid sticky foods.
• Make treats part of meals.
• Choose nutritious snacks.

The first baby teeth that come into the mouth are the two bottom front teeth. You will notice this when your baby is about six to eight months old. Next to follow will be the four upper front teeth and the remainder of your baby's teeth will appear periodically. They will usually appear in pairs along the sides of the jaw until the child is about 2-1/2 years old.
At around 2-1/2 years old, your child should have all 20 teeth. Between the ages of five and six, the first permanent teeth will begin to erupt. Some of the permanent teeth replace baby teeth and some don't. Don't worry if some teeth are a few months early or lat. All children are different.
Baby teeth are important as they not only hold space for permanent teeth, but they are important to chewing, biting, speech, and appearance. For this reason it is important to maintain a healthy diet and daily hygiene.

Endodontics

Endodontic FAQ

What is endodontics?

Endodontics is a branch of dentistry recognized by the American Dental Association involving treatment of the pulp (root canal) and surrounding tissues of the tooth. When you look at your tooth in the mirror, what you see is the crown. The rest of the tooth, the portion hidden beneath the gum line, is called the root. Though the outer portion of the root is a hard tissue called dentin, the inside channel or "root canal" contains a pulp of soft tissue, blood vessels and nerves. Bacteria that are introduced into the pulp as a result of tooth decay, periodontal disease, tooth fracture or other problems, can severely damage the pulp. When that happens, an endodontic specialist removes the diseased pulp to save the tooth and prevent further infection and inflammation. After successful endodontic treatment, the tooth continues to perform normally.

I'm worried about x-rays. Should I be?

No. While x-rays will be necessary during your endodontics treatment, we use an advanced non-film computerized system, called digital radiography, that produces radiation levels up to 90 percent lower than those of already low dose conventional dental x-ray machinery. These digital images can be optimized, archived, printed and sent to cotherapists via e-mail or diskette. For more information contact Schick Technologies, Inc.

What about infection?

Again, there's no need for concern. We adhere to the most rigorous standards of infection control advocated by OSHA, the Centers for Disease Control and the American Dental Association. We utilize autoclave sterilization and barrier techniques to eliminate any risk of infection.

What happens after treatment?

When your root canal therapy has been completed, a record of your treatment will be sent to your restorative dentist. You should contact his office for a follow-up restoration within a few weeks of completion at our office. Your restorative dentist will decide on what type of restoration is necessary to protect your tooth. It is rare for endodontic patients to experience complications after routine endodontic treatment or microsurgery. If a problem does occur, however, we are available at all times to respond.

What new technologies are being used?

Operating Microscopes:

In addition to digital radiography, we utilize special operating microscopes. Magnification and fiber optic illumination are helpful in aiding the doctor to see tiny details inside your tooth. Also, a tiny video camera on the operating microscope can record images of your tooth to further document the doctor's findings.

Electric Apex Locators:

In certain cases electric apex locators can minimize the number of x-rays needed to complete root canal treatment.

Ultrasonics:

Ultrasonic instruments can be valuable to remove or loosen obstructions that would otherwise prevent reliable endodontic therapy.

Periodontics

Periodontal Disease - What Causes It

Periodontal diseases are ongoing infections of the gums that gradually destroy the support of your natural teeth. Dental plaque is the primary cause of gum disease in genetically-susceptible individuals. Bacteria found in plaque produce toxins or poisons that irritate the gums.  They may cause them to turn red, swell, and bleed easily. If this irritation is prolonged, the gums separate from the teeth causing pockets (spaces) to form. Plaque can also harden into a rough, porous substance known as calculus (or tartar). This can occur both above and below the gum line. As periodontal diseases progress, the supporting gum tissue and bone that holds teeth in place deteriorate. If left untreated, this leads to tooth loss. However, don’t be fooled. With periodontal disease, bleeding, redness, and swelling do not have to be present. Further, pain is usually not associated with periodontal disease. This disease damages the teeth, gum, and jawbone of more than 80 percent of Americans by age 45.

What Causes It

Periodontal Disease as well as decay are both caused by Bacterial Plaque. Plaque is a sticky colorless film, composed primarily of various types of bacteria, which adhere to your teeth at and below the gum line. Plaque constantly forms on your teeth. It begins to form within minutes after cleaning. If not carefully removed by daily brushing and flossing, plaque hardens into a rough, porous substance known as calculus (or tartar). This cannot be removed without professional cleaning.
The Bacterial plaque produces toxins or poisons that irritate the gums, which may (but not always) cause them to turn red, swell and bleed easily. If this irritation is prolonged, the gums separate from the teeth, causing Periodontal Pockets (spaces) to form along the tooth. As periodontal diseases progress, the supporting gum tissue and bone that holds teeth in place deteriorate. If left untreated, this leads to tooth loss. 

Orthodontics

Diagnostic Records & Treatment Planning

If it is determined that treatment is indicated, you will be scheduled for diagnostic records. These records usually consist of study models, diagnostic photographs and orthodontic x-rays. Once these orthodontic records have been obtained, your doctor will review them and determine a specific treatment plan for your orthodontic needs. Then our office will give you a call to review your treatment plan, set up the necessary appointments to begin your orthodontic treatment and set up financial arrangements for you.

Successive Visits

Periodic visits are an important part of orthodontic treatment. Generally, we will want to see you every 4 to 8 weeks to check your progress and make adjustments to your braces. During this time, you will need to keep appointments, follow instructions, eat nutritiously and practice good oral hygiene. Also continue to visit your dentist regularly.
Once your braces are removed, retainers are utilized to hold your teeth in their new positions until your bone, gums and muscles adapt to the new teeth positions. The retention period is an important part of your overall treatment and should not be neglected!

Length of Treatment

Braces may be on between 6 months to 30 months or longer depending on the age of the patient, the severity of the problem, the patient's cooperation and the degree of movement possible.

Dental Care

Before any orthodontic treatment, your family dentist should make certain that all cavities have been treated and the health of your gums and underlying bone are free of periodontal disease.
In addition, your dentist or an oral surgeon will remove any teeth that your doctor prescribed to correct your bite. Your family dentist should also schedule cleaning and cavity checkup visits during your orthodontic care. We would like to reinforce the need to keep your regular visits with your family dentist because we are only an aid to your family dentist and not a replacement.
Please contact our office if you have any questions. The timing of your treatment is very important. You or your child may or may not be ready for treatment. Therefore, a consultation will allow us to better understand your needs.