Comprehensive Exam: This involves a detailed examination of your teeth, gums, soft tissues, tempormandibular joint and jaw muscles and includes a visual oral cancer screening. We consider the exam appointment the most important appointment as this is when any decay and other is noted, all the necessary diagnostic procedures are done (xrays, possibly photos diagnostic casts, etc) and appropriate treatment is decided.
Digital xrays: We use digital xrays at our practice. This cuts the radiation amount by almost 90% and there is no wait time.
Xrays are an essential part of a comprehensive exam and reveal many conditions that may not be apparent during a visual exam. Xrays help reveal early decay in between teeth, abscesses or cysts at the root tips, bone loss, cancerous/non cancerous lesions in the bone.
Teeth Cleaning: This includes gently scraping the tartar and plaque above the gumline with the Ultrasonic handpiece and hand instruments. Usually done for patients who have been diagnosed with healthy gums.
Fluoride Treatment: Fluoride helps to mineralise the enamel and make it more resistant to decay. In our office we deliver fluoride in the varnish form. The fluoride varnish is painted on the teeth especially the back chewing surfaces and left in place for 4-5 hours. During this time even though water, juice and eating is alright, sodas and any kind of chewy, sticky and hard foods must be avoided. You may brush your teeth to get it off after 4-5 hours.
Fluoride treatment is usually done in children under 14 years. It may be recommended in adults who have a lot of crowns and fillings, people who are on medications and suffer from dry mouth and people who are prone to getting cavities.
Fluoride alone cannot stop decay. Good oral hygiene practices, healthy nutrition consisting of a lot of fruits and vegetables and regular dental checkups play a very important role.
Periodontal disease is the body’s response to bacteria and bacterial by products present in plaque and tartar. It affects the bone and other supporting structures of the teeth. Periodontal disease can lead to shifting teeth, lose teeth and is the most common cause if tooth loss. Periodontal disease usually starts with Gingivitis which is inflamed, tender and bleeding gums. It is very important to have regular dental checkups and cleanings to prevent the progression of gingivitis to periodontitis. Gingivitis is also one of the common chronic oral diseases seen in school age children.
Chronic Adult periodontitis is classified into mild, moderate and severe. The treatment for mild and moderate periodontitis is usually a non-surgical procedure called Scaling and root planing which we do at our office. Patients with moderate periodontitis that does not respond as expected to non-surgical therapy and those with severe periodontitis are referred to a gum specialist (Periodontist).
Non surgical gum therapy(Scaling and Root Planing): This is a procedure done in patients diagnosed with mild to moderate gum disease. The gums are numbed and the plaque, tartar and bacterial film is removed from below the gum line and the root surfaces are smoothed to facilitate healthier gum attachment with the root.
If the patient’s response to the treatment is not optimal then the dentist and hygienist may recommend that you see a Periodontist.
Arestin: This is an antibiotic (minocycline) that is placed directly into the gum pocket in cases where the scaling and root planing has already been done and there are persistent isolated inflamed pockets. Since the antibiotic is used in very specific areas the body is exposed to a very small dose.
Periodontal Maintenance: This procedure is an important part of any periodontal treatment. After you have been treated by scaling and root planing or other gum treatment which may include surgery, your dentist or gum specialist will recommend that you have periodontal maintenance visits every 3- 4 mths. During these visits the Dentist and the hygienist will check your gum pockets, examine your teeth and existing fillings for decay, oral cancer screening and go over your oral hygiene routine.
Tooth Colored fillings: These are called Composite resin fillings.These fillings match the tooth color and bond to the it micromechanically and tend to have less leakage problems over the years as compared to silver mercury fillings.
Though composite fillings are durable and last a long time they may have to replaced someday.
Procedure: The decayed part of the tooth is removed, the prepared space cleaned and prepared before placing the filling and setting it with a special light. All this is done under local anesthetic.
SAME DAY CROWNS: Cerec is a CAD CAM system in which you scan the tooth and we do not have to use impression material as is done usually. The crown is made the same day that way patient saves time. They also do not have to deal with temporary crowns and wait for 2 weeks before the final crown comes back from the lab.
Tooth colored Crowns: Crowns or caps as they are sometimes called cover the tooth entirely and restore its form, function and appearance. It protects the tooth and prevents it from breaking in cases where fillings are not possible. A well made crown should last for many years but like anything that is in constant use, crowns may need to be replaced. Good oral hygiene and regular dental check ups help prolong the life of dental restorations.
The procedure involves 2 visits usually 2-3 weeks apart. The first visit is 1.5 hours long and involves preparing the tooth, taking an impression and selecting a shade to match your teeth.
A temporary crown is then placed to protect your tooth and maintain the space for the permanent crown. It is very important to get in touch with your dental office if a temporary crown breaks or come loose.
At the second visit the temporary crown is removed, tooth cleaned and the final crown is tried in. If it fits well and patient approves of the way it looks we go ahead and cement it with a permanent cement.
Crowns are always needed after a tooth has a root canal to prevent the tooth from breaking. They may be needed if a tooth is broken, has extensive decay or large old leaky fillings.
Onlays: This is a restoration made of resin, gold or porcelain. It can be an ideal replacement for crowns in some situations as less tooth structure is removed for preparing the tooth for it. The procedure for an onlay requires 2 visits about 2 weeks apart. At the first visit the tooth is numbed and prepared for the onlay. Impressions are then made and sent to the lab to have the onlay fabricated. In the meantime you are fitted with a temporary restoration to protect the tooth and maintain the space for the final restoration.
Veneers: Veneers are thin shells of porcelain that are custom made by your dentist and the dental lab to enhance your smile. These are bonded to your teeth.
As with other dental restorations veneers may need to be replaced someday due to staining or decay. However they are durable and can last many years.
You may need veneers if:
- Teeth are stained and discolored and do not respond to whitening.
- Crooked and misshapen
- Too small or too large.
The procedure for veneer involves 2 visits about 2 weeks apart. during the first vist the teeth are numbed and prepared minimally. impressions are taken, shade selected by you and your dentist together and sent to the lab to have the veneers fabricated. You will havve temporary veneers placed on your teeth for the interim.
On the second visit the temporaries are removed, teeth cleaned, veneers tried in and bonded to the teeth.
Teeth Whitening: Tooth whitening is a non invasive way of changing your tooth color in order to enhance your smile and make it more youthful.
We offer the opalescence system from Ultradent in our office. There are three ways of whitening your teeth:
- Preloaded trays
- In office one hour whitening
- Custom made take home trays
All the above methods get the same result and only differ in the time needed. Whitening may not work the same for everyone. Some of us will respond better than others. Teeth with stains on the surface will respond better than teeth with intrinsic and tetracycline stains.
Invisalign: Invisalign is a way of straightening your teeth without the use of wires and brackets like those used in traditional braces. A series of smooth comfortable plastic aligners are fabricated specially for you which gradually move the teeth into a position that has been determined by your dentist or orthodontist. You can achieve a great smile with little interference in your daily life.
Root Canals: When a tooth is badly decayed it may need a root canal to save it. In this procedure the inflammed or infected soft tissue core comprising of nerves and blood vessels is cleaned out and replaced with an inert material. A core filling and crown are strongly recommended for a tooth following a root canal to prevent it from breaking. A root canal saves a tooth and can prolong its life for many years.
Implants Supported Crowns, bridges and Dentures: When a tooth is lost due to decay or periodontal disease it may need to be replaced to establish proper function. One way of replacing the missing tooth is with an implant supported restoration. The implant is a titanium post that is surgically placed in the bone and allowed to integrate and heal for 3-6 months. This replaces the root portion of the tooth. An abutment and crown is then placed over the implant to replace the coronal portion of the tooth. When several or all teeth are missing then implants can be placed to increase retention and support for the dentures. For any implant related treatment we co-ordinate with the Oral Surgeon or Periodontist. They place the implants. The crowns, bridges or dentures following that are done at our office.
Dentistry for Children
Even though we are not a pediatric dentistry office, children are most welcome at our practice.
After an exam and appropriate xrays, teeth are cleaned and flouride varnish is applied to the teeth. If sealants are needed then those will be recommended. If the child needs extensive dental treatment or braces then he/she will be referred to the appropriate specialist.
Oral Appliance for Sleep Apnea
Sleep Apnea is a sleep disorder charachterised by pauses in breathing or instances of low breathing during sleep. There are 3 types of Sleep Apnea: Central Sleep Apnea(CSA), Obstructive Sleep Apnea(OSA) and Complex Sleep Apnea, which is a combination of OSA and CSA.
Obstructive Sleep apnea is the most common. Though a CPAP (continuous positve air pressure)device is used to treat the moderate and severe forms of the condition, mild forms of OSA can be treated with Oral appliance therapy(OAT). At our office we screen patients for sleep apnea and recommend evaluation by an MD if needed.
We provide OAT for sleep apnea in conjunction with patient’s Sleep Physician. The oral appliance used to manage sleep apnea called a mandibular advancement splint, is a custom made mouth piece. It is titrated over a period of few weeks to move the jaw forward while the patient sleeps. This opens up the airway allowing unrestricted flow of air.
Occlusal Splint Therapy (Nightguard): For patients who have a habit of clenching and grinding their teeth we offer occlusal splint therapy. Clenching and grinding our teeth is parafunctional activity that can result in tooth damage, headaches, pain in the jaw joint or in the head and neck area. In many instances patients are unaware of clenching and grinding their teeth. Each patient is evaluated for the above at their first appointment. An Occlusal splint or nightguard is recommended if deemed necessary. This helps prevent further damage and alleviates symptoms.
Medicare approved DME(durable medical equipment) provider.