Our Services, Your Care
Monroe Family Dentistry is staffed with knowledgeable and accredited professionals to perform the dental services you require. We are proud of the care we provide and offer the following complete suite of services.
Our Services Include:
Dental care for your children
- We provide children’s dental care, age 3 and up – Learn more…
Dental care for your teeth and gums
- General dentistry – Learn more…
- Periodontal disease therapy – Learn more…
Dental care for your bite and smile
- Orthodontics – Learn more…
- TMJ evaluation – Learn more…
- Teeth grinding – Learn more…
- Cosmetic procedures – Learn more…
Dental care for replacement of missing teeth
Dental care for other related conditions
- Non-Surgical Anti-Snoring Treatment- Learn more…
About Children’s Dental Care
Your Child’s Teeth
Good dental health begins at an early age when the first baby teeth come in. With proper dental care at home and regular visits to the dentist, your child can grow up cavity free.
Food particles and bacteria form a sticky substance called plaque on the teeth. Bacteria are present in the plaque which make acid from sugar that eats away the enamel coating on your child’s teeth. This is the cause of tooth decay. Brushing removes the plaque from the teeth as it forms, stopping tooth decay. Start brushing your baby’s teeth as soon as the first teeth appear. You may first use a piece of wet cotton gauze and then a small toothbrush as more teeth come in.
Use a small amount of good tasting fluoride toothpaste. Once your child is old enough to brush their own teeth, let them do so. However, you must monitor how effectively they brush. Your dentist can provide plaque disclosing tablets which show where your child is missing brushing away the plaque.
Flossing removes the bacterial plaque in between the teeth that the toothbrush can’t reach. Floss your child’s teeth daily to avoid decay between the teeth. Encourage your child to floss their own teeth as they get early. A floss holder may help their flossing effectiveness.
Fluoride strengthens the tooth’s enamel coating which helps prevent cavities. Concentrated fluoride treatments given by the dentist at regular checkups are suggested. This toughens the enamel on teeth that have already come in. Find out if your community water supply is fluoridated. If not, daily fluoride supplements can be given to your child. This strengthens forming enamel on the permanent teeth that will come in later.
Sealants are a safe, painless, cost effective way to protect your child’s back teeth from tooth decay. A thin plastic resin coating is bonded to the chewing surfaces of the molars and premolars. This forms a barrier which prevents food and bacteria from entering the tiny grooves on the tops of the back teeth. These grooves are so tiny that the toothbrush bristles cannot reach into them to remove bacteria. Sealants placed early upon eruption of the teeth greatly prevent biting surface tooth decay. It usually takes only a few minutes to seal each tooth. Sealants can last for many years before reapplication is required. The dentist checks the condition of each sealant at each examination.
Avoiding tooth decay
Reduce daily sugar intake. Avoid pop and carbonated beverages. Never let your child sleep with a bottle since bottle liquids including milk can cause rapid and severe tooth decay. Make sure your child always brushes after meals and snacks. Use dental floss daily.
Thumb sucking and pacifiers
Sucking on a thumb or pacifier is normal and common for a baby. It is suggested that this habit be discouraged after the age of 4 or 5 to avoid jaw problems requiring orthodontic correction. Ask your dentist for help if necessary.
Teething refers to the time that the baby teeth are coming in. Your baby may be unhappy due to sore gums around the newly erupting teeth. Excessive drooling and chewing on objects is common. Numbing creams and cold teething rings are sometimes helpful.
Your child’s first checkup
Your child’s first checkup should be around the age of 3 unless specific problems are noticed or emergencies arise. Depending on the cooperation of the child, the first visit may be as simple as a ride in the chair, a quick check of the teeth, and a visit to the treasure chest OR a complete examination, cleaning, x-rays, and fluoride. Every child is different and they should not be forced into treatment until they are ready. Childhood experiences at the dentist follow into adulthood. A great experience at the dentist is the goal. 2 checkups per year is suggested.
Problems requiring a dentist visit
Call your dentist if an adult tooth is loose or if you notice black or brown spots on the top surfaces or in between the teeth. See the dentist immediately if an adult tooth is knocked out. Don’t wash the tooth. Put it in milk wetted cotton gauze and see the dentist within 30 minutes if possible.
General dentistry practice includes all aspects of dental services including many specialty services depending on the training and skill of the general dentist. Common general dental services include: Treatment of adults and children, placement of all types of fillings, placement of crowns to restore teeth, replacement of missing teeth with bridges, implants or full or partial dentures, cosmetic procedures such as bleaching, bonding, or veneering of teeth, extraction an removal of teeth including 3rd molars, teeth cleaning and gum disease control procedures to maintain healthy teeth and gums, and root canal therapy to save infected teeth.
Patients with healthy teeth and gums should generally have their teeth cleaned twice per year. This removes tartar buildup which can contribute to gum disease and allows the dental hygienist to access current gum health. Polishing away stains enhances the smile.
Your teeth are meant to last a lifetime. Even if one of your teeth becomes injured or diseased, it can often be saved through root canal (endodontic) treatment.
Root canal treatment involves the removal of the tooth’s pulp, a small, thread-like tissue that was important for tooth development. Once removed, it is replaced with materials that seal off the root canal from the bone supporting the tooth’s root. Years ago, teeth with diseased or injured pulps were removed. Today, root canal treatment enables dentists to save many teeth that otherwise would be lost.
The pulp is the soft tissue that contains the blood vessels, nerves, and connective tissue of a tooth. It lies within the tooth and extends from the crown of the tooth to the tip of the root in the bone of the jaws.
When the pulp is diseased or injured and can’t repair itself, it dies. The most common causes of pulp death are a cracked tooth, a deep cavity, or an injury to a tooth. These problems can let the bacteria in saliva enter the pulp. The bacteria can then cause an infection inside the tooth. Left without treatment, pus builds up at the root tip, in the jawbone, forming a “pus pocket” called an abscess. An abscess can damage or destroy the bone surrounding the teeth.
When the diseased or injured pulp is not removed, pain and swelling can result. Certain substances released by bacteria can injure the bone that anchors your tooth in the jaw. Without treatment, your tooth may have to be removed.
Treatment usually involves from one to three dental visits. During treatment, your general dentist or endodontist (a dentist who specializes in problems of the tooth pulp) removes the diseased pulp. The pulp chamber and root canal(s) of the tooth are then cleaned, enlarged, and sealed. An antibiotic may be prescribed if infection has spread to the adjacent bone. Pain relievers are often provided to reduce discomfort.
As long as the root(s) of a treated tooth are nourished by the tissues around it, your tooth can remain healthy. Your treated and restored tooth could last a lifetime. A crown is usually placed as soon as possible to restore the tooth (especially a back tooth which has chewing pressure on it).
Many years ago the only options in filling materials were silver (amalgam) or gold. Today the dentist
can restore your teeth with natural appearing tooth like materials such as composite resins or porcelain ceramics. These filling materials are designed to bond to the internal of the tooth. This can strengthen the tooth and seal out access for bacteria at the marginal interface between the tooth and the filling material. Ask the dentist if these new materials are a good choice for you.
A crown (also called a cap) is a manmade cover that protects the top of a tooth. It may be used to restore and preserve a decayed, broken, or cracked tooth. Crowns can also correct some cosmetic tooth problems, giving you a better smile.
Your dentist may advise you to get a crown if you have:
- A decayed or damaged tooth that needs to be restored to its normal shape and size.
- A cracked or broken tooth with large cavities or worn fillings.
- A poor fitting crown.
- A tooth that has a large opening on its top surface after root canal therapy.
- A cosmetic problem.
- A bite problem.
- A crown is made of gold, or other metals, or porcelain. It can also be made of resin, or porcelain and metal. When choosing a crown, think about how it will look and how long it will last. Talk with your dentist about the type of crown that may be best for you.
- A metal crown is made of gold or other metals. It is very strong and won’t break. It is softer sometimes that opposing tooth structure or porcelain crowns and may wear with time. Because this type of crown isn’t tooth colored, it is not suggested in the front of the mouth.
- A tooth colored crown is made of porcelain (pigmented glass) or reinforced resin. It comes in a wide range of shades to blend with your other teeth. This type of crown may be susceptible to chipping unlike metal crowns. Suggested for front teeth only.
- A porcelain fused to metal crown is tooth colored but has a metal internal for enhanced strength and resistance to fracture. It can be used in both front and back teeth. It also comes in a wide range of shades to blend with your other teeth.
Restoring your tooth with a crown may take 2 to 3 dental visits. Expect to wait 2 weeks between appointments for the dental laboratory to fabricate the new crown.
Your dentist will usually numb the tooth with a local anesthetic before preparing your tooth for a crown. The tooth is then reduced and shaped. All decay is removed. The tooth may need rebuilding if larger parts are missing or if old failing fillings are present. An impression is taken of the prepared tooth and the surrounding teeth. A temporary crown is placed to protect the prepared tooth between visits.
Do the following to care for your temporary crown:
- Avoid eating hard or sticky foods which might dislodge your temporary crown.
- Brush gently at the gum line around the temporary crown to heal the gum tissue.
- Carefully floss between your teeth, pulling the floss out from the side of the tooth and not from the top.
Once the new crown is ready, the tooth is numbed and the temporary crown is removed. The dentist fits the new crown to the tooth making sure that all the crown margins fit well, the contacts between the adjacent teeth are snug, the color and shape are in harmony with the other teeth, and that the bite is even and correct. Once both you and the dentist agree that the crown fits right, it is cemented solidly in place with permanent cement.
Call your dentist if:
- Your temporary or permanent crown becomes loose or comes off.
- You have abnormal and increasing hot or cold sensitivity.
- You have a toothache which is increasing in intensity.
New crowns must be brushed around the gum line and flossed to prevent tooth decay just like your other natural teeth. Avoid biting on non food items or bones to decrease the chance of porcelain chipping or fracture. Normal good home care will help your new crown last for many years.
Teeth which cannot be restored properly or predictably may need to be removed. Sometimes the procedure is uncomplicated in nature and is referred to as a simple extraction.
On occasions the shape and curvature of the tooth’s roots create a situation where the tooth needs to be removed in sections. This procedure is referred to as a surgical extraction. Wisdom teeth (or 3rd molars) usually require some type of surgical extraction to remove.
Sutures are usually placed to speed up the healing process.
Antibiotics are prescribed in cases of bone infections. Pain medications are also prescribed.
The dentist and their staff will provide specific post operative instructions to avoid bleeding, discomfort, and speed the healing process. Follow these instructions carefully.
Periodontal, or gum, disease is an infection of the tissues that support your teeth. Your teeth are supported by gum tissue (or gingival), connective fibers called the periodontal ligament that anchor the tooth root into its socket, and bone. With proper gum care, these tissues can help keep your smile for a lifetime. Many adults, though, develop some type of periodontal disease. Left untreated, periodontal disease can be a major cause of tooth loss.
Periodontal disease is an infection of the tissues that support your teeth. Your gum tissue is not attached to the teeth as high as it may seem. There is a very shallow v-shaped crevice called a sulcus between the tooth and gums. Periodontal diseases attach just below the gum line in the sulcus, where they cause the attachment of the tooth and its supporting tissues to break down. As the tissues are damaged, the sulcus develops into a pocket. Generally, the more severe the disease, the greater the depth of the pocket.
The sticky film that constantly forms on your teeth is called plaque, and is made mostly of bacteria. Some of these bacteria produce byproducts (called toxins or enzymes) that can irritate the tissues that support your teeth. These byproducts can damage the attachment of the gums, periodontal ligament, and bone to your teeth. You can remove plaque with good oral hygiene such as brushing your teeth twice a day and cleaning between them once a day with floss or another interdental cleaner. When plaque is not removed through good oral hygiene, it builds up along the gum line and increases your risk of developing periodontal disease. Plaque that is not removed regularly can harden into a rough porous deposit called calculus, or tartar. Tartar itself does not seem to cause disease, but it may make it more difficult for you to remove plaque so it should be removed regularly. Tartar can only be removed when your teeth are professionally cleaned in the dental office.
Some factors can increase the risk of developing periodontal diseases. If one or more of the following apply to you, it is especially important that you practice good oral hygiene and follow your dentist’s and hygienist’s advice to maintain health teeth and gums:
People who smoke or chew tobacco are more likely to have periodontal disease. And it is more likely to be more severe than in those who do not use any tobacco products.
Some systemic diseases such as diabetes can lower your body’s resistance to infection, making periodontal diseases more severe.
Many medications, such as steroids, some types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers, and oral contraceptives can affect the gums. In Addition, medications that reduce your salivary flow can result in a chronically dry mouth, which can irritate your oral soft tissues. Let your dentist know about your medications and update your medical history files at the dental office when any changes occur.
Bridges that no longer fit properly, crooked teeth or fillings that are defective can contribute to plaque retention and increase your risk of developing periodontal disease.
Pregnancy or use of oral contraceptives increases hormone levels that can cause gum tissue to be more sensitive to the toxins and enzymes produced by plaque and can accelerate growth of some bacteria. The gums are more likely to become red, tender and swollen, and bleed easily.
It is possible to have periodontal disease and have no warning signs. That is one reason why regular dental dheckups and periodontal examinations are very important. However, several warning signs can signal that you have a problem with periodontal disease. If you notice any of the following, see your dentist:
- Gums that bleed easily.
- Red, swollen, or tender gums.
- Gums that have pulled away from the teeth.
- Pus between the teeth when the gums are pressed.
- Persistent bad breath or bad taste.
- Permanent teeth that are loose or separating.
- Any change in the way your teeth fit together when you bite.
- Any change in the fit of partial dentures.
Periodontal diseases are classified according to the severity of the disease. The two major stages of the disease are gingivitis and periodontitis.
Gingivitis is a milder and reversible form of periodontal disease that only affects the gums. It develops as toxins in plaque irritate gums, making them red, tender, swollen, and likely to bleed easily. It can usually be eliminated by daily brushing, cleaning between your teeth, and regular dental cleanings.
Gingivitis may lead to more serious, destructive forms of periodontal disease, called periodontitis. There are several forms of periodontitis, with the most common being chronic adult periodontitis. Periodontitis occurs when toxins, enzymes, and other plaque byproducts destroy the tissues that anchor teeth in the bone. The gum line recedes, which can expose the tooth’s root. Exposed roots can become susceptible to decay and sensitive to cold and touch. The sulcus deepens into a pocket in the early stage of periodontal disease. Plaque that collects in these pockets can be difficult to remove during regular brushing and interdental cleaning. Byproducts from the plaque that collect in these pockets can continue to damage the gums, periodontal ligament, and bone. In some cases, so much ligament and bone are destroyed that the tooth becomes loose. Usually, your dentist can still treat the disease at this point. In the worst of cases, a loose tooth may need to be extracted or may fall out on its own.
Prevention and reducing the risk developing periodontal disease begins with daily good oral hygiene.
Brush your teeth twice a day. With proper brushing, you can remove plaque from the inner, outer and chewing surfaces of each tooth. Your dentist or dental hygienist can show you a proper brushing technique. Using fluoride containing toothpaste also will help protect your teeth against cavities.
Carefully clean between your teeth once a day with dental floss or another interdental cleaner to remove plaque form areas your toothbrush can’t reach. It only takes a few minutes each day and is just as important in maintaining oral health as brushing your teeth.
If you need extra help controlling gingivitis and plaque that forms above the gum line, your dentist may recommend using an antimicrobial mouth rinse as an effective addition to your daily oral hygiene program.
Eat a balanced diet for good general health.
Visit your dentist regularly.
During your checkup, the dentist will examine your gums. This is called a periodontal examination. An instrument called a periodontal probe is used to gently measure the depth of the sulcus surrounding each tooth. The healthy sulcus depth is usually three millimeters or less. Periodontal diseases cause the sulcus to deepen into a pocket. A periodontal probe can determine where you have developed any pockets and the depth of these pockets. Generally, the more severe the disease, the deeper the pocket. Dental x-rays may be taken to evaluate the amount of bone supporting the teeth and to detect other problems not visible during the clinical examination. If periodontal disease is diagnosed, the dentist may provide treatment or may refer you to a periodontist, a dentist who specializes in the treatment of periodontal disease.
Treatment methods for periodontal disease depend upon the type of disease and how far the condition has progressed. The first step usually is a thorough cleaning that includes scaling to remove plaque and tartar deposits. The tooth roots also may be planed to smooth the root surface, allowing the gum tissue to heal and reattach to the tooth. In some cases, the occlusion, or bite, may require adjustment. Your dentist also may recommend medications to help control infection, pain, or to encourage healing. These medications can be given in various forms: a pill that you would swallow, a liquid mouth rinse, or in a form that the dentist could place directly in the periodontal pocket after scaling and root planning.
When deep pockets between teeth and gums (4 to 6 millimeters or deeper) are present, it is difficult for the dentist to thoroughly remove the plaque and tartar. Likewise, you may have trouble keeping these pockets clean and free of plaque. If the pockets do not heal after scaling and root planning, periodontal surgery may be needed. One of the goals of periodontal surgery is to reduce the depth of the periodontal pockets to make them easier to keep them clean. With surgery, the dentist can access hard to reach areas that require the removal of tartar and plaque. The tooth root is cleaned and smoothed. Sometimes the bone around the tooth also is smoothed to help remove these pockets. The gums then are sutured back into place or into a new position that will be easier to keep clean at home. Bone surgery may be used to rebuild or reshape bone that has been destroyed. Grafts of the patient’s bone or artificial bone may be used, as well as special membranes. The dentist may use splints, bite guards or other appliances to stabilize loose teeth and to aid the regeneration of tissue during healing. If excessive gum tissue has been lost from the tooth root (gum recession), a gum graft may be performed. After surgery, the dentist may apply a protective dressing over teeth and gums. An antibiotic and mild pain reliever may be prescribed.
Good oral hygiene at home is essential to help keep periodontal disease from becoming more serious or recurring. Your dentist may need to see you at more frequent intervals that in the past to control periodontal disease.
Orthodontics (straightening of the teeth) can make a profound improvement in both the appearance and function of the teeth. The position of the teeth is very important in creating harmony in the smile. The position of the teeth and how they relate to one another in both jaws affects how well we can chew our food and even how well we can speak. Crooked and rotated teeth are also more prone to tooth decay and gum disease.
Children with mal occlusions (poor bite relations) and crooked teeth are usually referred to the orthodontist for an initial evaluation at age 8 or 9. Sometimes the orthodontist will begin treatment with functional appliances while some of the primary (baby) teeth are still present. The idea is to take advantage of the child’s growth spurt to control the growth of the jaws in certain directions. This type of orthodontic treatment can sometimes greatly reduce the need for conventional orthodontics later requiring removal of permanent teeth for adequate space. Conventional orthodontics usually begins at age 10 when all the primary teeth have been lost.
Orthodontics requires that the patient be dedicated to the orthodontic treatment process. There are many short appointments over a 2 to 4 year period. Some cases are much more difficult than others.
Surgical orthodontics may be required when the upper and lower jaws don’t relate very well. In this case, the orthodontist works closely with a skilled oral surgeon who specializes in repositioning the jaws surgically to create favorable upper and lower jaw relations. The orthodontist aligns the teeth well in each arch and then the oral surgeon aligns the jaws.
TMJ/TMD is a complex set of symptoms usually involving pain about the jaw joints. The most common symptoms are:
- locking of jaw
- grinding of teeth
- neck/shoulder aches
- soreness around the ear (s)
- restricted range of jaw movement
- a mouth or tongue burning sensation
- clicking/popping noises opening and closing jaws
- toothache with no evidence of decay, infection or trauma
There can be multiple reasons for the pain and the problems:
- INTERNAL DERANGEMENT within the jaw joint. Approximately 1/3 of studied populations have this condition with no significant symptoms. There may be popping/ clicking or locking of the jaw with realignment of the jaw-joint structures during jaw use or not.
- MUSCLE SPASM is probably the most common cause for TMJ and is sometime difficult to treat because of the effects that it can have, especially over a prolonged period of time. Muscle spasm may be from the neck and/ or jaw muscles. This may cause a problem remote to the jaw joints and refer pain to the jaw joints.
- CHRONIC STRESS is often a precipitator of the problem. Patients sometimes have symptoms after a rear-end car wreck. Often this is upper back-neck mediated.
The most accurate method to treat TMJ is to establish the most likely cause and then to treat it. Treatment may include just helping a patient to understand his/her problem; physical therapy; neurology referral; bite splint therapy or rarely (1% or 2%) involving surgery.
Treatment of TMJ is often a team effort.
Information may be found on a Web search under TMJ or go to the TMJ Association.
A thorough dental exam may reveal the problems.
Cosmetic dentistry has come a long ways in the last few years. Vast improvements in resin bonding and tooth colored filling materials have occurred.
Back teeth can now be filled with 3 different tooth colored materials:
Direct composite resin fillings are most commonly placed in back teeth where a natural appearance is desired. They are relatively easy to place in one visit and the cost factor is only little higher (25 to 35%) than traditional silver fillings. The length of service can be as long as a silver filling.
Indirect composite resin inlays are tooth colored restorations that are fabricated in a dental laboratory. They take 2 appointments to complete and are very esthetic and durable. The cost factor is about twice that of a direct composite resin filling. They are well suited for larger restorations where correct placement of direct composite resins would be more difficult.
Indirect porcelain inlays and onlays are indicated for larger restorations on back teeth where a porcelain crown is not desired. They take 2 appointments to complete and are fabricated in a dental laboratory. The esthetics of these restorations can be very close to natural teeth if well placed. The cost factor is about 3 times that of a direct composite resin filling.
Back teeth can also be restored with all porcelain crowns or with porcelain fused to metal crowns. All porcelain crowns are more beautiful than porcelain fused to metal crowns but are also more fracture prone and have a higher cost.
Front teeth can be restored with many effective tooth colored materials and techniques:
Direct composite resin
is commonly used on front teeth. The entire front of the tooth or a portion of the tooth can be bonded with composite resin in one appointment. The shape of the front teeth can be changed with composite resin bonding. Composite resin bonding is half the cost of porcelain laminate veneering or porcelain crowning. Discoloration is possible over time and well as chipping and wear.
Indirect porcelain veneers or thin sections of porcelain bonded to the front surfaces of the front teeth are the most esthetic cosmetic procedure of all. They are durable and very wear resistant. The teeth can be widened and lengthened with this technique. They are fabricated in a dental laboratory and are placed in 2 appointments. The cost is similar to an all porcelain crown.
All porcelain or porcelain fused to gold (metal internal) crowns can be extremely attractive. They are used when the front teeth have been previously filled to a great degree or where drastic tooth shape changes are required for a proper smile.
Bleaching of the teeth can greatly whiten the color of the teeth. The best indication for bleaching is when all the teeth have a similar but darkened color. Old tooth colored fillings must be replaced after bleaching since they will not lighten in color. Bleaching techniques vary from chairside 1 visit bleaching to at home techniques involving bleaching trays or bleach strips.
Cosmetic contouring is a technique where the contours of the front teeth are shaped to create optimum harmony of all the teeth in the smile. This technique if needed is suggested before bleaching or any extensive cosmetic procedure on the front teeth.
Veneers are thin, translucent coatings or porcelain that are bonded to the front teeth to improve their color, size, or shape. Veneers can help you achieve the smile you want. They are extremely lifelike and beautiful in appearance.
Veneers can correct many dental problems such as:
- Teeth discolored from medication or age.
- Front teeth that are worn or chipped.
- Gaps and other spaces between teeth.
- Crooked teeth.
Veneers may require 2 to 3 office visits from start to finish. Your dentist will first examine and evaluate your teeth to determine the best cosmetic plan for you. The proper color is selected. Many times the teeth are bleached before the veneering process begins.
On the preparation appointment, the front teeth (usually 4 to 8 front teeth) are reduced slightly and contoured on the front surfaces and incising edges. An impression is then taken. Composite resin temporaries are then placed on the prepared front teeth. The laboratory takes about 2 weeks to fabricate the new porcelain veneers. During this waiting period:
Brush your teeth gently and avoid cold foods and liquids.
Avoid eating hard foods which may loosen your temporary veneers.
On the bonding appointment, your dentist will fit the veneers on your teeth, check the color, and check the shape to make sure that all the veneers create harmony in your new smile. Once this is completed, your teeth are cleaned thoroughly. The veneers are then bonded to your teeth with special light cured cement. Excess cement is removed and your bite is checked and adjusted. Your dentist will normally see you a few days later to evaluate the final cosmetic result and make any shape changes in the new veneers to maximize your new smile.
The following tips will help you maintain the beautiful appearance of your new veneers for many years:
- Brush your veneers with a soft toothbrush an clean around your gum line carefully. Avoid harsh abrasive toothpastes.
- Floss daily to remove plaque which can cause decay in between the teeth.
- Consider avoiding certain foods which could stain the margins of your veneers where they meet the natural tooth:
- Red wine
- Avoid smoking or chewing tobacco.
Bleaching of the teeth can greatly whiten the color of the teeth. The best indication for bleaching is when all the teeth have a similar but darkened color. Old tooth colored fillings must be replaced after bleaching since they will not lighten in color. Bleaching techniques vary from chairside 1 visit bleaching to at home techniques involving bleaching trays or bleach strips.
Chair side bleaching is done in the dental office in 1 visit. Sometimes a second visit is required for difficult cases. A protective coating is placed to cover the gum tissue around the teeth. The dentist then places a strong bleaching agent on the teeth which is activated with an intense light. The process takes about 1 hour to complete.
At home bleaching with soft pliable trays is the least expensive but still very effective technique. Impressions are taken to fabricate soft pliable trays which fit your teeth precisely (to avoid ingested large quantities of bleach). A mild bleaching gel is placed inside the trays. The trays are then inserted over your teeth to begin bleaching. The trays can be worn for 3 to 4 hour periods or worn overnight. 3 to 6 bleaching sessions are usually required for the desired bleaching result.
A new bleaching strip technique for the front teeth is available in professional strength for dental office use. It is much more powerful and effective than over the counter products.
See your dentist for more information on which technique is best for you.
If you have lost all of your natural teeth, whether it is from periodontal disease, tooth decay or injury, full dentures can replace your missing teeth and your smile. Replacing missing teeth will benefit not only your appearance but also your health. You’ll be able to eat and speak. These are two things that most people often take for granted until their natural teeth are prematurely lost.
A full denture, also called a complete denture, replaces natural teeth and provides support for the cheeks and lips. Without support from the denture, facial muscles can sag, making a person appear older.
There are various types of complete dentures:
A conventional full denture is made and placed in the patient’s mouth after the remaining teeth are removed and the tissues have healed. Healing may take several months.
An immediate full denture is inserted immediately after the remaining teeth are removed. The dentist takes measurements and makes models of the patient’s jaws during a preliminary visit. The dentures are then fabricated prior to removal of the remaining teeth. With immediate dentures, the denture wearer does not have to be without teeth during the healing period.
The framework of the full denture, called the denture base, is made of flesh colored acrylic plastic. The base of the upper denture covers the palate (the roof of the mouth) while that of the lower is shaped more like a horseshoe to accommodate room for the tongue. The gum and bone tissues of the dental ridge support the denture. The denture base, which conforms closely to the ridge, is held in place with a thin film of saliva. When the denture base of the upper denture rests over the gums and palate, a seal is created, which holds the denture in place. Cheek muscles and the tongue help hold the lower denture in place.
If you have a few sound individual teeth, the tooth roots may be used to provide support for an over denture. Root canal therapy is performed on the teeth. The dentist then reduces the teeth to just above the gum line. Special attachments can be used attach the over denture to these remaining roots. This holds the denture snugly in place. Good for lower dentures and sometimes with upper dentures where the ridge shape is unfavorable for good denture retention.
A complete denture may be attached to several implants (artificial roots that attach directly to the jaw), which allows a secure fit (especially on the lower jaw). Properly healed implants can help reduce jaw and gum shrinkage. Your dentist will determine what type of denture is right for you.
The good thing about dentures is that they can be made to closely resemble your natural teeth with little changes made or drastic improvements can be made in your new smile.
Immediate dentures normally require periodic adjustments and a permanent reline to improve the fit about 9 months after delivery.
All dentures require permanent relines every 4 to 5 years for proper fit. Complete dentures have a lifetime of about 10 years before they should be replaced.
If you have a few sound individual teeth, they may be used to provide support for a partial denture. The partial denture is anchored to the strongest of the remaining teeth and is supported by the jaw bone ridge. It is removable. This can be an effective and more cost effective way to replace missing teeth. Saving some of the lower jaw teeth is a good idea if possible.
This section will answer many of the questions you may have about implants. You may scroll down to read each section or click on any topic to jump to that topic.
- How long does a dental implant last?
- How many appointments are required?
- Is it painful?
- Will my insurance cover implants?
- May I finance my dental implant?
- Dental Implants: Are They Right For You?
An implant is an alternative to portable dentures, partials and bridges.
Just as a knee can be surgically reconstructed or a hip joint replaced, so too can missing teeth be replaced. If you are missing one or more teeth, you are probably experiencing some discomfort, either emotional or even physical and you will want replacements that are as natural as possible. A Dental Implant can offer stabilization for loose fitting dentures, support for existing bridgework, replacement for a single tooth or can be placed for a complete denture.
If dentures don’t work for you, you may consider dental implants. Unlike dentures, which can be removed, implants are permanently anchored into the jaw itself. With implants you’ll re-experience the ability to speak, laugh, chew and socialize with the confidence of permanent teeth.
Bioscience has fine-tuned the dental implant to allow placement of compatible materials within the bone to anchor one or more teeth. This process eliminates the need for bridges and even dentures. The procedures are ADA approved and the materials are FDA approved.
The Dental Implant can be of many different designs. The most popular is a small metal (titanium) screw, which is surgically placed into the jawbone, much like an artificial hip or knee surgical replacement. After adequate healing time, a replacement tooth or teeth are made to fit into the implant. In selected cases, the implant can even be inserted at the time of tooth removal.
What are the advantages of a dental implant?
- Stabilize removable dentures
- Replace removable dentures
- Replace removable partial dentures
- Strengthen existing bridgework
- Single tooth replacement without crowning teeth on either side of the space to hold a crown
- Renewed confidence in your smile
- Clearer speech
- Increased ability to chew food
- Preserves bone through internal bone stress
- Increased sex appeal
- Teeth do not need to be removed at night
- Dental implants do not decay like teeth
Many people are candidates for dental implants if they are missing teeth and are tired of full or partial dentures or do not wish to have a traditional bridge. A panorex X-ray and study models are usually all that is necessary. Sometime a CT scan is necessary to determine if adequate bone exists. In the case of inadequate bone synthetic bone substitute or a graft from your own hip will often provide the support necessary for your implants or different types of implants my be used. A referral to an oral surgeon will be required in these type of cases.
More than 40 million Americans over the age of 55 have lost some of all of their teeth. As Americans live longer, more active lives, many of these people face up to 30 or 40 years of toothlessness, according to the American Association of Oral and Maxillofacial Surgeons.
Tooth loss results in an inevitable shrinkage of gums and jawbones which can lead to pain from ill-fitting dentures, decreased chewing function, subtle malnutrition, social withdrawal and emotional distress. Dentures place constant pressure on the jawbones, thereby acceleration shrinkage and causing dentures to fit poorly because they no longer have a solid foundation on which to rest securely and comfortably.
Oral and maxillofacial surgeons, however, are providing a more permanent solution to toothlessness with oral implants. Oral implants are permanent tooth root substitutes which are surgically placed in the jawbone and act as anchors to stabilize artificial teeth. The result is improved function, without the pain, frustration or other problems associated with conventional dentures and a restored self-confidence, which may have deteriorated as a result of tooth loss.
Not everyone who is missing teeth, however is a good candidate for oral implants. Implants are not recommended for persons prone to infections or for people who are unable to maintain stringent oral hygiene. Additionally, implants may not be appropriate for children and teenagers whose bones have not fully matured.
Longevity cannot be guaranteed, though some patients have had their implants for
more than 25 years.
Usually there is a consultation appointment to diagnose the nature of your problem. If you have a straightforward situation, then the implants can be inserted the next appointment. Occasionally additional studies are necessary before the surgery to insert your implants. The implant trained general dentist or oral surgeon who places the implant would like to see you for a Post Operative Visit to make sure everything is OK after placement. Your general dentist can make any adjustment needed to your existing partial or full dentures after implant placement. Three to six months need to elapse after your surgical implant insertion, and then the oral surgeon will expose your submerged implants through your gum tissue. You will then need several visits to your restorative dentists to have your new teeth made to fit your new dental implants. The oral surgeon may like to see you after your new teeth are fabricated to view your new smile.
Dental implants are often done through a team approach. Sometimes dental implants are placed and restored by the implant trained general dentist. Other times dental implants may be placed be oral surgeons depending on the difficulty of the case. After placement and healing, the implant trained general dentist will restore your missing teeth.
Generally the discomfort of having an implant placed is less than having a tooth removed. For your comfort most procedures may be don’t in my surgical facility, wither under local anesthesia or local anesthesia and IV sedation.
In most cases, we bill your dental insurance for the implants and for the teeth. Not all insurance companies will cover the cost of implant placement and restoration of missing teeth. We can help you determine what benefits are available with your dental insurance policy. If you have a severe medical problem, such as reconstruction for an oral cancer or severe weight loss, the oral surgeon may be able to obtain medical coverage for implant placement and restoration of missing teeth for you in some cases.
Generally, fees are due the date of service. We accept American Express, Master Card, Visa and Discover. Financing is available through a credit company.
A bridge is a way to replace one or more missing teeth. Replacing missing teeth makes it easier to chew. It can improve your appearance. It also helps keep your teeth, gums, and jaws healthy.
Spaces left by missing teeth affect the rest of your teeth. These gaps can cause chewing problems. If even one tooth is missing, other teeth may slowly drift and shift out of place. This changes the way your teeth fit together (your bite). A poor bit may make your jaw sore. Your teeth may become harder to clean, leading to tooth decay and gum disease. Shifting teeth may eventually ruin your smile.
A fixed bridge is one ore more replacement teeth permanently attached to the natural teeth next to them. The bridge does not come in and out of the mouth like a partial denture. It is fixed into place. A bridge can be made of metal, tooth colored porcelain, or a combination of the two. Your dentist can suggest the best option for you.
There are two main types of bridges:
- A conventional bridge has replacement teeth that are attached to crowns. The crowns are placed over the natural teeth on either side of the space to be filled.
- A Maryland bridge has replacement teeth that are attached to the back of nearby natural teeth using a metal wing. The metal wing is bonded to tongue side surface of the teeth where it is not visible. This type of bridge may be an option when the natural teeth on each side of a space to be filled are in excellent condition.
The bridge procedure takes two or more dental visits to complete.
For a conventional bridge, the teeth on either side of the space to be filled must be reshaped. These reshaped teeth hold crowns that support the bridge. Limited reshaping is also necessary with a Maryland bridge. Impressions of your teeth are taken for either type of bridge. These impressions are used by the dental laboratory to make your bridge. The lab process takes about 2 to 3 weeks. A temporary bridge is placed over the prepared teeth during this time. See your dentist immediately if your temporary bridge comes loose.
When your new bridge is ready, your dentist places it on your teeth and adjusts the fit until feels correct. The bridge is then cemented or bonded into place. Sometimes the dentist will need to make minor adjustments to the bite after a bridge has been worn for a few days.
Good home care (daily brushing and flossing) and regular cleanings and checkups at the dentist will help your new bridge last for many years.
Although teeth grinding (bruxism) can happen at any time, people often grind their teeth in their sleep. You cay not even know you are doing it. The causes of teeth grinding are not clear. Stress is one possible cause, but often the reason for the habit is unknown.
Teeth grinding may cause the following damage:
- Chipped enamel
- Flattened, grooved, and worn teeth
- Loosened teeth
- Cracked teeth
- Periodontal (gum) problems
- Damage to bridges or other dental implants
If unchecked, bruxism may lead to jaw muscle or joint problems and even loss of your teeth.
Your dentist will examine your entire mouth and ask several questions. This evaluation will help confirm that you do grind your teeth. It may also help identify a possible cause of your teeth grinding habit.
Symptoms like these may be
a signal that you grind your teeth:
- A sore, tired jaw
- Sensitive teeth
- Loose teeth
- Dull headaches
- Neck aches
- Clicking sounds when you open your mouth
Possible treatment for teeth grinding:
- A mouth guard is a plastic device that fits over your teeth. It protects them from grinding damage. It’s worn when you’re most likely to grind your teeth.
- A bite adjustment helps your upper and lower teeth fit and work together better. Correcting an uneven bite can reduce the chances or grinding.
- Reducing stress may make grinding less likely by relaxing your jaw muscles. Your dentist may suggest ways to reduce stress, such as exercise.
- Medication in some cases may help relieve sore muscles or reduce stress.
- Repair of damaged teeth may require crowns or onlays depending on the amount of wear on the tops of the teeth.
A mouth guard made by the dentist can help protect your teeth from damage due to grinding. Because many people need to wear one at night, a mouth guard is sometimes called a nightguard. It is custom made out of plastic and fits either over the top of your upper or lower teeth. Wear your mouth guard exactly as your dentists instructs.
What causes snoring?
Snoring is a condition that occurs during sleep when the airway is narrowed, restricted or collapses, causing air to move more rapidly through the airway (especially when inhaling). The faster the air moves through the restricted airway, the greater chance there is for unsupported structures to vibrate, thus causing snoring.
Who suffers more?
It has been reported by the Mayo Clinic that the bed partner actually suffers more than the actual snorer. Therefore, the treatment of snoring actually helps two people get a better night’s sleep.
Why treat snoring?
Snoring may cause a disruption in your sleep and may also disrupt the sleep of your bed partner. More importantly, snoring may cause sleep fragmentation which could lead to daytime fatigue, or more importantly:
- Loss of concentration
- Increased blood pressure
- Memory loss
- Other cardiovascular problems
- Anxiety and depression
Why do dentists treat snoring?
The dentist is well versed in the uses of oral appliances, such as splints, to treat a variety of conditions. In addition, the dentist is better equipped to handle any of the side effects that may occur with the use of this device. Many dentists today have become interested in helping patients who snore get a better, more rested, peaceful night’s sleep. Using a particular type of anti snoring device is a very good way to accomplish this.
Other ways to help control snoring:
- Lose weight if you are overweight
- Reduce your consumption of alcohol
- Get more exercise (walking is great!)
- Try not to sleep on your back
- Do not eat late at night
Talk to your dentist for more information.