BLEACHING
Bleaching is a safe, effective way to lighten the color of teeth. A
mold of the teeth are taken to fabricate bleaching trays which custom
fit the patient's mouth. The patient wears these trays usually for 30-45
minutes or overnight depending on the product strength selected. Most
treatment takes two weeks, however, more time may be needed in severely
stained or discolored teeth.
BONDING
A procedure whereby a dentist uses special dental adhesives between tooth
surface and another material. The tooth is first chemically treated with
a special dental acid which causes microscopic porosites in the enamel.
The adhesives form a bond with the bonding material. These materials
come in various colors and shades. There are also flowable and dough-like
materials. The dentist chooses the one he feels best suits the procedure
he is performing. The materials at present are highly polishable, are
very strong and most last quite a long time. Some even contain fluoride
which aids in preventing new cavities from forming. Bonding uses include
restoring chips, filling holes, spaces or discolorations.
COMPOSITES
Composites are a plastic-like material in the resin family used to fill
teeth. The traditional composite resins are made up of a large amount
of inorganic filler particles bound by an organic polymer matrix or mesh. The newer generation composites have superior properties which include
higher strength, hardness, elasticity, abrasion resistance and high polishability
to make the restoration appear lifelike. Uses include cosmetic, filling
cavities, correcting size, color and shapes of teeth. They can be used
in front as well as back teeth.
CROWNS (CAPS)
Procedure whereby a tooth is covered to strengthen a damaged tooth. The
tooth may have been damaged by decay, or have a previous restoration that
has fractured. Root canaled teeth are also crowned if sufficient tooth
is missing or if the dentist feels that the tooth will last longer by
protecting it with the crown. There are several types of crowns. The dentist
and patient will make the decision as to which one is best for patient. This involves several phases. One in which the dentist prepares the tooth
and a temporary is fabricated and used to temporize the tooth while the
crown is being processed in a dental laboratory. The second step is inserting
the permanent crown. Failing to return to have the permanent crown placed
can cause damage to the underlying tooth due to weakness and poor fit
of the temporary crown.
DENTAL IMPLANTS
Dental implants are designed to provide the foundation for the restorative
dentist to replace missing teeth to form and function. The patient has
the ability to eat virtually anything. Facial contours and tooth space
is also maintained by replacing missing teeth. Implants are fabricated
of titanium posts which are inserted into the jaw bone where the teeth
are missing. There are many different types of implants and the determination
is made on examination and the degree of space, amount of remaining bone
and individual choice of dentist. Once the implant is placed, a healing
time is needed, which may take six months. Once the implant is ready,
it acts as if it were a tooth root substitute, where the dentist can now
perform his restorative treatment.
DENTURE
This is a removable appliance that is custom fabricated for the patient
to replace missing teeth. The materials used are made of acrylic resins
alone or in conjunction with various metals. A partial denture replaces
some teeth where the patient has some remaining permanent teeth. A complete
or full denture replaces all teeth. An immediate denture, whether complete
or partial, involves placing the appliance the same day the teeth are
removed.
EXTRACTION
An extraction is the removal of a tooth or teeth that is non-restorable,
non-useful, or harmful to the patient. There exists many systemic precautions,
do's and dont's that should be discussed by each individual and their
dentist. Post extraction precautions include some of the following:
- Pressure-bite on gauze or sponge over extraction site for at least
45 minutes after extractions.
- No rinsing or mouthwash use for at least 24 hours post extractions.
- Rinsing may be allowed after 24 hours depending on the patient, with
warm salt water, i.e. 1/2 teaspoon salt in approximately eight ounces
water every two hours. Best to still avoid mouthrinses.
- Avoid any pressure that may dissolve clot such as using straws, smoking,
etc.
- Avoid brushing the first 24 hours.
- Avoid alcohol for a few days.
If bleeding persists, important to call your dentist. If sutures were
placed after extraction it is important to return for removal of sutures
and to evaluate healing. If swelling occurs, which often happens after
extractions, it can be minimized by placing an ice bag as soon as possible
on the side of the extraction for a 15 minute interval and can be repeated
every 30 minutes for the next six hours post-operatively. Ice should be
used only on the day of surgery. For pain and infections, your dentist
may require oral pain medications and/or antibiotics.
MOUTHGUARDS
A mouthguard is an appliance made to protect teeth and surrounding tissue
from oral trauma during athletic or physical activities. The mouthguard
can be prefabricated or stock, or custom made by a dentist. Custom fit
ones have been shown to be more comfortable. For children, they must be
changed as new teeth erupt. It is known that mouthguards can prevent
serious injuries such as jaw fractures, neck injuries, concussions, and
teeth fractures. Studies have reported that concussions can be decreased
by almost 50% by wearing a mouthguard. Any activity where there is a
strong chance for contact, it is recommended that the mouthguard be worn.
ORTHODONTICS (BRACES)
Orthodontics is the art of aligning the teeth and jaws to improve the
patient's smile and oral health. It is recommended that a child be seen
by an orthodontist early on so as to form a baseline on development of
the child's arch and jaw. If braces are needed, placement usually occurs
between ten and fourteen years old. The reason for this age is due to
the fact that the mouth and head are still growing. Braces are worn depending
on each individual case. The average length of time is between eighteen
and thirty months which is followed by wearing a retainer for a few months
to allow the tissues and bones to form around new tooth position. With
braces, oral hygiene is more important than ever before. Due to the appliances
and tiny spaces that they contain, food and plaque get trapped. Decalcification
and cavities can form quickly so children must brush more often. The use
of fluoride toothpastes and rinses are also recommended to protect the
teeth.
PERIODONTAL SCALING
Periodontal scaling is a procedure whereby a dentist or hygienist removes
the deposits from under the gum line. Plaque and tartar is removed from
the root surface. The procedure is usually performed under local anesthesia
so as to make the patient more comfortable. Many times it can be performed
in two to four visits depending upon the amount of deposit or inflammation
present.
PORCELAIN VENEERS
Veneers are porcelain wafers that are laboratory fabricated and are bonded
onto the tooth. They are highly esthetic and lifelike. They are designed
to correct colors, sizes, shapes, spaces and alignments of teeth. They
are stronger and more durable than composites.
POSTERIOR PORCELAIN INLAY/ONLAY
This is a highly esthetic, non-metallic restoration that is bonded on
the prepared tooth to restore the beauty, strength and function of the
tooth. The procedure is similar to that of a crown, however, due to new
techniques of minimal invasiveness, the dentist tries to maintain as much
sound tooth structure as possible. An accurate impression is taken of
the tooth, a temporary filling is placed and a porcelain restoration is
fabricated by the dental laboratory. Upon return, the tooth is chemically
prepared, and the inlay/onlay is bonded onto the prepared tooth. The
bite is adjusted and polished. The tooth is once again functionally restored
to its almost natural form.
ROOT CANAL
A root canal is needed when the pulp or nerve of a tooth gets affected
by decay or trauma. The blood flow within the tooth rushes to the site
of inflammation in order to aid the tooth, but what occurs as a result
is a pressure on the nerve endings which generates the pain response. Pain usually occurs at night or when lying down, can be triggered by hot
or cold and can be occasional or continuous. What occurs is a slow progression
whereby decay may invade the pulp space and travel through the canal and
settle at the end of the root. What occurs is an abscess or swelling at
this site. Other causes of nerve pain can be fractures of teeth, large
fillings that are not tolerated by the pulp or constant trauma to the
tooth. Occasionally, it is difficult to diagnose which tooth may be the
culprit until localization occurs. Treatment involves cleaning the canal
space by removing the infected or affected nerve, washing the space and
filling the space with an inert, rubber-like material that helps seal
the space. Bio-compatible cements are used with this material to seal
any smaller openings. As with any procedure, success or failure of a procedure
depends on the circumstances, infection and patient. These can be discussed
with the individual dentist. After endodontic therapy, the patient returns
to the dentist to restore the tooth.
SEALANTS
Dental sealants are thin plastic coatings which are applied to the chewing
surfaces of the back teeth to prevent decay. Most tooth decay in children
and adolescents occur on the chewing surfaces of these back teeth or molars. This is because molars have irregular surfaces with pits and grooves which
tend to trap food and bacterial debris. Sealants flow into and coat these
pits and grooves so that bacteria cannot multiply and cause decay. The
teeth most likely to benefit from sealant applications are the first and
second molars just after they have erupted and before decay has had a
chance to occur. Generally, the first molars erupt at six years old and
second molars at about twelve years old.
SILVER (AMALGAM) FILLING
These are fillings which contain amalgam. Amalgam is formed from particles
that contain silver, copper, tin and mixed with mercury. It is packed
into the cavity before it hardens into a strong alloy. At first the color
is a silver color but after oxidation occurs it turns black.
TEETH CLEANING(PROPHYLAXIS)
Prophylaxis is a procedure where a dentist or dental hygienist removes
plaque and tartar from the teeth. This will make the gums and teeth healthier. It is not uncommon for patients to note that teeth appear slightly more
sensitive after a dental cleaning. The reason for this is that plaque
and tartar coat the tooth surface and shield them from substances in the
mouth. Once they are removed a transient sensitivity may occur but soon
leaves. It is important for one to brush and floss after every meal to
prevent buildup of plaque and tartar.
TEMPOROMANDIBULAR DISORDER - TMD
This is a condition whereby jaw muscles, temporomandibular joints, and
the nerves associated with this region cause pain. TMD most often affects
women twice as much as men. The causes include, overuse of jaw muscles
and trauma. The symptoms can include jaw pain, especially in morning,
earache - with no infection-, jaw clicking when opening jaw, difficulty
in opening mouth, stiff or locked jaw. The treatment would include resting
of jaw, anti-inflammatory drugs (non-aspirin), stress management, eating
soft foods, wearing a splint or mouthguard and avoiding chewing gum.
X-RAYS (RADIOGRAPHS)
X-rays are an important tool that provides the dentist the ability to
examine the roots, jaws, and facial bones of the patient. X-rays aid the
dentist in determining the degree of decay, periodontal disease, abscesses
or any pathology, i.e. cysts or tumors, that may not show clinically through
a visual examination alone. X-rays are taken based on the individual dentist's
assessment of the patient. Most new patients have a full set of x-rays
taken and check-up x-rays are taken as needed.
Types of X-rays
- Bitewing - determine the presence of decay in between teeth. Periapical
- shows root structures, cysts, bone level or other pathology.
- Panoramic - a broad view of entire structure of mouth on one film. It is used to determine if pathology is present, position of wisdom
teeth, etc. It is not used to diagnose cavities.
By using new, state-of-the-art technology, and by using new fast film,
radiation exposure has been greatly decreased.
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