Posts for category: Dental Procedures
Dental cleanings are an important part of regular dental office visits. Performed by a dental hygienist or dentist, cleanings serve two purposes: to remove bacterial plaque and calculus (hardened deposits of plaque) from tooth surfaces missed during daily brushing and flossing; and to remove stains that can dull your smile.
There are different degrees of cleaning, including root planing that removes plaque and calculus deep below the gum line, usually for patients affected by periodontal (gum) disease. For patients in good oral health, the basic cleaning approach is known as prophylaxis, a term derived from the Greek for guarding or preventing beforehand. The techniques used in a prophylaxis remove both “coronal” (tooth surfaces visible above the gum line) plaque and staining, providing both therapeutic and cosmetic benefits.
A typical prophylaxis includes a procedure known as scaling. Hygienists use special instruments known as scalers to remove plaque and calculus by hand, or an ultrasonic device that vibrates plaque loose and is flushed away with water. The procedure removes that rough coating you often feel as you rub your tongue against your teeth, leaving the tooth surfaces feeling smooth.
Tooth polishing is a subsequent procedure to scaling that also removes plaque and surface stains. Polishing is carried out with a motorized instrument with a rubber cup in which a polishing (or “prophy”) paste is contained. The hygienist moves the rapidly rotating cup filled with the paste over the tooth surface to remove plaque and stains. The end result is a highly smooth surface and a much shinier appearance.
People with dental insurance plans are often concerned tooth polishing may be viewed strictly as a cosmetic procedure, and thus not fully qualify for benefits. This should not be the case if coded properly: tooth polishing is part of the overall prophylaxis to remove plaque and staining. The primary purpose is therapeutic and preventive; the cosmetic effect is a by-product. Most dental plans will cover one or two prophylaxes (scaling and tooth polishing) a year, but there are variations so individuals should check their plans.
If you would like more information on dental cleaning, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Polishing.”
For a predictable outcome, a dental implant should be placed as soon as the bone and gum tissues following a tooth extraction have healed. But what happens if the tooth has been missing for months or years? You might then run the risk of not having enough bone to properly place an implant.
This can happen because of a disruption in the growth cycle of living bone tissue. As older bone cells dissolve (resorption), new bone develops to take its place. This is a dynamic process, as the amount and exact location of the new growth is in response to changes in the mouth, particularly from forces generated by the teeth as we chew. If, however, this stimulation transmitted to the bone no longer occurs because the tooth is missing, the bone will tend to dissolve over time.
In fact, within the first year after a tooth loss the associated bone can lose as much as a quarter of its normal width. This is why we typically place bone grafting material in an empty socket at the same time as we extract the tooth. This encourages bone growth during the healing period in anticipation of installing a dental implant or a fixed bridge. If, however, the bone has diminished to less than required for a dental implant, we must then use techniques to encourage new bone growth to support a future implant.
One such technique for restoring bone in the back of the upper jaw is to surgically access the area through the maxillary sinus (a membrane-lined air space within the bone structure of the face) positioned just over the jawbone to place grafting material. During surgery performed usually with local anesthesia, the surgeon accesses the sinus cavity, lifts the tissue membrane up from the sinus floor and applies the grafting material on top of the bone. Eventually, the new bone growth will replace the grafting material.
If successful, the new bone growth will be sufficient to support an implant. Thanks to this renewed growth, you’ll soon be able to enjoy better function and a transformed smile provided by your new implant.
If you would like more information on forming new bone for implants through sinus surgery, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sinus Surgery.”
You've probably heard of the relatively new method of straightening teeth with thin, plastic orthodontic appliances (“ortho” – to straighten; “odont” – teeth) known as clear aligners. Here are some reasons you might want to consider them for your orthodontic treatment:
- Appearance. Looks aren't everything, as the saying goes. But it may be that metal-covered teeth will not give you a look you want to sport for perhaps a year or more. Adults in particular find that metal braces don't always fit in with their self-image. Because clear aligners are virtually invisible, your teeth will look as they always do and it will not be obvious that you are undergoing orthodontic treatment.
- Control. When you have traditional braces, you cannot take them out of your mouth yourself. They must be professionally removed when your treatment is completed. With clear aligners, however, you can take them out to eat and also for important social occasions. Of course, that means you are also responsible for wearing them as often as needed — a minimum of 22 hours a day. It's a good bargain if you can live up to it, and most find that they can.
- Hygiene. One of the challenges of traditional braces is to learn to clean around them so that your teeth and gums stay healthy throughout treatment. It's not always so easy to do. With clear aligners, you can maintain your usual oral hygiene routine — and also clean the aligners themselves.
- Comfort. Sometimes the rigid brackets and wires of traditional braces can press into sensitive tissues of the mouth. It's something that you will eventually get used to, but it can be uncomfortable temporarily. The material of clear aligners is flexible, so this type of irritation is not an issue.
- Versatility. In recent years, the clear alignment system has been improved to handle more serious malocclusions (“mal” – bad; “occlusion” – bite). Enhancements have also been made to accommodate additional growth of molar teeth in the case of teenagers.
While there are some cases in which traditional braces are still the best option, clear aligners have more applications than ever before. They also have some clear advantages that are worth considering.
If you would like more information about clear aligners, please contact us or schedule an appointment for a consultation. You can also learn more about clear aligners in general by reading the Dear Doctor magazine article “Clear Aligners For Teenagers.”
When a tooth is beyond repair due to disease or injury, it may be necessary to remove it. A “simple” tooth extraction is among the most common in dentistry and certainly not the agonizing procedure depicted in common lore.
They’re referred to as simple extractions because the shape of the tooth and root allows for a fairly straightforward and uncomplicated removal. An example would be the normally cone-shaped upper front tooth that doesn’t offer a lot of resistance during the extraction process.
The process itself is fairly straightforward. Teeth are held in place by the periodontal ligament, an elastic tissue made of tiny fibers that attaches the tooth to the supporting bone. These fibers can be dislodged from the tooth with some careful manipulation — in the hands of an experienced dentist there’s a deft “feel” to the fibers loosening. Once they’ve detached, it requires little effort to remove the tooth; with the aid of local anesthesia, you won’t feel anything but a little pressure.
Immediately after the tooth is removed, we commonly insert bone grafting material in the socket to minimize bone loss until a permanent replacement like a dental implant can be installed after tissue healing. We then place sterile gauze over the site for a few minutes to control bleeding and, depending on the size of the wound opening, we may also place a few stitches to close it. We then give you instructions for caring and cleaning the site over the next few days, and prescribe antibiotics to reduce the chance of infection and anti-inflammatory drugs for any discomfort.
Although a simple extraction is a routine procedure, it’s important to perform a proper assessment of the tooth and the surrounding bone beforehand, including x-rays to determine the tooth’s exact shape and position. If we discover a complication that makes a simple extraction impractical (like multiple roots at acute angles), we may then refer you to an oral surgeon for a more complicated surgical extraction.
It’s our hope you’ll have your natural teeth for as long as you live. But if you must have one removed, you can rest assured it’s a common — and uneventful — experience.
If you would like more information on tooth extraction, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Simple Tooth Extraction.”
When you’re posting a profile photo on LinkedIn, Facebook, Match.com and other social media sites, which shot is likely to make the best impression in terms of “likeability,” “competence” and “influence”? One in which you’re smiling and showing some teeth, for starters, according to PhotoFeeler.com, a crowdsourcing website that helps people evaluate their head shots. If something about your teeth is holding you back from parting your lips when you smile for the camera, here are some tried-and-true options for doing something about it!
Picture-Perfect Color, Shape and Alignment
Improving the color of your teeth may be as easy as getting regular professional cleanings, which are necessary for removal of calculus — dark-yellow hardened buildup of bacterial plaque — and can polish out superficial staining caused by certain beverages and foods.
Actually changing the color of your teeth entails whitening/bleaching. Professional whitening achieves the fastest results because it uses the highest concentration of peroxide solution and custom-fitted trays. In-home whitening kits take longer to work but are less expensive. Results last anywhere from six months to two years.
For permanent whitening results, consider veneers or crowns. In addition to changing tooth color, they can also alter tooth shape, hide wear and even minimize gaps between teeth. Veneers are affixed to the front of teeth, while crowns cover the entire tooth.
Teeth that are chipped, cracked or have noticeable areas of decay, can be restored with bonding, in which a composite resin material is applied that is colored to match your natural teeth.
You can straighten misaligned teeth and no one even has to know you’re doing it. Barely visible and entirely invisible orthodontic appliances include clear braces, lingual braces (attached to the tongue-facing side of teeth) and clear aligners, which are removable for tooth brushing/flossing, cleaning the appliance, eating, and special occasions.
If you would like more information about enhancing your smile, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Beautiful Smiles by Design.”