Your regularly scheduled check-up is often referred to as a "cleaning", but there is much more to it than that! The technical term is oral prophylaxis, which means prevention of oral disease.

One way to prevent oral disease is to remove harmful plaque and tartar (calculus) both above and below the gum line. You may also be given special instructions on brushing or flossing to keep clean the areas where we found significant buildup. That is the familiar "cleaning" part of your checkup.

Before: This patient has a small notch in three of her four front teeth.

After: Minor contouring (shaping) of the enamel makes her teeth smooth and natural looking!

Veneers are laboratory fabricated, porcelain facings that are bonded to the front surfaces of teeth to whiten teeth, close spaces, straighten teeth, or repair chipped or worn teeth. The veneers are only about 1 mm thick (the thickness of a fingernail). That same thickness is "shaved" off the natural tooth surface so when the veneer is bonded to the tooth, the tooth doesn't feel or look "thicker".

Caps (Crowns) are rarely used for cosmetic correction any more, since the advent of veneers, but in some cases a crown may be necessary for a particular tooth. A tooth with a bad fracture or a large filling that is breaking down, or has decay around it, may be a candidate for a crown instead of a veneer. This patient has veneers on top, but one of the front teeth had a large filling and had to be crowned.

Fillings

After decay is removed from a tooth, something must be placed in that space to give strength back to the tooth.

Fillings: Fillings are the most common restorative procedure.

Onlays: In addition to fillings, lab fabricated onlays are sometimes used. Although many patients think of these as fillings as well, they are actually different since they are laboratory fabricated.

White fillings: White fillings are used almost all of the time in our office. They are an attractive, durable alternative to silver (amalgam) fillings. White fillings are made of a strong composite resin that is matched to the surrounding tooth color. In the past, white fillings were placed only on front teeth, but recently a stronger more durable material has been developed that can withstand the chewing pressure of back teeth.

Silver (amalgam) fillings: Although white composite resin fillings are used almost exclusively by our office, there may be unique circumstances that call for a silver (amalgam) filling. Typically, silver fillings are placed on back teeth (molars).

Gold inlay or onlay: Our office does not use gold inlays.A gold inlay or onlay is used when the cavity is too big for a filling, but isn't so big that a crown is required. An inlay is a filling within the cusp tips of the tooth. Onlays (also known as overlays) will overlay one or more cusps in order to protect and strengthen the tooth.

Root Canal Therapy

When the nerve of a tooth becomes infected or abscessed, Root Canal Therapy is the only way to save the tooth. A tooth can become abscessed as a result of deep decay, a cracked tooth, or trauma to the tooth. The only alternative to Root Canal Therapy is an Extraction.

During Root Canal Therapy, the tooth is "numbed" (just like having a filling). Then the unhealthy nerve is removed and medication is placed in the tooth to treat the bacterial abscess (infection). After the infection is removed and treated, a filling is placed in the roots where the unhealthy nerve was.

A tooth that has undergone Root Canal Therapy is more brittle and must be crowned to give the tooth sufficient strength. The tooth is cared for in the same way as other natural teeth. Brush and floss daily, and visit your dentist for regular preventative dental check-ups.

High-Tech Root Canal Therapy

The way root canal therapy is performed today is vastly different than those done a few years ago, not to mention a decade ago. The potential level for quality care has dramatically increased. It is a thing of the past to do root canals in five to six appointments, or by "touch or feel" because we could not see. Root canals can be done painlessly, faster, and more accurately due to the new technology available.

Non-surgical Root Canal Therapy

Root Canal Therapy is a dental procedure, performed with local anesthetic, which involves the removal of the nerve inside of the tooth because it has become irreversibly damaged or infected. This is usually due to the entry of bacteria into the center most part of the tooth called the dental pulp (nerve). ROOT CANAL is a commonly used term for endodontic therapy or root canal therapy. This procedure involves the removal of the entire nerve system, as well as cleaning, shaping and 3-dimensional filling of the canal system with gutta percha and a dental sealer. The procedure enables you to keep your natural tooth, which is preferable to any type of replacement.

What Happens During Root Canal Therapy?

Step one: After the tooth is "numbed", a small opening is made into the pulp chamber. The canals are located and measured, so they can be cleansed and shaped.

Step two: The canals are filled with a rubber-like material called gutta-percha and the opening is sealed with sterile cotton pellets and a temporary filling.

Step three: The tooth is typically restored within a couple of weeks. A crown is placed over the treated tooth in order to protect it, and if the tooth lacks sufficient tooth structure to hold the core build-up, a post may be placed inside. Any areas of infection around the roots will begin to heal.

The number of visits necessary to complete a root canal will vary depending upon the degree of infection, the number of canals in the tooth, if the canals are calcified, the anatomy of your tooth, and the complexity of the procedure. We always strive to achieve the best possible result; therefore, your treatment may take one visit, or it may take more.

Tooth Whitening

What is Tooth Whitening?

Tooth Whitening is actually a mild bleaching process that restores stained or discolored teeth to a healthy, natural color. Don't be misled by unproven and ineffective over-the-counter whitening solutions. Our office uses an advanced procedure that is only available from your dentist.

What Causes Tooth Discoloration?

Teeth become discolored for different reasons:

• Frequently drinking coffee, tea, or colas.
• Some antibiotics may darken developing teeth in children.
• Aging - The dentin underneath the enamel of a tooth gradually darkens with age.
• Use of tobacco products.
• If a tooth has been traumatized, sometimes the nerve will gradually "die," and the tooth becomes dark.
• After Root Canal Therapy, a tooth will generally darken.

Is Whitening Safe?

Whitening is very safe. We use a product that has been proven safe when used under the direction of a dentist.

Is Whitening For Me?

Your dentist will evaluate your teeth and smile to determine whether whitening is right for you.

What Is The At-Home Whitening Process?

	First, we will make impressions of your teeth so that our lab can create custom whitening trays to fit your mouth. These trays will guide the whitening agent to the areas of your teeth that need to be whitened. We will record the current color of your teeth to help you monitor your progress.
	Next, we will fit your custom trays in your mouth to ensure they feel comfortable. We will instruct you on how to apply the whitening agent to your trays and how to insert them into your mouth. You will take the custom trays and whitening agent home with you. The treatment can be applied any time of day since the clear, custom-fitted trays are barely visible and do not interfere with your ability to speak.

When Will I See Results?

Immediately! Most patients see results after the first treatment. It will typically take from 2 to 6 weeks to restore your teeth to a beautiful white. The time it will take depends on the original color of your teeth, how discolored they were, and how frequently the treatment is applied.

Are There Any Side-Effects?

Some patients may experience heightened tooth sensitivity to cold, or mild tooth or gum sensitivity during treatment, but these symptoms are only temporary and disappear within a few days.

X-rays

What are Dental X-rays? What most people call X-rays are actually X-ray photographs (also known as radiographs). An image is made using X-rays, which are similar to sunlight, but of a shorter wavelength, and able to show us what's below the surface of a tooth. Even though we call them X-rays, we are actually referring to the image created by X-rays.

Why are Dental X-rays Necessary?

X-rays are the only way to identify problems that aren't externally visible. X-rays are very essential in doing a complete and thorough dental examination. They are especially important in diagnosing serious conditions early to allow for effective treatment before you experience discomfort. X-rays show bone anatomy and density, decay between the teeth or how extensive the decay is, whether an abscess is present, impacted teeth, or if children have permanent teeth.

No cavity on first x-ray.	Months later, cavities that start between the teeth can't be seen by visual examination, but they can be detected on an x-ray.

This cavity was detected and filled before the patient felt any discomfort, and before the nerve became infected or the tooth became abscessed.

How Often Do I Need Dental X-rays?

The number and type of X-rays you will need depends on several factors such as age, current dental health, and external signs that may trigger a cause for concern. We are sensitive, however, to your concerns about exposure to radiation, and we only perform those X-ray procedures that are necessary for your continued dental health.

Are Dental X-rays Safe?

Dental X-rays are very safe. They are taken at fast speeds with low radiation. A special lead apron is used to further reduce exposure. Everyone is exposed to a certain level of "background" radiation every day. Background radiation comes from many sources, including the sun. The amount of radiation from dental X-ray photographs (two views) is approximately equivalent to only two days of exposure to background radiation. In other words, you receive as much radiation in two days of normal activity as you do from two bite-wing X-ray photographs. If you are curious about panoramic X-ray photographs, they are equivalent to only about eight days of background radiation.*

*Source: British Journal of Radiology, 56, 511-516, 1983

Still Have Questions or Concerns?

If you have any questions or concerns about dental X-rays, feel free to discuss them with any of our staff. They are highly trained in the prudent and effective use of dental X-rays and share your concerns about exposure levels.