General Dentistry Emergency Care Pediatric Dentistry Orthodontics General Dentistry The practice of dentistry encompasses an amazing array of services and procedures, all with a common goal: to help you to preserve your natural teeth as long as possible, ensure your oral health, and keep you looking and feeling great throughout life. There’s so much that can be done these days to improve the appearance of a person’s smile — at any age. From powerful, professional whitening treatments to amazingly realistic porcelain veneers to state-of-the-art dental implants, there’s a wide range of exciting possibilities. The first step in any smile makeover is a thorough dental examination to make sure that your cosmetic problems really are just that, and not a sign of underlying dental disease. Once your health has been established, your smile can be cosmetically enhanced in a variety of ways. Cosmetic & General Dentistry Procedures Modern dentistry offers a wide range of services to make sure your teeth stay healthy, function well and look great. These procedures include: Cleanings & Oral Exams, to keep your teeth and gums healthy, and catch early signs of dental disease Cosmetic Bonding, to repair small chips or cracks Crowns & Bridgework, to replace large amounts of lost tooth structure and/or missing teeth Dental Implants, for the longest-lasting tooth replacement available today Simple Extractions, to remove unhealthy teeth that cannot be saved Fillings, to restore decayed teeth Inlays & Onlays, to fill teeth with larger cavities Invisalign Clear Aligners, for highly discreet orthodontic treatment Oral Cancer Screenings, to detect a dangerous disease that can be cured if caught early Orthodontic Treatment, to move teeth into the right position Porcelain Veneers, for repairing larger chips and cracks, and reshaping teeth Removable Dentures, to help you smile again Root Canal Treatment, to rescue diseased teeth Sealants, to help prevent cavities Teeth Whitening, to brighten a faded or discolored smile TMD Treatment, for pain in the jaw area that can interfere with biting and chewing Tooth-Colored Fillings, for a completely natural, healthy look Tooth Decay Prevention, so you keep your natural teeth as long as possible When to Visit the Dentist Many people only go to the dentist when something is wrong. That is truly a shame, because they are missing out on so many preventive services that can save discomfort — and expense — down the road. Regular dental visits are essential to make sure oral health problems — from tooth decay to oral cancer — are detected and treated in a timely manner. Some individuals may need to see the dentist more often than others to stay on top of problems like plaque buildup and gum disease, but everyone should go at least once per year. Your regular dental visits will include a thorough oral exam to check the health of your teeth and gums; and oral cancer screening to spot any suspicious signs early; and a professional cleaning to remove stubborn deposits and make your teeth look and feel great. So don’t miss out on the many benefits dentistry offers you and your family! Your Smile Makeover The most important job you have as a member of your own smile makeover team is to communicate exactly what you don’t like about your smile and how you’d like it to be different. Before the first consultation, give some thought to the following questions: What do you like or dislike about the color, size, shape and spacing of your teeth? Are you pleased with how much your teeth show, both when you smile and when your lips are relaxed? Do you want teeth that are perfectly aligned and a bright “Hollywood White,” or would you prefer a more natural look with slight color, shape and shade variations? Would you like more or less of your gums to show when you smile? It is extremely helpful for you to bring in pictures you have collected — of smiles you like, smiles you don’t like, and/or photos of the way your own smile used to look, if that’s the result you’re aiming for. Now is the time to get started on creating a smile that will make you feel as good as you look! Emergency Care When you have a dental emergency — whether it’s caused by a sudden accident or chronic disease — your teeth and/or the tissues of the mouth that surround them need to receive proper care right away. As with any type of medical emergency, it’s important to be aware, before you’re actually in the situation, of what you can do to ensure the best outcome. Traumatic Dental Injuries A knocked-out permanent tooth requires quick thinking and immediate action. You’ll increase the chances that the tooth can be saved if you pick it up without touching the root, gently clean it off with water, and put it back in its socket facing the correct way. Hold it in place with gentle pressure as you rush to the dental office or emergency room. If you can’t replant it immediately, tuck it between the patient’s cheek and gum, or carry it in a container of cold milk. For a more traumatic injury such as a tooth that has been moved or loosened, treatment needs to occur within six hours. However, if there is uncontrollable bleeding, go immediately to the ER. Fortunately, other dental injuries that happen most frequently are less severe. The most common traumatic dental injuries are chipped teeth. If a tooth is chipped, try to find any pieces that have come off, as it might be possible to reattach them. Make an appointment for an office visit as soon as possible, and bring the pieces with you. Tooth Pain Acute or persistent tooth pain always signals a need for an urgent visit to the dental office. The most common cause of dental pain is tooth decay, a bacterial infection that can spread through many parts of the tooth, and even into the gum tissue. Sometimes, tooth pain indicates that you may need a root canal treatment — a procedure that not only relieves the pain of an infection deep inside the tooth, but also can keep the tooth from having to be removed. Other times, pain may be caused by a loose filling or sensitive tooth. The only way to know for sure what’s causing your tooth pain is to make an appointment at the dental office right away. Gum Emergencies Injuries and infections involving the soft tissues of the mouth may also require emergency treatment. The tissues of the gums, tongue, or cheek lining can be damaged by accidental bites, falls, sports injuries, and scalding liquids. They may also suffer injury from foreign bodies that become lodged below the gum line, and they can develop painful and potentially serious abscesses. A periodontal (gum) abscess is a pus-filled sac caused by an infection and is usually quite painful. Abscesses require immediate attention at the dental office. Any injury to the soft tissues of the mouth should be rinsed with dilute salt water. If there is visible debris, it should be cleared. Bleeding can usually be controlled by pressing a clean, damp material to the area for 10-15 minutes. If this does not work, go to the emergency room immediately. A foreign body lodged beneath the gum line can sometimes be gently worked out with dental floss or a toothpick. But if this can’t be accomplished easily, make a dental appointment so the area does not become damaged and/or infected. Orthodontic Emergencies Although there can be discomfort associated with orthodontic treatment, there are only a few true orthodontic emergencies. They include trauma or injury to the teeth, face or mouth. Infection or swelling of the gums, mouth or face, and severe, unmanageable discomfort or pain in these areas can also be orthodontic emergencies. In any of these situations, seek immediate care from the dental office or emergency room — whichever is your best option. For loose, broken or irritating pieces of orthodontic hardware, please call the dental office for advice. Pediatric Dentistry Your child won’t keep his or her first teeth forever, but that doesn’t mean those tiny pearly whites don’t need conscientious care. Maintaining your child’s dental health now will provide health benefits well into adulthood, as primary (baby) teeth serve some extremely important functions. For one thing, primary teeth serve as guides for the eruption of permanent (adult) teeth, holding the space into which these new teeth will erupt. The crowns (tops) of the permanent teeth actually push against the roots of the baby teeth, causing them to resorb, or melt away. In this way, the adult teeth can take their proper place. What’s more, your child’s primary teeth will be there for most of childhood, helping your child to bite, chew and speak. For the first six or so years, he or she will be relying on primary teeth exclusively to perform these important functions. Until around age 12, your child will have a mix of primary and permanent teeth. You will want to make sure those teeth stay healthy and are lost naturally — when it’s time. Your Child’s First Teeth Your child’s 20 baby teeth will begin to appear usually between six and nine months, though in some cases it may start as early as three months or as late as twelve months. The two lower front teeth tend to erupt first, followed by the two upper ones. The first molars come in next, followed by the canines (eyeteeth). Sometimes your baby can experience teething discomfort during this process. If so, there are courses of action to help make your child more comfortable. Your infant’s gums and newly erupting teeth should be gently wiped after each feeding with a water-soaked gauze pad or damp washcloth. Starting at age 2, when there are more teeth in the mouth, establish a daily brushing routine with a small, soft-bristled toothbrush and no more than a thin smear of fluoridated toothpaste. Your child may need your help with this important task until about the age of 6. Your Child’s First Dental Appointment The American Academy of Pediatric Dentistry recommends that your child see a dentist by his/her first birthday. Though this may sound early, learning proper pediatric oral hygiene techniques, checking for cavities, and watching for developmental problems is extremely important. There are a number of forms of tooth decay that can affect babies and small children. Early Childhood Caries (tooth decay) can develop rapidly, progressing from the hard, outer enamel layer of a tooth into the softer, inner dentin in six months or less. Most of all, it’s important for your child to have a positive experience at the dental office as he/she will be a regular visitor for years to come. Pediatric Dental Treatments There are a variety of dental treatments offered to prevent tooth decay in children, or to save or repair teeth when necessary. They include: Topical Fluoride — Fluoride incorporates into the enamel of teeth, making it harder and more resistant to decay. Although there is a small amount of fluoride in toothpastes and in some drinking water supplies, a higher concentration can be applied professionally to your child’s teeth for maximum protection. Dental Sealants — A plastic coating can be applied at the dental office to prevent cavities by sealing the little grooves on the chewing surfaces of back teeth known as “pits and fissures.” These little crevices become the perfect environments for decay-causing bacteria. Immature tooth enamel is more permeable and therefore less resistant to tooth decay. Dental sealants are easy to apply and provide years of protection. Root Canal Treatment — Perhaps you have had a root canal treatment yourself, to save an injured or severely decayed tooth. Well, sometimes children need root canals, too. As mentioned above, baby teeth are important guides to the permanent teeth that are already forming beneath your child’s gums. Therefore, saving them from premature loss can help prevent a malocclusion (“mal” – bad; “occlusion” – bite) that requires orthodontic treatment. Bonding — Chips and minor fractures to front teeth — common childhood occurrences — can be repaired with tooth-colored bonding materials. These lifelike resins made of plastic and glass can be used on baby teeth as well as permanent teeth and last until the youngster has completed facial growth. Orthodontic Concerns By around age 7, most malocclusions have become evident. Interceptive orthodontic treatment around this time can help direct proper tooth positioning and/or jaw growth, eliminating or simplifying the need for later treatment. There are many orthodontic problems that can be detected early and are examples of why a trained professional should evaluate your child during his/her growth and development. Sports & Your Child’s Teeth If your child is active in sports, a custom-made mouthguard is a highly recommended safeguard. According to the American Dental Association, an athlete is 60 times more likely to suffer dental harm when not wearing one of these protective devices. A custom mouthguard is made specifically for your child using a model of his or her teeth. This will offer greater protection than an off-the-shelf model. It’s an investment that pays off highly in the form of reduced pain, suffering — and dental expenses down the road! Orthodontics What a difference straight teeth can make! A great-looking smile can boost your self-confidence and have a positive impact on social and professional opportunities. Orthodontic treatment is the original smile makeover tool — and you will be happy to know that you’re never too old to take advantage of it. But it isn’t all about looks: Properly aligned teeth help you to bite, chew and even speak more effectively. They are also easier to clean, which helps keep your mouth free of tooth decay and gum disease. The amazing thing about orthodontics is that it harnesses the body’s natural ability to remodel its own tissue. With the application of light, constant force, orthodontic appliances gently reshape bone and move teeth into better positions. Some examples of these appliances are traditional metal braces, inconspicuous clear or tooth-colored braces, and clear aligners, a relatively new option for adults and teens. Bite Problems and How to Fix Them Orthodontic treatment can resolve a number of bite problems, which often become evident by around age 7. These include underbite, crossbite or excessive overbite, where upper and lower teeth don’t close in the proper position; open bite, where a space remains between top and bottom teeth when the jaws are closed; and crowding or excessive spacing, where teeth are spaced too close together or too far apart. To correct bite problems, teeth need to be moved — but doing that isn’t as hard as you might think! Teeth aren’t fixed rigidly in their supporting bone; instead, they’re held in place by a hammock-like structure called the periodontal ligament, which is very responsive to forces placed on the teeth. Orthodontic appliances move teeth by careful application of light, constant pressure. This force can be applied via metal wires that run through small brackets attached to the teeth (braces), or via the semi-rigid plastic of clear aligners. Orthodontics is for Children — and Adults Having orthodontic treatment in childhood is ideal in order to take advantage of a youngster’s natural growth processes to help move the teeth into proper alignment. Like the rest of the body, the teeth and jaws are now changing rapidly. So at this time it’s possible (for example) to create more room for teeth in a crowded mouth by using a “palatal expander” to rapidly widen the upper jaw. This phase of growth modification can shorten overall treatment time and ensure the best result if additional orthodontic appliances are needed. But remember, healthy teeth can be moved at any age, so you’ve never “missed the boat” for orthodontic treatment. In fact, about one in five of today’s orthodontic patients is an adult. Several new technological developments — including tooth-colored ceramic braces, clear aligners and invisible lingual braces — have made orthodontic appliances less evident, and enhanced the treatment experience for grown-ups. Before treatment, adults are carefully examined for signs of periodontal (gum) disease, which will be brought under control before treatment begins. Types of Orthodontic Appliances When you imagine someone wearing braces, you probably picture small metal brackets bonded to the front of the teeth, with a thin wire running through them. This time-tested style remains very popular — but it’s no longer the only option. Clear braces use brackets made of ceramic or plastic which, except for the slim archwire, are hardly visible. Lingual braces are just like traditional metal braces — except they’re bonded to the back of your teeth (the tongue side) so that no one can see them. Removable clear aligners are an alternative to fixed orthodontic appliances. They consist of a series of clear plastic “trays” that fit over your teeth exactly; each one moves your teeth a little bit, until they are in the proper position. Whether fixed or removable, each type of appliance may have advantages or disadvantages in particular situations. After a complete examination, the best treatment options for you will be discussed. Retention & Post Orthodontic Care Once your orthodontic treatment is completed, it’s extremely important to wear a retainer as directed. That’s because teeth naturally tend to drift back to their original locations — which is the last thing you want after you’ve gone to the trouble of straightening them! Wearing a retainer holds your teeth in their new position long enough for new bone and ligament to re-form around them, and helps keep your gorgeous new smile looking good for a lifetime.