Frequently Asked Questions
Basic Dental Services
How is a tooth extracted?
As a precaution, the dentist will first take X-rays of the tooth or teeth in question, to help plan the procedure. After preparing a method of extraction, you will be given a local anesthetic that will prevent you from feeling pain during the procedure. Next, the dentist will use a tool called an elevator to lift the tooth and loosen ligaments and gum tissue around the base of the tooth. Finally, the dentist will use a pair of forceps, to gently rock the tooth back and forth until it breaks free of the ligaments holding it in the gum tissue. Occasionally, a stubborn tooth will resist the dentist’s soft tug, refusing to come out. In these and more complex cases, the tooth may need to be broken up into smaller pieces for removal.
Once removed, we will pack gauze into the socket and have you place pressure on the area by biting down. If necessary, the dentist will place stitches to close the socket.
If you are sick the week prior to your scheduled extraction or on the day of, please contact our office, as alternative arrangements may need to be made. Please contact us if you have any questions or concerns.
Where can oral cancer occur?
• Salivary Glands
• Oropharyngeal Region (throat)
How effective is oral cancer treatment?
When oral cancer is diagnosed in its earliest stages, treatment is generally very effective. Any noticeable abnormalities in the tongue, gums, mouth or surrounding area should be evaluated by a health professional as quickly as possible. During the oral cancer exam, the dentist and dental hygienist will be scrutinizing the maxillofacial and oral regions carefully for signs of pathologic changes.
The following signs will be investigated during a routine oral cancer exam:
1. Red patches and sores – Red patches on the floor of the mouth, the front and sides of the tongue, white or pink patches which fail to heal and slow healing sores that bleed easily can be indicative of pathologic (cancerous) changes.
2. Leukoplakia – This is a hardened white or gray, slightly raised lesion that can appear anywhere inside the mouth. Leukoplakia can be cancerous, or may become cancerous if treatment is not sought.
3. Lumps – Soreness, lumps or the general thickening of tissue anywhere in the throat or mouth can signal pathological problems.
How is an oral cancer exam preformed and what are the treatments?
The oral cancer examination is a completely painless process. During the visual part of the examination, the dentist will look for abnormality and feel the face, glands and neck for unusual bumps. Lasers which can highlight pathologic changes are also a wonderful tool for oral cancer checks. The laser can “look” below the surface for abnormal signs and lesions which would be invisible to the naked eye.
If abnormalities, lesions, leukoplakia or lumps are apparent, the dentist will implement a diagnostic impression and treatment plan. In the event that the initial treatment plan is ineffective, a biopsy of the area will be performed. The biopsy includes a clinical evaluation which will identify the precise stage and grade of the oral lesion.
Oral cancer is deemed to be present when the basement membrane of the epithelium has been broken. Malignant types of cancer can readily spread to other places in the oral and maxillofacial regions, posing additional secondary threats. Treatment methods vary according to the precise diagnosis, but may include excision, radiation therapy and chemotherapy.
What do Sealants involve?
The teeth to be sealed are thoroughly cleaned and then surrounded with cotton to keep the area dry. A special solution is applied to the enamel surface to help the sealant bond to the teeth. The teeth are then rinsed and dried.
Sealant material is carefully painted onto the enamel surface to cover the deep grooves or depressions. Depending on the type of sealant used, the material will either harden automatically or with a special curing light.
Proper home care, a balanced diet, and regular dental visits will aid in the life of your new sealants.
What are the reasons for getting crowns?
Reasons for getting crowns include:
- Broken or fractured teeth
- Cosmetic enhancement
- Decayed teeth
- Fractured fillings
- Large fillings
- Tooth has a root canal
What does a crown involve?
A crown procedure usually requires two appointments. Your first appointment will include taking several highly accurate molds (or impressions) that will be used to create your custom crown. A mold will also be used to create a temporary crown which will stay on your tooth for approximately two weeks until your new crown is fabricated by a dental laboratory.
While the tooth is numb, the dentist will prepare the tooth by removing any decay and shaping the surface to properly fit the crown. Once these details are accomplished, your temporary crown will be placed with temporary cement and your bite will be checked to ensure you are biting properly.
At your second appointment your temporary crown will be removed, the tooth will be cleaned, and your new crown will be carefully placed to ensure the spacing and bite are accurate.
You will be given care instructions and encouraged to have regular dental visits to check your new crown.
What are the signs and symptoms for needing a root canal?
Signs and symptoms that show you may require a root canal treatment are:
- An abscess (or pimple) on the gums
- Sensitivity to hot and cold
- Severe toothache pain
- Sometimes no symptoms are present
- Swelling and/or tenderness
What are the reasons for root canal therapy?
Reasons may include:
- Decay has reached the tooth pulp (the living tissue inside the tooth)
- Infection or abscess have developed inside the tooth or at the root tip
- Injury or trauma to the tooth
What is a root canal treatment?
A root canal procedure requires one or more appointments and can be performed by a dentist or endodontist (a root canal specialist).
While the tooth is numb, a rubber dam (a sheet of rubber) will be placed around the tooth to keep it dry and free of saliva. An access opening is made on top of the tooth and a series of root canal files are placed into the opening, one at a time, removing the pulp, nerve tissue, and bacteria. If tooth decay is present, it will also be removed with special dental instruments.
Once the tooth is thoroughly cleaned, it will be sealed with either a permanent filling or, if additional appointments are needed, a temporary filling will be placed.
At the next appointment, usually a week later, the roots and the inside cavity of the tooth will be filled and sealed with special dental materials. A filling will be placed to cover the opening on top of the tooth. In addition, all teeth that have root canal treatment should have a crown (cap) placed. This will protect the tooth and prevent it from breaking, and restore it to its full function.
After treatment, your tooth may still be sensitive, but this will subside as the inflammation diminishes and the tooth has healed.
You will be given care instructions after each appointment. Good oral hygiene practices and regular dental visits will aid in the life of your root canal treatment.
What are the reasons for getting dental implants?
Reasons for dental implants include:
- Replace one or more missing teeth without affecting adjacent teeth
- Resolve joint pain or bite problems caused by teeth shifting into missing tooth space
- Restore a patient’s confident smile
- Restore chewing, speech, and digestion
- Restore or enhance facial tissues
- Support a bridge or denture, making it more secure and comfortable.
What does getting dental implants involve?
The process of getting implants requires a number of visits over several months.
X-rays and impressions (molds) are taken of the jaw and teeth to determine bone, gum tissue, and spacing available for an implant. While the area is numb, the implant will be surgically placed into the bone and allowed to heal and integrate itself for up to six months. Depending on the type of implant, a second surgery may be required in order to place the “post” that will hold the artificial tooth in place. With other implants the post and anchor are already attached and placed at the same time.
After several weeks of healing the artificial teeth are made and fitted to the post portion of the anchor. Because several fittings may be required, this step may take one to two months to complete. After a healing period, the artificial teeth are securely attached to the implant, providing excellent stability and comfort to the patient.
You will receive care instructions when your treatment is completed. Good oral hygiene and eating habits, alongside regular dental visits, will aid in the life of your new implant.
What are commonly Used Regenerative Procedures?
The following are the most commonly used regenerative procedures:
Dental implants and other restorative procedures depend on the jawbone being sufficiently strong and thick. When periodontal disease has taken hold, the jawbone may have become too thin to successfully support an implant. Natural bone regeneration (or bone grafting) is one of the best ways to promote growth and thicken the jawbone.
Initially, bone grafting material is obtained from elsewhere on the body or from a bone bank. The gums are gently pulled back, and an opening is made in the jawbone where the grafting material will be packed in tightly.
A membrane is used to maintain the shape of the new bone, and tissue stimulating proteins and a platelet-rich growth factor may be applied to promote faster healing. The surgical site will be sutured and packed with protective material.
The bone will naturally regenerate and become strong enough to eventually support an implant.
Gum Tissue Regeneration
Gum tissue regeneration is usually performed by way of gum grafting. When gum tissue has been lost as a result of periodontal disease, the smile may appear discolored, toothy or unpleasant. A gum graft aims to symmetrically contour the gum line, cover any exposed tooth roots and restore health to the gums.
Initially, a small strip of tissue will be removed from the roof of the mouth and placed in the middle of a split-thickness incision at the recipient site. The surgical site will be covered with a protective membrane which promotes tissue regeneration, covered in platelet-rich growth factor and tissue stimulating proteins, and then sutured closed.
The soft tissue surrounding the teeth will naturally regenerate, producing a healthy, smile.
Pocket Reduction Surgery
The aim of pocket reduction surgery is to reduce the depth of the gum pockets and make it much harder for bacteria to invade the gum tissue. Initially, the gum tissue is pulled back from the teeth and the subgingival area is thoroughly cleansed under local anesthesia.
Extensive scraping may be required to fully remove the plaque, debris and tartar from below the gum line. An antimicrobial agent may then be applied to the affected area to kill any remaining bacteria, and the surgical site will be sutured closed.
Pocket reduction surgery is very effective for halting tissue loss and promoting the natural healing of the gums.
Scaling and Root Planing
The term “scaling” refers to the removal of plaque and calculus (tartar) from the supragingival region (above the gum line). This treatment is usually conducted in the course of a routine professional cleaning, and performed under local anesthetic.
Root planing usually accompanies scaling and is performed in the subgingival region (below the gum line). Tartar and toxins are initially removed, and then the tooth root is smoothed down to promote good healing in the gum tissue.
The planing of the tooth root provides a smooth area which prevents bacteria from recolonizing. If these procedures do not completely eradicate the infection, surgical measures may be required.
What are the reasons for bone grafting?
Reasons for bone grafts include:
Bone grafting is a highly successful procedure in most cases. It is also a preferable alternative to having missing teeth, diseased teeth, or tooth deformities. Bone grafting can increase the height or width of the jawbone and fill in voids and defects in the bone.
There are essentially two basic ways in which bone grafting can positively impact the health and stability of the teeth:
- Jaw Stabilization – Bone grafting stabilizes and helps restore the jaw foundation for restorative or implant surgery. Deformities can also be corrected and the restructuring of the bone can provide added support.
- Preservation – Bone grafting can be used to limit or prevent bone recession following a tooth extraction, periodontal disease, or other invasive processes.
What is the process for bone grafting?
Initially, we start with an oral examination. The dentist will thoroughly examine the affected area in order to assess the general condition of the teeth and gums. If periodontal disease is present or the adjacent teeth are in poor condition, these factors will be fully addressed before the bone grafting procedure can begin.
The dentist will also recommend panoramic x-rays in order to assess the precise depth and width of the existing bone. On occasion, a CAT scan may be recommended to determine the bone condition. Depending on these results, the dentist may also anesthetize the area and explore into the gum in order to determine what kind and how much bone is required.
What types of bone grafting are there?
There are several types of bone grafts. Your dentist will determine the best type for your particular condition. These include:
- Autogenous Bone Graft – Harvested from the patient’s own body (usually from the posterior part of the lower jaw or the chin). This method is usually preferred because it produces the most predictable results.
- Allograft Bone Graft – Cadaver or synthetic bone is used in this type of graft.
- Xenograft – Cow bone is used in this type of graft.
The bone grafting procedure can often take several months to complete. Bone is typically harvested from your own body (or on rare occasions obtained from a “bone bank”) and added to the affected site. This bone will fuse with the existing bone and the migration of cells will cause firm adhesion and cell growth. Supplementing the jaw with bone will result in greater bone mass to help support and anchor the implant(s).
During the surgery, the dentist will numb the grafting and extraction sites using local anesthetic. A small incision will be made to prepare the site for the new bone and it will be anchored into place. On occasion, a synthetic membrane may be used to cover the new bone.
This membrane prevents soft tissue and bacterial invasions, and encourages new bone growth. The surgery does not require an overnight stay, and you will be provided with comprehensive instructions for your post-operative care.
The dentist will prescribe medications to help manage infection, discomfort and swelling.
What are the types of soft tissue grafting?
The three different types of common soft tissue grafts include:
- Free gingival graft – A strip of tissue is removed from the roof of the mouth and stitched to the grafting site in order to promote natural growth. This type of graft is most commonly used for thickening existing tissue.
- Connective tissue graft – For larger areas or root exposure, subepithelial tissue is needed to remedy the problem. This subepithelial connective tissue is removed from a small flap in the mouth and sutured to the grafting site. This is the most common treatment for root exposure.
- Pedicle graft – This type of graft involves the “sharing” of soft tissue between the affected site and adjacent gum. A flap of tissue is partially cut away and moved sideways to cover the root. The results of this type of graft are excellent because the tissue that is moved to the adjacent area includes blood vessels that are left in place.
What are the benefits of soft tissue grafting?
Soft tissue grafting is an extremely versatile procedure that has many uses. Recent developments in dental technology have made soft tissue grafting more predictable and less intrusive. Here are some of the main benefits associated with soft tissue grafting treatment:
- Increased comfort – Root exposure can cause substantial pain and discomfort. Eating hot, cold or even warm foods can cause severe discomfort. Soft tissue grafts cover the exposed root, decrease sensitivity and restore good health to the gum area.
- Improved aesthetics – Gum recession due to periodontal disease can cause the smile to look “toothy” or the teeth to appear uneven in size. Soft tissue grafting can be used as a cosmetic procedure to re-augment the gums, and make the smile appear more symmetrical.
- Improved gum health – Periodontal disease is a progressive condition that can destroy soft tissue very rapidly. When used in combination with deep cleaning procedures, soft tissue grafting can halt tissue and bone loss, and protect exposed roots from further complications.
What does soft tissue grafting treatment involve?
Initially, deep cleaning will be performed both above and below the gum line to clear the teeth and roots of calculus (tartar). The grafting procedure itself will generally be performed under local anesthetic, but this will depend on the size of the areas receiving grafts.
A small incision will be made at the recipient site in order to create a small pocket. A split thickness incision is made in this pocket and the donor tissue is placed between the two sections of this area. The donor tissue strip is generally larger than the incision, so some excess will be apparent.
Platelet rich growth factors which stimulate natural tissue growth and promote good healing may be applied to the site before suturing. In addition, tissue-stimulating proteins may be added to encourage quicker tissue growth. Finally, the wound site will be sutured to prevent shifting, and surgical material will be placed to protect the sensitive area. Gum uniformity and substantial healing will take place in the first six weeks after the procedure.
How is Bruxism diagnosed?
A BiteStrip® is an economical device used to diagnose bruxism at home. The device itself is a small electromyography which senses and monitors any activity in the jaw muscles during sleep. The frequency and severity of the condition can then be assessed and the best treatment plan can be formulated.
What are the reasons for the treatment of bruxism?
Here are some of the main reasons why bruxism should be promptly treated:
- Gum recession and tooth loss – Bruxism is one of the leading causes of gum recession and tooth loss. It damages the soft tissue directly and leads to loose teeth and deep pockets, where bacteria can colonize and destroy the supporting bone.
- Occlusal trauma – The abnormal wear patterns on the occlusal (chewing) surfaces can lead to fractures in the teeth, which may require restorative treatment.
- Arthritis – In severe and chronic cases, bruxing can eventually lead to painful arthritis in the temporomandibular (TMJ) joints (the joints that allow the jaw to open smoothly).
- Myofascial pain – The grinding associated with bruxism can eventually shorten and blunt the teeth. This can lead to debilitating headaches and muscle pain in the myofascial region.
What are the treatment options for bruxism?
There is no single cure for bruxism, though a variety of helpful devices and tools are available. Here are some common ways in which bruxism is treated:
- Mouthguards – An acrylic mouthguard can be designed from tooth impressions to minimize the abrasive action of tooth surfaces during normal sleep. Mouthguards should be worn on a long-term basis to help to stabilize the occlusion as well as prevent damage to teeth and to the temporomandibular joint.
- NTI-tss device – This device is fitted by a health professional and only covers the front teeth. The goal of the NTI-tss is to prevent the grinding of the rear molars by limiting the contraction of the temporalis muscle.
Other methods of treatment include relaxation exercises, stress management education, and biofeedback mechanisms. When the bruxing is under control, there are a variety of dental procedures such as crowns, gum grafts, and crown lengthening that can restore a pleasant aesthetic appearance to the smile.
What are the reasons for teeth whitening?
Reasons for teeth whitening include:
- Fluorosis (excessive fluoridation during tooth development).
- Normal wear of outer tooth layer.
- Stained teeth due to medications (tetracycline, etc.).
- Yellow, brown stained teeth.
What does teeth whitening involve?
This type of teeth whitening usually requires two visits. At the first appointment, impressions (molds) will be made of your teeth to fabricate custom, clear, plastic, trays.
At your second appointment, you will try on the trays for proper fit, and adjustments will be made if necessary. The trays are worn with special whitening solution either twice a day for 30 minutes or overnight for a couple of weeks depending on the degree of staining and desired level of whitening. It is normal to experience tooth sensitivity during the time you are whitening your teeth, but it will subside shortly after you have stopped bleaching.
You will receive care instructions for your teeth and trays, and be encouraged to visit your dentist regularly to help maintain a beautiful, healthy, white smile.
What kind of bite problems can Invisalign® correct?
Invisalign® corrects the same dental problems as traditional metal braces; the only difference is that Invisalign® trays are almost invisible to the naked eye, and can be removed at will.
Here are some problems that are commonly corrected with Invisalign®:
- Overcrowding – This occurs when there is too little space for the teeth to align normally in the mouth. Overcrowding can cause tooth decay and increase the likelihood of gum disease.
- Large gaps between teeth – This can sometimes occur because teeth are missing or because the jaw continues to grow abnormally.
- Crossbite – This common dental problem occurs when one or multiple upper teeth bite inside the lower teeth. As a consequence, uneven wear can lead to bone erosion and gum disease.
- Overbite – This problem occurs when the upper teeth project further than, or completely cover, the lower teeth. Eventually, jaw pain and TMJ may occur.
- Underbite – This is the inverse of the overbite; the lower teeth project further than, or completely cover, the upper teeth. Eventually, jaw pain and TMJ can occur.
What advantages does Invisalign® offer over traditional braces and veneers?
Traditional dental braces, Invisalign® aligning trays, and dental veneers are three different ways to perfect the alignment of the teeth. There are many different considerations to make when deciding which treatment will be best, and each of these options works better in certain situations.
Invisalign® differs from traditional braces in that the aligning trays are fully removable. This means that more discipline and commitment is required from the patient. This is not usually a problem since the trays are comfortable and nearly invisible. Almost identical results can be obtained by using either treatment.
Invisalign® is preferable to veneers in many cases because unlike veneers, Invisalign® actually straightens the teeth. Veneers are thin covers that the dentist permanently affixes to the teeth. Teeth must be etched beforehand, meaning that to remove dental veneers, an alternative covering must be constructed. In addition to being somewhat expensive, veneers can break and often last for less than 20 years.
What does Invisalign® treatment involve?
First, the dentist needs to devise an initial treatment plan before creating the special aligning trays. Three-dimensional digital images are taken of the entire jaw. These images allow the dentist to move specific teeth on the screen, view the jaw from different angles, and also foresee what the face might look like in years to come. In essence, this technology can show how Invisalign® trays will change the facial aesthetics.
Once planning is complete, a unique set of aligners is made. The total amount of aligners required varies with each individual case, but 20-29 sets per arch is typical.
What are some considerations when wearing Invisalign® trays?
Life with Invisalign® aligning trays may take several weeks to get used to. The trays should be worn constantly, except when eating and drinking. It is important to remove the trays when consuming food or drink because food can become trapped between the tray and the teeth, causing tooth decay.
Usually, new trays are necessary every two weeks, and progress between appointments can be seen with the naked eye. There is no doubt that Invisalign® aligning trays have revolutionized orthodontics. Invisalign® is renowned for being both comfortable and effective.
What are the reasons for cosmetic bonding?
Reasons for cosmetic bonding include:
- Closing spaces or gaps
- Fixing chipped teeth
- Fixing decayed teeth (teeth with cavities)
- Lengthening uneven teeth
- Protecting roots exposed by receding gums
- Restoring badly discolored teeth
What does dental bonding involve?
To begin, the dentist will isolate the teeth included in the procedure, etching them in preparation for bonding. After applying the etching conditioning liquid, the surface of the teeth will have small crevices that allow the tooth stronger adhesion with the bonding agent.
The dentist will then apply a bonding resin which cements the composite in place. After several layers of tooth-colored composite are applied, the composite and bonding resin are shaped and hardened with a specially calibrated light. Once the composite is fully set, the bonded areas are smoothed, buffed, and polished to blend in naturally with the surrounding teeth.
What are the reasons for getting porcelain veneers?
Reasons for porcelain veneers include:
- Cosmetically, to create a uniform, white, beautiful smile
- Crooked teeth
- Misshapen teeth
- Severely discolored or stained teeth
- Teeth that are too small or large
- Unwanted or uneven spaces
- Worn or chipped teeth
What does getting porcelain veneers involve?
Getting veneers usually requires two visits to complete the process, with little or no anesthesia required during the procedure. The teeth are prepared by lightly buffing and shaping the surface to allow for the thickness of the veneer. A mold or impression of the teeth is taken and a shade (color) will then be chosen by you and the dentist.
On the second visit the teeth will be cleansed with special liquids to achieve a durable bond. Bonding cement is then placed between the tooth and veneer and a special light beam is used to harden and set the bond.
You will receive care instructions for veneers. Proper brushing, flossing and regular dental visits will aid in the life of your new veneers.
What are the reasons for getting composite fillings?
Reasons for composite fillings include:
- Chipped teeth
- Closing space between two teeth
- Cracked or broken teeth
- Decayed teeth
- Worn teeth
How are composite fillings placed?
Composite fillings are usually placed in one appointment. While the tooth is numb, your dentist will remove decay as necessary. The space will then be thoroughly cleaned and carefully prepared before the new filling is placed. If the decay was near the nerve of the tooth, a special medication will be applied for added protection. The composite filling will then be precisely placed, shaped, and polished, restoring your tooth to its original shape and function.
It is normal to experience sensitivity to hot and cold when composite fillings are first placed, however this will subside shortly after your tooth acclimates to the new filling.
You will be given care instructions at the conclusion of your treatment. Good oral hygiene practices, eating habits, and regular dental visits will aid in the life of your new fillings.
What are the reasons for dentures?
Reasons for dentures include:
- Complete Denture – Loss of all teeth in an arch
- Partial Denture – Loss of several teeth in an arch
- Enhancing smile and facial tissues
- Improving chewing, speech, and digestion
What does getting dentures involve?
The process of getting dentures requires several appointments, usually over several weeks. Highly accurate impressions (molds) and measurements are taken and used to create your custom denture. Several “try-in” appointments may be necessary to ensure proper shape, color, and fit. At the final appointment, your dentist will precisely adjust and place the completed denture, ensuring a natural and comfortable fit.
It is normal to experience increased saliva flow, some soreness, and possible speech and chewing difficulty, however this will subside as your muscles and tissues get used to the new dentures.
You will be given care instructions for your new dentures. Proper cleaning of your new dental appliance, good oral hygiene, and regular dental visits will aid in the life of your new dentures.
What are the reasons for getting a fixed bridge?
Reasons for a fixed bridge include:
- Fill space of missing teeth
- Maintain facial shape
- Prevent remaining teeth from drifting out of position
- Restore chewing and speaking ability
- Restore your smile
- Upgrade from a removable partial denture to a permanent dental appliance
What does getting a fixed bridge involve?
Getting a bridge usually requires two or more visits. While the teeth are numb, the two anchoring teeth are prepared by removing a portion of enamel to allow for a crown. Next, a highly accurate impression (mold) is made which will be sent to a dental laboratory where the bridge will be fabricated. In addition, a temporary bridge will be made and worn for several weeks until your next appointment.
At the second visit, you permanent bridge will be carefully checked, adjusted, and cemented to achieve a proper fit. Occasionally your dentist may only temporarily cement the bridge, allowing your teeth and tissue time to get used to the new bridge. The new bridge will be permanently cemented at a later time.
You will receive care instructions at the conclusion of the procedure. Proper brushing, flossing and regular dental visits will aid in the life of your new permanent bridge.
What are the benefits of using SIROLaser ®?
The benefits of using SIROLaser ® include;
- Reduction of bacterium
- No need for anesthesia for many procedures
- Less post-operative pain for patients
- Less experience with scarring
- Faster healing times without the requirement of stitches
- Faster procedures with greater accuracy
How does SIROLaser® work?
SIROLaser® emits short, controlled waves of light that cut through soft tissue, cauterizing and sterilizing as it operates. This process effectively improves recovery by reducing post-operative pain and swelling, while decreasing bleeding and risk of infection. Additionally, these light-waves eliminate the need for anesthetic because they are often too short to generate a neural response.
During what procedures can SIROLaser® be utilized?
Because of SIROLaser’s® versatility, it can be used in numerous applications. Patients undergoing the following procedures can benefit from SIROLaser®:
- Root canal therapy
- Surgical extractions
- Dental implant placement
- Gum recontouring
- Treatment of periodontal disease
- Crown lengthening
- Oral biopsies
- Treatment of cold sores
- Filling cavities
What is a CEREC Machine and what does it do?
CEREC® stands for Chairside Economical Restoration of Esthetic Ceramic and is a machine comprised of several computer-assisted design (CAD) tools and a milling machine that creates custom ceramic restorative devices like crowns. CEREC® can benefit almost anyone needing a ceramic restoration. This is of great benefit to nervous patients, and it can also reduce the cost of treatment.
How can CEREC® benefit me?
CEREC® can benefit almost anyone needing a ceramic restoration. Exceptions include patients who have a prior history of breaking ceramic devices and those with a deep bite. CEREC® devices are proven to last for over 5 years, but recent research indicates that most CEREC®-created restorations last for more than 10 years.
Additional advantages associated with CEREC® include:
- No temporary restorations
- High-quality ceramic product
- Minimal invasiveness
- Less injections and discomfort
- Fewer dental visit
- Cost effectiveness
- More natural tooth is saved
- Long lasting restorations
- Biocompatible solutions
What is the CEREC® system comprised of?
The CEREC® System is sometimes called a CAD-CAM system. CAD-CAM means Computer Assisted Design and Computer Assisted Milling. The CEREC® system has three major components:
- Acquisition device: This device is home to a high-quality camera and a medical grade computer. The function of this unit is to photograph the prepared tooth. Three-dimensional images are created of the tooth on the screen, which the dentist uses to design the perfect ceramic restoration.
- Three-dimensional CAD software: This software allows the dentist to examine the tooth from every angle. It is the closest possible thing to holding the tooth in the hands and rotating it.
- Milling device: This unit actually manufactures the custom restoration from the specifications entered into the computer. A ceramic block that best resembles the existing tooth color is chosen and placed into the unit. Within minutes, the milling device produces the restoration the dentist designed.
What does a CEREC® restoration procedure involve?
The first step in the procedure is preparing the tooth for the restoration. Depending on your particular case, the dentist will take photos of your affected teeth using one of CEREC’s® two imaging solutions. If using CEREC® Omnicam, the dentist will take several images of the tooth, sending a three-dimensional, colored model to the CEREC® machine. If using CEREC® Bluecam, the dentist will coat the teeth with a contrasting agent before taking images of your teeth.
These images are transposed onto the computer screen, where the dentist will view the tooth from every angle and design the final restoration. When the design is complete, it will be transmitted to the milling unit.
The dentist will insert a block of ceramic, matching your tooth color, into the milling machine which will then create the full crown, onlay, inlay, or veneer. Before affixing the restoration to the tooth, the dentist will perform a dry fit to ensure comfort. Once a perfect fit is established, the restoration will be polished and affixed to the tooth with dental cement.
How do Cephalometric X-rays work?
Cephalometric X-rays are usually taken with a panoramic X-ray machine. The adapted machine will have a special cephalometric film holder mounted on a mechanical arm. An X-ray image receptor is exposed to ionizing radiation in order to provide the dentist with pictures of the entire oral structure. The advantage of both cephalometric and panoramic X-rays is that the body is exposed to less radiation.
What are the benefits of Cephalometric X-rays?
Cephalometric X-rays are not as common as “full sets” or bitewing X-rays, but they serve several important functions:
- Provide views of the side profile of the face.
- Provide views of the jaw in relation to the cheekbone.
- Provide information about “bad bites” or malocclusions.
- Allow measurement of the teeth.
- Identify fractures and other injuries to the teeth and jawbone.
- Assists in orthodontic planning.
How are Cephalometric X-rays taken?
Cephalometric X-rays are completely painless. The head is placed between the mechanical rotating arm and the film holder, which is placed on another arm. The arm rotates around the head capturing images of the face, mouth, and teeth. The clarity and sharpness of these images will depend on the positioning of the body. The images are usually magnified up to 30%, so any signs of decay, disease, or injury can be seen and treated.
After capturing cephalometric X-rays, the dentist will be able to see a complete side profile of the head. This can assist in orthodontic planning and allow an immediate evaluation of how braces might impact the facial profile and teeth. Another common use for this type of X-ray is to determine specific measurements prior to the creation and placement of dental implants.
What are the benefits of i-CAT® 3D Imaging?
i-CAT® scans can be completed in less than half a minute. This means that far less radiation enters the body than if a regular set of bitewing X-rays were taken. The main use for i-CAT® scans is as an aid to plan dental implant treatment and other oral surgery.
Dental implants are the most sophisticated replacement for missing teeth, but have historically proven to be time-consuming to place. i-CAT® scans vastly reduce the time it takes to place implants. It is thought that in the near future implants will be placed in a single visit because of this unique type of imaging.
How are i-CAT® scans used?
i-CAT® scans are advantageous because they allow the dentist to magnify specific areas of the face. In addition, the dentist can easily view cross-sectional “slices” of the jaw, which makes planning treatment easier and faster.
Here are some of the main ways in which i-CAT® scans are used in dentistry:
- Assess the quality of the jawbone where the implant will be placed.
- Determine where nerves are located.
- Diagnose tumors and disease in the early stages.
- Measure the density of the jawbone where the implant will be placed.
- Pinpoint the most effective placement for implants, including the angle of best fit.
- Plan the complete surgical procedure in advance, from start to finish.
- Precisely decide on the appropriate size and type of implants.
- View exact orientation and position of each tooth.
- View impacted teeth.
How are i-CAT® scans performed?
i-CAT® scans are quick and simple to perform. A Cone Beam Imaging System is at the heart of the i-CAT® scanner. During the scan, the patient sits stationary on a designated seat. The cone beams are used to take literally hundreds of pictures of the face. These pictures are used to compile an exact 3D image of the inner mechanisms of the face and jaw. The dentist is able to zoom in on specific areas and view them from alternate angles.
Previous patients report the i-CAT® scanner is comfortable because they remain in a sitting position at all times. Additionally, the scanner provides an open environment, meaning that claustrophobic feelings are eliminated. The i-CAT® scan is an incredible tool that is minimizing the cost of dental treatment, reducing treatment time and enhancing the end results of dental surgery.
What are the benefits of Panoramic X-rays?
Unlike bitewing X-rays that need to be taken every few years, panoramic X-rays are generally only taken on an as-needed basis. A panoramic X-ray is not conducted to give a detailed view of each tooth, but rather to provide a better view of the sinus areas, nasal areas and mandibular nerve. Panoramic X-rays are preferable to bitewing X-rays when a patient is in extreme pain, and when a sinus problem is suspected to have caused dental problems.
Panoramic X-rays are extremely versatile in dentistry, and are used to:
- Assess patients with an extreme gag reflex.
- Evaluate the progression of TMJ.
- Expose cysts and abnormalities.
- Expose impacted teeth.
- Expose jawbone fractures.
- Plan treatment (full and partial dentures, braces and implants).
- Reveal gum disease and cavities.
How are panoramic X-rays taken?
The panoramic X-ray provides the dentist with an ear-to-ear two-dimensional view of both the upper and lower jaw. The most common uses for panoramic X-rays are to reveal the positioning of wisdom teeth and to check whether dental implants will affect the mandibular nerve (the nerve extending toward the lower lip).
The Panorex equipment consists of a rotating arm that holds the X-ray generator, and a moving film attachment that holds the pictures. The head is positioned between these two devices. The X-ray generator moves around the head taking pictures as orthogonally as possible. The positioning of the head and body is what determines how sharp, clear and useful the X-rays will be to the dentist. The pictures are magnified by as much as 30% to ensure that even the minutest detail will be noted.
Panoramic X-rays are an important diagnostic tool and are also valuable for planning future treatment. They are safer than other types of X-rays because less radiation enters the body.
What is Pulp Therapy?
The “pulp” of a tooth cannot be seen with the naked eye. Pulp is found at the center of each tooth, and is comprised of nerves, tissue, and many blood vessels, which work to channel vital nutrients and oxygen. There are several ways in which pulp can be damaged. Most commonly in children, tooth decay or traumatic injury lead to painful pulp exposure and inflammation.
Pediatric pulp therapy is known by several other names, including: root canal, pulpotomy, pulpectomy, and nerve treatment. The primary goal of pulp therapy is to treat, restore, and save the affected tooth.
Pediatric dentists perform pulp therapy on both primary (baby) teeth and permanent teeth. Though primary teeth are eventually shed, they are needed for speech production, proper chewing, and to guide the proper alignment and spacing of permanent teeth.
What are the signs of pulp injury and infection?
Inflamed or injured pulp is exceptionally painful. Even if the source of the pain isn’t visible, it will quickly become obvious that the child needs to see the pediatric dentist.
Here are some of the other signs to look for:
Constant unexplained pain.
Sensitivity to warm and cool food temperatures.
Swelling or redness around the affected tooth.
Unexpected looseness or mobility of the affected tooth.
When should a child undergo pulp therapy?
Some of the undesirable consequences of prematurely extracted/missing teeth are listed below:
Arch length may shorten.
In the case of primary tooth loss, permanent teeth may lack sufficient space to emerge.
Opposing teeth may grow in a protruding or undesirable way.
Premolars may become painfully impacted.
Remaining teeth may “move” to fill the gap.
The tongue may posture abnormally.
How is pulp therapy performed?
Pulpotomy – If the pulp root remains unaffected by injury or decay, meaning that the problem is isolated in the pulp tip, the pediatric dentist may leave the healthy part alone and only remove the affected pulp and surrounding tooth decay. The resulting gap is then filled with a biocompatible, therapeutic material, which prevents infection and soothes the pulp root. Most commonly, a crown is placed on the tooth after treatment. The crown strengthens the tooth structure, minimizing the risk of future fractures.
Pulpotomy treatment is extremely versatile. It can be performed as a standalone treatment on baby teeth and growing permanent teeth, or as the initial step in a full root canal treatment.
Pulpectomy – In the case of severe tooth decay or trauma, the entire tooth pulp (including the root canals) may be affected. In these circumstances, the pediatric dentist must remove the pulp, cleanse the root canals, and then pack the area with biocompatible material. This usually takes several office visits.
In general, reabsorbable material is used to fill primary teeth, and non-reabsorbable material is used to fill permanent teeth. Either way, the final treatment step is to place a crown on the tooth to add strength and provide structural support. The crown can be disguised with a natural-colored covering, if the child prefers.
If you have questions or concerns about the pediatric pulp therapy procedure, please contact your pediatric dentist.