Regular dental cleanings, performed by a registered dental hygienist, are a crucial part of preventive dental care. By removing plaque and tartar, your oral health is enhanced and your risk of gingivitis and periodontal disease are minimized. Your dental hygienist will utilize manual instruments to scale away moderate plaque and tartar buildup, or an ultrasonic device to scale away heavier buildup. The cleaning is finished with polishing, a pleasant procedure that cleans the surface of teeth, removes stains, and leaves the mouth feeling clean and refreshed.

No matter how diligent you are in your home dental care regimen, you should still get a dental exam and cleaning twice per year. The importance of regular dental exams cannot be overemphasized – dental exams are the cornerstone of good dental health. In particular, regular checkups are essential for early detection of more serious problems. Early detection makes treatment easier, less expensive, and more effective. In your dental exam, your dentist will perform the following routine checks:

• Examine and assess gum health; check for gum disease.
• Examine any existing tooth decay.
• Take and analyze x-rays, which may reveal decay, bone loss, abscesses, tumors, cysts, and other problems.
• Screen for the presence of oral cancer.
• Verify the stability of any existing fillings or other restorations.
• Inform you of all findings and make treatment recommendations.

As damaging as plaque can be, it is easily removed by mechanical brushing. Plaque deposits build up on the teeth fairly quickly after eating and drinking, and if they are not brushed away at least twice a day, they can lead to tooth decay and periodontal disease. It takes just one day for bacteria to build up enough to make your mouth susceptible to disease.

Daily flossing is an effective way to clean teeth where regular brushing can’t reach. To floss properly, take 18″ of dental floss, wrap it around the middle finger of each hand, and pinch it between your thumb and index finger. Pull the floss taut, then slide it gently between each tooth and under the gum line. Slide the floss up and down the side of each tooth to remove plaque buildup. Be sure to use a clean section of floss as you move from tooth to tooth.

Over-the-counter mouth rinses can help to fight bad breath, remove loose food particles after brushing, and freshen the mouth. However, mouth rinses are never a substitute for brushing, flossing, or regular dental examinations, and may disguise warning signs of periodontal disease.

Diagnosis

Early signs of gum disease include redness, swelling, or inflammation around the gum line. If these warning signs appear, your dentist will check for hardened plaque, also known as tartar or calculus, below the gumline. Finally, your dentist may use a tool called a probe to test gums for bleeding and measure periodontal pockets. When gums are unhealthy, they pull away from the teeth, forming these pockets. If the periodontal pockets are deeper than 3mm, periodontal disease is confirmed.

Treatments

Deep cleaning can effectively control and reverse gum disease by removing the germs that lead to infection. This deep cleaning involves techniques called scaling and root planing. Scaling involves scraping away plaque and tarter from above and below the gumline. Planing involves smoothing out rough surfaces of teeth which can foster the bacteria growth that leads to infection. Left with clean, smooth teeth, patients will notice reduced redness and inflammation as the gum is better able to attach to the tooth enamel. Dentists may prescribe antibiotics or mouth rinses to kill any remaining bacteria after scaling and planing procedures are performed.

Periodontal Disease

Periodontal disease is marked by the breakdown of structures that surround, secure, and support the teeth. These structures include the jawbones, gums, and fibers which anchor the teeth to the gums. Periodontal disease is usually a result of untreated plaque buildup, and is the number one cause of tooth loss in adults. However, regular checkups and a strong home care regimen easily prevent periodontal disease.

Gingivitis

Gingivitis is an early stage of periodontal disease, when only the soft tissues of the mouth are affected. Plaque buildup leads to tartar and bacteria below the gumline, which leads to inflamed, irritated, or bleeding gums. The good news is, gingivitis is reversible. A good professional cleaning, followed by regular brushing, flossing, and checkups, restores gums to good health by removing plaque and bacteria.

Problem

Teeth that are chipped, discolored, uneven, stained or gapped.

Solution

Bonding with composite resin. The composite resin used in bonding is a tooth-colored material that is applied directly to the enamel of teeth and shaped to correct the patient’s aesthetic concern. When exposed to a special ultraviolet light, the resin hardens into place.

Alternatives

Porcelain veneers and crowns, while more expensive, last considerably longer than bonding.

Problem

Teeth that are chipped, discolored, uneven, stained or gapped. Teeth that are out-of-proportion in relation to the mouth. Teeth that are crooked or worn.

Solution

Customized, wafer-thin veneers (also called porcelain laminates) are cemented directly onto the front of the tooth, resulting in a natural appearance that covers any irregularities or aesthetic concerns.

Alternatives

Veneers are not an ideal choice for patients with tooth decay, advanced periodontal disease, or severe misalignment. In cases where veneers are not advisable, orthodontic treatments and porcelain crowns may be better choices.

Problem

Tooth decay that has led to the development of a cavity, or small hole, in the tooth.

Solution

Fillings. Your dentist will remove all areas of decay, and replace with a filling made of silver (amalgam) or composite resin. Composite resin fillings have surged in popularity because their appearance perfectly matches the natural appearance of teeth.

Alternatives

In cases of more extensive decay, porcelain inlays and onlays are an advisable alternative.

Problem

Tooth decay, weakened tooth structure, need for tooth restoration and reinforcement.

Solution

After the decay is removed, your dentist will take an impression of the area to be restored. A dental laboratory works from this impression to create a restorative inlay or onlay, usually out of gold or porcelain, that fits perfectly on the tooth. Inlays cover one or more tooth surfaces, where onlays are used on the chewing surface of the tooth. The inlay or onlay is cemented securely into place, for an incredibly durable, stable tooth restoration. Porcelain is the preferred restorative material; it is extremely strong and can perfectly match the patient’s natural tooth color.

Alternatives

Crowns may be the only alternative when tooth decay is in advanced stages.

Problem

Teeth that are chipped, cracked, badly decayed, or otherwise weakened.

Solution

Porcelain Crowns maintain the aesthetic appearance of teeth by covering the entire visible surface of the tooth, while adding significant reinforcement and protection to the tooth. After removing all areas of decay, your dentist will take an impression of the tooth to be crowned and send it to a dental laboratory to create the crown. Crowns can be made of porcelain or gold. Porcelain crowns are extremely natural looking; virtually indistinguishable from other teeth, making them an ideal choice for visible teeth. Gold crowns pose no risk of chipping, and therefore are useful when crowning back teeth.

Alternatives

Teeth that are badly decayed may require extraction, leaving bridges or implants as viable alternative treatments.

Problem

Patients who are missing a tooth or several teeth may experience difficulty chewing and speaking, dental shifts, and an undesirable sunken facial appearance. In addition, missing teeth can eventually lead to jaw and joint problems that are costly to treat.

Solution

Porcelain Fixed Bridges can improve chewing and aesthetic appearance, restoring the smile with a more permanent solution than dentures. Bridges replace missing teeth with artificial teeth. Your dentist will take a mold of the gap where a tooth is missing, and then send it to a laboratory to prepare a customized bridge. Before inserting the bridge, the surrounding teeth are prepared. The bridge is set into place and the artificial tooth is securely cemented to the adjacent teeth, restoring the attractive natural appearance and functionality of the tooth that was lost. If a resin-bonded bridge is chosen, the artificial tooth is secured by means of a metal appliance that attaches to the backs of adjacent teeth.

Alternatives

Dental implants are permanent, stable alternatives to bridges that do not rely upon surrounding teeth for support.

Problem

Problem

Tooth decay, weakened tooth structure, need for tooth restoration and reinforcement.

Solution

After the decay is removed, your dentist will take an impression of the area to be restored. A dental laboratory works from this impression to create a restorative inlay or onlay, usually out of gold or porcelain, that fits perfectly on the tooth. Inlays cover one or more tooth surfaces, where onlays are used on the chewing surface of the tooth. The inlay or onlay is cemented securely into place, for an incredibly durable, stable tooth restoration. Porcelain is the preferred restorative material; it is extremely strong and can perfectly match the patient’s natural tooth color.

Alternatives

Crowns may be the only alternative when tooth decay is in advanced stages.

Problem

Teeth that are chipped, cracked, badly decayed, or otherwise weakened.

Solution

Porcelain Crowns maintain the aesthetic appearance of teeth by covering the entire visible surface of the tooth, while adding significant reinforcement and protection to the tooth. After removing all areas of decay, your dentist will take an impression of the tooth to be crowned and send it to a dental laboratory to create the crown. Crowns can be made of porcelain or gold. Porcelain crowns are extremely natural looking; virtually indistinguishable from other teeth, making them an ideal choice for visible teeth. Gold crowns pose no risk of chipping, and therefore are useful when crowning back teeth.

Alternatives

Teeth that are badly decayed may require extraction, leaving bridges or implants as viable alternative treatments.

Problem

Patients who are missing a tooth or several teeth may experience difficulty chewing and speaking, dental shifts, and an undesirable sunken facial appearance. In addition, missing teeth can eventually lead to jaw and joint problems that are costly to treat.

Solution

Porcelain Fixed Bridges can improve chewing and aesthetic appearance, restoring the smile with a more permanent solution than dentures. Bridges replace missing teeth with artificial teeth. Your dentist will take a mold of the gap where a tooth is missing, and then send it to a laboratory to prepare a customized bridge. Before inserting the bridge, the surrounding teeth are prepared. The bridge is set into place and the artificial tooth is securely cemented to the adjacent teeth, restoring the attractive natural appearance and functionality of the tooth that was lost. If a resin-bonded bridge is chosen, the artificial tooth is secured by means of a metal appliance that attaches to the backs of adjacent teeth.

Alternatives

Dental implants are permanent, stable alternatives to bridges that do not rely upon surrounding teeth for support.

Problem

The inside of each tooth is filled with “pulp”, which carries the tooth’s blood supply and nerves. If bacteria gain access to the pulp, through a fracture or deep cavity, the pulp may become infected, leading to pain and a risk of tooth loss.

Solution

In a root canal, your dentist will remove the infected pulp and replace it with a rubber sealant. The tooth is then covered with a protective cap, which reinforces the tooth against future fractures and enhances the tooth’s appearance. Root canals have an extremely high success rate in saving teeth that would otherwise be lost to infection.

Alternatives

The only alternative to root canal therapy is tooth extraction.

Problem

Missing teeth.

Solution

Dental implants are the most realistic tooth replacements available. Implants begin with a surgically placed post that is securely anchored into the jawbone. The bone surrounding the anchor will heal in approximately six months. With a completely solid and stable anchor point, an artificial tooth is then installed. The end result is a new artificial tooth that is virtually indistinguishable from a natural tooth, both from an aesthetic and functional standpoint. In cases where several teeth are missing, dental implants can also act as the teeth to which bridges are fixed, again perfectly mimicking the function of healthy, natural teeth.

Alternatives

Dentures may be considered if the financial burden of dental implants it too great.

Problem

Ill fitting, loose dentures. While dentures that are loose and ill fitting make eating difficult, they can cause painful sore spots on the gums as they slide around while chewing.

Solution

An implant denture may be the answer. Usually two to four implants are surgically placed in the bone and become anchored as the bone heals and secures itself to the implant. This healing process takes about six months after which the dentist can begin constructing an implant denture. An implant denture is a removable denture with attachments on the underside that clip onto a bar connected to the implants. The attachments and bar hold the denture in place and keep it from moving when chewing and speaking. Implant dentures can be classified into two groups: Implant Retained Dentures and Implant Supported Dentures. Implant Retained Dentures are held in place by the attachments, but are mainly supported by the bone and gum tissue as is a conventional denture. Implant Supported Dentures are for patients who do not have sufficient bone and supporting gum tissue. This denture is mainly supported by the bar attached to the implants.

Alternatives

New dentures may be considered if the financial burden of dental implants is too great.

In simple terms, a dental implant is simply a hollow titanium pin that is surgically placed into your jaw. Then an “abutment”, or piece of metal, is screwed into the pin once healing is complete. Dr. Sweeney then places the “tooth” or crown on this abutment — giving you a very natural looking tooth.

Dentists often use dental implants instead of bridges because dental implants last longer and are much stronger — in fact, they look and feel just like real teeth. According to the Consumer Dentistry Website, studies have shown a five-year success rate of 95% for lower jaw implants and 90% for upper jaw implants. The lower success rate in upper jaw implants is because the upper jaw, especially the posterior section, is less dense than the lower jaw, making successful implantation potentially more difficult to achieve. Typically, a dental implant procedure is suggested if you’re missing a tooth or teeth. Dr. Sweeney can also use standard-sized implants or mini-dental implants to support dentures — often referred to as “implant-supported dentures.”

If you smoke or have gum disease, dentists advise you to either stop smoking or undergo treatment for periodontal disease before performing the dental implant procedure. Although dental implants aren’t susceptible to tooth decay, the gum tissue around the implant can become infected due to poor oral hygiene. Hence, it’s very important that you brush and floss your dental implant or implants — just as you would your natural teeth. It’s also important that you have regular cleanings to protect your investment.

Reasons Dental Implants Fail

• Lack of osseointegration — the process where the bone grows around the dental implant.
• The dental implant was poorly placed or should not have been placed at all.
• Infection due to smoking or poor oral hygiene.
• The abutment comes loose, causing the tooth to break or fall out.
• Undiagnosed or underlying medical problems.

Placing the dental implant is fairly straight-forward once specific pre-planning is complete. Dr. Sweeney places a hollow titanium post into the jaw bone; after the post is placed, a healing cap is placed into the top of the post to protect the inner threads while the gum tissue heals and the bone begins to adhere to the dental implant. This healing process can take 2 to 6 months.

Once the healing process is complete, the dentist then removes the protective cover and places the abutment (an extension) into the dental implant and tightens it using a special torque wrench. This process actually requires real skill to know how much torque to apply to ensure the abutment is screwed into the dental implant so that it doesn’t come loose.

Once your abutment is placed, Dr. Sweeney then makes the new crown which covers the abutment. The beauty of a dental implant is that it doesn’t shift over time the way a crown and bridge will, because it’s placed directly into your bone. The crown that covers the abutment may need to be replaced in about 10 – 20 years however, depending on wear.

For dental implant-supported dentures, the dentist places either standard-sized dental implants or “mini” dental implants into the bone and the dentures are then “snapped” onto them. Implant-supported dentures give you the support and confidence you’ve always wanted as they don’t move around like ordinary dentures. Even better, implant-supported dentures eliminate the need for messy dental creams and adhesives.

Modern dentistry makes routine tooth extractions relatively comfortable, painless procedures. For seven days after the extraction, your tooth socket will require some care. You will be instructed to steer clear of the empty tooth socket when brushing your teeth. Some bleeding can be expected, and pain medication may be prescribed for residual discomfort.

In cases of severe infection, where restorative approaches will not save a tooth, an extraction may be necessary.