Cleanings and Preventions
Dental
Exam
A comprehensive dental exam will be performed by your dentist at your initial dental visit. At regular check-up exams, your dentist and hygienist will perform the following:
-
Examination of diagnostic X-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
-
Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
-
Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
-
Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
-
Examination of existing restorations: Check current fillings, crowns, etc.
Fluoride Treatment
Fluoride is the most effective agent available to help prevent tooth decay. It is a mineral that is naturally present in varying amounts in almost all foods and water supplies. The benefits of fluoride have been well known for over 50 years and are supported by many health and professional organizations.
Fluoride works in two ways:
Topical fluoride strengthens the teeth once they have erupted by seeping into the outer surface of the tooth enamel, making the teeth more resistant to decay. We gain topical fluoride by using fluoride containing dental products such as toothpaste, mouth rinses, and gels. Dentists and dental hygienists generally recommend that children have a professional application of fluoride twice a year during dental check-ups. Systemic fluoride strengthens the teeth that have erupted as well as those that are developing under the gums. We gain systemic fluoride from most foods and our community water supplies. It is also available as a supplement in drop or gel form and can be prescribed by your dentist or physician.
Generally, fluoride drops are recommended for infants, and tablets are best suited for children up through the teen years. It is very important to monitor the amounts of fluoride a child ingests. If too much fluoride is consumed while the teeth are developing, a condition called fluorosis (white spots on the teeth) may result. Although most people receive fluoride from food and water, sometimes it is not enough to help prevent decay. Your dentist or dental hygienist may recommend the use of home and/or professional fluoride treatments for the following reasons:
-
Deep pits and fissures on the chewing surfaces of teeth.
-
Exposed and sensitive root surfaces.
-
Fair to poor oral hygiene habits.
-
Frequent sugar and carbohydrate intake.
-
Inadequate exposure to fluorides.
-
Inadequate saliva flow due to medical conditions, medical treatments or medications.
-
Recent history of dental decay.
Remember, fluoride alone will not prevent tooth decay! It is important to brush at least twice a day, floss regularly, eat balanced meals, reduce sugary snacks, and visit your dentist on a regular basis.
Sealants
Professional Dental Cleaning
Professional dental cleanings (dental prophylaxis) are usually performed by Registered Dental Hygienists. Your cleaning appointment will include a dental exam and the following:
-
Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments.
-
Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
-
Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.
Digital Dental X-Rays
Digital radiography (digital X-ray) is the latest technology used to take dental X-rays. This technique uses an electronic sensor (instead of X-ray film) that captures and stores the digital image on a computer. This image can be instantly viewed and enlarged, helping the dentist and dental hygienist detect problems more easily. Digital X-rays reduce radiation 80-90% compared to the already low exposure of traditional dental X-rays.
Dental X-rays are essential, preventative, diagnostic tools that provide valuable information not visible during a regular dental exam. Dentists and dental hygienists use this information to safely and accurately detect hidden dental abnormalities and complete an accurate treatment plan. Without X-rays, problem areas can go undetected.
Dental X-rays may reveal:
-
Abscesses or cysts.
-
Bone loss.
-
Cancerous and non-cancerous tumors.
-
Decay between the teeth.
-
Developmental abnormalities.
-
Poor tooth and root positions.
-
Problems inside a tooth or below the gum line.
Detecting and treating dental problems at an early stage can save you time, money, unnecessary discomfort, and your teeth!
Are dental X-rays safe?
We are all exposed to natural radiation in our environment. Digital X-rays produce a significantly lower level of radiation compared to traditional dental x-rays. Not only are digital X-rays better for the health and safety of the patient, they are faster and more comfortable to take. That means your time in the dental office will be reduced.
Digital dental X-rays are also better for the environment. Since the digital image is captured electronically, there is no need to develop the X-rays. That means no disposing of harmful waste and chemicals.
Even though digital X-rays produce a low level of radiation and are considered very safe, dentists still take necessary precautions to limit the patient’s exposure to radiation. These precautions include only taking those X-rays that are necessary, and using lead apron shields to protect the body.
How often should dental X-rays be taken?
The need for dental X-rays depends on each patient’s individual dental health needs. Your dentist and dental hygienist will recommend necessary X-rays based upon the review of your medical and dental history, a dental exam, signs and symptoms, your age, and risk of disease.
A full mouth series of dental X-rays is recommended for new patients. A full series is usually good for three to five years. Bite-wing X-rays (X-rays of top and bottom teeth biting together) are taken at recall (check-up) visits and are recommended once or twice a year to detect new dental problems.
Dental Sealants
A dental sealant is a thin, plastic coating applied to the chewing surface of molars, premolars and any deep grooves (called pits and fissures) of teeth. More than 75% of dental decay begins in these deep grooves. Teeth with these conditions are hard to clean and are very susceptible to decay. A sealant protects the tooth by sealing deep grooves, creating a smooth, easy to clean surface.
Sealants can protect teeth from decay for many years, but need to be checked for wear and chipping at regular dental visits.
Reasons for dental sealants:
-
Children and teenagers – As soon as the six-year molars (the first permanent back teeth) appear or any time throughout the cavity prone years of 6-16.
-
Adults – Tooth surfaces without decay that have deep grooves or depressions.
-
Baby teeth – Occasionally done if teeth have deep grooves or depressions and child is cavity prone.
What do sealants involve?
Sealants are easily applied by your dentist or dental hygienist and the process takes only a couple of minutes per tooth.
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.
Restorations
Reasons for composite fillings:
-
Chipped teeth.
-
Closing space between two teeth.
-
Cracked or broken teeth.
-
Decayed teeth.
-
Worn teeth.
Composite Fillings What is a composite filling?
A composite (tooth colored) filling is used to repair a tooth that is affected by decay, cracks, fractures, etc. The decayed or affected portion of the tooth will be removed and then filled with a composite filling.
There are many types of filling materials available, each with their own advantages and disadvantages. You and your dentist can discuss the best options for restoring your teeth. Composite fillings, along with silver amalgam fillings, are the most widely used today. Because composite fillings are tooth colored, they can be closely matched to the color of existing teeth and are more aesthetically suited for use in front teeth or the more visible areas of the teeth.
As with most dental restorations, composite fillings are not permanent and may someday have to be replaced. They are very durable and will last many years, giving you a long lasting, beautiful smile.
How are composite fillings placed?
Composite fillings are usually placed in one appointment. While the tooth is numb, your dentist will remove decay as needed. 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 temperature sensitivity when composite fillings are first placed, however this will subside within a couple weeks to a couple months after your tooth adjusts 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.
Crowns (Caps)
A crown (or cap) is a covering that encases the entire tooth surface, restoring it to its original shape and size. A crown protects and strengthens tooth structure that cannot be restored with fillings or other types of restorations.
Although there are several types of crowns, porcelain (tooth colored crown) are the most popular. They are highly durable and will last many years, but like most dental restorations, they may eventually need to be replaced. Porcelain crowns are made to match the shape, size, and color of your teeth, giving you a long-lasting, beautiful smile.
What does getting a crown involve?
A crown procedure can require one or two appointments, depending on the tooth. If two appointments are required, 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. 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.
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.
Reasons for crowns:
-
Broken or fractured teeth.
-
Cosmetic enhancement.
-
Decayed teeth.
-
Fractured fillings.
-
Large fillings.
-
Tooth has a root canal.
Reasons for a fixed bridge:
-
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.
Fixed Bridges
A dental bridge is a fixed (non-removable) appliance and is an excellent way to replace missing teeth.
There are several types of bridges. You and your dentist will discuss the best options for your particular case. The “traditional bridge” is the most popular type and is usually made of porcelain fused to metal. This type of bridge consists of two crowns that go over two anchoring teeth (abutment teeth) and are attached to pontics (artificial teeth), filling the gap created by one or more missing teeth.
Dental bridges are highly durable and will last many years; however, they may need replacement or need to be re-cemented due to normal wear.
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 two weeks until your next appointment.
At the second visit, your 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.
Dentures & Partial Dentures
A denture is a removable dental appliance and a replacement for missing teeth and surrounding tissue. They are made to resemble your natural teeth and enhance your smile.
There are two types of dentures- “complete” and “partial”. Complete dentures are used when all of the teeth are missing, while partial dentures are used when some natural teeth remain. A partial denture fills in the spaces created by missing teeth and also prevents other teeth from shifting.
A complete denture can either be “conventional” or “immediate.” A conventional type is made by our lab after the teeth have been removed and the gum tissue has been healed (usually takes 4 to 6 weeks). Immediate dentures are made in advance and immediately placed after the teeth are removed. This prevents the patient from having to be without teeth during the healing process. Adjustments will have to be made while tissues shrink and heal.
Dentures are very durable appliances. They last many years but may have to be remade, repaired, or readjusted due to normal wear.
Reasons for dental implants:
-
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.
-
Support a bridge or denture, making them more secure and comfortable.
Dental Implants
Dental implants are a great way to replace missing teeth and provide a fixed solution to having removable partial or complete dentures. Implants provide excellent support and stability for these dental appliances.
Dental implants are artificial roots (usually titanium) that are surgically placed into the upper or lower jaw bone by an Oral Surgeon or Periodontist. Your dentist will make crowns that fit into the artificial roots. The teeth attached to implants are very natural looking and often enhance or restore a patient’s smile!
Dental implants are very strong, stable, and durable and will last many years. On occasion, they will have to be re-tightened or replaced due to normal wear.
CEREC® Crowns
CEREC® Crowns
J & D Dental offers Chairside Economical Restorations of Esthetic Ceramic (CEREC® crowns), a revolutionary new dental procedure. Traditionally, if crowns were required to restore damaged teeth, multiple appointments and a great deal of waiting time in-between appointments would be inevitable.
At J & D Dental, Dr. Herbert and Dr. Konop have received special training in CEREC® technology. Both of our dentists can create ceramic restorations in minutes. This means that many treatments can be completed in just a single visit to our office.
CEREC® is comprised of several computer-assisted design (CAD) tools and a milling machine that creates custom ceramic restorations. Patients benefit from the reduced cost and time of this treatment.
Why choose CEREC® crowns?
Dr. Herbert and Dr. Konop use CEREC® to treat almost anyone needing a crown. 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 and beyond.
Advantages of CEREC® restorations:
-
No temporary restorations.
-
High-quality ceramic products.
-
Minimal invasiveness.
-
Less injections and discomfort.
-
Fewer dental visits.
-
Cost effectiveness.
-
More natural tooth is saved.
-
Long lasting restorations.
-
Biocompatible solutions.
-
No messy impressions.
-
What comprises a CEREC® system?
The CEREC® System is sometimes called a CAD-CAM system. Dr. Herbert and Dr. Konop have completed advanced training courses using this 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 J & D Dental's specially trained dentists 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 at J&D Dental: 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. This unit is right inside J & D Dental, so within minutes, the milling device produces the restoration the dentist designed.
What can I expect during a CEREC® restoration procedure?
The first step in the procedure is to prepare the tooth. Your J & D Dental dentist removes all tooth decay and prepares your tooth for the crown. Next, a highly detailed picture is taken by the licensed dental assistant at J & D Dental. Images are formulated with the CEREC® camera. CEREC® optical imaging utilizes an infrared wavelength.
The image is transposed onto the computer screen. It is here that your J & D Dental dentist is able to view the tooth from every angle and design the final restoration. When the design is complete, it is transmitted to the milling unit. Your dentist chooses a block of ceramic that matches the color of the teeth. This ensures that the restoration will be almost invisible.
Within 15 minutes, the full crown is complete right in our Downtown Minneapolis dental office! The restoration is made of compressed, rather than laboratory-layered, porcelain. This enhances strength and durability.
Before affixing the restoration to the tooth, your dentist will ensure it fits perfectly. It is then polished and bonded to the tooth with dental cement. The procedure is now complete and all without the need for a second visit!
If you have questions or concerns about CEREC®, please ask us during your next visit.
Cosmetic Dentistry
Make Sure to check some of our before and afters in our Smile Gallery
In the past decade there has been a dramatic interest in cosmetic dentistry. We all realize that having a healthy, bright, beautiful smile enhances our appearance and allows us to smile with confidence. Thanks to the advances in modern cosmetic dentistry, we are able to improve our teeth and smiles with quick, painless and surprisingly affordable treatments.
Cosmetic dental treatments can:
-
Change the size, shape, and alignment of certain teeth.
-
Fill in unattractive spaces between teeth.
-
Improve or correct bites.
-
Lighten or brighten the color of teeth.
-
Repair decayed, broken, cracked, or chipped teeth.
-
Replace missing teeth.
-
Replace old, unattractive dental treatments.
Remember, your smile speaks before you even say a word!
Veneers
Placement of composite and porcelain veneers is sometimes referred to as “instant orthodontics” because they can be used to cover a variety of dental problems involving teeth in the “smile zone” including:
-
Spaces between the teeth.
-
Poorly shaped or crooked teeth.
-
Broken or chipped teeth.
-
Permanently externally stained and/or internally stained teeth.
-
Unsightly or stained fillings.
We offer two types of dental veneers, porcelain veneers and composite veneers. Veneers are thin shells of tooth-colored, translucent porcelain or composite resin, custom made to fit over teeth and improve their color, shape and overall appearance. Placement of dental veneers can dramatically improve your smile and appearance.
Dental veneers are not appropriate for everyone or every tooth. Case selection is an extremely important factor in the success of this technique. Some veneer processes involve tooth structure that must be removed, which is not a reversible procedure. Only an examination by the dentists can determine whether dental veneers are appropriate for making the changes you want. Some of the situations where certain teeth or people are not good candidates for dental veneers include:
-
weakened teeth due to a significant amount of tooth structure missing
-
teeth with an inadequate amount of enamel present
-
people who habitually clench or grind on their teeth which can easily chip or break dental veneers
-
unstable bite
-
severely malpositioned or misaligned teeth. Orthodontic treatment may be required to achieve the desired treatment
Porcelain Veneers
Porcelain veneers differ quite a bit from composite veneers. It’s important to understand the differences in order to make the right choice for your smile. Porcelain veneers:
-
are very thin, about 0.5 – 0.7 millimeters and initially brittle however, once bonded to healthy tooth structure it becomes very strong
-
can last for many years, usually 10-15 years, if you take good care of them using good oral hygiene and avoiding using them to crack or chew hard objects like ice
-
create a very life-like and natural tooth appearance
-
are more stain resistant than composite veneers
-
require removal of tooth structure and are not reversible
-
require two visits and are more expensive than composite veneers.
-
cannot be repaired, if a porcelain veneer breaks it must be replaced
Composite Veneers
Composite veneers offer a variety of benefits. At J&D Dental, composite veneers:
-
are made chairside
-
can be completed in a single visit, often without any anesthetic.
-
are much more conservative than porcelain veneers since very little, if any tooth structure is removed
-
are easily repairable
-
can be periodic polished to keep them looking new, which quickly is performed during you regularly scheduled dental visit
-
are less expensive than other veneer options
Teeth Whitening
Teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel and is an ideal way to enhance the beauty of your smile.
Because having whiter teeth has become a concern for many of our patients, we offer two types of teeth whitening:
-
In office professional Phillips ZOOM! whitening
-
At home Phillips ZOOM! DayWhite/NiteWhite whitening
Since teeth whitening only works on natural tooth enamel, it is important to evaluate replacement of any old fillings, crowns, etc. Replacement of any restorations will be done after bleaching so they will match the newly bleached teeth.
Teeth whitening is not permanent. A touch-up may be needed every several years, and more often if you smoke, drink coffee, tea or wine.
Reasons for professional teeth whitening:
-
Fluorosis (excessive fluoridation during tooth development).
-
Normal wear of outer tooth layer.
-
Stained teeth due to medications (tetracycline, etc.).
-
Yellow, brown stained teeth.
Composite Fillings
What is a composite filling?
A composite filling is tooth colored and used to repair a tooth that is affected by decay, cracks, fractures, etc. The decayed or affected portion of the tooth will be removed and then filled with a composite filling.
You and your dentist can discuss the best options for restoring your teeth. Composite fillings, are the most widely used today. Because composite fillings are tooth colored, they can be closely matched to the color of existing teeth, and are more aesthetically suited for use in front teeth or more visible areas of the mouth.
As with most dental restorations, composite fillings are not permanent and may someday have to be replaced. They are very durable and will last many years, giving you a long lasting, beautiful smile.
Reasons for composite fillings:
-
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, the doctor will remove decay as needed. 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 temperature sensitivity when composite fillings are first placed, however this will subside within a couple weeks to a couple months after your tooth adjusts 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.
Porcelain Crowns (caps)
A crown (or cap) is a covering that encases the entire tooth surface restoring it to its original shape and size. A crown protects and strengthens tooth structure that cannot be restored with fillings or other types of restorations.
Although there are several types of crowns, porcelain (tooth colored crown) are the most popular, because they resemble your natural teeth. They are highly durable and will last many years, but like most dental restorations, they may eventually need to be replaced. Porcelain crowns are made to match the shape, size, and color or your teeth giving you a natural, long-lasting beautiful smile.
Reasons for porcelain crowns:
-
Broken or fractured teeth.
-
Cosmetic enhancement.
-
Decayed teeth.
-
Fractured fillings.
-
Large fillings.
-
Tooth has a root canal.
What does getting 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.
Periodontal Disease
At J&D Dental, our dentists and hygienists have your oral health as their top priority. We take great pride in making you feel at ease as we assist you in keeping great oral health. In some cases, you may need a “deep cleaning,” also known as scaling and root planing due to gum or periodontal disease. If your dentist and hygienist at J&D Dental have recommended this for you, they will work closely with you to help you understand your treatment and why it is needed. They will discuss the following topics with you.
What is gum disease?
Periodontal disease is an infection in your gum tissues. It is caused by bacteria colonies (plaque) that are not thoroughly removed through your home care routine. When plaque is not removed, it hardens on the tooth, and is called calculus (tartar). When calculus sits along and under your gum line, it causes your gum tissues to become inflamed. This can lead to bleeding gums and discomfort, bone loss, and a bad taste or odor in the mouth. Periodontal disease can range from early stages to advanced stages. In the most severe cases, tooth loss is possible.
Why do you need scaling and root planing?
By catching periodontal disease in its earliest stages at J&D Dental, we can prevent tooth loss. Scaling and root planing is the most common procedure to help return your gum tissues to a healthier condition. Scaling and root planing is a specialized deep cleaning tailored to your specific needs. This cleaning by your dental hygienist removes all calculus and plaque from the teeth, including the root surfaces below the gum line. By removing the bacteria irritants under the gum line, your tissues are able to reattach more firmly against the tooth. In advanced periodontal disease, we may refer you to a periodontist (gum specialist) who will assist you in keeping the disease under control.
Scaling and root planing services
Scaling and root planing is usually completed in two appointments by your dental hygienist. This is necessary for your comfort. When gum disease is present, this deep cleaning can be uncomfortable. For this reason, we get your tissues numb either with anesthetic or with a numbing mouthwash.. At the first appointment, we generally clean one half of your mouth and finish the other half at the second appointment. After your procedure, you may feel a little sore as your tissues tighten against your teeth. Swishing with warm salt water every few hours or using a pain reliever may be suggested, to help with the healing process. You should continue brushing, flossing, and rinsing routine at home.
Your hygienist may advise cleanings every 3-4 months, instead of every 6 months, depending on your specific needs. Periodontal disease can be an ongoing struggle, and we look forward to slowing or stopping the disease process with this treatment. We will keep you involved in the status of your condition, as it heals.
Flouride Treatment
Cracked Tooth
Cracked Tooth
Cracked and fractured teeth are common dental problems. As people retain their natural teeth longer (due to advances in dental technology), the likelihood of having a cracked tooth increases.
There are many reasons why teeth may crack, for example, biting on hard objects, trauma, grinding and clenching of teeth. All of these behaviors place the teeth under extra strain and render them more susceptible to cracking.
When tooth enamel is cracked, pain can become momentarily debilitating. In the absence of pressure on the crack, there may be no discomfort. However, as the cracked tooth performs a biting action, the crack widens. The pulp and inner workings of the tooth then become exposed, and painful irritation occurs.
As pressure is released again, the two parts of the crack fuse back together, and pain subsides. If left untreated, the pulp becomes irreversibly damaged and constantly painful. The resulting pulp infection can affect the bone and soft tissue surrounding the tooth.
Symptoms of a cracked tooth may include:
-
Unexplained pain when eating.
-
Sensitivity to warm and cold foods.
-
Pain with no obvious cause.
-
Difficulty pinpointing the location of the pain.
What kind of cracks can affect the teeth?
There are many ways in which a tooth can be cracked. The specific type of crack will determine what type of treatment is viable. In cases where the crack is not too deep, root canal therapy can be performed, and the natural tooth can remain in the mouth. In other situations, the tooth is too badly damaged and requires extraction.
Common types of cracks in teeth:
Crazes – These are generally tiny vertical cracks that do not place the teeth in danger. These scratches on the surface of the teeth are considered by most dentists to be a normal part of the tooth anatomy. A craze rarely requires treatment for health reasons, but a wide variety of cosmetic treatments can be performed to reduce the negative aesthetic impact.
Oblique supragingival cracks – These cracks only affect the crown of the tooth and do not extend below the gum line. Usually, the affected part of the tooth will eventually break off. Little pain will result, because the tooth pulp (that contains the nerves and vessels) will remain unaffected.
Oblique subgingival cracks – These cracks extend beyond the gum line and often beyond where the jawbone begins. When a piece breaks off, it will usually remain attached until the dentist removes it. Oblique subgingival cracks are painful and may require a combination of periodontal surgery (to expose the crown) and endodontic treatment to place a crown or other restorative device.
Vertical furcation cracks – These cracks occur when the roots of the tooth separate. This type of crack almost always affects the nerve of the tooth. Because the tooth will not generally separate completely, root canal therapy and a crown can usually save the tooth.
Oblique root cracks – These cracks tend not to affect the surface of the tooth at all. In fact, the damage is only apparent below the gum line and usually below the jawbone. Root canal therapy may be possible, depending on how close the fracture is to the tooth surface. However, extraction is almost always the only option after sustaining this classification of fracture.
Vertical apical root cracks – These cracks occur at the apex (tip of the root). Though the tooth does not require extraction from a dental perspective, many patients request an extraction because of the high degree of pain. Root canal therapy alleviates the discomfort for a while, but most often, teeth affected by such cracks are eventually extracted.
Treatments for cracked teeth
There are many different types of cracked teeth. Some can only be exposed using X-ray machines, while others are clearly visible to the naked eye. In cases where the tooth root is affected, root canal therapy is the most viable treatment option. The pulp, nerves and vessels of the tooth will be removed, and the resulting space will be filled with gutta-percha. A crown or filling will be added to stabilize the tooth, and it will continue to function as normal.
When the crack is too severe for the tooth to be saved, the dentist will perform an extraction. There are a number of restorative options in this case, such as bridges, dental implants and partial dentures. All of these structures can restore biting, chewing, and speaking functions.
If you have any questions or concerns about cracked teeth, please contact our office.
Root Canal Therapy
Root Canal Therapy
Most people who end up needing root canal treatment come in with a tooth ache. The doctor will test the tooth and any adjacent teeth by percussion and palpation. The dentist will also conduct a cold test.
If the tests are positive, a root canal treatment will be initiated. A root canal treatment is needed because the nerve of a tooth is affected by decay or infection. In order to save the tooth, the living tissue inside the tooth known as the pulp, nerves, bacteria, and decay are removed and the resulting space is filled with dental medicated materials.
Having a root canal completed is the treatment of choice to save a tooth otherwise it will have to be extracted. Many patients believe that removing a tooth that has problems is the solution; however what is not realized is that extracting (pulling) a tooth will ultimately be more costly and cause significant problems for adjacent teeth.
Root canal treatment is highly successful (80-90%) and usually lasts a lifetime, although on occasion, a tooth will have to be retreated due to new infections.
Signs and symptoms for possible root canal therapy
-
An abscess (or pimple) on the gums
-
Tooth/teeth sensitive to hot and cold
-
Severe toothache pain
-
Swelling and/or tenderness
-
Sometimes no symptoms are present if the nerve is already dead (necrotic)
Reasons for root canal therapy
-
Decay has reached the pulp (living tissue inside the tooth)
-
Infection or abscess has developed inside the tooth or at the root tip
-
Trauma to the tooth
What does root canal therapy involve?
A root canal usually takes one to two appointments depending on the severity. If the case is extremely challenging, a referral to an endodontist (one who specializes in root canal treatment) may be given.
Once the tooth is numb, a rubber dam (a sheet of rubber) will be placed to isolate the tooth by keeping it dry and free of saliva/debris. An access opening is made on top of the tooth and a series of root canal files are placed into the opening. The files remove the pulp, nerve tissue, and bacteria. If decay is present, it will also be removed with special dental instruments.
Once the tooth is thoroughly cleaned and sealed a permanent restoration (filling) will be placed to cover the opening on the top of the tooth. If additional appointments are needed, a temporary filling will be placed then 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 and a permanent restoration will be placed.
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 be sensitive, but this will subside as the inflammation diminishes.
Post-op care instructions are given after each appointment. Good oral hygiene practices and regular visits will aid in the life of your root canal treated tooth.
Dental Emergencies
Dental emergencies are quite frightening and often painful. Prompt treatment is almost always required to alleviate pain and to ensure the teeth have the best possible chance of survival.
Sometimes, teeth become fractured by trauma, grinding, or biting on hard objects. In other cases, fillings, crowns, and other restorative devices can be damaged or fall out of the mouth completely. If there is severe pain, it is essential to contact our office immediately. The pain caused by dental emergencies almost always gets worse without treatment, and dental issues can seriously jeopardize physical health.
Reasons for emergency dental visits
Avulsed tooth (tooth knocked out)
If a tooth has been knocked clean out of the mouth, it is essential to see a dentist immediately. When a tooth exits the mouth, tissues, nerves, and blood vessels become damaged. If the tooth can be placed back into its socket within an hour, there is a chance the tissues will grow to support the tooth once again.
Here are some steps to take:
-
Call our office.
-
Pick up the tooth by the crown and rinse it under warm water. DO NOT touch the root.
-
If possible, place it back into its socket – if not tuck it into the cheek pouch.
-
If the tooth cannot be placed in the mouth, put the tooth into a cup of milk, saliva, or water as a last resort. It is important to keep the tooth from drying out.
-
Get to our office, quickly and safely.
We will try to replace the tooth in its natural socket. In some cases, the tooth will reattach, but if the inner mechanisms of the teeth are seriously damaged, root canal therapy might be necessary.
Lost filling or crown
Usually, a crown or filling comes loose while eating. Once it is out of the mouth, the affected tooth may be incredibly sensitive to temperature changes and pressure. Crowns generally become loose because the tooth beneath is decaying. The decay causes shape changes in the teeth – meaning that the crown no longer fits.
If a crown has dropped out of the mouth, make a dental appointment as soon as possible. Keep the crown in a cool, safe place because there is a possibility that we can reinsert it. If the crown is out of the mouth for a long period of time, the teeth may shift or sustain further damage.
When we are not immediately accessible, here are the steps to take:
-
Apply clove oil to the tooth to alleviate pain.
-
Clean the crown, and affix it onto the tooth with dental cement. This can be purchased at a local pharmacy.
-
If the crown is lost, smear the top of the tooth with dental cement to alleviate discomfort.
-
DO NOT use any kind of glue to affix the crown.
We will check the crown to see if it still fits. If it does, it will be reattached to the tooth. Where decay is noted, this will be treated and a new crown will be made.
Cracked or broken teeth
The teeth are strong, but they are still prone to fractures, cracks, and breaks. Sometimes fractures are fairly painless, but if the crack extends down into the root, it is likely that the pain will be extreme. Fractures, cracks, and breaks can take several different forms, but are generally caused by trauma, grinding, and biting. If a tooth has been fractured or cracked, there is no alternative but to schedule an appointment as quickly as possible.
Where a segment of tooth has been broken off, here are some steps that can be taken at home:
-
Call our office.
-
Rinse the tooth fragment and the mouth with lukewarm water.
-
Apply gauze to the area for ten minutes if there is bleeding.
-
Place a cold, damp dishtowel on the cheek to minimize swelling and pain.
-
Cover the affected area with over-the-counter dental cement if you cannot see us immediately.
-
Take a topical pain reliever.
The nature of the break or fracture will limit what we are able to do. If a fracture or crack extends into the root, root canal therapy is often the most effective way to retain the tooth.
Dislodged/loose teeth
When a tooth has been dislodged or loosened from its socket by trauma or decay, it might be possible to save it. If the tooth remains in the mouth still attached to the blood vessels and nerves, there is a good chance root canal therapy will not be necessary.
It is important to call our office immediately to make an appointment. In the meantime, use a cold compress and over-the-counter medications to relieve pain. Your dentist will reposition the tooth and add splints to stabilize it. If the tooth fails to heal, root canal therapy might be required.
If you have questions or concerns about dental emergencies, please contact our office.
Dental Emergencies
Tooth Extractions
Tooth Extractions
There are a number of reasons that your dentist might recommend a tooth extraction. Some dental patients suffer from tooth decay; others need to remove teeth hindering orthodontic treatment, whereas various patients simply need wisdom teeth removal. While a tooth extraction can be a serious dental procedure, aftercare is just as critical as the procedure itself. As the dental patient, it is important to understand that pain and the risk of infection can be lessened with proper care.
Care immediately following oral surgery:
-
Keep pressure on the gauze pad that your doctor placed over the surgical area by gently biting down. Dampen the gauze sponge with water if it begins to dry out. Try to maintain constant pressure in intervals of 45-60 minutes, repeating as often as needed, or until bleeding lessens. Change the gauze as needed.
-
Keep your head elevated and try to lower your activity level as much as possible.
-
48 hours after surgery, rinse mouth with warm salt water every 1-2 hours. Avoid using any mouthwash containing alcohol as it can irritate the wound.
-
Keep your mouth clean by brushing areas around the surgical site, but be sure to avoid sutures. Touching the wounded area in any fashion should be prevented.
-
Use ice packs to control swelling by placing them on facial areas near extraction.
-
Take all prescribed medications accordingly. If any itching or swelling occurs, contact the practice immediately, or go to the nearest emergency room.
-
Try to eat softer foods, preferably high in protein.
-
Keep your body hydrated by drinking plenty of fluids, but do not drink through a straw for the next 5-7 days.
-
If you are a regular tobacco user refrain from smoking for the next 3-4 days as smoking increases your chances of getting a dry socket as well as an infection.
After your tooth has been extracted, healing will take some time. Within 3 to 14 days, your sutures should fall out or dissolve. For sutures that are non-resorbable, your doctor will schedule a follow-up appointment to remove the stitches for you. Your tooth’s empty socket will gradually fill in with bone over time and smooth over with adjacent tissues.
Possible complications after a tooth extraction
Bleeding – Bleeding after a tooth extraction is entirely normal. A pinkish tinted saliva and subtle oozing is fairly common during the first 36 hours. If bleeding gets excessive, control it by using dampened gauze pads and biting down to keep pressure on the area. As an alternative to gauze pads, a moistened tea bag can be used, as the tannic acid helps blood vessels contract. Apply pressure to the gauze or tea bag by gently biting down for 30 minutes. Please remember that raised tempers, sitting upright, and exercise can all increase blood flow to the head, which can cause excess bleeding. Try to avoid these as much as possible. If your bleeding does not reduce after 48 hours, please call the practice.
Bone sequestra (dead tooth fragments) – Some patients have small sharp tooth fragments that were unable to be completely removed during surgery. During the recovery period, these dead bone fragments, or bone sequestra, slowly work themselves through the gums as a natural healing process. This can be a little painful until the sequestra are removed so please call our practice immediately if you notice any sharp fragments poking through the surgery site.
Dry socket – In the days that follow your tooth extraction, pain should gradually subside. Rarely, patients report that pain increases to a throbbing unbearable pain that shoots up towards the ear. Often this is a case of dry socket. Dry socket occurs when the blood clot becomes irritated and ousted before healing is complete. Food and debris can then get into the socket causing irritation. Tobacco users and women taking oral contraceptives are at a higher risk of getting dry socket. Dry socket is not an infection but does require a visit to our office. If you think you may be suffering from dry socket, please contact the practice immediately.
Lightheadedness – Because you may have been fasting prior to surgery, your blood sugar levels may be lower than normal. Until your body has had the chance to catch up and process some sugars, you should remember to stand up slowly when getting up from a relaxed position. For somewhat immediate relief, try eating something soft and sugary, stay in a relaxed position, and reduce the elevation of your head.
Numbness – Many patients report still feeling numb hours after their tooth extraction procedure. An extended lack of feeling around the mouth is normal and can last 10-12 hours after surgery.
Swelling – Swelling should subside almost entirely within 10 days after surgery. Immediately following your tooth extraction, apply an ice pack to the facial areas near the extraction. Continue using the ice in 15 minute intervals for the first 36 hours. After 36 hours, ice will no longer be beneficial in reducing swelling and moist heat should be used instead. To decrease swelling, apply a warm damp cloth to the sides of your face.
Trismus (difficulty opening and closing mouth) – If you experience a sore jaw and difficulty chewing or swallowing, do not be alarmed. Occasionally patients’ chewing muscles and jaw joints remain sore 3-5 days after surgery. This soreness can also make it difficult to open and close your mouth. Soreness should eventually subside.
If you have any worries, or are experiencing any complications not mentioned, please contact our practice immediately so that we may address your concerns.