In between regular visits to the dentist, there are simple steps that each of us can take to greatly decrease the risk of developing tooth decay, gum disease and other dental problems.
- Brush thoroughly twice a day and floss daily
- Eat a balanced diet and limit snacks between meals
- Use dental products which contain fluoride, including toothpaste
- Rinse with a fluoride mouth rinse if advised to do so
- Make sure children under 12 drink fluoridated water or take a fluoride supplement if they live in a non-fluoridated area
- Visit your dentist regularly for professional cleanings and oral exams
- Replace your toothbrush every 3-4 months
The following are indications of good oral hygiene:
- Your teeth are clean and free of debris
- Gums are pink and do not hurt or bleed when you brush or floss
- Bad breath is not a constant problem
Dental Cleaning
It’s important to visit your dentist twice per year for a cleaning. Not only is it a great way to keep plaque from forming, it also gives the dentist a chance to look for changes in your gums and teeth. Here’s a bit of background on why dental cleanings are important:
A dental cleaning is a professional cleaning you receive from a dentist or dental hygienist. Most dental cleanings take only between 25 and 30 minutes. Cleanings should be performed every six months to prevent excessive plaque buildup. Plaque left untreated can lead to unhealthy gums and tooth decay. A routine dental cleaning should include scaling, root planing and polishing.
While the above description discusses the basics of dental cleanings, some advanced cleaning services include:
Scaling: this is the process of removing plaque and tartar from all tooth surfaces in a variety of methods, depending on the amount of plaque and tartar.
Dental hygienists traditionally perform scaling by hand. However, new and advanced technology has lead to more modern methods such as electric scalers. This sophisticated tool allows dental cleanings to be performed more efficiently and in less time. To achieve best results, both electric and manual scaling methods are combined for dental cleanings.
Root planing: this is the process of cleaning pockets in the gums to treat and prevent gum problems. Root planing is used to treat moderate to advanced gum diseases. When the gum is inflamed, gum pockets become deeper and may lose connections to the bone inside. The deeper the pockets, the easier it is for plaque deposits to become trapped and worsen gum problems.
Root planing involves inserting a pointed dental tool called scalers into the gum pockets to clean plaque buildup. Depending on the degree of difficulty, root planing may take several appointments and a local anesthesia may be used to prevent pain.
Polishing: this is the last step in tooth cleaning and involves finishing the surface of the teeth to make them shiny and clean. There are two kinds of polishing: air polishing and rubber tip polishing. Air polishing works by spraying high pressured water mixed with baking soda paste onto the surface of your teeth. This powered water washes away residue and plaque while baking soda removes stains. Rubber cup polishing uses a low-speed and gentle handpiece that contains a polishing paste made of abrasive ingredients ideal for removing stains.
Sealants
Sealants are used to fill narrow grooves in a tooth that cannot be adequately cleaned by brushing. In some cases, the tooth structure has fine grooves or pits which accumulate plaque, not because the person doesn’t brush, but because they’re too narrow to allow even one bristle into them. To avoid cavities developing over time, the dentist will brush on a coating that seals the grooves and pits, making it possible to brush off all the plaque and keep your teeth healthy.
Bonding
Bonding involves adhering composite resin material that is matched to the color of the tooth, to the front of the tooth. This is performed to repair damage caused by decay, to alter the alignment of the tooth, close gaps between the teeth, or for other cosmetic purposes. First the surface of the tooth is roughened in order to accept the bonding. A gel is applied so the resin will adhere to the surface of the tooth. The composite is then placed on the tooth and the bonding agent hardens with intense light. The last step is shaping and polishing to give a lustrous finish.
Nightguards & Mouthguards
Custom designed mouthguards and nightguards are made of flexible plastic and molded to fit the shape of your teeth. Mouthguards are recommended to protect the jaw and teeth during physical activity and sports such as boxing, football, basketball, or other activities where your mouth may be hit. Guards also protect the soft tissues of your tongue, lips and cheek lining. Nightguards are recommended for patients who clench or grind their teeth at night as a way to protect their teeth and bite.
On average, guards last between 3 and 10 years.
TMJ Treatments
TMJ stands for temporal-mandibular joint. Temporal, as in temple area of skull; mandibular as in mandible, or lower jaw; joint as in where the head and jaw meet. Problems in this joint may be caused by a misalignment of the teeth, trauma, or excess muscle tension. Cartilage buffers the two bones and five muscles that meet in this area, but any problems in this area can create quite a bit of pain and biting difficulties.
Symptoms of TMJ include:
- Headaches
- Earaches
- Trouble/soreness in opening and closing the mouth
- Clicking or popping of the jaw
- Pain in the jaw muscles
- Soreness in the area, sometimes extending to the face
Dental treatments for the condition can include replacing missing teeth, moving teeth, adjusting the bite and filling gaps between teeth. There is no one solution that is right for all cases. Occasionally a plastic mouthpiece is used to prevent clenching or grinding that is contributing to the problem. If untreated and in severe cases, surgery may be required to repair a badly damaged joint.
Root Canal Treatment
Root canal treatment (also referred to as root canal therapy or endodontic therapy) is made necessary when an untreated cavity reaches all the way to this pulp. Treatment may also be needed when deep restorations or trauma to a tooth cause nerve damage. Once the pulp becomes infected, it can begin to eat away at the surrounding bone (this is known as an abscess). If the pulp is infected, not only is it painful but it will require treatment as it cannot heal on its own. Symptoms that indicate the pulp has become infected may include sensitivity to hot/cold or sweets, pain, swelling, pain to biting or pressure, and a bad taste in the mouth. However, sometimes no symptoms are apparent and you may be unaware of any problem until a checkup.
A root canal is performed to clean out the infected tooth pulp and disinfect the canals of the tooth. Alternate treatment would be to extract the tooth. Once the infection is resolved, the canal is filled in to prevent any further infection. Usually a core build-up and crown is recommended for restoring a tooth that has undergone root canal therapy.
Tooth Extractions
Good oral hygiene should always be practiced since the loss of a single tooth can have major impact upon your oral health and appearance. Although dentists will use every measure to prevent tooth loss, there still sometimes necessary occasions when a tooth may need to be extracted.
A tooth may need to be extracted for the following reasons:
- Severe decay
- Advanced periodontal disease
- Infection or abcess
- Orthodontic correction
- Malpositioned teeth
- Fractured teeth or roots
- Impacted teeth
After careful examination and treatment, the dentist may advise to have a tooth extracted. Before a tooth is removed, the dentist will take an x-ray in order to understand the shape and position of the tooth and surrounding bone. Based on the degree of difficulty, we may refer you to a specialized oral surgeon.
For a simple extraction, a local anesthetic will be applied to prevent pain and discomfort. The tooth will be loosened with a tool called an elevator and then removed with dental forceps. Once the procedure is complete, the area may be closed with one or two stitches.
Wisdom Tooth Extractions
Wisdom teeth are the last molars or third molars that develop on each side of the jaws. Wisdom teeth usually emerge in the back of the mouth between the ages of 16-20.
Wisdom teeth are a valuable asset to the mouth when they are healthy and properly positioned. Often, however, problems develop that require their removal. When the jaw isn’t large enough to accommodate wisdom teeth, they can become impacted (unable to come in or misaligned). Wisdom teeth may also grow in sideways, emerge only part way through the gum or remain trapped beneath the gum and bone.
A wisdom tooth extraction is a relatively routine procedure. The dentist will numb the area in your mouth with a local anesthesia or use IV sedation so you are asleep during the procedure. Some pain and swelling may occur but will normally subside after a few days. You should call your dentist if you have prolonged or severe pain, swelling, bleeding or fever.
Fillings
A filling is a way to restore a tooth damaged by decay back to its normal function and shape. If you have a tooth that requires a filling, the dentist will first remove the decayed tooth material, clean the affected area, and then fill the cleaned out cavity with a filling material. A filling helps prevent further decay by closing off any cracks or spaces where bacteria can enter.
There are a variety of filling materials available including gold, silver, plastic and porcelain. The dentist will work with you to determine which material is best, depending on the extent of repair, where in the filling is needed, and cost. Each filling material is briefly explained below:
Gold fillings are custom made in a laboratory and then cemented into place. While gold fillings are often the most expensive choice, many consider it the best filling material. Gold inlays are well-tolerated by gum tissues and may last more than 20 years.
Amalgam (silver) fillings are a more inexpensive choice and are tolerant to wear. However, due to their dark color they are more noticeable than porcelain or composite restorations and are not recommended for fillings in very visible areas such as front teeth.
Composite (plastic) resins are custom made to the exact color of your natural teeth, creating a more natural appearance. While white fillings may be less noticeable than other materials, they usually only last between 3 and 10 years and may not be ideal for large fillings as they may chip or wear over time. They can also become stained from coffee, tea or tobacco.
Porcelain fillings are called inlays or onlays and are custom created in a lab and then bonded to the tooth. They can be matched to the
color of the tooth, resist staining, and are about the same cost as gold fillings. A porcelain restoration generally covers most of the tooth, making the filling nearly undetectable.
If decay or a fracture has damaged a large portion of the tooth, a crown (or “cap”) may be recommended. Decay that has reached the nerve may be treated through root canal therapy or through a procedure called pulp capping.
