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Services & Procedures2018-07-26T20:57:42+00:00

Restorative

Dental implants are a great way to replace missing teeth and also 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 and teeth (usually titanium) that are surgically placed into the upper or lower jaw bone by our Periodontist – a specialist of the gums and supporting bone. The teeth attached to implants are very natural looking and often enhance or restore a patient’s smile!

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.
  • Restore or enhance facial tissues.
  • Support a bridge or denture, making them more secure and comfortable.

What does the Dental Implant Process 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 onto the bone 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, eating habits, and regular dental visits will aid in the life of your new implant.

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.

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.

Reasons for Composit 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 dentist will remove decay as necessary. The space will then be throughly 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 protction. 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.

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 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.

Erosion Risk Assessment

Dental erosion has been diagnosed, treatment planned and treated in our office for the past twenty years. We utilize a multi-disciplinary approach using ENT (Ear, Nose and Throat), gastroenterologist, periodontist, psychologist and oral surgeon to properly treat this destructive problem, no matter what the ideology is.

Before:

After:

Wear Risk Assessment

The proper diagnosis of patient wear with or without TMJ problems has been a major aspect of our practice since Dr. Allen finished his advanced continued education with Dr. Joseph Clayton, who was the head of the Fixed Prosthetic Program at the University of Michigan. Proper diagnosis, treatment planning and treatment, along with proper patient follow-up, has made this aspect of functional dentistry a pillar of our practice. Combined with education and dental aesthetics, those factors have blended the functional and esthetic outcomes that our patients desire.

Before

After

What is TMJ?

Temporomandibular Joint Dysfunction Syndrome (TMJ) is a common condition affecting a wide variety of people. TMJ is characterized by severe headaches, jaw pain of varying degrees, grinding teeth, and an intermittent ringing in the ears. The vast majority of TMJ sufferers are unaware that the root cause of these problems is something that a dentist can effectively treat.

The symptoms of TMJ are debilitating and can greatly interfere with every day life. The comfort and general well being of the patient is at the heart of the dental practice, so pain relief is the first consideration. Dr. Allen is able to test, diagnose, and devise an immediate plan to treat the underlying causes of the TMJ disorder. He has a long list of continuing education seminars which highlights two summers of extensive studies with Joseph Clayton, DDS, at the University of Michigan focusing on full mouth rehabilitation and work with TMJ.

Reasons for treating TMJ

TMJ sufferers report that their symptoms generally worsen during periods of prolonged or unexpected stress, and that intense outbreaks of the condition can lead to neck pain and dizziness.

The most common cause of TMJ is the misalignment of the teeth, often called “bad bite.” It is possible for the dentist to realign or adjust the teeth without the need for painful or expensive surgeries. The realignment/adjustment will stop the pounding headaches, the jaw pain, and the dizziness.

The grinding teeth symptom is particularly common and usually occurs at night. The grinding will eventually erode the structure of the teeth and lead to much more severe dental problems in the future. Untreated TMJ is one of the prime underlying factors in eroded jawbones and loose teeth.

It is important for anyone experiencing the symptoms of TMJ to visit the dentist for an exact diagnosis.

What does treating TMJ involve?

TMJ could be a result of several different problems. Bad bite is the most common, but an injury resulting from a blow to the meniscus cartilage is also a possibility. Initially, the dentist will thoroughly examine the jaw area, the patient’s bite, take X-rays, and review the patient’s history in order to make an accurate diagnosis and recommend necessary treatment.

Once a firm diagnosis is attained, there are several ways in which relief can be provided. A specially molded bite guard can be created to stop teeth grinding during the night. A bite relationship analysis may be recommended. The dentist can also provide advice on relaxation techniques which will lessen the effects of stress. As a last alternative, the dentist is also able to prescribe muscle relaxants.

A better option is to change the shape of the teeth and get rid of the bad bite completely, often called “realignment.” This is especially useful because it alleviates TMJ symptoms and may improve the aesthetic appearance of the teeth as well. Realignment involves adjusting the relationship between how the upper teeth come together with the lower teeth. This may require new restorations and/or adjusting the natural teeth as well. It is not a painful procedure, and it is one the dentist has performed with great success numerous times. As with any procedure, the dentist will be happy to answer questions and discuss symptoms, options, and treatments.

If you are experiencing any symptoms of TMJ, we encourage you to contact our office today to schedule an appointment.

Cosmetic & Orthodontic

Veneers are very thin pieces of durable, tooth shaped porcelain that are custom made (for shape and color) by a professional dental laboratory. They are bonded onto the front of teeth to create a beautiful and attractive smile.

Veneers can completely reshape your teeth and smile. They can often be alternatives to crowns and the ideal solution in treating many dental conditions.

As with most dental restorations, veneers are not permanent and may someday need replacement. They are very durable and will last many years, giving you a beautiful long lasting smile.

Reasons for getting Porcelain Veneers:

  • 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.

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 now become the number one aesthetic concern of most patients, there are a number of ways to whiten teeth. The most popular method is using a home teeth whitening system that will whiten teeth dramatically. 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 Whitening Teeth:

  • 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 Tooth 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.

Orthodontic braces were historically associated with teenagers. Today, an increasing number of adults are choosing to wear braces to straighten their teeth and correct malocclusions (bad bites). In fact, it is now estimated that almost one third of all current orthodontic patients are adults

Can Adults Benefit from Orthodontic Braces?

Absolutely! Crooked or misaligned teeth look unsightly, which in many cases leads to poor self esteem and a lack of self confidence. Aside from poor aesthetics, improperly aligned teeth can also cause difficulties biting, chewing and articulating clearly. Generally speaking, straight teeth tend to be healthier teeth.

Straight teeth offer a multitude of health and dental benefits including:

  • Reduction in general tooth decay
  • Decreased likelihood of developing periodontal disease
  • Decreased likelihood of tooth injury
  • Reduction in digestive disorder

Fortunately, braces have been adapted and modified to make them more convenient for adults. There are now a wide range of fixed and removable orthodontic devices available, depending on the precise classification of the malocclusion.

What are my Options?

The following are the most common options for adults:

6 Month Smiles® – With the 6 Month Smile® system, you can have the smile you’ve always dreamed of in just 6 months! The brackets and wire are tooth-colored so they are not readily visible. Once the brackets are placed, you would visit us every month until treatment is completed.

Invisalign® – Invisalign aligners are both removable and invisible to onlookers. Invisalign® aligners are clear trays, and should be worn for the recommended amount of time each day for the quickest results. Invisalign® aligners are more comfortable and less obtrusive than traditional braces.

Although patients of any age can benefit from orthodontic braces, they tend to work much quicker on pre-teens and teenagers since they are still experiencing jaw growth. The American Association of Orthodontists (AAO) recommends that children should first see an orthodontist around the age of seven years-old. An orthodontic examination may be beneficial before age seven if facial or oral irregularities are noted. When we examine your child, we are looking at their growth and development so that we can make a proper recommendation in terms of whether orthodontics is needed.

What Causes misalignment of Teeth?

Poorly aligned teeth often cause problems speaking, biting and chewing. Most irregularities are genetic or occur as a result of developmental issues. Conversely, some irregularities are acquired or greatly exacerbated by certain habits and behaviors such as:

  • Mouth breathing
  • Thumb or finger sucking
  • Prolonged pacifier use
  • Poor oral hygiene
  • Poor nutrition​

What is involved when a Child gets Braces?

If we refer your child to an orthodontist, he or she will initially conduct a visual examination of your child’s teeth. This will be accompanied by panoramic x-rays, study models (bite impressions) and computer generated images of the head and neck. These preliminary assessments are sometimes known as the “planning phase” because they aid the orthodontist in making a diagnosis and planning the most effective treatment.

In many cases, the orthodontist will recommend “fixed” orthodontic braces for your child. Fixed braces cannot be lost, forgotten or removed at will, which means that treatment is completed more quickly. Removable appliances may also be utilized, which are less intrusive, and are generally used to treat various types of defects.

Here is a brief overview of some of the main types of orthodontic appliances used for children:

Fixed braces – Braces comprised of brackets which are affixed to each individual tooth, and an archwire which connect the brackets. The brackets are usually made of metal, ceramic, or a clear synthetic material which is less noticeable to the naked eye. After braces have been applied, the child will have regular appointments to have the braces adjusted by the orthodontist. Orthodontic elastic bands are often added to the braces to aid in the movement of specific teeth.

Headgear – This type of appliance is most useful to treat developmental irregularities. A headgear is a custom-made appliance attached to wire that is worn to aid in tooth movement. A headgear is intended to be worn for 12-20 hours each day and must be worn as recommended to achieve good results.

Retainers – Retainers are typically utilized in the third phase (retention phase). When the original malocclusion has been treated with braces, it is essential that the teeth do not regress back to the original misalignment. Wearing a retainer ensures the teeth maintain their proper alignment, and gives the jawbone around the teeth a chance to stabilize.

Oral Surgery

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!

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 include 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.

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 easier. 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 may 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 may 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, which reduces your time in the dental office. Also, since the digital image is captured electronically, there is no need to develop the x-rays, thus eliminating the disposal of harmful waste and chemicals into the environment.

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.

Panoramic X-rays (also known as Panorex® or orthopantomograms) are wraparound photographs of the face and teeth. They offer a view that would otherwise be invisible to the naked eye. X-rays in general, expose hidden structures, such as wisdom teeth, reveal preliminary signs of cavities, and also show fractures and bone loss.

Panoramic X-rays are extraoral and simple to perform. Usually, dental X-rays involve the film being placed inside the mouth, but panoramic film is hidden inside a mechanism that rotates around the outside of the head.

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-ray because less radiation enters the body.

Tooth decay can be extremely painful and puts the teeth at risk. Many extractions and restorative treatments are performed every single day because tooth decay has become too severe for the dentist to save the tooth. Diagnodent® is a safe fluorescent laser that detects hidden tooth decay accurately, quickly, and in its earliest stages.

All dentists are advocates for healthy, natural teeth. Restoration devices like crowns and bridges are popular because they allow the natural tooth to remain in the mouth. Diagnodent® accurately exposes areas of tooth decay without scratching, probing or “opening up the tooth.” This provides a greater chance of identifying, treating and retaining a natural tooth without the need for expensive and time-consuming restorations.

How can Diagnodent® help me?

Diagnodent® accurately exposes more caries than X-rays and examinations. In fact, this revolutionary diagnostic tool is over 90% accurate. Sometimes, caries “go underground” due to fluoridation. This essentially means that lesions that once lay on the surface of the tooth bed down, and remain invisible to the naked eye. Because Diagnodent® exposes caries earlier, more treatment options are possible.

Here are some of the other benefits associated with Diagnodent®:

What does the Diagnodent® process involve?

  • Allows dentists to perform treatment with greater confidence
  • Allows for the investigation of suspicious areas
  • Completely safe
  • Cost effective
  • Empirically measurable results
  • Helps reduce future dental procedures
  • More accurate than any other diagnostic tool
  • No exposure to X-rays
  • No need for invasive investigations
  • No pain or scratching

The Diagnodent® process is performed within the scope of a regular dental checkup. It is strikingly similar to having a laser pointer aimed at the teeth. Diagnodent® is a hi-tech tool, which first scans a clean tooth surface with a laser beam. This scanning procedure serves to calibrate the instrument by providing information about the tooth structure.
The Diagnodent® System is actually measuring the amount of laser fluorescence within the tooth. As each tooth is scanned, the amount of reflected laser light is recorded to produce a digital readout. If the tooth contains little or no decay, little or no laser light will be reflected back to the instrument. However, if a tooth contains caries of any significance, more laser light is reflected back. High readings (compared to the tooth originally scanned) indicate that caries are present within the structure of a particular tooth. The amount of laser light reflected back correlates with the amount of decay within the tooth.

Once the dentist determines which teeth are suffering from decay, a plan can be formulated and treatment options can be discussed. In most cases, the early detection of caries means more treatment options and a greater chance of saving the affected tooth.

If you have any questions about Diagnodent®, please ask us!

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.

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.

Oral Cancer Exams

According to research conducted by the American Cancer society, more than 30,000 cases of oral cancer are diagnosed each year. More than 7,000 of these cases result in the death of the patient. The good news is that oral cancer can easily be diagnosed with an annual oral cancer exam, and effectively treated when caught in its earliest stages.

Oral cancer is a pathologic process which begins with an asymptomatic stage during which the usual cancer signs may not be readily noticeable. This makes the oral cancer examinations performed by the dentist critically important. Oral cancers can be of varied histologic types such as teratoma, adenocarcinoma and melanoma. The most common type of oral cancer is the malignant squamous cell carcinoma. This oral cancer type usually originates in lip and mouth tissues.

There are many different places in the oral cavity and maxillofacial region in which oral cancers commonly occur, including:

  • 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

Reasons for oral cancer examinations

It is important to note that around 75 percent of oral cancers are linked with modifiable behaviors such as smoking, tobacco use and excessive alcohol consumption. We are happy to provide literature and education on making lifestyle changes and smoking cessation.

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:

  • 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.
  • 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.
  • Lumps – Soreness, lumps or the general thickening of tissue anywhere in the throat or mouth can signal pathological problems

Oral cancer exams, diagnosis and treatment

The oral cancer examination is a completely painless process. During the visual part of the examination, we look for abnormalities and feel the face, glands and neck for unusual bumps.

If abnormalities are found, we may perform a VELScope exam or a biopsy. VELscope is a handheld instrument that emits a safe blue light into the mouth. Healthy tissue reflects the light back, and appears pale green and fluorescent to the observer, while developing tumor cells appear dark. Since oral cancer is a very aggressive cancer, and in its early stages there are frequently no signs or symptoms, a VELscope can save critical time in the cancer diagnosis, greatly enhancing the chance of survival.

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.

During bi-annual check-ups, the dentist and hygienist will thoroughly look for changes and lesions in the mouth, but a dedicated comprehensive oral cancer screening should be performed at least once each year.

Oral Cancer Brush Biopsy

The OralCDx BrushTest is a painless laboratory test for oral precancer and cancer. Our dentists often use the BrushTest to evaluate “everyday” unexplained small white and/or red oral spots. The BrushTest can accurately determine if a common oral spot contains abnormal (dysplastic) cells that if left alone, may develop into oral cancer. If you are a smoker or have other risk factors for developing oral cancer, we may recommend a brush biopsy of suspicious lesions.

VELscope® Oral Cancer Screening

Since oral cancer is a very aggressive cancer, and in its early stages there are frequently no signs or symptoms, early detection can save critical time in the cancer diagnosis, greatly enhancing the chance of survival. Early detection raises the oral cancer survival rate to 90%. A revolutionary hand-held device, called VELscope (Visually Enhanced Lesion Scope) offers a painless early detection option.

Our mission is to keep current with all state-of-the-art dental technology. Our practice prides itself on being one of the first Dental offices in the area to invest in the VELscope technology. We will be offering VELscope screening to all of our patients in the high risk category for oral cancer. Since 25% of newly diagnosed cases do not fit the high-risk profile, if you feel that you would like to be screened please let us know.

How does the VELscope® work?

The VELscope® uses Fluorescence Visualization (FV) in an exciting new way. Essentially, bright blue light is shined into the mouth to expose changes and lesions that would otherwise be invisible to the naked eye. One of the biggest difficulties in diagnosing oral cancer is that its symptoms look similar to symptoms of less serious problems. The VELscope® System affords the dentist important insight as to what is happening beneath the surface.

The healthy soft tissue of the mouth naturally absorbs the VELscope® frequency of blue light. Healthy areas beneath the surface of the soft tissue show up green, and the problem areas become much darker.

Here are some of the advantages of using the VELscope® System:

  • Detects lesions, white and red patches
  • Detects problem areas that cannot be seen under white light
  • Exposes precancerous and cancerous tissue
  • FDA-approved
  • Helps dentists check that diseased soft tissue is completely removed
  • Helps diagnose oral cancer in its earliest stages, exponentially increasing the chance of survival
  • Quick, painless examinations

How is the VELscope® examination performed?

The VELscope® examination literally takes only two or three minutes. It is a painless and noninvasive procedure that saves many lives every single year.

Here is a brief overview of what a VELscope® examination is like:

Initially, the dentist will perform a regular visual examination of the whole lower face. This includes the glands, tongue, cheeks and palate as well as the teeth. Next a pre-rinse solution is swilled around the mouth for slightly less than a minute. The dentist provides special eyewear to protect the integrity of the retinas. The lights in the room are dimmed to allow a clear view of the oral cavity.

The small VELscope® is bent to project blue light inside the mouth. Lesions and other indicators of oral cancer are easily noticeable because they appear much darker under the specialized light.

If symptoms are noted, our oral surgeon may take a biopsy there and then to determine whether or not this is oral cancer. The results of the biopsy dictate the best course of action from there.

If you have any questions or concerns about oral cancer, please ask us!

The overwhelming fear of dental appointments can be a common cause of anxiety. Many people visualize a drill-wielding man in a white coat just waiting to cause pain and remove teeth. The reality, however, is very different. The comfort, relaxation and happiness of the patient are embedded deep at the heart of any good dental practice. Our staff will do whatever they can to reduce anxiety, allay fears and provide painless, quick treatments.

Recent technological advancements have meant that in many cases, dentists are able to replace noisy drills with painless laser beams. There are also a wide variety of safe anesthetics available to eliminate pain and reduce anxiety during routine appointments.

Here is a list of some of the most common dental fears:

  • Fear of embarrassment about the condition of teeth
  • Fear of gagging
  • Fear of injections
  • Fear of loss of control
  • Fear of not becoming numb when injected with Novocain
  • Fear of pain
  • Fear of the dentist as a person
  • Fear of the hand piece (or the drill)

How can one overcome dental anxiety?

Dental anxiety and fear can become completely overwhelming. It is estimated that as many as 35 million people do not visit the dental office at all because they are too afraid. Receiving regular dental check ups and cleanings is incredibly important. Having regular routine check ups is the easiest way to maintain excellent oral hygiene and reduce the need for more complex treatments.

Here are some tips to help reduce dental fear and anxiety:

  • Talk to the dentist – The dentist is not a mind reader. Though it can be hard to talk about irrational fears with a stranger, the dentist can take extra precautions during visits if fears and anxiety are communicated.
  • Bring a portable music player – Music acts as a relaxant and also drowns out any fear-producing noises. Listening to calming music throughout the appointment will help to reduce anxiety.
  • Agree on a signal – Many people are afraid that the dentist will not know they are in significant pain during the appointment, and will carry on the procedure regardless. The best way to solve this problem is to agree on a “stop” hand signal with the dentist. Both parties can easily understand signals like raising the hand or tapping on the chair.
  • Spray the throat – Throat sprays (for example, Vicks® Chloraseptic® Throat Spray) can actually control the gag reflex. Two or three sprays will usually keep the reflex under control for about an hour.
  • Take a mirror – Not being able to see what is happening can increase anxiety and make the imagination run wild. Watching the procedure can help keep reality at the forefront of the mind.
  • Sedation – If there is no other way to cope, sedation offers an excellent option for many people. We offer several types of sedation, but the general premise behind them is the same: the patient regains their faculties after treatment is complete.

Ask about alternatives – Advances in technology mean that dental microsurgery is now an option. Lasers can be used to prepare teeth for fillings, whiten teeth and remove staining. Discuss all the options with the dentist and decide on one that is effective and produces minimal anxiety.

Our office has a general dentist, oral surgeon, and periodontist on staff, so we are well-equipped to handle any dental emergency. If you are having tooth pain or have a dental emergency such as a tooth abscess, broken tooth, or have had trauma to either the teeth or jaw, please call our office right away. By seeking immediate care for a dental emergency, you will be assured to receive more successful and less invasive treatment than if you put off contacting your dentist. We understand that fear or anxiety may prevent you from seeking treatment. Our office has various sedation options to ensure you receive comfortable care. We will make our best efforts to see you promptly, even if you have never been to our office before.

A significant number of Americans do not visit the dentist for regular checkups because they are too fearful or suffer from dental anxiety. Sedation dentistry offers an excellent way to provide a safe, anxiety-free, dental experience to those who are afraid of the dentist.

Sedation dentistry is often mistakenly thought to induce sleep. In fact, most sedatives allow the patient to stay awake during the procedure. Sleepiness is a side effect of some medications, but nitrous oxide, oral conscious sedation and IV sedation only work to calm anxiety throughout the dental visit.

Sedation dentistry is popular because most sedatives can be taken by mouth, meaning no injections, no anxiety and no pain. Some sedatives work so effectively that even the smells and details of the procedure cannot be recalled afterwards. Safety and compliance are two important aspects of treatments, so sedation dentistry offers both the individual and the dentist the best alternative.

Whatever the form of sedative, it is essential to be accompanied by a caregiver. Sometimes, sedatives are provided the night before the dental visit, which means that driving to or from the appointment is not advisable.

Here are some advantages associated with sedation dentistry:

Anxiety is alleviated
Few side effects
More can be accomplished during each visit
No needles
No pain
Perfectly safe
Procedures seem to take less time

What kinds of sedatives are available?

The most popular types of dental sedatives are nitrous oxide, oral conscious sedation, and IV sedation. Different levels of sedation (mild, moderate and deep) can be utilized depending on individual needs. Before administering any sedative, we must analyze your full medical history, as well as taking note of any current medications.

Here is an overview of some of the most common types of dental sedatives:

Nitrous Oxide

Nitrous oxide, or “laughing gas,” is used as a mild sedative. It is delivered through a nose hood, and is administered throughout the entire procedure. Nitrous oxide elevates the general mood and can evoke a general sense of well-being. Most importantly, it relieves anxiety and reduces pain during the procedure. In addition, some tingling and numbness may be felt. There are few side effects associated with nitrous oxide, and it has been safely used in dentistry for many years.

IV Sedation

Intravenous sedation is a moderate type of sedation. Patients who have previously experienced IV sedation often report feeling like they slept through the entire procedure. Generally, IV sedation is used for shorter treatments. It is administered via direct injection into the bloodstream, which means the effects are immediate. Sometimes patients feel groggy and sleepy when the IV sedatives are withdrawn. This is why it is important to bring a designated driver for the drive home.

Oral Conscious Sedation

Oral conscious sedation is an excellent choice for people who fear needles. Oral medication is provided prior to treatment in order to induce a moderate state of sedation. Though oral sedatives do not cause sleep, they usually dull the senses. This means that most patients cannot remember the pain, smells or noises associated with the procedure. Usually, a dose of medication is taken prior to the appointment, and then topped up during the procedure as required.

Pediatric Dental Sedation

Our office offers dental sedation for children. In contrast to general anesthesia (which renders the child unconscious), dental sedation is only intended to reduce the child’s anxiety and discomfort during dental visits. In some cases, the child may become drowsy or less active while sedated, but this will quickly desist after the procedure is completed.

When is sedation used?

Sedation is used in several circumstances. Firstly, very young children are often unable keep still for long enough for the dentist to perform high-precision procedures safely. Sedation makes the visit less stressful for both children and adults and vastly reduces the risk of injury. Secondly, some children struggle to manage anxiety during dental appointments. Sedation helps them to relax, cope, and feel happier about treatment. Thirdly, sedation is particularly useful for children with special needs. It prevents spontaneous movement, and guides cooperative behavior.

When Should Children have their first Dental Visit?

The American Academy of Pediatric Dentistry (AAPD) suggests that parents should make an initial “well-baby” appointment approximately six months after the emergence of the first tooth, or no later than the child’s first birthday.

Although this may seem surprisingly early, the incidence of infant and toddler tooth decay has been rising in recent years. Tooth decay and early cavities can be exceptionally painful if they are not treated immediately, and can also set the scene for poor oral health in later childhood.

What potential dental problems can babies experience?

A baby is at risk for tooth decay as soon as the first tooth emerges. During the first visit, we try to help parents implement a preventative strategy to protect the teeth from harm, and also demonstrate how infant teeth should be brushed and flossed.

In particular, infants who drink breast milk, juice, baby formula, soda, or sweetened water from a baby bottle or sippy cup are at high-risk for early childhood caries (cavities). To counteract this threat, we discourage parents from filling cups with sugary fluids, dipping pacifiers in honey, and transmitting oral bacteria to the child via shared spoons and/or cleaning pacifiers in their own mouths.

Importantly, we can also assess and balance the infant’s fluoride intake. Too much fluoride ingestion between the ages of one and four years old may lead to a condition known as fluorosis in later childhood. Conversely, too little fluoride may render young tooth enamel susceptible to tooth decay.

What happens during the first visit?

During the initial visit, we will advise parents to implement a good oral care routine, ask questions about the child’s oral habits, and examine the child’s emerging teeth. The dentist and parent may sit knee-to-knee for this examination to enable the child to view the parent at all times. If the infant’s teeth appear stained, the dentist may clean them. Oftentimes, a topical fluoride treatment will be applied to the teeth after this cleaning.

What questions may the dentist ask during the first visit?

The dentist will ask questions about current oral care, diet, the general health of the child, the child’s oral habits, and the child’s current fluoride intake.

Once answers to these questions have been established, we can advise parents on the following issues:

  • Accident prevention
  • Adding xylitol and fluoride to the infant’s diet
  • Choosing an ADA approved, non-fluoridated brand of toothpaste for the infant
  • Choosing an appropriate toothbrush
  • Choosing an orthodontically correct pacifier
  • Correct positioning of the head during tooth brushing
  • Easing the transition from sippy cup to adult-sized drinking glasses (12-14 months)
  • Eliminating fussing during the oral care routine
  • Establishing a drink-free bedtime routine
  • Maintaining good dietary habits
  • Minimizing the risk of tooth decay
  • Reducing sugar and carbohydrate intake
  • Teething and developmental milestone

General & Prevention

Oral Surgeons

Oral Maxillofacial Surgeons are specialists with advanced training and expertise in the diagnosis and treatment of various head and neck conditions and injuries. The following are just some of the many conditions, treatments and procedures oral and maxillofacial surgeon deal with on a daily basis:

  • TMJ, Facial Pain, & Facial Reconstruction
  • Dental Implants
  • Tooth Extractions & Impacted Teeth
  • Wisdom Teeth
  • Misaligned Jaws
  • Cleft Lip & Palate
  • Apicoectomy
  • Oral Cancers , Tumors, Cysts, & Biopsies
  • Sleep Apnea
  • Facial Cosmetic Surgery

Wisdom Teeth

Third molars, commonly referred to as wisdom teeth, are usually the last four of 32 teeth to erupt in the mouth, generally making their appearance between the ages of 17 and 25. They are located at the back of the mouth (top and bottom), near the entrance to the throat. The term “wisdom” stems from the idea that the molars surface at a time typically associated with increased maturity or “wisdom”.In most cases, inadequate space in the mouth does not allow the wisdom teeth to erupt properly and become fully functional. When this happens, the tooth can become impacted (stuck) in an undesirable or potentially harmful position. If left untreated, impacted wisdom teeth can contribute to infection, damage to other teeth, and possibly cysts or tumors.

There are several types, or degrees, of impaction based on the actual depth of the teeth within the jaw:

Soft Tissue Impaction: The upper portion of the tooth (the crown) has penetrated through the bone, but the gingiva (gum) is covering part or all of the tooth’s crown and has not positioned properly around the tooth. Because it is difficult to keep the area clean, food can become trapped below the gum and cause an infection and/or tooth decay, resulting in pain and swelling.

Partial Bony Impaction: The tooth has partially erupted, but a portion of the crown remains submerged below the gum and surrounding jawbone. Again, because it is difficult to keep the area clean, infection will commonly occur.

Complete Bony Impaction: The tooth is completely encased by jawbone. This will require more complex removal techniques.

In most cases, inadequate space in the mouth does not allow the wisdom teeth to erupt properly and become fully functional. When this happens, the tooth can become impacted (stuck) in an undesirable or potentially harmful position. If left untreated, impacted wisdom teeth can contribute to infection, damage to other teeth, and possibly cysts or tumors.

There are several types, or degrees, of impaction based on the actual depth of the teeth within the jaw:

Soft Tissue Impaction: The upper portion of the tooth (the crown) has penetrated through the bone, but the gingiva (gum) is covering part or all of the tooth’s crown and has not positioned properly around the tooth. Because it is difficult to keep the area clean, food can become trapped below the gum and cause an infection and/or tooth decay, resulting in pain and swelling.

Partial Bony Impaction: The tooth has partially erupted, but a portion of the crown remains submerged below the gum and surrounding jawbone. Again, because it is difficult to keep the area clean, infection will commonly occur.

Complete Bony Impaction: The tooth is completely encased by jawbone. This will require more complex removal techniques.

Reasons to Remove Wisdom Teeth

While not all wisdom teeth require removal, wisdom teeth extractions are most often performed because of an active problem such as pain, swelling, decay or infection, or as a preventative measure to avoid serious problems in the future. If impaction of one or more wisdom teeth is present, and left untreated, a number of potentially harmful outcomes can occur, including:

  • Damage to nearby teeth: Second molars (the teeth directly in front of the wisdom teeth) can be adversely affected by impacted wisdom teeth, resulting in tooth decay (cavities), periodontal disease (gum disease) and possible bone loss.
  • Disease: Although uncommon, cysts and tumors can occur in the areas surrounding impacted wisdom teeth.
  • Infection: Bacteria and food can become trapped under the gum tissue, resulting in an infection. The infection can cause considerable pain and danger.

Wisdom Tooth Examination

As with any dental procedure, your dentist will want to initially conduct a thorough examination of the wisdom and surrounding teeth. Panoramic or digital x-rays will be taken in order for your dentist to evaluate the position of the wisdom teeth and determine if a current problem exists, or the likelihood of any potential future problems. The x-rays can also expose additional risk factors, such as deterioration or decay of nearby teeth. Early evaluation and treatment (typically in the mid-teen years) is recommended in order to identify potential problems and to improve the results for patients requiring wisdom teeth extractions. Only after a thorough examination can your dentist provide you with the best options for your particular case.

What does the Removal of Wisdom Teeth Involve? 

Wisdom teeth removal is a common procedure, one that takes place right here in our office by our oral surgeon. It is generally performed under local anesthesia and intravenous (IV) sedation. The surgery typically takes a couple of hours, and you will be released with post-operative instructions and medication (if necessary), to help manage any swelling or discomfort.

Humans have two upper (maxillary) canines and two lower (mandibular) canines. Canine teeth are sometimes referred to as cuspids, fangs, or “eye teeth” because of their direct positioning beneath the eyes. Canine teeth have thicker and more conical roots than incisors and thus have an especially firm connection to the jaw. Canine teeth often have the longest root of all teeth in the human mouth and the last to fully erupt and fall into place; often around age 13.

An impacted tooth essentially means that it is blocked, stuck, or unable to fully erupt and function properly. Third molars (wisdom teeth) most commonly fall victim to impaction, but the upper canine is the second most common tooth to become impacted. Wisdom teeth serve no important function in the mouth and are frequently removed; however, impacted canines are critical to the bite and require treatment for the following reasons:

  • Closing Gaps – Canines are the last of the front teeth to fall into place and therefore close any unsightly gaps between the other upper teeth.
  • First Touch – Canines play a vital role in the “biting” mechanism of the teeth. They touch first when the jaw closes, and guide the other teeth into position.
  • Proper Alignment & Function – Canine teeth are essential to the correct alignment and function of the other teeth on the dental arch. Missing or impacted canines can greatly affect the function and aesthetic appearance of the smile.

What does the treatment of Impacted Canines Inolve?

If your mouth is overcrowded for any reason, the dentist may recommend extraction of teeth. The extraction will generally be performed under local anesthetic by an oral surgeon. The un-erupted canine will then be exposed by lifting the gum, and guided into place using a special bracket.

In the case of younger patients, an orthodontic brace may be fitted to create a space on the dental arch for the impacted canine. Surgery for impacted canines usually does not require an overnight stay. Pain medication will be prescribed as necessary, and you’ll be given post treatment advice for your recovery.

What is a Periodontist?

​A periodontist is a dentist who specializes in the soft tissues of the mouth and the underlying jawbone which supports the teeth. A dentist must first graduate from an accredited dental school before undertaking an additional three years of study within a periodontology residency training program, in order to qualify as a periodontist.The primary focus of this residency training is on both surgical and non surgical management of periodontal disease and the placement of dental implants.

Conditions Treated by a Periodontist

​The periodontist is mainly concerned with: preventing the onset of gum disease (periodontal disease); diagnosing conditions affecting the gums and jawbone; and treating gingivitis, periodontitis, and bone loss. Periodontal disease is a progressive condition and the leading cause of tooth loss among adults in the developed world.The periodontist is able to treat mild, moderate and advanced gum disease by first addressing the bacterial infection at the root of the problem, providing periodontal treatment, then providing information and education on good oral hygiene and the effective cleaning of the teeth.

The most common conditions treated by a periodontist are:

  • Gingivitis – This is the mild inflammation of the gums which may or may not be signified by pain and bleeding.
  • Mild/moderate periodontitis – When the pockets between the teeth and the soft tissues are measured to be between 4-6mm it is classified as moderate periodontitis (gum disease).
  • Advanced periodontitis – When the pockets between the teeth and the soft tissues in general exceed 6mm in depth, significant bone loss can occur, causing shifting or loss of teeth.
  • Missing teeth – When teeth are missing as a result of bone loss, the periodontist can implant prosthetic teeth. These teeth are anchored to the jawbone and restore functionality to the mouth

Treatments Performed by a Periodontist

The periodontist is able to perform a wide range of treatments to halt the progression of gum disease, replace missing teeth and make the appearance of the smile more aesthetically pleasing.

Here are some of the treatments commonly performed by the periodontist:

  • Implant placement – When a tooth or several teeth are missing, the periodontist is able to create a natural-looking replacement by anchoring a prosthetic tooth to the jawbone.
  • Osteoplasty (hard tissue recontouring) – Once periodontitis has been treated, the periodontist can recontour the hard tissue to make the smile both natural-looking and aesthetically pleasing.
  • Gingivoplasty (soft tissue recontouring) – As gums recede due to periodontitis, the teeth may appear longer, causing a “toothy” smile. The periodontist can remove tissues or straighten the gum line to make the teeth look more even.
  • Bone grafting – Dental implants can only be positioned if there is sufficient bone to attach the prosthetic tooth to. If bone loss has occurred, bone grafting is an excellent way to add or “grow” bone so that an implant may be properly secured.
  • Deep pocket cleanings – As gingivitis and periodontitis progress, it becomes more difficult to cleanse the pockets between the soft tissues and the teeth. The periodontist can scale and root plane the teeth (sometimes under local anesthetic) to remove debris and infection-causing bacteria.
  • Crown lengthening – In order to expose more of the natural tooth, the periodontist can remove some of the surrounding gingival tissue

The periodontist is a highly skilled dental health professional who is able to diagnose and treat many commonly occurring soft tissue and bone problems in the oral cavity.

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