Oral Hygiene Care
Maintaining good oral hygiene is one of the most important things you can do for your teeth and gums. Healthy teeth not only enable you to look and feel good, they make it possible to eat and speak properly. Good oral health is important to your overall well being. Daily preventive care, including proper brushing and flossing, will help stop problems before they develop.
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. These include:
- 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
A dental cleaning is a professional cleaning you receive from a dentist or dental hygienist. Most dental cleanings take approximately 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. During your routine cleaning we will remove excess plaque and polish your teeth.
Halitosis is sophisticated word for “bad breath”. Depending on the cause, bad breath may strike on occasion or be a persistent condition. The most common cause of bad breath is bacteria. Because the mouth is moist and warm, it creates perfect conditions for the millions of bacteria that live in the mouth. In fact, approximately 80% of bad breath is caused by something in the mouth.
Some types of bad breath, such as "morning mouth," are considered fairly normal and are not usually health concerns. However, persistent bad breath may be a sign of more serious problems with the gums and teeth.
The following may cause bad breath:
- Poor dental hygiene – poor oral hygiene can leave food particles to decay in the mouth
- Infections in the mouth such as periodontal (gum) disease
- Respiratory-tract infections such as throat infections, sinus infections, lung infections
- External agents including foods such as garlic, onions, and coffee, as well as cigarettes and chewing tobacco
- Dry mouth caused by salivary gland problems or by breathing through the mouth
- Systemic illnesses such as diabetes, liver disease, kidney disease, lung disease, sinus disease, reflux disease and others
Call our office promptly if you have bad breath with painful, swollen gums that bleed easily or loose teeth. We will perform a physical examination of your mouth to determine the cause. If we discover that systematic problems are the cause, we may refer you to your family physician. In severe cases of gum disease, we may recommend a specialized periodontist.
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.
Non-Surgical Gum Treatment
The gums, ligaments, and bone around the teeth form the foundation for teeth. All structures are also referred to as the periodontium. When the periodontium is not healthy, it jeopardizes the teeth just as a bad foundation would threaten the stability of a house. Signs of unhealthy periodontium include: gums that are red and bleed easily, persistent bad breath, gums that are pulled away from the tooth, loose teeth, and changes in the position or bite of the teeth. With proper gum treatments, it may be possible to return gum tissue to a healthy state. If you're having a problem, come in and see us so we may treat it right away. The treatment usually involves a deep cleaning or root planing done under a local anesthetic, along with local antibiotic agents. It is important to have gum problems checked promptly, as gum disease left alone may eventually need treatment through surgery or extraction.
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 are still sometimes 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 extracted, 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, we will first apply a local anesthetic 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. We will then provide you with care instructions to alleviate discomfort and ensure proper healing.
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.
After the tooth is removed, we will provide care instructions to ensure proper healing. 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.
Root Canal Therapy
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, and 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.
NightGuards and 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.
If you have decided a guard is right for you, we will take an impression of your teeth which will then be sent to a lab to make a custom fit guard. In most cases you can choose from a variety of colors and styles. On average, guards last between 3 and 10 years.
TMJ / TMD 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:
- 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.