Cleanings

Three are three main types of cleanings you may receive at our office.   The service you receive is based on the health of your gums. The differences have been explained below.

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Prophylaxis

Prophylaxis in Greek this means to prevent or guard beforehand.  This is a cleaning you may receive if you do not have periodontal disease.  The dental hygienist will remove plaque and calculus (tartar) from the teeth which helps to prevent gum disease and promote healthy gums.  This procedure is usually performed every 4-6 months.

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Scaling and Root Planning

Scaling and Root Planning (Initial Deep Cleaning) this cleaning is a cleaning you may receive if you are diagnosed with gum disease (periodontal disease).  Periodontal disease causes your gums to have deep pockets (greater than 4mm) around your teeth.  These deep pockets will collect food and debris, which helps harbor harmful bacteria.  The bacteria will cause the pockets to become even deeper and a vicious cycle begins.  With this cleaning the hygienist will remove the plaque and calculus (tartar) from the teeth.  Given that the hygienist will have to clean deep into these pockets, more time and skill is needed.  The roots of the teeth which can become rough are smoothed to prevent bacteria from accumulating, thus preventing further disease.  An ultrasonic instrument is usually needed to aid in the removal of calculus (tartar).  This procedure is usually performed in quadrants (1/4 of the mouth) at a time.

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Periodontal Maintenance

This is a cleaning you may receive if you currently have or have a history of periodontal disease and you have already had Scaling and Root Planning performed.  This is done in place of a prophylaxis cleaning because the goal is to maintain healthy gums after gum disease and extra skill and effort is needed to clean around teeth with deeper pockets. This is cleaning usually performed every 4-6 months.

*Note: these procedures have a difference in cost with Scaling and Root Planning being more expensive than a Prophylaxis

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Composite (tooth Colored, Bonding) Filling

These are placed when decay is present or a tooth has chipped off.  This is the only material used on front teeth. The material used is a composite resin which comes in multiple shades to match any tooth.  The placement of these fillings is very demanding, with more steps and different layers. A bright blue light is used to “cure” or harden the material.  Composite fillings have become more popular in the last few years because of the demand for cosmetic dentistry but this filling does have some drawbacks.  Composites tend to wear down faster and they have a higher rate of recurrent decay (decay around the edge of a filling) than silver fillings.

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Amalgam (Silver) Filling

These are placed when a tooth has decay or chipped off.  This filling is made up of silver, copper and tin with mercury being added in the mixing stage.  [NOTE: Mercury is used in the mixing of amalgam.  As of July 2008 in a statement by the ADA, “amalgam is effective and safe for patients and dental personnel”].  Amalgam fillings have been around for many years and have proved their longevity and effectiveness at treating dental decay.  Silver fillings are limited to the back teeth and hold up against wear better than composites.

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Sealants

Sealants - are a preventative procedure performed to help reduce the risk of “pit and fissure” cavities.  On the chewing surfaces of teeth there are cusps and grooves.  Decay usually starts in the grooves of teeth because it is hard to clean deep into the grooves. (A toothbrush bristle will not reach the bottom of the groove) So, we place a thin flowable layer of resin into these grooves blocking decay and making the tooth more cleansable.

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Crowns (Caps)

A crown is prescribed for a tooth for multiple reasons, but most commonly for a tooth when the decay is too large for a conventional filling. Other reasons include: cusp fracture, root canals, covering an implant, Cracked tooth syndrome, or for cosmetic reasons.  Having a crown placed on a tooth will help restore this tooth to its natural state and prevent further breakdown if cared for correctly.  In our office we offer three types of crowns:

  • Complete Gold Crowns (Yellow or White Gold) ·        
  • Porcelain Fused to Metal Crowns(PFM)- metal is white gold ·        
  • All Porcelain/Ceramic Crowns

Each of these has its benefits and drawback.  Complete gold crowns usually hold up the best in the long term but are considered unattractive by some.  PFM Crowns have the strength and fit of metal with a tooth colored appearance but have the risk of porcelain fracture.  All porcelain crowns have the best appearance but lack strength and are also prone to fracture.  Each of these has their place in dentistry and patients are given the option of which crown they would like.

  • For a single crown there are usually 2 appointments.  The first appointment is one hour to prep the tooth and an impression will be taken and sent to a dental lab, your tooth will then be covered with a temporary crown. The second appointment is a half hour to adjust and cement the new permanent crown.  

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Bridges

A bridge is indicated when a tooth is missing and the teeth on either side are used as pillars to support the bridge and eliminate the missing tooth.  The teeth on both sides of the “space” are prepped to hold the bridge and impression is taken and then sent a dental lab.  The lab technician will then make the bridge.  You will return to the office to have the new bridge cemented permanently.  Bridges may replace one, two or more teeth but the longer the “span” the higher the chance of failure. Depending on your situation a bridge may or may not be the best option for you.  Partial Denture and Dental Implants are other options.

  • In our office a bridge usually takes two appointments. If a build up is needed add an appointment.

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Buildup

A buildup is a procedure similar to a filling but with the end result of a crown or bridge in mind.  If a tooth is broken down or heavily decayed your tooth may need a buildup before a crown can be placed on top.  You can think of this as a solid foundation for a house. House = Crown and Foundation = Buildup.  If a house doesn’t have a solid foundation it is ultimately set up for failure in the years to come.  Some teeth needing a crown or bridge may have enough tooth structure to support a crown and may not need a buildup.

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Root Canals

Teeth in need of a root canal can present in many ways.  Most often someone is in severe pain, usually due to a tooth infection.  Some teeth do not hurt at all and are found on an x-ray and others fall somewhere in between.  This usually has to do with the stage of nerve health.  The most common cause of tooth pain is a cavity that has gone deep into the tooth and the bacteria that cause tooth decay enter the nerve and create an infection.  This infection spreads to the surrounding bone causing pressure at the root tip creating a sensitive and painful tooth.             

At this point the nerve needs to be removed, the root canals need to be cleaned and the bacteria need to be removed.  Once this is done the canals are filled to prevent further movement of bacteria and a filling and crown are usually needed to restore the tooth.

A Root Canal in our office consists of two 1 hour visits to complete treatment. A crown will need to be placed on all back teeth that have had root canals.  A crown prevents your tooth from further breakdown after a Root Canal. A crown will need additional appointments.

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Dentures

Dentures are made to replace areas of missing teeth.  There are two main types of dentures. Complete (Full) Dentures and Partial Dentures.  The type you may need will depend on your situation.  Dentures are removable and not permanent.  They need to be cleaned daily and may need to be relined and adjusted occasionally.

  • Complete Denture- acrylic base with resin teeth

  • Immediate Denture- can be made so that your teeth can be extracted and the denture placed the same day so you don’t have to go with out teeth.    The advantage of this will allow you to always have teeth but the fit of the denture will become very loose as the bone heals from the extractions.  Relines will need to be done as needed until the healing is complete. (6-12 months) An additional fee will apply after 6 months from the insert date.

  • Partial Denture- Cast metal frame with acrylic base and resin teeth supported by the teeth in your mouth.

 There are many variations of each of these dentures and each is used on a case by case basis. 

 In our office a denture can take 2-5 appointments and usually takes around a month from start to finish.

 If you have a denture and it is not fitting well you may be able to reline your denture.  If the structural integrity is compromised it may be best to make a new denture.

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Dental Implants

Due to reliable success rates implants are becoming a standard of care in today’s dental treatment.  Implants can be used in many situations: replacing a single tooth, multiple teeth or even as supports for a denture.  If the prognosis for a root canal is questionable an extraction and an implant may be a better and more reliable option.  Implants can be a conservative option when considering a bridge.  With a bridge the teeth on either side of the space need to be shaved down thus removing tooth structure.  An implant does not require any tooth structure to be removed if the tooth is already missing. 

What is an implant?  An implant is a titanium screw that is placed into the bone to replace a tooth.  Once a dentist places the implant 3-6 months need to be allowed for the surrounding bone to grow into the implant.  Once the bone around the implant is stable an abutment can be placed on top of the implant. This abutment will serve to hold a crown.   The new crown will feel and act like a normal tooth.

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Veneers

Veneers are becoming more and more popular as patients can have a “smile makeover” without having extensive treatment.  Veneers can help to straighten, whiten, and reshape teeth. These are a thin layer of porcelain that is shaped by a lab technician and bonded to your existing teeth. The end result is an attractive smile. Veneers are more conservative than crowns because only small amounts of tooth structure need to be removed to place a veneer.

*In our office veneers can take anywhere from 3-6 appointments.  Careful planning needs to take place in order to have a good result. Our lab will be involved with models and photographs to make sure your smile turns out perfect.

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Night Guards

Night guards may be recommended for multiple reasons.  The most common reason is grinding your teeth at night.  This can lead to jaw and tooth pain as well as loss of tooth structure.  A night guard is a plastic tray custom made for your teeth that is to be worn at night or whenever you feel you are clinching your jaw. 

In our Night Guards can be made in two appointments. One appointment to make the tray and one appointment to fit and adjust the tray.  

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Bleach Trays

Bleach Trays are custom made resin trays that hold bleaching gel to whiten your teeth.  By wearing bleach trays to whiten your teeth you can be sure you have plenty of gel where it’s supposed to be- next to your teeth.  The bleaching gel included with your trays is higher strength than can be purchased at drug stores.

In our office bleach trays can be made in two appointments. One appointment to make the tray and one appointment to fit and adjust the tray.

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