Whether your dental needs are a complete exam and cleaning, a full-mouth restoration, or anything in between, Campbell dentist, Dr. Vandi will provide you with exceptional care as we enhance the natural beauty of your smile. Below are just some of the many procedures and services Dr. Vandi regularly provide to our patients – with a gentle touch, and stunning results. Your smile is our first priority, and we’ll give you something to smile about. If you have any questions, dental emergencies, or you are just looking for a new dentist in San Jose, please contact your Campbell Dental Office, Dr. Vandi today to schedule an appointment. We look forward to providing you with the personal care you deserve.
A preventive program is a cooperative effort by the patient, dentist, and dental staff to preserve the natural dentition and supporting structures by preventing the onset, progress, and recurrence of dental diseases and conditions.
Preventing dental disease starts at home with good oral hygiene and a balanced diet. It is continued in this Campbell dental office by the efforts of Dr. Vandi, your dentist and dental hygienist to promote, restore, and maintain your oral health. Prevention also includes regular dental exams, cleanings, and x-rays. Sealants and fluoride are also great preventive treatments that help protect the teeth. Prevention helps avoid serious and costly dental problems and is the key to having a healthy, confident, beautiful smile. We invite you to call or visit your Campbell dental office, Dr. Vandi today to learn more about our dental treatment options and to schedule your individual consultation at our office. We are eager to improve your dental health!
Simple Tooth Extractions
Dental Exams & Cleanings
Oral Cancer Exam
How to Properly Brush & Floss
Dentures & Partial Dentures
Simple Tooth Extraction
If you are experiencing extreme sensitivity or are suffering from advanced periodontal disease, you may be required to have a tooth extracted. With a simple extraction, the dentist can safely remove the affected tooth without the need for major surgery. There are numerous situations in which a simple extraction can help alleviate pain or prepare you for another cosmetic or restorative procedure. Some common reasons for extraction include:
Advanced periodontal disease that has loosened the tooth roots
Extra teeth or baby teeth that impede adult teeth
Preparing a patient for orthodontic treatment
Removing a fractured or malformed tooth
Severe tooth decay which cannot be remedied with root canal therapy
How is a tooth extracted?As a precaution, the dentist will first take X-rays of the tooth or teeth in question, to help plan the procedure. After preparing a method of extraction, you will be given a local anesthetic that will prevent you from feeling pain during the procedure. Next, the dentist will use a tool called an elevator to lift the tooth and loosen ligaments and gum tissue around the base of the tooth. Finally, the dentist will use a pair of forceps, to gently rock the tooth back and forth until it breaks free of the ligaments holding it in the gum tissue. Occasionally, a stubborn tooth will resist the dentist’s soft tug, refusing to come out. In these and more complex cases, the tooth may need to be broken up into smaller pieces for removal.
Once removed, we will pack gauze into the socket and have you place pressure on the area by biting down. If necessary, the dentist will place stitches to close the socket. If you are sick the week prior to your scheduled extraction or on the day of, please contact our office, as alternative arrangements may need to be made. Please contact your Campbell dental office Dr. Vandi, if you have any questions or concerns.
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
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. To learn more about the advantages of digital X-ray, we welcome you to call or visit us on our Campbell dental office, Dr. Vandi today.
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 bite-wing 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. If you have questions or concerns about panoramic X-rays, please feel free to call us and schedule an appointment in your Campbell dental office, Dr. Vandi.
Dental Exams & Cleanings
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.
Professional Dental CleaningProfessional dental cleanings (dental prophylaxis) are usually performed by Registered Dental Hygienists. Your cleaning appointment at Dr. Vandi dental office in Campbell CA will include a dental exam and the following:
- Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments.
- Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
- Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.
A sealant is a thin, plastic coating applied to the chewing surface of molars, premolars and any deep grooves (called pits and fissures) of teeth. More than 75% of dental decay begins in these deep grooves. Teeth with these conditions are hard to clean and are very susceptible to decay. A sealant protects the tooth by sealing deep grooves, creating a smooth, easy to clean surface. Sealants can protect teeth from decay for many years, but need to be checked for wear and chipping at regular dental visits.
Reasons for sealants:
Children and teenagers – As soon as the six-year molars (the first permanent back teeth) appear or any time throughout the cavity prone years of 6-16.
Adults – Tooth surfaces without decay that have deep grooves or depressions.
Baby teeth – Occasionally done if teeth have deep grooves or depressions and child is cavity prone.
What do sealants involve?Sealants are easily applied by your dentist or dental hygienist and the process takes only a couple of minutes per tooth. The teeth to be sealed are thoroughly cleaned and then surrounded with cotton to keep the area dry. A special solution is applied to the enamel surface to help the sealant bond to the teeth. The teeth are then rinsed and dried. Sealant material is carefully painted onto the enamel surface to cover the deep grooves or depressions. Depending on the type of sealant used, the material will either harden automatically or with a special curing light. Proper home care, a balanced diet, and regular dental visits at your Campbell dentist, Dr. Vandi will aid in the life of your new sealants.
Oral Cancer Exam
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:
- Salivary Glands
- Oropharyngeal Region (throat)
Reasons for oral cancer examinationsIt 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. Your dentist can 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 treatmentThe oral cancer examination is a completely painless process. During the visual part of the examination, the dentist will look for abnormality and feel the face, glands and neck for unusual bumps. Lasers which can highlight pathologic changes are also a wonderful tool for oral cancer checks. The laser can “look” below the surface for abnormal signs and lesions which would be invisible to the naked eye.
If abnormalities, lesions, leukoplakia or lumps are apparent, the dentist will implement a diagnostic impression and treatment plan. In the event that the initial treatment plan is ineffective, a biopsy of the area will be performed. The biopsy includes a clinical evaluation which will identify the precise stage and grade of the oral lesion.
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. If you have any questions or concerns about oral cancer, please call us and make an appointment with Campbell Dentist, Dr. Vandi.
How to Properly Brush & Floss
Brushing and flossing are of paramount importance to oral hygiene. Though bi-annual professional dental cleanings remove plaque, tartar and debris, excellent homecare methods are equally valuable. Proper brushing and flossing can enhance the health of the mouth, make the smile sparkle and prevent serious diseases.
Reasons why proper brushing and flossing are essential:
- Prevention of tooth decay – Tooth decay is one of the leading causes of tooth loss, and its treatment often requires complex dental procedures. Tooth decay occurs when the acids found in plaque erode the natural enamel found on the teeth. This phenomenon can easily be prevented by using proper home hygiene methods.
- Prevention of periodontal disease – Periodontal disease is a serious, progressive condition which can cause tooth loss, gum recession and jawbone recession. Periodontal disease is caused by the toxins found in plaque, and can lead to serious health problems in other parts of the body. Removing plaque and calculus (tartar) from the surface of the tooth using a toothbrush, and from the inter-dental areas using dental floss, is an excellent way to stave off periodontal problems.
- Prevention of halitosis – Bad breath or halitosis is usually caused by old food particles on or between the teeth. These food particles can be removed with regular brushing and flossing; leaving the mouth healthier, and breath smelling fresher.
- Prevention of staining – Staining or the yellowing of teeth can be caused by a wide variety of factors such as smoking, coffee and tea. The more regularly these staining agents are removed from the teeth using brushing and flossing techniques, the less likely it is that the stains will become permanent.
The Proper Way to BrushThe teeth should be brushed at least twice a day; ideally in the morning and before bed. The perfect toothbrush is small in size with soft, rounded-end bristles and no more than three months old. The head of the brush needs to be small enough to access all areas of the mouth, and the bristles should be soft enough so as not to cause undue damage to the gum tissue. The American Dental Association (ADA) has given electric toothbrushes their seal of approval; stating that those with rotating or oscillating heads are more effective than other toothbrushes.
Here is a basic guide to proper brushing:
1- Place the toothbrush at a 45-degree angle where the gums and teeth meet.
2- Use small circular motions to gently brush the gum-line and teeth.
3- Do not scrub or apply too much pressure to the teeth, as this can damage the gums and tooth enamel.
4- Brush every surface of every tooth, cheek-side, tongue-side, and chewing surfaces. Place special emphasis on the surfaces of the back teeth.
5- Use back and forth strokes to brush the chewing surfaces.
6- Brush the tongue to remove fungi, food and debris.
The Proper Way to FlossFlossing is a great way to remove plaque from the inter-dental regions (between the teeth). Flossing is an especially important tool for preventing periodontal disease and limiting the depth of the gum pockets. The inter-dental regions are difficult to reach with a toothbrush and should be cleansed with dental floss on a daily basis. The flavor and type of floss are unimportant; choose floss that will be easy and pleasant to use.
Here is a basic guide to proper flossing:
1- Cut a piece of floss to around 18 inches long.
2- Wrap one end of the floss around the middle finger of the left hand and the other end around the middle finger of the right hand until the hands are 2-3 inches apart.
3- Work the floss gently between the teeth toward the gum line.
4- Curve the floss in a U-shape around each individual tooth and carefully slide it beneath the gum line.
5- Carefully move the floss up and down several times to remove inter-dental plaque and debris.
6- Do not pop the floss in and out between the teeth as this will inflame and cut the gums.
Dentures & Partial Dentures
A denture is a removable dental appliance replacement for missing teeth and surrounding tissue. They are made to closely resemble your natural teeth and may even enhance your smile. There are two types of dentures - complete and partial dentures. Complete dentures are used when all of the teeth are missing, while partial dentures are used when some natural teeth remain. A Partial denture not only fills in the spaces created by missing teeth, it prevents other teeth from shifting.
A Complete denture may be either “conventional” or “immediate.” A conventional type is made after the teeth have been removed and the gum tissue has healed, usually taking 4 to 6 weeks. During this time the patient will go without teeth. Immediate dentures are made in advance and immediately placed after the teeth are removed, thus preventing the patient from having to be without teeth during the healing process. Once the tissues shrink and heal, adjustments will have to be made. Dentures are very durable appliances and will last many years, but may have to be remade, repaired, or readjusted due to normal wear.
Reasons for dentures:
- Complete Denture - Loss of all teeth in an arch.
- Partial Denture - Loss of several teeth in an arch.
- Enhancing smile and facial tissues.
- Improving chewing, speech, and digestion.
What does getting dentures involve?The process of getting dentures requires several appointments, usually over several weeks. Highly accurate impressions (molds) and measurements are taken and used to create your custom denture. Several “try-in” appointments may be necessary to ensure proper shape, color, and fit. At the final appointment, your dentist will precisely adjust and place the completed denture, ensuring a natural and comfortable fit.
It is normal to experience increased saliva flow, some soreness, and possible speech and chewing difficulty, however this will subside as your muscles and tissues get used to the new dentures. You will be given care instructions for your new dentures. Proper cleaning of your new dental appliance, good oral hygiene, and regular dental visits at your Campbell Dentist, Dr. Vandi will aid in the life of your new dentures.
In the past decade there has been a dramatic interest in cosmetic dentistry. We all realize that having a healthy, bright, beautiful smile enhances our appearance and allows us to smile with confidence. Thanks to the advances in modern cosmetic dentistry, we are able to improve our teeth and smiles with quick, painless and surprisingly affordable treatments.
Cosmetic dental treatments can:
- Change the size, shape, and alignment of certain teeth.
- Fill in unattractive spaces between teeth.
- Improve or correct bites.
- Lighten or brighten the color of teeth.
- Repair decayed, broken, cracked, or chipped teeth.
- Replace missing teeth.
- Replace old, unattractive dental treatments.
- And, remember, your smile speaks before you even say a word!
Full Mouth Reconstruction
Porcelain Fixed Bridges
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 a dentist or 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! Dental implants are very strong, stable, and durable and will last many years, but on occasion, they will have to be re-tightened or replaced due to normal wear.
Reasons for dental implants
- Replace one or more missing teeth without affecting adjacent teeth.
- Resolve joint pain or bite problems caused by teeth shifting into missing tooth space.
- Restore a patient’s confident smile.
- Restore chewing, speech, and digestion.
- Restore or enhance facial tissues.
- Support a bridge or denture, making them more secure and comfortable.
What does getting dental implants 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 dental 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 of 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.
An inlay restoration is a custom made filling made of composite material, gold, or tooth-colored porcelain. Porcelain inlays are popular because they resemble your natural tooth. A porcelain inlay is made by a professional dental laboratory and is permanently cemented into the tooth by your dentist. Inlays can be utilized to conservatively repair teeth that have large defective fillings or have been damaged by decay or trauma. Inlays are an ideal alternative to conventional silver and composite fillings. Also, they are more conservative than crowns because less tooth structure is removed in the preparation of inlays. As with most dental restorations, inlays are not always permanent and may someday require replacement. They are highly durable and will last many years, giving you a beautiful long lasting smile.
Reasons for inlay restorations:
- Broken or fractured teeth.
- Cosmetic enhancement.
- Decayed teeth.
- Fractured fillings.
- Large fillings.
What does getting an inlay involve?An inlay procedure usually requires two appointments. Your first appointment will include taking several highly accurate impressions (molds) that will be used to create your custom inlay and a temporary restoration. While the tooth is numb, the dentist will remove any decay and/or old filling materials. The space will then be thoroughly cleaned and carefully prepared, shaping the surface to properly fit an inlay restoration. A temporary filling will be applied to protect the tooth while your inlay is made by a dental laboratory.
At your second appointment your new inlay will be carefully and precisely cemented into place. A few adjustments may be necessary to ensure a proper fit and that your bite is comfortable. You will receive care instruction at the conclusion of your treatment. Good oral hygiene practices, a proper diet, and regular dental visits will aid in the life of your new inlay.
An onlay restoration is a custom made filling made of composite material, gold, or tooth-colored porcelain. Porcelain onlays are popular because they resemble your natural tooth. An onlay is sometimes also referred to as a partial crown. Porcelain onlays are made by a professional dental laboratory and is permanently cemented onto the tooth by your dentist. Onlays can be utilized to conservatively repair teeth that have large defective fillings or have been damaged by decay or trauma. Onlays are an ideal alternative to crowns (caps) because less tooth structure is removed in the preparation of onlays. Onlays are essentially identical to inlays with the exception that one or more of the chewing cusps have also been affected and need to be included in the restoration. As with most dental restorations, onlays are not always permanent and may someday require replacement. They are highly durable and will last many years, giving you a beautiful long lasting smile.
Reasons for onlay restorations:
- Broken or fractured teeth.
- Cosmetic enhancement.
- Decayed teeth.
- Fractured fillings.
- Large fillings.
What does getting an onlay involve?An onlay procedure usually requires two appointments. Your first appointment will include taking several highly accurate impressions (molds) that will be used to create your custom onlay and a temporary restoration. While the tooth is numb, the dentist will remove any decay and/or old filling materials. The space will then be thoroughly cleaned and carefully prepared, shaping the surface to properly fit an onlay restoration. A temporary filling will be applied to protect the tooth while your onlay is made by a dental laboratory.
At your second appointment, your new onlay will be carefully and precisely cemented into place. A few adjustments may be necessary to ensure a proper fit and that your bite is comfortable. You will receive care instruction at the conclusion of your treatment. Good oral hygiene practices, a proper diet, and regular dental visits will aid in the life of your new onlay.
A composite (tooth colored) filling is used to repair a tooth that is affected by decay, cracks, fractures, etc. The decayed or affected portion of the tooth will be removed and then filled with a composite filling. There are many types of filling materials available, each with their own advantages and disadvantages. You and your dentist can discuss the best options for restoring your teeth. Composite fillings, along with silver amalgam fillings, are the most widely used today. Because composite fillings are tooth colored, they can be closely matched to the color of existing teeth, and are more aesthetically suited for use in front teeth or the more visible areas of the teeth.
As with most dental restorations, composite fillings are not permanent and may someday have to be replaced. They are very durable, and will last many years, giving you a long lasting, beautiful smile.
Reasons for composite fillings:
- Chipped teeth.
- Closing space between two teeth.
- Cracked or broken teeth.
- Decayed teeth.
- Worn teeth.
How are composite fillings placed?
Composite fillings are usually placed in one appointment. While the tooth is numb, your dentist will remove decay as necessary. The space will then be thoroughly cleaned and carefully prepared before the new filling is placed. If the decay was near the nerve of the tooth, a special medication will be applied for added protection. The composite filling will then be precisely placed, shaped, and polished, restoring your tooth to its original shape and function. It is normal to experience 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.
Dental 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 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 teeth whitening:
- Fluorosis (excessive fluoridation during tooth development).
- Normal wear of outer tooth layer.
- Stained teeth due to medications (tetracycline, etc.).
- Yellow, brown stained teeth.
What does teeth 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.
Full Mouth Reconstruction
Full mouth reconstruction (AKA full mouth rehabilitation, AKA full mouth restoration) is the term to describe the process of rebuilding or simultaneously restoring all of the teeth in both the upper and lower jaws. Full mouth reconstruction typically involves a general or restorative dentist (performing procedures like crowns, bridges and veneers), and can incorporate dental specialties like periodontics (specializing in the gums), oral surgeons, orthodontics (specializing in tooth movements and positions) and endodontic (specializing in the tooth pulp).
The need for full mouth reconstruction may result from:
- Teeth that have been lost due to decay or trauma.
- Teeth that have been injured or fractured.
- Teeth that have become severely worn as a result of long-term acid erosion (foods, beverages, acid reflux) or tooth grinding.
- Ongoing complaints of jaw, muscle and headache pain requiring adjustments to the bite (occlusion).
Dr. Vandi is proud to provide Full Mouth Reconstruction to patients in Campbell, San Jose, Willow Glen, Los Gatos and all of Santa Clara County.
Porcelain Fixed Bridges
A dental bridge is a fixed (non-removable) appliance and is an excellent way to replace missing teeth. There are several types of bridges. You and your dentist will discuss the best options for your particular case. The “traditional bridge” is the most popular type and is usually made of porcelain fused to metal. This type of bridge consists to two crowns that go over two anchoring teeth (abutment teeth) and are attached to pontics (artificial teeth), filling the gap created by one or more missing teeth.
Dental bridges are highly durable and will last many years, however they may need replacement or need to be re-cemented due to normal wear.
Reasons for a fixed bridge:
- Fill space of missing teeth.
- Maintain facial shape.
- Prevent remaining teeth from drifting out of position.
- Restore chewing and speaking ability.
- Restore your smile.
- Upgrade from a removable partial denture to a permanent dental appliance.
What does getting a fixed bridge involve?Getting a bridge usually requires two or more visits. While the teeth are numb, the two anchoring teeth are prepared by removing a portion of enamel to allow for a crown. Next, a highly accurate impression (mold) is made which will be sent to a dental laboratory where the bridge will be fabricated. In addition, a temporary bridge will be made and worn for several weeks until your next appointment.
At the second visit, you permanent bridge will be carefully checked, adjusted, and cemented to achieve a proper fit. Occasionally your dentist may only temporarily cement the bridge, allowing your teeth and tissue time to get used to the new bridge. The new bridge will be permanently cemented at a later time. You will receive care instructions at the conclusion of the procedure. Proper brushing, flossing and regular dental visits will aid in the life of your new permanent bridge.
Whether your dental needs are a complete exam and cleaning, a full-mouth restoration, or anything in between, we promise to provide you with exceptional care as we enhance the natural beauty of your smile. Below are just some of the many procedures and services we regularly provide to our patients – with a gentle touch, and stunning results. Your smile is our first priority, and we’ll give you something to smile about.
Mini Dental Implants
Gum & Jawbone Corrective Treatments
TMJ (Tempro-Mandibular Joint Dysfunction)
Wisdom Teeth Extractions
After Tooth Extractions
After Dental Implant Surgery
Mini Dental Implants
Mini Dental Implants (MDIs) have changed the face of implant placement. Unlike full implant placement where multiple dental visits are required, MDIs eliminate the need for surgery. The development of long term MDIs now allows the dentist to place anchors in the jaw during one noninvasive treatment. The most common use for MDIs is the stabilization of dentures and over-dentures. MDIs firmly anchor the dental prosthesis, which means there is no longer any need to suffer with ill-fitting, loose dentures.
MDIs are designed to eliminate bone grafting and expedite treatment. Full implants require significant bone grafting and a recovery period. The latent period allowed the anchor of the implant to properly embed itself into the jawbone. The smaller size of MDIs means that no recovery period is necessary, and the denture can be fitted the same day.
What is the configuration of mini dental implants?An MDI is a tiny dental implant (similar to a screw) that is designed to act in place of a natural tooth root. MDIs are generally constructed from titanium and are either sprayed with calcium phosphate, or contain it along the length of the screw portion. The design and structure of MDIs promotes quick healing and long lasting results. The head portion of the implant looks very much like a ball. This ball fits firmly into the retaining mechanism and together these structures hold the dentures at a designated level. The dentures sit comfortably on the gum tissue and are able to withstand significant amounts of pressure and natural force.
What are the advantages of MDI placement?MDIs are a true innovation for people who are reluctant to have invasive dental surgery and for denture wearers. One significant advantage MDIs have over full implants is that they offer a viable treatment choice for patients who have experienced extensive bone loss. Depending on the quality and density of jawbone available at the implant site, four of these mini implants may be implanted at one time. Unlike full implants, MDIs don’t require invasive surgery, which makes MDIs a gentler option. MDIs also minimize cost. Full-sized implants can be expensive to place, especially if many visits are required. The most common use for MDIs is to stabilize a lower denture, however they can be placed anywhere in the mouth.
Here are some of the other advantages associated with MDIs:
- Better smelling breath.
- Clearer speech.
- Easier chewing and biting.
- Easier cleaning.
- Firmer denture fit.
- High success rate. Less discomfort.
- No cutting or sutures.
- No need for adhesives or messy bonding agents.
- No rotting food beneath the denture.
- No slipping, wobbling or discomfort.
- Permanent results.
- Quick treatment time.
- Reduced costs.
How are mini dental implants placed?The whole mini dental implant placement procedure takes approximately one hour. Generally, in the case of lower jaw implants, four MDIs will be placed about 5mm apart. Prior to inserting MDIs, the dentist will use many diagnostic and planning tools to find the optimal place to implant them.
Here is a brief overview of the MDI placement procedure:
- A mild anesthetic is administered.
- A small hole is drilled in the jawbone to situate each MDI.
- Each implant is screwed into place and tightened with a winged wrench.
- Finally, a ratchet wrench is used to fully stabilize the MDIs.
- The denture is measured against the mini implants and marks are made to indicate where the MDIs will fit.
- The denture is sent to the laboratory to have holes drilled to accommodate the MDIs.
Once the denture has been fully modified, it can be affixed to the MDIs. The rubber O-ring on each MDI snaps into the designated spot on the denture, and the denture then rests snugly on the gum tissue. MDIs hold the denture comfortably in a tight-fitting way for a lifetime.
In almost all cases, no stitching is required and no real discomfort is felt after the procedure. After the denture placement procedure is complete, light eating can be resumed. The denture can be removed and cleaned at will. MDIs enhance the natural beauty of the smile and restore full functionality to the teeth. If you have any questions or concerns about mini dental implants, please ask San Jose Implant Dentist, Dr. Vandi.
Bone grafting is often closely associated with dental restorations such as bridge work and dental implants. In the majority of cases, the success of a restoration procedure can hinge on the height, depth, and width of the jawbone at the implant site. When the jawbone has receded or sustained significant damage, the implant(s) cannot be supported on this unstable foundation and bone grafting is usually recommended for the ensuing restoration.
There are several major factors that affect jaw bone volume:
- Periodontal Disease – Periodontal disease can affect and permanently damage the jaw bone that supports the teeth. Affected areas progressively worsen until the teeth become unstable.
- Tooth Extraction – Studies have shown that patients who have experienced a tooth extraction subsequently lose 40-60% of the bone surrounding the extraction site during the following three years. Loss of bone results in what is called a “bone defect”.
- Injuries and Infections – Dental injuries and other physical injuries resulting from a blow to the jaw can cause the bone to recede. Infections can also cause the jaw bone to recede in a similar way.
Reasons for bone graftsBone grafting is a highly successful procedure in most cases. It is also a preferable alternative to having missing teeth, diseased teeth, or tooth deformities. Bone grafting can increase the height or width of the jawbone and fill in voids and defects in the bone.
There are essentially two basic ways in which bone grafting can positively impact the health and stability of the teeth:
Jaw Stabilization– Bone grafting stabilizes and helps restore the jaw foundation for restorative or implant surgery. Deformities can also be corrected and the restructuring of the bone can provide added support.
Preservation– Bone grafting can be used to limit or prevent bone recession following a tooth extraction, periodontal disease, or other invasive processes.
Oral ExaminationInitially, the dentist will thoroughly examine the affected area in order to assess the general condition of the teeth and gums. If periodontal disease is present or the adjacent teeth are in poor condition, these factors will be fully addressed before the bone grafting procedure can begin. The dentist will also recommend panoramic x-rays in order to assess the precise depth and width of the existing bone. On occasion, a CAT scan may be recommended to determine the bone condition. Depending on these results, the dentist may also anesthetize the area and explore into the gum in order to determine what kind and how much bone is required.
What Does Bone Grafting Involve?There are several types of bone grafts. Your dentist will determine the best type for your particular condition.
Autogenous Bone Graft- Harvested from the patient’s own body (usually from the posterior part of the lower jaw or the chin). This method is usually preferred because it produces the most predictable results.
Allograft Bone Graft- Cadaver or synthetic bone is used in this type of graft.
Xenograft- Cow bone is used in this type of graft.
The bone grafting procedure can often take several months to complete. Bone is typically harvested from your own body (or on rare occasions obtained from a “bone bank”) and added to the affected site. This bone will fuse with the existing bone and the migration of cells will cause firm adhesion and cell growth. Supplementing the jaw with bone will result in greater bone mass to help support and anchor the implant(s).
During the surgery, the dentist will numb the grafting and extraction sites using local anesthetic. A small incision will be made to prepare the site for the new bone and it will be anchored into place. On occasion, a synthetic membrane may be used to cover the new bone. This membrane prevents soft tissue and bacterial invasions, and encourages new bone growth. The surgery does not require an overnight stay, and you will be provided with comprehensive instructions for your post-operative care. The dentist will prescribe medications to help manage infection, discomfort and swelling.
A gum graft (also known as a gingival graft or periodontal plastic surgery), is a collective name for surgical periodontal procedures that aim to cover an exposed tooth root surface with grafted oral tissue. Exposed tooth roots are usually the result of gingival recession due to periodontal disease. There are other common causes, including overly aggressive brushing and trauma.
Here are some of the most common types of gum grafting:
Free gingival graft– This procedure is often used to thicken gum tissue. A layer of tissue is removed from the palate and relocated to the area affected by gum recession. Both sites will quickly heal without permanent damage.
Subepithelial connective tissue graft– This procedure is commonly used to cover exposed roots. Tissue is removed fairly painlessly from the outer layer of the palate and relocated to the site of gum recession.
Acellular dermal matrix allograft– This procedure uses medically processed, donated human tissue as a tissue source for the graft. The advantage of this is procedure is that there is no need for a donor site from the patient’s palate (and thus, less pain).
Reasons for gum graftingGum grafting is a common periodontal procedure. Though the name might sound frightening, the procedure is commonly performed with excellent results. Here are some of the major benefits associated with gum grafting:
- Reduced sensitivity – When the tooth root becomes exposed, eating or drinking hot or cold foods can cause extreme sensitivity to the teeth. Gum grafting surgery permanently covers the exposed root, helps reduce discomfort, and restores the good health of the gums.
- Improved appearance – Periodontal disease is characterized by gum recession and inflammation. Gum recession and root exposure can make the teeth look longer than normal and the smile to appear “toothy.” Gum grafting can make the teeth look shorter, more symmetrical and generally more pleasing to look at. In addition, adjacent tissue can be enhanced and augmented during the procedure for aesthetic purposes.
- Improved gum health – Periodontal disease can progress and destroy gum tissue very rapidly. If left untreated, a large amount of gum tissue can be lost in a short period of time. Gum grafting can help halt tissue and bone loss; preventing further problems and protecting exposed roots from further decay.
What does gum grafting treatment involve?Once the need for gum grafting surgery has been determined, there are several treatments the dentist will want perform before gum grafting takes place. First, the teeth must be thoroughly cleaned supra and subgingivally to remove calculus (tartar) and bacteria. The dentist can also provide literature, advice and educational tools to increase the effectiveness of homecare and help reduce the susceptibility of periodontal disease in the future.
The gum grafting procedure is usually performed under local anesthetic. The exact procedure will depend much on whether tissue is coming from the patient’s palate or a tissue bank. Initially, small incisions will be made at the recipient site to create a small pocket to accommodate the graft. Then a split thickness incision is made and the connective tissue graft is inserted into the space between the two sections of tissue. The graft is usually slightly larger than the recession area, so some excess will be apparent.
Sutures are often placed to further stabilize the graft and to prevent any shifting from the designated site. Surgical material is used to protect the surgical area during the first week of healing. Uniformity and healing of the gums will be achieved in approximately six weeks. If you have any questions about gum grafting, please ask your San Jose surgical dentist, Dr. Mehdi Vandi.
Gum & Jawbone Corrective Treatments
There are many reasons why the gums and jawbone may require corrective treatment, including periodontal disease, trauma and birth defects. Periodontal disease particularly, can greatly disfigure the natural appearance of the gums and teeth and give the smile an unaesthetic appearance. New “cosmetic surgery” procedures are now available in periodontics, which effectively correct cosmetic problems and restore natural beauty to the smile.
Here are some of the most common gum and jawbone corrective treatments:
Common Gum Treatments- Crown lengthening (gum lift) – Crown lengthening is usually performed to correct a “gummy” smile, or to expose more of the tooth prior to a restorative surgery. In some cases, the teeth look short and stubby and partly covered by gum tissue due to genetics or gingivitis. Excess gum tissue can easily be removed to reshape the outline of the gums, expose the natural tooth length, and provide a fuller, more attractive smile. The same procedure is also an excellent way to create a more aesthetic gumline for dental crowns and other restorative procedures.
- Gum grafts – Gum grafts are generally performed to correct a crooked smile, or to restore symmetry to the gumline after periodontal disease has been treated. Periodontal disease causes the gums to recede; making the smile look overly “toothy.” During a gum graft, a thin strip of tissue is removed from the palate and stitched in place over the recession site. Gum grafts are often used to re-contour the gum line and give the teeth a more pleasing appearance.
- Pocket reduction surgery – Periodontal disease can cause the smile to be marred with unattractive teeth, brown gums and ridge indentations. The aim of pocket reduction surgery is to clean the root surfaces of the teeth e subgingivally (beneath the gum line). During this procedure, tartar, plaque and bacteria that are affecting the teeth and gums will be removed. The gum is first gently separated away from the tooth, and then the calculus (tartar) and plaque are removed using special ultrasonic and hand instruments. An antimicrobial liquid may be administered to the area to destroy bacteria colonies and ensure the pockets are given the chance to naturally heal. Pocket reduction surgery is an effective way to restore health to the gums and bone.
Common Jawbone Treatments- Sinus augmentation – This procedure is usually performed prior to the placement of dental implants, to ensure that the prosthetic teeth are both functional and firmly affixed to the bone. The success of an implant hinges on the quantity and quality of the jawbone to which it will be attached. If the jawbone has receded or been injured, a sinus augmentation can slightly elevate the sinus floor to allow new bone to form. Generally, a small incision is made in the bone and the underlying space is packed with grafting material. The incision is sutured closed, and the implant will be placed when healing has occurred.
- Ridge modification – Ridge modification procedures are used to treat deformities in the jawbone which have occurred due to periodontal disease, trauma or birth defects. Birth defects particularly, can leave an unattractive indentation in the jaw, which makes placing dental implants difficult. During the ridge modification procedure, the gum is gently pulled away from the bone to fully expose the defect. The defect is filled with bone graft material or a similar synthetic product and then sutured closed. When healing occurs, the cosmetic appearance of the jaw is much improved and implants can be successfully placed where necessary.
- Bone grafts – There are a wide variety of reasons why a bone graft may be necessary. Bone grafting thickens the jawbone to allow for the successful placement of implant anchors. Bone grafts can also help elevate the sinus floor, fill craters or deformities in the jawbone itself, or allow for successful nerve repositioning. The grafting material may be harvested from the lower jaw, the iliac section of the pelvis, or synthetically created. In most cases, a small opening is made in the jawbone and packed with the bone graft material. Sutures are placed and restorative treatments are performed when healing is complete.
If you have questions or concerns regarding Gum or Jawbone corrective treatments please ask your dentist.
TMJ (Tempro-Mandibular Joint Dysfunction)
Tempro-Mandibular 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 of the dentist. The dentist is able to test, diagnose, and devise an immediate plan to treat the underlying causes of the TMJ disorder.
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 patients 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 by the dentist. 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.
Wisdom Teeth Extractions
Third molars, commonly referred to as wisdom teeth, are usually the last four of 32 teeth to erupt (surface) in the mouth, generally making their appearance between the ages of 17 to 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.
Reasons to remove wisdom teethWhile 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.
- Tooth Crowding: It has been theorized that impacted wisdom teeth can put pressure on other teeth and cause them to become misaligned (crowded or twisted). This theory isn’t universally accepted by all dental professionals, and it has never been validated by any scientific studies.
Wisdom teeth examinationAs 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, generally performed under local anesthesia, intravenous (IV) sedation, or general anesthesia by a specially trained dentist in an office surgery suite. The surgery does not require an overnight stay, and you will be released with post-operative instructions and medication (if necessary), to help manage any swelling or discomfort.
After Tooth Extractions
There are a number of reasons that your dentist might recommend a tooth extraction. Some dental patients suffer from tooth decay; others need to remove teeth hindering orthodontic treatment, whereas various patients simply need wisdom teeth removal. While a tooth extraction can be a serious dental procedure, aftercare is just as critical as the procedure itself. As the dental patient, it is important to understand that pain and the risk of infection can be lessened with proper care.
Care immediately following surgery:
- Keep pressure on the gauze pad that your doctor placed over the surgical area by gently biting down. Dampen the gauze sponge with water if it begins to dry out. Try to maintain constant pressure in intervals of 45-60 minutes, repeating as often as needed, or until bleeding lessens. Change the gauze as needed.
- Keep your head elevated and try to lower your activity level as much as possible.
- 48 hours after surgery, rinse mouth with warm salt water every 1-2 hours. Avoid using any mouthwash containing alcohol as it can irritate the wound.
- Keep your mouth clean by brushing areas around the surgical site, but be sure to avoid sutures. Touching the wounded area in any fashion should be prevented.
- Use ice packs to control swelling by placing them on facial areas near extraction.
- Take all prescribed medications accordingly. If any itching or swelling occurs, contact the practice immediately, or go to the nearest emergency room.
- Try to eat softer foods, preferably high in protein.
- Keep your body hydrated by drinking plenty of fluids, but do not drink through a straw for the next 5-7 days.
- If you are a regular tobacco user refrain from smoking for the next 3-4 days as smoking increases your chances of getting a dry socket as well as an infection.
Possible complications after a tooth extraction
- Bleeding – Bleeding after a tooth extraction is entirely normal. A pinkish tinted saliva and subtle oozing is fairly common during the first 36 hours. If bleeding gets excessive, control it by using dampened gauze pads and biting down to keep pressure on the area. As an alternative to gauze pads, a moistened tea bag can be used, as the tannic acid helps blood vessels contract. Apply pressure to the gauze or tea bag by gently biting down for 30 minutes. Please remember that raised tempers, sitting upright, and exercise can all increase blood flow to the head, which can cause excess bleeding. Try to avoid these as much as possible. If your bleeding does not reduce after 48 hours, please call the practice.
- Bone sequestra (dead tooth fragments) – Some patients have small sharp tooth fragments that were unable to be completely removed during surgery. During the recovery period, these dead bone fragments, or bone sequestra, slowly work themselves through the gums as a natural healing process. This can be a little painful until the sequestra are removed so please call our practice immediately if you notice any sharp fragments poking through the surgery site.
- Dry socket – In the days that follow your tooth extraction, pain should gradually subside. Rarely, patients report that pain increases to a throbbing unbearable pain that shoots up towards the ear. Often this is a case of dry socket. Dry socket occurs when the blood clot becomes irritated and ousted before healing is complete. Food and debris can then get into the socket causing irritation. Tobacco users and women taking oral contraceptives are at a higher risk of getting dry socket. Dry socket is not an infection but does require a visit to our office. If you think you may be suffering from dry socket, please contact the practice immediately.
- Lightheadedness - Because you may have been fasting prior to surgery, your blood sugar levels may be lower than normal. Until your body has had the chance to catch up and process some sugars, you should remember to stand up slowly when getting up from a relaxed position. For somewhat immediate relief, try eating something soft and sugary, stay in a relaxed position, and reduce the elevation of your head.
- Numbness – Many patients report still feeling numb hours after their tooth extraction procedure. An extended lack of feeling around the mouth is normal and can last 10-12 hours after surgery.
- Swelling – Swelling should subside almost entirely within 10 days after surgery. Immediately following your tooth extraction, apply an ice pack to the facial areas near the extraction. Continue using the ice in 15 minute intervals for the first 36 hours. After 36 hours, ice will no longer be beneficial in reducing swelling and moist heat should be used instead. To decrease swelling, apply a warm damp cloth to the sides of your face.
- Trismus (difficulty opening and closing mouth) – If you experience a sore jaw and difficulty chewing or swallowing, do not be alarmed. Occasionally patients’ chewing muscles and jaw joints remain sore 3-5 days after surgery. This soreness can also make it difficult to open and close your mouth. Soreness should eventually subside.
After Dental Implant Surgery
Following dental implant surgery, patients must take detailed care of the area surrounding their new implant. For the first month the dental implant is still integrating with the bone and tissues so the patient’s care routine will be slightly more involved during this initial period. Above all, do not disturb the wound in the initial days that follow surgery. Avoid rinsing, spitting, and touching the mouth for 24 hours after surgery to avoid contaminating or irritating the surgical site. After dental implant surgery it’s important to follow these care instructions:
- Antibiotics – Patients should take all prescribed antibiotics to prevent infection at the surgical site. Twenty-four hours after the surgery, patients should begin using the prescribed oral rinse twice daily alongside a warm saltwater rinse 4-5 times daily (preferably after every meal/snack).
- Bleeding - Blood in the patients’ saliva is normal during the first 24 hours following surgery. We suggest biting on gauze pads to help control and lessen blood flow. Gently bite down on the gauze pad and try to maintain constant pressure, repeating as often as needed, or until bleeding lessens.
- Dealing with pain – Shortly after your dental implant surgery the anesthetic will wear off. You should begin taking pain medication before this happens. Any over-the-counter pain medication can be taken (e.g., Tylenol®, Aleve®, ibuprofen, etc.).
- Diet - We recommend an initial diet of soft foods, but patients can resume a normal diet as soon as they feel capable of doing so. Stay hydrated. It is critical that you are drinking plenty of fluids.
- Hygiene – In order for the dental implants to heal properly, the surgical site must be kept clean. Continue to brush your teeth as you normally would, but avoid any sutures and do not brush the implant. The antibiotic and saltwater rinses will disinfect the implant itself.
- Swelling – After dental implant surgery some amount of swelling is to be expected. To help minimize swelling, try to keep your head elevated and lower your activity level as much as possible. Use ice packs for the first 48 hours and apply continuously, or as frequently as possible to minimize facial swelling.
- Wearing your prosthesis or night guard – Partial dentures, flippers, full dentures, retainers, or night guards should not be used for at least 10 days following surgery. If there are any special circumstances, our practice will discuss those with you during your pre-operative consultation.
- Smoking – Smoking after dental implant surgery has an increased risk of infection which also increases the risk of dental implants failing to integrate. We recommend that patients do not smoke for a minimum of 2 weeks after dental implant surgery.
What does recovery involve?
While each patient’s case is different, recovery after dental implant surgery happens in a series of phases. With your new dental implants, maintaining proper oral hygiene should be your primary focus. In order for the implant to properly fuse with the jawbone, it must remain clean. Also keep in mind that when properly cared for, a dental implant can serve its owner for life.
When maintaining proper hygiene, oral discomfort should gradually lessen. Swelling, bruising, and minor bleeding may still occur. If any pain does continue, feel free to continue using the pain medications. Healing time differs depending on whether a patient receives immediate crown placement, or waits for the implant to fuse with the jawbone. Your recovery timeframe will depend on your individual case and treatment plan; follow-up appointments will be scheduled accordingly.
The term “periodontics” refers to the dental specialty that pertains to the prevention, diagnosis and treatment of periodontal disease that affects the gums and jawbone. The gum tissues serve to surround and support the teeth and the underlying jawbone anchors teeth firmly in place. Periodontists have completed several years of extra dental training and are concerned with maintaining the function, health and aesthetics of the jawbone and tissues.
Reasons for periodontal treatmentPeriodontal disease is a progressive condition which begins with mild gum inflammation called gingivitis. It is the leading cause of tooth loss in adults living in the developed world, and should be taken very seriously. Periodontal disease (often called gum disease) is typically signified by red, swollen, painful, or bleeding gums, but in some cases has no noticeable symptoms.
Periodontal disease generally begins when the bacteria living in plaque cause an infection in the surrounding tissues of the teeth, causing them to become irritated and painful. Eventually, this infection will; cause the jawbone to recede and the tooth to become loose. There are several reasons why periodontal treatment may be necessary:
- Moderate/advanced gum disease – This occurs when the gums are bleeding, swollen or red around most teeth and the jawbone has begun to recede.
- Localized gum recession – The infection which propagates moderate or advanced gum disease often begins in one area. Gum recession may also be caused due to over brushing with a hard bristle brush, or due to a tooth that is not positioned properly. Immediate treatment is required to prevent further spreading.
- Before crown lengthening – The periodontist may lengthen the crown of the tooth by removing surrounding soft tissue to provide more tooth exposure.
- Ridge augmentation – This procedure, often called “recontouring” may be required to correct an uneven gum line. Before embarking on treatment, a periodontist needs to treat any bacterial infections and periodontitis.
The periodontist is trained in all aspects of dental implant procedures, which can restore functionality to the mouth when teeth have been affected by periodontitis. Because periodontal disease is progressive, it is essential to remove the bacteria and calculus build up to halt the spread of the infection. Your dentist will be happy to advise you on effective cleaning methods and treatment options.
Periodontal Scaling & Root Planing
Pocket Reduction Surgery
Soft Tissue Grafting
Crown lengthening is generally performed in order to improve the health of the gum tissue, or to prepare the mouth for restorative or cosmetic procedures. In addition, crown lengthening procedures can also be used to correct a “gummy” smile, where teeth are covered with excess gum tissue. Crown lengthening exposes more of the natural tooth by reshaping or recontouring bone and gum tissue. This treatment can be performed on a single tooth, many teeth or the entire gum line, to expose a pleasant, aesthetically pleasing smile.
Reasons for crown lengtheningCrown lengthening is a versatile and common procedure that has many effective uses and benefits. The vast majority of patients who have undergone this type of surgery are highly delighted with the results. Here are some of the most common reasons for crown lengthening:
- Restoration of damaged teeth – Periodontal disease can cause severe damage to the teeth, as can trauma and decay. Where teeth have been broken beneath the gum line, crown lengthening can be used to prepare the area for a new restoration to correct the damaged teeth.
- Cosmetic uses – Extra gum tissue can make teeth look unnaturally short, and also increase susceptibility to periodontal infections. Removing excess gum tissue can restore a balanced, healthy look and thus improve the aesthetic appearance of the smile.
- Dental crowns – Crown lengthening serves to provide more space between the supporting jawbone and dental crown. This prevents the new crown from damaging gum tissues and bone once it is in place.
What does crown lengthening involve?
Crown lengthening is normally performed under local anesthetic. The amount of time this procedure takes will largely depend in how many teeth are involved and whether a small amount of bone needs to be removed, in addition to the soft tissue. Any existing dental crowns will be removed prior to the procedure, and replaced immediately afterwards.
The dentist will make a series of small incisions around the soft tissue in order to separate the gums away from the teeth. Even if only one tooth requires the re-contour, neighboring teeth are usually treated to provide a more even reshaping. Separating the gums provides the dentist with access to the roots of the teeth and the underlying bone.
In some cases, the removal of a small amount of tissue will provide enough tooth exposure to place a crown. In other cases, the dentist will also need to remove a small amount of bone from around the teeth. The bone is usually removed using a combination of special hand instruments, and rotary instruments. The rotary instruments roughly resemble the drill that is used in cavity treatment. When the dentist is satisfied the teeth have sufficient exposure, the wound will be cleaned with sterile water and the gum tissue will be sutured with small stitches. The teeth will look noticeably longer immediately after surgery because the gums have now been repositioned.
The dentist will secure the surgical site using an intraoral (periodontal) bandage, which serves to prevent infection. Prescriptions may be provided for pain medication, and a chlorhexidine (antimicrobial) mouth rinse may be given to help reduce any bacteria attempting to re-colonize. The surgical site will be completely healed in approximately two to three months.
Gingival recession (receding gums) refers to the progressive loss of gum tissue, which can eventually result in tooth root exposure if left untreated. Gum recession is most common in adults over the age of 40, but the process can begin in the teenage years.
Gum recession can be difficult to self-diagnose in its earlier stages because the changes often occur asymptomatically and gradually. Regular dental check ups will help to prevent gum recession and assess risk factors. The following symptoms may be indicative of gum recession:
- Sensitive teeth – When the gums recede enough to expose the cementum protecting the tooth root, the dentin tubules beneath will become more susceptible to external stimuli.
- Visible roots – This is one of the main characteristics of a more severe case of gum recession.
- Longer-looking teeth – Individuals experiencing gingival recession often have a “toothy” smile. The length of the teeth is perfectly normal, but the gum tissue has been lost, making the teeth appear longer.
- Halitosis, inflammation and bleeding – These symptoms are characteristic of gingivitis or periodontal disease. A bacterial infection causes the gums to recede from the teeth and may cause tooth loss if not treated promptly.
Causes of Gum RecessionGum recession is an incredibly widespread problem that dentists diagnose and treat on a daily basis. It is important to thoroughly examine the affected areas and make an accurate diagnosis of the actual underlying problem. Once the cause of the gum recession has been determined, surgical and non surgical procedures can be performed to halt the progress of the recession, and prevent it from occurring in the future.
The most common causes of gingival recession are:
- Overaggressive brushing – Over brushing can almost be as dangerous to the gums as too little. Brushing too hard or brushing with a hard-bristled toothbrush can erode the tooth enamel at the gum line, and irritate or inflame gum tissue.
- Poor oral hygiene – When brushing and flossing are performed improperly or not at all, a plaque build up can begin to affect the teeth. The plaque contains various bacterial toxins which can promote infection and erode the underlying jawbone.
- Chewing tobacco – Any kind of tobacco use has devastating effects on the entire oral cavity. Chewing tobacco in particular, aggravates the gingival lining of the mouth and causes gum recession if used continuously.
- Periodontal disease – Periodontal disease can be a result of improper oral hygiene or caused by systemic diseases such as diabetes. The excess sugars in the mouth and narrowed blood vessels experienced by diabetics create a perfect environment for oral bacteria. The bacterium causes an infection which progresses deeper and deeper into the gum and bone tissue, eventually resulting in tooth loss.
Treatment of Gum RecessionEvery case of gum recession is slightly different, and therefore many treatments are available. The nature of the problem which caused the recession to begin with needs to be addressed first. If overly aggressive brushing techniques are eroding the gums, a softer toothbrush and a gentler brushing technique should be used. If poor oral hygiene is a problem, prophylaxis (professional dental cleaning) may be recommended to rid the gum pockets of debris and bacteria. In the case of a severe calculus (tartar) build up, scaling and root planing will be performed to heal the gingival inflammation and clean the teeth.
Once the cause of the gingival recession has been addressed, surgery of a more cosmetic or restorative nature may be recommended. Gum tissue regeneration and gum grafting are two excellent ways to restore natural symmetry to the gums and make the smile look more aesthetically pleasing. If you have any questions or concerns about periodontal disease, periodontal treatments, or gum recession, please ask your dentist.
Periodontal Scaling & Root Planing
The objective of scaling & root planning is to remove etiologic agents which cause inflammation to the gingival (gum) tissue and surrounding bone. Common etiologic agents removed by this conventional periodontal therapy include dental plaque and tartar (calculus). These non-surgical procedures which completely cleanse the periodontium, work very effectively for individuals suffering from gingivitis (mild gum inflammation) and moderate/severe periodontal disease.
Reasons for scaling and root planingScaling and root planning can be used both as a preventative measure and as a stand-alone treatment. These procedures are performed as a preventative measure for a periodontitis sufferer. Here are some reasons why these dental procedures may be necessary:
- Disease prevention – The oral bacteria which cause periodontal infections can travel via the bloodstream to other parts of the body. Research has shown that lung infections and heart disease have been linked to periodontal bacteria. Scaling and root planing remove bacteria and halts periodontal disease from progressing, thus preventing the bacteria from traveling to other parts of the body.
- Tooth protection – When gum pockets exceed 3mm in depth, there is a greater risk of periodontal disease. As pockets deepen, they tend to house more colonies of dangerous bacteria. Eventually, a chronic inflammatory response by the body begins to destroy gingival and bone tissue which may lead to tooth loss. Periodontal disease is the number one cause of tooth loss in the developed world.
- Aesthetic effects – Scaling and root planing help remove tartar and plaque from the teeth and below the gumline. As an added bonus, if superficial stains are present on the teeth, they will be removed in the process of the scaling and root planning procedure.
- Better breath – One of the most common signs of periodontal disease is halitosis (bad breath). Food particles and bacteria can cause a persistent bad odor in the oral cavity which is alleviated with cleaning procedures such as scaling and root planing.
What do scaling and root planing treatments involve?Scaling and root planing treatments are only performed after a thorough examination of the mouth. The dentist will take X-rays, conduct visual examinations and make a diagnosis before recommending or beginning these procedures. Depending on the current condition of the gums, the amount of calculus (tartar) present, the depth of the pockets and the progression of the periodontitis, local anesthetic may be used.
Scaling – This procedure is usually performed with special dental instruments and may include an ultrasonic scaling tool. The scaling tool removes calculus and plaque from the surface of the crown and root surfaces. In many cases, the scaling tool includes an irrigation process that can also be used to deliver an antimicrobial agent below the gums that can help reduce oral bacteria.
Root Planing – This procedure is a specific treatment which serves to remove cementum and surface dentin that is embedded with unwanted microorganisms, toxins and tartar. The root of the tooth is literally smoothed in order to promote good healing. Having clean, smooth root surfaces helps bacteria from easily colonizing in future.
Following these deep cleaning procedures, the gum pockets may be treated with antibiotics. This will soothe irritation and help the gum tissues to heal quickly. During the next appointment, the dentist or hygienist will thoroughly examine the gums again to see how well the pockets have healed. If the gum pockets still measure more than 3mm in depth, additional and more intensive treatments may be recommended.
If you have any concerns or questions about scaling and root planing, or periodontal disease, please ask your dentist.
Periodontal disease is a progressive condition which leads to gum inflammation, the recession of bone and gum tissue, and tooth loss if left untreated. There are a variety of effective treatments and procedures available, including pocket irrigation, which can assist in treating the progression of the disease.
Pocket irrigation aims to cleanse plaque from the interdental (between teeth) and subgingival (under the gumline) regions of the mouth in order to prevent the colonization of harmful oral bacteria. This procedure is also used to deliver antibacterials to the subgingival areas.
Reasons for pocket irrigationPocket irrigation, which is also known as oral irrigation, is a versatile dental treatment used for several different preventative purposes. Pocket irrigation may be performed as part of a professional dental cleaning, or at home with a specially modified oral irrigator. Here are the main ways in which pocket irrigation can be beneficial:
- Interdental cleaning – Pocket irrigators blast plaque, food particles and other debris from between the teeth. The removal of harmful materials and bacteria keep the gum pockets cleaner and shallower; thus helping the gum tissue remain healthy.
- Halitosis prevention – Halitosis (or bad breath) is generally a result of old food particles between the teeth, and tooth decay. A toothbrush or dental scraper alone may not be able to reach into the depths of the gum pockets, but water jets can flush out food particles and help clean above and below the gumline.
- Subgingival cleaning – Pocket irrigators have a rounded tip which eliminates the risk of tissue damage while cleaning under the gumline. The side port opening facilitates extensive cleansing by flushing out bacteria, particles and toxins from below the gumline.
- Antimicrobial application – Antimicrobial substances have proven effective for eliminating and preventing some strains of harmful oral bacteria. Antimicrobial substances can be combined with water, or used as a stand-alone treatment for successful pocket irrigation.
What does pocket irrigation treatment involve?Pocket irrigation is generally performed in combination with other dental treatments; for example, as part of a professional dental cleaning or in combination with pocket reduction surgery. In the case of a pocket reduction surgery, the tartar and subgingival plaque will be removed with special scaling and root planing instruments. When the pockets are free of debris, an antimicrobial agent may be applied using an oral irrigator. This will help reduce harmful oral bacteria which still remain in the pockets.
During a deep cleaning procedure, a pocket irrigator may be used after scaling and root planing to cleanse the pockets. Again, an antimicrobial agent may be applied to help reduce subgingival oral bacteria. Pocket irrigation can be performed at home as part of the daily oral routine using a water jet or water pick. Flushing the interdental area with water is less harmful to soft tissue than dental floss, but should not be used as a substitute for professional dental cleaning.
If you have any questions about pocket irrigation, cleaning your teeth, periodontal disease and treatment, please ask your dentist.
Pocket Reduction Surgery
Pocket reduction surgery (also known as gingivectomy, osseous surgery and flap surgery) is a collective term for a series of several different surgeries aimed at gaining access to the roots of the teeth in order to remove bacteria and tartar (calculus). The human mouth contains dozens of different bacteria at any given time. The bacteria found in plaque (the sticky substance on teeth) produce acids that lead to demineralization of the tooth surface, and ultimately contribute to periodontal disease.
Periodontal infections cause a chronic inflammatory response in the body that literally destroys bone and gum tissues once they invade the subgingival area (below the gum line). Gum pockets form and deepen between the gums and teeth as the tissue continues to be destroyed. Periodontal disease is a progressive condition which, if left untreated, causes massive bacteria colonization in gum pockets can eventually lead to teeth falling out. Pocket reduction surgery is an attempt to alleviate this destructive cycle, and reduce the depth of the bacteria-harboring pockets.
Reasons for the pocket reduction surgeryPocket reduction surgery is a common periodontal procedure which has been proven effective at eliminating bacteria, reducing inflammation and saving teeth. The goals of pocket reduction surgery are:
Reducing bacterial spread – Oral bacteria has been connected to many other serious conditions such as diabetes, heart disease and stroke. Oral bacteria can travel to various parts of the body from inside the bloodstream and begin to colonize. It is important to decrease bacteria in the mouth in order to reduce the risk of secondary infection.
Halting bone loss – The chronic inflammatory response induced by oral bacteria leads the body to destroy bone tissue. As the jawbone becomes affected by periodontal disease, the teeth lose their rigid anchor. When the teeth become too loose, they may require extraction.
Facilitate home care – As the gum pockets become progressively deeper, they become incredibly difficult to clean by the patient. The toothbrush and dental floss cannot reach to the bottom of the pockets, increasing the risk of further periodontal infections.
Enhancing the smile – An oral cavity that is affected by periodontal disease is not attractive to the eye. In fact, smiles may be marred by brown gums, rotting teeth and ridge indentations. Pocket reduction surgery halts the progression of gum disease and improves the aesthetics of the smile.
What does pocket reduction surgery involve?Before recommending treatment or performing any procedure, the dentist will perform thorough visual and x-ray examinations in order to assess the condition of the teeth, gums and underlying bone. Pocket reduction surgery may be performed under local or general anesthetic depending on the preferences of the patient. The gums will be gently pulled back from the teeth and bacteria and calculus (tartar) will be eliminated. Scaling and root planing will generally be required to fully remove the ossification (tartar) from the surface of the tooth root. If the root is not completely smooth, a planing procedure will be performed to ensure that when the gums do heal, they will not reattach to rough or uneven surfaces.
The final part of the surgery is usually the administration of an antimicrobial liquid to eliminate any remaining bacteria and promote healing. The gum is then sutured with tiny stitches that are left in place for 5-10 days. Though the gums will be more sensitive immediately following the procedure, there will be a significant reduction in pocket depth and a vast improvement in the condition of the teeth and gums. If you have any questions about pocket reduction surgery or treatment for periodontal disease, please ask your dentist.
Periodontal disease is an extremely serious progressive condition which can lead to tooth loss if left untreated. Periodontal disease occurs when a bacterial infection in the gum pockets causes the bone and gum tissue to recede away from the teeth. The quality and quantity of bone and gum tissue is greatly reduced as the gum pockets continue to deepen. Fortunately, prompt diagnosis combined with effective regenerative procedures can halt the progression of the disease and save the teeth.
There are many regenerative dental procedures available to restore health to the gums, bone and teeth. The following are the most commonly used regenerative procedures:
Dental implants and other restorative procedures depend on the jawbone being sufficiently strong and thick. When periodontal disease has taken hold, the jawbone may have become too thin to successfully support an implant. Natural bone regeneration (or bone grafting) is one of the best ways to promote growth and thicken the jawbone.
Initially, bone grafting material is obtained from elsewhere on the body or from a bone bank. The gums are gently pulled back, and an opening is made in the jawbone where the grafting material will be packed in tightly. A membrane is used to maintain the shape of the new bone, and tissue stimulating proteins and a platelet-rich growth factor may be applied to promote faster healing. The surgical site will be sutured and packed with protective material. The bone will naturally regenerate and become strong enough to eventually support an implant.
Gum Tissue Regeneration
Gum tissue regeneration is usually performed by way of gum grafting. When gum tissue has been lost as a result of periodontal disease, the smile may appear discolored, toothy or unpleasant. A gum graft aims to symmetrically contour the gum line, cover any exposed tooth roots and restore health to the gums. Initially, a small strip of tissue will be removed from the roof of the mouth and placed in the middle of a split-thickness incision at the recipient site. The surgical site will be covered with a protective membrane which promotes tissue regeneration, covered in platelet-rich growth factor and tissue stimulating proteins, and then sutured closed. The soft tissue surrounding the teeth will naturally regenerate, producing a healthy, smile.?
Pocket Reduction Surgery
The aim of pocket reduction surgery is to reduce the depth of the gum pockets and make it much harder for bacteria to invade the gum tissue. Initially, the gum tissue is pulled back from the teeth and the subgingival area is thoroughly cleansed under local anesthesia. Extensive scraping may be required to fully remove the plaque, debris and tartar from below the gum line. An antimicrobial agent may then be applied to the affected area to kill any remaining bacteria, and the surgical site will be sutured closed. Pocket reduction surgery is very effective for halting tissue loss and promoting the natural healing of the gums.
Scaling and Root Planing
The term “scaling” refers to the removal of plaque and calculus (tartar) from the supragingival region (above the gum line). This treatment is usually conducted in the course of a routine professional cleaning, and performed under local anesthetic. Root planing usually accompanies scaling and is performed in the subgingival region (below the gum line). Tartar and toxins are initially removed, and then the tooth root is smoothed down to promote good healing in the gum tissue. The planing of the tooth root provides a smooth area which prevents bacteria from recolonizing. If these procedures do not completely eradicate the infection, surgical measures may be required.If you have any questions about regenerative procedures or periodontal disease, please ask your dentist.
Ridge modification is an effective procedure for treating deformities in the upper and lower jaws. These deformities can occur as a result of periodontal disease, trauma, injury, wearing dentures, or developmental problems. Such defects can leave insufficient bone for the placement of dental implants and an additional unattractive indentation in the jaw line adjacent to the missing teeth.During the ridge modification procedure, the gum is lifted away from the ridge to fully expose the defect in the bone. The bony defect can be filled with bone graft material which can help regenerate lost bone, or a bone substitute. Finally, the incision is closed and several months of healing will be required. Depending on the case and type of implant and procedure, a dental implant may be placed during the ridge modification procedure or when healing is complete; much depends on the precise condition of the bone. Ridge modification improves the cosmetic appearance, functionality of the mouth, and the chance of enjoying dental implants for many years.
Soft Tissue Grafting
Soft tissue grafting is often necessary to combat gum recession. Periodontal disease, trauma, aging, over brushing, and poor tooth positioning are the leading causes of gum recession which can lead to tooth-root exposure in severe cases. When the roots of the teeth become exposed, eating hot and cold foods can be uncomfortable, decay is more prevalent and the aesthetic appearance of the smile is altered. The main goal of soft tissue grafting is to either cover the exposed root or to thicken the existing gum tissue in order to halt further tissue loss.The three different types of common soft tissue grafts include:
Free gingival graft – A strip of tissue is removed from the roof of the mouth and stitched to the grafting site in order to promote natural growth. This type of graft is most commonly used for thickening existing tissue.
Connective tissue graft – For larger areas or root exposure, subepithelial tissue is needed to remedy the problem. This subepithelial connective tissue is removed from a small flap in the mouth and sutured to the grafting site. This is the most common treatment for root exposure.
Pedicle graft – This type of graft involves the “sharing” of soft tissue between the affected site and adjacent gum. A flap of tissue is partially cut away and moved sideways to cover the root. The results of this type of graft are excellent because the tissue that is moved to the adjacent area includes blood vessels that are left in place.
Reasons for soft tissue grafting
Soft tissue grafting is an extremely versatile procedure that has many uses. Recent developments in dental technology have made soft tissue grafting more predictable and less intrusive. Here are some of the main benefits associated with soft tissue grafting treatment:
Increased comfort – Root exposure can cause substantial pain and discomfort. Eating hot, cold or even warm foods can cause severe discomfort. Soft tissue grafts cover the exposed root, decreases sensitivity and restore good health to the gum area.
Improved aesthetics – Gum recession due to periodontal disease can cause the smile to look “toothy” or the teeth to appear uneven in size. Soft tissue grafting can be used as a cosmetic procedure to re-augment the gums, and make the smile appear more symmetrical.
Improved gum health – Periodontal disease is a progressive condition that can destroy soft tissue very rapidly. When used in combination with deep cleaning procedures, soft tissue grafting can halt tissue and bone loss, and protect exposed roots from further complications.
What does soft tissue grafting treatment involve?
Initially, deep cleaning will be performed both above and below the gum line to clear the teeth and roots of calculus (tartar). The grafting procedure itself will generally be performed under local anesthetic, but this will depend on the size of the areas receiving grafts. A small incision will be made at the recipient site in order to create a small pocket. A split thickness incision is made in this pocket and the donor tissue is placed between the two sections of this area. The donor tissue strip is generally larger than the incision, so some excess will be apparent.
Platelet rich growth factors which stimulate natural tissue growth and promote good healing may be applied to the site before suturing. In addition, tissue-stimulating proteins may be added to encourage quicker tissue growth. Finally, the wound site will be sutured to prevent shifting, and surgical material will be placed to protect the sensitive area. Gum uniformity and substantial healing will take place in the first six weeks after the procedure.If you have any questions about soft tissue grafting, please ask your dentist.
Endodontics is a specialized branch of dentistry that deals with the complex structures found inside the teeth. The Greek word “Endodontics” literally means “inside the tooth,” and relates to the tooth pulp, tissues, nerves and arterioles. Endodontists receive additional dental training after completing dental school to enable them to perform both complex and simple procedures, including root canal therapy.
Historically, a tooth with a diseased nerve would be removed immediately, but endodontists are now able to save the natural tooth in most cases. Generally, extracting the inner tooth structures, then sealing the resulting gap with a crown restores health and functionality to damaged teeth. Signs and symptoms of endodontic problems:
- Inflammation and tenderness in the gums.
- Teeth that are sensitive to hot and cold foods.
- Tenderness when chewing and biting.
- Tooth discoloration.
- Unexplained pain in the nearby lymph nodes.
Reasons for endodontic treatmentEndodontic treatment (or root canal therapy) is performed to save the natural tooth. In spite of the many advanced restorations available, most dentists agree that there is no substitute for healthy, natural teeth. Here are some of the main causes of inner tooth damage:
Bacterial infections – Oral bacteria is the most common cause of endodontic problems. Bacteria invade the tooth pulp through tiny fissures in the teeth caused by tooth decay or injury. The resulting inflammation and bacterial infection jeopardize the affected tooth and may cause an abscess to form.
Fractures and chips – When a large part of the surface or crown of the tooth has become completely detached, root canal therapy may be required. The removal of the crown portion leaves the pulp exposed, which can be debilitating painful and problematic.
Injuries – Injuries to the teeth can be caused by a direct or indirect blow to the mouth area. Some injuries cause a tooth to become luxated, or dislodged from its socket. Root canal therapy is often needed after the endodontist has successfully stabilized the injured tooth.
Removals – If a tooth has been knocked clean out of the socket, it is important to rinse it and place it back into the socket as quickly as possible. If this is impossible, place the tooth in special dental solution (available at pharmacies) or in milk. These steps will keep the inner mechanisms of the tooth moist and alive while emergency dental treatment is sought. The tooth will be affixed in its socket using a special splint, and the endodontist will then perform root canal therapy to save the tooth.
What does an endodontic procedure invlove?Root canal therapy usually takes between one and three visits to complete. Complete X-rays of the teeth will be taken and examined before the treatment begins. Initially, a local anesthetic will be administered, and a dental dam (protective sheet) will be placed to ensure that the surgical area remains free of saliva during the treatment. An opening will be created in the surface of the tooth, and the pulp will be completely removed using small handheld instruments.
The space will now be shaped, cleaned and filled with gutta-percha. Gutta-percha is a biocompatible material that is somewhat similar to rubber. Cement will be applied on top to ensure that the root canals are completely sealed off. Usually, a temporary filling will be placed to restore functionality to the tooth prior to the permanent restoration procedure. During the final visit, a permanent restoration or crown will be placed. If you have questions or concerns about endodontic procedures, please ask your dentist.
Root Canal Therapy
Root canal therapy is needed when the nerve of a tooth is affected by decay or infection. In order to save the tooth, the pulp (the living tissue inside the tooth), nerves, bacteria, and any decay are removed and the resulting space is filled with special, medicated, dental materials, which restore the tooth to its full function.
Having a root canal done on a tooth is the treatment of choice to save a tooth that otherwise would die and have to be removed. Many patients believe that removing a tooth that has problems is the solution, but what is not realized is that extracting (pulling) a tooth will ultimately be more costly and cause significant problems for adjacent teeth. Root canal treatment is highly successful and usually lasts a lifetime, although on occasion, a tooth will have to be retreated due to new infections.
Signs and symptoms for possible root canal therapy
- An abscess (or pimple) on the gums.
- Sensitivity to hot and cold.
- Severe toothache pain.
- Sometimes no symptoms are present.
- Swelling and/or tenderness.
Reasons for root canal therapy
- Decay has reached the tooth pulp (the living tissue inside the tooth).
- Infection or abscess have developed inside the tooth or at the root tip.
- Injury or trauma to the tooth.
What does root canal therapy involve?A root canal procedure requires one or more appointments and can be performed by a dentist or endodontist (a root canal specialist). While the tooth is numb, a rubber dam (a sheet of rubber) will be placed around the tooth to keep it dry and free of saliva. An access opening is made on top of the tooth and a series of root canal files are placed into the opening, one at a time, removing the pulp, nerve tissue, and bacteria. If tooth decay is present, it will also be removed with special dental instruments.
Once the tooth is thoroughly cleaned, it will be sealed with either a permanent filling or, if additional appointments are needed, a temporary filling will be placed. At the next appointment, usually a week later, the roots and the inside cavity of the tooth will be filled and sealed with special dental materials. A filling will be placed to cover the opening on top of the tooth. In addition, all teeth that have root canal treatment should have a crown (cap) placed. This will protect the tooth and prevent it from breaking, and restore it to its full function.
After treatment, your tooth may still be sensitive, but this will subside as the inflammation diminishes and the tooth has healed. You will be given care instructions after each appointment. Good oral hygiene practices and regular dental visits will aid in the life of your root canal treatment.
Root Canal Retreatment
In rare cases, root canal therapy fails to work as expected. The treated tooth might not heal properly or a patient might experience post-surgical complications that jeopardize the tooth. Root canal retreatment involves the removal of the previous crown and packing material, the cleansing of the root canals, and the re-packing and re-crowning of the tooth. In short, root canal retreatment is almost identical to the original procedure, aside from the structural removal. The success rate for a root canal retreatment runs at around 75%.
Root canal treatments and retreatments are a better alternative than extraction for most individuals. If a tooth has good bone support, a solid surface and healthy gums beneath it, it stands a good chance of being saved. Opting for root canal retreatment can be far less expensive than the alternatives. Dental implants, extensive bridgework and the creation of aesthetically pleasing prosthetic teeth cost far more than working with the natural tooth. They also require maintenance and feel less natural than a “real” tooth.
Why is root canal retreatment required?Though the prospect of more endodontic surgery might not be pleasant, root canal retreatment is fairly simple. In general, the whole treatment can be completed in 1-3 visits. There are a number of reasons why root canal therapy unexpectedly fails, including:
- Cracked crown leaking filling material.
- Curved or narrow canals not treated during the original procedure.
- Delay in the placement of restorative devices following the procedure.
- New decay to the tooth.
- New fracture in the treated tooth.
- Saliva entering the restorative structure.
- Undetected complex canal structures.
What does root canal retreatment involve?On the day of the retreatment procedure a local anesthetic will be administered, unless another type of anesthetic has been selected. The affected tooth is isolated with a rubber dam. The dam protects the tooth during treatment from bacteria and saliva. The amount the dentist can do within a single appointment will much depend on the amount of inflammation present, and the complexity of the treatment. The first step in a root canal retreatment is to gain access to the inner tooth. If a crown and post have been placed, these will be removed.
Next, filling material and obstructions that block the root canals will be removed. This removal is conducted using an ultrasonic handpiece. The advantage of using this tool is that any unwanted material is vibrated loose. Tiny instruments will then be used to clean and reshape the root canals. X-rays may be taken to ensure that the roots are thoroughly clean. If this part of the treatment proves to be complex, medicated packing material will be applied, and the rest of the cleansing procedure will be done at the next visit.
When the dentist is confident that the root canals are completely clean, gutta-percha is used to pack the space. This rubbery material seals the canals to prevent bacterial invasion. Finally, a temporary crown or filling is applied to tooth. At a later date, the color-matched permanent crown will be placed. If you have any questions or concerns about root canal retreatment, please ask your dentist.
Cracked and fractured teeth are common dental problems. As people retain their natural teeth longer (due to advances in dental technology), the likelihood of cracked teeth increases. There are many reasons why teeth may crack, for example, biting on hard objects, trauma, grinding and clenching of teeth. All of these behaviors place the teeth under extra strain and render them more susceptible to cracking.
When tooth enamel is cracked, pain can become momentarily debilitating. When no pressure is exerted on the crack there may be no discomfort. However, as the cracked tooth performs a biting action, the crack widens. The pulp and inner workings of the tooth then become exposed, and painful irritation occurs. As pressure is released again, the two parts of the crack fuse back together, and pain subsides. If left untreated, the pulp becomes irreversibly damaged and constantly painful. The resulting pulp infection can affect the bone and soft tissue surrounding the tooth. Symptoms of a cracked tooth may include:
- Unexplained pain when eating.
- Sensitivity to warm and cold foods.
- Pain with no obvious cause.
- Difficulty pinpointing the location of the pain.
What kind of cracks can affect the teeth?There are many ways in which a tooth can be cracked. The specific type of crack will determine what type of treatment is viable. In many cases, if the crack is not too deep, root canal therapy can be performed and the natural tooth can remain in the mouth. In other situations, the tooth is too badly damaged and requires extraction. Here is a brief overview of some of the most common types of cracks:
Crazes – These are generally tiny vertical cracks that do not place the teeth in danger. These scratches on the surface of the teeth are considered by most dentists to be a normal part of the tooth anatomy. A craze rarely requires treatment for health reasons, but a wide variety of cosmetic treatments can be performed to reduce the negative aesthetic impact.
Oblique supragingival cracks – These cracks only affect the crown of the tooth and do not extend below the gum line. Usually, the affected part of the tooth will eventually break off. Little pain will result, because the tooth pulp (that contains the nerves and vessels) will remain unaffected.
Oblique subgingival cracks – These cracks extend beyond the gum line, and often beyond where the jawbone begins. When a piece breaks off, it will usually remain attached until the dentist removes it. Oblique subgingival cracks are painful and may require a combination of periodontal surgery (to expose the crown), and endodontic treatment to place a crown or other restorative device.
Vertical furcation cracks – These cracks occur when the roots of the tooth separate. This type of crack almost always affects the nerve of the tooth. Because the tooth will not generally separate completely, root canal therapy and a crown can usually save the tooth.
Oblique root cracks – These cracks tend not to affect the surface of the tooth at all. In fact, the damage is only apparent below the gum line and usually below the jawbone. Root canal therapy may be possible; depending on how close the fracture is to the tooth surface. However, extraction is almost always the only option after sustaining this classification of fracture.
Vertical apical root cracks – These cracks occur at the apex (tip of the root). Though the tooth does not require extraction from a dental perspective, many patients request an extraction because of the high degree of pain. Root canal therapy alleviates the discomfort for a while, but most often, teeth affected by such cracks are eventually extracted.
How are cracks in the teeth treated?There are many different types of cracked teeth. Some can only be exposed using X-ray machines, while others are clearly visible to the naked eye. In cases where the tooth root is affected, root canal therapy is the most viable treatment option. The pulp, nerves and vessels of the tooth will be removed, and the resulting space will be filled with gutta-percha. A crown or filling will be added to stabilize the tooth and it will continue to function as normal.
When the crack is too severe for the tooth to be saved, the dentist will perform an extraction. There are a number of restorative options in this case, such as bridges, dental implants and partial dentures. All of these structures can restore biting, chewing and speaking functions. If you have any questions or concerns about cracked teeth, please ask your dentist.
Root amputation is a specialized dental procedure, whereby one root is removed from a multi-root tooth. The tooth is then stabilized and rendered fully functional with a crown or filling. The multi-root teeth best suited to the root amputation procedure are the molars at the back of the mouth. These large flat teeth have either two or three roots depending on whether they are situated on the upper or lower jaw.
The general purpose of root amputation is to save an injured or diseased tooth from extraction. Most dentists agree that there is no better alternative than retaining a healthy natural tooth, and the root amputation procedure makes this possible. Dental implants, extensive bridgework and custom-made tooth replacements can be expensive and time-consuming. Generally, root amputation and the necessary crown work are less expensive and can be completed in 1-3 short visits.
When is root amputation necessary?It is important to note that root amputation can only be performed on an otherwise healthy tooth. Even in the case of a “key” tooth, extraction will be performed if the tooth is diseased, badly fractured or otherwise injured. Suitable teeth for root amputation have a healthy tooth surface, strong bone support and healthy underlying gums. There are several problems that may lead to root amputation including:
- Broken, fractured or injured teeth and roots.
- Embedded bacteria within the structure of the root.
- Severe bone loss in a concentrated area due to periodontitis.
- Tooth decay in a concentrated area of the tooth.
What does root amputation involve?Prior to root amputation, it is necessary to perform root canal treatment. The amputation itself involves cutting deep into the tooth where blood vessels and nerves are located. For this reason, the pulp of the tooth including these vessels and nerves needs to be removed before resectioning the roots. The root canal and amputation treatments will be performed under local anesthetic. During the root amputation procedure, a small incision will be created in the gum to fully expose the roots of the affected tooth. The root will be sectioned off from the rest of the tooth and then removed. To kill any remaining bacteria, the whole area will be cleansed with saline solution, and then sutures (stitches) will be applied to seal the incision.
Finally, a temporary crown or filling will be placed to secure the tooth. Depending on the specific situation, painkillers, antibiotics and a medicated anti-microbial mouthwash may be prescribed. In 7-10 days, the stitches will be removed and the gum will have healed. Arrangements can now be made to place the permanent crown or filling. If you have any questions or concerns about root amputation, please ask your dentist.
A dental implant is essentially an artificial tooth root which is attached to the jaw bone. Eventually, a replacement tooth or bridge will be firmly fixed to this root, restoring complete function to the tooth. The key to a successful and long-lasting implant is the quality and quantity of jawbone to which the implant will be attached. If bone has been lost due to injury or periodontal disease, a sinus augmentation can raise the sinus floor to allow for new bone formation.
In the most common sinus augmentation technique, a tiny incision is made near the upper premolar or molar region to expose the jawbone. A small opening is cut into the bone and the membrane lining the sinus on the other side of the opening is gently pushed upward. The underlying space is filled with bone graft material and the incision is closed. The bone which is used for this procedure may be from your own body or from a cadaver. Sometimes the dentist might use synthetic materials which can also stimulate bone formation. The implants are placed after healing has occurred; this will depend on the individual case. Sinus augmentation has been shown to increase the success of dental implant procedures.
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?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.
What types of drugs are used in oral conscious sedation?Most of the drugs used in sedation dentistry are classified as benzodiazepines. Benzodiazepines reduce anxiety, muscle spasms, insomnia and seizures. Each medication has a different half-life, meaning that the effects last for varying amounts of time. The estimated length of the procedure determines which type of drug is going to be most effective. Here are some of the most common drugs used in oral conscious sedation:
Valium® – This sedative has amnesic properties and a long half-life. It is usually used for time-consuming, complex procedures.
Halcion® – Usually used to treat insomnia, Halcion is an effective sedative with amnesic properties. A short half-life makes this sedative useful for shorter procedures.
Ativan® – This sedative is best known for reducing anxiety. It has amnesic properties and a medium half-life. Ativan is typically used for treatments shorter than two hours.
Versed® – This sedative has the shortest half-life and is therefore less commonly used. It alleviates anxiety in much the same way as nitrous oxide, and is used for visits that will take less than 30 minutes.
Dental Anxiety and Fear
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. The staff at the practice 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. There are 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.
Dental EmergencyDental emergencies are quite frightening and often painful. Prompt treatment is almost always required to alleviate pain and to ensure the teeth have the best possible chance of survival.
Sometimes teeth become fractured by trauma, grinding or biting on hard objects. In other cases, fillings, crowns and other restorative devices can be damaged or fall out of the mouth completely. If there is severe pain, it is essential to make an appointment with the dentist as quickly as possible. The pain caused by dental emergencies almost always gets worse without treatment, and dental issues can seriously jeopardize physical health.
Avulsed tooth (tooth knocked out)If a tooth has been knocked clean out of the mouth, it is essential to see a dentist immediately. When a tooth exits the mouth, tissues, nerves and blood vessels become damaged. If the tooth can be placed back into its socket within an hour, there is a chance the tissues will grow to support the tooth once again. Here are some steps to take:
1- Call the dentist.
2- Pick up the tooth by the crown and rinse it under warm water. DO NOT touch the root.
3- If possible, place it back into its socket – if not tuck it into the cheek pouch.
4- If the tooth cannot be placed in the mouth, put the tooth into a cup of milk, saliva, or water as a last resort. It is important to keep the tooth from drying out.
5- Get to the dentist, quickly and safely.
Lost filling or crownUsually, a crown or filling comes loose while eating. Once it is out of the mouth, the affected tooth may be incredibly sensitive to temperature changes and pressure. Crowns generally become loose because the tooth beneath is decaying. The decay causes shape changes in the teeth – meaning that the crown no longer fits.
If a crown has dropped out of the mouth, make a dental appointment as soon as possible. Keep the crown in a cool, safe place because there is a possibility that the dentist can reinsert it. If the crown is out of the mouth for a long period of time, the teeth may shift or sustain further damage. When the dentist is not immediately accessible, here are the steps to take:
1- Apply clove oil to the tooth to alleviate pain.
2- Clean the crown and affix it onto the tooth with dental cement. This can be purchased at the local pharmacy.
3- If the crown is lost, smear the top of the tooth with dental cement to alleviate discomfort.
4- DO NOT use any kind of glue to affix the crown.
Cracked or broken teethThe teeth are strong, but they are still prone to fractures, cracks and breaks. Sometimes fractures are fairly painless, but if the crack extends down into the root, it is likely that the pain will be extreme. Fractures, cracks and breaks can take several different forms, but are generally caused by trauma, grinding and biting. If a tooth has been fractured or cracked, there is no alternative but to see the dentist as quickly as possible. Where a segment of tooth has been broken off, here are some steps that can be taken at home:
1- Call the dentist.
2- Rinse the tooth fragment and the mouth with lukewarm water.
3- Apply gauze to the area for ten minutes if there is bleeding.
4- Place a cold, damp dishtowel on the cheek to minimize swelling and pain.
5- Cover the affected area with over-the-counter dental cement if there is no way to see the dentist immediately.
6- Take a topical pain reliever.
Dislodged/loose teethWhen a tooth has been dislodged or loosened from its socket by trauma or decay, it might be possible to save it. If the tooth remains in the mouth and attached to the blood vessels and nerves, there is a good chance root canal therapy will not be necessary.
It is important to call the dentist immediately to make an appointment. In the meantime, use a cold compress and over-the-counter medications to relieve pain. The dentist will reposition the tooth and add splints to stabilize it. If the tooth fails to heal, root canal therapy may be required. If you have questions or concerns about dental emergencies, please contact your dentist.