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Most dental patients come into the office twice a year for a teeth cleaning. However, some patients are told that they need to get a deep cleaning instead, and that they need to see us more often than twice a year. While a regular teeth cleaning is a routine procedure, it’s important to know that a deep cleaning is very different and is actually a treatment for an oral disease.
If you pay attention when you visit the dentist, you may hear our staff and hygienists referring to your appointment as “a prophy”. This is short for “prophylactic”, which is a word that comes from Greek and means “treatment to prevent a disease”. We call a teeth cleaning prophylactic because the purpose of a cleaning is to prevent disease or dental problems in a patient that has otherwise healthy teeth and gums.
A deep cleaning is often referred to as “soft tissue management” or “periodontal therapy”. That’s because a deep cleaning is actually a treatment for periodontal disease (or gum disease). Your dentist will recommend a deep cleaning if you are showing signs of developing gum disease or if you have already been diagnosed with gum disease.
A deep cleaning is not just an extra-thorough version of a prophy teeth cleaning. Regular teeth cleanings involve removing plaque and debris from the visible part of the teeth and polishing your teeth. A deep cleaning includes going below the gumline to remove disease-causing bacteria and cleaning the tooth roots so it is harder for bad bacteria to grow there.
If left untreated, gum disease eventually leads to tooth loss and other health problems associated with chronic oral disease. So if your dentist or hygienist tells you that you need a deep cleaning, it’s not like they’re offering you the “Deluxe Car Wash” versus the “Basic Car Wash”. What they’re telling you is that we need to create a treatment plan to manage the health of your gums so that we can keep your smile as happy and healthy as possible!
There is nothing as charming and precious as a child’s happy smile. Unfortunately, we find that some parents and caregivers think of baby teeth (also known as milk teeth) as disposable. Their logic seems to be, if kids are going to lose their teeth soon anyway, it’s okay for them to get a little tooth decay or other oral problems. There are many reasons that this is not true!
First and foremost, we don’t want to see kids who are in pain. Cavities often lead to toothaches and infections in the tooth can spread to the gums and jawbone, causing more problems. We want every child to get to know the dentist in a positive way, so we want their earliest memories of the dentist to be rewarding and educational teeth cleanings and exams, not filled with tears and fear. Taking good care of baby teeth is vital to making sure we show your child that the dentist‘s office is a fun and welcoming place! Plus, the fewer oral problems your child has, the less they’ll have to be pulled out of school for trips to the dentist.
Taking good care of baby teeth is good practice for children. They will need to know good oral hygiene habits to keep their adult teeth healthy for the rest of their lives. Making oral healthcare a respected part of your household routine is very important. And don’t forget to set a good example by taking good care of your own teeth too!
The baby teeth help prepare the mouth for the proper positions of adult teeth when they come in. But if the baby teeth aren’t cared for properly, they can’t do this very important job. For example, if a child has a baby tooth removed early due to tooth decay, the remaining baby teeth may crowd that area, leaving no gap for the adult tooth to move into when the time comes. The result can be crowded or misaligned adult teeth that are hard to clean and require more extensive orthodontic treatment (braces).
How you should care for your child’s teeth changes as they grow. Even babies need their gums cared for before they start teething! If you need tips on how to care for your child’s teeth and teach good habits at any stage, please let us know. We’d be happy to give you instructions!
As dental professionals, our ultimate goal is for every one of our patients to live their whole lives without losing their teeth. However, in the unfortunate situation that a patient is missing their teeth, dentures are a great solution to return a smile to beauty and function. Dentures have a long and legendary history, and modern technology has made today’s dentures even more natural-looking and customized than ever before.
The earliest examples of dentures appeared in the 7th Century B.C. The ancient Etruscans used a combination of gold wire and human and animal teeth to create these early dentures. By the 5th Century B.C., ancient Romans were creating similar dentures. Wooden dentures appeared in Japan in the early 1500s. These dentures were similar to modern dentures in that they were carefully carved to match the shape of a person’s mouth. The Japanese later made dentures from stone, ivory and animal horn in addition to wood.
The number of people who need dentures has grown pretty quickly over the last few hundred years. As access to sugar and tobacco increased, mostly because of large sugar cane and tobacco plantations in the Americas, tooth decay became more common and widespread. The more people ate sugar and smoked, the more their teeth fell out. It makes sense that modern dentistry started to be developed around the same time.
Affordable dentures are a recent thing. For most of the history of dentures, they were an item reserved for the upper classes. The materials and expertise required to make them made dentures very expensive.
Contrary to popular belief, the first U.S. President, George Washington, did not have dentures made of wood. His dentures were made from carved hippopotamus ivory, gold wire, and human teeth. In fact, most dentures in the 1700s and 1800s were made with other people’s teeth, which had either been collected from bodies on battlefields or even stolen from graves! Thankfully, early dentists started developing porcelain dentures, which eventually eliminated the need to take teeth from the dead or those down on their luck.
Today, dentures are made from a specialized form of acrylic (a kind of durable, hard plastic) that can be made to look just like natural teeth and gums. While most dentures are held in place by friction/suction or adhesives, there are now dentures that can be held in place by mini dental implants. These implant-supported dentures are more secure and can even help prevent tooth-loss-related bone loss. The invention of dental implants in the last century also means that many people who might have gotten dentures in the past are replacing their teeth entirely with permanent prosthetic teeth, complete with a titanium tooth root.
We hope this history of dentures has made you grateful for the advances in modern dentistry. We certainly are!
Despite what some people seem to think, a hygienist’s greatest desire is not to scold patients. A dental hygienist’s greatest desire is to see healthy mouths free of tooth decay and dental disease. As the professional at our practice that you see the most often, your dental hygienist is on the front lines of keeping your smile healthy, so you better make sure to stay on his or her good side!
Here are a few things you shouldn’t do if you want to stay on your dental hygienist’s nice list.
Rumors have been flying around about a study that says flossing doesn’t prevent gum disease, but flossing is still vitally important for your dental hygiene. Think flossing doesn’t matter? Tell that to your dental hygienist when she finds a popcorn kernel between your teeth from when you went to the movies three weeks ago! When debris is allowed to build up between teeth, it can become a breeding ground for bacteria that cause tooth decay. Relying on your hygienist to clean between your teeth every few months isn’t enough! You still have to floss daily if you want healthy teeth and gums.
We get it, it’s super strange to leave your mouth wide open for a long time. But please try to keep it open as wide as you can for as long as you can! Hygienists depend on being able to see inside your mouth in order to do their jobs thoroughly and spot problems like tooth decay, signs of bruxism, gum disease and more. If your hygienist keeps having to ask you to open your mouth, that’s a sign that you’re making things very difficult for him or her.
This one is more about common courtesy than your dental health, though we’re all for extra brushing. If you brush in the morning and before bed, you might not bother to brush your teeth right before your dental appointment. But we guarantee that making the extra effort to brush your teeth right before your professional teeth cleaning goes a long way with your hygienist. Also, if you know you have a dental appointment that day, avoid stinky foods like onion and garlic that may linger on your breath hours later, even after brushing! It’s just the polite thing to do.
This may be the most important thing to avoid. The hygienist is a trained dental professional who, along with the dentist, is part of a team dedicated to keeping your healthy and treating problems in the most conservative and gentle way possible. Much of the time, the hygienist is the first person to spot signs of trouble, such as tooth decay that needs repair or bleeding gums that are a sign of gingivitis or gum disease. If your hygienist says you need to come in for cleanings more frequently than twice a year and that you need to cut back on sugary drinks, this is his or her way of reducing your risks for dental problems and disease. Following your dental hygienist’s recommendations could eventually make the difference between losing or keeping all your teeth!
As dental professionals, most of what we do is about relieving and preventing pain. However, sometimes post-procedure pain is an unfortunate but unavoidable step on the road to a healthy and functional smile. If you end up needing a dental procedure, we will give you specific recommendations for how to relieve any pain as part of your post-treatment instructions. In the meantime, here is an overview of pain relievers in relation to your dental health care.
Over-the-counter (OTC) pain relievers are medications that don’t require a prescription from a doctor to buy. One category of these is called non-steroidal anti-inflammatories, or NSAIDs. These medications relieve pain and reduce inflammation at the same time, which can help improve the condition that is causing the pain. Examples include ibuprofen (Advil or Motrin), naproxen (Aleve) or aspirin. Another common over-the-counter pain reliever is acetaminophen, known by the brand name Tylenol. Each of these pain relievers differs slightly, so your dentist will likely recommend the type that is best for your situation. You can buy these medications right off the shelf at drugstores and many grocery and convenience stores.
As you might expect, pain relievers that require a prescription from a doctor are stronger and may be used to treat more intense post-operative pain. Some prescription pain relievers are just stronger doses of OTC medications, such as ibuprofen or naproxen. Other prescription pain relievers are opioids, such as hydrocodone and oxycodone (a.k.a. OxyContin). Opioids come with a risk of addiction because they are narcotics, so they must be taken according to instructions and with great care. If you have a history of substance abuse, you should talk to your dental surgeon or doctor about whether you should take opioids for your dental pain.
If you’ve been under the care of an oral surgeon for wisdom teeth removal, tooth extractions, or another procedure, you know that sometimes the oral surgeon will prescribe post-operative pain management medications beforehand. Most of the time, these prescription pain relievers are offered “just in case”. Depending on the procedure, some patients will not experience a level of pain that cannot be alleviated with over-the-counter medications. For your comfort, the oral surgeon will provide prescription painkillers in the event that over-the-counter medications are not effective.
Simpler procedures may also have residual pain that can be handled with over-the-counter pain relievers. For example, pain from swelling after treatments that involve the manipulation of gum tissue can usually be handled by over-the-counter medications like ibuprofen.
If you have concerns about dental pain or which medications are right for you, be sure to discuss this with the dentist. We are happy to provide post-procedure pain management recommendations, no matter which treatment we’ve done on your smile.
Like an orthodontist or a periodontist, a prosthodontist is a type of dentist who has received specialized training in a particular type of dentistry. After completing their education in general dentistry, a prosthodontist continues to train for three additional years in the repair or replacement of teeth and jaw structure restorations. Specially trained prosthodontists even work with head and neck deformities.
Prosthodontics is the dental specialty of dental prosthetics or prosthetic dentistry. In Greek, “prostho” means “replacement” or “addition,” and “dont” means “tooth.” So prosthodontists are specially trained in repairing your smile where teeth are damaged or missing.
You might visit a prosthodontist if you want to improve the esthetics of your smile. Prosthodontists can repair your smile with many different dental prosthetics, including, but not limited to:
Bridges are dental appliances that replace missing teeth and create a “bridge” between teeth. A prosthetic tooth, called a “pontic,” is attached to an existing tooth to fill a gap in your smile.
Crowns cover and support a tooth to protect the tooth from breaking or to restore an already broken tooth. They can also cover a discolored tooth and are a great way to make your teeth stronger and improve their appearance.
Dentures are a set of removable teeth that replace missing teeth. They can improve your smile and your overall dental health by making it easier to chew and eat and by preventing facial sagging.
Dental implants are prosthetic replacements for natural teeth. They are anchored in the jawbone and permanently secured in your mouth, and they look and act like natural teeth.
Inlays and onlays replace old fillings. An inlay is like a regular filling and fits inside of the cavity of the tooth. An onlay also fits inside the cavity, but it covers the tooth cusp as well.
Veneers are thin prosthetics that are placed over a tooth to improve its appearance or strengthen it.
Prosthodontists also work on TMJ/TMD problems in the jaw joint.
General dentists can do some of the treatments that prosthodontists do, but prosthodontists specialize in these tooth restoration procedures. They even regularly lead teams of dentists to solve your dental problems and focus on the diagnosis, treatment planning, rehabilitation and maintenance of your oral health, appearance and comfort.
Like every other part of our bodies, our mouths change as we age. As the carefree days of youth fade you may be faced with new challenges when it comes to your oral health, or you may start to pay for bad habits from your younger days. And even if you’ve taken good care of your teeth & treated problems as they arise, some old solutions may age as well and need to be repaired or replaced.
Perhaps the most notable change as we age is the color of our teeth. Over time, the hard outer layer of your teeth called enamel, gets thinner. Because enamel is semi-transparent, this makes it so the dentin underneath shows through, which makes teeth appear duller and yellow. A lifetime of teeth staining habits, such as smoking tobacco or drinking red wine, coffee or tea can also eventually lead to discolored teeth. A dentist may be able to help whiten your teeth with a professional teeth whitening treatment. Discuss your goals for brightening your teeth with your dentist so that we can recommend the best option based on your overall oral health.
While fillings are one of the most common procedures that dentists perform and patients receive, fillings don’t last forever. Over time tooth fillings can get worn down and no longer be properly seated on your tooth. This can lead to tooth decay as bacteria and other debris get in between the filling and your tooth. One of the first signs of a filling that’s gone bad is tooth sensitivity to hot or cold. If you experience any new or strange sensations with your fillings, tell the dentist so we can examine your fillings.
Chronic dry mouth is more common in seniors, especially those undergoing cancer treatments that use radiation. Hundreds of medications also have dry mouth as a side effect. Saliva naturally helps flush away food particles that can become food for tooth decay-causing bacteria and also helps reduce acids that can cause decay. If you mouth isn’t producing enough saliva, you are at a much higher risk for both tooth decay and bad breath. Don’t hesitate to talk to your dentist about your medications and your symptoms so you can find a solution before your dry mouth has a negative impact on your oral health.
In most cases, dentures are an affordable and natural-looking solution to missing teeth. However, many denture wearers will notice that while they have a perfect fit when they first get their false teeth, over time the dentures can start to feel loose or uncomfortable. This is due to bone loss in the jaw under your dentures, which causes the ridge under your gums to change shape. Most of the time, re-lining dentures can fix this problem. However, sometimes dentures need to be replaced. A permanent solution to this problem would be dental implants, either to support dentures or to support individual crowns. Dental implants can prevent the bone loss that makes dentures fit poorly and restore your mouth to its natural appearance and function. If you are having trouble with your dentures, bring this up to your dentist as soon as possible. We don’t want you to live in discomfort!
As dental care professionals, our ultimate goal is to ensure as many of our patients as possible keep all their teeth for a lifetime. We know that disease and accidents sometimes makes this impossible, but we want our senior patients to have beautiful and functional smiles even if they’ve lost teeth. The most common cause of tooth loss is gum disease or periodontitis, which weakens teeth, gums and the jawbone. Lack of teeth can affect your quality of life in many ways, including difficulty speaking clearly, trouble chewing and eating, and a reluctance to smile or show your teeth in social situations. All of these are problems that can be alleviated with the appropriate preventive and restorative care. If your missing teeth are affecting your quality of life, talk to the dentist about whether bridges, implants, or dentures can help.
Perhaps the earliest example of dental implants were seashells found in the jaw of an ancient Mayan skeleton from 1,300 years ago. While the Mayans were known for their surprisingly advanced dental knowledge, their seashell solution is a long way from today’s modern dental implants. And like many amazing, world-changing inventions, dental implants discovered practically by mistake.
It all started in Sweden in 1952. An orthopedic surgeon named Dr. Per-Ingvar Branemark conducted an experiment studying bone healing and blood flow that involved placing titanium rods in the legs of rabbits. At the end of his months-long experiment, he went to remove the rods from the rabbits’ legs and discovered they were totally fixed in place. The bone had fused to the titanium and grown around it.
This was remarkable because the human body (and the rabbit body for that matter) usually doesn’t like foreign objects being placed inside it. The body views the object as a threat and rejects it. Just think about how irritated and painful your skin becomes when you get a splinter.
Following his discovery, Dr. Branemark coined the term “osseointegration” to describe the process of bone adhering to metal. (“Osseo” comes from the Latin word for bone.) Using titanium as anchors for replacement teeth was on of the first applications that Dr. Branemark thought of for his discovery. He placed the first implants in a dental patient in the mid-1960s, however, it wasn’t until the 1980s that the use of titanium implants became accepted by the rest of the medical and dental community.
Since then, the technology has continued to advance as scientists and dentists strive create better versions of dental implants. Improvements have been made to the materials, shapes and installation techniques of dental implants, leading to shorter healing times and making the procedure available to a wider range of patients.
The difference between traditional techniques of tooth replacement and dental implants is like the difference between a peg leg and a high-tech bionic prosthetic leg. The development of dental implants allowed dentists, for the first time, to truly replace a tooth. Because implants have a root and a crown structure just like a real tooth, they function just like a real tooth and can last for decades, unlike bridges and dentures which often need to be adjusted and replaced.
While many patients have only heard of the dental implants procedure within the last few years, the truth is that the concept of dental implants has been around for centuries, and modern dental implants have been around for over 60 years. The success of implants in restoring missing teeth to patients’ mouths truly makes it feel like we’re in a golden age of dentistry. Dentists the world over are grateful to have this amazing technology at their disposal to restore patients’ smiles.
A periodontist is a fully trained dentist who specializes in treating periodontal disease (advanced gum disease) and the placement of dental implants. To put it more simply, you can think of a periodontist as a dentist who specializes in caring for your gums.
After completing dental school and earning their dental degree, a dentist must complete an additional three years of specialized training in order to become a periodontist. During this training the dentist becomes an expert in the gums and their underlying bone structures, the placement of dental implants and both the surgical and non-surgical treatments for gum disease.
The conditions that periodontists most commonly treat are gingivitis, periodontal disease (gum disease) and tooth loss. These conditions can also be thought of as a progression. Left unattended, gingivitis develops into periodontal disease, which can lead to tooth loss. The role of the periodontist is to intervene at whichever stage the patient is at and try to create the best possible outcome for their oral health.
The treatment that periodontists may be best known for is a deep cleaning, also called a scaling and root planing. This is a procedure specific to the treatment of periodontitis which involves removing debris and infection-causing bacteria from the pockets that develop between inflamed gums and the teeth. Repeated deep cleanings are essential to keeping periodontal disease from advancing to the point of tooth loss.
A periodontist’s specific knowledge of the gums and jawbone structures makes them the ideal specialists for replacing teeth with dental implants. Dental implants are artificial tooth roots that are inserted into the bone and gums. Periodontists also perform related procedures, such as bone grafting. In a patient with bone loss due to missing teeth or periodontal disease, bone grafting can be used to reinforce or “grow” more bone so that a dental implant can be placed securely.
Periodontists also perform some cosmetic treatments that involve the soft tissues of the mouth. Gum re-contouring can fix gums that have receded due to gum disease, giving the smile a healthier look. Crown lengthening can expose more of the hard tooth structure, giving teeth a longer appearance or fixing a “gummy” smile.
While all dentists are trained to care for your gums, periodontists offer care for advanced or complex cases, including those where additional health complications may be involved. That’s why it’s very important to see your periodontist regularly if your general dentist has referred you to one. The periodontist and your dentists will work together to ensure you are getting all the treatment you need to keep your smile as healthy and functional as possible.
The answer: Bone loss.
A common legend says that an astronaut who returned to Earth after an extended stay on a space station had bones so weak that he broke his arm lifting a tea cup. While this story may be an exaggeration, astronauts do lose bone density at a about ten times the rate of osteoporosis when in space (source) due to the absence of gravity.
What does gravity have to do with your bones? All the bones in your body get built up or broken down (resorbed) based on the amount of stress they’re under. For most of the bones in your body, their major stressor is gravity. However, for the bones of your jaw, their stress comes from biting and chewing. But when someone loses their teeth, this stress goes away, which can lead to jawbone being resorbed by the body.
While dentures are an aesthetic and functional replacement for teeth, they apply biting and chewing pressure to your gums, instead of directly to your jawbone like a natural tooth does. Because the roots of natural teeth are embedded in your bone, so when you bite or chew something, that force is transferred through your tooth into the bone of your jaw.
This bone loss explains why you can get a new set of dentures that fit perfectly right after they’ve been manufactured, but as time goes on, they fit more and more poorly, until they are loose and uncomfortable. The dentures themselves have not changed, but the shape of the bone under your gums has.
For this reason, many believe there is no such thing as truly affordable dentures. Even the best, highest quality dentures will eventually need to be replaced due to the biological reality of bone resorption. However, it’s important to note that bone loss in your jaw will happen even more rapidly if you don’t replace your teeth with anything at all. If you’re missing teeth, dentures can help you speak, eat and look normally again. Any dentures that allow you to get some of the normal function of your mouth back are affordable dentures!
For a permanent solution to bone loss after tooth loss, dental implants are the best option. That’s because implants act as an artificial tooth root that transfers biting and chewing force directly into your jawbone, just like a natural tooth. Because your bone is still under stress from the implant, it won’t be resorbed by your body. While dental implants are more of a financial investment at first, they’ll never have to be replaced like dentures, so you only have to pay for them once. Plus, they can be maintained just like real teeth, with daily brushing, flossing and semi-annual visits to the dental hygienist.
Dental implants have allowed for the invention of a new type of denture: the implant-supported denture. This type combines the affordability of dentures with the bone-stimulating qualities of implants to create a tooth replacement solution that is much more stable than traditional dentures that are held on with adhesives. This makes implant-supported dentures the most affordable dentures there are, both in terms of your wallet and your oral health!
