Services

Professional dental cleanings (dental prophylaxis) are usually performed by Registered Dental Hygienists.  Your cleaning appointment will include a dental exam and the following:

• Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface.  Calculus forms above and below the gum line and can only be removed with special dental instruments.
• Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth.  It is a growing colony of living bacteria, food debris, and saliva.  The bacteria produce toxins (poisons) that inflame the gums.  This inflammation is the start of periodontal disease!
• Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.

Digital radiography (digital x-ray) is the latest technology used to take dental x-rays.  This technique uses an electronic imaging (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 since most decay occurs in the least accessible areas to vision or instruments.

Dental x-rays may reveal:

• Abscesses or cysts.
• Bone loss.
• Cancerous and non-cancerous tumors.
• Decay between the teeth.
• Developmental abnormalities.
• Poor tooth and root positions.
• Problems inside a tooth or below the gum line.

Detecting and treating dental problems at an early stage may save you time, money, unnecessary discomfort, and preserve your teeth longer.

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.

Fluoride is the most effective agent available to help prevent tooth decay.  It is a mineral that is naturally present in varying amounts in almost all foods and water supplies.  The benefits of fluoride have been well known for over 50 years and are supported by many health and professional organizations.

Fluoride works in two ways:

Topical fluoride strengthens the teeth once they have erupted by seeping into the outer surface of the tooth enamel, making the teeth more resistant to decay.  We gain topical fluoride by using fluoride containing dental products such as toothpaste, mouth rinses, and gels.  Dentists and dental hygienists generally recommend that children have a professional application of fluoride twice a year during dental check-ups.

Although most people receive fluoride from food and water, sometimes it is not enough to help prevent decay.  Your dentist or dental hygienist may recommend the use of home and/or professional fluoride treatments for the following reasons:

• Deep pits and fissures on the chewing surfaces of teeth.
• Exposed and sensitive root surfaces.
• Fair to poor oral hygiene habits.
• Frequent sugar and carbohydrate intake.
• Inadequate exposure to fluorides.
• Inadequate saliva flow due to medical conditions, medical treatments or medications.
• Recent history of dental decay.

Remember, fluoride alone will not prevent tooth decay!  It is important to brush at least twice a day, floss regularly, eat balanced meals, reduce sugary snacks, and visit your dentist on a regular basis.

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. In our office the tooth is checked for decay with a special stain before a sealant is applied.  when possible a “permanent” type filling material is utilized as a sealant in hopes that the sealant will last longer than traditional sealant material, which wears at a much faster rate.

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 will aid in the life of your new sealants.

Most tooth decay can be successfully treated with a filling, inlay, onlay or crown assuming that their is enough healthy tooth structure to support one of these options. When there is not enough healthy tooth remaining, extraction may be the best, or only, choice for relieving pain and preventing the spread of infection.

Although permanent teeth hopefully will last a lifetime, extractions can be necessary due to the following.

A CROWDED MOUTH

• Making room for incoming teeth or prior to an orthodontic realignment when teeth are too large. Wisdom teeth or third molars are often removed to prevent crowding and discomfort and risk of lost second molars.

INFECTION

• When Root Canal Therapy and Antibiotics can’t halt an infection or when a patient has a compromised immune system.

SEVERE DECAY

• When there is no longer enough healthy tooth surface to support a crown, inlay or onlay.

PERIODONTAL DISEASE

• Loosening due to the recession of gum and bone tissue holding the tooth in place.

TRAUMA

• An impact to the mouth can break teeth above and below the gumline. When limited viable structure remains intact, tooth extraction and replacement becomes the best option.

DIAGNOSIS AND TREATMENT

To determine if an extraction is right option for you, we’ll need to conduct an exam, which typically includes taking x-rays. If the tooth cannot be saved, it’s important to extract it as soon as possible to prevent infection in the tooth and jawbone.

We will take every step to ensure your comfort during this brief procedure. In most cases, we recommend replacing an extracted tooth to preserve the jawbone and stabilize your bite. We’ll talk with you about replacement options at the time of your examination.

What is Dental Bonding?

Dental bonding is the application of a tooth-colored composite resin (plastic) to repair a decayed, chipped, fractured, discolored tooth, to make teeth appear longer, and as a cosmetic alternative to amalgam fillings. Bonding can be done in a single visit to your dentist.

When should Dental Bonding be considered?

• To repair decayed teeth (composite resins are used to fill cavities)
• To repair chipped or cracked teeth
• To improve the appearance of discolored teeth
• To close spaces between teeth
• To make teeth look longer
• To change the shape of teeth
•  As a cosmetic alternative to amalgam fillings
• To protect a portion of the tooth’s root that has been exposed when gums recede

Is Dental Bonding right for me?

Dental bonding isn’t for everyone. If your smile is crooked as the result of an over- or underbite, this treatment won’t serve to correct it. Instead, speak with your dentist to determine if more in-depth work is needed like adjusting your bite or any complex chips or gaps in your teeth. Bonding is primarily for those who seek a cosmetic solution for teeth that are otherwise healthy.

What can you expect during your visit?

Composite bonding is a safe and effective technique that was developed more than 50 years ago, and has been widely available for over three decades, according to the American Dental Association (ADA). The fillings and processes today are very efficient, making it easier for both you and your dentist.

The treatment itself often starts with the removal of some surface enamel, allowing the dentist to best shape the composite resin to your tooth, followed by the application of the bonding agent. Your dentist will then add the composite resin, cure it with a special light and finish by polishing your teeth. Because the process involves a high level of technique for a natural mold and shape, it’s best to work with a dentist who has experience and specialty in this area.

WHAT ARE THE ADVANTAGES AND DISADVANTAGES OF DENTAL BONDING?

Advantages:

• Dental bonding is among the easiest and least expensive of cosmetic dental procedures.
• Bonding can usually be done in one office visit unless several teeth are involved.
• Dental bonding involves the removal of less tooth enamel than veneers or crowns.

Disadvantages:

• While composite resin is somewhat stain resistant, it’s not as stain resistant as a crown or veneer.
• Composite resin may eventually chip or break off the tooth after three to ten years.

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, as much as possible.

It is normal to experience sensitivity to hot and cold when composite fillings are first placed, however this will subside shortly after your tooth acclimates to the new filling.

You will be given care instructions at the conclusion of your treatment.  Good oral hygiene practices, eating habits, and regular dental visits will aid in the life of your new fillings.

A crown is a covering that encases the entire tooth surface restoring it to its original shape and size.  A crown protects and strengthens tooth structure that cannot be restored with fillings or other types of restorations.

Although there are several types of crowns, porcelain (tooth colored crown) are the most popular, because they resemble your natural teeth.  They are highly durable and will last many years, but like most dental restorations, they may eventually need to be replaced.  Porcelain crowns are made to match the shape, size, and color or your teeth giving you a natural, long-lasting beautiful smile.

Reasons for crowns:

• Broken or fractured teeth.
• Cosmetic enhancement.
• Decayed teeth.
• Fractured fillings.
• Large fillings, which leave teeth at a high risk of fracture.
• 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.

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.  The teeth are prepared by 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

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.  Porcelain fixed bridges are most popular because they resemble your natural teeth.  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 can 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 your treatment.  Proper brushing, flossing and regular dental visits will aid in the life of your new permanent bridge.

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 (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 should 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.

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. This procedure varies depending on the location of the implant and how it is to be utilized.

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.

Tooth 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 tooth whitening system that can whiten teeth dramatically.  Since tooth 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.

Tooth whitening is not permanent.  Teeth will return to their natural color over time, therefore bleaching must be maintained for the best results. It will be required more frequent if there is a severe shade change, or if exposed to staining foods, such as wine, coffee, tea or smoking.

Reasons for tooth 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 tooth whitening involve?

This type of tooth 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.

Our office chooses home whitening over in-office bleaching for a few reason.
In office bleaching tends to produce more sensitivity and the patient must have home bleaching trays made anyway to maintain the whitening.
Trays also allow patient to control their results and provide the flexibility of bleaching only certain teeth, if only 1 or 2 teeth are discolored.

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.

Having a root canal done on a tooth is the treatment of choice to save a tooth that otherwise would 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 (removing) a tooth will ultimately be more costly and will likely cause significant problems for adjacent teeth.

Root canal treatment is highly successful and usually lasts a long time, 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).
•  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, most 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.

A crown is a covering that encases the entire visible tooth surface restoring it to its proper function.  A crown protects and strengthens tooth structure that cannot be restored with fillings or other types of restorations. A crown prevents the tooth from fracturing (splitting), which usually would result in the loss of the tooth, Generally, restoring the tooth with a crown will save you time, effort, and money when compared to the cost of replacing a lost tooth.

Although there are several types of crowns, porcelain (tooth colored crown) are the most popular.  They are highly durable and will last many years, but like most dental restorations, they may eventually need to be replaced.  Porcelain crowns are made to match the shape, size, and color or your teeth giving you a natural, long-lasting beautiful smile.

Reasons for crowns:

• Broken or fractured teeth.
• Cosmetic enhancement.
• Decayed teeth.
• Fractured fillings.
• Large fillings.
• Tooth has a root canal.

What does getting a crown involve?

A crown procedure usually requires two appointments.  Your first appointment will include taking several highly accurate molds (or impressions) that will be used to create your custom crown.  A mold will also be used to create a temporary crown which will stay on your tooth for approximately two weeks until your new crown is fabricated by a dental laboratory.

While the tooth is numb, the dentist will prepare the tooth by removing any decay and shaping the surface to properly fit the crown.  Once these details are accomplished, your temporary crown will be placed with temporary cement and your bite will be checked to ensure you are biting properly.

At your second appointment your temporary crown will be removed, the tooth will be cleaned, and your new crown will be carefully placed to ensure the spacing and bite are accurate.

You will be given care instructions and encouraged to have regular dental visits to check your new crown.

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. Dentures are probably the most challenging dental restoration for a patient to adapt too.

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 and tissue changes. The most common problem for denture wearers is the continual loss of bone from the lack of natural teeth, which results in instability of the dentures. A lower full denture is probably the least accepted dental prosthesis due to ill fit and difficulty to 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. Generally, further visits to adjust the dentures will be necessary.

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 will aid in the life of your new dentures.

Periodontal disease is diagnosed by your dentist or dental hygienist during a periodontal examination.  This type of exam should always be part of your regular dental check-up. It is important to know that even advanced periodontal disease many times does not present any pain or discomfort to the patient, and therefore they are unaware of the problem until becomes severe.

A periodontal probe (small dental instrument) is gently used to measure the sulcus (pocket or space) between the tooth and the gums.  The depth of a healthy sulcus measures three millimeters or less and does not bleed.  The periodontal probe helps indicate if pockets are deeper than three millimeters.  As periodontal disease progresses, the pockets usually get deeper. Because it is a progressive disease (gets worse over time) and the result is the detachment of the bone and tissues from the tooth root.

Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category below:

Gingivitis
Gingivitis is the first stage of periodontal disease.  Plaque and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed.

Periodontitis
Plaque hardens into calculus (tartar).  As calculus and plaque continue to build up, the gums begin to recede from the teeth.  Deeper pockets form between the gums and teeth and become filled with bacteria and pus.  The gums become very irritated, inflamed, and bleed easily.  Slight to moderate bone loss may be present.

Advanced Periodontitis
The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed.  Unless treated, the affected teeth will become very loose and may be lost.  Generalized moderate to severe bone loss may be present.

Periodontal treatment methods depend upon the type and severity of the disease.  Your dentist and dental hygienist will evaluate for periodontal disease and recommend the appropriate treatment.

Periodontal disease progresses as the sulcus (pocket or space) between the tooth and gums gets filled with bacteria, plaque, and tartar, causing irritation to the surrounding tissues.  When these irritants remain in the pocket space, they can cause damage to the gums and eventually, the bone that supports the teeth!

If the disease is caught in the early stages of gingivitis, and no damage has been done, one to two regular cleanings will be recommended.  You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings.

If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planing (deep cleaning) will be recommended.  It is usually done one quadrant of the mouth at a time while the area is numb.  In this procedure, tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planing).  This procedure helps gum tissue to heal and pockets to shrink.  Medications, special medicated mouth rinses, and an electric tooth brush may be recommended to help control infection and healing.

If the pockets do not heal after scaling and root planning, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean.  Your dentist may also recommend that you see a Periodontist (specialist of the gums and supporting bone).

It only takes twenty four hours for plaque that is not removed from your teeth to turn into calculus (tartar)!  Daily home cleaning helps control plaque and tartar formation, but those hard to reach areas will always need special attention.

Once your periodontal treatment has been completed, your dentist and dental hygienist will recommend that you have regular maintenance cleanings (periodontal cleanings), usually four times a year.  At these cleaning appointments, the pocket depths will be carefully checked to ensure that they are healthy.  Plaque and calculus that is difficult for you to remove on a daily basis will be removed from above and below the gum line.

In addition to your periodontal cleaning and evaluation, your appointment will usually include:

• 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.
• Examination of existing restorations: Check current fillings, crowns, etc.
• Examination of tooth decay: Check all tooth surfaces for decay.
• Oral cancer screening: Check the face, neck, lips, tongue, throat, cheek tissues, and gums for any signs of oral cancer.
• Oral hygiene recommendations: Review and recommend oral hygiene aids as needed. (Electric toothbrushes, special periodontal brushes, fluorides, rinses, etc.)
• Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.

Good oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control!

Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste (preferably a toothpaste with fluoride).

1. Place the brush at a 45 degree angle to the gums and gently brush using a small, circular motion, ensuring that you always feel the bristles on the gums.
2. Brush the outer, inner, and biting surfaces of each tooth.
3. Use the tip of the brush to clean the inside of the front teeth.
4. Brush your tongue to remove bacteria and freshen your breath.

Electric toothbrushes are also recommended.  They are easy to use and can remove plaque efficiently.  Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.

Daily flossing is the best way to clean between the teeth and under the gumline.  Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.

1. Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
2. Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
3. Curve the floss into a “C” shape around each tooth and under the gumline.  Gently move the floss up and down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush.  If you are using an over-the-counter product for rinsing, it’s a good idea to consult with your dentist or dental hygienist on its appropriateness for you.

Use other dental aids as recommended by your dentist or dental hygienist: Interdental brushes, rubber tip stimulators, tongue cleaners, irrigation devices, fluoride, medicated rinses, etc., can all play a role in good dental home care.