Teething
Normally the first tooth erupts between ages 6 to 12 months. Gums are sore, tender and sometimes irritable until the age of 3. Rubbing sore gums gently with a clean finger, the back of a cold spoon or a cold, wet cloth helps soothe the gums. Teething rings work well, but avoid teething biscuits—they contain sugar that is not good for baby teeth.

While your baby is teething, it is important to monitor the teeth for signs of baby bottle decay. Examine the teeth, especially on the inside or the tongue side, every two weeks for dull spots (whiter than the tooth surface) or lines. A bottle containing anything other than water and left in an infant’s mouth while sleeping can cause decay. This happens because sugar in the liquid mixes with bacteria in dental plaque, forming acids that attack the tooth enamel. Each time a child drinks liquids containing sugar, acids attack the teeth for about 20 minutes. When awake, saliva carries away the liquid. During sleep, the saliva flow significantly decreases and liquids pool around the child’s teeth for long periods, covering the teeth in acids.

Infant’s New Teeth
The primary, or “baby,” teeth play a crucial role in dental development. Without them, a child cannot chew food properly and has difficulty speaking clearly. Primary teeth are vital to development of the jaws and for guiding the permanent (secondary) teeth into place when they replace the primary teeth around age 6.

Since primary teeth guide the permanent teeth into place, infants with missing primary teeth or infants who prematurely lose primary teeth may require a space maintainer, a device used to hold the natural space open. Without a maintainer, the teeth can tilt toward the empty space and cause permanent teeth to come in crooked. Missing teeth should always be mentioned to your family dentist. The way your child cares for his/her primary teeth plays a critical role in how he/she treats the permanent teeth. Children and adults are equally susceptible to plaque and gum problems—hence, the need for regular care and dental checkups.

A Child’s First Dental Visit
A child’s first dental visit should be scheduled around his/her first birthday. The most important part of the visit is getting to know and becoming comfortable with a doctor and his staff. A pleasant, comfortable first visit builds trust and helps put the child at ease during future dental visits. If possible, allow the child to sit in a parent’s lap in the exam room. Children should be encouraged to discuss any fears or anxiety they feel.

Why Primary Teeth Are Important
Primary teeth are important for several reasons. Foremost, good teeth allow a child to eat and maintain good nutrition. Healthy teeth allow for clear pronunciation and speech habits. The self-image that healthy teeth give a child is immeasurable. Primary teeth also guide eruption of the permanent teeth.

Good Diet and Healthy Teeth
The teeth, bones and soft tissue of the mouth require a healthy, well-balanced diet. A variety of foods from the five food groups helps minimize (and avoid) cavities and other dental problems. Most snacks that children eat cause cavities, so children should only receive healthy foods like vegetables, low-fat yogurt and cheeses, which promote strong teeth.

Infant Tooth Eruption
A child’s teeth actually start forming before birth. As early as 4 months of age, the primary or “baby” teeth push through the gums—the lower central incisors are first, then the upper central incisors. The remainder of the 20 primary teeth typically erupt by age 3, but the place and order varies.

Permanent teeth begin eruption around age 6, starting with the first molars and lower central incisors. This process continues until around age 21. Adults have 28 secondary (permanent) teeth—32 including the third molars (wisdom teeth).

Preventing Baby Bottle Tooth Decay
Tooth decay in infants can be minimized or totally prevented by not allowing sleeping infants to breast or bottle-feed. Infants that need a bottle to comfortably fall asleep should be given a water-filled bottle or a pacifier. Our office is dedicated to fighting baby bottle tooth decay. Let us know if you notice any signs of decay or anything unusual in your child’s mouth.

The “Temporomandibular Joint,” more commonly referred to as the “jaw joint,” assists in the basic opening and closing movements of the jaw. Unfortunately, this joint is a common area for recurring pain. Although conventional wisdom suggests that “popping” sounds in the jaw indicates a TMJ dysfunction, this is not always true. Many times, your jaw is functioning properly even if a “popping” sound is present when chewing or talking.

We offer a TMJ exam that evaluates the joint tissue in the “hinge” of the jaw. Possible problems include swelling, deterioration of the joint tissue or damaged joint tissue (which cushions the jaw bones during the opening and closing movement of the mouth). Common pain relievers and cold compresses can provide temporary relief for most cases of TMJ.

For more serious cases of TMJ, we will recommend alternate treatments. Often, we will suggest using a mouth guard to relieve teeth grinding. In some cases, we will instruct you to use orthodontic appliances or retainers to alleviate discomfort or redirect positioning of the TMJ joint. For the most severe cases of TMJ, we may recommend certain invasive procedures.

Snoring affects millions of people of all ages, both male and female. Oral appliance therapy is the most common treatment for the most severe snoring problems. Treatment procedures range from changing your sleep patterns to utilizing orthodontic-related appliances that help open the airways during sleep.

What causes snoring?
Snoring is caused by the vibrations of your soft and/or hard tissue palates; these vibrations occur because of increasingly narrow air passages. When air passes through these passages, a “flapping” sound occurs because the tissue is soft in nature. Surgery (to alleviate the snoring) is not always successful, however, because the sound may not originate from the soft palate; the snoring sometimes originates from tissues in the upper airway.

• Common causes for snoring:
• Smoking
• Alcohol
• Health Problems
• Obesity
• Obstructed Nasal Passages - Deviated Septum
• Poor Muscle Tone of the Tongue
• Daytime Fatigue
• Sleep Apnea
• Hypothyroidism
• Allergies
• Sleep Apnea

Loud snorers may have a more serious case of blocked air passages, known as obstructive sleep apnea syndrome (OSAS). In these cases, the blockage of air is so great that no air can get through, causing repeated awakenings throughout the night. Obstructive sleep apnea can contribute or lead to many other conditions, such as high blood pressure, stroke, heart attack and depression, so it is important to be diagnosed by a medical professional if you experience any sleep-related symptoms.

An endodontist is a specialist in the area of soft tissue inside the tooth. Endodontists, who perform root canals, receive advanced education after graduating from dental school and typically only deal with endodontic-related problems.

A common misconception is that a root canal is an uncomfortable procedure. Actually, root canals are similar to having a cavity filled, producing minimal discomfort.

Common causes for the need of endodontic treatment:

• Inflamed/infected tooth pulp
• Severe sensitivity to hot and cold elements
• Tooth decay
• Chipped or broken tooth
• Blow to the tooth
• Swelling or tenderness near the infected tooth
• Repeated dental procedures on a tooth

Please contact our office for an evaluation if you experience any of the symptoms above.

A root canal is a procedure that extracts decayed pulp from the central part of the tooth, reshapes the canal and replaces it with strengthening filler.

A cavity is the result of superficial decay of the enamel of the tooth. Left long enough, this decay can burrow into the deeper reaches of the tooth, causing extensive damage to tooth structure. When the damage goes beyond what can be treated with a filling, dentists can perform a root canal (or endodontics), preserving the tooth and retaining its original integrity; thereby, saving a tooth that in the past would have to have been pulled.

Procedure:

• The patient undergoes anesthesia.
• A dental dam is used to isolate the tooth.
• The tooth is opened to allow for removal of infected or dead dental pulp.
• The tooth is comprehensively cleaned, including any cracks and canals.
• With special tools, the doctor reshapes the canals.
• The tooth is filled again with cutting edge biocompatible filling material.
• A temporary covering is used to cover the access opening.
• Patients MUST see their regular dentist quickly for a permanent restoration of the tooth.

Veneers are thin, semi-translucent “shells” typically attached to your front teeth. Veneers are customized from porcelain material and permanently bonded to your teeth. Veneers are a great alternative to otherwise painful dental procedures to improve the appearance of your smile.

Common problems that veneers are used for:

• Spaces between the teeth
• Broken or chipped teeth
• Unsightly, stained or discolored teeth
• Permanently stained or discolored teeth
• Crooked or misshapen teeth

Veneers are a great aesthetic solution to your smile that may even help you avoid orthodontic treatment. Subtle changes to your smile can be achieved with veneers, and in most cases, veneer application is completed in only two office visits.

Please contact our office if you have any further questions on veneers.

Bonding is a common solution for:

• Fixing or repairing chipped or cracked teeth
• Reducing unsightly gaps or spaces between teeth
• Hiding discoloration or faded areas on the tooth’s surface

Often used to improve the appearance of your teeth and enhance your smile. As the name indicates, composite material, either a plastic or resin, is bonded to an existing tooth. Unlike veneers or crowns, composite bonding removes little, if any, of the original tooth.

Composite bonding has many advantages:

• It is a quick process, which typically lasts less than one hour.
• It does not reduce the tooth’s original structure and is relatively inexpensive.
• Composite resins come in many different shades and provide better matching of shades to the natural color of your teeth.
• Composite bonds, however, are not as durable and long-lasting as veneers and crowns and may need to be re-touched or replaced in the future.

Composite bonds stain more easily and therefore require proper care and regular cleaning. In order to ensure the longest possible duration of the bonding, composites should be brushed and flossed daily. Common staining elements include coffee, tea, tobacco, foods and candy.

We now have Lumineers™ by Cerinate available in our office! Lumineers™ can make everyone’s smile more beautiful without the painful removal of tooth structure. Lumineers™ are a painless, permanent cosmetic solution for stained, chipped, discolored or misaligned teeth. Lumineers™ are porcelain veneers that can be made as thin as a contact lens and are placed over existing teeth without drilling or requiring removal of painful tooth structure, in most cases (unlike traditional veneers). And in most cases, no anesthesia shots are needed!

Many patients with minor orthodontic problems happily correct their smile with Lumineers™. These special porcelain veneers are also notorious for their longevity. They are clinically proven to last up to 20 years and even include a 5-year warranty! They are also quite different from traditional veneers as the procedure can be reversed since the tooth structure is still intact after placement.

Lumineers™ are almost as natural as your real teeth. You should continue visiting your dentist regularly for cleanings and checkups and also continue a good oral hygiene regimen. You can continue eating and drinking everything you normally did before the procedure!

Each patient’s case is different; therefore, fees often vary. Your dentist will determine the cost for your treatment plan after a thorough examination. Contact us for more information on Lumineers™ and how they can improve your smile!

Periodontal simply means “the tissue around the teeth.” Periodontists specialize in the treatment and surgery of this area, which is often characterized by gum disease. Plaque is the most common element causing gum disease.

Unfortunately, periodontal-related problems are often discovered after they have persisted for an extended period of time. Proper oral hygiene, daily dental care and regular dental checkups will minimize the risk of gum disease. Gum disease ranges from mild (gingivitis) to moderate (periodintitis) to the severe (periodontitis). Treatments are available for every case of gum disease.

Common problems associated with gum disease:

• “Long” teeth (receding gum lines expose the root portions of your teeth)
• Discolored or deteriorating tooth structure
• Gum depressions (holes in between the teeth in the gum tissue)
• Infected gum line (discoloration or inflammation of the gum tissue)
• Tooth loss or tooth movement

The effects of gum disease can be damaging to your dental health. However, through proper preventive care and oral hygiene, you can avoid problems associated with gum disease.

Please contact our office for a periodontal evaluation.

Crowns
A crown is a permanent covering that fits over an original tooth that is either decayed, damaged or cracked. Crowns are made of a variety of different materials such as porcelain, gold, acrylic resin or a mix of these materials. Porcelain generally has the most natural appearance, although it is often less durable.

The treatment plan for a patient receiving a crown involves:

1. Numbing the tooth to remove the decay in or around it.
2. Re-sculpturing the tooth to provide an ideal fit for the crown.
3. Making an impression of your teeth in order to create a custom-made crown (usually takes one to two weeks).
4. Making a temporary crown out of acrylic resin and fitting it onto the tooth during the interim period when the permanent custom-made crown is being created.
5. Applying the permanent crown (when received from the lab) by removing the temporary crown and fitting the permanent one onto the tooth.
6. After ensuring that the crown has the proper look and fit, the dentist cements it into place.

This process generally consists of a minimum of 2-3 visits over a three to four week period. Once the procedure is completed, proper dental hygiene, including daily brushing and flossing, is required to maintain healthy, bacteria-free teeth, gums and crowns. This helps in the prevention of gum disease. Given proper care, your crowns can last a lifetime.

Bridges
A bridge is a dental device that fills a space that a tooth previously occupied. A bridge may be necessary to prevent:

• Shifting of the teeth that can lead to bite problems (occlusion) and/or jaw problems and resultant periodontal disease.
• Bridges safeguard the integrity of existing teeth and help maintain a healthy, vibrant smile.

There are three main types of bridges, namely:

• Fixed bridge- this is the most popular and consists of a filler tooth that is attached to two crowns, which fit over the existing teeth and hold the bridge in place.
• The “Maryland” bridge is commonly used to replace missing front teeth and consists of a filler that is attached to metal bands that are bonded to the abutment teeth. The metal bands consist of a white-colored composite resin that matches existing tooth color.

The Cantilever bridge is often used when there are teeth on only one side of the span. A typical three-unit cantilever bridge consists of two crowned teeth positioned next to each other on the same side of the missing tooth space. The filler tooth is then connected to the two crowned teeth, which extend into the missing tooth space or end.

Inlays and onlays are indirect restorations. They are a great alternative to traditional metal fillings, primarily because less of the tooth structure needs to be removed. Inlays and onlays are suitable for treating mild to moderate decay, and can be used to restore a cracked or fractured tooth if the damage is not extensive enough to require a crown.

Generally, inlays are small restorations that fit within the contours of the biting surface of a tooth, while onlays cover a portion or the entire chewing surface.

Inlays and onlays can be made from porcelain, gold or composite resin. Once fabricated, they are securely bonded to the tooth.

Advantages of inlays and onlays:

• Since they can be fabricated from tooth-colored materials, inlays and onlays are aesthetically pleasing. Unlike traditional metal fillings, the restoration is virtually invisible.
• Less removal of the tooth structure is required to achieve optimal results.
• They do not cause excessive wear and tear to opposing tooth structures.
• Inlays and onlays prevent the need for more significant treatment in the future.

The process for placing inlays and onlays generally requires two or more office visits. Initially, once the decay is removed, your prosthodontist will take an impression of the tooth. A temporary restoration is placed until the custom made inlay/onlay is manufactured in a laboratory.

Following a proper oral hygiene regimen daily, ensures the success and longevity of your new restoration.

Dental implants are artificial tooth replacements that were first developed half a century ago by a Swedish scientist named Per-Ingvar Branemark. Implants arose from the patient’s need to secure loose-fitting dentures. Since the advent of the implant, engineering and enhancements to the implant have enabled dentists to expand the implant’s usefulness, including the replacement of missing or lost teeth. Today, implant techniques provide a wide range of tooth replacement solutions including:

• Single Tooth Replacement
• Anterior Replacement
• Posterior Replacement
• Full Upper Replacement

Types of Implants
There are three main types of implants:

• The root implant
• The plate form implant
• The subperiosteal implant

The root implant—by far, the most popular—is the most effective because it mirrors the size and shape of a patient’s natural tooth. This implant is often as strong as the patient’s original tooth. The implant or artificial root is placed into the jawbone under local anesthesia, then allowed to heal and integrate with the bone. Once the healing process is completed and the jawbone is attached to the implant, the patient returns to the dental office where the implant is fitted with the new tooth. This process generally takes anywhere from three to eight months.

The plate form implant is ideal in situations where the jawbone is not wide enough to properly support a root implant. The plate form implant is long and thin, unlike the root implant, and anchors into thin jawbones. It is inserted the same way as a root implant. In certain cases, the plate form implant is immediately fitted with the restoration without waiting for the healing process to run its course.

The subperiosteal implant is used when the jawbone has receded to the point where it can no longer support a permanent implant.

Implant As a Treatment Option
If the missing tooth space has no surrounding teeth, the dentist may decide an implant is the most appropriate treatment choice or option.

The treatment plan for a bridge usually requires two trips to your dentist. Specifically, it involves:

• Numbing the surrounding teeth with a local anesthetic and cleaning plaque or decay.
• Reducing the teeth so that the crowns can be fitted.
• Making a mold or impression of the teeth in order to create a customized permanent impression (this generally takes 1-2 weeks).
• Fitting the patient with a temporary bridge until the permanent bridge is ready for placement.
• Removing the temporary bridge and replacing it with the permanent one.
• Adjusting the bridge for the proper bite and fit and permanently bonding it into the mouth.

Post Implant Care
Although proper oral hygiene is always recommended for maintaining good dental health, it is especially important when a patient has received a dental implant. Bacteria can attack sensitive areas in the mouth when teeth and gums are not properly cleaned, thus causing gums to swell and jaw bones to gradually recede. Recession of the jawbone will weaken implants and eventually make it necessary for the implant to be removed. Patients are advised to visit their dentists at least twice a year to ensure the health of their teeth and implants. Dental implants can last for decades when given proper care.

Invisalign® is the clear way to straighten teeth without braces, using aligners. Aligners are removable and virtually invisible, which means you can straighten your teeth without anyone knowing; and you can still eat and drink what you want. Also, you can brush and floss normally to maintain healthy gums and teeth; and there are no wires, metal or brackets to cause mouth abrasions.

Many of our patients had never considered traditional braces but are now happily and comfortably improving their smiles with Invisalign®.

WHAT IS INVISALIGN®?

• Invisible way to straighten your teeth without braces.
• Series of clear, removable, custom-made Aligners.
• Uses no metal wires or brackets.
• Custom-made for comfort.

HOW DOES INVISALIGN® WORK?

• Wear each set of Aligners for about two weeks.
• Remove only to eat, drink, brush and floss.
• Your teeth will move gradually each week.
• Visit us every 8-10 weeks.
• Total treatment time averages 6-15 months.
• Average number of Aligners is between 18 and 30.

Periodontal disease, injury and tooth decay can all cause a loss of your natural teeth. However, we can bring back the smile on your face with dentures to restore your missing teeth. With improved technology and updated materials, dentists can now make them appear more natural and more comfortable for the patient.

There are two types of dentures: complete and partial. Complete dentures cover the patient’s entire jaw while partial dentures, with their metal framework, replace multiple missing teeth. Ask our doctors to see which type would be right for you.

It may take some time to adjust to your dentures. Speaking and eating may feel different at first, but these regular activities will resume normally once you are accustomed to your dentures.

Your teeth will darken over time. Changes in the color of your teeth can be caused by such factors as the food and beverages consumed (like coffee, tea and soda). Other known factors for discoloration may include childhood medications or illnesses, tobacco use or improper oral hygiene. Restoring your natural white smile is a priority for our dental whitening team. We can provide a variety of options for whitening your smile.

Tooth whitening services are growing in popularity, and it’s one of the most requested services offered by our practice. Everyone sees the growing consumer market focused on whiter teeth. The reality is that over-the-counter, “too good to be true” solutions typically don’t work.

We are trained professionals using industry-approved methods. Our goal is to meet the needs of every patient, and every patient’s needs are different. One of the methods used by our practice is a gentle hydrogen-peroxide gel-activated solution. Our process will whiten your entire smile in one visit. Call us today for a whitening evaluation.

Nothing improves your appearance more than a Bright, White SMILE!

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BriteSmile
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The grooves and depressions that form the chewing surfaces of the back teeth are extremely difficult (if not impossible) to clean of bacteria and food. As the bacteria reacts with the food, acids form and break down the tooth enamel, causing cavities. Recent studies indicate that 88 percent of total cavities in American school children are caused this way.

Tooth sealants protect these susceptible areas by sealing the grooves and depressions, preventing bacteria and food particles from residing in these areas. Sealant material is a resin typically applied to the back teeth, molars and premolars and areas prone to cavities. It lasts for several years but needs to be checked during regular appointments.