Implants Whitening Periodontal Pocketing and Bone Loss Root Planing Crowns Bridges Removable Bridge or Partial Dentures Root Canals or Endodontics Extractions Oral Surgeons Orthodontics Implants Implants are currently an alternate to replace missing teeth. An implant is surgically placed inside the bone and a tooth can be attached to it. We do implants on patients that do not want conventional bridges, partials or dentures. Most insurance companies will not pay for them. Patients must be healthy and there has to be sufficient bone to hold the implant. Whitening There are many ways to whiten teeth. The best and most efficient is the whitening where the Dentist makes custom trays and you use it at home. Because it fits really well and the material is held on the teeth with the Splint, it can whiten faster and longer. It will also do a much better job of whitening the teeth. The over the counter whiteners work well too. But they take longer and often times end up as expensive as the dentist made kinds. They do not whiten as much and patients end up swallowing a lot more of the whitening material. Periodontal Pocketing and Bone Loss If tartar and plaque are not removed regularly, periodontal pocketing and bone loss will result. The Plaque and tartar will work down the tooth between the tooth and the gums around the tooth. This goes deeper and deeper between the tooth and the gums just like a pocket on a shirt. As the pocket gets deeper and deeper it becomes harder to clean and also the bone shrinks away from this irritant. If pockets get deeper than 4 or 5 mm. they must be treated. Patients cannot clean these deep pockets and will eventually lose the teeth. Deep Cleaning and sometimes surgery is needed to reduce these pockets. Root Planing Hygienists and dentists use instruments and devices to go into the pockets around the teeth. The tartar and plaque around the tooth must be removed to return the tooth to maximum health. The root surface of the tooth is smoothed also so that it will not irritate the gums and will prevent reattachment of plaque and tartar. Because of the infection from deep pockets the gums are very sore and irritated. Many times patients must be numbed or use Nitrous Oxide when root planing is done. Crowns Many types of Crowns are available to patients. These are restorations that completely cover the tooth and restore the tooth to its original or ideal shape and size. The oldest and still the strongest and best are the all Gold Crowns. These are made of Alloys of gold. Metals such as platinum and others are added to gold to make it hard and durable. Some other metals such as steel, silver, tin , plastic etc. can be used to make crowns. However some are only temporary. Porcelain and Porcelain fused to metal are the next type of crowns. These are tooth colored and shaded to match the teeth. Because porcelain is a glass it can break so care must be taken. These are used most often in the anterior area of the mouth. Crowns are usually used when there is a lot of damage or missing natural tooth. They can also be used to make the teeth look better or reshape badly aligned teeth or badly stained teeth. In many cases it is used instead of Orthodontics or braces to make the teeth look straighter. Bridges Permanent Bridges are replacements for missing teeth. A Bridge is fabricated to attach to each tooth on either side of the missing tooth. It is usually cemented in permanently and feels and looks like natural teeth. A bridge can be made out of metal or porcelain. Sometimes a bridge can be anchored on two teeth together and extended back one tooth. This is called a cantilever bridge. Removable Bridge or Partial This is a removable replacement for missing teeth. It is held in place by wire hooks or other clips or attachments. Depending on the style and design it can be very comfortable and is a lower cost alternative to fixed bridges and Implants in replacing teeth. Dentures This is a removable appliance that replaces all the missing teeth. When all of the teeth have been removed a plastic device can be fabricated to replace the teeth that have been removed. It is held in place by a close fit of the plastic to the gums. They teeth can be oriented in any way, size and Color. We take great detail to make sure that all patients are satisfied with the position and fit of a denture. We fabricate the denture in wax first. We make sure that everything is perfect first. Bite, color, size, shape can be confirmed prior to placement. All patients approve of the denture first prior to placement. Afterwards there are at least 2 or 3 free follow up adjustments and analysis. This will guarantee that all patients are satisfied with their dentures. Root Canals or Endodontics This is a procedure that removes the nerve and or any infection that gets inside a tooth. Decay can get so extensive that it will get inside a tooth and eventually get into the nerve. It will kill the tooth and cause an infection inside the tooth. This is called a tooth abscess. Because the infection is inside the tooth and the nerve and blood vessel dies the infection builds up pressure inside the tooth and drains out the end of the tooth. Extractions Most of the time teeth can be saved. Even when the crown or top of the tooth is completely gone a tooth can be saved if the roots are good. The teeth can be built up with posts and pins and a crown placed. Also a root canal can be done if the nerve is damaged or there is an abscess of the tooth. Teeth also can be saved when up to 50 or 60% of the bone is left around the tooth. Perio surgery and gum treatments can sometimes keep a tooth for many years. Sometimes due to cost or too extensive damage to the tooth a tooth has to be removed. This usually can be done in the office. However if the removal is very difficult or complicated we will refer patients to an oral surgeon. Oral Surgeons We refer patients to the oral surgeon for difficult extractions. They also will do bone surgeries biopsies and other extensive face, head and neck surgeries. Some oral surgeries also do facial treatments. Orthodontics In our office will will do minor tooth movement and space maintenance when baby teeth are lost prematurely. Extensive teeth movement involving braces are referred to an orthodontist. They will move the teeth and restore the position and bite into proper alignment. It is very important to note that they will not check for decay and will not clean the teeth. Patients must continue to keep their recall appointments. Patients should be cleaned and examined every 6 months. Children also should receive Fluoride treatments up until the age of 16 every 6 months.