Cleanings & Preventative Maintenance
A comprehensive dental exam will be performed by your dentist at your initial dental visit. At regular check-up exams, your dentist and hygienist will include an examination of dental radiographs (x-rays), an oral cancer screening, existing restoration and tooth decay examination, and an examination of the gum and bone structures supporting the teeth. Any necessary treatment to achieve dental health will be discussed and a treatment plan will be developed and recommended.
Oral Cancer Screening
Oral cancer can be easily diagnosed with annual examinations. If caught early enough, treatment can be effective. There are many areas of the mouth and oral cavity where oral cancer may occur (e.g. lips, tongue, cheeks, etc.). The most common type of oral cancer is squamous cell carcinoma. Most oral cancer is associated the controllable behaviors by the patient (e.g. alcohol and tobacco usage). If you have any lumps or bumps or areas that concern you, bring them to the attention of the dentist and/or dental hygienist.
Radiographs (x-rays) are very important in dentistry. They allow for a complete examination of teeth from the inside out. They allow the dentist and dental team to see what is going on not only around the teeth, but inside the teeth and in the bone as well.
Digital radiographs use drastically reduced radiation as compared to traditional radiographs. Moreover, the digital radiographs are generated immediately on the chairside computer where they can be viewed by not only the dental team, but also by the patient. If there are issues with the teeth on the radiographs, the patient will be shown on a blown-up picture where and why there is problem.
Despite the low levels of radiation associated with dental radiographs, all precautions are taken to prevent unwanted exposure to radiation. Patients will be fitted with lead aprons and thyroid gland shields.
Our policy is for patients to take a full mouth series of radiographs at the initial visit. This allows the dentist to see all areas of the mouth and teeth including areas around the roots of the teeth not normally seen on bitewing radiographs. A full mouth series is typically good for 3-5 years depending on the patient. An annual set of bitewing radiographs are taken to detect decay between the teeth. Some patients with high amounts of decay or infection may need radiographs more often.
For patients who have developing teeth (children) or patients with high levels of the bacteria that cause cavities, fluoride provides an excellent barrier to help prevent decay. Fluoride is present in city drinking water, toothpastes, and is placed on teeth during dental cleanings. It interacts with the enamel (the outer layer of teeth) and helps protect the tooth from the bacteria that cause decay. We recommend that children have a professional fluoride treatment twice per year at dental check-ups. Fluoride can also be beneficial for patients who have sensitivity issues or dry mouth (xerostomia). We may recommend home fluoride treatments for these patients.
It is important to remember that fluoride alone will not prevent tooth decay. Excellent homecare consisting of brushing 2-3 times per day and flossing daily is just as important to maintaining good dental health.
Sealants are a wonderful preventative technique to help prevent tooth decay. Sealants are an easily applied plastic layer on the top surface of teeth. They fill in deep pits and grooves and prevent food from getting caught and causing tooth decay. Most tooth decay begins on the occlusal (top) surfaces of teeth. Sealants dramatically help to prevent decay from starting.
Typically sealants are placed on permanent molars once they are fully erupted. There are patients whose dental anatomy on other permanent or primary (baby) teeth would benefit from sealants due to deep pits and grooves. If you would benefit from sealants, we will discuss it with you.
Sealants are placed non-invasively. A gel to clean the pits and grooves is used before application of the sealant. The teeth are then rinsed and dried off. While they are dry, the sealant material is placed on the tooth and hardened with a dental curing light.
Brush & Floss
Of all of the things we can do to keep your beautiful smile looking healthy, nothing is more important than your brushing and flossing at home. Brushing twice per day and flossing once per day are paramount for maintaining good dental health. Eating a healthy diet is also an important factor.
Many patients make the mistake of brushing too hard. If you are replacing your toothbrush because the bristles are splayed out, you are brushing too hard. We recommend using a soft bristle toothbrush w/toothpaste that contains fluoride. Brushing should not be rushed but should not take longer than 2 minutes. The brush should be angled at a 45 degree angle towards the gums to get the bristles under the gum tissue. Using a small circular motion, gently brush the inner, outer and tops of each tooth. The most common areas to miss when brushing are the cheek-side surfaces of the upper molars and the tongue-side surfaces of the lower molars. Pay particular attention to these areas. Brushing the tongue also helps to remove harmful bacteria that cause cavities and bad breath.
We recommend the Sonicare electric toothbrushes. They are particularly useful for patients who brush too hard and patients who have difficulty brushing well due to a loss in dexterity due to illness/age. If we feel a patient will benefit from using an electric toothbrush, we will recommend it. It is important to remember when using an electric toothbrush to let it do the work: if you continue to brush hard with an electric toothbrush, you will cause damage to your teeth.
As good as brushing is for your teeth, a toothbrush cannot clean all surfaces of your teeth. The area between your teeth is best cleaned by flossing. Another common area for cavities to start is the area in between teeth where they touch. When you floss your teeth, the floss should “pop” between the contact point. This is where food can get caught resulting in decay. Floss keeps this area free from bacteria and food particles. In addition, floss helps prevent periodontal disease by keeping the gum tissues healthy.
To floss properly, about 18 inches of floss should be used. Each end is wrapped around your fingers leaving about 2 inches spread between your hands. Wrap the floss between the teeth and form a “C” with the floss moving it up and down along the tooth surfaces. If you have not flossed recently you will have some bleeding of the gums. As you get back in the habit of flossing, your gingival health will improve and the bleeding should stop. If your gums continue to bleed, ask your dentist to evaluate the cause. We recommend that some patients use floss holders if they have difficulty holding the floss or have trouble getting their fingers into the back of their mouth.
We do not recommend rinsing your mouth with water after brushing. Your toothpaste contains fluoride which can be washed off the teeth with rinsing. Some patients should use mouth rinses with fluoride to help prevent decay and/or sensitivity. Do not swallow mouth rinses with fluoride as they will cause an upset stomach.
Different emergencies require different treatments. Sometimes it is necessary to have treatment immediately, other times treatment can wait. Tooth fractures are caused by biting something hard or grinding the teeth. The amount of pain associated with a tooth fracture depends on the amount of tooth that is fractured and on the individual patient. There is usually sensitivity following a tooth fracture. Severe pain may necessitate immediate treatment. Usually pain will worsen if not treated.
An avulsed tooth is a tooth that has been knocked out of the mouth. If the tooth can be replaced into its socket, it will sometimes be able to be saved. If this occurs, gently rinse the tooth off and place it gently back into the socket. Call the dentist immediately. If it cannot be placed back into the mouth, keep the tooth stored in milk. If the tooth is left out of the mouth for more than one hour, it’s chances of survival are very low. Call the dentist immediately. In most cases, if the tooth is salvageable, the tooth will require root canal therapy.
If a tooth loses a filling or a crown, the need for treatment will be somewhat dependent on the patient. For crowns, oftentimes replacing the cement with toothpaste and re-seating the crown will suffice until the crown can be permanently re-cemented at the dental office. If the crown was dislodged due to decay under the crown, a root canal and/or new crown may be needed.
Fractured restorations will be rough to the tongue and may be sensitive to cold. Temporary restoration materials can be purchased at the local pharmacy, but usually do not work very well. Restorations fracture for a variety of reasons: trauma, fractured restoration material, decay. The treatment will vary based on the cause of the fracture. Call your dentist as quickly as possible to schedule an appointment to get your tooth back to optimum health. Teeth left unrestored may become infected and need more expensive and expansive treatment.