Santa Ynez Valley Dental

A dental cleaning, or prophylaxis, is a routine procedure that usually takes between 30 minutes to an hour and occurs 2 times per year. A deep cleaning, or scaling and root planing, is a procedure that could take up to 4 appointments to complete and will last an hour or more. This is a one time treatment unless recurrent disease occurs. A periodontal maintenance cleaning is scheduled after scaling and root planing for subsequent and long term routine care, usually 3 or 4 times a year. The level of cleaning needed is determined by bacteria level, bone loss, and periodontal (gums/ bone) disease diagnosis. Most patients will fall into the prophylaxis category and see the hygienist 2 times a year or every 6 months. Radiographs and an exam will also be a provided after routine cleanings. Dr. Morelli will advise you if any issues are found at this time.

Veneers are thin porcelain or composite tooth colored restorations that cover only the front side of your teeth. They are generally diagnosed for treatment on patients with misshapen, crooked, gapped, broken, and discolored teeth. In some cases, veneers can be fabricated without the need to prepare a patients teeth with a drill. However, this is not always the case and most of the time a small amount of tooth structure will need to be removed to allow for the veneers to fit and function properly. Porcelain veneers take two appointments to complete and composite veneers generally take only one. Treatment and timeline depends solely on the desired outcome and longevity of the restoration; a composite veneer takes less time, but has a much shorter life expectancy. Bonding is the application of dental composite (white) to tooth structure via a dental adhesive. The final bond occurs once the material is cured in place by an LED light. Bonding can usually be done in one visit and the final result is beautiful and natural looking. Bonding can improve the appearance of chipped, fracture, cracked, excessively spaced, or stained teeth.

Dental fillings restore your damaged tooth structure with a composite (white), amalgam (silver), porcelain (white), or metal (gold) material. Most patients prefer white filling material, but in some instances other materials are more suited to a longer lasting restoration. The most common white filling material used today is the composite material made of resin and glass.

A dental cleaning, or prophylaxis, is a routine procedure that usually takes between 30 minutes to an hour and occurs 2 times per year. A deep cleaning, or scaling and root planing, is a procedure that could take up to 4 appointments to complete and will last an hour or more. This is a one time treatment unless recurrent disease occurs. A periodontal maintenance cleaning is scheduled after scaling and root planing for subsequent and long term routine care, usually 3 or 4 times a year.

A denture is a removable replacement for missing teeth and adjacent tissues. It is made of acrylic resin, sometimes in combination with various metals. There are three types of dentures: complete dentures, partial dentures, and hybrid dentures. Complete dentures and hybrid dentures replace all the teeth while a partial denture fills in the spaces created by missing teeth and helps prevent other teeth from changing position. Depending on your need a complete denture can be “conventional” or “immediate”. A conventional denture is placed in the mouth after five dental visits from the point of teeth being extracted. An immediate denture is placed in the mouth as soon as the teeth are removed. The need for either type will vary from patient to patient. Partial dentures are similar to complete dentures, except the plastic teeth and acrylic gums surround frameworks made of metal or flexible thermoplastic material and use existing teeth for support. While the metal framework partial dentures will take five visits to place, the thermoplastic type (Valplast) will take fewer appointments for final placement. Implant Retained Dentures Hybrid dentures are the newest treatment option for patients who do not have enough bone to support a complete denture. A hybrid denture is one supported by implants and has a metal framework encased in acrylic, which supports the artificial teeth. All dentures will need to be adjusted for sore spots and relined, rebased, or remade at some point. It is recommended to have annual check-ups to evaluate your gums, jaw bones, and the denture relationship or “fit”.

Dental implants are artificial tooth replacements used to replace tooth loss. The procedure is categorized as a form of prosthetic dentistry, though it also falls into the category of cosmetic dentistry as well. A dental implant is made of three parts: the implant, the abutment, and the crown. The implant is made of titanium, has a surface characteristic similar to a screw, and is placed into the bone. The abutment fits into the implant via a male adaptation on one side. The other side of the abutment houses the crown. All three parts can be screwed together for a strong restoration. Sometimes only the abutment and implant are screwed together and then the crown is cemented onto the abutment on the opposite side from the implant. These two options are dependent on angulation and will be determined at the time of restoration. Dental implants are stronger and more durable than their restorative counterparts (bridges and dentures) and have a 95% success rate over 30 years of research. Implants offer a permanent solution for tooth loss. Additionally, implants may be used in conjunction with other restorative procedures for maximum effectiveness. For example, a single implant can serve to support a crown replacing a single missing tooth or two implants can be used to support a dental bridge for the replacement of multiple missing teeth. Multiple implants can also be placed to support a full denture for edentulous patients (toothless).

Dental crowns, also known as “caps,” restore the functionality of damaged teeth. Crowns may be used to protect a cracked tooth, restore functionality of a tooth with excessive decay, or replace a pre-existing crown. The purpose of a dental crown is to encase a tooth with a custom-designed material. Crowns can be made of gold, porcelain (white), zirconia (white), and a combination of gold and porcelain (white). A bridge is used sometimes when a single or multiple teeth are missing and existing teeth on either side of the gap are used as abutments to support a span of artificial crowns. Thus, bridging the gap! During the crown or bridge procedure your tooth is prepared and a molded impression of the teeth are sent to a dental laboratory. A fitted, temporary crown/ bridge is created during this visit to temporarily protect your teeth while the final restoration is being made in the dental laboratory. Once completed, the crown/ bridge is cemented or adhesively bonded on a second visit.

Wisdom teeth extractions are ideally completed between the ages of 17-21 and are recommended to facilitate the long term health of patients via diminished crowding, improved oral hygiene, and decreased bone loss on adjacent teeth. The key to successful outcome during extractions is anesthetic prior to the procedure and proper home care afterward. Most often the patients who experience the worst outcome are those who waited too long for treatment, tobacco/ smokers, and those with poor hygiene habits post surgery. Under great anesthesia, good homecare/ diet, and good follow-up 95% of extractions are successful! For those patients whose anxiety is too great we have treatment options that help alleviate the fear: anxiety medication, nitrous oxide, and, if severe, referral to an Oral Surgeon for full sedation.

Endodontic therapy or Root Canal treatment is the elimination of infection and protection of the decontaminated tooth from future microbial invasion. Root canals and their associated pulp chamber are within a tooth and contain nerve tissue, blood vessels and a number of other cellular entities. Endodontic therapy includes the complete removal of these structures, the subsequent cleaning, shaping and decontamination with small files, irrigating solutions, and subsequent filling those canals with a rubber material called gutta percha.

Teeth whitening is a bleaching process that gently lightens stained or discolored teeth. Whitening uses a safe and effective gel designed to change the refractive index of light striking your tooth surface effectively making them brighter in appearance. (Our office uses a 15% carbamide peroxide gel, which is a low percent gel so teeth will not be damaged). We also offer an in-office alternative called ZOOM! whitening. This process of whitening takes 1-2 hours and is a quicker alternative to traditional take-home bleaching trays.

Orthodontics and dentofacial orthopedics is the formal name of the dental specialty concerned with the diagnosis, prevention, interception, guidance and correction of bad bites. If your teeth are crowded, protrusive (sticking out), spaced too far apart, meet in an abnormal way, or do not meet at all, correction may be recommended. Braces and aligners are the “appliances” dentists and orthodontists most commonly use to guide your teeth into their proper positions. Once completed, retainers preserve and stabilize the results of your orthodontic treatment. Clear Aligners Our office provides orthodontic clear aligners for our patients to correct their misaligned dentition. We feel this is the best option for mild to moderate correction and helps to facilitate patient compliance and success through minimal aesthetic difficulty. Patients are provided with a free consultation to determine their need and case completion timeline. Within 3 weeks we can give a comprehensive preview of how your teeth will be moved and what they will look like when your case is completed. Most cases can be completed within 1-1.5 years.

Sleep Apnea Sleep apnea is a common condition in the United States. It can occur when the upper airway becomes blocked repeatedly during sleep, reducing or completely stopping airflow. This is known as obstructive sleep apnea. The “apnea” in sleep apnea refers to a breathing pause that lasts at least ten seconds. More than 18 million American adults have sleep apnea, but it occurs in all age groups and both sexes. Childhood sleep apnea is gaining prevalence with some estimates showing 2-3% of the US population, however, those estimates could be as high as 10-20% in habitually snoring children. Obstructive sleep apnea occurs when the muscles in the back of the throat fail to keep the airway open, despite efforts to breathe. Another form of sleep apnea is central sleep apnea, in which the brain fails to properly control breathing during sleep. Obstructive sleep apnea is far more common than central sleep apnea. Sleep apnea can cause fragmented sleep and low blood oxygen levels. For people with sleep apnea, the combination of disturbed sleep and oxygen starvation may lead to hypertension, heart disease and mood and memory problems. Treatment for diagnosed sleep apnea in our office is an oral sleep appliance. These are used to open the airway by moving the lower jaw forward, thus moving the tongue away from the oropharynx. This allows improved airflow, increases the oxygen levels in the blood, and reestablishes the normal sleep pattern. The market for types of appliances has increased and can be confusing for patients, however, Dr. Morelli highly recommends the TAP III Elite sleep appliance, which he uses most often and calls it the Ferrari of oral appliance therapy. Delivery of a sleep appliance takes two appointments. The first appointment involves full mouth impressions of your teeth, a bite registration to determine your bite relationship, fabrication of a jaw muscle deprogrammer, and fabrication of models. The second appointment is the delivery, adjustment, and instructions for use. Night Guards Dental guards are recommended treatment for patients with nocturnal or daytime teeth grinding (bruxism) habits. In addition to limiting teeth wear, night guards (NG) help to support the muscles used to chew and the jaw joint called the temporomandibular joint (TMJ). In some cases, patients with severe habits and or symptoms will need to be referred to a TMD (Temporomandibular Dysfunction) specialist, or a sleep clinic for further diagnosis and treatment. There are two main types of night guards: soft, which is flexible and preferred by mild bruxism patients, and hard, which is not flexible and made for patients with mild to severe bruxism and misaligned teeth. Options are discussed prior to fabrication of the night guard. Both types will last from 1-5 years on average before need for replacement. If you decide to try a dental night guard, consider the following points for best results: • Custom-fit: fabricated from molds taken of your teeth, delivered on a separate appointment and adjusted for optimum fit and function. • Over-the-counter: purchased at a store or pharmacy, generally adequate to relieve grinding, not intended to relieve muscles or joint pain, fit is fair to poor, and inexpensive. • Sleep Apnea: diagnosis of SA will preclude and limit the use of a guard. A sleep appliance should be worn during night hours in lieu of a night guard.