Care Dental

Full mouth reconstruction refers to the process of completely restoring all of the teeth in your mouth. Full mouth reconstruction, unlike a “smile makeover,” is a necessary series of procedures, rather than an elective surgery. Full mouth reconstruction is needed when: Teeth have been lost Teeth have been injured or fractured Teeth have become worn as a result of acid-erosion Jaw pain is present due to bite problems PROCEDURES INVOLVED IN FULL MOUTH RECONSTRUCTION Every patient’s needs are different and, therefore, require different procedures. Usually, full mouth reconstruction requires multiple office visits and some amount of healing time. Dr. Grant will determine which procedure or combination of procedures is necessary to restore and rebuild your perfect smile. Dr. Grant will also refer you to other dental specialists if needed. Some options include: Teeth cleaning (prophylaxis) Crown lengthening to prepare tooth structure for possible crowns or bridges Surgery to reposition the jaw (orthognathic surgery) Contouring of the gum tissue Reduction of natural tooth structure to prepare for crowns, bridges, and veneers Placement of temporary restorations to get you used to your new teeth or bite adjustment Placement of permanent restorations such as crowns, veneers, inlays/onlays, or bridges Braces to move teeth into the ideal position for reconstruction Bone or soft tissue grafting to increase the stability of your teeth or implants

WHAT ARE DENTAL IMPLANTS? A natural tooth consists of a root and a crown. If you compare natural teeth to implant-supported replacement teeth, you’ll see they have the same basic parts. Both have a crown (the visible part used to chew food). Both have a root that holds the tooth securely under the gum and is anchored into the jaw. The difference is that the implant is made of titanium – the same time-tested material used by surgeons for artificial joints. When you lose a tooth, you lose both the root and the crown. Before replacing the crown, the root must first be replaced with a small dental implant. Time is allowed for bone to heal and grow around the dental implant. The bone bonds with the titanium, creating a strong foundation for artificial teeth. A support post (abutment) is then placed on the implant and a new replacement tooth (crown) is placed on top of the abutment. In many cases a temporary replacement tooth can be attached to the dental implant immediately after it is placed. If all of your teeth are missing, a variety of treatment options are available to support the replacement teeth.

Porcelain veneers are thin shells of ceramic that bond directly to the front surfaces of the teeth. They are an ideal choice for improving your smile and have become increasingly popular due to their simplicity and versatility. As a cosmetic dental procedure, dental veneers create a brighter, whiter smile composed of more perfectly aligned and shapely teeth. Veneers are sometimes placed for cosmetic reasons alone, rather than for necessary health purposes. The translucent quality of today’s porcelain veneers provides a more natural look than what has been available to past generations. This allows a beautiful and natural looking smile. Porcelain material is a perfect solution for the demands of your teeth. Placing custom teeth veneers requires a high degree of technical skill as well as attention to cosmetic detail – skills that demonstrate the extensive training prosthodontists undergo. Arizona Specialists places veneers routinely and designs each case individually to match and enhance the characteristics of each patient’s smile. Despite the cause of unattractive teeth, veneers alone have the ability to solve most, if not all, of your cosmetic concerns regarding your smile and existing teeth. These problems include: Wear and Tear: Teeth naturally wear down as people age. Older teeth are more likely to have cracks, chips, or an uneven appearance. Worn Enamel: The thin, hard white substance covering your teeth (enamel) may become worn, dulled, and discolored over time. Uneven Teeth: Uneven length or width of teeth can be the result of teeth grinding or general wear. Genetics: Certain people may be born with abnormal appearance of teeth or spacing between the teeth that grows wider as they age. WILL DENTAL VENEERS LOOK LIKE NORMAL TEETH? When bonded to the teeth, the ultra-thin porcelain veneers are virtually undetectable and highly resistant to coffee, tea, or even cigarette stains. For strength and appearance, their resemblance to healthy, white tooth enamel is unsurpassed by other restorative options. HOW DURABLE ARE PORCELAIN VENEERS? With proper care, porcelain veneers will brighten your smile for well over a decade. Dr. Grant will ensure that your veneers are crafted from the highest quality porcelains and are bonded with the most advanced and proven materials available. Refraining from using your veneers as tools to open and cut things will prolong their life and if accidental breakage or damage occurs, it is usually possible to replace only the veneer involved.

A dental crown should look, feel and function exactly like a natural tooth. At Premier Care of Sonoma County, we use cutting edge materials and techniques to produce crowns with maximum longevity and maximum aesthetic appeal.

Porcelain inlays and tooth colored restorations (onlays) are unnoticeable and actually add strength to weakened teeth. These restorations look great and are very strong thanks to new bonding technologies and the advanced skills of your prosthodontist.

A dental bridge — a device used to replace missing teeth — attaches artificial teeth to adjacent natural teeth, called abutment teeth. Bridges are either permanently attached (fixed bridges) or they can be removable (removable bridge). Fixed bridges are applied by either placing crowns on the abutment teeth or by bonding the artificial teeth directly to the abutment teeth. Removable bridges are attached to the teeth with metal clasps or by precision attachments.

Dental sealants protect the depressions and grooves of your teeth from food particles and plaque that brushing and flossing can’t reach.

A denture or a complete denture as it is often called, is an appliance that is inserted in the mouth, replaces natural teeth and provides support for the cheeks and lips. Most dentures are made of acrylic and can be fabricated two different ways. A conventional denture is made after all teeth have been extracted and the tissues (gums) have healed. An immediate denture is fabricated and inserted immediately after the teeth are extracted and the tissues are allowed to heal under the denture. An upper denture has acrylic, usually flesh colored, that covers the palate (roof of the mouth). A lower denture is shaped like a horseshoe to leave room for the tongue.

New dentures will typically fit your mouth very securely as it has been designed specifically for your gums. As time goes on, your gum tissues will change and the fit of the denture will become more loose and more prone to movement inside your mouth. Having the denture professionally relined every one to two years will keep the denture secure and functional.

Dental bonding is an alternative to teeth veneers and can be used as a restorative procedure for teeth that are chipped, cracked, discolored, or misarranged. How does dental bonding work? The tooth is prepared for dental bonding by lightly etching the surface and applying a bonding liquid. Once the liquid sets, a plastic resin is applied and sculpted into the desired shape by the prosthodontist. Once set, the resin is trimmed, smoothed, and polished for a natural appearance.

Inlays and onlays can be made of porcelain, gold, or a composite resin. These pieces are bonded to the damaged area of the tooth. An inlay (which is similar to a filling) is used inside the cusp tips of the tooth. An onlay is a more substantial reconstruction (similar to the inlay), but extending out over one or more of the cusps of the tooth. Traditionally, gold has been the material of choice for inlays/onlays. In recent years, however, porcelain has become increasingly popular due to its strength and color which can potentially match the natural color of your teeth.

What are dental implants? A natural tooth consists of a root and a crown. If you compare natural teeth to implant-supported replacement teeth, you’ll see they have the same basic parts. Both have a crown (the visible part used to chew food). Both have a root that holds the tooth securely under the gum and is anchored into the jaw. The difference is that the implant is made of titanium – the same time-tested material used by surgeons for artificial joints. When you lose a tooth, you lose both the root and the crown. To replace the tooth, the surgeon first replaces the root with a small dental implant. Time is allowed for bone to heal and grow around the dental implant. The bone bonds with the titanium, creating a strong foundation for artificial teeth. A support post (abutment) is then placed on the implant and a new replacement tooth (crown) is placed on top of the abutment. In many cases, a temporary replacement tooth can be attached to the implant immediately after it is placed. If all of your teeth are missing, a variety of treatment options are available to support the replacement teeth. Surgical Advances in Dental Implants: Using the most recent advances in dental implant technology, Dr. Flores is able to place single stage implants. These implants do not require a second procedure to uncover them, but do require a minimum of six weeks of healing time before artificial teeth are placed. There are even situations where the implant can be placed at the same time as the tooth extraction – further minimizing your number of surgical procedures. Dental implant placement is a team effort between a periodontist and a restorative dentist. Dr. Flores performs the actual implant surgery, initial tooth extractions, and bone grafting if necessary. The restorative dentist (your dentist) fits and makes the permanent prosthesis. Your dentist will also make any temporary prosthesis needed during the implant process.

The initial stage of treatment for periodontal disease is usually a thorough cleaning that may include scaling or root planing. The objective of these non-surgical procedures is to remove etiologic agents such as dental plaque and tartar, or calculus, which cause gingival inflammation and disease. Scaling and root planing can be used as a stand-alone treatment, or a preventative measure. They are commonly performed on cases of gingivitis and moderate-to-severe periodontal disease. We will only perform scaling and root planing after a thorough examination of the mouth, which may include taking x-rays and visually examining the mouth. Depending on the condition of the gums, the amount of tartar present, the depth of the pockets, and the progression of periodontitis, we may recommend scaling and root planing. In some cases, a local anesthesia may be used during the procedure. Scaling: When scaling is performed, calculus and plaque that attaches to the tooth surfaces is removed. The process especially targets the area below the gum line, along the root. Scaling is performed with a special dental tool called an ultrasonic scaling tool. The scaling tool usually includes an irrigation process that can be used to deliver an antimicrobial agent below the gums to help reduce oral bacteria. Root Planing: Root planing is performed in order to remove cementum and surface dentin that is embedded with unwanted microorganisms, toxins and tartar. The root of the tooth is literally smoothed, which promotes healing, and also helps prevent bacteria from easily colonizing in the future.

When recession of the gingiva occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem, gum reconstruction using grafting techniques is an option. When there is only minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the mucosa, the first line of defense against bacterial penetration is lost. In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance of the gum and tooth. When significant, gum recession can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to root caries and root gouging. A gingival graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth or gently moved over from adjacent areas to provide a stable band of attached gingiva around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root. The gingival graft procedure is highly predictable and results in a stable, healthy band of attached tissue around the tooth.

Why would I need crown lengthening? Crown lengthening is usually performed to improve the health of the gum tissue, prepare the mouth for a procedure, or correct a “gummy smile”. A “gummy smile” is used to describe an instance where teeth are covered with excess gum tissue resulting in a less esthetically-pleasing smile. The procedure involves reshaping or recontouring the gum tissue and bone around the tooth in question to create a new gum-to–tooth relationship. Crown lengthening can be performed on a single tooth, many teeth, or the entire gum line. Crown lengthening is often required when your tooth needs a new crown or other restoration. The edge of that restoration is deep below the gum tissue and not immediately accessible. It is also usually too close to the bone or below the bone. Crown lengthening allows us to reach the edge of the restoration, ensuring a proper fit to the tooth. It should also provide enough tooth structure so the new restoration will not come loose in the future. This allows you to clean the edge of the restoration when you brush and floss to prevent decay and gum disease. About the Crown Lengthening Procedure: Crown lengthening takes approximately one hour but will largely depend on the amount of teeth involved and if any amount of bone will need to be removed. The procedure is usually performed under local anesthetic and involves a series of small incisions around the tissue to separate the gums from the teeth. Even if only one tooth requires the procedure, it will probably be necessary to adjust the surrounding teeth to enable a more even reshaping. In some cases, extraction of a small amount of bone will be necessary as well. When we are satisfied that the teeth have sufficient exposure and the procedure is completed, the incisions will be cleaned with sterile water. Sutures and a protective bandage are then placed to help secure the new gum-to-tooth relationship. Your teeth will look noticeably longer immediately after surgery because the gums have now been repositioned. You will need to be seen in one or two weeks to remove the sutures and evaluate your healing. The surgical site should be completely healed in approximately two to three months following the procedure.

Maintenance therapy is an ongoing program designed to prevent disease in the gum tissues and bone supporting your teeth.

A dental prophylaxis is a cleaning treatment performed to thoroughly clean the teeth and gums. Prophylaxis is an important dental treatment for stopping the progression of gingivitis and periodontal disease. Professional teeth cleaning is an effective procedure in keeping the oral cavity in proper health and halting the progression of gum disease. The benefits include: Plaque removal. Tartar (also referred to as calculus) and plaque buildup, both above and below the gum line, can result in serious periodontal problems. Unfortunately, even with a proper home brushing and flossing routine, it can be impossible to remove all debris, bacteria and deposits from gum pockets. The experienced eye of a dentist or hygienist using specialized dental equipment is necessary to catch potentially damaging buildup. A healthier looking smile. Stained and yellowed teeth can dramatically decrease the esthetics of a smile. Prophylaxis is an effective treatment in ridding the teeth of these unsightly stains. Fresher breath. Bad breath (or halitosis) is generally indicative of advancing periodontal disease. A combination of rotting food particles (possibly below the gum line) and potential gangrene stemming from gum infection, results in bad breath. The routine removal of plaque, calculus and bacteria at our facility can noticeably improve halitosis and reduce infection.