Lakeside Dental Care

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.

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. The teeth are made of plastic, porcelain or a combination of both. Dentures can be fabricated to fit over endodontically treated teeth and a complete denture can be attached to dental implants to allow for a more secure fit of the appliance. Dentures over a normal course of time will wear and need to be replaced or relined in order to keep the jaw alignment normal. The alignment will slowly change as the bone and gum ridges recede or shrink due to the extraction of the teeth. Regular dental examinations are still important for the denture wearer so that the oral tissues can be checked for disease or change.

Most dentistry looks like dentistry. Our goal is to provide dentistry that is undetectable. We replace existing dental crowns and fillings with restorations that look and feel like your natural teeth. Where damage to a person’s teeth is extreme, and apparently beyond repair, we can use porcelain or porcelain “pasted on gold” crowns to make the smile appear “as new”. This is an extremely reliable technique for repairing the most severe of dental problems, even permanently replacing missing teeth to offer a complete smile and a functional bite. We are renowned for the quality of our work and the fantastic changes we make for people using this technology. These treatments are used for a long-lasting correction of major dental problems. It is usual for these treatments to last for 20 to 30 years, which is as close to permanent as dental treatment can get.

There are many advantages to tooth-colored restorations. Resin onlays are bonded to the teeth creating a tight, superior fit to the natural tooth. Such restorations can be used in instances where much of the tooth structure has been lost. The tooth remains intact and stronger. Since the resin used in tooth-colored restorations contain fluoride this can help prevent decay. The resin wears like natural teeth and does not require placement at the gum line, which is healthier for your gums!

Dental sealants are a simple procedure in which a tooth-colored acrylic "coating" is painted onto the surface of the tooth. Dental sealants effectively "seals" the deep grooves, acting as a barrier and protecting enamel from plaque and acids. Dental sealants protect the depressions and grooves of your teeth from food particles and plaque that brushing and flossing can't reach.

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.

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.

Inlays and onlays are made of porcelain, gold, or composite resin and are bonded to the damaged area of the tooth. An inlay, which is similar to a dental filling, is placed inside the cusp tips of the tooth. Traditionally, gold has been the material of choice for inlays and onlays. However, in recent years, porcelain has become increasingly popular due to its strength and color, which has the potential of matching the natural color of your teeth.

Dental whitening can be used to correct tooth discoloration. Discolorations can be caused by staining, aging, or chemical damage to teeth. Using the latest in whitening technology, we can offer a safe method for creating a beautiful “brilliant” smile. In cases of extreme tooth discoloration, crowns or veneers may be the only choice, but because of the low cost of whitening treatments, teeth whitening is nearly always worth a solid try.

There are many ways you can play an active role in maintaining your oral health. Having your teeth cleaned in our office every six months is an excellent place to start. Our hygienists and dentists identify plaque and problem areas before thoroughly cleaning your teeth, providing you with information to sustain a happy, healthy smile.

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. 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.

Some teeth are extracted because they are severely decayed; others may have advanced periodontal disease, or have broken in a way that cannot be repaired. Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth), or in preparation for orthodontic treatment.

A root canal is one of the most common dental procedures performed, well over 14 million every year. This simple treatment can save your natural teeth and prevent the need of dental implants or bridges. At the center of your tooth is the pulp. The pulp is a collection of blood vessels, nerve tissue and connective tissue. Infection of the pulp can be caused by trauma to the tooth, deep decay, cracks and chips, or repeated dental procedures. Symptoms of the infection can be identified as visible injury or swelling of the tooth, sensitivity to temperature or pain in the tooth and gums. If you experience any of these symptoms, your dentist will most likely recommend non-surgical treatment to eliminate the diseased pulp. This injured pulp is removed and the root canal system is thoroughly cleaned and sealed. This therapy usually involves local anesthesia and may be completed in one or more visits depending on the treatment required. Success for this type of treatment occurs in about 90% of cases. If your tooth is not amenable to endodontic treatment or the chance of success is unfavorable, you will be informed at the time of consultation or when a complication becomes evident during or after treatment.

Cracked teeth demonstrate many types of symptoms, including pain when chewing, temperature sensitivities, or even the release of biting pressure. It is also common for tooth pain to come and go, making it difficult to diagnose the cause of discomfort. Chewing can cause movement of the cracked pieces of your tooth, and the pulp within the tooth becomes irritated. At the same time, when biting pressure is released, the crack can close quickly, resulting in sharp pain. Eventually, the pulp will become damaged and tooth will consistently hurt, even when you are not chewing. It is possible that cracks can lead to infection of the pulp tissue, which can spread to the bone and gum surrounding the problematic tooth.

With the appropriate care, your teeth that have had endodontic treatment will last as long as other natural teeth. Yet, a tooth that has received treatment may fail to heal or pain may continue to exist. Sometimes, the pain may occur months or years after treatment. If so, Endodontic Retreatment may be needed. Improper healing may be caused by: Curved or narrow canals were not treated during the initial treatment. Complicated canals went undetected during the initial treatment. The crown or restoration was not placed within the appropriate amount of time following the procedure. The crown or restoration did not prevent saliva from contaminating the inside of the tooth. In some cases, new problems can influence a tooth that was successfully treated: New decay can expose a root canal filling material, causing infection. A cracked or loose filling or crown can expose the tooth to new infection. Once retreatment has been selected as a solution to your problem, we will reopen your tooth to gain access to the root canal filling material. This restorative material will be removed to enable access to the root canal. We will clean your canals and carefully examine the inside of the problematic tooth. Once cleaned, we will fill and seal the canals and place a temporary filling in the tooth.

Generally, a root canal is all that is needed to save teeth with injured pulp from extraction. Occasionally, this non-surgical procedure will not be sufficient to heal the tooth and Dr. Grant will recommend surgery. Endodontic surgery can be used to locate fractures or hidden canals that do not appear on x-rays but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated with this procedure. The most common surgery used to save damaged teeth is an apicoectomy or root-end resection. WHAT IS AN APICOECTOMY? The video above illustrates this simple procedure. An incision is made in the gum tissue to expose the bone and surrounding inflamed tissue. The damaged tissue is removed along with the end of the root tip. A root-end filling is placed to prevent reinfection of the root and the gum is sutured. The bone naturally heals around the root over a period of months restoring full function.

This procedure encourages the root to continue development as the pulp is healed. Soft tissue is covered with medication to encourage growth. The tip of the root (apex) will continue to close as the child gets older. In turn, the walls of the root canal will thicken. If the pulp heals, no additional treatment will be necessary. The more mature the root becomes, the better the chance to save the tooth.

In this case, the unhealthy pulp is removed. The doctors place medication into the root to help a hard tissue form near the root tip. This hardened tissue provides a barrier for the root canal filling. At this point, the root canal walls will not continue to develop, making the tooth susceptible to fractures. So it is important to have the tooth properly restored by your dentist.

Braces use constant, gentle pressure, applied to your teeth over time, to move them into proper position. Your braces are at work every moment of your orthodontic treatment. While braces are available in a variety of styles, including metal, plastic and ceramic, they all have the same goal: To correctly align your teeth and jaws for enhanced aesthetic appeal and for better oral health.

Metal braces are popular with children and teens, and are smaller and more comfortable than ever before. Traditional metal braces feature two main components: the brackets that are placed on each tooth and the arch wire that is threaded through them. As the wire applies pressure to one side of the tooth, the jawbone on the other side gives way. This causes the tooth to move and new bone to grow behind it. Elastics (rubber bands) are used in conjunction with braces, exerting a constant force to move teeth. Elastics must be worn at all times and changed every day in order to maintain the proper force.

Lingual braces work just like traditional metal braces, but are placed behind teeth instead of on the front. This allows them to be completely hidden, so no one knows that you are wearing them. Typically, anyone who could have traditional metal braces is also a good candidate for lingual braces.

Clear braces are a popular choice for adults and teens that would like a discreet alternative to traditional metal braces. Options include clear aligners such as Invisalign® and clear ceramic braces, which use tooth-colored ceramic brackets and wires instead for a nearly invisible look.

After the active orthodontic treatment period is complete and your braces have been removed, you will be given a retainer. This marks the beginning of the retention phase, during which a retainer is used to hold teeth in their new positions while the jawbone, gums and muscles adapt. You must wear the retainer as instructed, otherwise your teeth may revert to their former positions, and the benefits of having had braces will be lost.

Appliances are used during various stages of the orthodontic process, either to retain the new position of teeth, or in some cases to influence the growth of the jaws for a better bite alignment. Appliances may be fixed or removable.

Designed to widen your upper jaw, a palatal expander applies outward pressure on your upper molars to slowly expand your palate.

Spacers are plastic rings that are inserted between back teeth before you have braces, providing space for your teeth to shift. If a spacer comes out, call our office to see if you need a replacement. Do not chew sticky foods with or floss teeth that have spacers in them.

Rubber bands are used with fixed metal braces. They must be worn at all times and changed daily per our instructions.

For a severe overbite or underbite, headgear is sometimes used to continuously pull on your teeth, restricting further growth forward.

Designed to complete the final tooth necessary movements, positioners are usually the last step in the orthodontic process.