Preventive and Diagnostic
A dentist has many options when it comes to restoring a patient’s mouth. These options need to be discussed with the patient after radiographs (X-rays) and a comprehensive oral examination (C.O.E) is completed.
All dental treatment should be preceded by a dental examination. At Garden City Center for Dental Excellence, all patients seen for the first time receive a comprehensive oral examination. This exam is a thorough evaluation of the hard and soft tissues of the oral cavity and a head/neck region. The purpose of this C.O.E is to identify and diagnosis oral pathology and dental disease.
- Head/Neck Examination: A visual and tactile examination affords the dentist an opportunity to evaluate the head and neck regions. Visually, we inspect the head and neck area for abnormal changes. Pigmented lesions, nodules and tissue growths identified for further evaluation and biopsy. Palpating the soft and hard tissues of this area can help identify enlarged lymph nodes and nodules that are not on the skin’s surface. These can be signs of other underlying areas of concern.
- Radiographic Examination: Radiographs (x-rays) provide the dentist with information that is invisible to the naked eye. Decay between the teeth, bone loss under the gums and abscesses in the bone can be diagnosed from x-rays. Early detection of these problems allows for early treatment, minimizing in many cases, extensive dentistry if left undetected.
- Periodontal Evaluation: A Periodontal Evaluation is an examination of the gums, bone and the ligament that support the teeth in the mouth. Factors such as pocket depth, bleeding, suppuration (pus), gum recession and tooth mobility are recorded and used to create a baseline. From this information a periodontal diagnosis is made. If periodontal disease is present in any stage, a treatment protocol is established to help treat this condition. Subsequent evaluations help monitor the status of the patient’s gums and associated structures to determine if further treatment is necessary.
- Intraoral Examination: The Intraoral and Extraoral Examinations complete the comprehensive evaluation. Here we inspect the soft tissue for irregular changes. Muscles of mastication (chewing) are evaluated for tenderness. The teeth are evaluated for decay and existing restorations are examined for any problems that would warrant them to be replaced. Conditions such as grinding, malocclusions (bad bites) and joint pain are identified.
Periodic Oral Exams are completed on a regular basis at each hygiene visit. These evaluations allow the dental team to identify new problems as they arise, and to monitor existing issues to see if they warrant any further treatment. Keeping a close tab on your dental health helps identify dental concerns in their early stages which helps minimize extensive dental treatment.
Once all of this information is collected and analyzed, a diagnosis can be made and a list of necessary treatment determined. Only after consultation with the patient during which proposed treatment options are discussed, should treatment begin.
To help maintain optimal oral health, we will work with you to establish a dental plan to keep your smile healthy and beautiful. We will review your personal oral hygiene routines and are happy to answer any questions you may have.
Your teeth are not the only important part of your mouth. Your gums are essential to oral hygiene as well.
While we strongly encourage every patient to take an active role in his/her oral hygiene by regular brushing and flossing after meals and before bedtime, sometimes this is not enough. Plaque, a biofilm that continuously forms on your teeth, needs to be regularly removed. Bacteria in this plaque layer can cause both cavities and gum inflammation, which can further lead to periodontal disease.
A regularly scheduled dental prophylaxis (cleaning) allows the dental team to remove the plaque, tarter (calculus) and the bacterial toxins that cause gingival inflammation and periodontal disease. In addition, regularly scheduled periodic exams afford the dentist the opportunity to assess your oral health and monitor specific areas of concern.
Based on the condition of your oral hygiene, specific recommendations are made as to how often your teeth should be professionally cleaned and polished. For those individuals with poor oral hygiene, possibly as a result of orthodontic appliances or poor manual dexterity, we recommend more frequent cleanings. This helps prevent tooth breakdown and gum disease.
Inflammation of the gum tissue can progress to periodontal disease without any signs or symptoms of pain or discomfort. Left untreated, periodontal disease can result in tooth mobility, spaces between teeth, tooth pain, infection and tooth loss.
Early detection and diagnosis is essential for maintaining periodontal health. Since there is no cure for gum disease, identification of the disease process as soon as possible is critical. Routine prophylactic cleanings may be adequate for a healthy mouth, but individuals with gum disease (periodontitis) need additional therapy to help minimize the damage caused by the disease and return the gums and supporting structures to a healthy state.
In some cases, deep cleanings (Scaling and Root Planning) are adequate treatment. In those individuals where the disease has progressed, gum surgery by a periodontist may be needed. As with any disease process, the best treatment is prevention. Proper brushing, flossing and periodic evaluations are the first step in combating gum disease.
ZOOM!® Whitening is an in-office treatment that whitens your teeth in one visit. A protective gel or a rubber shield is placed over the gums to protect the soft tissue and to isolate the teeth. A whitening agent containing carbamide peroxide is then applied to the teeth, and a special light source is then used to enhance the action of the whitening agent.
Another whitening option we offer are Take Home Trays for at-home whitening. An impression of your teeth is taken to make a customized mouth trays to hold the whitening gel, containing carbide peroxide, against the teeth. Once the trays are made, they are worn for 1-2 hours a day for up to 14 days. At the end of the 14 days, you will enjoy a noticeably whiter and brighter smile!
Porcelain veneers are thin pieces of porcelain used to recreate the natural look of teeth. To place a veneer, a very small amount of the original tooth enamel must be removed. Afterwards, an adhesive layer is placed between the slightly prepped tooth and the veneer. The veneer is then hardened with a curing light.
A porcelain veneer is an extremely esthetic restoration fabricated in the dental laboratory. In basic terms it is a thin porcelain shell that bonds to the front of the tooth wrapping over the incisal edge.
Porcelain veneers are considered the restoration of choice when the tooth is discolored, stained, mottled, or has a congenitally unnatural size or shape. Typically when a veneer is considered, the underlying tooth has minimal restorations present.
The process takes approximately two to three visits. At the first visit we will discuss the new shape and look of your teeth and how we will accomplish this by fabricating veneers. Utilizing photographs and a diagnostic wax up, in many cases, we can actually simulate in your mouth how your new veneers will appear. Through the use of composite resin we can fabricate or “mock up” temporary veneers to give you a preview of your new smile.
Once we have put this plan in place, we carefully prepare (modify) the teeth for the new veneers. The next step is to take a mold of the newly prepared teeth, followed by selecting a shade for our new restorations. The porcelain veneers are custom fabricated at our dental laboratory by skilled dental technicians. While your new veneers are being created at our lab we will provide you with a beautiful temporary solution to wear during this process.
The veneers when placed can alter the shade, shape, size and contour of otherwise unsightly teeth, creating a brighter, vibrant and naturally esthetic smile.
A bridge replaces missing teeth without the use of a denture or dental implant. A false tooth is held in place by being attached to a neighboring tooth. In order to fabricate a bridge, crowns are made for the teeth on either side of the space and a false tooth is placed in between the crowns, which act as supports.
The dental implant or “fixture” which is fabricated from titanium or titanium alloy, is surgically placed in selected sites in the upper and/or lower arch(s). Through a biologic process called osseointegration, the dental implant “fuses” to the bone creating a rigid anchor to support a dental prosthesis (crown, bridge, complete denture or partial denture).
Abutment components are screwed into the implant fixture. It is these components that extend through the soft tissue into the mouth and onto which a crown or bridge is screwed and/or cemented, or onto which a removable denture is secured.
In order to place an implant fixture in a specific site, that site needs to have adequate bone and soft tissue to accommodate the implant. In those areas that are inadequate, surgical procedures to enhance and increase the amount of bone and soft tissue can be performed. These procedures need to be evaluated on a site-by-site basis since not all bone and soft tissue deficiencies are candidates for augmentation.
After a careful clinical and radiographic examination (in some cases a CT scan is required), the restorative dentist and patient plan out the desired treatment necessary to restore the area. This area can be a single tooth, multiple tooth sites and/or the entire upper and lower arches. Working closely with either an oral surgeon or periodontist, the restorative dentist and laboratory technician review the treatment plan and develop the necessary steps to implement treatment.
Pre-surgical planning is critical. This allows for possible complications to be identified and treatment modified prior to the surgical placement of the implants. While pre-surgical planning does not eliminate all potential complications related to the location of the implant placement, many are avoided.
After an adequate period of healing (3-6 months), the implants are ready to be restored. In some cases, a second, minor surgical procedure is necessary to uncover the implants, making them accessible to the oral cavity.
Based on the restorative treatment plan, the restorative dentist can now begin to restore these areas and create a functional and esthetic smile.
For those individuals who are missing all of their teeth in either the upper jaw or lower jaw, a complete Full Upper or complete Full Lower denture is an affordable option to restore your smile.
A complete denture is a prosthetic appliance made from highly esthetic resin teeth set in an acrylic base that intimately fits over your upper and/or lower jaw bones.
The dentist, through a series of appointments, takes impressions (molds) of your upper and lower jaws. The denture teeth are positioned to provide maximum function, esthetics, phonetics and comfort. After skillful adjustment, the dentures seat comfortably in your mouth providing a confident smile while allowing you to speak and eat normally.
Speak to one of our dentists to find out more about Full Upper/ Full Lower dentures and if this is the right treatment option choice for you.
For individuals who have multiple missing teeth , a Partial Denture may be the solution for you. Spaces in your mouth, in most cases, may be restored with crowns, bridges or implant prosthetics. For some individuals this may not be possible. When this is the case, the partial denture is the recommended treatment of choice.
Similar to a complete denture, a series of appointments are needed to take impressions (molds), set teeth, try in the denture and make the necessary adjustments. The final result will be an esthetic appliance that is retentive and comfortable.
There are several types of partial dentures. Some have teeth set in pink acrylic (to mimic the gums) which is attached to a metal framework with clasps. Other types do not have a metal framework and the teeth are set in pink acrylic which sits on the gums.
Inside the tooth, under the enamel and dentin is the pulp tissue. The pulp contains blood vessels, nerves and connective tissue. Endodontic treatment is necessary when the pulp becomes infected. The inflammation or infection may have a variety of causes: deep decay, repeated dental procedures, trauma to the tooth and faulty restorations to name a few. Left untreated, an inflamed or infected pulp may lead to a dental abscess and may cause pain.
When treatment is indicated, the inflamed and/or infected pulp tissue is removed from the canal. The canal is carefully cleaned and disinfected. The canal is then filled with a rubber like material called gutta percha. Once this is completed, the tooth can be restored with a crown.¹
¹ Information provided by American Association of Endodontists