Routine dental cleanings are important to maintain good oral hygiene. Professional cleaning by a hygienist can remove mineralized plaque that may develop even with careful brushing and flossing, particularly in areas that are difficult to reach. It is recommended you go in for a cleaning once every six months.
How it’s done
You can expect your dental cleaning to last between 45 minutes to an hour. Typically, a trained hygienist will do the cleaning, and a dentist may come in for an exam at the end. Most people find that dental cleanings are painless, and do not cause any discomfort.
There are two important steps to a dental cleaning. The first step is scaling the teeth, whereby the hygienist will remove the plaque and tartar from the tooth surfaces. This can be performed by hand or with electric scalers depending on the hygienists preference.Typically, the hygienist will also clean the pockets of the gums to remove any plaque buildup there.
The second step is polishing to remove any final plaque and buff the teeth. Polishers generally have several different sized heads to clean hard to reach places
Dental Exams and X-Rays
Routine dental exams are important to maintaining healthy teeth and gums. Additionally, they can help to avoid the financial costs associated with large treatment plans later on. The Academy of General Dentistry recommends twice yearly checkups for people of all ages. At this frequency, most problems can be caught while they remain in an early stage.
How it’s done The dentist first examines your mouth visually, using dental equipment such as mouth mirrors, assorted dental tools, and high-intensity lights. Also review other important items such as:
Medical history: The dentist will assess how any new medical conditions or illnesses may affect your dental health.
Examination of tooth decay: Your mouth will be checked for cracked or decayed teeth.
Oral cancer screening: The face, neck, lips, tongue, throat, tissues, and gums will be checked for any signs of oral cancer.
Gum disease evaluation: Your gums and bone around the teeth will be checked for any evidence of periodontal disease.
Examination of existing restorations: Current fillings, crowns, and other restorations are checked for good contact.
Additionally, your dentist will take diagnostic x-rays to reveal any other hidden problems, especially in the areas below the gums. Bitewing x-rays are typically taken every 12 months and a panoramic x-ray, which revolves around the head, is taken every 3-5 years.
When treating a cavity, the dentist will remove the decayed portion of your tooth and fill it with another substance. This procedure is called a filling. There are multiple options for the material to be used in the filling, the most common are composite fillings and amalgam fillings.
A composite filling is also known as a tooth colored filling, since the material used in the filling can be closely matched to the color of your teeth. Composite fillings provide good durability for small to medium cavities, and the procedure typically involves removing less of a tooth than you would during an amalgam filling. They are also particularly well suited for treating front or highly visible teeth because of their natural look.
When can a composite filling be used for?
Decayed tooth (i.e. cavity)
Chipped or broken teeth
Decreasing the gap between teeth
How it’s done After the dentist numbs the area where the filling is to be placed, he will remove any decayed portions. A substance is then applied to help open up the pores of your teeth for a stronger bond, hardened, and cured with a special light. Once this is complete, the filling is applied in thin layers to slowly form the complete filling. After the composite has hardened, the filling will be smoothened and polished to be comfortable and fit your bite.
Endodontics/Root Canal Therapy
Endodontics is one of the dental specialties dealing with tooth pulp and tissues surrounding the root of a tooth. It involves many procedures such as root canal therapy, treating cracked teeth and dental truama. The signs of root canal problems are well familiar: severe pain, swelling, sensitivity to hot or cold water or a darkening tooth. In the past, root canal therapy was unpleasant, but thanks to modern dentistry, you don’t have to fear root canals anymore. You will be surprised how comfortable modern root canal therapy can be.
Root Canal Therapy
Root canal therapy is needed when the nerve of a tooth is affected by decay or infection. In order to save the tooth, the pulp (the living tissue inside the tooth), nerves, bacteria, and any decay are removed and the resulting space is filled with special, medicated dental materials, which restore the tooth to its full function.
Having a root canal done on a tooth is the treatment of choice to save a tooth that otherwise would die and have to be removed. Many patients believe that removing a tooth that has problems is the solution, but what is not realized is that extracting (pulling) a tooth willultimately be more costly and cause significant problems for adjacent teeth. Root canal treatment is highly successful and usually lasts a lifetime, although on occasion, a tooth will have to be retreated due to new infections.
Signs and symptoms for possible root canal therapy:
• An abscess (or pimple) on the gums
• Sensitivity to hot and cold
• Severe toothache pain
• Sometimes no symptoms are present
• Swelling and/or tenderness
Reasons for root canal therapy:
• Decay has reached the tooth pulp (the living tissue inside the tooth)
• Infection or abscess have developed inside the tooth or at the root tip
• Injury or trauma to the tooth
What does root canal therapy involve?
A root canal procedure requires one or more appointments and can be performed by a dentist or endodontist (a root canal specialist). While the tooth is numb, a rubber dam (a sheet of rubber) will be placed around the tooth to keep it dry and free of saliva. An access opening is made on top of the tooth and a series of root canal files are placed into the opening, one at a time, removing the pulp, nerve tissue, and bacteria. If tooth decay is present, it will also be removed with special dental instruments. Once the tooth is thoroughly cleaned, it will be sealed with either a permanent filling or, if additional appointments are needed, a temporary filling will be placed.
At the next appointment, usually a week later, the roots and the inside cavity of the tooth will be filled and sealed with special dental materials. A filling will be placed to cover the opening on top of the tooth. In addition, all teeth that have root canal treatment should have a crown (cap) placed. This will protect the tooth and prevent it from breaking, and restore it to its full function.
After treatment, your tooth may still be sensitive, but this will subside as the inflammation diminishes and the tooth has healed. You will be given care instructions after each appointment. Good oral hygiene practices and regular dental visits will aid in the life of your root canal treatment.
There are times when patients may need to have a natural, permanent tooth extracted. Patients may have a large area of decay, breakage that cannot be repaired or may have experienced periodontal disease that leaves the tooth loose and susceptible to removal. Some patients have teeth removed in preparation for orthodontic treatment or because of poor positioning such as impaction.
It is important to understand that the removal of a single tooth can have a major impact on your overall dental health and can result in shifting teeth, jaw joint issues and reduced chewing efficiency. To avoid these complications, dentists will discuss with patients alternatives to extractions (such as root canal therapy) or ways to replace the teeth following removal (bridges, dentures, and dental implants).
The process of extraction
When teeth are extracted, the dentist numbs the area with local anesthetics. This may include the jawbone, gums, and the tooth itself. Patients experience firm pressure while the tooth is rocked back and forth to widen the socket. There is no transference of pain during the extraction—if you experience discomfort, let the dentist know right away.
Sectioning of the tooth
There are times when teeth require sectioning. This is common and is done when the tooth has a firm anchor in the socket or the root is curved making it more difficult to remove in a more traditional sense. The dentist cuts the tooth structure into sections and removes the sections one at a time.
* Bleeding – patients are expected to deal with some bleeding. Following the extraction, the empty tooth socket should be covered with a moist gauze, patients should bite down firmly to control. Blood clotting is expected and necessary in the empty socket for proper healing. Do not dislodge the blood clot. Avoid using straws, hot liquids, and smoking within the first 24 hours, avoid spitting and rinsing.
* Swelling – swelling can occur following tooth extraction. Patients can use ice on the face for 10 minutes on, 20 minutes off. This cycle can be repeated over the first 24 hours.
* Pain medication – non-prescription pain relief medications (ibuprofen and acetaminophen) can be used if patients experience pain and discomfort.
* Eating – it is important to chew foods away from the extraction site following removal. Alcoholic beverages and hot liquids should be avoided for 24 hours, and some patients may find a liquid diet during the first day to be beneficial.
* Brushing and cleaning – avoid brushing the teeth surrounding the extraction site for 24 hours. Then resume gentle cleaning while avoiding commercial mouth rinses. These can irritate the extraction site. After 24 hours, patients can rinse with a salt water rinse (1/2 teaspoon of salt in a cup of water) following meals and before bedtime.
* Dry socket – when the blood clot fails to form, it can result into a dry socket. Healing is significantly delayed when this happens. Dry sockets appear as dull throbbing pain days after the extraction and pain can be moderate to severe. It can also result in a bad taste in the mouth and bad breath. Patients should contact their doctor if they are experiencing dry socket to sooth pain with a medicated dressing.
* Healing – once a tooth has been extracted, there will be a noticeable hole in the bone of the jaw where the tooth was once in place. Over several months, this will smooth out and the bone will regrow in the area. After 1-2 weeks, most patients no longer notice any inconvenience with the extraction site.
A sealant is a thin, plastic coating applied to the chewing surface of molars, premolars and any deep grooves (called pits and fissures) of teeth. More than 75% of dental decay begins in these deep grooves. Teeth with these conditions are hard to clean and are very susceptible to decay. A sealant protects the tooth by sealing deep grooves, creating a smooth, easy to clean surface. Sealants can protect teeth from decay for many years, but need to be checked for wear and chipping at regular dental visits.
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