ORAL HYGIENE CARE
Maintaining good oral hygiene is one of the most important things you can do for your teeth and gums. Healthy teeth not only enable you to look and feel good, they make it possible to eat and speak properly. Good oral health is important to your overall well-being. Daily preventive care, including proper brushing and flossing, will help stop problems before they develop.
In between regular visits to the dentist, there are simple steps that each of us can take to greatly decrease the risk of developing tooth decay, gum disease and other dental problems. These include:
Brush thoroughly twice a day and floss daily
Eat a balanced diet and limit snacks between meals
Use dental products which contain fluoride, including toothpaste
Rinse with a flouride mouth rinse if advised to do so
Make sure children under 12 drink fluoridated water or take a fluoride supplement if they live in a non-fluoridated area
Visit your dentist regularly for professional cleanings and oral exams
Replace your toothbrush every 3-4 months
The following are indications of good oral hygiene:
Your teeth are clean and free of debris
Gums are pink and do not hurt or bleed when you brush or floss
Bad breath is not a constant problem
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A dental cleaning is a professional cleaning you receive from a dentist or dental hygienist. Most dental cleanings take only between 25 and 30 minutes. Cleanings should be performed every six months to prevent excessive plaque buildup. Plaque left untreated can lead to unhealthy gums and tooth decay. A routine dental cleaning should include scaling, root planing and polishing.
Scaling: this is the process of removing plaque and tartar from all tooth surfaces in a variety of methods, depending on the amount of plaque and tartar.
Dental hygienists traditionally perform scaling by hand. However, new and advanced technology has lead to more modern methods such as electric scalers. This sophisticated tool allows dental cleanings to be performed more efficiently and in less time. To achieve best results, both electric and manual scaling methods are combined for dental cleanings.
Root planing: this is the process of cleaning pockets in the gums to treat and prevent gum problems.
Root planing is used to treat moderate to advanced gum diseases. When the gum is inflamed, gum pockets become deeper and may lose connections to the bone inside. The deeper the pockets, the easier it is for plaque deposits to become trapped and worsen gum problems.
Root planing involves inserting a pointed dental tool called scalers into the gum pockets to clean plaque buildup. Depending on the degree of difficulty, root planing may take several appointments and a local anesthesia may be used to prevent pain.
Polishing: this is the last step in tooth cleaning and involves finishing the surface of the teeth to make them shiny and clean.
There are two kinds of polishing: air polishing and rubber tip polishing. Air polishing works by spraying high pressured water mixed with baking soda paste onto the surface of your teeth. This powered water washes away residue and plaque while baking soda removes stains. Rubber cup polishing uses a low-speed and gentle handpiece that contains a polishing paste made of abrasive ingredients ideal for removing stains. Back to top
Halitosis is sophisticated word for “bad breath”. Depending on the cause, bad breath may strike on occasion or be a persistent condition. The most common cause of bad breath is bacteria. Because the mouth is moist and warm, it creates perfect conditions for the millions of bacteria that live in the mouth. In fact, approximately 80% of bad breath is caused by something in the mouth.
Some types of bad breath, such as "morning mouth," are considered fairly normal and are not usually health concerns. However, persistent bad breath may be a sign of more serious problems with the gums and teeth.
Bad breath may be caused by the following:
Poor dental hygiene – poor oral hygiene can leave food particles to decay in the mouth
Infections in the mouth such as periodontal (gum) disease
Respiratory-tract infections such as throat infections, sinus infections, lung infections
External agents including foods such as garlic, onions, and coffee, as well as cigarettes and chewing tobacco
Dry mouth caused by salivary gland problems or by breathing through the mouth
Systemic illnesses such as diabetes, liver disease, kidney disease, lung disease, sinus disease, reflux disease and others
Call our office promptly if you have bad breath with painful, swollen gums that bleed easily or loose teeth. We will perform a physical examination of your mouth to determine the cause. If we discover that systematic problems are the cause, we may refer you to your family physician. In severe cases of gum disease, we may recommend a specialized periodontist. Back to top
Botox and Dermal Fillers
Botulinum Toxin (Xeomin, Dysport, Botox) for Best Therapeutic and Esthetic Outcomes.
Botulinium toxin therapeutic treatment of migraines, TMJ syndrome, facial pain and bruxism cases
Dermal fillers (Juvederm): Enhancing the cupids bow to create a beautiful lip
Volumizing the nasolabial folds, marionette lines, mentalis region and lifting up the corners of the mouth using anatomical landmarks
Smoothing lip lines and eliminating vertical "smokers" lines
Sealants are used to fill narrow grooves in a tooth that cannot be adequately cleaned by brushing. In some cases, the tooth structure has fine grooves or pits which accumulate plaque, not because the person doesn't brush, but because they're too narrow to allow even one bristle into them. To avoid cavities developing over time, the dentist will brush on a coating that seals the grooves and pits, making it possible to brush off all the plaque and keep your teeth healthy. Back to top
Bonding involves adhering composite resin material that is matched to the color of the tooth, to the front of the tooth. This is performed to repair damage caused by decay, to alter the alignment of the tooth, close gaps between the teeth, or for other cosmetic purposes.
First the surface of the tooth is roughened in order to accept the bonding. A gel is applied so the resin will adhere to the surface of the tooth. The composite is then placed on the tooth and the bonding agent hardens with intense light. The last step is shaping and polishing to give a lustrous finish. Back to top
A filling is a way to restore a tooth damaged by decay back to its normal function and shape. If you have a tooth that requires a filling, the dentist will first remove the decayed tooth material, clean the affected area, and then fill the cleaned out cavity with a filling material. A filling helps prevent further decay by closing off any cracks or spaces where bacteria can enter.
There are a variety of filling materials available including gold, silver, plastic and porcelain. The dentist will work with you to determine which material is best, depending on the extent of repair, where in the filling is needed, and cost. Each filling material is briefly explained below:
· Gold fillings are custom made in a laboratory and then cemented into place. While gold fillings are often the most expensive choice, many consider it the best filling material. Gold inlays are well-tolerated by gum tissues and may last more than 20 years.
· Amalgam (silver) fillings are a more inexpensive choice and are tolerant to wear. However, due to their dark color they are more noticeable than porcelain or composite restorations and are not recommended for fillings in very visible areas such as front teeth.
· Composite (plastic) resins are custom made to the exact color of your natural teeth, creating a more natural appearance. While white fillings may be less noticeable than other materials, they usually only last between 3 and 10 years and may not be ideal for large fillings as they may chip or wear over time. They can also become stained from coffee, tea or tobacco.
· Porcelain fillings are called inlays or onlays and are custom created in a lab and then bonded to the tooth. They can be matched to the color of the tooth, resist staining, and are about the same cost as gold fillings. A porcelain restoration generally covers most of the tooth, making the filling nearly undetectable.
If decay or a fracture has damaged a large portion of the tooth, a crown (or "cap") may be recommended. Decay that has reached the nerve may be treated through root canal therapy or through a procedure called pulp capping. Back to top
NON-SURGICAL GUM TREATMENT
The gums, ligaments, and bone around the teeth form the foundation for teeth. All structures are also referred to as the periodontium. When the periodontium is not healthy, it jeopardizes the teeth just as a bad foundation would threaten the stability of a house. Signs of unhealthy periodontium include: gums that are red and bleed easily, persistent bad breath, gums that are pulled away from the tooth, loose teeth, and changes in the position or bite of the teeth. With proper gum treatments, it may be possible to return gum tissue to a healthy state. If you're having a problem, come in and see us so we may treat it right away. The treatment usually involves a deep cleaning or root planing done under a local anesthetic, along with local antibiotic agents. It is important to have gum problems checked promptly, as gum disease left alone may eventually need treatment through surgery or extraction. Back to top
Crowns and bridges are used to restore and enhance teeth that are damaged or to take the place of missing teeth. A crown (also referred to as a cap) is used to entirely cover a damaged tooth. A crown not only strengthens a tooth, but it can dramatically improve a tooth’s appearance, shape and alignment.
Crowns may be used to:
- Replace a large filling when there is little tooth structure remaining
- Protect a weak tooth from fracturing
- Restore a fractured tooth
- Attach a bridge
- Cover a dental implant
- Cover a discolored or poorly shaped tooth
- Cover a tooth that has had root canal treatment
A bridge is an ideal method to fill the space created by missing teeth. A bridge is one or more artificial teeth cemented into place using the teeth on either side for support. This is an option for filling the space created by a missing tooth. Bridge work is as much an art as it is an exact science since it replaces a missing tooth both functionally and cosmetically. The materials used may be gold alloys, porcelain bonded to metal alloy, or all ceramic material made to match your natural tooth color. The choice of material depends on requirements for strength, wear, and aesthetics.
It is important that a missing tooth be replaced as soon as possible. If not treated, the teeth surrounding the gap begin to shift inward. Since teeth use their neighbors for support, if one is missing they begin to "fall” and shift into the open spaces. This may worsen the bite because of the changes in pressure and can eventually result in problems with the jaw such as TMJ.
Bridges and crowns are made by first taking an impression of your mouth. The impression is sent to a dental lab where your crown or bridge will be custom made to fit your mouth and match your natural tooth color. A temporary crown or bridge will be placed into your mouth until your permanent crown or bridge is ready and cemented into place.
Bridges and crowns are very durable and can last a lifetime with extra care and good oral hygiene. Back to top
Good oral hygiene should always be practiced since the loss of a single tooth can have major impact upon your oral health and appearance. Although dentists will use every measure to prevent tooth loss, there still sometimes necessary occasions when a tooth may need to be extracted. A tooth may need to be extracted for the following reasons:
- Severe decay
- Advanced periodontal disease
- Infection or abcess
- Orthodontic correction
- Malpositioned teeth
- Fractured teeth or roots
- Impacted teeth
After careful examination and treatment, the dentist may advise to have a tooth extracted. Before a tooth is removed, the dentist will take an x-ray in order to understand the shape and position of the tooth and surrounding bone. Based on the degree of difficulty, we may refer you to a specialized oral surgeon.
For a simple extraction, we will first apply a local anesthetic to prevent pain and discomfort. The tooth will be loosened with a tool called an elevator and then removed with dental forceps. Once the procedure is complete, the area may be closed with one or two stitches. We will then provide you with care instructions to alleviate discomfort and ensure proper healing. Back to top
WISDOM TOOTH EXTRACTIONS
Wisdom teeth are the last molars or “third molars” that develop on each side of the jaws. Wisdom teeth usually emerge in the back of the mouth between the ages of 16-20.
Wisdom teeth are a valuable asset to the mouth when they are healthy and properly positioned. Often, however, problems develop that require their removal. When the jaw isn't large enough to accommodate wisdom teeth, they can become impacted (unable to come in or misaligned). Wisdom teeth may also grow in sideways, emerge only part way through the gum or remain trapped beneath the gum and bone.
A wisdom tooth extraction is a relatively routine procedure. The dentist will numb the area in your mouth with a local anesthesia or use IV sedation so you are asleep during the procedure.
After the tooth is removed, we will provide care instructions to ensure proper healing. Some pain and swelling may occur but will normally subside after a few days. You should call your dentist if you have prolonged or severe pain, swelling, bleeding or fever. Back to top
ROOT CANAL TREATMENT
Root canal treatment (also referred to as root canal therapy or endodontic therapy) is made necessary when an untreated cavity reaches all the way to this pulp. Treatment may also be needed when deep restorations or trauma to a tooth cause nerve damage. Once the pulp becomes infected, and can begin to eat away at the surrounding bone (this is known as an abscess). If the pulp is infected, not only is it painful but it will require treatment as it cannot heal on its own. Symptoms that indicate the pulp has become infected may include sensitivity to hot/cold or sweets, pain, swelling, pain to biting or pressure, and a bad taste in the mouth. However, sometimes no symptoms are apparent and you may be unaware of any problem until a checkup.
A root canal is performed to clean out the infected tooth pulp and disinfect the canals of the tooth. Alternate treatment would be to extract the tooth. Once the infection is resolved, the canal is filled in to prevent any further infection. Usually a core build-up and crown is recommended for restoring a tooth that has undergone root canal therapy. Back to top
A dental implant is an ideal tooth restoration for people who are missing one or more teeth as a result of injury, periodontal disease, or any other reason. A dental implant is a metal post that a periodontist or oral surgeon surgically positions into the jaw. Once in place and bone surrounding the implant has had time to heal, a replacement tooth is attached to the post. While implants are typically more expensive than other methods of tooth replacement, they provide superior benefits. Implants are stronger than natural teeth and generally last 10-20 years. They are also a more favorable approach than bridgework since they do not depend on neighboring teeth for support.
To receive implants, you need to have healthy gums and adequate bone to support the implant. You must also be committed to excellent oral hygiene and regular dental visits as these are critical to the long-term success of dental implants. Back to top
A denture is a removable replacement for missing teeth and surrounding tissues. There are two types of dentures available, including partial and complete dentures. Partial dentures are used when some natural teeth remain, while complete dentures are used to completely replace all teeth. Dentures are made to resemble your natural teeth so there should be no noticeable change to your appearance. In fact, dentures may even improve your smile!
This restoration method is used to restore your smile and mouth function if all your teeth have been lost. The dentures are custom created to resemble natural teeth and are positioned to take the place of natural teeth. Complete dentures are removable and may require adjustments in order to create a proper fit with the gums and mouth.
A removable partial denture is a device used when one or more natural teeth still remain in the upper or lower jaw. They usually consist of replacement teeth attached go a gum-colored plastic base which is held in place in the mouth. A fixed partial denture acts the same as a removable denture, but it is cemented into place using adjacent teeth for support.
New dentures may feel awkward or loose for the first few weeks until the muscles of your cheek and tongue learn to keep them in place and you are comfortable eating and speaking. Although this may require some practice you will adjust and enjoy the benefits a full mouth of teeth can provide. Back to top
NIGHTGUARDS AND MOUTHGUARDS
Custom designed mouthguards and nightguards are made of flexible plastic and molded to fit the shape of your teeth. Mouthguards are recommended to protect the jaw and teeth during physical activity and sports such as boxing, football, basketball, or other activities where your mouth may be hit. Guards also protect the soft tissues of your tongue, lips and cheek lining. Nightguards are recommended for patients who clench or grind their teeth at night as a way to protect their teeth and bite.
If you have decided a guard is right for you, we will take an impression of your teeth which will then be sent to a lab to make a custom fit guard. In most cases you can choose from a variety of colors and styles. On average, guards last between 3 and 10 years. Back to top
TMJ stands for temporal-mandibular joint. Temporal, as in temple area of skull; mandibular as in mandible, or lower jaw; joint as in where the head and jaw meet. Problems in this joint may be caused by a misalignment of the teeth, trauma, or excess muscle tension. Cartilage buffers the two bones and five muscles that meet in this area, but any problems in this area can create quite a bit of pain and biting difficulties.
Symptoms of TMJ include:
- Trouble/soreness in opening and closing the mouth
- Clicking or popping of the jaw
- Pain in the jaw muscles
- Soreness in the area, sometimes extending to the face
Dental treatments for the condition can include replacing missing teeth, moving teeth, adjusting the bite and filling gaps between teeth. There is no one solution that is right for all cases. Occasionally a plastic mouthpiece is used to prevent clenching or grinding that is contributing to the problem. If untreated and in severe cases, surgery may be required to repair a badly damaged joint.
Botulinium toxin therapeutic treatment of migraines, TMJ syndrome, facial pain and bruxism cases
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Cosmetic dentistry includes procedures correct imperfections or enhance the appearance of the mouth. Tooth color, alignment, spacing as well as regularity of the teeth are the characteristics that give the overall appearance. Any of these can be enhanced to provide a stunning new smile.
Tooth whitening is a popular procedure to make teeth whiter and brighter, and therefore more attractive. Bleaching can be used to whitening stained and discolored teeth, or simply to enhance a dull smile. Either way, tooth whitening is a safe and relatively painless procedure ideal for most patients. Our office offers two methods of whitening: in-office whitening and tray whitening.
In-office whitening is an ideal for anyone wanting immediate results. The entire process takes place in our office in about an hour, making it the perfect choice for busy individuals. In this process, a protective gel is applied to your gums to protect the soft tissue. A special light-activated gel is then applied to your teeth and a special light or laser is used to enhance the action of the agent - making your teeth whiter and brighter. As a final step, we take impressions of your teeth to create custom trays for at home touch-ups, and give you instructions for keeping your smile bright. The result is dramatically whiter teeth that will last for years.
Tray whitening is a less expensive whitening treatment you can use while in the comfort of your own home. We will first take an impression of your mouth to create a customized clear whitening trays for you to wear. Within a few days your trays will be ready to be picked up and we will show you how to apply the special bleaching material to the trays. The whitening gel trays should be worn 30-60 minutes up to twice a day. At the end of this period, you will see maximum whitening results that are nothing short of dazzling. Occasional treatment can be used at your convenience to maintain your new smile. Back to top
Orthodontics is the art of using appliances to straighten and align teeth. Most commonly it involves the use of braces to move teeth into proper positing. In this method, brackets are bonded to the teeth and arch wires are threaded through the brackets. The arch wires act as a track, guiding each tooth to its proper position. There are several types of orthodontic braces available to patients, including traditional metal braces, ceramic "tooth colored" braces, as well as clear plastic braces.
Damon Bracket -- The Damon bracket uses a “sliding-door” technology called “self-litigation.” This new technology allows a wire to slide back and forth inside the bracket. This method requires no elastics, creates less friction and is therefore more comfortable for the patient than traditional braces. Damon brackets require fewer adjustments and a shorter treatment period.
Ceramic “Tooth Colored” Brackets -- Ceramic braces are translucent brackets that blend in with your natural tooth color. They are used with patients who are concerned about the appearance of their smile as they are less metallic looking than traditional braces. Ceramic braces are designed to resist staining and discoloration over long periods of time.
Clear Braces -- Clear Braces utilize brackets made of monocrystalline sapphire, which make the braces nearly see-through except for the thin arch wire. Next to the Invisalign system (below), clear braces are the closest thing to invisible braces.
Metal Braces -- Metal Braces are the most economical and traditionally used braces. Metal braces are also ideal for those with more extensive realignment needed.
Orthodontic Retainers are appliances made from plastic and stainless steel to custom fit your mouth. They act as a guide to hold your teeth into place after braces are removed. The retainer holds your teeth in place so your surround gums and bone can adjust around them – allowing you to maintain your realigned smile. Although the time you must wear a retainer will vary, many orthodontists recommend retainers are worn into the early 20s until the bone in your jaw and mouth has stopped growing. Back to top
The Invisalign treatment consists of a series of clear, snap-on, custom fit, removable mouth trays that apply a controlled amount of force to your teeth, forcing them to shift. The system provides the same beautiful results as traditional braces, but since the trays are made of clear plastic, they are virtually invisible. In addition, because Invisalign trays are removable, they can be taken out while eating, drinking, brushing and flossing.
The Invisalign System works by first creating a series of trays that will each moving your teeth gradually until the end result is achieved. At the end of each two-week period, you will switch trays. Throughout the process, you will visit your dentist every six weeks to ensure treatment is progressing as planned. Once your treatment is complete, you will likely wear a clear retainer to ensure your new smile stays in place.
As with all orthodontic appliances, the cost of Invisalign varies according to the complexity of the case. However, Invisalign is generally more expensive than traditional braces. Insurance policies generally cover Invisalign to the same extent that they cover traditional braces. To learn more, visit the Invisalign website by clicking here. Back to top
Veneers are a dental procedure in which a covering is placed over the outside (visible area) of the tooth. Veneers are usually only applied to the part of the tooth that is visible when talking or smiling. The procedure can be direct or indirect.
The direct technique usually involves placing composite resin on the outside of the tooth using bonding. This method is usually referred to as bonding.
The indirect technique usually involves two appointments because the veneers will be fabricated at a dental laboratory. At the first appointment the teeth are prepared, impressions taken, and the teeth are given a temporary covering. In two to three weeks the veneers are back from the laboratory, the temporaries are removed and the veneers are bonded to the teeth. The laboratory fabricated veneers are usually made using porcelain or pressed ceramic and are very aesthetic.
The advantage of veneers versus crowns is that much less tooth material is removed, and the procedure is generally less uncomfortable. Veneers are recommended for teeth that have large fillings or little tooth structure. Back to top
X-rays are a focused beam of x-ray particles passed through bone which produce an image on special film, showing the structure through which it passed. This provides the familiar black and white images doctors and dentists use to diagnose problems and disease. Without an x-ray of the whole tooth and supporting bone and gum tissues, there would be no way to detect infection or pathology that requires attention.
In our office we use digital radiography which allows us to take x-rays using up to 90% less radiation than conventional film x-rays. Using this technology, we are able to take an x-ray of your mouth by using a small sensor which records the image of your teeth and sends it to a computer. The result is a highly detailed image of your mouth that can easily be enhanced to better diagnosis dental concerns and determine the very best treatment for each case. Back to top
DIGITAL IMAGING SOFTWARE
We use digital imaging software in our office, which allows us to take a digital picture of you and use our imaging system to predict how a particular treatment or cosmetic procedure would change the appearance of your teeth. This software is beneficial for patients who are considering cosmetic procedures but are not sure if they’re ready for dramatic changes. Digital imaging also allows us to document your dental case and procedures very well.We take digital images of your face, teeth and smile to provide us with a permanent dental record and to provide a visual documentation of treatment. Back to top
ELECTRONIC CLAIM PROCESSING
Our office utilizes electronic claims processing. This means that rather than sending your dental claim through the mail, it is sent electronically to your insurance company with the click of the button. By filing your claim electronically, information is submitted more efficiently and with fewer errors.This benefits our patients because the turn around time on claims is faster and fewer claims are returned or denied. We are happy to submit your dental claims to your insurance company on your behalf. Back to top
4194 Convoy Street • San Diego, CA 92111 Tel 858-569-1918 • Fax 858-569-6244
504 E. Las Tunas Drive • San Gabriel, CA 91776 Tel 626-285-1918 • Fax 626-287-6175