|
DIAGNOSTIC AND PREVENTATIVE
Dental Exam:
A comprehensive dental exam will be performed by Dr. Epstein at your initial dental visit. The comprehensive exam includes:
-
Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
-
Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
-
Examination of tooth decay: All tooth surfaces will be checked for decay with special instruments.
-
Examination of existing restorations: Check current fillings, crowns, etc.
-
Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
Professional Dental Cleaning: Professional dental cleanings (dental prophylaxis) are performed by Certified Dental Hygienists. Your cleaning appointment will include a periodic dental exam and the following:
-
Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments.
-
Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease.
-
Teeth polishing: Removes stain and plaque that is not otherwise removed during toothbrushing and scaling.
Dental X-Rays: Dental radiographs (x-rays) are essential, preventative, diagnostic tools that provide valuable information not visible during a regular dental exam. X-rays are a necessary part of the diagnostic process, and not to use them could lead to undiagnosed disease. Without an X-ray of the whole tooth, and supporting bone and gum tissues, there is no real way to detect infection or pathology that requires attention.
Our office use the new state of the art DIGITAL DENTAL x-rays.
Dental x-rays may reveal:
-
Abscesses or cysts.
-
Bone loss.
-
Cancerous and non-cancerous tumors.
-
Decay between the teeth.
-
Developmental abnormalities.
-
Poor tooth and root positions.
-
Problems inside a tooth or below the gum line.
Detecting and treating dental problems at an early stage can save you time, money, unnecessary discomfit, and your teeth.
Are dental x-rays safe?
In our office we use digital radiography which allows us to take X-rays using 50-70% less radiation versus conventional X-rays. Coupled with computer monitoring, digital x-ray technology allows us to enhance the images for better diagnosis of any dental concerns.
How often should dental x-rays be taken?
The need for dental x-rays depends on each patient's individual dental health needs. Your dentist and dental hygienist will recommend necessary x-rays based on the review of your medical and dental history, dental exam, signs and symptoms, age consideration, and risk for disease.
A full mouth series of dental x-rays is recommended for new patients unless the patient has current x-rays from a previous dental office. A full series is usually good for three to five years. Bite-wing x-rays (x-rays of top and bottom teeth biting together) are taken at recall (check-up) visits and are recommended once a year to detect new dental problems.
Scans vs Dental Impression: We take highly accurate digital impressions of your teeth utilizing the cutting-edge technology of Lava™ Chairside Oral Scanner C.O.S. from 3M™ ESPE™. With the Lava C.O.S., traditional tray impressions are no longer necessary.
DENTAL PROCEDURES
Cavity Prevention: Cavities are the result of many factors. In the past, the recommended preventative measures have included brushing, flossing, fluoride and diet control – decreasing intake of sugar and carbohydrates. New research has shown that changing the acidity of one’s mouth may lead to a greater decrease in the number of cavities. Paul David Epstein, D.M. D. is pleased to offer our patients CariFree/Oral BioTech© which was developed with the vision of helping patients become cavity-free by assessing risks for dental disease, diagnosing the presence of the bacterial caries infection that causes cavities and treating the infection using preventive medical techniques. For additional information, please speak with Dr. Epstein or his staff or visit the Cariefree website, www.carifree.com .
Sealants: Sealants are used to fill in 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. These grooves may develop unnecessary cavities over time. The dentist will brush on a coating that seals the grooves and pits.
Fillings: Fillings are used replace the affected decayed tooth structure. Teeth are treated with bonded tooth colored composite resin fillings or silver amalgams.
Bonding: Bonding involves adhering composite resin material that is matched to the color of the tooth, to the front of the tooth. This is done to repair damage done to the tooth by decay, to alter the alignment of the tooth, close gaps between the teeth, or for cosmetic purposes. First the surface of the tooth is roughened in order to accept the bonding and hold it. A gel is applied to micro etch the tooth surface, and a primer/bond agent is applied so the material adheres to the surface. Then the material itself is placed on the tooth and hardened with intense light. The composite resin material is shaped and polished to get a lustrous finish as a last step.
Non-surgical Gum Treatments: (Scaling and root planing): . If you experience one or more of the following it may be a sign of gum disease (periodontal disease): 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 the proper care, however, it may be possible to return them to a healthy state. The treatment usually involves a deep cleaning or root planing done under a local anesthetic, and may require local antibiotic agents. If the gum disease gets too severe it may need to be treated through surgery.
Veneers: Dental veneers are thin porcelain shells placed directly on top of the tooth after preparation of the tooth surface. These shells are bonded to the front of the teeth changing their color, shape, size, or length. Dental veneers can eliminate gaps between teeth, tooth discoloration due to medications or smoking, broken or chipped teeth and can correct misaligned teeth.
Crowns: Crowns are full coverage restorations that are used to cover a tooth that is likely to break, or is too broken down to be restored with a filling. They are most commonly done after root canal treatment, or when a large filling wears out. The larger the hole made by a cavity that has to be treated, the more likely a crown will be needed. Even after a filling is put in a large cavity, a tooth is more likely to break. Keep in mind that the jaw muscles are the strongest in the human body. Teeth are subjected to tremendous pressures. Crowns ride over the weakened tooth, providing strength and protecting the tooth against breakage. A broken or cracked tooth is a far more serious matter and much more difficult to treat. Crowns prevent this, as well as improving the esthetic look of your smile.
It takes two appointments to restore a tooth with a crown. In the first any decay is removed from the tooth and it is shaped to accept the crown. Then an impression is made of the tooth for use in fabricating a crown. Between the two visits the crown is made, usually of high-strength porcelain over gold alloy, all ceramic material, or gold. During this time a temporary crown is worn. In the second visit this temporary is removed. Then the permanent crown is adjusted as needed and then cemented in place.
Implants: A dental implant is an option to replace a missing tooth. In this procedure, a small titanium shaft is surgically implanted into the bone and allowed to set. The bone grows around it forming a tight connection, which additionally slows or stops the bone loss that occurs when the root of a natural tooth is missing. Once the implant is firmly set in the mouth, the dentist then works to attach the replacement tooth onto the top of the shaft. This solution has the advantages over bridge work that it does not stress the surrounding teeth for support, and, should the tooth wear out, another can simply be replaced on the shaft.
Implants can also be used as support as part of an implant bridge. This is an alternative to removable partial dentures, and has several advantages. First, there is no adjustment period to acclimatize the patient who, once the work is done, only feels teeth, not metal supports intruding into the mouth. Second, this slows the bone loss occasioned by missing teeth. Third, there is no discomfort or difficulty in eating. And, best of all, of course, they don't have to be taken out all the time.
Bridge: This is an option for filling the space created by a missing tooth. It is formed to look like the missing tooth, and it takes its place in the mouth. The sides of a bridge use the two surrounding teeth for support, hence the name. A bridge replaces the missing tooth, both functionally and cosmetically. Bridge work is as much an art as it is an exact science. The materials used may be gold alloys, porcelain bonded to metal alloy, or all ceramic material. The choice of material depends on requirements for strength, wear, and/or esthetics.
It is important that a missing tooth be replaced as soon as possible for several reasons. If not treated the teeth surrounding the gap begin to shift inward, creating a whole chain reaction of bad things. Teeth use their neighbors for support, and, with one missing, they start to "fall." As this worsens the bite changes in response to the pressure. This can eventually result in problems with the entire jaw, e.g. TMJ.
Dentures and Partial Dentures: There are different types of dentures, but they share their common function. They replace teeth that have become loose or been lost due to bone loss. When bone loss around the roots of teeth is great enough to loosen them or let them fall out, it's time for dentures. Relax. No one enjoys losing their natural teeth, but you can still eat and talk regularly.
The entire mouth is examined and a determination is made as to which teeth will have to be removed, and which will remain. The loose teeth are then extracted. Dentures are fitted to go over or around whatever teeth remain in the mouth, depending on the type. There is an adjustment period after dentures are placed in the mouth, and it can take some getting used to. But once accustomed to the dentures, all the normal functionality and appearance return and one just carries on as usual. Often implants can used to further stabilize the dentures.
TMJ Disorder: TMJ stands for temporal-mandibular joint. When a patient experiences one or more of the following symptoms: stiffness of the jaw, trouble chewing, headaches, earaches and/or trouble with his or her bite, the patient may have a temporomandibular joint disorder.
Temporal, as in temple area of skull; mandibular as in mandible, or lower jaw; joint as in it's where the head and jaw meet. Problems in this joint may be caused by a misalignment of the teeth, grinding, clenching, trauma, or excess muscle tension. Aside from the two bones that meet there, cartilage buffers them and five muscles are involved in the area. If something goes wrong a good deal of trouble can result.
Diagnosis to determine the type of TMJ problem is the necessary first step in treatment. Most TMJ problems are muscular and should be initially treated with reversible splint therapy. The splint (orthotic, nightguard) is a laboratory fabricated appliance that fits over the upper or lower jaw and is precisely equilibrated (aligned or balanced) to allow the lower jaw to position itself to its proper position. In this position the muscles will be in their most relaxed position.
Orthodontics: Dr. Epstein is certified in INVISALIGN treatment. Invisalign is a step wise progression of moving teeth using clear trays. New trays are fitted and placedevery 2 weeks for the duration of treatment. |
