Here is some background information that provides orientation for our patients.

What is a cavity?

Dental caries, also known as tooth decay or a cavity is the most prevalent disease process in humans. The bacterial plaque is a thin film that form on the teeth daily. This bacteria ingests the sugars from the diet and creates acid as a waste product. These acids dematerialize tooth enamel and cause decay. There are no symptoms with early tooth decay. Only when it advances does the patient become aware of it, requiring more advanced treatment.

Early decay can be treated with tooth colored composite materials that are bonded in place. More advanced decay may require a crown (cap) to restore it properly.

What is periodontal disease?

The word periodontal literally means “around the tooth.” Healthy cum tissue fits around the cuff of each tooth. Where the gum line meets the tooth it forms a slight v-shaped crevice called a sulcus. In healthy teeth, this space is usually three millimeters or less.

Periodontal disease are infections that affect the tissues and bone that support teeth. As the tissues are damaged, the sulcus develops into a pocket that is greater than three millimeters. Generally, the more severe the disease, the greater the pocket and bone loss. The enlarged pockets allow harmful bacteria to grow and make it difficult to practice effective oral hygiene. Left untreated, periodontal diseases may eventually lead to tooth loss.

What causes periodontal diseases?

The mouth is filled with countless bacteria. Periodontal disease begins when certain bacteria in plaque (the sticky, colorless film that constantly forms on the teeth and the surfaces lining the mouth) produce toxins and enzymes that irritate the gums and cause inflammation. The resulting inflammation, which may be painless, can damage the attachment of the gums and bone to the tooth.

Good oral hygiene – brushing twice a day and flossing or using another interdental cleaner once a day – helps reduce the plaque film. Plaque that is not removed regularly an harden in to rough porous deposits called calculus, or tartar. Tartar is not the main cause of periodontal diseases, but the pores in tartar hold bacteria and toxins, which are impossible to remove even with regular brushing. Once the hardened tartar forms, it can only be removed when the teeth are cleaned professionally in the dental office.

How would I know if I had periodontal disease?

Unlike tooth decay, which often causes discomfort, it is possible to have periodontal diseases without noticeable symptoms. That is why regular dental check ups and periodontal examinations are very important. Several warning sings can signal a problem. While periodontal disease may begin slowly in some patients, other may develop a rapidly progressive form of the disease. If you notice the following, see your dentist.

  • Gums that bleed easily
  • Red, swollen or tender gums
  • Gums that have pulled away from your teeth
  • Persistent bad breath
  • Pus between teeth and gums
  • Loose or separating teeth
  • A change in the way your teeth fit together when you bite
  • A change in the fit of partial dentures

Treating Periodontal Disease

Periodontal treatment methods depend upon the type and severity of the disease. If the disease is caught early (gingivitis), and no damage has been done, you may simply be given instructions on improving your daily hygiene.

The first non-surgical step usually involves a special cleaning, called scaling or root planing to remove plaque and tartar deposits on the tooth and root surfaces. This procedure helps the gum tissue to heal and pockets to shrink. This is sometimes referred to as “periodontal” or “deep cleaning” and may take ore than one visit.

Your dentist also may recommend medications to help control infection and pain, or to aid healing. These medications could be a pill, a mouth rinse or a substance that the dentist places directly in the periodontal pocket after the scaling and root planing. Your dentist may also stress the need to control any related systemic disease like diabetes.

At the next visit, the dentist checks the pocket depth to determine the effect of the scaling and root planning. If the disease has advanced to the point where the periodontal pockets are deep and the supporting bone is lost, surgery may be necessary. You may be referred to a periodontist for this treatment.

Periodontal surgery

When the sulcus develops deep pockets, it is difficult to completely remove plaque and tartar even with thorough daily oral hygiene. If the pockets do not heal after scaling and root planing, periodontal surgery may be needed to reduce the pocket depth and make teeth easier to keep clean.

Surgery allows the dentist to access hard-to-reach areas that require the removal of tartar and plaque. The gums are sutured back into place or into a new position to make the tissue snug around the tooth.

Bone surgery, including grafts may be used to rebuild or reshape bone destroyed by periodontal disease. Splints, bite guards or other appliances may be used to stabilize loose teeth and to aid in the regeneration of tissue during healing. If excessive gum tissue has been lost, a gum graft may be performed.

After surgery, the dentist may apply a protective dressing over teeth and gums and a special mouth rinse may be recommended or prescribed. An antibiotic and mild pain reliever also may be prescribed.


Once your periodontal treatment is completed, your dentist will want to see you at regular intervals. In some cases your appointments may alternate between your general dentist and a periodontist. Your dentist may recommend more frequent checkups. Daily cleaning helps keep the plaque under control and reduces tartar formation, but it won’t completely prevent it. Have your teeth cleaned regularly at the dental office to reduce plaque and remove calculus from places your toothbrush and floss have missed.

If you use tobacco, ask your dentist or physician for information about how to successfully stop the habit. Tobacco contains chemicals that can slow the healing process and make the treatment results less predictable. Good oral hygiene at home is essential to help keep periodontal disease from becoming more serious or from recurring. It takes just a few minutes twice a day to care for your teeth and gums.

Baby Teeth

People usually think of a newborn baby as having no teeth. But the 2o primarily teeth that will erupt in the next two and a half years are already present at birth in the baby’s jawbones. At birth, most of the crowns and primary teeth are almost complete, and the chewing surfaces of the permanent molars have begun forming.

Primary teeth are just as important as permanent teeth – for chewing, speaking, and appearance. In addition, the primary teeth hold the space in the jaws for the permanent teeth. Both primary and permanent teeth help give the face its shape and from.

The teething cycle

When teeth begin erupting, some babies may have sore or tender gums. Gently rubbing your child’s gums with a clean finger, small, cool spoon or wet gauze pad can be soothing. You can also give he baby a clean teething ring to chew on. If your child is still cranky and uncomfortable, consult your dentist or physician. Contrary to common belief, fever is not normal for a teething baby. If you infant has a fever while teething, call your physician.

A baby’s front four teeth usually erupt first, beginning as early as six months after birth. Most children have  a full set of 20 primary teeth by the time they are three years old. As your child grows, the jaws also grow, making room for the permanent teeth which will begin to erupt at about age six. At the same time, the roots of the primary teeth begin to be absorbed by the tissues around them, and the permanent teeth under them begin to erupt. By the time your child reaches 21, all 32 of the permanent teeth will usually have erupted.

Wisdom Teeth

If you’re a teen who’s 13 or older, you probably have most of your permanent, or adult teeth. The last of the permanent teeth to appear are called third molars or wisdom teeth. They usually begin to erupt, pushing their way through the gums, between ages 17 and 21.

Wisom teeth that are healthy and properly positioned can be an asset. For some teens however one or more of the four wisdom teeth may be missing, having never been formed. In most cases, wisdom teeth remain impacted, trapped beneath the gum and bone and against the teeth in front of them. They may partially erupt because the jaw can be crowded by other permanent teeth. the partially erupted teeth may tilt sideways and may cause damage to adjacent teeth.

Regular dental checkups are important not just for having your teeth cleaned but for allowing your dentist to track the progress and condition of your adult teeth. After examining your mouth and taking x-rays your dentist can evaluate your wisdom teeth and discuss whether or note they should be removed.

Why are they sometimes removed?

Because they are so far back in the mouth, wisdom teeth often are not needed for chewing and they are difficult to keep clean. Your dentist may recommend the early removal of impacted wisdom teeth to prevent against the potential complications of:

  • The wisdom tooth partially erupts through the gum. This creates an opening where bacterial may enter and cause infection. Pain, swelling and jaw stiffness may result.
  • The impacted wisdom tooth may continue growing without having enough room, which may damage the adjacent teeth.
  • A fluid filled sac (cyst) or tumor may form on or near the impacted tooth, destroying surrounding bone or tooth roots.

Understanding Root Canal Treatments

Natural teeth are meant to last a lifetime. Even if one of your teeth becomes injured or decayed, it can often be saved through a specialized dental procedure know as a root canal (endodontic) treatment. To help you understand when and why you might need this procedure and how a damaged tooth can be saved, we have answered some of the most frequently asked questions about endodontic treatment.

What is a root canal treatment?

Root canal treatment usually involves the removal of a tooth’s pulp, a small thread-like tissue that was important for tooth development. Once removed, it is replaced with materials that seal off the root canal from it’s surrounding tissues. Years ago, disease or injured teeth were often extracted. Today, even if the pulp in one of your teeth becomes injured or infected the tooth can be saved through root canal (endodontic) treatment. Endodontics is the branch of dentistry concerned with prevention, diagnosis and treatment of diseases or injuries to the dental pulp.

What is dental pulp?

The pulp is soft tissue inside the tooth that contains blood vessels, nerve and connective tissue. It lies in a canal that runs through the center of the dentim – the hard tissue on the inside of the tooth that supports the outer layer of tooth enamel. The crown (the portion of the tooth visible above the gums) contains the pulp chamber. The pulp extends from this chamber down through the root canal to the tip of the root that lies in the bone of the jaws. Teeth have only one pulp chamber but may have more than one root and several root canals.

What happens if the pulp gets injured?

When the pulp is diseased or injured and unable to repair itself, it loses its vitality. The most common causes of pulp death are a cracked tooth, a deep cavity, complications involving deep restorations or traumatic injury to the tooth, all of which can allow bacteria and their products to enter the pulp.

Why does the pulp need to be removed?

If the injured or diseased pulp is not removed, the tissues surrounding the root of the tooth can become infected and an abscess can form, resulting in pain and swelling. Even if there is no pain, certain substances released by bacteria can damage the bone that anchors the tooth in the jaw. Without treatment, the tooth may have to be removed.

Why couldn’t you just remove the tooth?

There are many disadvantages to losing a natural tooth. When a tooth is removed and not replaced, the adjacent teeth may begin to shift from their normal position. This may cause the teeth to become crooked and crowded, which decreases biting and chewing efficiency. Crowded or crooked teeth may be more prone to develop gum disease because they are harder to keep clean than properly aligned teeth. A replacement tooth ( an implant or a bridge) is usually more expensive than endodontic treatment and can involve more extensive dental procedures on adjacent teeth. A natural tooth is normally better than an artificial tooth.

How long will the restored tooth last?

A tooth with a root canal filling can provide years of service similar to adjacent teeth that have not been treated. Teeth witih root canal fillings can however, become decayed, develop fracture lines or become periodontally involved, just like any other tooth. Oral hygeine and regular dental exams will help you keep and maintain healthy teeth whether they are endodontically treated or not.

What material will be used for the crown?

Crowns are made of a number of materials. Gold allyoys or non precious alloys, porcelain or ceramic, acrylic or composite resin or cominations of these materilas may be used. The type of material used for the crown will depend on a number of factors including where the tooth is located in your mouth. the color of the tooth and the amount of natural tooth remaining. Speak to your dentist about which option is suited to your situation.

Three tooth replacement options

If you’re missing one or more teeth, you may be particularily aware of their importance to you appearance and dental health. The loss of a back tooth may cause your mouth to sink and your face to look older. All your teeth work together to help you chew, speak and smile. When teeth are missing, it is difficult to do these things. Fortunately, missing teeth can be replaced, and they should be.

Choosing the correct treatment is very important. Following are three options, depending on your needs and the best way to meet them.


A dental implant feels and looks like your own lost tooth. Here’s how it works. Your dentist inserts a metal post beneath your cum. It fuses to bone in your jaw and acts like teh root of a tooth. Then your dentist mounts a replacement tooth on the implant, where it’s most likely to blend in with the way your own teeth look and feel.

Most patients find that an implat is secure and stable – a good replacement for their own tooth. Implants, however are not an option for everyone. Because implants require surgery, patients should be in good health and have healthy gums. Further the patient either must have adequate bone to support the implant, or be a good candidate for surgery to build up the area need to implant. Patients also should be committed to very through oral hygiene every day, and regular dental visits. If you are considering implants, a full evaluation by your dentist will determine if you would be a good candidate.

Advantages of implants

  • Look and feel like normal teeth
  • Adjacent teeth do not have to be involved in the placement procedure
  • Minimize future jawbone shrinkage


  • Cost is higher than alternative procedures

if the number of implants required is extensive or complex, referral to a dental specialist may be indicated. Your dentist will help you with this decision. Following are specialist who may be called upon, and brief descriptions of their areas of expertise:

  • prosthodontist – restoration and replacement of teeth
  • oral or maxillofacial surgeon – dental surgery
  • periodontist – gum disease

Fixed Partial Dentures

Another alternative is a fixed partial denture (also called a fixed bridge). This is a restoration that replaces or spans the space where one or more teeth have been lost. A fixed partial denture is bonded or cemented in place — only a dentist can remove it.

Your appearance, dental health and proper functioning of your mouth are all important reasons for wearing a fixed partial denture. It helps maintain the natural shape of your face and may help support your lips and cheeks.

If you need extensive fixed partial denture work, your dentist will provide treatment or refer you to a orthodontist.

How a fixed partial denture is attached

A fixed partial denture is commonly cemented to the natural teeth next to the space left by the missing teeth. A false tooth (called a pontic) replaces the lost tooth. A pontic is attached to a crown (restoration that covers a tooth). Crowns, which are cemented on adjacent natural teeth serve as retainers that provide support for the fixed partial denture.

Different types of fixed partial dentures.

A fixed partial denture can be attached to your natural teeth. Different types of materials may be used in fixed partial dentures. These include gold, and porcelain fused to metal.

In some instances, a resin-bonded fixed partial denture, frequently called a “Maryland Bridge” can be sued to replace one or more missing teeth. Because it is attached by a special procedure called bonding, it doesn’t require the use of crowns or extensive tooth preparation. Your dentist can determine whether this treatment method is appropriate for you.

Advantages of fixed partial bridges:

  • Look, feel and function like natural teeth
  • No need to remove from mouth for cleaning


  • More expensive than removable partial dentures
  • Treatment is time-consuming and can be complicated
  • Check-ups necessary every few months.

Removable partial dentures

As its name describes, a removable partial denture (also called a removable bridge) readily can be take out of the mouth for cleaning. Although removable partial dentures generally are less expensive, fixed partial dentures, when indicated may feel more stable and comfortable.

Depending on your situation, however, a removable partial denture may be for you. Removable partial dentures usually have replacement teeth attached to a pink or gum colored plastic bases connected by metal framework. They may attache to your natural teeth with metal clasps or devices called precision attachments. A claspless removable partial denture, when indicated, may provide better support and esthetics. Crowns on your natural teeth may improve the way a removable partial denture fits your mouth. Ask your dentist which type is right for you.

Growing accustomed to a removable partial denture

Inserting and removing the new removable partial denture takes some practice. It may feel awkward for the first few weeks. However, your mouth eventually should become accustomed to it. The partial denture should fit into place with relative ease.

Your dentist can explain how long the removable partial denture should be worn and when it should be removed. At first, you may be asked to wear it all the time. While this may temporarily cause discomfort, it is the quickest way to identify any parts requiring adjustment. If the denture puts too much pressure on one area, that spot will become sore. Your dentist may recommend that you remove the denture before going to sleep and replace it when you awaken.

Advantages of removable partial dentures over fixed dentures:

  • Often look better
  • Easy to repair
  • Less expensive


  • Can be lost or broken when out of the mouth.

 Bruxism (Clenching, grinding teeth)

44 million Americans suffer from chronic clenching and grinding resulting in broken crowns, sore muscles, worn teeth, disturbed sleep, neck and jaw pain, fatigue.

There is a simple solution to protect teeth, muscles and joings. It’s called the NTI-tss Plus

The NTI-tss Plus is a small, taco-shaped device that fits securely and comfortably on your upper or lower front teeth while you sleep. It is a small custom fit piece of thermoplastic, not a large obtrusive guard. Everyone clenches their teeth at night. the NTI-tss Plus reduces the intensity of clenching by not allwoing the back teeth to touch. By discluding the posterior teeeth., grinding and clenching are minimized. This protects your teeth from damaging wear.
The NTI-tss Pluss is made of safe, clear, hard thermosplastic material. It is non-porous, so it won’t stain or absorb odors. It’s non-allergenic and easy to care for. the NTI-tss Pluss does not contain monomer or Bisphenol-A.