Dental Glossary

Dental Glossary

Abfraction

Abfraction is the commonly seen condition of notching of the teeth near or even under the gum line. Though a combination of hard toothbrush bristles and improper brushing techniques can cause enamel to be lost at the gum line, this is not the cause of abfraction. When your bite is slightly off, it's common that one tooth may hit sooner than the rest. This causes undue stress on the involved teeth and they begin to flex. It's this continual flexing and stress that, over time, causes the enamel to separate from the inner dentin layer, forming the familiar looking notch associated with abfraction.

How do we correct abfraction?
There are two steps involved in solving the abfraction problem. First, we need to adjust your bite. We may have to adjust only the tooth in question, or we may have to adjust all your teeth. Chewing forces must be evenly distributed among all your teeth. We may have to have you back several times as we carefully fine-tune your bite.
The second phase involves restoring the damage by bonding a filling in place. White, natural looking fillings can fill in the damage and restore the tooth to nearly its original color and shape.

Amalgam

Amalgam is a mixture of mercury, and an alloy of silver, tin and copper. Mercury makes up about 45-50 percent of the compound. Mercury is used to bind the metals together and to provide a strong, hard durable filling. After years of research, mercury has been found to be the only element that will bind these metals together in such a way that can be easily manipulated into a tooth cavity.

Is mercury in dental amalgam safe?
Dental amalgam has never been proven to be unsafe by most researchers. However there is some controversy. There may be a small percentage of the population who may b e allergic or sensitive to the mercury in amalgam.
What alternatives are there to amalgam?
The profession is moving away from amalgam use and using other safer and more cosmetically appealing materials, such as composite resins and porcelains. Gold filling in certain areas of the mouth are also a great choice if aesthetics are not a concern.

Anesthesia

We use two type of anesthesia in our office - local anesthesia or nitrous oxide (laughing gas) sedation

Local Anesthesia: We use several kinds of local anesthetics drugs. Most patients refer to these as novacaine. Most often, we will administer 2% lidocaine with 1:100,000 epinephrine. The epinephrine is a vasoconstrictor which causes the blood vessels in the administered area to constrict allowing the lidocaine to be more effective, and stay where we place it. We also use 3% mepivacaine without epinephrine for patients with cardiac problems or hypertension or if there is sensitivity to epinephrine. A relatively new anesthetic called septocaine is giving deep local anesthesia for a shorter period of time. When we do surgeries, we will use longer lasting anesthesia like marcaine or 2% lidocaine with 1:50,000 epinephrine

Nitrous Oxide Sedation (laughing gas)

This is administered by inhalation, meaning that you breathe it through your nose with a nose piece. This can be used in combination with local anesthetic. This drug acts by increasing a patient's pain threshold and lowering their anxiety level. While administering Nitrous Oxide, a patient's "protective reflexes" are still intact, meaning that they can breathe on their own, swallow, and respond to commands. This sedation basically reduces the nervousness in a patient and helps get rid of the "butterflies in the stomach" feeling. When a patient is removed from the nitrous oxide, they return to normal within a few minutes. They can even drive home themselves if they have a license. This type of sedation is used for children and adults alike.

Anxiety

People are anxious about going to the dentist for different reasons, including worrying about the effectiveness of localized anesthetic and feeling like the dentist is rushed or is neglecting your concerns. Other factors include anticipation of pain, the cost of the procedure, past experiences, and even the sterile smell of the dental office. Interrupting the normal day's routine to visit the dentist also is a factor in general anxiety.

We reduce your anxiety before you ever step foot in the dental office. This process begins on the phone, while making appointments. Our office staff has been trained in caring patient services; and they will inform you of what to expect and answer your questions to ensure your confidence and comfort during your visit. Once you arrive for your appointment, we have made sure to make the reception room comfortable and clean, and filled it with magazines and dental health information and resources. We have made the office resemble a spa, with aromatic candles, music and television and other amenities to help you relax and unwind.

Some children are anxious because they are visiting the dentist's office for the first time. This experience into the unknown is a common reason for nervousness. We believe in keeping the young child well informed, no surprises! We believe in Tell, Show, Do and explaining all aspect of the dental procedure and instruments we use. Sometimes we will make up names like Mr. thirsty and cavity creeps to keep the child involved on their level. Televisions also help with the dental experience.

Knowledge is the greatest defense against anxiety. Avoiding caffeine before a dental appointment can make you less anxious. Eating high-protein foods produces a calming effect, unlike sugary foods. During the procedure, focus on breathing regularly and slowly. When you are nervous you tend to hold your breath, which decreases oxygen levels and further increases feelings of panic.

Baby Bottle Tooth Decay

Baby bottle tooth decay is caused by the frequent and long-term exposure of a child's teeth to liquids containing sugars. Among these liquids are milk, formula, fruit juice, sodas, and other sweetened drinks. The sugars in these liquids pool around the infant's teeth and gums, feeding the bacteria that cause plaque. Every time a child consumes a sugary liquid, acid attacks the teeth and gums. After numerous attacks, tooth decay can begin. The condition also is associated with breast-fed infants who have prolonged feeding habits or with children whose pacifiers are frequently dipped in honey, sugar or syrup. The sweet fluids left in the mouth increases the chances of cavities while the infant is sleeping.

How to prevent baby bottle tooth decay.
Never allow children to fall asleep with a bottle containing milk, formula, juice or other sweetened liquids. Clean and massage the baby's gums to help establish healthy teeth and to aid in teething. Wrap a moistened gauze square or washcloth around the finger and gently massage the gums and gingival tissues. This should be done once a day. Plaque removal activities should begin upon eruption of the first baby tooth. When brushing a child's teeth, use a soft toothbrush and a pea-shaped amount of fluoride toothpaste. Parents should first bring their child to the dentist when the child is about 3 years old unless you may suspect a problem.

Preventing baby bottle tooth decay involves changes in a child's diet. A series of small changes over a period of time is usually easier, and eventually leads to better oral health.

To incorporate these changes:
- Gradually dilute the bottle contents with water over a period of 2-3 weeks.
- Once that period is over, if you give a child a bottle, fill it with water or give the child a clean pacifier. The only safe liquid to put in a bottle to prevent baby bottle tooth decay is water.
- Decrease consumption of sugar, especially between meals.
- Children should be weaned from the bottle as soon as they can drink from a cup, but the bottle should not be taken away too soon, since the sucking motion aids in the development of facial muscles, as well as the tongue.

Bleaching/Whitening

Many people have had their teeth bleached, and probably millions more are thinking about it. The desire for a brighter smile with whiter teeth is very strong, and tooth bleaching safely lightens the color of the teeth, lasting for up to five years. The most effective and safest method of tooth bleaching is dentist-supervised.

Generally, bleaching is successful in at least 90 percent of patients, though it may not be an option for everyone. Consider tooth bleaching if your teeth are darkened from age, coffee, tea or smoking. Teeth darkened with the color of yellow, brown or orange respond better to lightening. Other types of gray stains caused by fluorosis, smoking or tetracycline are lightened, but results are not as dramatic.

If you're in a hurry for whiter teeth, you may decide to have your teeth lightened immediately. We will use an in-office bleaching system while you sit in the dental chair. You may also choose dentist-supervised at-home bleaching, which is more economical and provides the same results.

If you choose at-home teeth whitening, impressions will be made of your teeth to fabricate a mouthguard appliance for you. The mouthguard is custom made for your mouth and is lightweight so that it can be worn comfortably while you are awake or sleeping. The mouthguard is so thin that you should even be able to talk and work while wearing your mouthguard. Along with the mouthguard, you'll receive the bleaching materials. You'll be given instructions on how to wear the mouthguard. If you choose the in office whitening system, you will also receive the whitening mouth guards to use monthly.

Some bleaching systems recommend bleaching your teeth from two to four hours a day. Generally this type of system requires three to six weeks to complete, and works well on patients with sensitive teeth. Other systems recommend bleaching at night while you sleep. This type of system usually requires only 10-14 days to complete.

Lightness should last from one to five years, depending on your personal habits such as smoking and drinking coffee and tea. At this point you may choose to get a touch up. This procedure may not be as costly because you can probably still use the same mouthguard. The retreatment time also is much shorter than the original treatment time

Brushing

One effective brushing technique involves using a circular or elliptical motion to brush a couple of teeth at a time, gradually covering the entire mouth. Place a toothbrush beside your teeth at a 45-degree angle and gently brush teeth in an elliptical motion. Brush the outside of the teeth, inside the teeth, your tongue and the chewing surfaces and in between teeth. Using a back and forth motion causes the gum surface to recede, or can expose the root surface or make the root surface tender. You also risk wearing down the gum line.

In general, a toothbrush head should be small (1" by 1/2") for easy access. It should have a long, wide handle for a firm grasp. It should have soft, nylon bristles with round ends. Some brushes are too abrasive and can wear down teeth. A soft, rounded, multi-tufted brush can clean teeth effectively. Press just firmly enough to reach the spaces between the teeth as well as the surface. Medium and hard bristles are not recommended.

We recommend brushing at least 2 minutes twice a day. Using some type of timer is another way to measure your brushing time. Patients generally think they're brushing longer, but most spend less than a minute brushing. We recommend electric toothbrushes, either Oral-B/Braun or Sonic Care. Each of these brushes has the ideal tooth brushing motion and has various tips to get to other parts of your month. Usually there is a minimum 2 minute time on these brushes.

Bruxism (Teeth Grinding)

Bruxism is the technical term for grinding and clenching that abrades teeth and may cause facial, neck and shoulder pain. Another term which goes hand-in-hand with bruxism is a condition referred to as TMJ (Myofacial Pain Disorder). People who grind and clench, called bruxers, unintentionally bite down too hard at inappropriate times, such as in their sleep. In addition to grinding teeth, bruxers also may bite their fingernails, pencils and chew the inside of their cheek. People usually aren't diagnosed with bruxism until it is too late because so many people don't realize they have the habit. Others mistakenly believe that their teeth must touch at all times.

People who have otherwise healthy teeth and gums can clench so often and so hard that over time their teeth become sensitive. They experience jaw pain, tense muscles and headaches along with excessive wear on their teeth. Forceful biting when not eating may cause the jaw to move out of proper balance.

When a person has bruxism, the tips of the teeth look flat. Teeth are worn down so much that the enamel is rubbed off, exposing the inside of the tooth which is called dentin. When exposed, dentin may become sensitive. Bruxers may experience pain in their temporomandibular joint (TMJ)—the jaw—which may manifest itself as popping and clicking. Women have a higher prevalence of bruxism possibly because they are more likely to experience tissue alterations in the jaw resulting from clenching and grinding. Stress is the catalyst to bruxism which can trigger this condition..

Stress and certain personality types are at the root of bruxism. For as long as humankind has existed, bruxism has affected people with nervous tension. Anger, pain and frustration can trigger bruxing. People who are aggressive, competitive and hurried also may be at a greater risk for bruxism.

The objective of therapy is to control the forces placed on the teeth and jaw joint. We can make a special acrylic mouth appliance, such as a night guard that's worn to absorb and control the force of biting. This appliance can prevent future damage to the teeth and relieve them of associated joint and muscle pain. Medication may also be prescribed to relieve pain and soreness

Some of the signs are the following:
1. Sensitive and sore teeth, especially to cold
2. Clicking or popping jaw joints
3. Jaw pain especially when you wake up in the morning
4. Sore muscles in the facial, neck, or shoulder muscles
5. Headaches
6. Pain in the temple region
7. Pressure behind the eyes

Cavities

Tooth decay is the disease known as caries or cavities. Unlike other diseases, however, caries is not life threatening and is highly preventable, though it affects most people to some degree during their lifetime.

Tooth decay occurs when your teeth are frequently exposed to foods containing carbohydrates (starches and sugars) like soda pop, candy, ice cream, milk, cakes, and even fruits, vegetables and juices. Natural bacteria live in your mouth and form plaque. The plaque interacts with deposits left on your teeth from sugary and starchy foods to produce acids. These acids damage tooth enamel over time by dissolving, or demineralizing, the mineral structure of teeth, producing tooth decay and weakening the teeth.
How are cavities prevented?
The acids formed by plaque can be counteracted by simple saliva in your mouth, which acts as a buffer and remineralizing agent. However, though it is the body's natural defense against cavities, saliva alone is not sufficient to combat tooth decay. The best way to prevent caries is to brush and floss regularly. To rebuild the early damage caused by plaque bacteria, we use fluoride, a natural substance which helps to remineralize the tooth structure. Fluoride is added to toothpaste to fight cavities and clean teeth. The most common source of fluoride is in the water we drink. Fluoride is added to most community water supplies and to many bottled and canned beverages. If you are at medium to high risk for cavities, we may recommend special fluoride gels, mouth rinses, or dietary fluoride supplements. He may also recommend sealants.
What can I do to help protect my teeth?
The best way to combat cavities is to follow three simple steps:
1. Cut down on sweets and between-meal snacks. Remember, it's these sugary and starchy treats that put your teeth at extra risk.
2. Brush after every meal and floss daily.
3. See your dentist and the dental hygienist at least every six months for checkups and professional cleanings. Because cavities can be difficult to detect a thorough dental examination is very important. If you get a painful toothache, if your teeth are very sensitive to hot or cold foods, or if you notice signs of decay like white spots, tooth discolorations or cavities, make an appointment right away. The longer you wait to treat infected teeth the more intensive and lengthy the treatment will be. Left neglected, cavities can lead to root canal infection, permanent deterioration of decayed tooth substance and even loss of the tooth itself.
 
Child's First Visit
The ideal time is around 3 years old, unless you suspect a problem. This time frame is a perfect opportunity for the dentist to carefully examine the development of your child's mouth. Because dental problems often start early, the sooner the visit the better. To safeguard against problems such as baby bottle tooth decay, teething irritations, gum disease, and prolonged thumb-sucking, we can provide or recommend special preventive care.
How do I prepare my child and myself for the visit?
Before the visit, ask us about the procedures of the first appointment so there are no surprises. Plan a course of action for either reaction your child may exhibit-cooperative or non- cooperative. Talk to your child about what to expect, and build excitement as well as understanding about the upcoming visit. Bring with you to the appointment any records of your child's complete medical history. Children seem to do best in the morning when they are fresh. It is also nice to have the child observe the parent get their teeth cleaning.
What will happen on the first visit?
Many first visits are nothing more than introductory icebreakers to acquaint your child with the hygienist, the dentist and the practice. If the child is frightened, uncomfortable or non-cooperative, a rescheduling may be necessary. Patience and calm on the part of the parent and reassuring communication with your child are very important in these instances. Short, successive visits are meant to build the child's trust in the dentist and the staff, and can prove invaluable if your child needs to be treated later for any dental problem. Also, parents may be asked to wait in the reception area so a relationship can be built between your child and the dentist. If the child is compliant, the first session often lasts between 15-30 minutes and may include the following, depending on age:
- A gentle but thorough examination of the teeth, jaw, bite, gums and oral tissues to monitor growth and development and observe any problem areas;
- If indicated, a gentle cleaning, which includes polishing teeth and removing any plaque, tartar build-up and stains;
- X-rays (usually at age 5 or older);
- A demonstration on proper home cleaning; and,
- Assessment of the need for fluoride.

We should be able to answer any questions you have and try to make you and your child feel comfortable throughout the visit. The entire dental team and the office should provide a relaxed, non- threatening environment for your child.
When should the next visit be?
Children, like adults, should see the dentist every six months. Some dentists may schedule interim visits for every 3 months when the child is very young to build up a comfort and confidence level, or to treat a developing problem.
Five ways to protect your child's oral health at home
Parents typically provide oral hygiene care until the child is old enough to take personal responsibility for the daily dental health routine of brushing and flossing. A proper regimen of preventive home care is important from the day your child is born.
- Clean your infant's gums with a clean, damp cloth.
- As soon as the first teeth come in, begin brushing them with a small, soft-bristled toothbrush and a pea-sized dab of fluoride toothpaste. Remember, most children are also getting fluoride from the community water supply.
- To avoid baby bottle tooth decay and teeth misalignment due to sucking, try to wean your child off of the breast and bottle by one year of age, and monitor excessive sucking of pacifiers, fingers and thumbs. Never give your child a bottle of milk, juice or sweetened liquid as a pacifier at naptime or bedtime.
- Help a young child brush at night-the most important time to brush, due to lower salivary flow and higher susceptibility to cavities and plaque. Perhaps let the child brush their teeth first to build self-confidence, then the parent can follow up to ensure that all plaque is removed. Usually by age 5 or so, the child can learn to brush his or her own teeth with proper parental instruction.
- The best way to teach a child how to brush is to lead by good example. Allowing your child to watch you brush your teeth teaches the importance of good oral hygiene.

Why are primary teeth important?
Though you lose them early in life, your primary teeth, also called baby teeth, were essential in the development and placement of your permanent teeth. Primary teeth maintain the spaces where permanent teeth will erupt and help develop proper speech patterns that would otherwise be difficult without maintenance of the space; crowding and misalignment can occur, resulting in more complicated treatment later. Baby teeth also are good primers for teaching your child good oral care habits. It is important to take care of your child's primary teeth. Even though primary teeth last only a few years, decay, cavities and infection can take its toll, and may require expensive treatment to repair.
When do baby teeth come in?
Your child's primary teeth generally make their appearance when he or she is six or seven months old, though it can occur as early as birth. There are 20 primary teeth followed by 32 permanent teeth that will eventually replace them. Your child should have all his or her primary teeth at age three and will keep them until age five or six when they begin to loosen and fall out. This process usually lasts until the child is 12 or 13. Primary teeth fall out because permanent teeth are pushing them, and by about age 14 children have a full set of 28 permanent teeth, plus four additional teeth, called wisdom teeth that grow behind the permanent teeth in late adolescence for a total of 32.
What can relieve my child's discomfort?
Between the ages of six months and three years, your child may experience sore gums and general oral discomfort as primary teeth erupt. While some lucky children experience no apparent discomfort during eruption, many others do. Signs that eruption is causing discomfort in your child include crankiness, lack of appetite, excessive drooling, fever, restless behavior, pink or red cheeks, coughing, upset stomach, and chewing or sucking of fingers and toys. There are ways you can bring your child relief. A cold, wet cloth for your baby to suck on can sooth gums. There are also teething accessories and toys your child can chew on to relieve discomfort. Thumb sucking also brings relief, however, dentists recommend this practice should cease upon the arrival of the first set of permanent teeth or by age 3, so it does not interfere with the normal development of a child's oral cavity.
Should loose primary teeth be pulled?
Losing primary teeth before they are ready to fall out can affect the proper positioning of the permanent teeth. If a baby tooth is lost too early, other teeth may tip or fill in the vacant space, forcing permanent teeth to come in crooked. If a baby tooth is knocked out, see your dentist, who may recommend a space maintainer to reserve the gap until the permanent tooth comes in. In instances where a primary tooth is loose because of the emergence of a permanent tooth, have the child wiggle the tooth or eat something hard, such as an apple to help it along. Once the shell of the tooth is disconnected from the root, the discomfort in extracting a loose primary tooth is minimal.

Chronic Headache Pain

Many chronic headaches that have been incorrectly diagnosed as migraine or sinus headaches are in fact muscle spasm headaches caused by temporomandibular joint dysfunction. TMJ is a syndrome that develops when the teeth and bite are not in harmony with the jaw joint.

To check to see if you have TMJ dysfunction, do you have any of the following symptoms?
1. Head or neck aches.
2. Sensitive teeth to cold or heat.
3. Worn or broken teeth.
4. Loose teeth.
5. Receding gums.
6. Notching of teeth at the gum line.
Most people who clench or grind their teeth are completely unaware that they have a problem. If you have any of the above symptoms you may have TMJ dysfunction syndrome. Treatment is safe and gentle, especially if you catch it early enough to avoid permanent long term damage. Treatment can usually be done without the use of braces.

Composite Resin (White Filling)

A composite resin is a tooth-colored filling (plastic mixture filled with glass -- silicon dioxide). Introduced in the 1960s, dental composites were confined to the front teeth because they were not strong enough to withstand the pressure and wear generated by the back teeth. Since then, composites have been significantly improved and can be successfully placed in the back teeth as well. Composites are not only used to restore decayed areas, but are also used for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth. Following preparation, we place the composite in layers, using a light specialized to harden each layer. When the process is finished, we will shape the composite to fit the tooth. The dentist then polishes the composite to prevent staining and early wear.

Dental History/Advances

In 2002 the Academy of General Dentistry celebrated its 50th anniversary. Since 1952, many incredible strides have been taken to provide quality continuing education to general dentists in order to better serve the public. Though the dental profession has changed a great deal since then, it has changed even more through the ages. Many of the most common dental tools were used as early as the Stone Age. Thankfully, technology and continuing education have made going to the dentist a much more pleasant-and painless-experience. Here is a look at the history of dentistry's most common tools, and how they came to be vital components of our oral health care needs.
Where did toothbrushes and toothpaste come from?
The first toothbrushes were small sticks or twigs mashed at one end to create a broader cleaning surface. The Chinese lay claim to the first bristle toothbrush. Europe adopted the bristle brush in the 17th century, and many dentists practicing in colonial America advised their patients to use the brush. The first electric toothbrush was marketed in 1880, though the Swiss developed the first effective electric toothbrush just after World War II. It was introduced in the United States around 1960. A year later, the first cordless model was developed and proved to be popular with consumers and dentists. Toothpaste also saw its earliest form in ancient civilizations. Early toothpaste ingredients included powdered fruit, burnt or ground shells, talc, honey and dried flowers. Despite the decidedly non-minty flavor of early toothpaste, various recipes continued to appear throughout ancient history and well into the Middle Ages. Unfortunately, many of these toothpastes contained abrasive elements that dissolved tooth enamel. Toothpaste as we know it emerged in the 1800s, with ingredients that included soap and chalk. In 1892, the first collapsible tube was marketed and reigned supreme until 1984 when the pump-dispenser was introduced.. In 1956, Proctor & Gamble introduced Crest brand toothpaste with fluoride.
When was drinking water fluoridated?
In 1945, two cities-Newburgh, N.Y., and Grand Rapids, Mich.-introduced sodium fluoride into their public water systems to help fight tooth decay among residents. At the same time, a group of Wisconsin-based dentists succeeded in getting the state's water system fluoridated. After substantial testing showed that fluoride reduced incidents of cavities by as much as two-thirds, the U.S. Public Health Service in 1951 urged the entire country to fluoridate public drinking water. The idea for water fluoridation resulted from an observation made by a Colorado Springs dentist in the early 1900s. Dr. Frederick McKay noticed that locals had brown stains on their teeth. He called the staining "enamel mottling" and attributed it to drinking water with high fluoride content. He reported that the locals had a reduced incident of tooth decay. In 1940, another dentist revealed that one part fluoride per one million parts water was the ideal ratio for reducing decay while preventing staining. Soon after, fluoride gained acceptance, and today more than 60 percent of Americans have fluoridated water.
What's the history behind false teeth?
Thanks to modern technology, today's false teeth are largely indistinguishable from real teeth. This wasn't always the case. Perhaps the most famous false-toothed American was the first president, George Washington. Popular history gave Mr. Washington wooden teeth, though this was not the case. In fact, wooden teeth are impossible; the corrosive effects of saliva would have turned them into mushy pulp before long. As a matter of fact, the first president's false teeth came from a variety of sources, including teeth extracted from human and animal corpses. Despite this seemingly gruesome practice, dental practitioners preceding President Washington's time attempted aesthetic restorations. Ancient civilizations used ivory and bone to create new teeth. Unfortunately, this craft was lost until the mid-1800s. Rotten or damaged dentin was simply extracted, and gaps became a way of life. When false teeth were warranted, threads of silk or tightly coiled springs were used to hold the new teeth in place; it wasn't much of an anchor and teeth had to be removed before eating lest they literally spring from the wearer's mouth. Additionally, genuine teeth extracted from the living and the dead and set in another's mouth soon rotted. Those who could afford it, opted to have new teeth fashioned from ivory, gold or silver. It wasn't until 1774 that two Frenchmen, a pharmacist and a dentist, designed a set of porcelain teeth. Steady improvements were made on the teeth, most notably in 1808 when an Italian dentist invented a single porcelain tooth imbedded with a platinum pin. These teeth came to America in 1822, and for the rest of the century dentists and technicians tinkered with the design, fit and feel of the teeth. A breakthrough occurred in 1839 with the discovery of vulcanized rubber, which was used to hold false teeth. Today's dentures are made of either plastic or ceramic.
How long have we had anesthesia?
Though dentistry has been around in one form or another since the days of primitive man, painless extraction wasn't available until the 1830s. In the beginning, teeth were removed with a well-placed chisel and a hard swing of a mallet. Thousands of years later, during peaks of the great Greek and Roman civilizations, the chisel-and-mallet method was abandoned in favor of forceps. In the 1790s, a British chemist began to experiment with the use of nitrous oxide as a pain-inhibitor and noted that it’s most famous side effect, laughing. He coined the anesthetic's popular nickname, laughing gas. During the next 50 years, the gas became very popular. People were so taken with the exhilarating effects of the gas that inhalation parties became the rage. In 1863 the gas was combined with oxygen, becoming a staple of surgical procedures. Soon after the adoption of nitrous oxide, local anesthetics were developed. Just prior to the 1900s, cocaine was used, but once its addictive qualities were identified, the search began for a suitable alternative. Many of the alternatives were forms of synthetic cocaine, but none were successful until 1905 when a German chemist discovered procaine, which he named Novocain. The anesthetic proved extremely popular with dental professionals, as well as a public relived at the sound of "painless dentistry."

Dental Emergency

Injuries to the mouth may include teeth that are knocked out (avulsed), forced out of position and loosened (extruded) or fractured. In addition, lips, gums or cheeks are often cut. Oral injuries are often painful and should be treated as soon as possible.
How soon should I see a dentist?
Immediately, getting to a dentist within 30 minutes can make the difference between saving or losing a tooth.
When a tooth is knocked out:
Immediately call your dentist for an emergency appointment.
Handle the tooth by the crown, not the root. Touching the root (the part of the tooth below the gum) can damage cells necessary for bone re-attachment.
Gently rinse the tooth in water to remove dirt. Do not scrub.
Place the clean tooth in your mouth between the cheek and gum to keep it moist. It is important not to let the tooth dry out.
If it is not possible to store the tooth in the mouth of the injured person, wrap the tooth in a clean cloth or gauze and immerse in milk.
When a tooth is pushed out of position:
Attempt to reposition the tooth to its normal alignment using very light finger pressure, but do not force the tooth.
Bite down to keep the tooth from moving.
We may splint the tooth in place to the two healthy teeth next to the loose tooth.
When a tooth is fractured:
Rinse mouth with warm water. Use an ice pack or cold compress to reduce swelling.
Use ibuprofen, not aspirin, for pain.
Immediately get to us, where we will determine treatment based on how badly the tooth is broken. Only he can tell how bad the break is.
Minor fracture: Minor fractures can be smoothed with a sandpaper disc or simply left alone. Another option is to restore the tooth with a composite restoration. In either case, treat the tooth with care for several days.
Moderate fracture: Moderate fractures include damage to the enamel, dentin and/or pulp. If the pulp is not permanently damaged, the tooth may be restored with a full permanent crown. If pupal damage does occur, further dental treatment will be required.
Severe fracture: Severe fractures often mean a traumatized tooth with a less favorable prognosis.
When tissue is injured:
Injuries to the inside of the mouth include tears, puncture wounds and lacerations to the cheek, lips or tongue. The wound should be cleaned right away with warm water, and the injured person taken to a hospital emergency room for the necessary care. Bleeding from a tongue laceration can be reduced by pulling the tongue forward and using gauze to place pressure on the wound.
What can I do to be prepared?
Pack an emergency dental care kit, including:
our phone number
Saline solution
Handkerchief
Gauze
Small container with lid
Ibuprofen (Not aspirin. Aspirin is an anti-coagulant, which may cause excessive bleeding in a dental emergency.)
 
Dentures
A denture is a removable replacement for missing teeth and adjacent tissues. It is made of acrylic resin, sometimes in combination with various metals. Complete dentures replace all the teeth, while a partial denture fills in the spaces created by missing teeth and prevents other teeth from changing position. Complete dentures are either "conventional" or "immediate." A conventional denture is placed in the mouth about a month after all the teeth are removed to allow for proper healing, whereas an immediate denture is placed as soon as the teeth are removed. The drawback with an immediate denture is that it may require more adjustments after the healing has taken place. We can make a full conventional denture when all teeth have been lost or all extraction sites have healed (up to eight weeks or longer.) The denture process takes about one month and five appointments: the initial diagnosis is made; an impression and a wax bite are made to determine vertical dimensions and proper jaw position; a "try-in" is placed to assure proper color, shape and fit; and the patient's final denture is placed, following any minor adjustments. New denture wearers need time to get accustomed to their new "teeth" because even the best fitting dentures will feel awkward at first. While most patients can begin to speak normally within a few hours, many patients report discomfort with eating for several days to a few weeks. To get accustomed to chewing with a new denture, start with soft, easy-to-chew foods. In addition, denture wearers often notice a slight change in facial appearance, increased salivary flow, or minor speech difficulty.
How do you care for a denture?
A denture is fragile, so it is important to handle it with care. Remove and brush the denture daily, preferably with a brush designed specifically for cleaning dentures, using either a denture cleanser or toothpastes. Never use harsh, abrasive cleansers, including abrasives toothpastes, because they may scratch the surface of the denture. Don't sterilize your denture with boiling water because it will cause it to become warped. If you wear a partial denture be sure to remove it before brushing your natural teeth. When not in use, soak it in a cleanser solution or in water. Get in the habit of keeping the denture in the same safe and handy place to reduce the likelihood of misplacement.
Should a denture be worn at night?
While you may be advised to wear your denture almost constantly during the first two weeks- even while you sleep-under normal circumstances it is considered best to remove it at night. Research has shown that removing the denture for at least eight hours during either the day or night allows the gum tissue to rest and allows normal stimulation and cleansing by the tongue and saliva. This promotes better long-term health of the gums.
Are there any alternatives to dentures?
Dentures are no longer the only way to restore a mouth that has few teeth. Strategically placed support, or implants, can now be used to support permanently cemented bridges, or anchors for a partial denture. The cost tends to be greater, but the implants and bridges more closely resemble the "feel" of real teeth. Dental implants are becoming the alternative of choice to dentures, but not everyone is a candidate for implants.

Diabetes and Dentistry

It is estimated that 12 to 14 million people, or one-third of the population in the United States, have diabetes, but only one-half of these individuals are diagnosed.

Studies have shown that diabetics are more susceptible to the development of oral infections and periodontal disease than those who do not have diabetes. Oral infections tend to be more severe in diabetic patients than non-diabetic patients. And, diabetics who do not have good control over their blood sugar levels tend to have more oral health problems. These infections occur more often after puberty and in aging patients.
What types of problems could I experience?
Diabetics may experience diminished salivary flow and burning mouth or tongue. Dry mouth (xerostomia) also may develop, causing an increased incidence of decay. Gum recession has been found to occur more frequently and more extensively in moderate- and poorly-controlled diabetic patients because plaque responds differently, creating more harmful proteins in the gums. To prevent problems with bacterial infections in the mouth, We may prescribe antibiotics, medicated mouth rinses, and more frequent cleanings.

Make sure to take extra good care of your mouth and have dental infections treated immediately. Diabetics who receive good dental care and have good insulin control typically have a better chance at avoiding gum disease.

Diet and exercise may be the most important changes that diabetics can make to improve their quality of life and their oral health. Diabetic patients should be sure both their medical and dental care providers are aware of their medical history and periodontal status. To keep teeth and gums strong, diabetic patients should be aware of their blood sugar levels in addition to having their triglycerides and cholesterol levels checked on a regular basis. These may have a direct correlation on your chances of obtaining periodontal disease.

Diagnodent

Sometimes, it's difficult for us to diagnose cavities, especially in the pits and grooves on the biting surfaces of your back teeth. The widespread use of fluoride has made finding and restoring cavities early in their development more difficult in recent years. Fluoride hardens the outer enamel layer of your teeth, which means decay has a difficult time gaining a foothold. As a result, cavities are typically smaller and can be much harder to diagnose. The traditional way to check for cavities was by looking for visual signs of decay on the tooth, checking X-rays, or feeling for a soft area with a dental explorer. However, we now have a diagnostic tool called the Diagnodent that helps us locate even the smallest amount of decay. Diagnodent is a laser technology that scans your teeth with harmless pulses of light. When a cavity is present, fluorescent light of a different wavelength bounces back to the sensor, which is translated to a digital read-out. In general, the higher the number correlates to a greater amount of decay in the tooth. When a cavity is present, the Diagnodent also produces an audible signal. The result is a smaller, more conservative restoration that will last longer and have fewer possible complications.

Dry Mouth

Dry mouth is caused by a decrease in the amount of salvia in the mouth when the salivary glands do not work properly. The salivary glands help keep your mouth moist, which helps prevent decay and other oral health problems.

Dry mouth may be a sign of a serious health condition or may occur when a person is upset or experiences stress. It also can be caused by aging, radiation therapy and chemotherapy, medications, or diseases such as AIDS, diabetes or Sjogren's Syndrome. Even patients with Alzheimer's disease or who suffer a stroke may experience dry mouth.

Studies show that up to 400 medications, prescriptions and over-the-counter, can contribute to symptoms associated with dry mouth. The most common troublemakers are anti-hypertensives, anti-depressants, painkillers, tranquilizers, diuretics, and antihistamines. You want to prevent dry mouth if possible because it causes difficulty in tasting, chewing or swallowing. It also allows plaque to build up on your teeth faster, leading to a higher risk of cavities. In certain cases, a lack of moisture can make your tongue become very sensitive, causing a condition called burning tongue syndrome.

Flosses and Water Picks

Plaque is a sticky layer of material containing germs that accumulates on teeth, including places where toothbrushes can't reach. This can lead to gum disease. The best way to get rid of plaque is to brush and floss your teeth carefully every day. The toothbrush cleans the tops and sides of your teeth. Dental floss cleans in between them. Some people use water picks, but floss is the best choice. Floss removes plaque and debris that adhere to teeth and gums in between teeth, polishes tooth surfaces, and controls bad breath. Floss is the single most important weapon against plaque, perhaps more important than the toothbrush. Many people just don't spend enough time flossing or brushing and many have never been taught to floss or brush properly. When you visit Dr. Barry or hygienist, ask to be shown.

Flossing is the one most important step in oral care that people forget to do or claim they don't have time for. By flossing your teeth daily, you increase the chances of keeping your teeth a lifetime and decrease your chance of having periodontal or gum disease. Flossing cleans away the plaque from between your teeth, decreases the chance of interproximal decay and increases blood circulation in the gums.

Dental floss comes in many forms: waxed and unwaxed, flavored and unflavored, wide and regular. Wide floss, or dental tape, may be helpful for people with a lot of bridgework. Tapes are usually recommended when the spaces between teeth are wide. They all clean and remove plaque about the same. Waxed floss might be easier to slide between tight teeth or tight restorations. However, the unwaxed floss makes a squeaking sound to let you know your teeth are clean. Bonded unwaxed floss does not fray as easily as regular unwaxed floss, but does tear more than waxed floss.

There are two flossing methods: the spool method and the loop method. The spool method is suited for those with manual dexterity. Take an 18-inch piece of floss and wind the bulk of the floss lightly around the middle finger. (Don't cut off your finger's circulation!) Wind the rest of the floss similarly around the same finger of the opposite hand. This finger takes up the floss as it becomes soiled or frayed. Maneuver the floss between teeth with your index fingers and thumbs. Don't pull it down hard against your gums or you will hurt them. Don't rub it side to side as if you're shining shoes. Bring the floss up and down several times forming a "C" shape around the tooth being sure to go below the gum line. The loop method is suited for children or adults with less nimble hands, poor muscular coordination or arthritis. Take an 18-inch piece of floss and make it into a circle. Tie it securely with three knots. Place all of the fingers, except the thumb, within the loop. Use your index fingers to guide the floss through the lower teeth, and use your thumbs to guide the floss through the upper teeth, going below the gum line forming a "C" on the side of the tooth.
How often should I floss?
At least once a day. To give your teeth a good flossing, spend at least two or three minutes.
What are floss holders?
You may prefer a prethreaded flosser or floss holder, which often looks like a little hacksaw. Flossers are handy for people with limited dexterity, for those who are just beginning to floss, or for caretakers who are flossing someone else's teeth.
Is it safe to use toothpicks?
In a pinch, toothpicks are effective at removing food between teeth, but for daily cleaning of plaque between teeth, floss is recommended. Toothpicks come round and flat, narrow and thick. When you use a toothpick, don't press too hard as you can break off the end and lodge it in your gums.
Do I need a water pick (irrigating device)?
Don't use water picks as a substitute for tooth brushing and flossing. But they are effective around orthodontic braces that retain food in areas a toothbrush cannot reach. However, they do not remove plaque. Water picks are frequently recommended for persons with gum disease. Solutions containing antibacterial agents like chlorhexidine or tetracycline, available through a dentist's prescription, can be added to the reservoir.

Flouride

Fluoride is a compound of the element fluorine, which is found universally throughout nature in water, soil, air and in most foods. Existing abundantly in living tissue as an ion, fluoride is absorbed easily into tooth enamel, especially in children's growing teeth. Once teeth are developed, fluoride makes the entire tooth structure more resistant to decay and promotes remineralization, which aids in repairing early decay before the damage is even visible.
"Systemic" fluoride is ingested when added to public and private water supplies, soft drinks and teas, and is available in dietary supplement form. Once systemic fluoride is absorbed via the gastrointestinal tract, the blood supply distributes it throughout the entire body. Most fluoride not excreted is deposited in bones and hard tissues like teeth.
"Topical" fluoride is found in products containing strong concentrations of fluoride to fight tooth decay. These products, including toothpastes and mouth rinses, are applied directly to the teeth and are then expectorated or rinsed from the mouth without swallowing. We recommend brushing with fluoride toothpaste at least twice a day or after every meal, combined with a regimen of flossing and regular dental checkups.
Professionally-administered topical fluorides such as gels or varnishes are applied by the dentist and left on for about four minutes, usually during a cleaning treatment. For patients with a high risk of dental caries, the dentist may prescribe a special gel for daily home use, to be applied with or without a mouth tray for up to six weeks.
Fluoridated water protects against cavities and root caries-a progressive erosion of adult root surfaces caused by gum recession-and helps remineralize early carious lesions. Thanks to these preventive benefits, public water fluoridation is considered the most efficient and cost-effective dental caries prevention measure available. More than 144 million United States residents in more than 10,000 communities drink fluoridated water, most from public water supplies with sodium fluoride added artificially. Small percentages get water from private wells with naturally fluoridated water.
The Environmental Protection Agency has determined that the accepted "optimal" range of fluoride in water lies between 0.7 and 1.2 parts per million (ppm) or mg per liter. The limit allowed by the EPA in public water is 4 ppm. Backed by results from more than 140 documented studies undertaken in 20 different countries over the past several decades, fluoridated water adhering to these standards has been scientifically established as safe for drinking. Water fluoridation is endorsed by nearly every major health and safety-related organization. Fluoridation of community water supplies is the single most effective public health measure to prevent tooth decay and to improve oral health for a lifetime.
Can I get too much fluoride?
In general, the use of fluoride is considered safe unless it's misused or over concentrated. Drinking excessively fluoridated water can cause dental fluorosis, a harmless cosmetic discoloring or mottling of the enamel, visible by chalky white specks and lines or pitted and brown stained enamel on developing teeth.
Avoid swallowing toothpaste, mouth rinses or other topical supplements, and be careful not to accidentally take too much. If you are concerned about the fluoride levels in your drinking water, call the local public water department. If the source is a private well, request a fluoride content analysis taken via a water sample through your local or county health department.
Are children more sensitive to fluoride?
Children are more vulnerable to dental fluorosis because their developing teeth are sensitive to higher fluoride levels. They are at greater risk if they swallow or use too much toothpaste and fluoride supplements, or regularly drink water containing excessive fluoride levels. Monitor your child's intake and use of fluoride matter.

Gum Disease (Periodontal Disease)

Gum disease or periodontal disease, a chronic inflammation and infection of the gums and surrounding tissue, is the major cause of about 70 percent of adult tooth loss, affecting three out of four persons at some point in their life.
What causes gum disease?
Bacterial plaque - a sticky, colorless film that constantly forms on the teeth - is recognized as the primary cause of gum disease. Specific periodontal diseases may be associated with specific bacterial types. If plaque isn't removed each day by brushing and flossing, it hardens into a rough, porous substance called calculus (also known as tartar).Toxins (poisons) produced and released by bacteria in plaque irritate the gums. These toxins cause the breakdown of the fibers that hold the gums tightly to the teeth, creating periodontal pockets which fill with even more toxins and bacteria. As the disease progresses, pockets extend deeper and the bacteria moves down until the bone that holds the tooth in place is destroyed. The tooth eventually will fall out or require extraction.
Genetics is also a factor, as are lifestyle choices. A diet low in nutrients can diminish the body's ability to fight infection. Smokers and spit tobacco users have more irritation to gum tissues than non-tobacco users, while stress can also affect the ability to ward off disease. Diseases that interfere with the body's immune system, such as leukemia and AIDS, may worsen the condition of the gums. In patients with uncontrolled diabetes, where the body is more prone to infection, gum disease is more severe or harder to control.
What are the warning signs of gum disease?
Signs include red, swollen or tender gums, bleeding while brushing or flossing, gums that pull away from teeth, loose or separating teeth, puss between the gum and tooth, persistent bad breath, change in the way teeth fit together when the patient bites, and a change in the fit of partial dentures. While patients are advised to check for the warning signs, there might not be any discomfort until the disease has spread to a point where the tooth is unsalvageable. That's why patients are advised to get frequent dental exams.
In the early stages, most treatment involves scaling and root planing-removing plaque and calculus around the tooth and smoothing the root surfaces. Antibiotics or antimicrobials may be used to supplement the effects of scaling and root planing. In most cases of early gum disease, called gingivitis, scaling and root planing and proper daily cleaning achieve a satisfactory result. More advanced cases may require surgical treatment, which involves cutting the gums, and removing the hardened plaque build-up and recontouring the damaged bone. The procedure is also designed to smooth root surfaces and reposition the gum tissue so it will be easier to keep clean.

Halitosis

More than 90 million people suffer from chronic halitosis or bad breath. In most cases it originates from the gums and tongue. The odor is caused by bacteria from the decay of food particles, other debris in your mouth, and poor oral hygiene. The decay and debris produce a sulfur compound that causes the unpleasant odor.

Bad breath is primarily caused by poor oral hygiene, but can also be caused by retained food particles or gum disease. Proper brushing including brushing the tongue, cheeks, and the roof of the mouth will remove bacteria and food particles. Flossing removes accumulated bacteria, plaque and food that may be trapped between teeth. Mouth rinses are effective in temporary relief of bad breath. Consult your dentist and/or physician if the condition persists.

Bad breath also may occur in people who have a medical infection, gum disease, diabetes, kidney failure, or a liver malfunction. Xerostomia (dry mouth) and tobacco also contribute to this problem. Cancer patients who undergo radiation therapy may experience dry mouth. Even stress, dieting, snoring, age and hormonal changes can have an effect on your breath. An odor that comes from the back of your tongue may indicate post-nasal drip. This is where the mucus secretion, which comes from the nose and moves down your throat, gets stuck on the tongue and causes an odor. Bad breath originating in the stomach, however, is considered to be extremely rare.

Saliva is the key ingredient in your mouth that helps keep the odor under control because it helps wash away food particles and bacteria, the primary cause of bad breath. When you sleep, however, salivary glands slow down the production of saliva allowing the bacteria to grow inside the mouth. To alleviate "morning mouth," brush your teeth and eat a morning meal. Morning mouth also is associated with hunger or fasting. Those who skip breakfast, beware because the odor may reappear even if you've brushed your teeth.
Do certain foods cause bad breath?
Very spicy foods, such as onions and garlic, and coffee may be detected on a person's breath for up to 72 hours after digestion. Onions, for example, are absorbed by the stomach and the odor is then excreted through the lungs. Studies even have shown that garlic rubbed on the soles of the feet can show up on the breath.
How do I control bad breath?
It is important to practice good oral hygiene, such as brushing and flossing your teeth at least twice a day. To alleviate the odor, clean your tongue with your toothbrush or a tongue scraper, a plastic tool that scrapes away bacteria that builds on the tongue. Chewing sugar-free gum also may help control the odor. If you have dentures or a removable appliance, such as a retainer or mouthguard, clean the appliance thoroughly before placing it back in your mouth. Before you use mouth rinses, deodorizing sprays or tablets, talk with your dentist because these products only mask the odor temporarily, and some products work better than others.

Implants

A dental implant is an artificial tooth root (synthetic material) that is surgically anchored into your jaw to hold a replacement tooth or bridge in place. The benefit of using implants is that they don't rely on neighboring teeth for support, they are permanent and stable. Implants are a good solution to tooth loss because they look and feel like natural teeth.

Implant material is made from different types of metallic and bone-like ceramic materials that are compatible with body tissue. There are different types of dental implants: the first is placed directly into the jaw bone, like natural tooth roots; the second is used when the jaw structure is limited; therefore, a custom-made metal framework fits directly on the existing bone.
Strategically placed, implants can now be used to support permanently cemented bridges, eliminating the need for a denture. The cost tends to be greater, but the implants and bridges more closely resemble real teeth.
You must be in good health and have the proper bone structure and healthy gums for the implant to stay in place. People who are unable to wear dentures may also be good candidates. If you suffer from chronic problems, such as clenching or bruxism, or systemic diseases, such as diabetes, the success rate for implants decreases dramatically. Additionally, people who smoke or drink alcohol may not be good candidates.

What can I expect during this procedure?
The dentist must perform surgery to anchor the "artificial root" into or on your jaw bone. The procedure is done in the dental office with local anesthesia. Medications may be prescribed for soreness.
The process can take up to nine months to complete. Technology, however, is trying to decrease the healing time involved. Each patient heals differently, so times will vary. After the screws and posts are placed surgically, the healing process can take up to six months and the fitting of replacement teeth no more than two months.
The success rate for implants depends on the tooth's purpose and location in the mouth. The success rate is about 95 percent for those placed in the front of the lower jaw and 85 percent for those placed in the sides and rear of the upper jaw.

Your overall health may affect the success rate of dental implants. Poor oral hygiene is a big reason why some implants fail. It is important to floss and brush around the fixtures at least twice a day, without metal objects. Your dentist will give you specific instructions on how to care for your new implants. Additional cleanings of up to four times per year may be necessary to ensure that you retain healthy gums.

Infection Control

Infection control is the process of protecting patients, as well as dentists and their staff, against the spread of germs in the office. Dentists often come in contact with saliva and blood particles, all of which can carry bacteria and viruses that can spread from instruments and equipment dentist’s use.
In 1986, less than 30 percent of dentists wore gloves, masks or gowns. Thanks to approved procedures and heightened awareness to the dangers of infection, these infection control tools are required in all dental practices today. To fight the spread of diseases, such as HIV, Hepatitis B (HBV), syphilis and herpes viruses, your dentist has strict procedures and uses a variety of measures to ensure sterility in the office.
Universal precautions are safety procedures established by the Centers for Disease Control and Prevention and the American Dental Association. These precautions require all dental staff involved in patient care to use appropriate protective garb such as gloves, masks and eyewear. After each patient visit, the gloves are discarded, hands are washed and a new pair of gloves is used for the next patient. In fact, most of what a dentist wears can be thrown away after a single use. These precautions are used for each and every patient to prevent the transmission of the AIDS virus and other blood-borne and infectious diseases.
Do dentists sterilize the handpiece and other instruments after each patient?
Dentists sterilize handpieces and other instruments to prevent the transmission of diseases, after exams and procedures. Dental offices follow and monitor specific heat sterilization procedures, which are outlined by the Centers for Disease Control and Prevention and the American Dental Association. Most dental instruments are sterilized in special machines; it takes much more than just soap and water to make sure instruments are free of bacteria. Recommended sterilization methods include placing these tools into an autoclave (steam under pressure).
How are other objects sterilized?
Before you enter the examining room, all surfaces, such as the dental chair, drawer handles and countertops are disinfected. To sterilize equipment that can't be moved, such as X-ray units and countertops, disinfectant is applied after each patient to ensure a sterile environment. Some offices may drape this equipment with protective covers, which are replaced after each patient. Sharp items and anything contaminated with blood or saliva are disposed of in special containers with safety lids

Invisalign

If you have crooked or misaligned teeth, but don’t want to deal with the hassles of conventional braces, Invisalign® is the answer. This simple and effective orthodontic treatment option will give you the beautiful smile you’ve always wanted. Invisalign® makes use of a series of clear, removable, customized dental forms that fit comfortably in a patient's mouth. The virtually invisible dental aligners are each worn for about two weeks and can be removed to eat, drink, brush, and floss. Invisalign® generally requires 18 to 30 aligners throughout the entire treatment process, each of which is progressively modified to straighten your teeth little by little over a period of nine to fifteen months. Appointments will be made every four to six weeks to monitor your progress and ensure proper treatment.

Latex Allergy

Latex is a natural rubber harvested from trees and used in many consumer products. Allergy to natural rubber latex is now being recognized as an increasingly serious medical problem that affects not only health care workers, but the general population as well. The incidence of latex allergy, which now approaches 25 percent for health care workers (physicians, nurses, dentists, dental hygienists, and dental assistants) and two percent of other people, increased dramatically since the 1980s, due in large part to the increased use of latex gloves by health care workers in order to protect patients and themselves from HIV infection and other diseases.
Latex also is present in many household items, including baby bottle nipples, balloons, some bandages, condoms, diaphragms, elastics in garments and socks, erasers, hoses, makeup, rubber bands, stretch textiles, and many toys.

Latex allergy can be a significant problem because:
- Almost everybody is exposed to latex.
- Some people are allergic to latex and don't know it.
- The more an unsuspecting allergic person is exposed to latex the more serious the reaction can become.
- People who already have allergies (hay fever, reactions to animal dander, eczema, etc.) are more susceptible to additional allergies.
What are the symptoms of latex allergy?
Latex allergies can cause nausea, low blood pressure, and respiratory arrest. Symptoms begin within minutes after contact with the protein allergens in latex. The more common latex allergy is less serious. The symptoms include dry skin, hives, tingling sensations, or itching and symptoms usually appear 48-72 hours after the initial exposure. The most serious manifestation of latex allergy, anaphylactic shock, is the same reaction that people who are allergic to bee stings and penicillin get when stung or injected with the antibiotic.

Serious reactions are also due to continuous inhalation of the powder which lines latex gloves and become airborne when the gloves are "snapped off" during removal. The powder contains latex protein (the allergen) and can remain suspended in the air for up to 12 hours. Continuous exposure to such an environment can cause an asthma-like reaction where the individual has difficulty in breathing, coughing spells, itchy throat, chest pains, tiredness, sneezing, tearing, runny nose, etc. These symptoms, common to many other diseases, often are misdiagnosed

Lumineers

Are you a candidate for veneers? Yes. LUMINEERS BY CERINATE are the biggest breakthrough ever in achieving the smile that you’ve always wished for. These contact lens-thin “smile shapers” are so thin, yet so strong, that there is no need for the removal of any sensitive tooth structure, no shots, no drilling, and therefore, NO PAIN. No matter what your problem is, LUMINEERS are the perfect solution to your smile issues!

Chipped Teeth

Do you have a chip on one of your teeth, like right in the front where everyone can see? Bet it bothers you big time. While bonding may offer a temporary fix, it may not be the most reliable way to ensure an attractive smile for the long run. LUMINEERS offers a painless, permanent and pleasant way to fix your chipped tooth for good. You’ll always smile with confidence.

Mouthguards

A mouthguard is a flexible appliance made out of plastic that is worn in athletic and recreational activities to protect teeth from trauma.

Why should I wear a mouthguard?

To protect your mouth from injuries. The dental profession unanimously supports the use of mouthguards in a variety of sports activities. More than 200,000 injuries to the mouth and jaw occur each year.

Do mouthguards prevent injuries?

A mouthguard can prevent serious injuries such as concussions, cerebral hemorrhages, and incidents of unconsciousness, jaw fractures and neck injuries by helping to avoid situations where the lower jaw gets jammed into the upper jaw. Mouthguards are effective in moving soft issue in the oral cavity away from the teeth, preventing laceration and bruising of the lips and cheeks, especially for those who wear orthodontic appliances.

What are the different types of mouthguards?

Stock mouthguard: The lowest cost option is a stock item, which offers the least protection because the fit adjustment is limited. It may interfere with speech and breathing because this mouthguard requires that the jaw be closed to hold it in place. A stock mouthguard is not considered acceptable as a facial protective device.

Mouth-formed protectors: These mouthguards come as a shell-liner and "boil-and-bite" product. The shell is lined with acrylic or rubber. When placed in an athlete's mouth, the protector's lining material molds to the teeth and is allowed to set.

Custom-made mouth protectors: The best choice is a mouthguard custom-made by us. It offers the best protection, fit and comfort level because it is made from a cast to fit your teeth.

How should I care for a mouthguard?

- Clean your mouthguard by washing it with soap and warm (not hot) water.
- Keep your mouthguard in a well-ventilated plastic storage box when not in use. Make sure the box has several holes so the mouth-guard will dry.
- Heat is bad for mouthguards, so don't leave it in direct sunlight or in a closed automobile.
- Don't bend your mouthguard when storing.
- Don't handle or wear someone else's mouthguard.

Mouth Rinses

Rinses are generally classified by the U.S. Food and Drug Administration (FDA) as either cosmetic or therapeutic, or a combination of the two. Cosmetic rinses are commercial over-the-counter (OTC) products that help remove oral debris before or after brushing, temporarily suppress bad breath, diminish bacteria in the mouth and refresh the mouth with a pleasant taste. Therapeutic rinses have the benefits of their cosmetic counterparts, but also contain an added active ingredient that helps protect against some oral diseases. Therapeutic rinses are regulated by the FDA and are voluntarily approved by the American Dental Association (ADA). Therapeutic rinses also can be categorized into types according to use: antiplaque/ antigingivitis rinses and anticavity fluoride rinses.

Should I use a rinse?

That depends upon your needs. Most rinses are, at the very least, effective oral antiseptics that freshen the mouth and curb bad breath for up to three hours. Their success in preventing tooth decay, gingivitis (inflammation of the gingival gum tissue) and periodontal disease is limited, however. Rinses are not considered substitutes for regular dental examinations and proper home care. A regimen of brushing with fluoride toothpaste followed by flossing, along with routine trips your dental office, is sufficient in fighting tooth decay and periodontal disease.

Which type should I use?

Again, that depends upon your needs. While further testing is needed, initial studies have shown that most over-the-counter antiplaque rinses and antiseptics aren't much more effective against plaque and periodontal disease than rinsing with plain water. Most dentists are skeptical about the value of these antiplaque products, and studies point to only a 20 to 25 percent effectiveness, at best, in reducing the plaque that causes gingivitis.
Many dentists consider the use of fluoride toothpaste alone to be more than adequate protection against cavities. Dentists will prescribe certain rinses for patients with more severe oral problems such as caries, periodontal disease, gum inflammation and xerostomia (dry mouth). Patients who've recently undergone periodontal surgery are often prescribed these types of rinses. Likewise, many therapeutic rinses are strongly recommended for those who can't brush due to physical impairments or medical reasons.

What is the best mouth rinse?

Anticavity rinses with fluoride have been clinically proven to fight up to 50% more of the bacteria that cause cavities. However, initial studies have shown that most over-the-counter antiplaque rinses and antiseptics are not much more effective against plaque and gum disease than rinsing with water. Most rinses are effective in curbing bad breath and freshening the mouth for up to three hours.

My Oral Health

You may be able to prevent two of the most common diseases of modern civilization, tooth decay (caries) and periodontal disease, simply by improving your diet. Decay results when the hard tissues are destroyed by acid products from oral bacteria. Certain foods and food combinations are linked to higher levels of cavity-causing bacteria. Although poor nutrition does not directly cause periodontal disease, many researchers believe that the disease progresses faster and is more severe in patients whose diet does not supply the necessary nutrients. Periodontal disease affects the supporting tissues of the teeth and is the leading cause of tooth loss in adults.

Poor nutrition affects the entire immune system, thereby increasing susceptibility to many disorders. People with lowered immune systems have been shown to be at higher risk for periodontal disease. Additionally, today's research shows a link between oral health and systemic conditions, such as diabetes and cardiovascular disease. So eating a variety of foods as part of a well-balanced diet may not only improve your dental health, but increasing fiber and vitamin intake may reduce the risk of other diseases.

How can I plan my meals and snacks to promote better oral health?

Eat a well-balanced diet characterized by moderation and variety. Develop eating habits that follow the recommendations from reputable health organizations such as The American Dietetic Association and The National Institutes of Health. Choose foods from the four basic food groups: fruits and vegetables, breads and cereals, milk and dairy products, meat, chicken, fish or beans. Avoid fad diets that limit or eliminate entire food groups which usually result in vitamin or mineral deficiencies.

Always keep your mouth moist by drinking lots of water. Saliva protects both hard and soft oral tissues. If you have a dry mouth, supplement your diet with sugarless candy or gum to stimulate saliva.

Foods that cling to your teeth promote tooth decay. So when you snack, avoid soft, sweet, sticky foods, such as cakes, candy and dried fruits. Instead, choose dentally healthy foods such as nuts, raw vegetables, plain yogurt, cheese and sugarless gum or candy.

When you eat fermentable carbohydrates, such as crackers, cookies and chips, eat them as part of your meal, instead of by themselves. Combinations of foods neutralize acids in the mouth and inhibit tooth decay. For example, enjoy cheese with your crackers. Your snack will be just as satisfying and better for your dental health. One caution: malnutrition (bad nutrition) can result from too much nourishment as easily as too little. Each time you eat, you create an environment for oral bacteria to develop. Additionally, studies are showing that dental disease is just as related to overeating as heart disease, obesity, diabetes and hypertension. So making a habit of eating too much of just about anything, too frequently, should be avoided.

Oral Cancer

Oral cancer, the sixth most common cancer, accounts for about 3.6 percent of all cancers diagnosed, with roughly 40,000 new cases of oral cancer reported annually in the United States. The vast majority of oral cancers occur in people older than 45 years, with men being twice as likely as women to develop the disease. The most frequent oral cancer sites are the tongue, the floor of the mouth, soft palate tissues in back of the tongue, lips, and gums. If not diagnosed and treated in its early stages, oral cancer can spread, leading to chronic pain, loss of function, irreparable facial and oral disfigurement following surgery, and even death. Dr. Barry can perform a thorough screening for oral cancer.

What causes oral cancer?

Scientists aren't sure of the exact cause of oral cancer. However, the carcinogens in tobacco products, alcohol and certain foods, as well as excessive exposure to the sun have been found to increase the risk of developing oral cancer. Risk factors for oral cancer may also be genetically inherited.

What are the warning signs to watch out for?

Oral cancer-represented by red, white or discolored lesions, patches or lumps in or around the mouth-is typically painless in its early stages. As the malignant cancer spreads and destroys healthy oral tissue, the lesions or lumps become more painful. However, oral cancer is sometimes difficult to self-diagnose so routine dental exams are recommended. See us immediately if you observe: any sore that persists longer than two weeks; a swelling, growth or lump anywhere in or about the mouth or neck; white or red patches in the mouth or on the lips; repeated bleeding from the mouth or throat; difficulty swallowing or persistent hoarseness.

We screen for oral cancer during routine checkups. We feels for lumps or irregular tissue changes in your neck, head, cheeks and oral cavity, and thoroughly examines the soft tissues in your mouth, specifically looking for any sores or discolored tissues.

How is oral cancer treated?

If we suspect oral cancer, a biopsy of the lesion is required to confirm the diagnosis. Surgery is required to remove the tumors, which may cause disfiguration. Radiation therapy may be used as part of the treatment.

What can I do to prevent oral cancer?

Oral cancer accounts for roughly 9,000 deaths annually (about 3 percent of all cancer-caused deaths). Of all major cancers, oral cancer has the worst five-year survival rate at about 54 percent. Because oral cancer is usually not diagnosed in its early stages, less than half of all oral cancer patients are cured. You can help prevent oral cancer by not smoking, using spit tobacco and drinking excessive alcohol. When tobacco use and alcohol use are combined, the risk of oral cancer increases 15 times more than non-users of tobacco and alcohol products. Research suggests that eating plenty of fruits and vegetables may safeguard against oral cancer. Because successful treatment and rehabilitation are dependent on early detection, it is extremely important to see us for an oral cancer screening and regular checkup at least every six months. Survival rates greatly increase the earlier oral cancer is discovered and treated.

Reducing your risk of oral cancer

You can help by letting us know if you notice any of these warning signs:
- a red, white, or otherwise discolored patch or lump in or around your mouth;
- a sore that does not heal or that bleeds easily;
- an area that seems to have thickened, raised, or become hardened;
- a rough patch of tissue;
- difficulty chewing or swallowing;
- or a chronic sore throat or hoarseness.
It's vital that you not ignore a mouth sore just because it doesn't hurt; most pre-cancerous and cancerous lesions are completely painless. You can also minimize your chances of developing oral cancer by making some lifestyle changes. Don't smoke or use chewing tobacco, avoid excessive alcohol use, and make sure you're eating plenty of fruits and vegetables each day.

Oral Health

Oral health means more than just an attractive smile. Poor oral health and untreated oral diseases and conditions can have a significant impact on quality of life. And in many cases, the condition of the mouth mirrors the condition of the body as a whole. Recent reports indicate a relationship between periodontal (gum) disease and stroke, heart disease, and pre-term low-birth-weight babies. Likewise, more than 90 percent of all systemic diseases have oral manifestations, meaning Dr. Barry may be the first health care provider to diagnose a health problem.

What problems can poor oral health cause?

According to the recently released Surgeon General's report on oral health in America, a large percentage of the population suffers from a reduced quality of life due to oral and facial pain. This pain is largely due to infections of the gums that support the teeth and can lead to tooth loss. More than 75 percent of the population is affected by some type of periodontal disease or gingivitis.

Recent reports show that infections in the mouth can affect major organs. One example is bacterial endocarditis, a condition in which the lining of the heart and heart valves become inflamed. Poor mouth care also can contribute to oral cancer, which now takes more lives annually than cervical or skin cancer.

In addition, poor oral health affects the digestive process, which begins with physical and chemical activities in the mouth. Problems here can lead to intestinal failure, Irritable Bowel Syndrome and other problems.
What symptoms from other diseases show up in the mouth?

Mouth tissues reflect symptoms of other problems. In addition, many diseases can be diagnosed in their early stages through an oral examination. These diseases may be characterized by swollen gums, mouth ulcers, dry mouth and/or excessive gum problems. Some of these diseases include diabetes, leukemia, cancer, heart disease and kidney disease.
 
Oral Health and Your Heart

Researchers are finding possible links between periodontal infections and other diseases throughout the body. Current studies suggest that there may be a link between periodontal (gum) disease, heart disease and other health conditions. In fact, research suggests that gum disease may be a more serious risk factor for heart disease than hypertension, smoking, cholesterol, gender and age. New studies suggest that people who have gum disease seem to be at a higher risk for heart attacks, although no one is certain how this relationship works. Your oral health affects your overall health, but the studies that will find exactly why these problems are linked are still underway.

How can gum disease affect my overall health?

The current theory is that bacteria present in infected gums can come loose and move throughout the body. The same bacteria that cause gum disease and irritate your gums might travel to your arteries. Researchers are unsure what causes the bacteria to become mobile, but it has been suggested that bacteria can be dislodged and enter the bloodstream during tasks as simple as brushing, flossing or even chewing.

Research shows that risk varies according to the level of gum infection. The worse the infection, the more likely the bacteria are to become blood-borne. Infected gums bleed, making it easier for bacteria to enter your bloodstream. If bacteria become dislodged, the bacteria enter through cuts or sores in your mouth and travel to other parts of the body through your bloodstream. Once bacteria reaches the arteries, they can irritate them in the same way that they irritate gum tissue. This could cause arterial plaque to accumulate in the arteries, which can cause hardening and block blood-flow. Compromised blood-flow to your heart can cause a heart attack. Also, arterial plaque can come loose and travel to other parts of the body. If blockage occurs in the brain, it can cause a stroke.

Orthodontics

Orthodontics is a special discipline of dentistry concerned with aligning the teeth and jaws to improve one's smile and oral health. "Ortho" means correct or straight, and "Odont" means tooth.

Dr. Barry usually recommends braces to improve the patient's physical "orofacial" appearance. Through orthodontic treatment, problems like crooked or crowded teeth, overbites or underbites, incorrect jaw position and disorders of the jaw joints are corrected.

Patients with orthodontic problems can benefit from treatment at nearly any age. An ideal time for placement of braces is between 10 and 14 years of age, while the head and mouth are still growing and teeth are more accessible to straightening. However, because any adjustments in facial appearance can be traumatic to a child during these sensitive years, parents should discuss the matter with their children before braces are applied.

And braces aren't just for kids. More and more adults are also wearing braces to correct minor problems and to improve their smiles.

The orthodontist will know what appliance is best for your particular problem, but the patient often has a choice. Braces generally come in three varieties: The most popular type is brackets, metal or plastic, which are bonded to teeth and are far less noticeable. The "lingual" types of braces are brackets that attach to the back of teeth, hidden from view. Bands are the old-fashioned type that covers most of your teeth with metal bands that wrap around the teeth. All use wires to move the teeth to the desired position.

That depends upon your treatment plan. The more complicated your spacing or bite problem is, and the older you are, the longer the period of treatment, usually. Most patients can count on wearing full braces between 18 and 30 months, followed by the wearing of a retainer for at least a few months to set and align tissues surrounding straightened teeth.

Will treatment be uncomfortable?

The interconnecting wires are tightened at each visit, bearing mild pressure on the brackets or bands to shift teeth or jaws gradually into a desired position. Your teeth and jaws may feel slightly sore after each visit, but the discomfort is brief. Keep in mind also that some teeth may need to be extracted to make room for teeth being shifted with braces and for proper jaw alignment.

Do I have to avoid any foods or personal habits?

Yes. Cut down on sweets, chips and pop. Sugary and starchy foods generate acids and plaque that can cause tooth decay and promote gum disease.

Cut healthy, hard foods like carrots or apples into smaller pieces. Sticky, chewy sweets like caramel can cause wire damage and loosen brackets. Avoid hard and crunchy snacks that can break braces, including popcorn, nuts and hard candy. More don’ts: ice cube chewing, thumb sucking, excessive mouth breathing, lip biting and pushing your tongue against your teeth.

What about home care of my teeth with braces?

With braces, oral hygiene is more important than ever. Braces have tiny spaces where food particles and plaque get trapped. Brush carefully after every meal with fluoride toothpaste and a soft-bristled toothbrush. Rinse thoroughly and check your teeth in the mirror to make sure they're clean. Take time to floss between braces and under wires with the help of a floss threader. Have your teeth cleaned every six months to keep your gums and teeth healthy. Insufficient cleaning while wearing braces can cause enamel staining around brackets or bands.

Piercing

Oral piercing can cause pain, swelling, infection, drooling, taste loss, scarring, chipped teeth, and tooth loss. Regulations vary in each state, so be careful if you decide to get any kind of piercing. To avoid serious infections such as HIV or Hepatitis, make sure that you ask the person performing the piercing about care after the piercing, possible side effects, cleanliness and anything that may concern you. Does the piercer use a fresh needle for every piercing? Some may reuse needles to keep down the cost of the piercing. Make sure they completely sterilize all needles and instruments in an autoclave, which uses extreme heat to sanitize instruments. If they are not prepared to answer your questions in a clear, professional manner, go somewhere else.

Also, make sure that they use the right kind of metal, such as surgical-grade stainless steel. Some people have allergic reactions to certain metals, which can lead to further complications.

Chipped teeth

Fractured teeth are a common problem for people with oral piercings. People chip teeth on tongue piercings while eating, sleeping, talking and simply chewing on the jewelry. The fracture can be confined to the enamel of your tooth or may go deep into your tooth, which may require a root canal or extraction.

Possible infections

Any infection can be serious. It is not unusual for the tongue to swell after being punctured, but in some cases the tongue becomes infected and swells so much that it can cut off your breathing. In rare cases, doctors may pass a breathing tube through a patient's nose until such an infection is resolved.

Dentists are learning that oral infections can lead to infections in other parts of the body. Your mouth has high levels of bacteria. When you puncture any part of the oral cavity, this bacterium may find its way into your bloodstream. Bacteria can reach your heart and cause a variety of health problems.

How do I maintain my piercing?

Once your tongue has been pierced, it will take three to four weeks to heal. Barring complications, you will be able to remove the jewelry for short periods of time without the hole closing. Some suggest that you remove the jewelry to protect your teeth every time you eat or sleep. Some parlors sell plugs that you can place in the hole, which should allow you to remove the jewelry for as long as necessary.

The piercer will place a larger, starter 'barbell' in your tongue to give it enough room to heal when your tongue swells. If you decide to keep the piercing, make sure to get a smaller barbell after the swelling goes down, which will be less likely to get in the way of your teeth and more difficult for you to chew on. Keep your piercing clean. Use an antiseptic mouthwash after every meal and brush the jewelry the same as you would your teeth. After the tongue has healed, take the piercing out every night and brush it as you would your teeth to remove any unseen plaque. Consider removing the piercing before eating, sleeping or strenuous activity.

Root Canal

A root canal is a procedure done to remove the damaged or dead pulp in the root canal of the tooth by cleaning out the diseased pulp and reshaping the canal. The canal is filled with gutta percha, a rubberlike material, to prevent recontamination of the tooth. The tooth is then permanently sealed with possibly a post and/or a gold or porcelain crown. This enables patients to keep the original tooth.

First, you will probably be given a local anesthetic to numb the area. Next, a gap is drilled from the crown into the pulp chamber, which, along with any infected root canal, is cleaned of all diseased pulp and reshaped. Medication may be inserted into the area to fight bacteria. Depending on the condition of the tooth, the crown may then be sealed temporarily to guard against recontamination, or the tooth may be left open to drain, or fill the canals.

If you're given a temporary filling, usually on the next visit it's removed and the pulp chamber and canal(s) are filled with rubberlike gutta percha or another material to prevent recontamination. If the tooth is still weak, a metal post may be inserted above the canal filling to reinforce the tooth. Once filled, the area is permanently sealed. Finally, a gold or porcelain crown is normally placed over the tooth to strengthen its structure and improve appearance.

More than 95 percent of root canal treatments are successful. However, on occasion, a root canal therapy will fail altogether, marked by a return of pain.

Natural tissue inflammation may cause discomfort for a few days, which can be controlled by an over-the-counter analgesic. A follow-up exam can monitor tissue healing. From this point on, brush and floss regularly, avoid chewing hard foods on the treated tooth.

Sensitivity

Tooth sensitivity is caused by the stimulation of cells within tiny tubes located in the dentin (the layer of tissue found beneath the hard enamel that contains the inner pulp). When the hard enamel is worn down or gums have receded-causing the tiny tube surfaces to be exposed-pain can be caused by eating or drinking food and beverages that are hot or cold; touching your teeth; or exposing them to cold air.

Hot and cold temperature changes cause your teeth to expand and contract. Over time, your teeth can develop microscopic cracks that allow these sensations to seep through to the nerves. Exposed areas of the tooth can cause pain and even affect or change your eating, drinking and breathing habits. Taking a spoonful of ice cream, for example, can be a painful experience for people with sensitive teeth.

Sensitive teeth are one of the most common complaints among dental patients. At least 45 million adults in the United States and 5 million Canadians, suffer at some time from sensitive teeth.

Some toothpaste contains abrasive ingredients that may be too harsh for people who have sensitive teeth. Ingredients found in some whitening toothpastes that lighten and/or remove certain stains from enamel, and sodium pyrophosphate, the key ingredient in tartar-control toothpastes may increase tooth sensitivity.

What can I do about sensitive teeth?

Tooth sensitivity can be reduced by using desensitizing toothpaste, applying sealants and other desensitizing ionization and filling materials including fluoride by your dentist, and decreasing the intake of acid-containing foods. Tartar control toothpastes will sometimes cause teeth to be sensitive as well as drinking diet soft drinks throughout the day.
Avoid using hard bristled toothbrushes and brushing your teeth too hard, which can wear down the tooth's root surface and expose sensitive spots. The way to find out if you're brushing your teeth too hard is to take a good look at your toothbrush. If the bristles are pointing in multiple directions, you're brushing too hard.

Do some products work to help decrease sensitivity?

Toothpastes for sensitive teeth usually contain a desensitizing agent that protects the exposed dentin by blocking the tubes in the teeth that are connected to nerves. In most cases, these products must be used on a regular basis for at least a month before any therapeutic benefits may be noticed.

What can the dentist do for my sensitive teeth?

Dentists have a variety of regimens to manage tooth hypersensitivity, including both in-office treatments and patient-applied products for home use. If you are diagnosed with dentin hypersensitivity, your dentist may apply a desensitizing agent or a protective coating. You may be prescribed a stannous fluoride gel or an over-the-counter desensitizing toothpaste containing fluoride and either potassium nitrate or strontium chloride. These ingredients help block transmission of sensation from the tooth to the nerve. It also might help to massage the special paste onto your gums with your finger after brushing.

Sports and Dental Issues

Following the rules and remembering dental first aid steps can help save your teeth the next time you dive into a swimming pool, reports the Academy of General Dentistry, an organization of general dentists dedicated to continuing dental education.

During the summer, swimming pool accidents are the number one cause of dental emergencies. Swimming underwater and quickly coming to the surface can cause some children to hit the hard ledge, loosening the front tooth.
Also, running on slippery, slick cement and ceramic pool surfaces sends many children headfirst into the ground, often causing chipped or displaced (loose) teeth. Diving into shallow waters and hitting the bottom pushes the tooth up and can fracture the whole bone.

A study published in General Dentistry, the clinical journal of the Academy of General Dentistry, investigated 72,000 adult emergency room patient visits; of those, 2,895 visits were for the treatment of dental conditions, representing 3.8 percent of all the hospital emergency room visits. Visits most often occurred between 5 p.m. to 9 p.m. with the highest number of visits on Saturday and Sunday.

Follow these simple first aid steps for a tooth that has been either knocked loose or knocked out:
If a tooth is displaced (loose), push the tooth back into its original position, bite down so the tooth does not move, call your dentist or visit the emergency room. The dentist may splint the tooth in place to the two healthy teeth next to the loose tooth.

For an avulsed (knocked out) tooth, pick the tooth up by the crown, not by the root -- handling the root may damage the cells necessary for bone reattachment and hinder the replant. If the tooth can not be replaced in its socket on site, do not let the tooth dry out. Place it in a container with a lid and use low-fat milk, saline solution or saliva. Visit the dentist as soon as possible — the longer the tooth is out of the mouth, the less likely the tooth will be able to be saved.

Include:
- Dentist's phone numbers, home and office
- Handkerchief
- Gauze
- Small container with a lid
- Saline solution (salt and water also works)
- Low-fat milk (if available)
- Water
- Ibuprofen. Use ibuprofen, not aspirin. Aspirin is an anti-coagulant which may cause excessive bleeding in

Technology

Dentistry has come a long way in making patient check-ups more comfortable. With today's technology, dentists are better equipped to detect and treat decay and perform other procedures with maximum comfort. we have added some of the relatively newer technologies. Below is a brief list of some of the tools available. Dentists keep their eye on new technologies as they are introduced to ensure that they are safe and beneficial for patient use. As members in the Academy of General Dentistry, dentists read clinical studies to determine the efficacy of a product prior to purchasing new equipment.

Air abrasion

Air abrasion is a conservative procedure used to remove small areas of decay or to prepare a tooth for the placement of restorations or sealants. This procedure works with an air compression device that delivers, under pressure, tiny particles of aluminum oxide to the surface of a tooth structure to blast away decay. This is similar to sandblasting a building in order to clean it.
Air abrasion is good with early decay and helps to preserve tooth structure. Discomfort is minimized and many patients do not need any anesthesia. Children and adults who are fearful of needles, noise or the vibration of a regular dental handpiece may prefer this option if it is available. Air abrasion cannot be used as an alternative for every procedure.

Intraoral cameras

First developed in 1987, the intraoral camera is a wand-like device with a tiny magnifying lens that projects a picture from a patient's mouth onto a screen. The image, which is magnified up to 40 times its original size, allows the dentist to see fractured enamel, gum recession, fracture lines in teeth, and breakdowns of restorations, and then also allows the patient to see the images.After these pictures are taken, we are better able to diagnose and recommend treatment plans for their patients. The pictures also can provide documentation for insurance companies.

Diagnodent: laser cavity detection

Digital x-rays: reduces radiation by up to 75%

Toothbrushes

Angled heads, raised bristles, oscillating tufts and handles that change colors with use: you name it, toothbrushes come in all shapes, colors and sizes, promising to perform better than the rest. But no body of scientific evidence exists yet to show that any one type of toothbrush design is better at removing plaque than another. The only thing that matters is that you brush your teeth. Many just don't brush long enough. Most people brush less than a minute, but to effectively reach all areas and scrub off cavity-causing bacteria, it is recommended to brush for two to three minutes.
Which toothbrush is best?

In general, a toothbrush head should be small (1" by 1/2") for easy access to all areas of the mouth, teeth and gums. It should have a long, wide handle for a firm grasp. It should have soft nylon bristles with rounded ends so you won't hurt your gums.

When should I change my toothbrush?

Be sure to change your toothbrush, or toothbrush head (if you're using an electric toothbrush) before the bristles become splayed and frayed. Not only are old toothbrushes ineffective, but they may harbor harmful bacteria that can cause infection such as gingivitis and periodontitis. Toothbrushes should be changed every three to four months. Sick people should change their toothbrush at the beginning of an illness and after they feel better.
You should brush your teeth at least 2-3 minutes twice a day. Brush your teeth for the length of a song on the radio, the right amount of time to get the best results from brushing. Unfortunately, most Americans only brush for 45-70 seconds once a day.

Electric vs. manual toothbrushes

Electric toothbrushes don't work that much better than manual toothbrushes, but they do motivate some reluctant brushers to clean their teeth more often. The whizzing sounds of an electric toothbrush and the tingle of the rotary tufts swirling across teeth and gums often captivates people who own electric toothbrushes. They are advantageous because they can cover more area faster. Electric toothbrushes are recommended for people who have limited manual dexterity, such as a disabled or elderly person and those who wear braces. Sometimes, it takes more time and effort to use an electric toothbrush because batteries must be recharged, and it must be cleaned after every use. Most electric toothbrushes have rechargeable batteries that take 10 to 45 minutes to recharge. The gearing in an electric toothbrush occasionally must be lubricated with water. Prices range from $60 to $99.

Toothpaste

Brushing with toothpaste (also called a "dentifrice") is important for several reasons. First and foremost, a toothpaste and a correct brushing action work to remove plaque, a sticky, harmful film of bacteria that grows on your teeth that causes caries, gum disease, and eventual tooth loss if not controlled. Second, the toothpaste contains fluoride, which makes the entire tooth structure more resistant to decay and promotes remineralization, which aids in repairing early decay before the damage can even be seen. Third, special ingredients in the dentifrice help to clean and polish the teeth and remove stains over time. Fourth, toothpastes help freshen breath and leave your mouth with a clean feeling.

What type of toothpaste should I use?

As long as your toothpaste contains fluoride, the brand you buy really does not matter, whether or not it is in paste, gel, or even powder form, or containing a certain flavor. All fluoride dentifrices work effectively to fight plaque and cavities and clean and polish tooth enamel. Your dentifrice brand should also bear the ADA (American Dental Association) seal of approval on the container, which means that adequate evidence of safety and efficacy have been demonstrated in controlled, clinical trials.

If your teeth are hypersensitive to hot or cold, consider trying a toothpaste designed for sensitive teeth. Dentifrices containing baking soda and/or hydrogen peroxide (which are both good cleansing agents) give the teeth and mouth a clean, fresh, pleasant feeling that can offer an incentive to brush more, but fluoride is the true active ingredient at work protecting your teeth. Some prefer a tartar control toothpaste containing pyrophosphates to prevent the buildup of soft calculus deposits on their teeth. New pastes offer advanced whitening formulas aimed at safely removing stains to make teeth brighter and shinier, although they can't nearly match the effectiveness of a professional bleaching formula administered or prescribed by a dentist.

Veneers

Porcelain veneers are ultra-thin shells of ceramic material, which are bonded to the front of teeth. This procedure can be the ideal choice for improving the appearance of the front teeth. Porcelain veneers are placed to mask discolorations, to brighten teeth, and to improve a smile. Highly resistant to permanent staining from coffee, tea, or even cigarette smoking, the wafer-thin porcelain veneers can achieve a tenacious bond to the tooth, resulting in an esthetically pleasing naturalness that is unsurpassed by other restorative options.
Why a porcelain veneer?
Porcelain veneers are an excellent alternative to crowns in many situations. They provide a much more conservative approach to changing a tooth's color, size, or shape. Porcelain veneers can mask undesirable defects, such as teeth stained by tetracycline, by an injury, or as a result of a root-canal procedure, and are ideal for masking discolored fillings in front teeth. Patients with gaps between their front teeth or teeth that are chipped or worn may consider porcelain veneers. Generally, veneers will last for many years, and the technique has shown remarkable longevity when properly performed.

What happens during the procedure?

Patients need three appointments for the entire procedure: diagnosis and treatment planning, preparation, and bonding. Diagnosis and treatment planning: It's critical that you take an active role in the smile design. Spend time in the decision-making and planning of the smile. Understand the corrective limitations of the procedure. Have more than one consultation, if necessary, to feel comfortable. Preparation of teeth: This appointment will take about two hours. To prepare the teeth for the porcelain veneers, the teeth are lightly buffed to allow for the small added thickness of the veneer. Usually, about a millimeter of the tooth is removed, which may require a local anesthetic. At this appointment, a mold is taken of the teeth, which is sent to the laboratory for the fabrication of the veneers. This can take about two to three weeks. Usually a temporary veneer is placed. Bonding of veneers: This appointment will take about one or two hours. First, we place the veneers with water or glycerine on the teeth to check their fit and get a sense of the shade or color. While the veneers are resting on your teeth, view the esthetic results, and pay particular attention to the color. At this point, the color of the veneers can still be adjusted with the shade of the cement to be used. The color cannot be altered after veneers are cemented. To apply the veneer, the tooth is cleansed with specific chemicals to achieve a bond. Once a special cement is sandwiched between the veneer and tooth, a visible light beam initiates the release of a catalyst to harden the cement

Wisdom Teeth

Wisdom teeth are third molars. Normally people have three permanent molars that develop in each quadrant of the mouth; upper, lower, right and left. The first molars usually grow into the mouth at around six years of age. The second molars grow in at around age 12. The third molars usually will try to grow in at around age 18 to 20 years. Since that is considered to be the age when people become wiser, third molars gained the nickname, "wisdom teeth." Actually, they are no different than any other tooth except that they are the last teeth to erupt, or grow into the mouth. They are just as useful as any other tooth if they grow in properly, have a proper bite relationship, and have healthy gum tissue around them. Unfortunately, this does not always happen.

What is an impaction?

When wisdom teeth are prevented from erupting into the mouth properly, they are referred to as impacted. Teeth that have not erupted are not necessarily impacted. It may be that it is still too early in someone's dental development, and if time passes they might grow in properly. A dentist must examine a patient's mouth and his or her x-rays to determine if the teeth are impacted or will not grow in properly. Impacted teeth may cause problems. Impacted teeth can result in infection, decay of adjacent teeth, gum disease or formation of a cyst or tumor from the follicle, which is the tissue which formed the crown of the tooth. Most dentists recommend removal of impacted wisdom teeth to prevent potential problems.
Erupted wisdom teeth
Erupted wisdom teeth may also need to be removed. The dentist may recommend this if the tooth is non-functional, interfering with the bite, badly decayed, involved with or at risk for periodontal disease, or interfering with restoration of an adjacent tooth. Once again, every case is different and only we can determine if there is a reason for you to have a tooth removed.

When should wisdom teeth be removed?

The following symptoms may indicate that the wisdom teeth have erupted and surfaced, and should be removed before they become impacted-meaning; the teeth have surfaced and have no room in the mouth to grow. However, each individual may experience symptoms differently.
Symptoms may include:
- pain
- infection in the mouth
- facial swelling
- swelling of the gum line in the back of the mouth
Many oral health specialists will recommend removal of the wisdom teeth, (when the roots are approximately formed, or three-fourths developed, usually in the adolescent years),as early removal will help to eliminate problems, such as an impacted tooth that destroys the second molar. Third molar impaction is the most prevalent medical developmental disorder.

What problems are often associated with impacted third molars?

- bacteria and plaque build-up
- cysts development (a fluid- filled sac)
- tumor development
- infection
- jaw and gum disease

Woman's Oral Health

Women's oral health depends on their different stages of life. For many women, these changes are directly related to surges in sex hormone levels, such as in puberty, menstruation, pregnancy, lactation and menopause. Women are also more likely to be diagnosed with TMJ, Myofacial pain, eating disorders, and Sjogren's Syndrome (dry mouth).

As a woman, you need to adhere to good oral hygiene. Make sure to brush with fluoride toothpaste at least twice a day and after each meal when possible and floss thoroughly each day. To help avoid problems, we may request to see you more frequently during hormonal surges.

Puberty-The surge in hormones that occurs during puberty may cause swollen gums, especially during menstruation. Herpes-type lesions and ulcers also can develop. Girls may experience sensitive gums that react more to irritants.

Oral Contraceptives- Oral contraceptives mimic pregnancy because they contain progesterone or estrogen. Therefore gingivitis may occur with long-term use. Use of certain antibiotics while taking oral contraceptives can decrease its effectiveness. Women who use birth control pills are twice as likely to develop dry sockets and should consult their dentist before scheduling major dental procedures.

Pregnancy- Pregnant women have a risk for increased inflammation of the gums because of the surge in estrogen and progesterone. If the plaque isn't removed, it can cause gingivitis-red, swollen, tender gums that are more likely to bleed. And, women with periodontal disease may be at risk for pre-term, low-birth weight babies. They are also at risk for developing pregnancy tumors- inflammatory, benign growths that develop when swollen gums become irritated. Usually these tumors shrink soon after the pregnancy is over. If a women experiences morning sickness, it is important to neutralize the acid caused by vomiting which causes tooth erosion. Patients can use a paste made of baking soda and water, rubbing it on the teeth. After 30 seconds, rinse off the paste, then brush and floss. If this is not possible, rinse with water.

Menopause- During menopause, some women can experience dry mouth, burning sensation, and changes in taste. Gums can even become sore and sensitive. Hormonal replacement therapy may cause gums to bleed, swell and become red.

Other factors-Diet pills and certain medications (over-the-counter and prescriptions) can decrease salivary flow, which puts patients at risk for cavities, gum disease and discomfort. Patients with eating disorders, such as bulimia (self-induced vomiting), cause erosion on the backside of the upper front teeth. (An additional sign is sores that appear at the corners of the mouth.) Smoking also creates a higher risk for periodontal disease.

X-Rays

Radiographic or X-ray examinations provide us with an important tool that shows the condition of your teeth, its roots, jaw placement and the overall composition of your facial bones. X-rays can help us determine the presence or degree of periodontal disease, abscesses and many abnormal growths, such as cysts and tumors. X-rays also can show the exact location of impacted and unerupted teeth. They can pinpoint the location of cavities and other signs of disease that may not be possible to detect through a visual examination. We use digital x- rays to cut down on radiation exposure up to 75%.

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