PREVENTATIVE:
A healthy mouth has clean teeth and pink, tight, healthy gums. The periodontium (bone and gums around the tooth) are in health when tissue are pink and pocket/probing depths are 0-3mm. This is achieved by daily brushing and flossing, eating healthy, nutritious food, and regular check up with your dentist. A cleaning every six months is the recommended frequency in people with healthy mouth.

There are 32 permanent teeth and 20 primary or baby teeth. The recommended first dental check-up for children is age 2 ½-3 years old depending on the child’s maturity. Very often they have all their primary teeth erupted at that time. Furthermore, they usually lose their first tooth, the lower central incisors, at about age 6. They lose their last primary tooth at around 12 years old. All primary teeth will be replaced by a permanent tooth between age 6-12 years of age. It’s normal to have pain, discomfort as it wiggles and usually doesn’t need my help, just a little Tylenol or Motrin.
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Calculus (tartar) on teeth are calcium deposits that are combination of plaque and bacteria that needs to be removed by gentle scrapping with dental instruments.

PROPHYLAXIS, a dental cleaning, is necessary every six months. This entails minimal scrapping of plaque and calculus and polishing of teeth. If you have gum disease or periodontitis we may need to do deep cleaning or scaling/root planning which requires local anesthesia and more involved removal and scrapping of calculus, bacteria, pellicle, diseased tissue, etc. Occassionally, a perio irrigation is used in conjuction with the deep cleaning to ensure better healing. This is using a medicated rinse subgingivally to wash toxins and debris out of the pockets. When pockets are beyond 5 mm in depth, Dr. C may recommend subgingival placement of antibiotic called Arestin to further stop the growth of bacteria that are causing the gum infection. After treatment of your gum disease, it is usually necessary to get your teeth cleaned every 3-4 months to maintain a healthy mouth and to prevent relapse of periodontitis and prevent loss of tooth.
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RESTORING TEETH:
When you have a cavity, we can restore your tooth in several ways. We can restore it with a simple amalgam or silver filling. It’s a bit aggressive in the preparation of the tooth because we need to make it a certain shape and bulk, but it’s cheap. It’s not very esthetic. There are newer and better materials available today. Another options is composite or white fillings. It’s a great material because it’s very esthetic; your tooth looks untouched when we’re done. We are also able to conserve tooth structure because we need to remove only the area of decay and the material is bonded on the tooth. But it’s a more expensive material. We are also able to restore with gold or porcelain inlay, which is good dentistry but requires two appointments.

When a cavity is huge and has reached and infected the nerve or pulp of the tooth, we need to remove the nerve and clean out the canals to save the tooth. This procedure is called a root canal therapy (RCT). A root canal may be indicated, as well, if the nerve is damaged from trauma or fracture of tooth exposing the nerve. If the cavity is too big and the tooth is unrestorable, we may have to extract the tooth and the tooth is lost. A tooth may have fractures, cracks, huge old fillings, or may have a RCT; these teeth may be restored with crowns.
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A crown is an artificial “cap” or coverage to restore lost tooth structure, and restore function. It requires trimming the tooth and two appointments. A crown may be full or partial coverage. A partial crown may be called an onlay, ¾, or 7/8. A post and build-up may be necessary to place in a tooth that has had root canal to restore the missing portion of the tooth in preparation to restoring it with a crown.
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COSMETIC DENTISTRY:
Veneers are part of cosmetic dentistry. Veneers are thin porcelain facings that are placed to make changes in color, shapes, height, width, etc. for cosmetic purposes to attain harmony and beauty in a smile. Teeth whitening or bleaching are other procedures to lighten the color of teeth for a whiter and brighter smile. In our office we do the 1-hour Zoom whitening, the Nitewhite take-home kit, and also the Crest whitestrips. Dr. C can help you choose the right system for you depending on your budget and lifestyle.
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TOOTH REPLACEMENT:
When a tooth is lost, we have several ways of restoring and replacing the tooth to get your mouth back into full function and harmony. We can restore with a “bridge”-which is a crown on one tooth, another crown on the other tooth, and hanging a fake tooth in between all attached together. It may be 3-units long or may be attached together in 4, 5, 6, etc. units depending on the situations. Once cemented on, it appears that all teeth are there and functions as a natural tooth. We may also restore with removable partial dentures- which is a plate made of plastic or metal/plastic combo that have missing teeth attached so that when placed in the mouth seems to replace the missing teeth. These need to be removed and cleaned regularly. Implants are the standard of the times to replace lost teeth. It requires implant placement, abutment placement, and a crown placement to restore an area. There may be healing periods required after each step (upto 3 months), bone and crest augmentation, etc.
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