Routine Teeth Cleaning & Check-up

Your teeth cleaning & check-up visits are as important as every other dental treatment. These visits include many dental services that are a vital part in maintaining long-term oral health.

Silverdale Dental Center recommends that healthy teens and adults should have their teeth professionally cleaned at least once every 6 months. The frequency of professional teeth cleaning depends on the health of your teeth and gums. If you have braces, are a smoker, or have a tendency to get gum infections you should visit your dentist more often. Ask your dentist or dental hygienist how often you should schedule your cleanings.

What to Expect During your Teeth Cleaning

During the prophylaxis (cleaning) portion of your routine visit, your Dental Hygienist will remove soft (plaque) and hard (tartar, calculus, or stains) deposits from your teeth that cause cavities.

The primary purpose of having your teeth cleaned is to prevent or delay the progression of periodontal diseases. Your dental hygienist may start with an “air polisher” (an air, water, and flavored baking soda spray) to remove stains and soften deposits and then polish and floss to remove any remaining stains. We use a fluoride solution in our polishing paste for everyone, not only because it strengthens the teeth against decay but also because it has a proven anti-bacterial effect, which helps to prevent periodontal disease. You will be given personalized home care instructions and a final mouthwash.

What to Expect During your Dental Check-up

The professional cleaning visits include a short dental examination or check-up once a year for teens & adults, ages 14 & up, and twice a year for children 13 and under. The examination includes a health history update and a soft-tissue/oral cancer screening. Your dentist will examine your entire mouth and look for any signs of decay, and periodontal (gum) disease. Your dentist will also examine your bite and your TMJ (Temporo-mandibular joint) and prescribe any X-rays you may need. During this process you are always encouraged to ask as many questions as you feel necessary.

Dental cleanings can be done with minimal, if any, discomfort to the patient. We want your cleanings and check-ups to be a pleasant, experience. Nitrous oxide (laughing gas) is available at an additional fee for your comfort and relaxation. Please notify us if you are uncomfortable for any reason.

Resin (Tooth-Color) & Amalgam (Silver) Dental Fillings

When your dentist finds a cavity (hole) in one of your teeth the dentist will need to remove the decayed portion of the tooth and then fill in the area on the tooth where the decayed material once was. Dental fillings are also used to repair cracked or broken teeth and teeth that are worn down from misuse (such as from nail-biting or tooth grinding).

The Procedure

1. The dentist will numb the area around the tooth with a local anesthetic.
2. A drill will be used to remove the decayed area of the tooth.
3. After the decay has been removed, your dentist will prepare the space for the filling by cleaning the cavity of bacteria and debris.
4. If the decay is near the root, your dentist may first put in a liner to protect the nerve.
5. For metal fillings, your dentist will finish off by putting the filling in, and then polishing it.
6. For tooth-colored fillings, the tooth-colored material is applied in layers, followed by the use of a special light used to harden each layer. Last, your dentist will shape the composite material, trim off any excess material and polish the tooth.

Types of Dental Fillings

Several dental filling materials are available. At Silverdale Dental Center we offer silver colored / amalgam (which consists of mercury mixed with silver, tin, zinc, and copper) fillings or tooth-colored fillings called composite resin fillings. The best filling for you will depend upon the location and extent of the decay, the cost of the filling material, your insurance coverage, and your dentist's recommendation.

Amalgam (Silver-colored Fillings)

Advantages:

• The amalgam filling itself is very strong, and can withstand chewing.
• Amalgam fillings are less expensive than composite resin fillings.

Disadvantages:

• Silver-colored fillings don't match the color of your teeth; therefore they are not a good choice for front teeth.
• Amalgam fillings can give a grayish tint to the surrounding tooth structure.
• Amalgam fillings are more likely to cause cracks and fractures in teeth.
• A small amount of people are allergic to the mercury present in amalgam fillings.

Tooth-Colored Fillings (Composite Resin)

Advantages:

• Composite resin fillings are tooth-colored; therefore they are a great choice for front teeth.
• Composite resin fillings actually chemically bond to tooth structure, providing more support to the tooth.

Disadvantages:

• Composite resin fillings are more expensive than amalgam fillings.
• Composite resin fillings take longer to place than amalgam fillings.
• Composite resin fillings are more likely to chip off the tooth than an amalgam filling.

We care about our Environment:

We belong to Envirostars - A regional pollution prevention recognition program provided by local agencies in King, Kitsap, and Snohomish counties in parternship with the Puget Soundkeeper Alliance. Envirostars has given our office four stars.

Silverdale Dental Center is proud to use The Amalgam Collector™. The Amalgam Collector is designed to trap the wastewater generated in dental procedures. Heavy metal particles and other solids are separated out, and the remaining filtered water and other fluids are released into the sewer system. This helps lower the burden of the silver, zinc, copper and bound mercury that reach our water treatment plants, so that our drinking water and our environment contain a lower percent of heavy metals.

Tooth Extractions

You may need a Tooth Extraction:

• to remove teeth that are severely decayed that can not be saved by Root Canal Therapy
• to remove teeth if you are a patient with advanced Periodontal Disease
• to remove teeth which are broken beyond repair.
• to remove impacted wisdom teeth
• to remove teeth which are causing crowding
• for teeth that may be preventing other teeth from erupting
• to correct malocclusion ("bad bite") or teeth that are not aligned properly
• in preparation for Orthodontic Treatment (Braces)

The Procedure

To determine whether a tooth extraction is necessary, your dentist will examine your mouth and teeth and take an X-ray of the problem tooth. Although most extractions can be done by your dentist at Silverdale Dental Center, some difficult extractions must be performed by an oral surgeon.

Once it has been determined that you need a tooth extraction, your dentist will anesthetize (numb) the tooth that will be extracted, and the jawbone and gums that surround it. During the extraction you should not feel pain, but expect to feel a lot of pressure.

After the extraction, a small amount of bleeding is normal. Avoid smoking and drinking through a straw for 24 hours. Your dentist may prescribe pain medication and will advise you on how to best take care of your mouth after a tooth extraction.

Periodontal (Gum) Therapy

Periodontal Disease

Periodontal disease is an infection of the tissues that support your teeth. There is a very shallow v-shaped crevice called a sulcus between the tooth and gums. Periodontal diseases attack just below the gum line in the sulcus, causing the attachment of the tooth and it's supporting tissues to break down. As the damage occurs, the sulcus develops into a pocket. The depth of the pocket depends on the severity of the disease. As the disease becomes more severe, the depth of the pocket increases.

Types of Periodontal Diseases

Gingivitis

• The mildest form of periodontal disease
• Gums become red, swollen, and bleed easily
• Causes almost no pain
• Professional treatment and good oral care can fix gingivitis
• If untreated, may lead to Periodontitis

Chronic Periodontitis

• Most commonly found form of periodontitis
• Results in inflammation within the supporting tissues of the teeth, with progressive loss of tissue attachment and bone
• Signs: pocket formation and/or recession of gum tissue
• Tissue attachment loss usually happens slowly, but faster progression can occur

Aggressive Periodontitis

• Very destructive form of periodontal disease
• Appears in patients who are normally healthy
• Signs: rapid loss of tissue attachment and destruction of bone

Periodontitis caused by Systemic Diseases

• Associated with some systemic diseases, such as diabetes
• This form also shows up frequently in patients who have rare blood diseases or genetic disorders

Necrotizing Periodontal Diseases

• Signs: pain, bleeding, and a foul odor
• Description: infections showing necrosis (death) of gingival tissues, periodontal ligament and alveolar bone
• Can be caused by emotional stress, tobacco use and HIV

What Causes Periodontal Disease?

Factors that increase the risk of periodontal disease:

• Tobacco smoking or chewing
• Systemic diseases such as diabetes
• Some types of medication such as steroids, blood pressure medications, anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers and oral contraceptives
• Bridges that no longer fit right
• Crooked or crowded teeth
• Defective fillings
• Pregnancy

Warning signs of Periodontal Diseases:

• Red, swollen, tender gums or gums that bleed easily
• Gums that have pulled away from the teeth
• Teeth that seem to be separating
• Persistent bad breath or bad taste
• Loose teeth
• Change in the way your teeth fit together when you bite
• Change in the fit of partial dentures

Diagnosing Periodontal Diseases

When your dentist examines your gums during your routine check-up it is called a periodontal examination. The dentist will use a periodontal probe to measure the depth of the sulcus around each tooth. The depth of a healthy sulcus should be around three millimeters or less. The periodontal exam will indicate the development of any pockets and the depth of them. Typically, as the disease becomes more severe, the depth of the pocket increases. Your dentist may take dental X-rays to examine the amount of bone supporting the teeth and to find other problems not visible without an X-ray.

Treatment for Periodontal Diseases

If the periodontal disease, gingivitis, is caught early and with no sign of damage, your dentist may not need to do any treatment and instead will just explain how to improve your oral hygiene. For more severe forms of Periodontal Disease, different treatments may be used.

If the disease has progressed, the first step would be a unique cleaning, called scaling and root planning (also called a periodontal or deep cleaning) which may take more than one visit. This cleaning removes plaque and tartar deposits on the tooth and root surfaces, which helps gum tissue to heal and pockets to reduce in size.

You may be advised to take medications in the form of pills or a mouth rinse to help lessen the chance of infection and pain, and to help with healing. Sometimes the dentist uses a substance which is placed in the periodontal pocket after the deep cleaning.

If, at your next appointment after the scaling and root planing visit, the disease has advanced and the periodontal pockets are still deep and the supporting bone is lost, surgery may be the next step.

Periodontal Surgery

During surgery the dentist will removal tartar and plaque that could not otherwise be reached. Then the gums will be sutured back into a new position to make tissue snug around the tooth. Bone surgery, including bone grafts, may be necessary to rebuild or reshape destroyed bone.

During the healing process, loose teeth may be stabilized and tissue regenerated with the use of splints or bite guards. A gum graft may be needed if a lot of gum tissue has been lost.

After surgery, your dentist may put a protective dressing over your teeth and gums and a mouth rinse, an antibiotic, and a pain reliever may be prescribed to aid in healing.

How can I prevent periodontal (gum) disease?

To prevent periodontal disease take good care of your teeth every day and have regular dental checkups at least once every 6 months.

Tips to Keep Gums Healthy

Brush your teeth thoroughly twice a day.

Brushing thoroughly twice a day will remove bacteria from the teeth. Use a soft-bristled toothbrush that is not worn. Use toothpaste and a mouth rinse with fluoride to strengthen the teeth and help prevent decay.

Floss between your teeth every day.

Use floss or an interdental cleaner, to clean between your teeth to remove bacteria and food particles. Early gum disease can usually be fixed with daily brushing and flossing.

Eat a balanced diet.

Avoid snacking between meals and choose a healthy variety of foods from the basic food groups.

Visit your dentist every 6 months.

Professional dental cleaning is essential in preventing periodontal diseases.

Warning

Remember that it is possible to have no warning signs of periodontal disease. If these periodontal diseases go untreated they may eventually lead to tooth loss.

Xerostomia (Dry Mouth) Treatment

Definition

Xerostomia (pronounced zero-sto'me-ah) is the medical word for dry mouth due to decreased or absent saliva. This problem is quite common and is caused by a variety of medical conditions and medications. If left untreated, this condition can cause serious health issues such as tooth decay, bad breath, difficulty with swallowing, an altered taste sensation and many other oral health problems.

Helpful Hints

• Sip cool water throughout the day, let ice chips melt in mouth (don't chew ice!). Most people do not drink enough fluids and this can contribute to a dry mouth.
• Try drinking milk with meals. Milk has moisturizing properties and helps some people to swallow their food.
• Use a cool air humidifier in the bedroom. Clean and change water daily. Start the humidifier an hour or two before bedtime and let it run through the night.
• Avoid alcohol and alcohol-containing mouthwashes. Alcohol has a drying effect and can also irritate the tissues.
• Restrict caffeine intake. Caffeine also has a drying effect. Use caffeine-free tea, coffee and sodas.
• Use sugar-free candy, gum and beverages. Acidic candies and foods can cause a sore mouth.
• If possible, sleep on your side in order to reduce mouth breathing.
• See your dentist frequently. People with dry mouth are more prone to oral yeast infections as well as cavities. Report any unusual oral soreness-to-burning sensations to your dentist. Excellent oral hygiene is necessary to prevent cavities and gum disease.

Commercial Saliva Substitutes and Moisturizing Gels

Saliva substitutes are designed to replace your own saliva. They are available without a prescription and can be found or ordered from most pharmacies. They can be used as often as needed and do not have side effects. Some examples include:

Liquid

• Moi-Stir (Kingswood Labs) – pump spray & 75 ct. box rayon swabsticks
• MouthKote (Parnell) – 8 oz pump spray
• Optimoist (Colgate Oral Pharmacy) – 2 oz pump spray, 12 oz refill bottle (formerly Xero-Lube)
• Salivart Synthetic Saliva (Gebauer) – 25 or 75g can with nitrogen propellant
• Saliva Substitute (Roxane) – 120ml squeeze bottle

Tablets

• Salix SST 9 (saliva substitute tablets – Scandinavian Pure & Naturals)
  - 100 tablets per box, cost $8-9
  - easy to carry, pleasant flavor

Gels

• Oral Balance (LaClede) – 1.5 oz tube
  - moisturizing gel, especially useful at nighttime
  - spread on tissues and under dentures as needed for long-lasting effects

Tooth Whitening (Bleaching)

With the bleaching systems we use at Silverdale Dental Center, you will be able to bleach your teeth at home with custom fitted trays obtained from our office.

Hydrogen peroxide has been used for many years to bleach teeth. It was usually applied by dentists and used with heat and/or light to stimulate the bleaching action.

In recent years, new techniques have allowed patients to apply carbamide peroxide (similar to hydrogen peroxide) to their teeth at home using custom fitted trays. Although weak bleaching compounds can be purchased in pharmacies or grocery stores, the fastest bleaching compounds and best fitting trays may be obtained only from dentists. Dentists or dental auxiliaries should supervise this type of bleaching.

Fee for bleaching includes:

• Impression appointment
• Information/instruction/informed consent sheets
• Custom mouth bleach trays and bleaching gel for 30 days, two applications per day for two trays
• Additional bleach gel is available for an additional fee

Bleaching Systems Available at Silverdale Dental Center

At Silverdale Dental Center, we have two bleaching systems that we use: Nite White, by Discus Dental and trèswhite, by Opalescence. Below we have provided information about each system.

Nite White by Discus Dental

Nite White is a fast, safe and effective tooth whitening system. The whitening gel is a thick solution that is dispensed to patients by our dental office, and then applied by the patient at home using a clear and inconspicuous custom-fitted tray.

The delicious Peppermint Cream flavored gel is worn overnight, while you sleep, for ultimate performance and maximum convenience. In most cases, you can achieve exceptional whitening results in less than 10 days or nights.

The active ingredient in Nite White, carbamide peroxide, has been recognized by the FDA for many years as an oral antiseptic and is now used for its superior tooth whitening properties. Nite White is available in a variety of carbamide peroxide concentrations to whiten even the most difficult stains.

If you would prefer a daytime whitening alternative to traditional overnight systems, Day White whitens teeth in only 30 minutes twice a day. If you have any questions about your whitening options, please consult our office at (360) 692-9560 or
 info@silverdaledentalcenter.com.

The Discus Dental Whitening Process

During your diagnostic visit, your dentist will take impressions of your teeth. This allows your dentist to make a custom gel-holding appliance called a whitening tray.

At your second visit, you will be fitted with your whitening tray and provided with the Nite White take-home whitening kit. You will also be given specific instructions on how to administer the gel and how often to wear your tray.

Follow the take-home directions and those of your dentist. Continue to maintain proper oral hygiene through brushing and flossing.

Frequently Asked Questions

How does Nite White work?

It's a bleaching process that lightens discolorations of enamel and dentin. The system uses a mild solution retained in a custom-fitted tray that is worn over your teeth.

What causes Tooth Discoloration?

There are many causes. The most common include again, consumption of staining substances (coffee, tea, colas, and tobacco), trauma, nerve degeneration, and old restorations. During tooth formation, consumption of tetracycline or excessive fluoride may also cause tooth discoloration.

Who can use this system?

Almost anyone. However, there are some cases where the treatment may not be effective. Our dentists will determine viable candidates for the process through a thorough oral examination and diagnosis. Nite White is ideal for patients who have healthy, unrestored teeth and would like to have a whiter, brighter smile, day or night.

Is this process safe?

Yes! Research and clinical studies indicate that whitening teeth with carbamide peroxide under the supervision of a dentist is safe for teeth and gums. In fact, many dentists consider this whitening process the safest cosmetic dental procedure available today.

How does it work?

The whitening gel is placed in a thin bleaching tray that fits over your teeth. As the active ingredient in the gel (carbamide peroxide) is broken down, oxygen enters the enamel and dentin and bleaches the colored substances. The structure of the tooth is not changed; only the tooth color is made lighter.

How long does it take?

Results are usually seen after the first application. Maximum results generally occur when the process is continued for 10-14 nights.

Are there any side effects?

Some people experience temporary increased tooth sensitivity to cold during the treatment. These symptoms disappear within 1-3 days after interruption or completion of the treatment. Patients using Nite White EXCEL are less likely to get tooth sensitivity.

How long do the results last?

The teeth will always be lighter than they once were. However, some patients may need a tooth whitening “touch-up” for 1-2 days, once or twice a year. In order to maintain the whitest tooth shade possible, it is best to avoid substances like coffee, tea, red wine, and tobacco.

Patient Instructions

These instructions will also be available on the inside of your Nite White Excel 2 Whitening Kit.

trèswhite by Opalescence

whiten your smile

Your whiter Smile is only a week away. Introducing trèswhite, the easiest, fastest and best tasting way to put the white back in your smile.

très easy

Whitening your teeth has never been easier. trèswhite's innovative pre-loaded whitening trays are simply inserted onto the teeth for a custom fit. The thin membrane tray adheres to the teeth and remains securely in place for the 30 minute wear time. Yes, only 30 minutes, once a day. It's that easy.

très fast

trèswhite is the most powerful whitening take-home product available. Because it contains such a high concentration of peroxide, results are achieved rapidly. Some people see results in as little as one day. Now that's fast. trèswhite is also safe. The trèswhite trays are pre-loaded with two specific gels. A whitening gel is loaded along the bottom of the tray for whitening the teeth and a barrier gel is loaded along the gum line for protecting the gums. This barrier gel helps keep the whitening gel on the teeth.

très yummy

Who knew that something so effective could taste so good? trèswhite's mint and melon flavors make whitening your teeth almost as enjoyable as the results you'll achieve.

Ask your dentist which of these systems would work best for you.

Potential Side Effects of Teeth Whitening

The experience of tens of thousands of patients using dental office supervised home bleaching has shown the following occasional side effects. Note that the following side effects will always subside if bleaching is stopped.

If you experience any of the above symptoms, STOP bleaching. Contact our office for an appointment to describe your sensitivity symptoms if you do not already have a bleach check appointment.

If you experience any or all of the above sensitivities, it does not mean you will not be able to bleach. It does mean that your technique needs to be modified and customized to avoid sensitivity.

Modifications to reduce sensitivity may include:

• Decreasing the time spent bleaching each day
• Purposely skipping days without bleaching during the bleaching process
• Minimizing the amount of bleach placed in each tooth compartment

In General

• Do not use this bleaching system if you are pregnant or nursing.
• Keep bleaching products out of the reach of children.
• Do not eat, drink, or use tobacco products while wearing our custom trays.
• Avoid citrus foods and juices while bleaching because they can cause tooth sensitivity.
• The area of the tooth closest to the gums may take longer to lighten than the biting edge. These areas will also remain the darkest part of the tooth.
• It is normal to see dark color in the trays where you have old amalgam (silver) fillings.
• Once you have completed the treatment, your teeth may be slightly whiter than they will remain. The final color will be achieved about two weeks after finishing the whitening process.
• Consumption of heavily pigmented products such as coffee, tea, colas, red wine, and tobacco products will stain teeth after treatment as easily as before treatment.
• Occasionally (as frequently as once per year), a few additional touch-up bleaching sessions may be needed so the desirable bleached shade of the teeth can be retained.

Accelerated Bleaching

If you want to bleach your teeth faster, you may apply bleaching gel more than two hours per day. Any convenient time during the day is acceptable. Of course, increased bleaching time may stimulate more side effects. Ask us about increased bleaching time if you have reasons to want faster bleach.

Please Note: If you have porcelain veneers, composite restorations, or tooth-colored crowns, discuss this with your dentist, since these materials will be a different shade of tooth-color than your newly bleached teeth.

Cracked Tooth Syndrome

If you have a cracked tooth, you have a very commonly occuring problem in one of your teeth.

A cracked tooth can be a very painful experience. Cracks develop over a lifetime of heavy use and especially when teeth are subjected to the stress of chewing hard foods, ice, or biting on unexpected hard objects. The most susceptible teeth are molars and bicuspids subject to heavy wear that have large fillings. People who clench their teeth excessively can crack unfilled and otherwise perfect teeth. Painful incomplete cracks are sometimes difficult to diagnose. Once a section of tooth breaks off (complete crack), pain usually subsides and the diagnosis is obvious.

Signs and Symptoms:

Treatment of Cracked Teeth:

1. Simple Crack: The majority of cracked teeth (about 9 out of 10) can be treated by placement of a crown (cap) on the tooth. When the tooth is prepared for the crown, and a temporary crown is cemented, the pain is usually eliminated. If you experience no significant pain while wearing the temporary, your permanent crown will likely be successful.
   
2. Complex Crack: Occasionally (about 1 in 10) root canal therapy is required as well as a crown because of the complex nature of the crack into the nerve. If pain persists after placement of the temporary crown, you may have a crack requiring a rooth canal before the permanent crown is cemented. Root canal therapy usually requires one or two additional appointments.
   
3. Vertical Root Cracks: Some complex cracks are vertical, down tooth roots into the bone. These cracks are not restorable and require extraction of the affected root or the entire tooth. Unfortunately, vertical root cracks are difficult to diagnose.

Root Canal (Endodontic) Treatment

Successful Root Canal Therapy and the appropriate restoration can save a tooth for a lifetime!

A Root Canal is typically a simple procedure which involves one to three visits. If the nerves and blood vessels of a tooth have been damaged beyond repair, a dentist may attempt to save the tooth instead of extracting it by performing root canal treatment. The pulp, inside each tooth, runs down through the root and provides nutrients and nerves to the tooth. If the pulp becomes injured it will die, and without treatment, eventually become infected.

Why are Root Canals needed?

Deep cavities or cracked teeth are common causes of pulp death. These types of problems allow bacteria into the pulp, thus causing infection. The infection allows pus to build up at the root tip, forming an abscess which can cause damage to the bone around the teeth. If the infected pulp is not removed, pain and swelling may occur.

Signs that you may need a Root Canal

Some signs to look out for are:

The Procedure

At the first appointment, during Root Canal Treatment, the dentist will drill a small hole through the crown, and remove the infected pulp tissue. Once the pulp is removed, the root canals are then cleaned out, disinfected, and sealed off for protection. To seal and protect the tooth between dental visits a temporary filling will be placed in the crown opening. Your dentist may prescribe medicine for any infection that spread beyond the tooth.

At your next appointment your dentist will check for remaining infection. If the infection is entirely gone, your dentist will place a crown or other restoration on the tooth to protect and restore it. After Root Canal Treatment, the tooth will function like any other tooth.

What to Expect after the Procedure

It is possible to experience any of the following symptoms after any of these appointments: sensitivity to hot and/or cold; sensitivity to pressure; possible swelling. In some cases, pain medication may be necessary. If you experience swelling, call our office; it may be necessary to prescribe an antibiotic for you.

Crowns

A crown (cap) is a cover that protects the top of a tooth. Crowns are typically used to restore and preserve a decayed, cracked, or broken tooth. Crowns are also used to correct some cosmetic tooth problems.

You might need a crown if you have:

• a tooth with a big opening on the surface from a recent root canal surgery
• a crown that is not fitted right
• decayed or damaged teeth that need to be restored
• a bite problem or cosmetic tooth problem
• cracked or broken teeth with big cavities or old fillings

Types of Crowns

Metal Crown

• Very strong & unbreakable
• Made of gold or other metals
• Not tooth-color, thus not a good choice for front teeth

Tooth-Colored Crown

Combination Crown

Wisdom Teeth Extraction (Removal)

Wisdom Tooth Removal is typically performed because of lack of room in the mouth for the wisdom teeth. Humans have four wisdom teeth at the back of the mouth which typically erupt between the ages of 18 and 24 years. Because the wisdom teeth are the last of all our teeth to erupt, almost all of the room in the mouth is already used up and can not fit the wisdom teeth.

Why should you get your Wisdom Teeth removed?

Signs of Wisdom Tooth Problems:

The Procedure

With the use of X-rays your dentist can determine if your wisdom teeth need to be removed and how difficult the removal may be. The dentists at Silverdale Dental Center can perform most wisdom tooth extractions, but depending on the difficultly of removal, your dentist may need to refer you to an oral surgeon.

Before the extraction you may choose to have Nitrous Oxide (laughing gas) to help you relax. The dentist will then numb the area all around the wisdom tooth. During the procedure your dentist will first need to raise a gum flap to gain access to the wisdom tooth. Using an incision and a small drill, your dentist will remove any bone that is in the way and then section off the wisdom tooth and remove each piece. Stitches are often placed in the gum so that gum tissues lay back into place correctly. The stitches typically are removed a week later or dissolve away within a few days.

Your dentist will explain all after-care procedures at your removal visit.

Mini-Implants

What are mini-implants?

Mini-implants are a smaller version of the standard dental implant. Mini-implants are typically used to hold dentures in place. The procedure stabilizes the existing lower denture by anchoring it into place with the mini-implants. This unique procedure can be completed in one visit with virtually no discomfort.

The Procedure

Mini-implants are a newer procedure and do not require surgery. This procedure can be performed in about an hour with no cutting of the gums and no stitches to have removed. The mini-implants are inserted through the overlying gum tissue and directly into the bone underneath. This is done painlessly under local anesthetic, unlike the procedure for standard dental implants. Another benefit to mini-implants, in comparison to dental implant surgery, is reduced irritation and discomfort after placement.

Partial Dentures - Removable & Fixed

When teeth are missing it is sometimes difficult and sometimes embarrassing to chew, speak or smile. Having all your teeth is important for both self esteem and the proper functioning of your mouth.

Fixed Partial Dentures

A fixed partial denture, also known as a fixed bridge, is bonded or cemented in the space where one or more teeth have been lost. Fixed partial dentures help support the natural shape of your face, as well as your lips and cheeks.

How does a Fixed Partial Denture work?

A fixed partial denture holds the false tooth (pontic) in place and is usually cemented to the adjacent natural teeth. A crown fits on top of the pontic and is cemented in to provide support to the fixed partial denture.

There are several types of fixed partial dentures and materials that can be used. One option, a "Maryland Bridge", is a resin-bonded fixed partial denture, which doesn't require the use of crowns or complicated tooth preparation. Talk to your dentist to see which type of partial fixed denture would work best for you.

Advantages of Fixed Partial Dentures compared to Removable Partial Dentures:

• Permanently in place - No need to remove for cleaning
• Looks & works like natural teeth
• Feels more permanent, stable & comfortable

Disadvantages of Fixed Partial Dentures compared to Removable Partial Dentures:

Removable Partial Dentures

A removable partial denture can be beneficial to eating, speaking and your general appearance. It can prevent your face from sagging by giving support to your lips and cheeks.

How does a Removable Partial Denture work?

A removable partial denture, also known as a removable bridge, typically consists of replacement teeth attached to gum-colored plastic bases connected by metal framework. The removable partial denture will attach to your natural teeth by metal clasps or precision attachments. Your dentist can explain which type of attachment will work best for you.

Although your new removable partial denture may feel awkward for the first few weeks, with practice you will get used to it and it will easily fit in to place. If your denture should cause pressure or soreness in any area, your dentist can make adjustments for your comfort. You will be given detailed information on how to use and take care of your removable partial denture and how often to remove it.

Advantages of Removable Partial Dentures compared to Fixed Partial Dentures:

• Less expensive
• Problems are easier to repair
• Can look better
• Less time-consuming procedure

Disadvantages of Removable Partial Dentures compared to Fixed Partial Dentures:

Full Dentures

A full denture will benefit both your appearance and your health. When you lose all of your natural teeth, things you take for granted become very difficult: eating, speaking, face structure and support. Without natural teeth or a full denture, your face may sag from lack of support of the cheeks and lips. A full denture can provide this support by replacing your natural teeth and giving you a beautiful smile.

The Procedure

To ensure successful denture placement we will start with a complete denture examination. During this procedure your dentist will determine that a denture is actually needed. An examination of the mouth will determine the condition of the soft tissues, the size and shape of the dental arches, and the relationship between the upper and lower jaws. We will also look for retained tooth roots, hyperplastic or loose tissue, and oral cancer.

The denture examination includes a panoramic X-ray, and together will show any hidden problems to aid in the proper diagnosis.

Types of Full Dentures

There are two types of full dentures explained below. Talk to your dentist about which type is best for you.

Conventional Full Denture

A conventional full denture is placed after a patient's remaining teeth are removed and the gum tissues have healed. The process for tissue healing may take months and the patient will have to go without teeth during the healing period.

Immediate Full Denture

An immediate full denture is constructed before teeth are removed so that you will not have to wait for months for your denture without any teeth. Your dentist will take impressions of your mouth before your existing natural teeth are removed so that when your dentist removes the rest of your natural teeth, the denture can be inserted immediately.

The denture will be placed over the newly extracted spaces and will prevent swelling. Your dentures will need to be evaluated every three months because your mouth will change while the extraction sites heal, thus causing the dentures to need adjustments.

Porcelain Veneers

A veneer is a thin, custom-made layer of porcelain crafted to fit over the front surface of a tooth to fix large gaps between teeth or to correct uneven, chipped, or discolored teeth. Porcelain veneers allow us to alter tooth position, shape, size and color. A precise shade of porcelain can be chosen to give the required color to exactly match your teeth. Porcelain veneers can give you a beautiful new smile which boosts self confidence and can even prove to be life changing.

Remember that the placement of porcelain veneers is usually an irreversible process because veneers require a minimal amount of tooth reduction (approximately .5 mm) to accommodate the shell.

The Procedure

The application of porcelain veneers can require up to 3 trips to your dentist.

Treatment Plan

At your first visit, your dentist will diagnose the need for porcelain veneers and develop a treatment-plan. During this time he will examine the current condition of your teeth and help you select the color, shape and length for your fixed tooth.

Preparation Session

During the preparation session, your dentist will remove a small amount of enamel to make room for the veneers. He will then create a mold of your teeth and send it to a laboratory. Veneers are made by a dental technician, usually in a dental lab, working from the model provided by your dentist. Within two weeks, the laboratory will send back the porcelain veneers to your dentist.

Bonding Session

During the bonding session your dentist will give you a trial fitting so that you may see the fit and the color before the final placement. If you are not satisfied, this is the time to request any changes. Once you have decided that these veneers are right for your smile, your dentist will clean your teeth with bond-aiding chemicals, and cement the veneers to your teeth, using a white light to harden the cement. Finally, your dentist will polish the porcelain veneers and the procedure will be complete.

Sometimes the application of a porcelain neneer does not require the use of a local anesthetic. But, for patients that are particularly sensitive or anxious, a local anesthetic is a good choice.

What to Expect after the Procedure

After placement your porcelain veneers will be very strong and will be able to resist normal forces. Sensitivity to hot and cold may be experienced after the placement of your veneers. Sensitivity is normal and usually goes away within two weeks.

How to care for your newly placed veneers:

• Brush and floss, as you did prior to getting porcelain veneers, with any non-abrasive toothpaste. Don't worry that you will damage your veneers by flossing or brushing.
• Avoid foods and beverages that may stain or discolor your veneers such as coffee, tea or red wine.
• If you are a bruxer or clencher, please let your dentist know. He/she will fabricate a soft night guard for you to wear to minimize the stresses placed upon your teeth while you sleep.
• Please avoid eating anything that will bend or twist the laminates.

How long do Veneers last?

Veneers should last for many years, but they can chip, break, or become discolored just like any other teeth. Small chips can usually be repaired, but discolored veneers can not be bleached. If a future problem (breaks, discoloration) is unfixable a new veneer can be fitted. Your dentist will explain how long each individual veneer should last.