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When X-rays pass through your mouth during a dental exam, more X-rays are absorbed by the denser parts (such as teeth and bone) than by soft tissues (such as cheeks and gums) before striking the film. This creates an image on the radiograph. Teeth appear lighter because fewer X-rays penetrate to reach the film. Cavities and gum disease appear darker because of more X-ray penetration. The interpretation of these X-rays allows the dentist to safely and accurately detect hidden abnormalities.

How often dental X-rays (radiographs) should be taken depends on the patient`s individual health needs. It is important to recognize that just as each patient is different from the next, so should the scheduling of X-ray exams be individualized for each patient. Your medical and dental history will be reviewed and your mouth examined before a decision is made to take X-rays of your teeth.

The schedule for needing radiographs at recall visits varies according to your age, risk for disease and signs and symptoms. Recent films may be needed to detect new cavities, or to determine the status of gum disease or for evaluation of growth and development. Children may need X-rays more often than adults. This is because their teeth and jaws are still developing and because their teeth are more likely to be affected by tooth decay than those of adults.

No matter how often you brush and floss, plaque and tartar deposits can still build up on your teeth. A professional teeth cleaning is the single most effective way to remove these deposits and prevent them from causing more serious problems in the future. While a traditional teeth cleaning involves manually scraping away these deposits with special dental tools, advances in dental technologies now give you more options for teeth cleanings.

A laser teeth cleaning, also known as an ultrasonic cleaning, is a popular alternative to traditional teeth cleanings. With a laser teeth cleaning, an ultrasonic scaler (rather than a manual probe) is used to remove deposits, kill harmful microbes and eliminate bacteria around the teeth and gums through high-frequency sound waves. Many patients find laser teeth cleanings more comfortable than traditional teeth cleanings because they are quicker, quieter and pain-free.

A deep cleaning may be recommended if excessive plaque and tartar deposits have developed below the gum line. Deep cleanings, also known as scaling and root planning, involve a two-part process: first, the stubborn deposits are removed, and then the root surfaces are smoothened. A deep cleaning helps prevent periodontal disease and restores gum tissues to a healthy state.

Oral cancer is one of the most common cancers today and has one of the lowest survival rates, with thousands of new cases being reported each year. Fewer than half of all people diagnosed with oral cancer are ever cured.

Moreover, people with many forms of cancer can develop complications—some of them chronic and painful—from their cancer treatment.  These include dry mouth and overly sensitive teeth, as well as accelerated tooth decay.

If oral cancer is not treated in time, it could spread to other facial and neck tissues, leading to disfigurement and pain.

Older adults over the age of 40 (especially men) are most susceptible to developing oral cancer, but people of all ages are at risk.

Oral cancer can occur anywhere in the mouth, but the tongue appears to be the most common location. Other oral structures could include the lips, gums and other soft palate tissues in the mouth.

Warning Signs

In general, early signs of oral cancer usually occur in the form of lumps, patchy areas and lesions, or breaks, in the tissues of the mouth. In many cases, these abnormalities are not painful in the early stages, making even self-diagnosis difficult.

Here are some additional warning signs:

Hoarseness or difficulty swallowing.
Unusual bleeding or persistent sores in the mouth that won't heal.
Lumps or growths in other nearby areas, such as the throat or neck.
If a tumor is found, surgery will generally be required to remove it. Some facial disfigurement could also result.

Prevention

Prevention is the key to staving off oral cancer. One of the biggest culprits is tobacco and alcohol use. Certain kinds of foods and even overexposure to the sun have also been linked to oral cancer. Some experts believe certain oral cancer risk factors are also hereditary.
A diet rich in fruits and vegetables is one of the best defenses against oral cancer. Maintaining good oral hygiene, and regular dental checkups, are highly recommended.

Gingivitis is the medical term for early gum disease, or periodontal disease. In general, gum disease can be caused by long-term exposure to plaque, the sticky but colorless film on teeth that forms after eating or sleeping.

Gum disease originates in the gums, where infections form from harmful bacteria and other materials left behind from eating. Early warning signs include chronic bad breath, tender or painful swollen gums and minor bleeding after brushing or flossing. In many cases, however, gingivitis can go unnoticed. The infections can eventually cause the gums to separate from the teeth, creating even greater opportunities for infection and decay.

Although gum disease is the major cause of tooth loss in adults, in many cases it is avoidable.

If gingivitis goes untreated, more serious problems such as abscesses, bone loss or periodontitis can occur.

Periodontitis is treated in a number of ways. One method, called root planing, involved cleaning and scraping below the gum line to smooth the roots. If effective, this procedure helps the gums reattach themselves to the tooth structure.  However, not all instances of scaling and root planing successfully reattach the tooth to the gums.  Additional measures may be needed if the periodontal pockets persist after scaling and root planing

Pregnancy has also been known to cause a form of gingivitis. This has been linked to hormonal changes in the woman's body that promote plaque production.

Root canals get a bad wrap. But don't believe the rumors; the dreaded root canal isn't dreadful at all! Root canals are needed when either decay or an injury infects the inner tooth (the pulp). In the earliest stages of infection, you may not feel any pain at all. But when it progresses, you could have a toothache and swelling, or a dental abscess might form. Root canals remove the infection and prevent it from spreading. Thanks to laser root canals, this process is faster, more comfortable and, in many cases, more thorough than conventional root canals. Pulp capping is an alternative to root canals that are used when the infection has yet to penetrate the pulp. Pulp capping can also prevent a large dental filling from getting too close to the nerve.

If your silver fillings make you feel self conscious when you smile, or it's simply time to replace them, consider white fillings. White fillings are just as durable as they are attractive! Made of composite resin, white fillings match the natural color of your teeth and are an excellent option for small to mid-sized cavities. White fillings are strong, stain-resistant and require less removal of your tooth structure than amalgam fillings.

Tooth extractions are routine dental treatments that help prevent more serious dental problems from arising. An extraction is a preventative treatment, and can be your secret to a long lasting smile. A broken tooth, significant tooth decay that cannot be treated by a root canal, and patients with advanced gum disease may be considered for simple tooth extractions.

Most tooth extractions happen quickly. They take only a few minutes. In fact, you will spend most of your time in the dentist chair waiting for the local anesthesia you receive for pain management to completely numb the tooth, jawbone and surrounding gums.

The doctor will begin by rocking the tooth back and forth, and then rotating it to widen the socket for easier extraction. By this point, the local anesthesia will have done its job and pain receptors will be completely numb. Instead of pain, you may feel a bit of pressure, but no pain from the tooth extraction.

People who grind their teeth can sometimes develop a serious problem with their jaw, which left untreated, can adversely affect the teeth, gums and bone structures of the mouth.

One of the most common jaw disorders is related to a problem with the temporomandibular joint, the joint that connects your lower jaw to your skull, and allows your upper and lower jaw to open and close and facilitates chewing and speaking.

People with temporomandibular joint disorders (TMD) often have a clicking or popping sound when opening and closing their mouths. Such disorders are often accompanied by frequent headaches, neck aches, and in some cases, tooth sensitivity.

Some treatments for TMD include muscle relaxants, aspirin, biofeedback, or wearing a small plastic appliance in the mouth during sleep.

Minor cases of TMD involve discomfort or pain in the jaw muscles. More serious conditions involve improperly aligned joints or dislocated jaws. The most extreme form of TMD involves an arthritic condition of the jaw joint. Traumatic injuries also can cause jaw dislocation.

In these cases, jaw surgery may be required to correct the condition. Some jaw surgery can be performed arthroscopically.

Everyone's talking about Invisalign braces, and for good reason. Invisalign braces have completely transformed the way we think about and experience dental braces. With Invisalign braces, there's no worry about metal brackets and wires that are uncomfortable and unattractive. Invisalign braces include a series of clear plastic aligners that are virtually invisible and completely removable. You can eat what you want, drink what you want, and brush and floss more thoroughly to keep your dental health in top shape!

Years ago, smile makeovers involved multiple dental treatments over a period of several months. That's no longer the case, thanks to porcelain veneers. Porcelain veneers are ultra thin shells made of translucent porcelain that can be bonded to your teeth for cosmetic purposes. Extremely versatile and durable, porcelain veneers are an excellent option whether you want a total smile makeover or need to cover a chipped tooth, mask a cracked tooth, or close gaps between your teeth. They require little to no prepping and can often be applied in just one dental visit!

Crowns are synthetic caps, usually made of a material like porcelain, placed on the top of a tooth.

Crowns are typically used to restore a tooth's function and appearance following a restorative procedure such as a root canal. When decay in a tooth has become so advanced that large portions of the tooth must be removed, crowns are often used to restore the tooth.

Crowns are also used to attach bridges, cover implants, prevent a cracked tooth from becoming worse, or an existing filling is in jeopardy of becoming loose or dislocated. Crowns also serve an aesthetic use, and are applied when a discolored or stained tooth needs to be restored to its natural appearance.

Procedures

A tooth must usually be reduced in size to accommodate a crown. A cast is made of the existing tooth and an impression is made. The impression is sent to a special lab, which manufactures a custom-designed crown. In some cases, a temporary crown is applied until the permanent crown is ready. Permanent crowns are cemented in place.

Crowns are sometimes confused with veneers, but they are quite different. Veneers are typically applied only to relatively small areas.
Caring For Your Crowns

With proper care, a good quality crown could last up to eight years or longer. It is very important to floss in the area of the crown to avoid excess plaque or collection of debris around the restoration.

Certain behaviors such as jaw clenching or bruxism (teeth grinding) significantly shorten the life of a crown. Moreover, eating brittle foods, ice or hard candy can compromise the adhesion of the crown, or even damage the crown.

Before development of dental implants, dentures were the only alternative to replacing a missing tooth or teeth.

Implants are synthetic structures that are placed in the area of the tooth normally occupied by the root. Implants are anchored to the jawbone or metal framework on the bone and act as a foundation for an artificial tooth or permanent bridge. In some cases, implants can be used to attach dentures.

Not everyone is a candidate for a dental implant, however. For a successful implant to take hold, a candidate must have proper bone density and have a strong immune system. In all cases, dental implants require strict oral hygiene.

Implants are so well designed that they mimic the look and feel of natural teeth. Implants are usually made of a synthetic yet biocompatible material like metal or ceramic.

Surgery is necessary to prepare the area for an implant and place the implant in the mouth. Following the procedure, a period of time is required for the implant to take hold and for bone tissue to build up and anchor the device. In some cases, metal posts are inserted into the implant during a follow-up procedure to connect the tooth.

Because implants require surgery, patients are administered anesthesia and, if necessary, antibiotics to stave off infection following the procedure. 

Bridges are natural-looking dental appliances that can replace a section of missing teeth. Because they are custom-made, bridges are barely noticeable and can restore the natural contour of teeth as well as the proper bite relationship between upper and lower teeth.

There are several types of fixed dental bridges (cannot be removed), including conventional fixed bridges, cantilever bridges and resin-bonded bridges.  Some bridges are removable and can be cleaned by the wearer; others need to be removed by a dentist.

Porcelain, gold alloys or combinations of materials are usually used to make bridge appliances.

Appliances called implant bridges are attached to an area below the gum tissue, or the bone.

Fixing a chipped tooth, cracked tooth or a gap in your teeth is fast, easy and affordable with dental bonding! 
 
Bonding is a process in which an enamel-like material is applied to a tooth`s surface, sculpted to an ideal shape, hardened, and then polished for an ideal smile. This procedure usually can be accomplished in a single visit.

Bonding is often performed in order to fill in gaps or change the color of your teeth. It typically only entails one office visit, and the results last for several years.

Bonding is more susceptible to staining or chipping than other forms of restoration such as veneers. When teeth are chipped or slightly decayed, bonded composite resins may be the material of choice. Bonding also is used as a tooth-colored filling for small cavities and broken or chipped surfaces.

In addition, bonding can be used to close spaces between teeth or cover the entire outside surface of a tooth to change its color and shape. Crowns, also known as caps, are used in cases where other procedures will not be effective. Crowns have the longest life expectancy of all cosmetic restorations, but are the most time consuming.

A denture is a removable replacement for missing teeth and adjacent tissues. It is made of acrylic resin, sometimes in combination with various metals.

Types of dentures

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.

Candidates for complete dentures have lost most or all of their teeth. A partial denture is suitable for those who have some natural teeth remaining. A denture improves chewing ability and speech, and provides support for facial muscles. It will greatly enhance the facial appearance and smile.

Complete or full dentures are made when all of your natural teeth are missing. You can have a full denture on your upper or lower jaw, or both.
Complete dentures are called "conventional" or "immediate" according to when they are made and when they are inserted into the mouth. Immediate dentures are inserted immediately after the removal of the remaining teeth. To make this possible, the dentist takes measurements and makes the models of the patient`s jaws during a preliminary visit.
An advantage of immediate dentures is that the wearer does not have to be without teeth during the healing period. However, bones and gums can shrink over time, especially during the period of healing in the first six months after the removal of teeth. When gums shrink, immediate dentures may require rebasing or relining to fit properly. A conventional denture can then be made once the tissues have healed. Healing may take at least 6-8 weeks.

An overdenture is a removable denture that fits over a small number of remaining natural teeth or implants. The natural teeth must be prepared to provide stability and support for the denture.

Partial dentures are often a solution when several teeth are missing.
Removable partial dentures usually consist of replacement teeth attached to pink or gum-colored plastic bases, which are connected by metal framework. Removable partial dentures attach to your natural teeth with metal clasps or devices called precision attachments. Precision attachments are generally more esthetic than metal clasps and are nearly invisible. Crowns on your natural teeth may improve the fit of a removable partial denture and they are usually required with attachments. Partials with precision attachments generally cost more than those with metal clasps.

How are dentures made?

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.

First, an impression of your jaw is made using special materials. In addition, measurements are made to show how your jaws relate to one another and how much space is between them (bite relationship). The color or shade of your natural teeth will also be determined. The impression, bite and shade are given to the dental laboratory so a denture can be custom-made for your mouth.

The dental laboratory makes a mold or model of your jaw, places the teeth in a wax base, and carves the wax to the exact form wanted in the finished denture. Usually a "wax try-in" of the denture will be done at the dentist`s office so any adjustments can be done before the denture is completed.

The denture is completed at the dental laboratory using the "lost wax" technique. A mold of the wax-up denture is made, the wax is removed and the remaining space is filled with pink plastic in dough form. The mold is then heated to harden the plastic. The denture is then polished and ready for wear.

Getting used to your denture

For the first few weeks, a new denture may feel awkward or bulky. However, your mouth will eventually become accustomed to wearing it. Inserting and removing the denture will require some practice. Your denture should easily fit into place. Never force the partial denture into position by biting down. This could bend or break the clasps.

At first, you may be asked to wear your denture all the time. Although this may be temporarily uncomfortable, it is the quickest way to identify those denture parts that may need adjustment. If the denture puts too much pressure on a particular area, that spot will become sore. Your denture can be adjusted to fit more comfortably. After making adjustments, you may need to take the denture out of your mouth before going to bed and replace it in the morning.

Start out by eating soft foods that are cut into small pieces. Chew on both sides of the mouth to keep even pressure on the denture. Avoid sticky or hard foods, including gum.

Care of your denture

It's best to stand over a folded towel or a sink of water when handling your denture, just in case you accidentally drop it. Brush the denture (preferably with a denture brush) daily to remove food deposits and plaque, and keep it from becoming permanently stained. Avoid using a brush with hard bristles, which can damage the denture. Look for denture cleansers with the American Dental Association (ADA) Seal of Acceptance. Pay special attention to cleaning teeth that fit under the denture`s metal clasps. Plaque that becomes trapped under the clasps will increase the risk of tooth decay.

Hand soap or mild dishwashing liquid to clean dentures is also acceptable. Other types of household cleaners and many toothpastes are too abrasive and should not be used for cleaning dentures. A denture could lose its proper shape if it is not kept moist. At night, the denture should be placed in soaking solution or water. However, if the appliance has metal attachments, they could be tarnished if placed in soaking solution.

Even with full dentures, you still need to take good care of your mouth. Every morning, brush your gums, tongue and palate with a soft-bristled brush before you put in your dentures. This removes plaque and stimulates circulation in the mouth. Selecting a balanced diet for proper nutrition is also important for maintaining a healthy mouth.

Adjustments

Over time, adjusting the denture may be necessary. As you age, your mouth naturally changes, which can affect the fit of the denture. Your bone and gum ridges can recede or shrink, resulting in a loose-fitting denture. Loose dentures can cause various problems, including sores or infections. Dentures that do not fit properly can be adjusted. Avoid using a do-it-yourself kit to adjust your dentures, as this can damage the appliance beyond repair. Glues sold over the counter often contain harmful chemicals and should not be used on a denture.

If your denture no longer fits properly, if it breaks, cracks or chips, or if one of the teeth becomes loose, see your dentist immediately. In many cases, dentists can make necessary adjustments or repairs, often on the same day. Complicated repairs may require that the denture be sent to a special dental laboratory.

Over time, dentures will need to be relined, re-based, or re-made due to normal wear. To reline or re-base a denture, the dentist uses the existing denture teeth and refits the denture base or makes a new denture base. Dentures may need to be replaced if they become loose and the teeth show signs of significant wear.

Common concerns

Eating will take a little practice. Start with soft foods cut into small pieces. Chew slowly using both sides of your mouth at the same time to prevent the dentures from tipping. As you become accustomed to chewing, add other foods until you return to your normal diet.

Continue to chew food using both sides of the mouth at the same time. Be cautious with hot or hard foods and sharp-edged bones or shells.
Some people worry about how dentures will affect their speech. Consider how your speech is affected when you have a number of your natural teeth missing.

Pronouncing certain words may require practice. Reading out loud and repeating troublesome words will help. If your dentures "click" while you`re talking, speak more slowly. You may find that your dentures occasionally slip when you laugh, cough or smile. Reposition the dentures by gently biting down and swallowing. If a speaking problem persists, consult your dentist.

Denture adhesives

Denture adhesives can provide additional retention for well-fitting dentures. Denture adhesives are not the solution for old, ill-fitting dentures. A poorly fitting denture, which causes constant irritation over a long period, may contribute to the development of sores. These dentures may need a reline or need to be replaced. If your dentures begin to feel loose, or cause pronounced discomfort, consult with your dentist immediately.

Whitening procedures have effectively restored the smile of people with stained, dull, or discolored teeth.

The darker tissue of your teeth, the dentin, can become exposed as the outer layer of enamel is worn away by the effects of aging or things like caffeine and tobacco.

Food particles are naturally attracted to a tooth's enamel by a certain protein. Products like coffee and tea, berries and soy sauce are notorious for staining teeth. Over time, teeth actually become more absorbent and vulnerable to staining from food and other substances.

One type of stain—caused by traumatic injuries, medications and fluorosis—actually begins inside the tooth; brushing and flossing don’t help. Another type of stain—one that can be more easily attacked by brushing, flossing and rinsing—is caused by external factors such as foods.

More and more people today are choosing tooth-whitening procedures to reverse the effects of aging and abuse from food and tobacco stains.
Some commercially available "whitening toothpastes" can be somewhat effective at removing stains and making teeth a few shades brighter. However, many of these products have abrasive substances that can actually wear away your tooth's enamel.

Whitening agents actually change the color of your teeth, but only are effective on certain types of stains. For example, bleaching agents have a difficult time removing brownish or grayish stains. These products also are not as effective on pitted or badly discolored teeth, or on restorations such as crowns, bridges, bonding and tooth-colored fillings (porcelain veneers or dental bonding may be more appropriate in this case).

Professional whitening performed by our office is considered to be the most effective and safest method; done properly, tooth whitening can last as long as five years. Over-the-counter whitening systems are somewhat effective as long as they are monitored and directions followed closely.