Services

Replacing Missing Teeth With Dental Implants

If you're missing teeth, you're not alone. Tooth loss is a far more common problem than you think. In fact, studies show that 178 million people across the United States are missing at least one tooth, and 35 million are completely edentulous (missing all their teeth). Whether you have lost one tooth or multiple ones to gum disease, tooth decay, or a traumatic injury, the office of Jamaica Dental PC can help. We provide state-of-the-art care and offer the latest solutions to help patients reestablish complete, healthy, and beautiful smiles.

Dental implants for a smile that looks and feels completely natural!

Today, dental implants represent the most advanced system for the replacement of missing teeth. While conventional fixed bridges and dentures remain effective and satisfying ways to replace missing teeth, dental implants come the closest to replicating the look, feel, and function of a natural smile.

With dental implants, you can once again enjoy all your favorite foods and speak and smile with renewed confidence and ease. Because dental implants behave in much the same way as the roots of natural teeth, they provide unrivaled stability for the placement of a broad range of dental prostheses, including crowns and bridges up to a complete set of teeth. For patients who wear full dentures, dental implants provide the added stability and retention required to improve comfort and fit while preventing any embarrassing slippage.

If you are struggling with tooth loss and looking for the best solutions for the replacement of missing teeth, visit the office of Jamaica Dental PC to learn more about dental implants and all the state-of-the-art services we provide. At the office of Jamaica Dental PC, we take pride in creating beautiful and healthy smiles!

Let The Office Of Jamaica Dental PC Help You Rebuild A Beautiful Smile

Missing teeth do more than cause embarrassing gaps in your smile. For one thing, they can also affect your ability to speak or chew nutritious food with ease. By not replacing missing teeth, the adjacent ones can shift towards the space over time and change your bite and compromise the health of your smile in many ways.

With all of the advances in dental materials, technology, and treatment methods available today, it's easier than ever before to replace missing teeth with the most natural-looking and aesthetically pleasing results of care.

At the office of Jamaica Dental PC, we're pleased to offer leading solutions to improve your oral health and give you a smile you can feel confident sharing with the world. We give you back the complete smile you have lost and provide personalized solutions for all of your oral healthcare needs. To find out more about dental implants or schedule an appointment so that we can take a closer look at your smile, give us a call today.

One of the dental solutions available for the treatment of multiple lost or missing is a removable denture. While a removable denture is an effective prosthetic appliance for restoring one’s smile, there can be issues with stability that affects the comfort and function of the denture. However, there is a way to effectively address these problems with the placement of mini dental implants.

Mini dental implants are narrower in diameter than traditional dental implants. This makes them an excellent option for providing added denture stability in cases where a grafting procedure to create enough bone volume for the placement of full size implants would otherwise be needed. Furthermore, mini implants can be placed in a less invasive manner, making them an easier procedure to tolerate for people with certain medical conditions.

An implant-supported denture is fitted with special housings that allow the denture to essentially snap on to the head of the mini implant to provide the needed denture stabilization.

In our office, we use the Iluma Ultra Cone Beam CT Scanner. Cone-beam computed tomography systems are radiographic systems used by dental professionals to analyze and reconstruct 3D images of a patient’s teeth, jaws and surrounding anatomy. The information obtained by means of CBCT imaging is useful in both diagnosis and precise treatment planning when two-dimensional diagnostic films are insufficient. Dental CBCT is useful for multiple types of analyses as well as the assessment of maxillofacial disorders or pathology. It is also most useful in surgical planning, including the accurate placement of dental implants.

The success of a dental implant procedure relies on the establishment of a structural and functional connection between the dental implant and the surrounding jawbone. Osstell technology and systems provide a non-invasive method for assessing the degree of osseointegration and measuring the stability of the dental implant. By providing objective and reliable data on the degree of osseointegration, the healing process can be evaluated, thereby making treatment outcomes more predictable.

Simplant is an advanced information gathering, treatment planning, and computer guided support platform that addresses the initial phases of the implant process all the way through the actual placement of the implants. The Simplant 3D system provides essential analysis and assistance to all facets of the dental implant process from acquiring the diagnostic records to the final restoration procedure. Simplant allows for the most efficient and effective dental implant treatment planning, taking into account all of the cosmetic and functional requirements of the patient’s case.

A root canal procedure is considered one of the most effective methods of preserving a tooth that has been severely compromised by dental decay or injury. According to statistics more than 95% of root canals are successful. In fact, with good oral hygiene and regular dental care, a tooth that has undergone root canal therapy can last as long as other natural teeth. However, as with any health related procedure there will be a small percentage of cases that are not successful. Occasionally, a tooth that has received a root canal may either fail to heal, or pain from that tooth may continue to exist. There are even situations where pain and symptoms develop months or years after the root canal treatment. In these cases, Endodontic Retreatment may be needed.

There are several reasons that a tooth may not heal as anticipated after the initial root canal therapy:

• Curved or narrow canals posing treatment complications
• Undetected canals due to complicated or unusual root anatomy
• Placement of a permanent restoration was delayed, allowing contamination and reinfection of the root canal
• The permanent restoration did not prevent saliva from contaminating the inside of the tooth

Even teeth that were successfully treated with a root canal procedure can be compromised by new problems that develop including:

• New decay that exposes the root canal to bacteria and causes a new infection in the tooth
• A loose, cracked, or broken dental restoration that exposes the tooth to a new infection
• A fracture of the crown or root of the tooth

If it is decided that endodontic retreatment is the most suitable option for you, the involved tooth will be reopened through a small hole in the biting or chewing surface. Restorations that had been placed on the tooth previously may be disassembled to allow access to the canals. Once the canals have been accessed, the previous root canal filling materials will be removed and the inside of the canals cleaned and carefully examined. The canals are inspected for previously undetected or unusual canals. When all of the canals have been cleaned and prepared, they are then are sealed and a temporary filling is placed. After the completion of an endodontic retreatment procedure, you are to once again return to your restorative dentist for the fabrication and placement of a more permanent restoration.

At our office, our team of endodontists and staff are trained and experienced in all aspects of microscopic and microsurgical endodontics. Working with surgical operating microscopes enables our endodontists to perform procedures with the ultimate precision, efficiency, and confidence. Whether the treatment is performed by means of a non-surgical procedure or as a surgical endodontic one, the microscope provides superior illumination and magnification that allows maximum visualization of the root of the tooth. Any defects that can impact the treatment and prognosis of the tooth such as cracks, root fractures, calcified canals, as well as canals with challenging anatomy, will be visualized with this optical system. Additionally, because our microscopic and microsurgical endodontic procedures involve the use of smaller instruments there is less tissue trauma from treatment, resulting in shorter recovery time and better healing.

What is a Root Canal?

Root canal therapy is a very common dental procedure. According to recent statistics in the United States alone almost 41,000 root canals are performed every day and close to 15 million are done over the course of a year. Because it has high success rate, a root canal procedure is considered one of the most effective methods of saving and retaining a tooth that has been severely compromised by dental decay or injury.

Your teeth are much more than just the hard outer biting surfaces and the roots. Inside of each one is a central chamber that contains connective tissue, a nerve supply, and blood vessels. Collectively these core tissues, known as the dental pulp, help your tooth to grow and mature before it emerges into the mouth. Once your tooth is in place, the dental pulp provides nourishment, keeps the tooth vital, and alerts you of problems. Having sensitivity to various stimuli like biting down and eating or drinking hot or cold items is a warning from the nerves inside your tooth that dental decay is present, dental trauma has occurred, or an infection is brewing. The degree of pain that you experience depends on the extent of the damage and nerve involvement.

If your dentist informs you that a tooth needs a root canal, it is because the dental pulp has become irreversibly damaged or has died. However, if enough intact tooth structure remains and there is healthy bone support around the compromised tooth, you do not need to have the tooth extracted. A fully developed tooth does not require the dental pulp to remain functional. You can preserve your natural tooth by having your dentist perform a root canal on the tooth.

It is important that when a root canal is recommended, you begin care promptly. Delaying the procedure increases the risk of more widespread symptoms developing. Left untreated a dental infection can develop or worsen and have serious consequences to your overall health

How is a Root Canal performed?

With the modern dental instruments and advanced techniques available today having a non-surgical root canal procedure is often as comfortable as getting a routine dental filling. While some root canals can be completed in one visit, others may involve 2 or 3 appointments. How long it takes depends on factors such as the number of canals in a tooth, their anatomy and whether an active infection is present. If it is determined that the tooth is not a candidate for a root canal procedure, or if complications develop during or after care that have an impact on the prognosis of your tooth, the dentist will inform you.

During a non-surgical root canal procedure your dentist will remove the diseased dental pulp, clean the internal portion of your tooth, and then fill all the prepared canals with a biocompatible filling material. Non-surgical root canal therapy is typically performed under local anesthesia, but additional options like nitrous oxide, IV and oral sedation are available to reduce any anxiety that may be associated with dental procedures.

What happens after treatment?

Once your root canal therapy is completed and the tooth is symptom free, you are to return to your restorative dentist. Our office will send your dentist a record of your endodontic care. Your restorative dentist may then recommend placing a permanent restoration like a crown on the tooth. This will protect the tooth and give it back its appropriate natural form and function.

How much will it cost?

While the cost varies depending on which tooth is involved and the complexity of the case, saving a tooth by means of a root canal procedure is a wise investment. With proper maintenance and care teeth that have been treated with root canals can last a lifetime.

As part of your child’s dental prevention program, dental sealants are often recommended to protect their permanent back teeth from developing dental decay. In fact according to the American Dental Association, dental sealants reduce the risk of cavities in molars by approximately 80%.

While establishing a good oral hygiene regimen, maintaining proper toothbrushing habits, and avoiding sticky sweets are essential for the prevention of dental decay, children’s teeth often need more protection. The reason for this is that the deeply grooved chewing surfaces of the back permanent teeth can be difficult for a child to keep free of leftover food and cavity-causing bacteria. Moreover, young children do not always brush their teeth, as often or as thoroughly as they should, making them particularly vulnerable to dental decay.

Dental sealants afford additional protection from dental decay by providing a strong plastic-like protective coating for the chewing surfaces of a child’s permanent back teeth. They basically fill in the pits, fissures and grooves on these teeth to seal out harmful bacteria and food particles. Beyond preventing the development of cavities, sealants may also be useful over areas of incipient dental decay to stop further damage from occurring.

Applying dental sealants is a relatively quick and painless process. They are simply brushed on in a series of steps during a child’s dental visit and then cured (set) with a light wand. Sealants are strong and durable and can last for several years. The condition of your child’s dental sealants will be evaluated at each checkup and reapplied if the need arises.

Every year million of cases of dental and facial injuries occur as the result of sport-related trauma. While all sports have some risk of oral injury, it is especially prevalent in recreational activities that involve frequent body contact with other players or the ground, as well as the possibility of being struck by other objects such as, balls, bats, or sticks.

One way to significantly reduce the risk of damage to your teeth, cheeks, lips, tongue, face, or jaw as the result of a sports-related injury is to wear a mouthguard. A mouthguard is a removable appliance made of a sturdy plastic that sits comfortably over your teeth. Typically, mouthguards are designed to cover just the top teeth but may also be fabricated to include the lower teeth as well depending on your particular situation. Individuals who wear braces or have some types of dental work may require a specific type of mouthguard that provides more coverage.

There are three types of sports mouthguards on the market, including pre-formed and ready to wear stock mouthguards, boil and bite mouthguards, and custom mouthguards fabricated by your dentist. Our office will help you to select just the right sports mouthguard to protect your smile. While the first two choices offer some level of protection, the best and most comfortable mouthguards to safeguard your smile are the ones individually designed and customized by your dentist.

Dental Bonding

Dental bonding is a procedure that is often used to restore teeth affected by decay as well as for the repair of chipped or fractured teeth and masking a range of dental imperfections such as stains, discolorations, gaps, misshapen, or undersized teeth. A popular method for restoring and improving the appearance of a person’s smile, dental bonding qualifies as a cosmetic procedure by virtue of the fact that the composite resins used for the procedure are tooth-colored and come in a range of shades that blend seamlessly with natural tooth structure.

A dental bonding procedure, which is performed to fill a cavity or to cosmetically repair a chip, fracture, enamel defect or gap between teeth is known as a “direct composite restoration.” For a direct composite restoration, both artistry and precision are required as the dentist places the selected shade of composite resin and carefully sculpts it to rebuild or improve the appearance of a tooth.

In terms of the cosmetic repair of dental defects, the masking of discolorations or the closure of gaps between teeth, a dental bonding procedure is considered the most economical and quickest method of care out of all the cosmetic solutions available for these types of corrections. Unlike porcelain veneers or ceramic crowns, dental bonding is a minimally invasive, one-visit cosmetic procedure. Moreover, unless a cavity is being cleaned and prepared prior to a dental bonding procedure, no drilling of tooth structure and no anesthesia is required.

How is a dental bonding procedure performed?

When performing a bonding procedure, it is important to enable the composite resin to firmly adhere to the underlying tooth structure. To do this the surface of the tooth is etched and then painted with a liquid bonding agent just prior to the placement of the filling or cosmetic bonding. As the dentist places the composite resin, it is carefully sculpted to achieve the desired shape and then cured with a special light or allowed to set. Once hardened, the newly bonded restoration is polished and buffed for a smooth finish. Some dentists may offer composite veneers as an alternative to porcelain veneers, artistically bonding and blending successive layers of composite resin to transform the appearance of a tooth.

Caring For Bonded Teeth

While a bonding procedure offers an excellent and cost-effective method of care for the treatment of minor cosmetic dental issues, there are a couple of considerations with this approach. Teeth that are restored or cosmetically enhanced with a dental bonding procedure are as a rule more susceptible to staining and chipping than with other types of cosmetic treatments. For this reason, highly pigmented foods and drinks are to be avoided along with tobacco products. As dental bonding can easily chip and break, it is also important not to bite into hard objects or foods and to avoid oral habits such as biting one’s nails or chewing on pens. However, with proper hygiene and care, a bonded restoration can last for many years.

Dental Fillings

Dental Fillings are the most common type of dental restoration used to replace sections of teeth that missing, damaged or decayed. While traditional dental materials like gold, amalgam, porcelain, and composite successfully restore teeth; recent advances in dental technology have made a wider and improved selection of restorative choices available. Some of the newest state-of-the-art filling materials, including ceramic and the latest composite materials, are not only strong and durable, they offer the most aesthetically pleasing and natural looking results.

A dental cleaning is a procedure done by a dentist or dental hygienist to get into hard to reach areas of the gums and teeth in order to remove bacteria and food debris. Dental cleanings should be scheduled at least once per year, so that patients can have plaque and tartar scraped off of their teeth. Plaque is a hard substance that adheres to the surface of a tooth. Too much plaque and tartar can cause gum disease and problems with teeth. A dentist has special tools that can remove this plaque and tartar so that teeth are fresh and clean again. Because plaque and tartar buildup happen on a daily basis, patients should still brush and floss regularly.

During a dental cleaning the dentist will get inside the hard to reach areas and clean out the spaces in between the gums and teeth. If the patient is suffering from gum disease or early gum disease, a deep cleaning, periodontal scaling or root planing may be administered. In this procedure, the dentist gets into the flaps of gum under the tooth and into the pockets where bacteria can hide. A patient with pockets deeper than 4 mm is usually recommended to have a root planing or scaling. Patients with periodontal disease may need to have more than one cleaning per year.

At the office of Jamaica Dental PC, we emphasize taking a proactive approach as the best way to maintain a healthy, beautiful smile. By coming to our office as recommended for checkup visits and routine care, we can help you and every member of your family prevent the onset and progression of many oral health problems. As skilled and experienced providers of care, we offer a comprehensive range of preventive services, including examinations, professional teeth cleanings, and oral cancer screenings, along with patient education on hygiene, diet, and healthy practices.

What Happens at the First Checkup Visit?

Your first visit to our office establishes your oral health baseline and provides essential information on your dental interests and needs. We begin by carefully reviewing your medical and dental histories and taking special note of all of your dental concerns, as well as any symptoms that you may be experiencing. This initial conversation is followed by a thorough clinical examination, including an oral cancer screening, periodontal evaluation, and an analysis of your occlusion (bite). To perform a comprehensive oral exam, we'll recommend and take diagnostic films as needed. As we take a close look at your smile, we'll examine your teeth, the supporting bone and soft tissues, and the surrounding areas of the mouth, head, and neck. We'll make a note of any signs of clenching or grinding your teeth and assess your TMJ (temporomandibular joint) function. A comprehensive oral exam can also reveal the consequences that certain dietary choices, eating disorders, medications, harmful habits, and inadequate oral hygiene practices may have on your smile.

We want every patient to enjoy the benefits of a healthy and beautiful smile. At the office of Jamaica Dental PC, you can rest assured that your oral exam is performed with the utmost care and that every member of our team is sensitive to your needs. Based on your oral exam findings and what we see on your diagnostic films, we'll outline what further treatment, if any, may be needed and discuss all your options in care.

A Healthy Smile is Vital to Your Overall Well-Being

At the office of Jamaica Dental PC, we recognize that a healthy smile is more than just an attractive asset; it is also essential to one's overall well-being. Harmful conditions affecting your teeth, gums, jaws, and structures in and around the oral cavity can impact your overall well-being. As we perform an oral exam and check for the development of common dental conditions such as tooth decay or gum disease and screen for oral cancer, we also take note of any signs of problematic health issues that may have originated elsewhere in the body.

Today, researchers are establishing more and more links between poor oral health and systemic disease. Mounting evidence supports the idea that dental disease contributes to a range of health issues, including the following conditions:

• Digestive disorders

• Respiratory Problems

• Cardiovascular Disease

• Stroke

• Diabetes

• Alzheimer's Disease

The reverse is also true. Just as oral health problems can be linked to systemic illnesses, diseases in the body can likewise produce oral health issues. According to statistics, more than 90% of all systemic diseases (conditions affecting organs and systems in the body) can manifest signs and symptoms in the oral cavity. Experiencing dry mouth, bad breath, gum problems, ulcerations, or other oral lesions may be indicative of an underlying medical condition.

The Importance of Routine Checkups and Professional Dental Cleanings

Enjoying a smile that looks good and functions at its best is not something you can take for granted. To maintain optimal oral health and a vibrant smile requires an effective dental hygiene regimen, a nutritious diet, routine checkups, professional cleanings, and a comprehensive program of preventive care.

Remember, it's important not to hold off seeing the dentist until you're in terrible pain or think there's something wrong. By scheduling a routine appointment for a comprehensive dental checkup and professional cleaning, we can help you keep your smile looking and functioning at its very best.

Our office encourages patients to come in twice a year for routine checkups and professional cleanings. In this way, we can monitor your oral health, reduce your risk of dental disease, and detect any issues early in their onset when they are typically the simplest to treat.

While maintaining a healthy smile depends upon keeping your teeth and gums clean at home, even for the best "brushers" and "flossers," it's difficult to reach every nook and cranny between the teeth and gums. For this reason, we emphasize the importance of professional teeth cleanings. In this way, our hygienist can thoroughly remove any accumulated plaque and tartar from between the teeth and gums, including areas that you may have missed. Since dental plaque harbors the bacteria that are responsible for cavities and gum disease, its removal prevents these disease processes from occurring. Following a dental cleaning and polishing to remove any superficial stains from your teeth, your mouth will feel fresh and clean.

Checkup and cleaning visits also represent an opportunity to educate patients in the best oral hygiene homecare methods and routines to maintain a healthy smile. As your trusted partner in care, we'll carefully explain and demonstrate the proper techniques for brushing, flossing, and other healthy oral care practices.

Even though proper dental care is essential at every stage of life, it's especially important for children to establish a strong foundation for a lifetime of oral health. With routine checkups, preventive treatment, and age-appropriate education in the best methods for taking care of their teeth, we can help your little ones protect their smiles from dental disease. We also monitor your children's dental and jaw development as they grow; keeping a close watch to determine if any orthodontic intervention will be needed to align their smiles.

Our goal is to help you and every member of your family establish healthy practices that will last a lifetime. At the office of Jamaica Dental PC, we're proud of the reputation we've established for providing skilled and compassionate care. We work hard to make every visit to our office a positive experience while building long-standing relationships with our patients and achieving outstanding treatment outcomes.

What Do Dental X-Rays Show?

Although we perform a thorough visual inspection of every aspect of your smile, the only way to see the deeper structures of the teeth, as well as the surrounding tissues and bone, is with dental x-rays or radiographs. Diagnostic x-rays not only reveal the presence of dental disease, but they also provide valuable information on the development, health, and integrity of teeth and orofacial structures.

Thanks to advances in technology, x-rays have entered the digital age. Instead of using traditional film-based methods, which involved long-exposure times and developing solutions, digital x-ray images can now be acquired, stored, and managed via digital sensors and integrated software programs.

Digital radiography offers several benefits to the patient, including the following:

• Quicker with minimal exposure to x-ray radiation

• Images can be viewed immediately after acquisition

• Images can be electronically shared

• Digital radiographs do not require any developing chemicals, create less waste, and are safer for the environment

• Images are immediately stored in the patient's electronic file, where they can be easily viewed on a screen, shared, or printed out.

What Are the Different Types of Dental X-Rays?

The type of diagnostic images our office will recommend depends on the nature of your visit and your oral healthcare needs.

Here's a list of some of the most common diagnostic films and the value of these images:

• Periapical x-ray - This small film is typically taken of an individual tooth and provides a view of the entire tooth from the top of the crown to the tip of the root and bone adjacent to it.

• Bitewing x-ray - This small film captures detailed views of the crowns of the premolars or molars and is typically used to check for dental decay.

• Full Mouth Series - This set of x-rays consists of bitewing and periapical views of all the teeth.

• Panoramic Film (panorex) - This film provides a 2D panoramic view of all the teeth and the left and right sides of the jaw. It offers a view of erupted teeth, developing teeth, impacted teeth, and allows an assessment of the health and integrity of the jawbone.

• Cephalometric Film - This film provides a profile view of the face and jaws and is often used by orthodontists to assess a patient's skeletal facial and jaw growth.

Today, it's also possible to capture detailed three-dimensional images for diagnostic purposes, treatment planning, and the delivery of care. By using Cone-beam computed tomography (CBCT) your dentist can acquire, analyze, and reconstruct 3D images of a patient's teeth, jaws, and surrounding anatomy. This technology is often employed for diagnosis, surgical planning, treatment, and the accurate placement of dental implants.

The terms dental crowns and caps are synonymous. When dental decay, cracked fillings, root canals or clenching and grinding of the teeth have caused extensive damage to the underlying tooth structure, a dental filling may not be a sufficient restoration. The only way to completely restore the cosmetic appearance and function of this tooth is often full coverage with a dental crown. The good news is that a completed dental crown looks and feels like a natural tooth.

In addition to restoring a single natural tooth, crowns can be used in other situations including being the supporting ends of a dental bridge, as a dental implant restoration, or as coverage for a cracked tooth to prevent further breakdown. A crown may be also be indicated when a discolored or stained tooth needs to be restored to have a more pleasing natural appearance. Crowns can be made of either of porcelain baked onto a metal substrate, all-porcelain, or many of the new ceramic materials that have been developed.

Chronic jaw clenching and grinding one’s teeth is called bruxism. While it can happen any time of day, it often occurs at night causing an individual to wake up with any number of symptoms including jaw pain, headaches, and sore teeth that may feel loose. Although, stress and anxiety are the most common causes of bruxism there may be other contributing factors such as a sleep disorder, an abnormal bite, as well as teeth that are missing or poorly aligned.

To alleviate the symptoms of bruxism, wearing a night guard while sleeping is frequently recommended. This appliance is designed to fit over the teeth and to keep the jaws slightly apart. Wearing a night guard prevents a number of damaging events, including muscle strain, excessive pressure on the jaw joint (the TMJ), and such dental damage as chipped or cracked teeth resulting from the teeth grinding against each other.

In addition to preventing damage to the soft and hard tissues surrounding the orofacial cavity, a custom night guard fabricated at the dental office can help curb a bruxism habit and give the wearer a better night’s sleep.

Commonly referred to as “laughing gas,” nitrous oxide is used as a mild sedative to reduce anxiety and allow a level of relaxation during a procedure. Nitrous oxide is inhaled through a small mask over the nose. It is administered for the duration of the procedure and is turned off as the procedure is coming to an end. The effects of this method of sedation wear off very quickly.

This antibiotic, which is delivered right into the gingival sulcus (pocket within the gum) has proven very effective in slowing the disease process and inhibiting bacterial growth.

An impacted tooth is one that fails to erupt and remains covered to varying degrees by the soft tissue and bone. After the wisdom teeth, the most frequently impacted teeth are the maxillary canines. Since the canines play such an important role in the dental arch in terms of optimal function and facial support, it is important whenever possible to bring these teeth into alignment.

In situations involving an impacted canine, we will develop an overall treatment plan to correct any underlying malocclusions and to bring the impacted canine into the dental arch. This is typically followed by the placement of orthodontic appliances and the development of space as needed for the impacted tooth. At the appropriate juncture in treatment, the patient will be referred for a surgical procedure to remove the necessary amount of bone and soft tissue covering the canine. During this surgical procedure an orthodontic attachment to facilitate moving the tooth into alignment will be placed on the tooth. Once sufficient healing has taken place, we can proceed to gradually move the canine into its proper position.

Crown lengthening is a common procedure that is routinely performed to re-contour gum tissue and bone, as needed, with the intent of making more tooth structure available for the placement of a dental crown or dental bridge. This is often the case when a tooth is decayed or otherwise damaged below the gum line.

Alternatively, a crown lengthening procedure can also be performed for reasons that are purely aesthetic to reduce the appearance of a “gummy smile” when too much of the gums and far too little tooth structure is displayed when smiling. It can be performed on a single tooth to make the gum line appear even with the other teeth or on several teeth to improve a smile’s overall appearance.

Gingival recession is a problem which effects millions of Americans. It may be caused by toothbrush abrasion, periodontal disease or simply as a product of aging. When gingival recession occurs the teeth appear longer, the root surface is exposed and generalized sensitivity of the teeth occurs. These problems can all be addressed by the use of gum grafting. This is a procedure where we can literally move the gum to a position that covers more of the tooth structure. This can also be accomplished by using graft tissue – either an autograft from the patient’s palate or a synthetic graft to cover the exposed tooth surfaces. Any type of this procedure will alleviate the sensitivity and will allow for an outstanding aesthetic result.

Every time you close your mouth or bite down to bring your teeth together there should be a healthy distribution of forces. Additionally, your top teeth should contact the bottom teeth during jaw movement in a functionally harmonious way. Having any premature or uneven contact between the upper and lower teeth can lead to unhealthy jaw deviations when biting as well as other symptoms of soreness or discomfort.

An occlusal adjustment is a procedure to correct uneven contacts or bite interferences to restore a healthy distribution of forces to your teeth as they function. It involves the selective minor filing and reshaping of the occlusal or incisal surfaces (biting surfaces) of the teeth. An occlusal adjustment is a precise procedure that in most cases creates no discomfort. The adjustment may be performed on a single tooth, or on multiple teeth as needed.

Today, with advanced dental technology even the slightest bite discrepancies can be detected, allowing you to receive the most precise occlusal adjustments.

Periodontal splinting is a procedure whereby teeth that are mobile are connected to each other to improve their stability and comfort during jaw closure, biting, and chewing. By splinting teeth that have weakened support, the prognosis for maintaining these teeth in the mouth is better. The added stability provided by periodontal splinting also promotes optimal results with tissue regeneration procedures.

Cases that may require periodontal splinting include, teeth whose support has been compromised by periodontal disease or trauma. When multiple teeth are splinted together the biting force can be sustained by the entire joined unit, rather than the individual teeth. Periodontal splints can be fabricated in a number of ways, including placing composite resin to secure a section of a reinforced ribbon applied to the involved teeth.

In cases of periodontal disease, an osseous grafting procedure may be necessary to address the bony defects around a tooth that have been caused by the progression of periodontal disease. An osseous grafting procedure, which involves guided tissue regeneration, rebuilds the bone and supporting tissues that have been lost. During this surgical procedure, the roots of the involved teeth are thoroughly cleaned and the bony defects prepared and filled with a suitable bone graft material. The bone graft is then covered by special membrane and the gums are then sutured back into place. With healing and time the osseous graft will fill in for the lost bone, thereby providing renewed support for the tooth.

When gum disease has advanced beyond the initial stage, periodontal surgery is often recommended to effectively remove bacteria and tartar from around the teeth, reduce gingival pocket depth, restore lost tissue as possible and halt the disease process. Untreated gum disease is a progressive condition, which will continue to compromise the appearance of one’s smile, dental health, oral function and overall well being if the appropriate measures are not taken.

With proper surgical treatment and maintenance care, the chances of tooth loss, further damage to the bone and soft tissues supporting the teeth, and complications from health problems that are linked to periodontal disease can be decreased.

Gum disease is typically the result of inadequate or ineffective oral hygiene practices that lead to the accumulation of dental plaque, which is sticky film that is colonized by oral bacteria. The harmful bacteria and the products they produce provoke a defensive, inflammatory response in the gums. When this inflammation is not resolved, tissue damage ensues and spaces between the gums and teeth that are known as periodontal pockets develop. As the periodontal pockets deepen, the bacteria become more difficult to remove and the gaps between the surface of the teeth and gums get larger. When pocket depth increases to the point of being beyond the reach of deep cleanings and other conservative methods of care (5mm or more), gum surgery to clean and treat the damage to gums and underlying bone is recommended.

By performing pocket reduction surgery the following is accomplished:

• Sub-gingival bacteria beneath the gums and from the surfaces of the roots of the teeth is removed
• Damage to the underlying bone is halted and affected bone is re-contoured
• Effective oral hygiene to clean the teeth and gums is made easier

While a surgical procedure known as flap surgery during which the tissue is surgically reflected away from the teeth and bone so that the area can be treated before the tissue is sutured back into place, is typically performed, some practitioners are now using soft tissue laser procedures to reduce pocket depth.

The two most common forms of dental disease, caries (tooth decay) and periodontal disease (gum disease) are caused by the presence of bacterial communities in dental plaque, which is a sticky film that is constantly accumulating in the mouth. While in the case of tooth decay the acidic products of the plaque bacteria progressively erode tooth structure, in gum disease an inflammatory response is provoked in the periodontal tissues that surround and support the teeth. If left untreated, periodontal disease can lead to gingival pocket formation, gum recession and diminishing alveolar bone with the eventual loosening and loss of teeth.

According to the Centers for Disease Control and Prevention (CDC), one out of every two adults aged 30 and over in the United States is affected by periodontal disease. Furthermore, that number increases to over 70% for individuals 65 and older. Since gum disease is the main cause of tooth loss in adults and there is an increasing association with systemic diseases such as heart disease, stroke, diabetes, respiratory problems and adverse pregnancy outcomes, periodontal disease represents a serious public health concern.

Although inadequate oral hygiene practices, infrequent dental checkups and few if any professional teeth cleanings are the main reasons for the development of gum disease, there are other factors that can contribute to the risk. An individual may be predisposed to periodontal disease because of genetic factors, smoking and tobacco use, harmful oral habits, misaligned teeth, poor nutrition, and stress as well as the fluctuating hormones in pregnancy. Diseases such as diabetes, rheumatoid arthritis and HIV infection can also increase the risk and severity of periodontal disease. Additionally, certain medications for the therapeutic treatment of systemic disease can lay the groundwork for periodontal problems by producing side effects such as dry mouth (xerostomia) or causing the gums to enlarge.

What are the signs and symptoms of gum disease?

Since much of the course of periodontal disease is not painful, there may be little awareness by an affected individual that a condition, which is harmful to oral health as well as one that is linked to larger systemic problems, is present.

Some of the signs and symptoms of gum disease to be aware of include the following:

• Inflamed and red gums
• Bleeding when brushing or flossing
• Receding gums and exposed root surfaces of the teeth
• Sensitivity to hot or cold temperatures
• Bad breath or a bad taste in the mouth
• Teeth that feel loose
• The development of new spaces between the teeth or a change in the bite
• Change in the fit of existing partial dentures
• Discharge around the teeth and gums
• Sharp or dull pain when biting down or chewing food

While gum disease is a progressive condition, if treated early in its onset it can be reversed to restore oral health. At more advanced stages, the disease can be managed to halt its progression and prevent the most severe consequences.

The earliest stage of gum disease is known as gingivitis, which is caused by the buildup of dental plaque at the gumline. Gingivitis is extremely common and is typically associated with bleeding when brushing or flossing. With gingivitis there is no evidence of bone loss or significant periodontal pockets between the teeth and gums. Gingivitis can be successfully treated and reversed with a series of professional dental cleanings and an improved regimen of oral hygiene at home.

If gingivitis is allowed to progress, it can advance to the next stage, which is known as periodontitis. When periodontitis is present, the tissue damage extends beyond the gums to include the loss of the collagen attachment of the tooth to the surrounding bone, the development of deep periodontal pockets and the loss of supporting alveolar bone. In this stage the connective tissue and bone that hold the teeth in place begin to break down. Without proper treatment, periodontitis will progress from a mild to moderate loss of supporting tissue to the complete destruction of the alveolar bone around the teeth. As periodontal treatment advances, more extensive procedures are required to halt its progression. The dentist may recommend a series of deeper cleanings involving root planing and scaling, surgical procedures to reduce pocket depth, bone or tissue grafts, laser dentistry procedures, or antimicrobial medications.

By far, the best approach to care is the prevention of periodontal disease. By maintaining an effective regimen of brushing and flossing at home, following a healthy lifestyle and seeing the dentist for routine checkups and professional dental cleanings, gum disease and its consequences are largely preventable.

By performing a deep cleaning, which is also known as a scaling and root planing, your dentist and dental hygienist can remove any excessive buildup of plaque and tartar that has accumulated around your teeth in the area below the gumline. The goal of this procedure is to treat periodontal disease by eliminating inflammation and reducing the size of pockets between the teeth and gums. While a dental scaling is intended to carefully eliminate any accumulated deposits on the surface of the tooth below the gumline, a root planing goes deeper to smooth the surface of the root so that the gums can properly reattach and heal.

The dentist will determine how many visits your scaling and root planing will require and how many sections of your mouth will be addressed at each appointment. Deep cleanings coupled with an excellent regimen of oral hygiene at home can be effective in restoring your periodontal health. If the tissues do not respond to this intervention, additional procedures including periodontal surgery will be considered.

In addition to the development of pockets and bone loss, periodontal disease can cause the gums to recede, thereby exposing the roots of the teeth. When the root of a tooth loses its overlying soft tissue, it becomes more vulnerable to decay, sensitivity and additional bone loss. Gum recession also takes a toll on smile aesthetics. Having front teeth affected by this problem can make a broad smile less aesthetically appealing as uncovered root structure is displayed. While gum recession is often a consequence of gum disease, aggressive tooth brushing and other habits can also wear away gum tissue. 

By performing a gum graft procedure, which is also known as a “gingival graft or soft tissue graft,” the dentist replaces the soft tissue over the exposed area of the tooth to address the problems created by receding gums. Gum tissue for grafting procedures can be harvested from a nearby site in the mouth or obtained from another donor source. A gum graft may be performed on a single tooth or multiple ones. And, based upon the needs of the case, the dentist will determine which type of gum graft to employ.

The three types of gum grafts include the following:

• Free gingival graft-This graft utilizes a small piece of tissue that is taken from the palate. It is often indicated when extra thick tissue is needed to prevent further recession.
• Connective tissue graft- This frequently used graft is harvested from a sub-layer of connective tissue located under the uppermost tissue layer on the roof of the mouth.
• Pedicle graft-This type of graft is created from a flap of tissue that is adjacent to the area of the gum recession.

Following a gum graft procedure, the dentist will provide detailed post-operative care instructions as well as set up appointments to make sure the surgical site is healing properly and to check that the graft is successful.

While a surgical procedure, periodontal surgery is generally very well tolerated by patients and in most cases can be performed under local anesthesia.

An incision will be made to allow us to gently pull the gum tissue away from the teeth. All calculus and plaque will be meticulously removed and all root surfaces will be smoothed. Antibiotic may be placed in the surgical site. The gum tissue will then be sutured back into place eliminating the pocket. In many cases a protective packing may be placed to keep the area clean and to facilitate faster healing.

The suture material (stitches) generally will remain in the mouth for 7-10 days.

Though the gums will be more sensitive immediately following the procedure, there will be a significant reduction in pocket depth and a vast improvement in the condition of the teeth and gums.

Wisdom teeth, which are also known as the third molars, are the last permanent teeth to develop in the oral cavity as well as the final ones to come into place. However, as is often the case, many wisdom teeth do not have sufficient room to erupt, are not developing properly, or are causing issues for the adjacent teeth and the surrounding tissues. Oral and maxillofacial surgeons frequently see patients with impacted or problematic wisdom teeth for an evaluation or extractions as indicated.

A wisdom tooth is considered impacted when it is submerged under gum tissue or bone and unable to erupt into position. Based on the type and amount of overlying tissue, impactions are classified in a few different ways. Soft tissue impactions occur when a wisdom tooth remains covered by gum tissue. If a wisdom tooth remains completely, or partially obstructed by bone, it's known as a bony impaction.

Impacted wisdom teeth can potentially cause many problems and may need to be removed when they are the source of:

Although the extraction of wisdom may be recommended for older patients, the early removal of problematic or potentially problematic wisdom teeth in young adults is often the case. Among the many reasons for this approach to care is that extractions at this stage of life are simpler, and patients experience a shorter recovery time with fewer complications.

Whatever the case may be, patients of all ages can rely on the expertise of an oral and maxillofacial surgeon for the evaluation and treatment recommendations for developing, impacted, or erupted wisdom teeth.

In some cases, a tooth that has had a root canal, which did not sufficiently heal or has become re-infected, is not a candidate for endodontic retreatment. For these teeth a minor surgical procedure that treats the infection from the root-end of the tooth, which is known as an apicoectomy, may be indicated. An apicoectomy is an excellent next step procedure to preserve a previously treated tooth, eliminate a dental infection, and to restore the health of the surrounding tissues. It is most useful in cases where fractures or hidden canals still cause pain or infection around a treated tooth, as well as when an endodontic retreatment procedure is not recommended because it may further weaken and jeopardize the tooth.

An apicoectomy may be performed under local anesthesia. It is typically a straightforward procedure during which an incision is made in the gum tissue above the root of the involved tooth. This is to expose the inflamed or infected tissue surrounding the root tip of the tooth. Once uncovered, the damaged tissue in the area is removed along with a few millimeters of the tooth’s root tip. A biocompatible filling material is then placed in the end of the remaining portion of the root to seal it and prevent any possibility of reinfection. The gum tissue flap is put back into place and sutured to complete the procedure.

Post-surgical discomfort is generally mild, and you may have some swelling in the area. Most patients return to their normal activities very quickly. If needed, apply a cold compress to reduce discomfort and swelling after the procedure. The appropriate pain medication will be prescribed or recommended. If your discomfort does not respond to medication, or other symptoms that concern you develop, please call our office.

Prior to undergoing an apicoectomy the dentist will discuss all the risks and benefits of the procedure. If during the course of an apicoectomy, any significant fractures are discovered in the tooth that changes the prognosis, you will be immediately advised.

It is important to be aware that occasionally, a long-lasting mouth sore may be a sign of oral cancer. A biopsy or tissue sample may be recommended when suspicious lesions in the oral cavity are present. Early detection and treatment are the best ways to ensure the most favorable outcome of care.

Bone loss in the jaws and around the teeth can be the result of missing teeth, periodontal disease, or trauma. This bone loss is more than a detriment to oral health and function; it can also alter facial appearance as the support for the natural contours of the face is diminished.

When a tooth is extracted, the natural stimulation to the underlying bone that is generated by the forces of biting or chewing is lost.  The fact of the matter is that bone width can be reduced by as much as 25% in the first year following tooth loss.

By performing grafting procedures, we can help restore the bone to its original dimensions to maintain facial esthetics, repair the damage caused by periodontal disease as well as facilitate the success of procedures such as the placement of dental implants. A bone graft provides a platform or “scaffolding” for new bone growth and the material for a bone graft can be derived from the patient, other donor sources or be comprised of synthetic, bone-like materials.

Several types of grafting procedures are performed depending upon the particular needs of the case.

A bone graft can be placed immediately upon the extraction of a tooth or some time after tooth loss. Placing a bone graft at the time of tooth removal reduces the amount of bone loss in the area to maintain the hard tissue support that is required for the future placement of a dental implant. When a bone graft is placed awhile after tooth loss, a separate surgical procedure is required to reflect the soft tissue, expose the underlying bone, place a graft and then suture the soft tissue back into place.

For patients lacking a sufficient amount of bone for a dental implant to replace a maxillary back tooth (upper back tooth), a procedure, which is known as a “sinus lift” is performed. During this surgical procedure, the sinus membrane is lifted, and bone graft material is added between the jaw and the floor of the sinus to provide the needed bone height to support a dental implant successfully.

In addition to bone grafting for purposes of ridge preservation or augmentation to allow for dental implants, an aesthetic ridge augmentation procedure to restore the natural contours of the bone is sometimes performed in preparation for fixed bridgework to achieve a more cosmetically pleasing result.

To guide tissue regeneration as well as protect the graft and promote healing, we may place specialized membranes and biologically active materials over the grafting material.

Sometimes it is necessary to extract a tooth. This situation can arise for a variety of reasons. Extractions are commonly performed in cases where a deciduous “baby” tooth is reluctant to fall out, a severely broken down and non-restorable tooth is present, or a “wisdom tooth” is poorly positioned and unable to erupt into place. Oral and maxillofacial surgeons are frequently referred patients by both general dentists and specialists for the extraction of permanent or primary (deciduous or “baby”) teeth that are erupted, unerupted, fractured, severely broken down, or ankylosed (fused to the surrounding bone). Oral and Maxillofacial surgeons are also best equipped to provide care for patients who are undergoing complex medical treatment, have certain medical conditions or take specific medications that can influence dental extractions, healing and recovery.

In addition to providing skilled, knowledgeable, precise and experienced care in all situations for which dental extractions are required, oral and maxillofacial surgeons are trained in all methods of dental anesthesia and sedation to ensure patient comfort throughout every procedure.

Following all dental extractions, our oral and maxillofacial surgeon provides detailed instructions for post-operative care and any follow-up appointments as required.

Extraction site preservation is a procedure designed to reduce the bone loss or resorption that follows the extraction of teeth. Its purpose is to maintain the integrity, volume and natural contours of the alveolar bone that surrounds and supports the teeth to facilitate the successful restoration of the area with a dental implant or the placement of another type of prosthesis.

After the removal of a tooth, the dentist places bone grafting material, which serves as a scaffold for bone growth, and/or a membrane containing elements that promote bone regeneration in the tooth socket to both facilitate optimal healing and encourage new bone development in the area.

Bone loss in the jaws and around the teeth can be the result of missing teeth, periodontal disease, or trauma. This bone loss is more than a detriment to oral health and function; it can also alter facial appearance as the support for the natural contours of the face is diminished.

When a tooth is extracted, the natural stimulation to the underlying bone that is generated by the forces of biting or chewing is lost. The fact of the matter is that bone width can be reduced by as much as 25% in the first year following tooth loss.

By performing grafting procedures, the oral and maxillofacial surgeon can help restore the bone to its original dimensions to maintain facial esthetics, repair the damage caused by periodontal disease as well as facilitate the success of procedures such as the placement of dental implants. A bone graft provides a platform or “scaffolding” for new bone growth and the material for a bone graft can be derived from the patient, other donor sources or be comprised of synthetic, bone-like materials.

Several types of grafting procedures are performed depending upon the particular needs of the case.

A bone graft can be placed immediately upon the extraction of a tooth or some time after tooth loss. Placing a bone graft at the time of tooth removal reduces the amount of bone loss in the area to maintain the hard tissue support that is required for the future placement of a dental implant. When a bone graft is placed awhile after tooth loss, a separate surgical procedure is required to reflect the soft tissue, expose the underlying bone, place a graft and then suture the soft tissue back into place.

For patients lacking a sufficient amount of bone for a dental implant to replace a maxillary back tooth (upper back tooth), a procedure, which is known as a “sinus lift” is performed. During this surgical procedure, the sinus membrane is lifted, and bone graft material is added between the jaw and the floor of the sinus to provide the needed bone height to support a dental implant successfully.

In addition to bone grafting for purposes of ridge preservation or augmentation to allow for dental implants, an aesthetic ridge augmentation procedure to restore the natural contours of the bone is sometimes performed in preparation for fixed bridgework to achieve a more cosmetically pleasing result.

To guide tissue regeneration as well as protect the graft and promote healing, the oral and maxillofacial surgeon may place specialized membranes and biologically active materials over the grafting material.

Oral and Maxillofacial Surgeons are highly skilled specialists trained to provide treatment for all types of facial trauma including the emergency management of dental and maxillofacial injuries, as well as any required facial reconstruction procedures.

Oral and maxillofacial trauma can range from dental injuries or lacerations in and around the mouth to more complex and severe damage to the soft tissues and many bones of the face and skull. These injuries are often caused by motor vehicle accidents, assaults, sports or work related injuries, falls, or other mishaps involving direct physical trauma to the mouth and face.

Dentoalveolar Injury

Dentoalveolar Injuries refer to injuries involving the teeth and the bone surrounding the teeth. These injuries can include teeth that have been dislodged with or without a segment of the surrounding bone, or an avulsion, which means that a tooth has been completely “knocked out” of its socket. Treatment of these injuries requires they be treated without delay to reposition and stabilize the involved teeth and/or bone in the correct anatomical positions.

While the Oral and Maxillofacial Surgeon can provide the initial treatment for this type of a traumatic injury, the involved teeth should be followed and assessed by the general dentist or the endodontist for any long-term effects to the teeth, the surrounding bone, or the occlusion, as well as to perform any necessary procedures to restore these teeth.

Soft Tissue Injuries

Soft tissue injuries of the Maxillofacial region include lacerations within the mouth (intra-oral) and facial lacerations. The diagnosis and treatment of soft tissue injuries involves repairing the injury to achieve the best cosmetic result, and as possible to maintain function and sensation in the involved area.

Facial Bone Fractures

Fractures of the upper or lower jaws, fractures to the orbit of the eye, the cheekbone, and nasal fractures are common facial injuries involving the bones of the face that are treated by an Oral and Maxillofacial Surgeon.

Facial bone fractures are treated in much the same way as fractures of other parts of the body. The goals are to restore alignment, achieve bony union, prevent any infections from developing, reestablish function, and to maintain normal facial appearance. Treatment considerations for facial fractures may include the health and age of the patient, the location of the injury, as well as the degree of severity of the fracture and the associated damage.

While the bones in the face cannot be put in a cast like the treatment of limb fractures, other methods of stabilization are employed by the Oral and Maxillofacial Surgeon to allow effective and complete healing of the involved bones. Certain jaw fractures may require a surgical procedure and stabilization. This may involve the placement of small plates and screws at the affected site, or the temporary wiring of the jaws together.

The oral and maxillofacial region consists of hard and soft tissues that have many different and important functions. Oral pathology refers to the wide range of diseases and conditions manifesting themselves and affecting this area of the body. The signs and symptoms of these problems might be localized and have minor implications for an individual’s overall health, or may be a sign of larger systemic (throughout the body) medical conditions. Suspicious lesions in the mouth and maxillofacial region might also be cancerous and can lead to far more serious consequences if not detected and treated promptly.

If tissue abnormalities or lesions are present in the oral and maxillofacial area it must be determined if they are the result of congenital or genetic conditions, infection, trauma, environmental causes, have developed for another medical reason or are idiopathic (without a known cause). A patient’s medical history, including lifestyle and habits in conjunction with a description of any signs and symptoms that a patient is experiencing can provide helpful information towards a diagnosis. Following a clinical exam, a biopsy as well as further diagnostic testing, is performed as needed to identify the source of the pathology.

If an individual on their own notices any suspicious growths, ulcerations, or unusual bumps anywhere in their mouth or in the head and neck region, it is important that they have them promptly evaluated.

A full night’s sleep is essential to your overall health and wellness. If you are well rested, you feel good and can function at your best. According to statistics, approximately 25 million adults in the United States suffer from obstructive sleep apnea and more than three times that number snore. As specialists who are trained in the complexities of head and neck anatomy as well as its relationship to airway function, oral and maxillofacial surgeons are well equipped to provide the guidance and care in cases of obstructive sleep apnea.

What Is Sleep Apnea?

Sleep apnea is a serious and potentially life-threatening disorder involving repeated pauses in breathing while asleep. The most common form of this condition is obstructive sleep apnea. This occurs when there is an obstruction of an individual’s airway that interferes with the flow of oxygen through nose or mouth during sleep.

In someone afflicted with obstructive sleep apnea, the muscles of the throat and mouth relax during sleep to the point where they fall back into the upper airway and create a blockage that restricts breathing.

What Are Some of The Signs & Symptoms of Sleep Apnea?

The signs and symptoms of this disorder during sleeping hours may include, loud snoring, episodes of breathing cessation, abrupt awakenings, episodes of gasping for air, along with difficulties getting a good night’s sleep. An individual with sleep apnea will exhibit problems during the day as well. Sleep apnea can lead to a morning headache, excessive daytime sleepiness, difficulty concentrating, and irritability. Furthermore suffering with sleep apnea can be associated with other medical conditions such as diabetes, cardiovascular and heart issues, gastric reflux and depression.

How Do I Know If I Have Sleep Apnea?

A sleep study is typically conducted to determine the severity of the disorder. The results of this study along with other medical findings will play a role in determining the recommended therapy. In some cases testing to diagnose obstructive sleep apnea and determine blood oxygen levels along with how well you are breathing while sleeping can be done in the comfort of your own home.

What Is The Treatment For Sleep Apnea?

The most common form of therapy for obstructive sleep apnea is a CPAP machine that is worn while sleeping. This device provides a steady stream of pressurized air into the respiratory system through a mask. However, in the presence of mild to moderate sleep apnea, an oral appliance is often prescribed to treat the condition. Worn in a similar fashion to a mouthguard or an orthodontic retainer, the appliance is designed to help keep the tongue and soft tissues in the back of the throat from collapsing, thereby enabling the airway to stay open during sleep. While conservative treatment to ensure a healthy as well as restful night’s sleep is often successful, in some cases surgery is recommended. Our oral and maxillofacial surgeon can advise patients on the right course of care and perform any required surgical procedures.

The Prevalence of Temporomandibular Joint Problems

According to the National Institute of Dental and Craniofacial Research (NIDCR), temporomandibular joint disorders (TMJ), also referred to as temporomandibular disorders (TMD), are the most common source of chronic facial pain and jaw dysfunction. It is estimated that more than 10 million people in the United States are affected by temporomandibular joint problems.

What is the Temporomandibular Joint?

Two temporomandibular joints connect the left and right sides of the lower jaw to the temporal bone. Both joints and their associated muscles, ligaments, and tendons work together to allow for all manner of oral function as the jaw moves up and down, front to back and from side to side. Containing a shock-absorbing, soft disc that sits between the rounded condyles of both sides of the lower jaw and the corresponding concavities in the skull’s temporal bone, the TMJ makes chewing, speaking, yawning and all jaw movements possible.

Since the TMJ is a joint with both up and down hinge-like movements, as well as side to side and front to back sliding motions to perform, it is often considered one of the most complicated joints in the body and one of the most difficult to treat when problems arise.

Types and Symptoms of TMJ Disorders

TMJ disorders can fall into one or more of the following three categories:

• Myofascial pain - Refers to pain in the area of the jaw joint due to various causes of increased muscle tension and spasm
• Internal derangement - Involves displacement of the disc, jaw dislocation or trauma to the condyles of the jaw
• Degenerative joint disease - Arthritis

The risk of developing a TMJ problem is higher in the presence of long-term teeth grinding or bruxism, a jaw injury or various types of arthritis such as rheumatoid arthritis and osteoarthritis. Furthermore, the manifestations of a TMJ disorder can vary from person to person with a wide range of symptoms possible, including earaches, ringing in the ears (tinnitus), headaches, back and neck pain, vertigo, muscle spasms, and joint tenderness as well as jaw pain, popping or grating sounds with jaw movement, jaw locking and limited jaw movement. For some people, a TMJ disorder can be resolved within a relatively short period, while for others it will continue to persist despite extensive therapy.

Diagnosis and Treatment

When evaluating for the presence of a TMJ disorder, an oral and maxillofacial surgeon will perform a thorough clinical assessment of joint symptoms and function. Special radiographic imaging and other diagnostic tests will be ordered as needed. The treatment of a TMJ disorder may include oral appliances such as night guards or stabilization splints to alleviate strain on the joints. Other types of therapy may include steroid injections, occlusal adjustments as well as orthodontic or prosthodontic treatment to improve occlusion. In cases of severe and persistent TMJ problems, the oral and maxillofacial surgeon may recommend a surgical procedure.

Methods of self-care can be helpful in alleviating some of the symptoms of a TMJ disorder. Patients are typically advised to eat soft foods, avoid extreme jaw movements such as wide yawning and gum chewing, to practice stress reduction and relaxation techniques and to apply ice packs or moist heat as directed. As recommended, a patient should follow the oral and maxillofacial surgeon's or therapist’s instructions for gentle stretching exercises. The short-term use of over-the-counter, non-steroidal, anti-inflammatory drugs and pain medications may provide relief. If not, stronger pain or anti-inflammatory drugs, muscle relaxants or anti-depressants may be prescribed

IV Sedation involves a sedative that is administered intravenously, or directly into a vein. It is indicated when deeper sedation is required. This type of sedation can be quickly modified to your state of consciousness and can be continued as long as necessary for the procedure.

IV Sedation requires an empty stomach. Patients receiving this type of sedation will be instructed as to how many hours prior to their dental procedure they should stop eating or drinking. In addition to this, patients receiving IV sedation will need to have an escort present for the appointment and to be able to drive them home when the appointment is completed.

A frenum (also known as a frenulum) in the oral cavity is a fold of tissue connecting moveable soft tissue such as the lips, cheeks or tongue to the fixed tissues next to the teeth and floor of the mouth. This fold of tissue can contain some muscle fibers as well.

The major frena in the mouth can be found in three locations. The first is the maxillary labial frenum located on the underside of the middle of the upper lip, connecting it to the gum tissue above and between the front two teeth on top. Another frenum is the mandibular labial frenum, which is located on underside of the lower lip connecting it to the gum tissue below and between the front two teeth on bottom.  The third is the lingual frenum, which is found on the underside of the tongue connecting it to the floor of the mouth.

In most cases these frena do not adversely limit tongue function, or affect the teeth or their surrounding hard and soft tissues. However, there are situations where they do and a surgical procedure is required to alleviate these problems. A maxillary labial frenectomy is the most common one performed, and is considered when a large and ropey frenum is attached too close to the crowns of the teeth or extends too far towards the roof of the mouth. Issues with the maxillary frenum can cause space between the two front teeth, keeps the teeth apart, and can even affect the gums and bone between the front two teeth. A lingual frenectomy is considered when the lingual frenum attaches too far forward on the tongue and is impairing function including, speech, swallowing or eating.

When an abnormal frenal attachment is present, certain surgical procedures like a frenectomy to remove a portion of the frenum can be performed. This surgery prevents further tissue damage, allows for appropriate tooth movement and stability, and restores normal function.

Dental emergencies can come about in any number of ways. Your discomfort may be due to an injury to the oral facial area, the acute flare up of a longstanding problem, or the result of the sudden onset of seemingly inexplicable pain. Whatever the case may be, urgent dental care is needed to provide you with relief and to avoid any further consequences to your oral health or function, as well as your overall well being.

There are many reasons to seek emergency dental care, including severe toothaches, chipped or fractured teeth, a dental abscess, impacted teeth, loose or broken fillings, lost or dislodged crowns, broken dentures and more. While the pain of a toothache is one of the more common reasons that patients come to our dental office for emergency dental care, we also promptly treat emergencies that are not necessarily painful like crowns that have been dislodged and broken dentures that leave embarrassing gaps in one’s smile.

Whether your dental emergency is painful, if it affects the appearance of your smile, or if you suspect that an infection is present, contact our office immediately for care. We will make every effort to see you as promptly as possible.

Invisalign is a form of orthodontic treatment that works to correct many different types of malocclusions through the use of a series of clear plastic trays called aligners. In many cases it provides an excellent treatment alternative to traditional orthodontic braces and metal wires.

Invisalign utilizes 3-D computer imaging technology to correct problematic bites or malocclusions by planning a complete sequence of custom-made clear aligners. This series of clear aligners, each of which is worn for a couple of weeks, incrementally move the teeth into place until the final desired corrections are reached.

The advantage and appeal of Invisalign appliances is that they are more cosmetic and more comfortable than most other orthodontic appliances. With Invisalign appliances orthodontic treatment is practically “invisible.”

*Invisalign is a registered trademark of Align Technology, Inc.

In cases where a set of conventional braces is the best approach to care, but a more cosmetic appearance is desired, ceramic braces offer an excellent alternative to metal braces. Ceramic braces, or clear braces, blend in with the natural color of your teeth. While being far less visible, they still function in very much the same way as metal braces to deliver outstanding results of care. An excellent aesthetic choice, ceramic braces can be a bit more fragile than their metal counterparts.

The most common type of braces seen today, remain “metal braces”. Made of high-grade stainless steel these braces are significantly smaller and have a lower profile than their predecessors from years ago. Each brace, which is known as an orthodontic bracket, is individually bonded to the front of each tooth. Metal braces allow for efficient and highly controllable tooth movement.