General Dentistry

Amalgam filling material includes equal parts of elemental mercury and an alloy powder mostly composed of silver, tin and copper.

Mercury in our drinking, irrigation, and fishing waters is a serious environmental and human-health concern. A potent neuro-toxin, mercury poisoning is devastating to animal species, and is a tragic and debilitating experience for people and families suffering its effects. Only 11 states and 19 localities require dental offices to have amalgam separators, with varying levels of enforcement success. In general, the dental industry is self-regulating regarding amalgam waste, and our communities are relying on individual dental offices to protect the water stream from mercury-containing dental waste.

Many of today’s modern dental practices choose state-of-the-art tooth-colored restoration materials. But even if your office does not place amalgam fillings, you still need an amalgam separator. In a survey taken at the 2009 American Dental Association Convention, only 39 of 100 dental offices surveyed had amalgam separators. The popular answer for not installing a separator was that the office did not place amalgam fillings, not recognizing that the removal of amalgam fillings directs significant mercury-containing waste into the water stream. In a typical one-dentist office that only removes amalgam fillings, the amalgam separator captured 2 pounds of mercury-containing waste material in one year.

Amalgam separators are a readily available, relatively inexpensive, and low-maintenance piece of equipment in the dental practice. Some brands can be installed with very simple plumbing skills, others are easily put in and maintained by your dental supply company.

Find an amalgam separator supplier in the Pollution Prevention section of the GreenDoc Product Guide.

Check with your separator company to find out the life cycle of the collected waste. In some cases, it is recycled back into dental filling material or into non-medical use; other companies will “retort” the material, which is a process that involves securing the toxic waste material in a cement-like substance which is then diverted to landfill.

If you are a dental patient, make sure your dental office has an amalgam separator, even if they are only removing amalgam filling material. Check out more questions to ask your dentist about their eco-friendly choices.

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

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

Do mouthguards prevent Injuries?
A mouthguard can prevent serious injuries such as concussions, cerebral hemorrhages, incidents of unconsciousness, jaw fractures and neck injuries by helping to avoid situations where the lower jaw gets jammed into the upper jaw. Mouthguards are effective in moving soft tissue in the oral cavity away from the teeth, preventing laceration and bruising of the lips and cheeks, especially for those who wear orthodontic appliances. In what sports should I wear a mouthguard? Anytime there is a strong chance for contact with other participants or hard surfaces, it is advisable to wear a mouthguard. Players who participate in basketball, softball, wrestling, soccer, lacrosse, rugby, in-line skating, and martial arts as well as recreational sports such as skateboarding and bicycling should wear mouthguards while competing. Currently, five sports at the amateur level require mouthguards during practice and competition: boxing, football, ice hockey, men’s lacrosse and women’s field hockey.
Why don’t kids wear mouthguards?
Parents are sometimes uninformed about the level of contact and potential for serious dental injuries involved with sports in which the child participates. Some, though not all schools, reinforce the health advantage of mouthguards for their contact sports. Cost may be another consideration, although mouthguards come in a variety of price ranges.

What are the different types of mouthguards?
Stock mouthguard: The lowest cost option is a stock item, which offers the least protection because the fit adjustment is limited. It may interfere with speech and breathing because this mouthguard requires that the jaw be closed to hold it in place. A stock mouthguard is not considered acceptable as a facial protective device. Mouth-formed protectors: These mouthguards come as a shell-liner and “boil-and bite” product. The shell is lined with acrylic or rubber. When placed in an athlete’s mouth, the protector’s lining material molds to the teeth and is allowed to set. The lining of the “boil-and-bite” mouthguard is immersed in boiling water for 10-45 seconds, transferred to cold water and then adapted to the teeth. The “boil-and-bite” mouthguard is used by more than 90 percent of athletes who use mouthguards. While they are less expensive than custom-made guards, the fit is not as good and they do not last as long. Custom-made mouth protectors: The best choice is a mouthguard custom-made by your dentist. It offers the best protection, fit and comfort level because it is made from a cast to fit your teeth.
How should I care for a mouthguard?

• Clean your mouthguard by washing it with soap and warm (not hot) water.
• Before storing, soak your mouthguard in mouthwash.
• Keep your mouthguard in a well-ventilated plastic storage box when not in use. Make sure the box has several holes so the mouthguard will dry.
• Heat is bad for mouthguards, so don’t leave it in direct sunlight or in a closed automobile.
• Don’t bend your mouthguard when storing.
• Don’t handle or wear someone else’s mouthguard.
• Call your dentist who made the mouthguard if there are any problems.

Your teeth are meant to line up perfectly and are designed to fit together in a very specific way. When your teeth don’t touch the way that they should, it can lead to long-term oral health problems. Luckily, this can be corrected with a bite adjustment.

What is a bite adjustment?
Bite adjustments re-shape your teeth to correct the way that they connect. When your bite doesn’t align correctly, it causes one or more of the teeth to touch harder than they should. This can lead to grinding of the teeth—also called bruxism—and many other issues.

What are the signs that a bite adjustment may be necessary?
There are a multitude of symptoms that point to dental problems that can be corrected through a bite adjustment. The most common of these include loose or shifting teeth, frequent headaches related to exertion of the jaw, pain in the mouth—especially while eating, and a grinding noise in the jaw when chewing or talking.

What problems does it correct?
There are a variety of bite problems and dental difficulties that can be corrected with an adjustment, including teeth grinding and pain associated with TMJ disorder.

How effective is bite adjustment?
Bite adjustments are very effective. Patients report a decrease in teeth grinding, which leads to fewer headaches and makes them more comfortable while eating and sleeping over the long run. These adjustments also prevent gum recession and pain associated with wearing down of the teeth due to high impact.

What happens during the procedure?
On the initial visit, Dr. Abraham will do a comprehensive assessment of your bite, and go over any dental procedures that you may have had in the past. X-rays may be ordered and dental impressions made to further diagnose the problem. The teeth will be marked to determine which areas are receiving harsh impact, through the use of indicator tape. The actual reshaping is performed with a dental drill. After subsequent visits to seek out and correct further issues, the teeth will be polished.

Is the process painful?
In general, no. Only the enamel is reshaped, and enamel has no feeling. In some cases, however, extensive reshaping may be necessary, and fillings will be placed to restore normal contours. If this type of treatment is necessary, proper anesthesia will be used

Are follow-up visits necessary?
Yes. You’ll likely feel an improvement immediately, but this may call other irregularities to your attention. After the initial reshaping, you may notice that other teeth touch at a higher impact than they should. These teeth are reshaped at subsequent visits. Patients may also require further resurfacing in the future, due to the natural wear of teeth or degradation of the teeth caused by oral disease.

Are you waking up in the morning with a sore jaw, achy teeth, or even a headache? These symptoms can be the result of keeping your mouth clenched or grinding your teeth while you sleep. A custom fit bite guard can help ease the pain. Our bite guards are soft and fit comfortably on the upper or lower teeth to lessen the stress and pressure of grinding. Please feel free to ask us if a bite guard can help protect your teeth and jaw.

If you’ve suffered from a trauma to bones of the jaw or a defect affecting the integrity of the jawbone, then bone grafting may be necessary.

What is bone grafting?
Bone grafting is the process by which fractures or holes in bone are “filled” with new bone or material. This aids the body in healing the area.

Who needs bone grafting?
This procedure is reserved only for severe cases. Usually, a candidate for bone grafting would be someone who has been treated for bone cancer, was born with a defect causing holes in the bones, or has suffered from a previous trauma to the bone that has not properly healed. Additionally bone grafting is usually done after an extraction to preserve the architecture of the jaw bone.

How does bone grafting work?
The matrix of the bone is composed largely of collagen, and bones contain four different cell types, all of which are important in the healing and strengthening process. There are three distinctly different types of bone grafting. The first, osteogenesis, works by forming new bones with the cells that are present in the graft. It gives the body material to work with and allows it to make new bone matter on its own. The second, osteoconduction, allows new bone to be formed on the framework set in place by the graft. Finally, there is osteoinduction. This process converts cells that are unable to create bone into cells that are capable of repairing bone structure, through a chemical process.

What is involved in a typical bone graft?
You will be placed under anesthesia while the surgery is performed. The actual surgical procedure varies depending upon the severity of the trauma, but an incision will be made that allows Dr. Abraham to place the graft. In most cases bone can be obtained from a tissue bank, or a synthetic material can be used. It is usually held in place with screws or pins, and the incision is closed with stitches.

What can I expect during recovery?
Recovery time varies widely and it largely dependent upon the size and complexity of the graft. In general, you can expect discomfort for the first week, and strenuous activities may be restricted for a few months. Your dentist will provide you with specific instructions regarding your recovery and aftercare.

If you’re looking to improve the appearance of your smile, dental bonding may be just the ticket. Here, we take a look at some common questions regarding the procedure.

What is dental bonding?
Dental bonding uses a composite resin to fill in spaces in the teeth, such as cracks and gaps. It’s also used to lighten discoloration and even out crooked teeth.

Who is a good candidate for bonding?
Anyone suffering from cracked, discolored, uneven teeth, or small gaps. Dr. Abraham will perform a complete oral health exam to determine whether this procedure is right for you. You are discouraged from smoking after a dental bonding procedure, as this yellows the resin rather quickly. If you are a smoker, you will need to discuss this with Dr. Abraham before opting for dental bonding.

What are the advantages of bonding?
Bonding creates a pleasing appearance, and is less costly than some other cosmetic dental procedures, such as crowns or veneers. It’s also less time consuming—in most cases taking only one office visit. Bonded teeth require no special care; just continue to practice good dental hygiene like brushing and flossing the teeth.

Are there any disadvantages?
The only major disadvantage of dental bonding is that the materials used are not as resistant to stains as other traditional means of tooth correction, like porcelain veneers.

Is it permanent?
No. While much longer-lasting than some other cosmetic dentistry procedures, it is not permanent. Bonding typically lasts anywhere from three to seven years, after which time the process will need to be repeated. It’s important to practice good dental hygiene to increase the lifespan of your dental bonding.

What happens during the bonding procedure?
During the initial consultation, Dr. Abraham will discuss the process with you, map out a plan based around your specific issues and set up an appointment. The actual bonding process begins with the application of an etching agent that creates a textured surface. This prepares the teeth to accept the bonding materials. Next, a thin layer of a plastic-like material is applied to the front side of your teeth. Then, the bonding material will be placed on your teeth, sculpted into a desirable appearance, and colored. For single tooth bonding, the tooth will be colored to match your remaining teeth. A light featuring a high intensity beam hardens the resin, and the teeth are polished. The entire procedure takes no more than a few hours.

Is it painful?
Not at all. Bonding is completely painless, and does not require anesthesia unless a filling is being placed as well. A few patients reported an increase in tooth sensitivity for a short period after the bonding procedure.

If you’ve recently lost one or more teeth, a bridge is an excellent way to replace them. Discussed here are some of the most frequently asked questions regarding dental bridges.

What are dental bridges?
A bridge is a false tooth, or set of false teeth, that replace one or more missing teeth. Typically, a dental bridge consists of three connected crowns, with the middle crown being the replacement tooth. This type of bridge uses the two adjacent teeth as anchors to hold the new tooth in place. In some cases—such as when the connected teeth are not healthy enough to serve as anchors or are missing themselves—the teeth are built up artificially.

Who is an ideal candidate to receive a dental bridge?
Anyone who has lost one or more teeth, is otherwise in good oral health, and is looking for a durable, lasting replacement is an excellent candidate for a dental bridge.

Why should I get a dental bridge?
Missing teeth affect more than just appearance. They can lead to bite problems, misalignment, speech impediments, and TMJ disorder, among other things. An increased risk of periodontal disease and tooth decay has also been linked to missing teeth. It is essential for your oral health to replace lost teeth.

What occurs during the placing of a dental bridge?
Initially Dr. Abraham will perform a full exam to assess your oral health, and determine if a dental bridge is the best option for you. Then he will begin to prepare your adjacent teeth for the bridge by grinding them down. A local anesthetic is used, so the procedure is rather painless. After the preparation is complete, an impression will be made of your teeth using a putty-like material. This impression will be the mold that your bridge is crafted around. The actual crafting of the bridges takes some time, as it is important that they fit precisely to avoid complications. You will be fitted with a temporary bridge. When your custom bridge is complete, you will return to the office and it will be cemented in place.

Are dental bridges permanent?
No, but they are very long-lasting. When taken care of properly, dental bridges last an average of five to fifteen years or more. Re-fittings or new bridges are required after that time.

Do they require any special care?
No. The only care required to maintain your dental bridge is practicing good dental hygiene—regular brushing and flossing—and regular checkups with your dentist. You should also make an effort to reduce bad oral habits that may cause unnecessary wear or degradation, such as teeth grinding, nail biting, and smoking.

If you’re looking to improve the appearance of, or have suffered trauma to, one or more of your teeth,
dental crowns provide a great way to regain the strength and natural beauty of your teeth.

What is a dental crown?
A dental crown is a cap placed over a tooth. Full crowns cover all visible portions of the tooth, right down to the gum line, and are the most often used. There are variations—onlays and ¾ crowns—that cover less of the tooth but still provide support. Crowns are commonly crafted with porcelain, resin, metal, and/or gold.

Why would I need dental crowns?
Dental crowns provide a way to restore the integrity of teeth that are cracked or decayed, and in cases where a filling is so large that not much of the original tooth structure remains. They’re also used cosmetically to improve the appearance of teeth that are severely discolored or misshapen.

How long do crowns last?
The life span of your dental crowns is greatly affected by your oral habits. Activities such as biting your nails, eating ice, grinding your teeth, and using your teeth to open food packaging increase the wear and tear, and have a definite negative impact on your crowns. Practicing good dental hygiene is also very important. In general, you can expect them to last anywhere from five to fifteen years.

What is involved in placing dental crowns?
The actual procedure will vary somewhat depending upon the reason for the crown, and the type of crown used. Dr. Abraham will perform a full workup to assess your overall oral health, and determine if dental crowns will be your ideal solution. He will likely order x-rays as well and test the integrity of the tooth structure to determine if other procedures are necessary before the crown can be placed. Next, the tooth will either be filed down or built up, depending on the problem at hand. Your tooth will be filed down to create room for the crown to fit around it. If the tooth is decayed or otherwise damaged to the point where there isn’t much left to work with, Dr. Abraham will build up the tooth with filling material to create a base for the crown. Once the reshaping is complete, impressions will be made and sent to a lab to be used in the creation of your crown(s). Finally, the crown will be placed and cemented.

Is the process painful?
No. Local anesthesia is used during the resurfacing session to alleviate any pain.
Do crowns require any special care?

No, just continue to practice good oral hygiene. Brush your teeth at least twice daily, and floss at least once daily. When flossing, pay close attention to the crowned tooth, making certain to floss at the base where the crown meets the gum.

Dental hygiene is the process of keeping the teeth, gums, and mouth clean and healthy. Many people consider regular brushing and flossing to be the only actions required to maintain good dental hygiene. While certainly important, much more is required to attain optimum oral health.

Why is dental hygiene important?
Dental hygiene is incredibly important to remain healthy. Everything that you eat or drink leaves behind a residue in your mouth. When not properly cleaned, this increases the amount of germs and bacteria in the mouth to unhealthy levels, increasing your risk for many different health problems.

What are the adverse effects of poor dental hygiene?
Poor dental hygiene leads to a variety of different problems. Bad breath, or halitosis, is the most common effect of poor dental hygiene. Another common problem is discolored , missing, or decaying teeth. These issues are very off-putting to others, affecting your social and professional life. More importantly, poor dental hygiene can lead to very serious health issues, such as oral cancer and gum disease. Various studies have linked gum disease to an increased risk for heart attack and stroke. It’s essential that you care for your mouth properly.

What are the key aspects of a good dental hygiene regimen?
Regular brushing of the teeth is key. Teeth should be brushed twice daily at a minimum, to prevent plaque buildup. Using fluoride toothpaste aids in strengthening the teeth and protecting them against decay. It’s important that all areas of the teeth are brushed carefully to remove as much food as possible. Flossing is also very important, and should be done at least once daily. When flossing, be sure that you clean between all of the teeth, not just those in front. An oft ignored area of the mouth is the tongue. Cleaning the tongue each time you brush your teeth removes decaying food and bacteria known to cause infection and disease. Vital to any good dental hygiene program is routine professional teeth cleaning. At least twice per year is recommended. Good dental hygiene extends beyond cleaning and maintenance, however. The foods that you eat, the liquids that you drink, and your habits all have an impact on your oral health. Please feel free to ask Dr. Abraham about ways to set up and maintain healthy oral hygiene habits; he can offer many tips and tricks to help you quickly settle into a more healthy routine.

Losing your teeth can be a very depressing experience. With the teeth gone, the facial muscles tend to sag and can make you look much older, affecting your self confidence. It’s harder to eat, and more difficult to make certain sounds. Dentures can restore normalcy to your life.

What are dentures?
Dentures are a set of false teeth that are custom crafted to fit in your mouth and replace any missing teeth. They offer an advantage over other tooth replacement procedures because they are removable and non-invasive. Both full and partial dentures are available.

What is the difference between full and partial dentures?
Full dentures are a complete set of false teeth. If you have teeth remaining, these will be removed, and the tissue allowed to heal completely before the dentures are placed. This can take up to a few months, during which time you will not have any teeth and be limited to soft, easily chewed foods. Partial dentures are a better option if you’re missing numerous teeth, but the remaining teeth are healthy and strong. This type of denture replaces only the missing teeth, leaving the remaining natural teeth.

Are they uncomfortable?
There is a period of adjustment when you first start wearing dentures. It can take some time to get used to the feeling of the dentures in your mouth, especially if you’ve been without your teeth for an extended period of time. You may find it difficult or awkward to chew certain foods, and speaking may feel strange. Some soreness or irritation is to be expected at first. However, once you’ve gotten used to your dentures they will feel completely natural. If you continue to experience soreness for a long period of time, contact your dentist and set up an appointment to make sure your dentures are a proper fit and there are no signs of gum deterioration.

Can I eat normal foods with dentures?
Certainly; however, keep in mind that it will take some time to get used to chewing. It’s best to start with small pieces of soft foods until you learn to control your chewing a little better. Chew slowly. Move on to more difficult foods as you become comfortable.

How do I care for my dentures?
It’s very important to maintain good dental hygiene. Brushing at least twice daily, and soaking the dentures in a solution overnight, is recommended. There are special brushes available made specifically for use with dentures that should be used. It’s also important to gently brush the gums and tongue with a soft-bristled brush each morning before placing the dentures in your mouth.

How long can I expect my dentures to last?
There is no set time line. Dentures will require adjustments over their life span due to normal wear and tear. When the dentures and mouth are cared for properly, they will last many years. Regular dental appointments will be necessary.

Cavities cause a great deal of pain and discomfort. You may think that your only option is to have the tooth pulled. Fillings are an excellent alternative.

What are fillings?
A “filling” is the common name given to a dental procedure that removes decay—a cavity—in a tooth and fills the space left behind with a synthetic material. Fillings can be made from many different materials, such as gold, amalgam, or composite tooth colored material. Your dentist will choose the material that’s right for you.

Why would I need a filling?
Leaving cavities in place is very dangerous to your oral health. Cavities will continue to get worse as time passes, and can lead to more serious dental problems, like abscesses, gum disease, and permanent tooth loss. Fillings allow you to remove the decay from your natural tooth, while still maintaining its strength and integrity. Fillings are also used in cases where the teeth have been worn down prematurely due to bad habits like nail chewing, and sometimes can be used to repair cracked or broken teeth.

Are fillings permanent?
No. When you get a filling, you will have to return to have the space refilled as time passes, due to discoloration or looseness from natural wear and tear. It’s very important that you schedule regular appointments with your dentist to have the filling checked, as fillings are susceptible to leaks or cracks. When this happens, bacteria gets beneath the filling and, since that area cannot be cleaned, severely decays the tooth. Often, by the time you notice a problem with your filling, it is already too late to save the tooth. Regular check-ups prevent this issue. Your fillings will last longer if you practice good oral hygiene and avoid nail biting, crunching ice, and opening packages with your teeth

What happens during the procedure?
After you and Dr. Abraham determine that a filling is the best option, and choose the most appropriate filling material to use, the next step is to numb the area. The decay will be removed using a dental drill. There are a variety of bits for dental drills. Dr. Abraham will likely use two: one to drill the enamel and a second for the dentin—the softer material that lies beneath the enamel. After all of the decay has been removed, the filling material will be placed into the vacated space. Some filling materials require that the surface of the tooth is etched, so that the filling bonds more strongly to the tooth.

Is it painful?
Local anesthesia is used to numb the mouth before the procedure begins. There is no pain while the tooth is being drilled or filled. There will be some discomfort as the anesthesia wears off that can be easily controlled with medication. Most people actually report a lessening in pain after the procedure, as the fillings “insulate” the nerves in the teeth.

What is Tooth Decay?
Tooth enamel is hard yet porous. Plaque on the surface of your teeth can produce acids that seep into the pores (rods) of the enamel and break down its internal structure. This process, called demineralization, can create a weak spot on the surface of the tooth that may become a cavity if left untreated. Decay often begins on biting surfaces, between the teeth, on exposed roots, and around existing fillings. Untreated, decay spreads into the tooth and can destroy the tooth structure. Decay enters and infects the pulp. Acid enters rods in the teeth and breaks down enamel.

The Role of Fluoride
Fluoride helps prevent tooth decay by slowing the breakdown of enamel and speeding up the remineralization process. The new enamel crystals that form are harder, larger, and more resistant to acid. Fluoride increases the rate of remineralization and protects against demineralization Fluoride enters rods in the tooth to treat broken-down enamel Enamel is remineralized after addition of fluoride

Treating and Preventing Tooth Decay
Common sources of fluoride are fluoridated drinking water, toothpaste, and mouth rinse. Inform your dentist if your drinking water is not fluoridated. He or he may recommend that you use high-concentration fluoride gels, mouth rinses, drops, or tablets. To help strengthen weak spots and exposed roots and prevent the early stages of tooth decay, brush regularly with a fluoridated toothpaste. In one study, patients using a fluoride toothpaste developed 41% fewer cavities than patients using a toothpaste without fluoride. Daily brushing with a fluoride toothpaste, as well as regular flossing and professional cleanings, will help prevent cavities and preserve your oral health.

Many people have a fear of being put under—put into a state of unconsciousness through the use of general anesthesia. In dental procedures, local anesthesia is a very effective alternative. It offers many advantages over general anesthesia.

What is local anesthesia?
Local anesthesia, sometimes referred to as regional anesthesia, numbs only the areas of the body that are to be effected by a surgery or procedure. With dentistry, local anesthesia is used for most procedures, such as fillings and root canals, among other things. Local anesthesia allows the patient to remain awake and alert without feeling any of the pain associated with the procedures.

How does it work?
Local anesthesia works by numbing the nerves of the area to be worked on. It blocks the nerve impulses of the area. It is applied either through a topic solution or, more commonly, a syringe injection.

Will it hurt when it’s applied?
Injection can be a bit uncomfortable, as with any shot, but the pain will pass quickly as the drug takes effect.

What are the risks?
There are few risks involved when using local anesthesia. Negative reaction to the drug is a possibly with any kind of anesthesia, but is far more common when dealing with a general anesthesia or nerve block. Too much anesthesia can lead to convulsions, or even cardiac arrest, but a skilled anesthesiologist is very careful during the application process, checking often to be sure that the drug is going where it’s supposed to and that too much is not being applied. If you have any questions or concerns, talk with your dentist about them prior to your procedure.

What are the advantages of local anesthesia?
It is thought to be less risky than general anesthesia, with fewer side effects. It also allows you to be awake and alert during the procedure, so you are available to answer questions. There is no “recovery period” where you feel groggy waiting for the medication to wear off. With local anesthesia, you can leave the dentist’s office and go about your day as you normally would, with no restrictions on driving, working, or decision making.

Periodontal care is the term used to describe the practice of taking care of your gums. Having healthy gums is essential to your overall oral health, so if you have—or think you may have—gum disease, it’s very important that you see your dentist for periodontal care.

What is gum disease?
Gum disease is an infection in the gums: the soft tissues surrounding the teeth. There are two stages of gum disease. The first is called gingivitis, and the second is periodontitis.

What are some signs that I may have gum disease?
The earliest sign of gingivitis is sore, puffy gums that bleed easily. Halitosis, or bad breath, is also a side effect of gingivitis, due to the buildup of plaque on the teeth, gums, tongue, and palate. Other signs of gingivitis are loose teeth, changes in your bite pattern, receding gums, and pus between the teeth and gums. Keep in mind, however, that not everyone has symptoms. Some people show no symptoms at all, and others may not realize that they are in the early stages of gingivitis due to other dental problems.

What causes gingivitis?
Gingivitis is caused by poor dental hygiene. When you don’t care for your teeth properly by brushing and flossing regularly, and getting regular cleanings and checkups, plaque builds up in the crevices between the teeth. Plaque is full of bacteria. It is this build up of bad bacteria that causes the infection in the gum tissue.

Can gum disease be treated?
Absolutely. When gingivitis is caught in the early stages, it can often be reversed simply by practicing good dental hygiene. As the disease progresses, it is more difficult to treat, but treatments are available. They vary widely and depend on your dentist, any other dental issues that you may have, and the stage of your gum disease.

What happens if I don’t treat my gingivitis?
If you allow your gingivitis to go untreated, it will develop into periodontitis. While gingivitis is treatable, periodontitis is not, and poses a far more serious risk to your overall health. Periodontitis is the leading cause of tooth loss in adults. When the gums become so deeply infected, it can spread into the pulp of the teeth. When this happens, the teeth cannot function properly and will either fall out on their own, or be removed by the dentist. If your gum disease progresses this far, you will likely need dental implants or dentures.

How can I prevent gum disease?
The single most important thing that you can do to prevent gum disease is to practice good dental hygiene. Brush your teeth at least twice daily. Floss—making sure that you get between all of the teeth, including those in the back—at least once daily. Use a fluoride toothpaste, and avoid bad habits like eating a lot of sugary food, grinding your teeth, opening food packaging or bottles with your teeth, and eating ice. Professional cleaning at a dentist’s office is recommended at least once per year. It’s also extremely important to have regular dental checkups to detect any problems in their early stages, as gingivitis can be reversed if it’s caught soon enough.

Temporaries
are not strong. They may break or come off occasionally. If so, slip it back on the tooth with some Fixodent™ (Denture Adhesive) and call us for an appointment. Please do not leave the temporary out of your mouth because the teeth will move and the final restoration will not fit. Please do not floss around your temporary crown. The size, shape, and color of the temporary does not resemble the final restoration.

Temporary restorations may leak saliva or food onto the tooth. Sensitivity to hot, cold, pressure, or sweets is not uncommon. If you feel the bite is not correctly balanced, please call for an appointment for a simple adjustment.

Permanent Crowns

Temporary restorations may leak saliva or food onto the tooth. Sensitivity to hot, cold, pressure, or sweets is not uncommon. If you feel the bite is not correctly balanced, please call for an appointment for a simple adjustment.

After the final cementation of your restoration, it may take a few days to get used to the new crown or bridge. Hot and cold sensitivity is possible for a few weeks and occasionally lasts for several months. As with the temporary, if the bite doesn’t feel balanced please call us.

Do not chew hard or sticky foods on the restoration for 24 hours from the time they were cemented. The cement must set up during this time to have optimum strength.

Proper brushing, flossing, and regular 6-month (minimal) cleanings are required to help you retain your final restoration.

The only area that a crowned tooth can decay is at the edge of the crown at the gum line. Often, small problems that develop around the restorations can be found at an early stage and corrected easily, but waiting for a longer time may require redoing the entire restoration.

Sore Spots: Usually, your mouth will have a few “sore spots” after wearing the denture/partial for 24 hours. These areas can be relieved with very little effort during your next appointment.

Chewing: The new bite may not feel completely comfortable for several weeks. We can adjust the contacting surfaces of your teeth after the dentures/partials have settled into place.

Cleaning the Dentures/Partials and your Mouth: Your denture/partials can be cleaned easily by using a denture brush and a mild toothpaste. Periodic denture soaks are also very useful (ex: Polident). We recommend leaving your partials out of your mouth at night and soaking in water.

Dentures only: Brush your gums with a regular toothbrush once per day to toughen and clean them.

Partials only: Use special care to clean parts of the partial that contact any natural teeth.

Both the partial and the natural teeth must be kept very clean on a daily basis to reduce the chance of new dental decay starting.

We have done our best to provide you with well-fitted, functional, and esthetic dentures/partials. We feel confident that after a few weeks of becoming adjusted to the new dentures/partials, you will have years of satisfaction from them. Over time, your jawbone and gums shrink when there are teeth missing. When this occurs, your dentures/partials will feel loose and may require relining.

Wearing ill-fitting dentures/partials for too long without refitting can cause severe bone loss and very serious oral disease. Please call our office if these symptoms occur.

Tooth Extraction Post Operative Instruction

Firmly bite the gauze placed over the wound for one hour (1/2 hour for a baby tooth) to help the bleeding stop. If bleeding persists, change to a new gauze and continue biting firmly for another 1/2 to one hour or until the bleeding stops.

Do not rinse your mouth vigorously for 24 hours after the treatment. Keep your teeth and mouth clean by brushing gently after meals, but avoid touching the wound.

During the first week after treatment, gently rinse your mouth with warm salt water (1/2 teaspoon of salt with 1 glass of warm water) several times a day to help heal the wound.
Take medications as prescribed by the dentist.

Pain relief medication: Take 1-2 tablets only when necessary.
Antibiotics (prescribed in some cases): Please take the complete dosage prescribed.

Plastic Temporary Restorations

Plastic Temporary Restorations will serve you for a short period of time while your permanent veneer is being made. They are attached only slightly to the underlying tooth so they can be removed easily. If a veneer comes off, call us and we will replace it immediately. If you are in a situation that will not allow you to come in, place the temporary back in place with some Fixodent (denture adhesive). You must still see us as soon as possible. The size, shape, and color of the temporary does not resemble the final veneer. Temporary veneers may leak saliva or food onto the tooth. Sensitivity to hot, cold, pressure, or sweets is not uncommon. You may also see stains under the temporaries. These will be removed prior to final cementation. Avoid heavy brushing of the temporaries and do not floss between them because you may pull them off. Your final porcelain veneers will be as close to the natural beauty and function of teeth as possible. They look and feel normal in every way.

Permanent Veneers
We place our veneers with the finest materials and techniques available today. However, you should be aware of the following information about your restorations:

As with natural teeth, avoid chewing excessively hard foods on the veneered teeth (hard candy, ice, raw carrots, etc.) because the porcelain material can break under extreme forces.

Proper brushing, flossing, and regular 6-month (minimal) cleanings are essential to the long-term stability and appearance of your veneers. Often, problems that may develop with the veneers can be found at an early stage and repaired easily, while waiting for a longer time may require redoing entire restorations. The gums may recede from the veneers, displaying discolored tooth structure underneath. This situation usually takes place after many years and may require veneer replacement.

Tooth Decay
Tooth decay is most commonly found on molars (permanent teeth in the back of the mouth). On the surface, molars have deep pits and grooves. It is here that food particles and bacteria often collect and form cavities. Even frequent brushing can’t remove all of the bacteria build up.
What are Sealants?
Sealants are made from a material that bonds to molar surfaces, in order to smooth out the pits and grooves. This flatter surface on the tooth helps regular brushing clean more effectively. What a comfort to know that your brushing efforts are cleaning more than ever before!
Simple and Painless
The application of sealants is a routine procedure. The teeth are thoroughly cleaned before the sealant is simply brushed on. A light is then used to help the sealant harden. No drilling or anesthetic are required, making it a viable solution for even the most nervous patient.

We use a teeth whitening technology to enhance your personal appearance. Under the care of our teeth whitening assistant, your whitening experience will be carefree. Our professional whitening system is safe and effective when compared to over-the-counter teeth whitening products.

In Office Whitening

People with a time constraint for that special occasion will often ask for a teeth whitening solution that is quick. As a Park City general dentistry service we love offering in office whitening. It is recommended to have a teeth cleaning just prior to our in office whitening. Plan on sitting back and listening to spa music, receive a complimentary paraffin hand wax for one hour while we do all the work for you. This service combined with our take home whitening system, see below, has been proven to be effective in white teeth maintenance.

Take Home Whitening Trays

Custom whitening trays are a great way for you to maintain white teeth and a bright smile in the comfort of your own home. The process is simple! We take impressions of your teeth to make custom fitting whitening trays. We will show you how to place the whitening solution into the trays for optimal whitening results.

Benefits:
This teeth whitening process can remove an average of seven years of staining from your teeth. Use on your own schedule to get the results you desire. When used as directed, results can be seen as soon as one week after your first visit to our office. We often recommend whitening prior to any cosmetic procedures to enhance your smile transformation.

Time Frame:
One 20 minute visit for take home trays and 1 hour for in office whitening.

Park City Dental Spa is proud to announce that we have incorporated the VELscope System into our dental practice.

The VELscope system, recently approved by the FDA, was developed by the British Columbia Cancer Agency and Vancouver-based LED Dental Inc. It is a revolutionary hand-held device that provides dentists and hygienists with a new tool to aid in the early detection of oral cancer. The VELscope examination is a non-invasive, painless procedure which takes only a few minutes. The dentist shines a blue light into the mouth to cause it to fluoresce. This fluorescence helps the dentist visualize abnormal tissue which may be, or may lead to, oral cancer.

Over 30,000 people are diagnosed with oral cancer annually in the United States. With a mortality rate of over 50% at 5 years, one person every hour of every day dies of oral cancer in America. If detected early however, oral cancer is 90% survivable. Dr. Abraham, with Park City Dental Spa states: “We’ve always conducted an annual comprehensive oral cancer screening for all of our patients, but the VELscope System will allow us to see things we’ve been unable to see previously. By detecting potential problems earlier, we’ll be providing our patients with the best oral health care currently available.”

If you are unhappy with the appearance of your teeth, veneers may be a good option for you. This form of cosmetic dentistry helps to improve the appearance of teeth that are chipped, misaligned, generally worn and discolored. There are many advantages to veneers over other methods of cosmetic dentistry. If you are considering getting veneers to improve the appearance of your teeth, here are a few of the most commonly asked questions about the procedure, which may help you in your decision.

What exactly are veneers?
Veneers are porcelain shells that are placed on the front of your teeth, and bonded into place to help improve their appearance. The veneers are extremely thin, so they do not do add to the size of your teeth, however they are incredibly strong and durable.

How are the veneers put in place?
During your initial visit, Dr. Abraham will prepare the tooth, so that they can get an impression to mold the veneer. He will have to trim the enamel that is on the front of the tooth. The amount of enamel that is shaved off is extremely minimal, and usually amounts to about what the thickness of the veneer itself will be. Dr. Abraham will then take an impression of your tooth, so that the veneer can be made. The impression is sent to a Dental Lab, and in the meantime you will receive temporary veneers. It usually takes the lab around 7-10 days to make your veneers and send them back to us. Once they are received Dr. Abraham will put them in place to see how well they fit. If all is well, he will then cement them into place with a bonding agent.

How long will my dental veneer last?
The time frame can vary, but the average dental veneer usually lasts about five to fifteen years. This is only a general time frame though, and there are many people that have had veneers last much longer than that, while others have had to replace them in just a few years.