Welcome to
Cañada Hills Dental 

*Twist top of seal-syringe applicator 
* Extrude a 1/2 pea size drop of Everlasting Whites gel in to each tooth indentation of your month tray. 
* Place tray in tray in your month. keep whitening gel off of gums. if contact is made with gums, wipe immediately
* Wear trays once a day for 40 mins, as prescribed by your Dentist.
*Rinse an d brush out your trays and your teeth to remove excess material aster each treatment.
*Repeat this procedure for 7 to 10 or until you have achieved the whiteness you want.
*if sensitivity should occur, extent whitening intervals to every other day or every third day until desired whiteness achieved.
*Suggestions: refrain from eating, drinking. or smoking for 30mins after wearing the gel. Also, avoid citrus to minimize possible discomfort.
*refrigerate material when not in use.
* Happy Whitening! 

Dental Hygiene/Teeth Cleaning:
Healthy teeth require the regular care of dentist and the patient's cooperation to ensure that daily brushing and flossing are a way of life. Today we can easily declare that by regularly visiting your dentist, and by following good dental hygiene, you will not be threatened with unhealthy teeth and gums.Routine Checkup

It is very important for you to understand that during your routine checkup, you will receive much more than just a cleaning. I don't know if you have ever given it much thought, but you are receiving a COMPLETE SUITE of diagnostic, preventive, and educational services specifically and individually designed to help you keep the best possible smile for a lifetime. Based upon your specific dental needs, your dental team will formulate a program designed to accomplish your dental goals. Some or all of the following procedures will be included in your Recall and Maintenance appointment.

During the DIAGNOSTIC phase of your visit we may include:

1) A review and updating of your medical history.
2) A recording of any changes in your prescribed medications and physical condition.
3) Necessary X-rays for detecting decay, bone loss and oral pathologies (disease) such as cysts etc.
4) An examination of your teeth to detect decay.
5) An inspection of all existing restorations (filling and or crowns) for leakage and cracks which may result in future decay.
6) Evaluation of your periodontal (gum) tissues.
7) Checking your biting patterns.
8) Evaluating possible cosmetic alterations which you may feel will improve your smile.

The PREVENTIVE services of your visit may include:

1) Blood pressure screening (if necessary)
2) Head and neck oral cancer screening.
3) Scaling of your teeth to remove all plaque and calculus (tartar).
4) Polishing of teeth to remove all surface stains.
5) Polishing all porcelain crowns.
6) Polishing all silver restorations.
7) Flossing.
8) Application of fluoride if necessary.
9) Referral to a specialist for specific treatment if necessary. (ie. Endodontist, Periodontist or an Oral Surgeon).

The EDUCATIONAL aspect of your visit may include:

1) A tour of your mouth with our intra-oral camera and a discussion of findings.
2) Toothbrushing and flossing instructions.
3) Instructions on specific plaque-control items such as: Perio-Aid®, rubber tip, Interplak®, Rotadent®
4) Dietary discussion (if necessary).
5) Presentation of prescribed dental treatment.
6) Updating you on what's new in home care products and the latest advances in Dentistry.
7) A discussion of the recommended time periods between Recall and Maintenance visits.

We hope you can see now that your oral hygiene Recall and Maintenance visit IS MORE than just 'a cleaning'. We believe that our patients deserve the benefits of the Complete Suite of available dental services that can assist in the protection of their overall medical and dental health.

Please remember, good oral hygiene is a great habit to get into! The rewards of a Complete Suite Recall and Maintenance Appointment are a healthy dentition, a bright smile and the confidence that you have begun a program that will continue to provide benefits to you for years to come.

Tooth Brushing:

The Brush To Use
Hard bristles were once recommended but are now thought to be too abrasive to the teeth and gums. We now suggest a soft, rounded-end nylon bristle brush. Be sure to discard brushes when the bristles are bent or frayed or approximately every three to four months.

How To Brush:
Begin by placing the head of the brush beside your teeth, with the bristles angled against the gum line (where the teeth and gums meet). Think of the brush as both a toothbrush and a gum brush. With the bristles contacting both tooth and gum, move the brush back and forth several times across each tooth individually.
Use a short stroke and a gentle scrubbing motion, as if the goal were to massage the gum. Don't try to force the bristles under the gum line; that will happen naturally, especially with a brush that has soft, flexible bristles.

Brush the outer surfaces of the upper and lower teeth. Then use the same short back-and-forth strokes on the inside surfaces. Try to concentrate harder on the inside surfaces; studies show they're more often neglected. For the upper and lower front teeth, brush the inside surfaces by using the brush vertically and making several gentle up-and-down strokes over the teeth and gums.

Finish up by lightly scrubbing the chewing surfaces of the upper and lower teeth. You should also brush your tongue for a fresher breath.

Flossing:

Instructions
With all of the wonders of modern man available to you there is no better way to clean the sides of your teeth than DENTAL FLOSS. Inexpensive, readily available and easy to use. A modern wonder, maybe not. But it is and has always been an excellent tool in the fight against dental decay and periodontal disease. There are many types of dental floss available in your local drugstore. Please speak with our hygienist regarding the best floss for your particular set of dental needs.

In our office, we can replace old, broken down metal fillings or missing teeth that detract from your smile using ceramic, composite or fiber reinforced composites.

Porcelain laminate veneers are probably the most esthetic means of creating a more pleasing and beautiful smile. They require a minimal amount of tooth reduction ( approximately .5 mm ) and are, therefore, a more conservative restoration than a crown. Porcelain veneers allow us to alter tooth position, shape, size and color. They are not the only alternative for all esthetic abnormalities but are truly a remarkable restoration when they are the treatment of choice.

Porcelain veneers are thin, hand-sculpted pieces of dental porcelain. They are molded and shaped on a model that is made from an impression of your teeth. Using various colors of porcelain powders mixed with water, the technician molds and sculpts the veneer. The porcelain veneers improve the look of your smile while blending naturally with your other teeth.

White Fillings:
In the past, teeth were most commonly repaired with amalgam (silver) fillings or gold restorations. Thanks to advances in modern dental materials and techniques, teeth can be restored with a more aesthetic and natural appearance. There are different types of cosmetic fillings currently available. The type used will depend on the location of the tooth and the amount of tooth structure that needs to be repaired.

Direct Composite:
The simplest form of 'white filling' is technically called a Composite. It is made up of a composite quartz resin and usually contains some sort of light sensitive agent. These light cured composites are extremely cosmetic and most often bonded into place in one appointment. For this reason, they are often referred to as "bonding". They can be used in both the front of the mouth as well as in your back teeth. These materials come in a variety of shades so that they will match the color of your own teeth. Some of these composite materials have been specifically designed to actually withstand the incredible forces you can exert when chewing on your back teeth.

In order to bond a filling material to your tooth it is first necessary to remove decay, prepare the tooth and then to condition the enamel and dentin. Once conditioned, a thin resin is applied which bonds to the etched surface. The bond strength of these fillings is incredible. Today we can bond plastics and even amalgam (silver fillings) to your teeth. Bonding increases the strength of these restorations far beyond those of only a short time ago.

After placement, composites are hardened by shining an intense light on them for a specified period of time, usually around 40 seconds. Since we tend to look at this light all the time (many times a day) it is necessary for us to protect our eyes from it with an orange shield. It is not necessary for us to protect your eyes since you look at this light only once in a while. However, it is probably a good idea for you not to look directly into the light anyway. An ounce of prevention, is indeed, worth a pound of cure!

We are constantly asked the same question, When can I eat?". Well, after placement, as long as you brought your own food and you are willing to share, you may chew right away. These fillings are instantly hardened by the light. Your teeth may experience some degree of temperature sensitivity for a few days to a week. If it does not disappear within that period of time, contact your dentist.

Indirect Composite/Porcelain Inlay
The other type of 'white filling' is called a Composite or Porcelain Inlay. These fillings are usually placed in back teeth when esthetics is of utmost concern. In order to increase their strength and longevity, they are fabricated in the laboratory and then bonded into position in the office. This is a two visit procedure rather than the one visit required to place a composite filling. However, when it comes to strength and cosmetics, the extra time and expense is well worth it! I hope that you now understand a little bit more about white fillings.

Porcelain Veneers:
laminate veneers are probably the most esthetic means of creating a more pleasing and beautiful smile. They require a minimal amount of tooth reduction ( approximately .5 mm ) and are, therefore, a more conservative restoration than a crown. Porcelain veneers allow us to alter tooth position, shape, size and color. They are not the only alternative for all esthetic abnormalities but are truly a remarkable restoration when they are the treatment of choice.

Some facts you might want to know about Porcelain Veneers:

• Since they require approximately .5mm of tooth reduction, porcelain veneers are NOT considered a reversible form of treatment.
• Occasionally the preparation of a Porcelain Laminate Veneer does not necessitate the use of a local anesthetic. However, for those patients that are particularly sensitive or anxious, a local       anesthetic is advisable.
• The laboratory time required for the fabrication of a Porcelain Laminate Veneer is approximately one week. Due to the minimal amount of tooth reduction, it is usually not necessary to fabricate any type of temporary restoration. Should a temporary be needed, they can, in most circumstances, be made at the time of treatment.
• Between your preparation visit and the insertion visit, you can expect some sensitivity to hot and cold. This is normal and is due to the removal of a small portion of the enamel covering of the tooth. This sensitivity should disappear after the placement of your Porcelain Laminate Veneer.
• Your second visit, the insertion of your laminate, can be accomplished, once again , with or without local anesthetic. This visit is usually longer in length. The laminates are placed with a light sensitive resin which is hardened by using a white light.
• Once placed your laminates are very strong and will resist most of the forces placed upon them by a normal diet. Porcelain has great crushing strength but poor tensile strength. Therefore, you should avoid anything that will tend to twist the laminate. Opening pistachio nuts with your teeth, chewing on bones or jelly apples is probably not a good idea. As with most things, common sense should prevail.

Maintenance of Your New Porcelain Veneers :

The maintenance of your Porcelain Laminate Veneer is relatively simple. A few suggestions, however, are in order:

1) Please brush and floss as you normally would to prevent oral hygiene problems. Once placed, Porcelain Laminate Veneers are typically the kindest restoration to the gum tissues that we currently have in our prosthetic armamentarium. Do not be afraid that you will damage your laminates by either flossing or brushing. Any non-abrasive tooth paste is acceptable. A good home care regimen will insure the esthetic success of your laminate restorations for years to come.
2) Some sensitivity to hot and cold may be experienced after the placement of your veneers. This relates to the amount of enamel left on your tooth after preparation, the proximity of the nerve as well as several other factors. Some sensitivity is absolutely normal and usually dissipates after one-two weeks. If this sensitivity should remain or concern you at all, please call your dentist.
3) As mentioned before, a normal diet should pose no problem at all. Please avoid anything that will tend to bend or twist the laminates.
4) If you are known to be a bruxer or clencher, please let your dentist know. He/she will fabricate a soft-nite guard for you to wear to minimize the stresses placed upon your teeth while you sleep.
Approximately one week after the placement of your laminates you will be asked to return to the office for a treatment evaluation. This visit is extremely important. It gives your dentist the opportunity to evaluate the placement of the laminates, the tissue response and to answer any questions you might have regarding your new smile.

We hope that your Porcelain Laminate Veneers have fulfilled all of your esthetic goals. With proper home care and scheduled evaluation visits, they can provide you with a beautiful smile for years to come.

Silver Fillings (Amalgams):

•Silver fillings, otherwise known as Amalgams, are an alloy of several metals ( Silver, Zinc, Tin etc. ) and Mercury. Once mixed, they make up dental amalgam. This restoration has been used successively for many, many years and has stood the test of time. Periodically, reports are generated about the possibility of mercury toxicity from old existing silver fillings. To date, it is the opinion of the American Dental Association that there is no substantial proof that dental amalgam poses any threat to the safety of the dental public.
• Initially, the decayed tooth is excavated and all the decay is removed.
• The tooth is then shaped in a specific manner in order to accept a silver filling.
• Finally, a band is placed around your tooth and the amalgam is condensed into the prepared tooth. The final filling is then carved and adjusted to your bite.
• Once placed, it takes almost two (2) weeks for your new filling to become fully hardened. You may, however, safely chew on it after twenty-four (24) hours. But, please, chew carefully!
• New silver fillings can be sensitive to hot and cold liquids and other foods for the first four to six weeks or in some special cases, even longer. If the sensitivity should continue for an extended period of time or if the discomfort is extreme, call your dentist so that he/she can evaluate the situation and prescribe the appropriate therapy.
• Sometimes, due to the effects of the local anesthesia, it is quite difficult to make sure that your bite is exactly right. If you feel any discomfort in chewing, call your dentist. A minor adjustment is usually all it takes to make you comfortable. Don't wait too long! Teeth can become quite sensitive if the bite is " high ". You can generate in excess of 40,000 pounds per square inch when chewing on your back teeth. Fillings which have not had the appropriate amount of time to harden, or are " high", cannot stand this kind of pressure and may break.






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Crowns
At your clinical examination, Dr. Haley may have suggested that the proper means of restoring your tooth was a crown. The reasons for making that suggestion can vary from case to case. Some of the indications for a crown are:

1) A previously filled tooth where there now exists more filling than tooth. The existing tooth structure becomes weakened and can no longer support the filling.
2) Extensive damage by decay.
3) Discolorations and compromised esthetics.
4) Fractures
5) Root canal - After root canal, teeth tend to become brittle and are more apt to fracture. They, therefore, need to be protected by a crown.
6) Bridges - When missing teeth are replaced with a bridge, the adjacent teeth require crowns in order to support the replacement teeth.

Crowns strengthen and protect the remaining tooth structure and can improve the appearance of your teeth. Crowns can be made from different materials which include the full porcelain crown, the porcelain is fused to a metal crown and the all metal crown. You and your dentist will decide which type is appropriate, depending upon the strength requirements and esthetic concerns of the tooth involved.

Fitting a crown requires at least two appointments. During your first visit, the tooth is prepared for the crown, an impression or mold is made of the tooth, and a temporary crown is placed over the prepared tooth. At the subsequent visit, the temporary crown is removed and the final crown is fitted and adjusted and cemented into place.

First Visit:
The first visit begins by giving you a local anesthetic. Depending upon the type of local anesthetic used, you can expect to be numb for one to four hours. If your anesthesia should last longer, do not be concerned. Not everyone reacts to medication in the same manner. One word of caution : While you are numb, please be careful not to bite your lip or tongue. A soft diet or no meal at all while you are numb is probably a good idea. If your child has been the patient, please watch them carefully to be sure they do not play with their tongue or lip while it is numb.

Once you are numb, your dentist will prepare your tooth in a very specific way in order to maximize the retention and esthetics of your new porcelain to metal crown. After the tooth is fully prepared, we proceeded with the impression stage. We used a thin piece of retraction cord which is placed around your tooth in order to get the impression material under the gum where the crown ends. Please rest assured that this small piece of cord was removed prior to the end of today's visit.

Should you experience any discomfort you can take a mild analgesic (Tylenol™, Advil™, Anacin™, etc.) as long as there is no medical contraindication based upon your medical history. Typically, you can take anything you would normally take for a headache. If the discomfort persists, please call your dentist.

Once the impression stage is completed , your dentist or his assistant will place a temporary (transitional ) crown (or bridge if multiple teeth were involved) on your tooth. These plastic (acrylic) restorations are placed on teeth to protect them and the gum tissues between dental visits. The temporary cementing medium used is designed to allow the easy removal of the temporary at your next scheduled visit.

There are a couple of additional facts you should know about regarding the care of your temporary crown:

Home care is extremely important while your temporary crown is in place. The health of your gum tissue and the success of your final treatment restoration depends upon it. PLEASE do not be afraid to clean your teeth between visits. With a minimal amount of home care, you should be able to maintain the continued health of your teeth and gum tissue during the time required to fabricate your new crown.

Sometimes, even with meticulous care, temporary crowns or bridges may become loose between visits. If this should occur, please place the temporary crown or bridge back on your tooth immediately. Putting a drop of Vaseline™ in the temporary crown or bridge will very often increase the retention and hold the temporary in place until you can schedule an appointment. Once again, REPLACING THE TEMPORARY CROWN IMMEDIATELY IS VERY IMPORTANT ! It only takes a short time for teeth to move if the temporary is not put back into its proper position. This could affect the final restoration significantly and may necessitate new impressions and a great deal of time. If you can not replace the temporary crown yourself, put it in a safe place and call the office. We will be happy to re-cement it for you at the earliest possible moment.

Second visit At that time, the temporary crown is removed and any temporary cement is cleaned from the prepared tooth. Your dentist will fit the final crown, check for accuracy, adjust for any bite discrepancies and evaluate the esthetics. If all of these factors are acceptable, the crown is cemented to your tooth. It is not unusual for the new crown to be mildly sensitive to cold temperatures for a few weeks. However, if the sensitivity is severe, does not subside, or if the bite feels uncomfortable, contact your dentist. Further adjustments to the crown may be necessary.

We hope that this brief instruction sheet will answer most of your questions regarding crowns. Following these simple guidelines will help provide you with the finest in dental care. If you have any questions regarding this or any other procedure, please contact your dentist.

Bridges:
The loss of a single tooth can have a major impact on your dental health and personal appearance. Your teeth support and rely on each other. When one or more teeth are missing, the remaining teeth can shift out of their normal position. Teeth adjacent to the space or from the opposite jaw will often drift or tilt. These teeth are often more susceptible to decay and gum disease because they are more difficult to clean around. All of this shifting and drifting will lead to changes in the bite, which may put stress on the jaws, muscles and teeth. Ultimately, your ability to chew comfortably and your appearance may be affected.

If tooth loss occurs, your dentist may recommend that a bridge be placed. A bridge consists of a replacement tooth/teeth attached to crowns on each side. The bridge is cemented to the teeth adjacent to the space, effectively replacing the missing tooth and preventing any shifting.

The procedures involved in making a bridge are very similar to those for making a crown. Bridges can be made from the same materials as crowns - full porcelain, porcelain fused-to-metal, and all metal. At least two appointments are necessary. At the first visit, your dentist will prepare the teeth next to the missing tooth for crowns. An impression of the prepared teeth will be made and a temporary bridge will be placed. At the subsequent visit, your dentist will fit and adjust the bridge and then cement it in place.

Your new bridge will require some special care when brushing and flossing. Your dental professional will instruct you how to clean around and under the bridge. They may recommend various cleaning aids to help you keep the plaque off and prevent further decay and gum disease.

Today, due to tremendous advances in Implant Dentistry, our LAST CHOICE for a single missing tooth is a Fixed Bridge.

Dentures:
If you are like most people who are learning about dentures, you probably have many questions. Dentures have been around for many years. The earliest form of denture was introduced more than 2,000 years ago. Today, dentures are of better quality and more comfortable than ever before.

Replacing missing teeth has substantial benefits for your health and your appearance. A complete denture, also called a full denture, replaces all the natural teeth and provides support for cheeks and lips. Without this support, sagging facial muscles can make a person appear older. And by replacing missing teeth, dentures improve a person’s ability to speak and to eat.

Here are answers to a few common questions about dentures.

What is the difference between conventional dentures and immediate dentures?

Complete dentures are called conventional or immediate, according to when they are made and when they are inserted into the mouth. Conventional dentures are made and inserted after the remaining teeth are removed and tissues have healed. Healing may take several months.

Immediate dentures are inserted immediately after the removal of the remaining teeth. To make this possible, the dentist takes measurements and makes models of the patient's jaws during a preliminary visit.

An advantage of immediate dentures is that the wearer does not have to be without teeth during the healing period. However, bones and gums can shrink over time, especially during the period of healing in the first six months after the removal of teeth. When gums shrink, immediate dentures may require rebasing or relining to fit properly.

What is an overdenture?

An overdenture is one that fits over a small number of remaining natural teeth that have been prepared by the dentist. The prepared teeth provide stability and support for the denture. Your dentist can determine if an overdenture would be suitable for you.

What will dentures feel like?

New dentures may feel awkward for a few weeks until you become accustomed to them. The dentures may feel loose while the muscles of your cheek and tongue learn to keep them in place.

It is not unusual to experience minor irritation or soreness. You may find that saliva flow temporarily increases. As your mouth becomes accustomed to the dentures, these problems should diminish. One or more follow-up appointments with the dentist are generally needed after a denture is inserted. If any problem persists, particularly irritation or soreness, be sure to consult your dentist.

Will dentures make me look different?

Dentures can be made to closely resemble your natural teeth so that little change in appearance will be noticeable. Dentures may even improve the look of your smile and help fill out the appearance of your face and profile.

Will I be able to eat with my dentures?

Eating will take a little practice. Start with soft foods cut into small pieces. Chew slowly using both sides of your mouth at the same time to prevent the dentures from tipping. As you become accustomed to chewing, add other foods until you return to your normal diet. Continue to chew food using both sides of the mouth at the same time. Be cautious with hot or hard foods and sharp-edged bones or shells.

Will dentures change how I speak?

Pronouncing certain words may require practice. Reading out loud and repeating troublesome words will help. If your dentures click while you are talking, speak slower.

You may find that your dentures occasionally slip when you laugh, cough or smile. Reposition the dentures by gently biting down and swallowing. If a speaking problem persists, consult your dentist.

How long should I wear my dentures?

Your dentist will provide instructions about how long dentures should be kept in place. During the first few days, you may be advised to wear them most of the time, including while you sleep. After the initial adjustment period, you may be instructed to remove the dentures before going to bed. This allows gum tissues to rest and promotes oral health. Generally, it is not desirable that the tissues be constantly covered by denture material.

Should I use a denture adhesive?

A denture adhesive should not be used for a prolonged period. Dentures are made to fit securely. When a denture feels loose it may require relining. A poor-fitting denture may cause irritation and possible sores. Although an adhesive may be used for a short time until you are able to visit your dentist, prolonged use is not usually recommended, except for special situations.

How do I take care of my dentures?

Dentures are very delicate and may break if dropped even a few inches. Stand over a folded towel or a basin of water when handling dentures. When you are not wearing them, store your dentures away from children and pets.

Like natural teeth, dentures must be brushed daily to remove food deposits and plaque. Brushing helps prevent dentures from becoming permanently stained and helps your mouth stay healthy. It’s best to use a brush designed for cleaning dentures. A toothbrush with soft bristles can also be used. Avoid using hard-bristled brushes that can damage dentures.

Your dentist can recommend a denture cleanser. Some denture wearers use hand soap or mild dishwashing liquid, which are both acceptable for cleaning dentures. Avoid using other powdered household cleansers, which may be too abrasive.

The first step in cleaning dentures is to thoroughly rinse away loose food particles. Moisten the brush and apply denture cleanser. Brush every surface, scrubbing gently to avoid damage.

Dentures may lose their shape if they are allowed to dry out. When they are not worn, dentures should be placed in a denture cleanser soaking solution or in water. Your dentist can recommend the best method. Never place dentures in hot water, which could cause them to warp.

Ultrasonic cleaners are also used to care for dentures. However, using an ultrasonic cleaner does not replace a thorough daily brushing.

Can I make minor adjustments or repairs to my dentures?

You can seriously damage your dentures and harm your health by trying to adjust or repair your dentures. A denture that is not made to fit properly can cause irritation and sores.

See your dentist if your dentures break, crack, chip, or if one of the teeth becomes loose. A dentist can often make the necessary adjustments or repairs on the same day. A person who lacks the proper training will not be able to reconstruct the denture. This can cause greater damage to the denture and may cause problems in your mouth. Glue sold over-the-counter often contains harmful chemicals and should not be used on dentures.

Will my dentures need to be replaced?

Over time, dentures will need to be relined, remade or rebased due to normal wear. To make a rebased denture, the dentist uses the existing denture teeth and makes a new denture base.

Dentures may need to be replaced because a mouth naturally changes with age. Bone and gum ridges can recede or shrink, causing jaws to align differently. Shrinking ridges can cause dentures to fit less securely. Loose dentures can cause health problems, including sores and infections. A loose denture also makes chewing more difficult and may change your facial features. It’s important to replace worn or poorly-fitting dentures before they cause problems.

Must I do anything special to care for my mouth?

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

How often should I schedule dental appointments?

Your dentist will advise you about how often to visit. Regular dental check-ups are important. The dentist will examine your mouth to see if your dentures continue to fit properly. The dentist also examines your mouth for signs of oral diseases including cancer.

With regular professional care, a positive attitude and persistence, you can become one of the millions of people who wear their dentures with a smile

Chances are you or a family member have been told that a root canal is necessary to save a tooth; perhaps root canal therapy is already underway. In either case, it is important to understand what will happen during root canal treatment and why this procedure is necessary to save a tooth.

Why Root Canal Treatment?

If you have been told that a root canal is necessary to save one of your teeth, it is important that you understand why this procedure is necessary and what happens during root canal treatment. Root canal treatment (endodontics) treats disorders of the nerve (also called the pulp) of the tooth . It used to be that a tooth with a diseased or infected nerve had to be removed. In 95 percent of the cases today, however, this is no longer true. We believe in saving teeth (instead of removing them). We make every effort to help you keep your natural teeth for a lifetime!

What Makes a Root Canal Necessary?

The following are the most common factors contributing to need for root canal treatment:
• Physical irritation caused by deep decay or a very large filling
• Severe gum disease
• Trauma, such as a physical blow to a tooth or a constant striking of a tooth in the opposite jaw that traumatizes the tooth

Regardless of the initial cause, the tooth pulp becomes irritated and infected. Bacteria grow within the tooth pulp, causing pressure and pain, sometimes accompanied by swelling of the face. Sometimes the deterioration of the pulp happens so gradually the bacteria can destroy the pulp. As this happens, the bone surrounding the tooth may become infected and abscessed, which may lead to the destruction of the bone surrounding the tooth.

What Happens During Treatment?

If we determine through x-rays and a clinical examination that root canal treatment is necessary, we will schedule a series of appointments for you . it is important that you keep these appointments to prevent delays in treatment and healing, which can affect the outcome. It is also essential that you take all antibiotics and medications prescribed to hasten healing and reduce swelling.

1) First, we want to relieve any discomfort you might be experiencing and ensure your comfort throughout the treatment. When necessary, an anesthetic is used to numb the tooth and surrounding and area. The tooth may be isolated with a rubber dam, which confines the treatment area and protects the mouth from bacteria and chemical agents. An opening in made through the crown of the tooth into the pulp.
2) We carefully remove the diseased pulp. The root canal area inside your teeth is cleaned, enlarged and shaped. Then, depending on your individual case, the root canal and pulp chamber may be permanently filled and sealed. In some cases, we place a temporary medication in the tooth to control bacterial growth and reduce infection.
3) A temporary filling is placed in the opening of the tooth until the next visit. In some cases, the tooth may be left open in order to allow the infection to drain. We will decide what is right for your case and do whatever is necessary to assure your comfort.
4) At the next appointment, we sterilize the inside of the tooth to remove the bacteria. Throughout the root canal procedure, we take x-rays to ensure that all of the infected pulp is removed and that the walls inside the canal are smooth.
5) To complete the process, the root canal and pulp chamber are permanently filled and sealed.
6) Finally, the tooth is fully restored to chewing function.

We believe in saving teeth and we will make every effort to save yours!

What care follows the treatment?

1) Once the root canal treatment has been completed, you should consider the following: 1. Brittleness—a non-vital (endodontically treated) tooth is more brittle than a vital one and is more susceptible to fracture. Therefore --, in most cases, we recommend that your root canal tooth be crowned (capped) following treatment.
2) Discoloration, you may notice that your endodontically treated tooth ( especially a front tooth) has undergone a change in color. Though this discoloration is of no medical concern, you may be interested in having the tooth whitening if we don not decide to place a crown on the tooth.

What are dental implants?

Dental implants are basically sophisticated screws made of a medically pure metal, Titanium. These screws are then placed in the jaw bone and rest under the gum for 3 - 6 months. During this time they actually fuse to the jawbone and become osseo (bone) integrated. After the appropriate healing time, we uncover the implants and use them to replace one or more missing teeth by fabricating some sort of dental prosthesis.

How long have implants been used in dentistry?

Dental implants have been available for the past 50 or so years. There are significant differences, however, between the various types of implants that have been used to replace missing teeth. These differences are important since they are directly related to the implants success rates. The implants currently in use today, OSSEOINTEGRATED IMPLANTS, were originally developed in Sweden by Dr. P.I. Branemark., a Swedish Orthopedist approximately 25-30 years ago. They have been used in the U.S. for the past 12 years.

I understand they originated in Sweden and is there a difference between the different implant manufacturers?

All implants in use in the United States are regulated by the Food and Drug Administration. Originally, the only system available was the Noblepharma™ Branemark implant. Today, there are numerous implant companies in use on a daily basis. All of these companies are FDA approved and must meet very stringent requirements. Your dental team will choose the system that is best for you and the one that allows them to accomplish your mutual restorative goal.

What are implants made of?

Implants are made of commercially and medically pure Titanium. This is the same metal that has been successfully used in hip implants for many years. It is inert and is not known to cause any type of rejection phenomenon.

How complicated is the surgery?

Implant surgery is done in two stages. The first stage involves the placement of the implants into the available jaw bone. This is most commonly done with just local anesthesia. It is complicated only in the sense that the surgery requires great precision. Every attempt is made to insure success. The room is set up similar to an operating room, the equipment thoroughly sterilized and the most modern techniques utilized. Stage two involves the uncovering of the implants after they have integrated ( fused ). This can be accomplished with minor gum surgery or with a dental laser and is a relatively minor procedure. In both instances, minimal postoperative discomfort is noticed. You will be given the appropriated antibiotics and analgesics just as a precaution. Very definitive postoperative instruction will be given to you at the time of surgery. If you follow the guidelines, everything should proceed without a hitch.

Can implants be rejected?

No! They are made of an inert metal which has no history of rejection by the body. They are not a living organ such as the lung or liver and therefore there is no rejection phenomenon. If failure should occur, and this is only a remote possibility, it is mechanical in nature and not due to rejection by the body. Depending on the source you read, implants are anywhere from 85-95 percent successful depending upon factors such as implant location, amount and quality of bone etc. These factors will be evaluated before we place your implants. If you have any questions regarding this or any other aspect of the implant process, ask your dentist.

If I lose several teeth, do they each have to be replaced with a separate implant?

No. Although implants simulate the roots of teeth, biomechanically one implant can be used to replace one or more teeth. This will depend upon the mechanical requirements of your chosen prosthesis. At your consultation your dentist will discuss the various treatment alternatives and the type and number of implants that are needed in order to fulfill our treatment objectives.

What about infection and complications?

During the surgery every attempt is made to maintain a totally sterile field. This tends to minimize any potential for postoperative infection. Once again, your dentist will prescribe the appropriate antibiotics as a precautionary measure. Once the implants have been engaged in your prosthesis, it is imperative for you to maintain scrupulous oral hygiene. Success very often depends on your cooperation and homecare efforts.

What types of restorations can be placed on implants?

The answer to this question depends upon your treatment objectives. This can vary from simple removable prostheses, using the implants for retention, to totally implant supported porcelain fused to metal crowns and bridges. Implant bridges can be either removable or fixed (not removable) depending upon the number of implants. We are now finally able to replace single or multiple missing teeth returning the dentition to a biologically healthy and esthetically pleasing state.

Will I be able to chew and function normally?

Yes. Once your implants have integrated, you will be able to function normally without any unusual sensations. Your chewing ability will really depend upon the type of prosthesis you have chosen.

How long is the entire implant process?

Dental implants take approximately 3-4 months in the lower jaw and 6 months in the upper to integrate. Once integrated, it takes several visits to several months to complete the restoration depending upon the complexity.

What is the cost?
The cost of implant dentistry is based upon a combination of the surgical phase and the prosthetic phase. Your total treatment fee will depend upon the number of implants and the complexity of your final restoration.

IMPLANT HOME CARE INSTRUCTIONS:

If you have just had your implant prosthesis inserted or are considering an implant prosthesis, you may be wondering what procedures are necessary for the proper maintenance of your new prosthesis. Well, here's the whole story in a nutshell! The home care needed for dental implants is probably more important than that required for your natural teeth. The appliances that we fabricate on top of dental implants are wonders of engineering but unfortunately, can not be designed to be maintenance free. There are many areas around the implants and the prosthesis that need special attention to make sure that dental plaque does not accumulate. As with your own teeth, plaque, a sticky substance that adheres to teeth and is a breeding area for bacteria, must be removed at least every 12 hours to avoid potential periodontal ( peri-implant ) disease. What are the tools needed to combat peri-implant disease and how should they be implemented.

The care of your Implant Prosthesis consists of three steps:

1) Educating and training you about proper oral hygiene techniques.
2) Removal of plaque and calculus (tartar) on a regularly scheduled basis by your Hygienist.
3) Maintaining meticulous oral hygiene between your recall visits.

Home plaque control is a critical component of your implant care. The following devices have proved extremely helpful in plaque removal and as tools in the proper maintenance of dental implant/prostheses. Soft Toothbrush, End Tuft Brush, Proxy Brush™v • Dental Floss( i.e. Post Care Dental Implant Floss, Super-Floss™ )
• Rotadent™
• Oral Irrigation Devices ( i.e. Water Pik™)
• Mouthwashes containing essential oils ( i.e. Listerine™ )
Individual Instruction sheets are available for each of the above mentioned cleaning aids. Your dentist and hygienist are also available to assist you in any way they can. Remember, it's not the tool that counts, but the elbow grease behind it.

The proper maintenance of your dental implant prosthesis must be a good blend of proper hygiene technique, appropriate instrumentation and adequate frequency. Your hygienist will suggest a suitable recall schedule for you based upon the complexity of your dental restoration. She or he will also demonstrate each and every technique so that you can become familiar with the tools that are required for implant care. Then it's up to you. With a little effort, your dental implant prosthesis can provide you with years of comfort, satisfaction and service.

We hope that this brief explanation answered some of your questions regarding implant dentistry. We will be happy to discuss any of these questions with you at your consultation. Please write down your questions so that we can be sure to answer them to your satisfaction. Occasionally, dental implants may take the place of a missing tooth. These regularly perform as well as an original tooth and are an excellent option in many cases. Surgical and non-surgical treatment of gums including bone grafts and soft tissue root covering. Also you will find all kinds of single tooth implants and implants supported bridges & dentures in our office. One of the main goals of modern dentistry is the prevention of tooth loss. All possible measures should be taken to preserve and maintain your teeth because the loss of a single tooth can have a major impact upon your dental health and appearance. However, it is still sometimes necessary to remove a tooth. Here are some of the reasons a tooth may need to be extracted.

• Severe Decay
• Advanced periodontal disease
• Infection or abscess
• Orthodontic correction
• Malpositioned teeth
• Fractured teeth or roots
• Impacted teeth