Teeth cleaning is part of oral hygiene and involves the removal of dental plaque from teeth with the intention of preventing cavities (dental caries), gingivitis, and periodontal disease. People routinely clean their own teeth by brushing and interdental cleaning, and dental hygienists can remove hardened deposits (tartar) not removed by routine cleaning.
The most common method of crowning a tooth involves using a dental impression of a prepared tooth by a dentist to fabricate the crown outside of the mouth. The crown can then be inserted at a subsequent dental appointment. Using this indirect method of tooth restoration allows use of strong restorative materials requiring time-consuming fabrication methods requiring intense heat, such as casting metal or firing porcelain which would not be possible to complete inside the mouth. Because of the expansion properties, the relatively similar material costs, and the cosmetic benefit, many patients choose to have their crown fabricated with gold.
As new technology and materials science has evolved, computers are increasingly becoming a part of crown and a fabrication, such as in CAD/CAM dentistry.
Prior to beginning these procedures, the patient is generally numbed in the area intended for instrumentation. Because of the deeper nature of periodontal scaling and root planing, either one half or one quarter of the mouth is generally cleaned during one appointment. This allows the patient to be entirely numbed in the necessary area during treatment. It is typically not recommended to have the entire mouth scaled at one appointment because of the potential inconveniences and complications of numbing the entire mouth- i.e., inability to eat or drink, likelihood of self injury by biting, etc.
Generally, the first step is the removal of dental plaque, microbial biofilm, from the tooth, a procedure called scaling. Root planing involves scaling the tooth’s root. These procedures may be referred to as scaling and root planing, periodontal cleaning, or deep cleaning. These names all refer to the same procedure. The term “deep cleaning” originates from the fact that pockets in patients with periodontal disease are literally deeper than those found in individuals with healthy periodontia. Such scaling and root planing may be performed using a number of dental tools, including ultrasonic instruments and hand instruments, such as periodontal scalers and curettes.
The objective for periodontal scaling and root planing is to remove dental plaque and calculus (tartar), which house bacteria that release toxins which cause inflammation to the gum tissue and surrounding bone.
Removal of adherent plaque and calculus with hand instruments can also be performed prophylactically on patients without periodontal disease. A prophylaxis refers to scaling and polishing of the teeth in order to prevent oral diseases. Polishing does not remove calculus, but only some plaque and stains, and should therefore be done only in conjunction with scaling. Watch Erica’s Triangle Tooth Talk to learn more.
Root Canal Treatment
Temporomandibular joint dysfunction (TMD, TMJD) is an umbrella term covering pain and dysfunction of the muscles of mastication (the muscles that move the jaw) and the temporomandibular joints (the joints which connect the mandible to the skull). The most important feature is pain, followed by restricted mandibular movement, and noises from the temporomandibular joints (TMJ) during jaw movement. Although TMD is not life-threatening, it can be detrimental to quality of life, because the symptoms can become chronic and difficult to manage.
TMD is a symptom complex rather than a single condition, and it is thought to be caused by multiple factors. However, these factors are poorly understood, and there is disagreement as to their relative importance. There are many treatments available, although there is a general lack of evidence for any treatment in TMD, and no widely accepted treatment protocol. Common treatments include provision of occlusal splints, psychosocial interventions like cognitive behavioral therapy, and pain medication or others. Most sources agree that no irreversible treatment should be carried out for TMD.
About 20% to 30% of the adult population are affected to some degree. Usually people affected by TMD are between 20 and 40 years of age, and it is more common in females than males. TMD is the second most frequent cause of orofacial pain after dental pain.
Sleep Apnea Appliances
A sleep apnea oral appliance is typically molded to fit a particular patient’s teeth by a dentist specializing in treating sleep disorders. Appliances usually function by moving the lower jaw forward in order to open up the airway during sleep, thus promoting better breathing and less apneas. Some oral appliances restrict tongue movement in order to prevent the tongue from blocking the airway.
Oral appliances have a mixed success rate in treating sleep apnea. They are generally more successful at treating mild and moderate sleep apnea and less effective at treating severe sleep apnea. They may bring the level of apnea a patient experiences down significantly but fail to completely eliminate it. Their popularity stems largely from the fact that most patients find them more comfortable than CPAP machines (the most common sleep apnea treatment). Because they are perceived as comfortable, patients are more likely to wear them consistently and comply with treatment.
Tooth extraction is usually relatively straightforward, and the vast majority can be usually performed quickly while the individual is awake by using local anesthetic injections to eliminate painful sensations. Local anesthetic blocks pain, but mechanical forces are still vaguely felt. Some teeth are more difficult to remove for several reasons, especially related to the tooth’s position, the shape of the tooth roots and the integrity of the tooth. Dental phobia is an issue for some individuals, and tooth extraction tends to be feared more than other dental treatments like fillings. If a tooth is buried in the bone, a surgical or trans alveolar approach may be required, which involves cutting the gum away and removal of the bone which is holding the tooth in with a surgical drill. After the tooth is removed, stitches are used to replace the gum into the normal position.
Immediately after the tooth is removed, a bite pack is used to apply pressure to the tooth socket and stop the bleeding. After a tooth extraction, dentists usually give advice which revolves around not disturbing the blood clot in the socket by not touching the area with a finger or the tongue, by avoiding vigorous rinsing of the mouth and avoiding strenuous activity. Sucking, such as through a straw, is to be avoided. If the blood clot is dislodged, bleeding can restart, or alveolar osteitis (“dry socket”) can develop, which can be very painful and lead to delayed healing of the socket. Smoking is avoided for at least 24 hours as it impairs wound healing and makes dry socket significantly more likely. Most advise hot salt water mouth baths which start 24 hours after the extraction.
Velscope Oral Cancer Screenings
This is a screening device that assist our dentists as early diagnosers that diagnose patients to catch oral cancer in early stages. An examination of the mouth by our dentists is a common, precautionary step taken during most patient visits. Watch Dr. Tart’s Triangle Tooth Talk to learn more.
In dentistry, a veneer is a layer of material placed over a tooth, either to improve the aesthetics of a tooth or to protect the tooth’s surface from damage. There are two main types of material used to fabricate a veneer: composite and dental porcelain. A composite veneer may be directly placed (built-up in the mouth), or indirectly fabricated by a dental technician in a dental lab, and later bonded to the tooth, typically using a resin cement such as Panavia. In contrast, a porcelain veneer may only be indirectly fabricated. Full veneer crown is described as a restoration that covers all the coronal tooth surfaces. Laminate veneer, on the other hand, is a thin layer that covers only the surface of the tooth and generally used for aesthetic purposes.
Tooth whitening is either restoration of natural tooth shade or whitening beyond natural tooth shade, depending on the definition used.
Restoration of the underlying, natural tooth shade is possible by simply removing surface (extrinsic) stains (e.g. from tea, coffee, red wine and tobacco) and calculus (tartar). This is achieved by having the teeth cleaned by a dental professional (commonly termed “scale and polish”, see debridement and polishing), or at home by various oral hygiene methods. Calculus is difficult to remove without a professional clean.
To whiten the natural tooth shade, bleaching is suggested. It is a common procedure in cosmetic dentistry, and a number of different techniques are used by our practice. Learn more about teeth whitening treatments at Triangle Dentistry.