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Posts for: April, 2014

UltrasonicScalerscanEffectivelyCleanMostPatientsGumTissues

While you may most associate professional dental cleanings with that “squeaky” clean feeling you have afterward, there is a much higher goal. What is also referred to as “non-surgical periodontal therapy,” these cleanings seek to remove bacterial plaque and tartar (hard deposits) not only from the visible portions of the tooth but also the root surfaces (scaling), so as to reduce the risk and occurrence of periodontal gum disease.

For generations, this was primarily achieved by dental hygienists using hand-held instruments specially designed to manually remove plaque from tooth surfaces. Since the 1950s, though, a new technology known as ultrasonic or power scaling has become more prevalent in use. Initially only used in the outer most portions of the gum tissue (the supra-gingival area) power scaling is increasingly employed to clean the sub-gingival area, much closer to the tooth roots. As this technology has developed, it’s been shown to be just as effective, if not superior in some cases, to manual scaling for removing plaque and tartar.

Ultrasonic or power scalers work by emitting high vibration energy that crushes and removes plaque and calculus (tartar). The resulting shockwaves also tend to disrupt bacterial cell function. The hygienist uses water to flush away the dislodged calculus. They have a number of advantages over manual scaling: they’re quite effective on deep gum pockets, especially when specially designed tips are used; they require less time than manual scaling; and when used correctly power scalers are gentler to tooth structures.

However, they do have a few drawbacks. Because they produce an aerosol effect, power scalers can project contaminants from the patient’s mouth into the atmosphere, requiring special protective equipment for the hygienist. They’re not recommended for patients with hypersensitive teeth, especially regarding temperature change, or for teeth with areas of de-mineralization (the loss of mineral content in the enamel). Care should be taken when they’re used with implants or porcelain or composite crowns — specially designed tips are necessary to avoid scratching the restoration. They may also have an effect on cardiac pacemakers.

In the end, the best approach is a combination of both power and manual scaling techniques. Depending on your individual needs, ultrasonic scaling can do an effective job in removing plaque and tartar and help you avoid gum disease.

If you would like more information on ultrasonic cleaning techniques, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Cleanings Using Ultrasonic Scalers.”


DoYouWantAPerfectOrNaturalSmileWeNeedToKnow

Are you unhappy with the appearance of your smile? Do you get anxious about smiling in social settings? Have you ever wished you had teeth like your favorite celebrity? If you have answered yes to any of these questions it might be time to discuss a smile makeover with us!

During our initial meeting we will ask you exactly what look you are hoping to achieve. Open communication will help ensure ultimate success and satisfaction — you need to tell us what you want and we need to tell you what is actually possible. Then we can plan a solution that is both aesthetically pleasing and functional.

We will also decide which cosmetic materials and techniques to use; this can range from composite resins (tooth-colored fillings), porcelain veneers (thin layers of dental ceramic that are bonded to your tooth enamel) or porcelain crowns (which replace the entire external form of a tooth).

Essentially, most people seem to want one of two looks — a “perfect” Hollywood smile or a more “natural” look. For those who want a “perfect” smile, we will focus on achieving symmetry so that your smile appears perfectly balanced. We will also focus on achieving uniform and maximum tooth brightness and whiteness.

For those who want a more “natural” smile, we can enhance your smile by gently improving brightness while maintaining a more normal symmetry to each tooth shape and size. This can produce a more elegant, youthful smile, not just a Hollywood white smile. We can also maintain slight color, shape and shade variations throughout your mouth.

The best tool for testing our vision is with the use of a tool we call a “provisional restoration.” During this phase of the process we will actually create your new smile using temporary materials, allowing you to “test drive” your new look before committing to permanent materials. This way we can make sure you get exactly what you want. Once you give us the green light, these restorations will be replaced with your permanent new teeth.

Call our office today so we can get started! For more information on the importance of communication between dentist and patient during a smile makeover, read the Dear Doctor magazine article “Great Expectations: Is What You Get What You Want?


By Drake Tollefson DDS
April 17, 2014
Category: Uncategorized
Tags: dental implants  
WhosAfraidofDentalImplantSurgery

Performing dental implant surgery involves placing a metal post inside the bone of the jaw, and ensuring that it fits so precisely and functions so well that you never notice the tooth replacement — and yet it can last for decades. Does it sound terrifically complex or painful? It's not! In fact, the procedure has a success rate of 95-97%, the highest of any tooth replacement option. Here's what you need to know about dental implant surgery.

A dental implant is designed to replace the root part of the tooth. To replace the visible part of the tooth, a crown, bridge or denture can be attached once the implant is secure — which may be the same day or several weeks later, depending on the individual situation. Dental implants are made of titanium (or its alloys), because this metal has a unique property: it's capable of fusing to bone, a process called osseo-integration.

Before placing the implant, a lot of planning goes on — typically involving X-rays (radiographs), and sometimes CT scans. This ensures that the operation itself goes smoothly. When it's time for the procedure you'll receive a local anesthetic, and we'll make sure you don't feel anything.

Next, we access the bone itself, often by making a small flap-like incision in the gum tissue. The living bone is handled with extreme care as a tiny amount is removed to make space for the implant. After the implant is fitted precisely in the bone, the gum tissue is closed, often with self-absorbing sutures (stitches) that don't need removal. And then the procedure's over.

Is implant placement painful? The simple answer is no — most people feel no pain during surgery and very little discomfort afterward. At most, you may experience some mild vibration during the bone preparation process. If you're nervous about the procedure, it's possible to have a sedative or anti-anxiety medication beforehand. Afterward, taking mild non-steroidal anti-inflammatory medication for a day or two is usually all you need to relieve any post-operative discomfort.

If you have questions about dental implant surgery, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Dental Implants.”


By Drake Tollefson DDS
April 14, 2014
Category: Dental Procedures
Tags: root canal   endodontics  
RootCanalsTheTop5ThingsYouShouldKnow

Everyone's heard the jokes about root canals. Now, let's go beyond the myths and get to the “root” of the matter. Here are a few things everyone should know about this relatively painless and beneficial procedure.

1) If you experience discomfort after eating hot or cold foods, sharp pain when biting down, swelling of the gum tissue, or acute tooth pain, you may need root canal treatment.

All of the above are symptoms of disease in the pulp tissue, which lies deep within the roots of teeth, inside tiny canals that go from one end of the root to the other. Pulp tissue can become infected or inflamed for a variety of reasons, such as trauma or deep tooth decay, causing pain and leading to further complications.

2) Diseased pulp tissue in the root canal must be removed to prevent more problems.

The acute pain may go away — but without treatment, the infection in the pulp tissue won't. It will eventually travel through the ends of the tooth's roots and into surrounding areas. This can lead to dental abscesses, and may even cause systemic problems and diseases in other parts of the body.

3) Root canal treatment is effective.

Removing the diseased pulp tissue removes the infection. Pulp tissue itself is a remnant of tooth development which the tooth no longer needs. After the tissue is removed, the root canal is filled with a biocompatible material, and then it is sealed. A crown or other restoration is usually done after root canal treatment to restore the tooth to its full function.

4) Root canal treatment is generally pain-free.

Just like having an ordinary filling, the process begins with an anesthetic administered to numb the tooth and the nearby area. A tiny hole in the tooth's biting surface provides access to the canal, and minute instruments are used for the procedure. Afterwards, over-the-counter pain relievers are typically all that's needed to relieve the sensitivity that may persist for a day or two following the treatment.

5) A properly done root canal preserves your natural teeth.

A tooth that has had appropriate root canal treatment and restoration can last just as long as a natural tooth. That's important, because the other option — removal of the tooth — can lead to issues like unwanted tooth movement and bite problems. Saving your natural teeth should be the first priority in proper dental care.

If you would like more information about root canals, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Common Concerns About Root Canal Treatment” and “Signs and Symptoms of a Future Root Canal.”


By Drake Tollefson DDS
April 01, 2014
Category: Oral Health
Tags: gummy smile  
TreatingaGummySmileDependsonitsCause

Something about your smile isn’t quite right. It’s too “gummy” — too much of the upper gum line is visible and it looks out of proportion to your teeth and lips. Most dentists identify a smile as too gummy if four millimeters or more (approximately an eighth of an inch) of the gum tissue is visible at a full smile.

Fortunately, there are ways to minimize this effect. It’s important, though, to first determine the true cause before we embark on any treatment plan.

Your teeth may be the actual cause. As we mature, teeth “erupt” through the gums and the supporting bone and appear in the mouth. They continue to erupt until meeting their “antagonists,” the opposing teeth from the opposite jaw. In addition, the gums go to the proper position where the root meets the enamel of the teeth around late adolescence. The normal result is a length of the crown (the visible portion of the tooth) of approximately 10 mm.

If the teeth don’t erupt fully or the gums don’t go to their proper position, the teeth appear shorter and the gums more prominent. Using a surgical technique called crown lengthening, we remove excess gum tissue and, if necessary, reshape the underlying bone to reveal the proper amount of tooth length. Teeth also shorten due to excessive wear; the teeth continue to erupt to compensate for the wear that occurs over time. The attached gum tissue follows with the tooth. This can be corrected with orthodontic treatment (for bite correction) and porcelain veneers.

Two more causes of a gummy smile are when a person has a hyper-mobile upper lip — the upper lip can raise too much lift when smiling — and an upper jaw length that appears too long for the face. If lips rise higher than the normal 6-8 mm when we smile, too much of the gum line appears. This can be treated temporarily with Botox injections to reduce the mobility of the muscles, or there is a surgical procedure that reduces the mobility of the upper lip. For an elongated upper jaw, orthognathic (“to straighten the jaw”) surgery relocates the jaw to a more upward position that diminishes the amount of gum tissue that shows during smiling.

Treatments for a gummy smile range from simple techniques to more complex surgical procedures. Only a thorough dental exam will reveal the best treatment path to follow.

If you would like more information on treatments for “gummy” smiles, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Gummy Smiles.”