Dental Care  //  Dentistry 101

For decades, dental profession has been stereotyped as the branch of medicine in which the cure is more frightening than the disease itself. Today, dental doctors focus on prevention of dental disease rather than waiting untill symptoms become so painful they can no longer be ignored.

Due to continuing evolution of dental medicine, there are more options for safe, quick, and relatively pain-free treatment of serious dental problems than ever before. Recovery time and post-procedural discomfort have been dramatically reduced over the years allowing you to resume normal daily activities right away. Taking into consideration Dr. Vinson’s gentle touch and compassionate manner, you may be surprised at how relaxing and pleasant a trip to the dentist can be.

Truly, there is no reason to live with tooth pain when safe, gentle and comfortable treatment is only an office visit away.

What is Periodontal Disease?

Periodontal (Gum) Disease is a “silent” disease. Most people do not know they have it, or how serious it is, until their teeth become loose and fall out. It is estimated that more than 75% of all adults have gum disease in various stages! Recent Dental/Medical research has shown a direct link between periodontal disease and general health. People with periodontal disease have an increased risk of stroke, heart attack, diabetic complications, and serious problems with pregnancy.

What are the Signs?

• Do your gums bleed when you brush, floss or use a toothpick?
• Are your gums pulling away from your teeth making your teeth appear longer?
• Has there been a change in the way your teeth come together when you bite or chew on food?
• Are your teeth becoming loose?
• Do you have bad breath?

If any of these statements are true, then you may have a problem with your gums. You may need more than just a routine cleaning of your teeth to get your gums healthy again. A thorough evaluation of your gums will help determine if there is any bone loss and suggest appropriate treatment to prevent the progression of disease.

What are the Stages?

Gingivitis is the early stage of periodontal disease. Ineffective oral hygiene leads to the accumulation of plaque and tartar (light yellow substance coating the teeth) that begins to irritate the gums. This irritation leads to red and puffy appearance of the gums and bleeding upon brushing.

There is no bone loss, yet. During this stage, cure is possible by appropriate gum treatment followed by diligent home care.

After several years of neglect the gums start to shrink away from this irritation exposing the root portion of the teeth. The lower front teeth are particularly at risk as the bone is thinner in this area

With Periodontitis, the plaque and calculus spreads down the root infecting the bone and the ligament holding the tooth into the jaw. This is a more serious stage of gum disease, since the infection has begun to destroy the bone around the tooth.

As the plaque and tartar continues the progress down the root unhindered, the gums and bone recede even further; the teeth become loose and eventually are lost.

How can I avoid this?

If not treated, periodontitis will slowly and painlessly destroy the bone that supports the tooth. The treatment of periodontitis involves removing the plaque and calculus (tartar) that has formed under the gum - known as scaling, followed by smoothing the root surfaces - also known as root planing.

All patients that undergo periodontal treatment need to have their teeth cleaned and their gums checked on a regular basis in order to prevent further periodontal problems. Periodontal disease is a chronic problem. Without ongoing treatment, the infection and disease will recur, and each time it does, more bone can be lost, until eventually the teeth will need to be removed.

What is the difference between “White” and “Silver” fillings?

Amalgam “Silver” Fillings: Used for well over a century, dental amalgam is the most thoroughly researched and tested restorative material among all those in use. While questions have arisen about the safety of dental amalgam relating to its mercury content, the major U.S. and international scientific and health bodies—including the National Institutes of Health, the U.S. Public Health Service, the Centers for Disease Control and Prevention, the Food and Drug Administration and the World Health Organization, among others—have been satisfied that dental amalgam is a safe, reliable and effective restorative material. Amalgam fillings, like other filling materials, are considered biocompatible—they are well tolerated by patients with only rare occurrences of allergic response.

Disadvantages of amalgam include:

• Possible short-term sensitivity to hot and cold temperatures after the filling is placed.
• They are not as esthetically pleasing, especially when the restored tooth is near the front of the mouth.
• Frequently, it is necessary to remove more healthy tooth structure to accommodate an amalgam filling compared to the composite.
• Lastly, the hardness of metal alloy when placed within flexible walls of natural tooth, acts as a wedge and overtime will lead to tooth fracture.

Composite “White” Fillings: Composite fillings are a mixture of acrylic resin and finely ground glasslike particles that produce a tooth-colored restoration. Composite fillings provide good durability and resistance to fracture in small-to-mid size restorations that need to withstand moderate chewing pressure. Less tooth structure is removed when the tooth is prepared, resulting in a smaller filling than that of an amalgam. Composites can also be “bonded” or adhesively held in a cavity, often allowing for a more conservative repair to the tooth.

When treating dental caries, the esthetic and functional considerations make the composite filling, Dr. Vinson’s personal choice.

Though natural teeth can be replaced with help of dental implants, preserving your teeth is very important for phsycological, functional as well as financial reasons. Sometimes in order to save your natural tooth, an Endodontic (Root Canal) treatment is necessary for it to remain a healthy part of your mouth.

While in some cases there are no clear symptoms indicating that a root canal treatment is necessary, most common signs include:

• pain,
• prolonged sensitivity to heat or cold,
• discoloration of the tooth, or
• swelling or tenderness in the nearby gums.

An alternative of removing a tooth that hurts is often an easy and predictable solution. However, it is only a short term answer. When left un-restored, remaining space will lead to serious complications.

What is the pulp?

The nerve inside the tooth is called the pulp, because in addition to the actual nerve tissue it contains the blood supply that insures its vitality.

In any other part of your body, if a similar tissue becomes diseased, the body merely throws it off and forms new tissue. A tooth is unique, because the pulp is totally encased within hard walls. The body simply cannot get to it in order to affect a repair.

What is the function of the pulp?

You might think that a tooth's nerve tissue is vitally important to a tooth's health and function, but in reality it's not. A tooth's nerve tissue plays an important role in the growth and development of the tooth, but once the tooth has erupted through the gums and has finished maturing the nerve's only function is sensory (it provides the tooth with the ability to feel hot and cold).

In regards to our normal day to day oral functions the sensory information provided by a single tooth is really quite minimal. On a practical level it is pretty much academic whether a tooth has a live nerve in it or not. With or without nerve, the tooth is able to serve its primary function, which is providing a surface for chewing food.

What is the root canal treatment?

It is the role of the dentist to do what the body is unable to do. That is removal of the inflamed or infected pulp, cleaning and shaping the inside of the canal space, and finally sealing the space inside.

When large amounts of tooth structure are missing or compromised due to the disease process, it may be necessary to place a post down into the canal space to function as an anchor for the new crown or cap that may be needed to fully restore your tooth's functionality.

Do root canals cause dead teeth?

A popular myth....
When the root canal treatment is complete, the tooth is by no means dead. It receives quite adequate support from the surrounding tissues and may be expected to last as long as any other natural tooth.

What should I expect after the treatment?

Most of our patients report that having Endodontic (root canal) treatment is as unremarkable as having a cavity filled. However following post-operative care will make sure that recovery is uneventful.

What is a Crown?

Crowns are a type of dental restoration which, when cemented into place, fully cup over the portion of a tooth which lies above the gums. Since dental crowns encase the entire visible aspect of a tooth, a dental crown in effect becomes the tooth's new outer surface. Dental crowns are often referred to as "dental caps" or "tooth caps."

What is a Dental Bridge?

When a tooth has been lost but there are still teeth on either side of the resulting space, replacement teeth can be attached to two crowns constructed for the 2 teeth on either side of the open space. This is called a bridge because it bridges the open space. The teeth on each end of the space are used as anchors (abutments). Bridges are cemented onto prepared teeth and become permanent part of your mouth.

Is Dental Bridge for me?

A Dental Bridge is a great way to replace missing teeth. It replaces chewing surface that was lost when the tooth was removed. It looks and feels like your own teeth. It keeps your permanent teeth functioning and in their correct position. In areas where the teeth have significant loss of tooth structure due to caries, existing fillings or root canals, a dental bridge may be a functional and cost-effective solution.

What is an implant?

A natural tooth has a crown - the part which is visible above the gumline, and a root - the anchor hidden below the gumline.

A dental implant is used to replace the root when the natural tooth is missing. Depending on the number of these artificial roots and the quality of jawbone surrounding them, we can anchor

• individual crowns,
• dental bridges and
• even poor fitting dentures.

What?! You are going to place a screw inside my mouth?

Just like an orthopedic pin, a dental implant is a titanium fixture that is surgically grafted into the bone. This pin has threads on the sides to allow for stabilization immediately following implant placement. The ability to immobilize the dental implant allows for faster and more predictable healing. This is the reason why your implant looks like a common screw.

What should I expect during procedure?

The process of implanting a titanium pin inside the jawbone takes less than an hour. This fast and predictable treatment, with a success rate of over 97%, is done by making a small cut in the gums, carefully measuring and preparing a space to receive an implant, followed by the actual implant insertion.

Post-operatively most patients report none or minimal discomfort because the operative area is often very small, and the fact that the jawbone receiving an implant has limited nerve supply.

Still, because of their association with dentistry, dental implants are erroneously considered painful and scary.

What should I expect after the treatment?

Following post-operative care instructions is an important part of implant surgery, and will ensure speedy and comfortable recovery.

What is a Bone Graft?

Bone grafting is performed to reverse the bone loss that is most commonly caused by:

• periodontal disease,
• loss of a tooth/teeth, or
• ill fitting removable dentures.

It is also used to augment bone prior to implant placement in areas that lack sufficient height or thickness for proposed implant treatment.

Why is preserving bone and surrounding gum tissue important?

Loss of bone and gum tissue following tooth extraction often results in both functional and cosmetic defects. Such tissue loss often results in an unsightly collapsed appearance, especially in the front of the mouth where proper mainenance of tissue health is critical to normal esthetics. In other areas of the mouth, loss of bone and gum tissue often compromise the dentist's ability to adequately replace the missing teeth with conventional removable or fixed bridgework or with a dental implant supported prestoration.

How can bone and gum tissue be preserved following tooth extraction?

Following removal of the tooth a specially bioengineered graft material that helps support bone formation is placed within the extraction socket. The bone graft material has similar structure to human bone, and not only supports new bone growth but also has been shown to preserve bone and overlying soft tissue following tooth removal. Because gum tissue grows at a much faster rate than bone, natural fiber membranes are used to prevent gum tissue from growing in and displacing the bone graft before it matures. The need for the use of membrane is normally determined at the time of surgery depending on the clinical situation. This treatment helps prevent bone and gum loss following tooth loss.