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Cleanings & Preventions

A preventive program is a cooperative effort by the patient, dentist, and dental staff to preserve the natural dentition and supporting structures by preventing the onset, progress, and recurrence of dental diseases and conditions.

Preventing dental disease starts at home with good oral hygiene and a balanced diet. It is continued in the dental office by the efforts of your dentist and dental hygienist to promote, restore, and maintain your oral health.

Prevention also includes regular dental exams, cleanings, and x-rays. Sealants and fluoride are also great preventive treatments that help protect the teeth.

Prevention helps avoid serious and costly dental problems and is the key to having a healthy, confident, beautiful smile.

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Digital radiography (digital x-ray) is the latest technology used to take dental x-rays. This technique uses an electronic sensor (instead of x-ray film) that captures and stores the digital image on a computer. This image can be instantly viewed and enlarged helping the dentist and dental hygienist detect problems easier. Digital x-rays reduce radiation 80-90% compared to the already low exposure of traditional dental x-rays.

Dental x-rays are essential, preventative, diagnostic tools that provide valuable information not visible during a regular dental exam. Dentists and dental hygienists use this information to safely and accurately detect hidden dental abnormalities and complete an accurate treatment plan. Without x-rays, problem areas may go undetected.

Dental x-rays may reveal:

  • Abscesses or cysts.
  • Bone loss.
  • Cancerous and non-cancerous tumors.
  • Decay between the teeth.
  • Developmental abnormalities.
  • Poor tooth and root positions.
  • Problems inside a tooth or below the gum line.

Detecting and treating dental problems at an early stage may save you time, money, unnecessary discomfort, and your teeth!

Are dental x-rays safe?

We are all exposed to natural radiation in our environment. Digital x-rays produce a significantly lower level of radiation compared to traditional dental x-rays. Not only are digital x-rays better for the health and safety of the patient, they are faster and more comfortable to take, which reduces your time in the dental office. Also, since the digital image is captured electronically, there is no need to develop the x-rays, thus eliminating the disposal of harmful waste and chemicals into the environment.

Even though digital x-rays produce a low level of radiation and are considered very safe, dentists still take necessary precautions to limit the patient’s exposure to radiation. These precautions include only taking those x-rays that are necessary, and using lead apron shields to protect the body.

How often should dental x-rays be taken?

The need for dental x-rays depends on each patient’s individual dental health needs. Your dentist and dental hygienist will recommend necessary x-rays based upon the review of your medical and dental history, a dental exam, signs and symptoms, your age, and risk of disease.

full mouth series of dental x-rays is recommended for new patients. A full series is usually good for three to five years. Bite-wing x-rays (x-rays of top and bottom teeth biting together) are taken at recall (check-up) visits and are recommended once or twice a year to detect new dental problems.

Physicians have relied on computerized axial tomography scans (CAT), for many years. CAT scans are an X-ray procedure that uses many different X-ray images with the help of computers to generate cross-sectional or even 3D views of internal organs and structures within the body. A knee replacement surgery, for example, would never be performed without first examining 3D imaging.

More recently however, dentists have begun to rely on 3D imaging techniques and i-CAT® scans to provide them with a detailed view of the mouth and skull. The advantage that 3D imaging holds over regular dental x-rays is that the bone structure, bone density, tissues and nerves can be viewed clearly.

i-CAT® scans can be completed in less than half a minute. This means that far less radiation enters the body than if a regular set of bitewing x-rays were taken. The main use for i-CAT® scans is as an aid to plan dental implant treatment and other oral surgery.

Dental implants are the most sophisticated replacement for missing teeth, but have historically proven to be time-consuming to place. i-CAT® scans vastly reduce the time it takes to implant teeth. It is thought that in the near future, implants will be placed in a single visit because of this unique type of imaging.

How are i-CAT® scans used?

i-CAT® scans are advantageous because they allow the dentist to magnify specific areas of the face. In addition, the dentist can easily view cross-sectional “slices” of the jaw, which makes planning treatment easier and faster.

Here are some of the main ways in which i-CAT® scans are used in dentistry:

  • Assess the quality of the jawbone where the implant will be placed.
  • Determine where nerves are located.
  • Diagnose tumors and disease in the early stages.
  • Measure the density of the jawbone where the implant will be placed.
  • Pinpoint the most effective placement for implants, including the angle of best fit.
  • Plan the complete surgical procedure in advance, from start to finish.
  • Precisely decide on the appropriate size and type of implants.
  • View exact orientation and position of each tooth.
  • View impacted teeth.

How are i-CAT® scans performed?

i-CAT® scans are quick and simple to perform. A Cone Beam Imaging System is at the heart of the i-CAT® scanner. During the scan, the patient sits stationary on a designated seat. The cone beams are used to take literally hundreds of pictures of the face. These pictures are used to compile an exact 3D image of the inner mechanisms of the face and jaw. The dentist is able to zoom in on specific areas and view them from alternate angles.

Previous patients report the i-CAT® scanner is comfortable because they remain in a sitting position at all times. Additionally, the scanner provides an open environment, meaning that claustrophobic feelings are eliminated. The i-CAT® scan is an incredible tool that is minimizing the cost of dental treatment, reducing treatment time and enhancing the end results of dental surgery.

If you have questions or concerns about i-CAT® scans or 3D imaging, please contact our office.

According to research conducted by the American Cancer society, more than 30,000 cases of oral cancer are diagnosed each year. More than 7,000 of these cases result in the death of the patient. The good news is that oral cancer can easily be diagnosed with an annual oral cancer exam, and effectively treated when caught in its earliest stages.

Oral cancer is a pathologic process which begins with an asymptomatic stage during which the usual cancer signs may not be readily noticeable. This makes the oral cancer examinations performed by the dentist critically important. Oral cancers can be of varied histologic types such as teratoma, adenocarcinoma and melanoma. The most common type of oral cancer is the malignant squamous cell carcinoma. This oral cancer type usually originates in lip and mouth tissues.

There are many different places in the oral cavity and maxillofacial region in which oral cancers commonly occur, including:

  • Lips
  • Mouth
  • Tongue
  • Salivary Glands
  • Oropharyngeal Region (throat)
  • Gums
  • Face

Reasons for oral cancer examinations

It is important to note that around 75 percent of oral cancers are linked with modifiable behaviors such as smoking, tobacco use and excessive alcohol consumption. Your dentist can provide literature and education on making lifestyle changes and smoking cessation.

When oral cancer is diagnosed in its earliest stages, treatment is generally very effective. Any noticeable abnormalities in the tongue, gums, mouth or surrounding area should be evaluated by a health professional as quickly as possible. During the oral cancer exam, the dentist and dental hygienist will be scrutinizing the maxillofacial and oral regions carefully for signs of pathologic changes.

The following signs will be investigated during a routine oral cancer exam:

  • Red patches and sores – Red patches on the floor of the mouth, the front and sides of the tongue, white or pink patches which fail to heal and slow healing sores that bleed easily can be indicative of pathologic (cancerous) changes.
  • Leukoplakia – This is a hardened white or gray, slightly raised lesion that can appear anywhere inside the mouth. Leukoplakia can be cancerous, or may become cancerous if treatment is not sought.
  • Lumps – Soreness, lumps or the general thickening of tissue anywhere in the throat or mouth can signal pathological problems.

Oral cancer exams, diagnosis and treatment

The oral cancer examination is a completely painless process. During the visual part of the examination, the dentist will look for abnormality and feel the face, glands and neck for unusual bumps. Lasers which can highlight pathologic changes are also a wonderful tool for oral cancer checks. The laser can “look” below the surface for abnormal signs and lesions which would be invisible to the naked eye.

If abnormalities, lesions, leukoplakia or lumps are apparent, the dentist will implement a diagnostic impression and treatment plan. In the event that the initial treatment plan is ineffective, a biopsy of the area will be performed. The biopsy includes a clinical evaluation which will identify the precise stage and grade of the oral lesion.

Oral cancer is deemed to be present when the basement membrane of the epithelium has been broken. Malignant types of cancer can readily spread to other places in the oral and maxillofacial regions, posing additional secondary threats. Treatment methods vary according to the precise diagnosis, but may include excision, radiation therapy and chemotherapy.

During bi-annual check-ups, the dentist and hygienist will thoroughly look for changes and lesions in the mouth, but a dedicated comprehensive oral cancer screening should be performed at least once each year.

If you have any questions or concerns about oral cancer, please ask your dentist or dental hygienist.

Regular dental check ups are essential for maintaining excellent oral hygiene and diagnosing potential problems, but they are not a “fix-all” solution. Thorough oral homecare routines should be practiced on a daily basis to avoid future dental problems.

Periodontal disease (also called gum disease and periodontitis) is the leading cause of tooth loss in the developed world, and is completely preventable in the vast majority of cases. Professional cleanings twice a year combined with daily self-cleaning can remove a high percentage of disease-causing bacteria and plaque. In addition, teeth that are well cared for make for a sparkling white smile.

There are numerous types of oral hygiene aids on the supermarket shelves, and it can be difficult to determine which will provide the best benefit to your teeth.

Here are some of the most common oral hygiene aids for homecare:

Dental Flosses

Dental floss is the most common interdental and subgingival (below the gum) cleaner and comes in a variety of types and flavors. The floss itself is made from either thin nylon filaments or polyethylene ribbons, and can help remove food particles and plaque from between the teeth. Vigorous flossing with a floss holder can cause soft tissue damage and bleeding, so great care should be taken. Floss should normally be used twice daily after brushing.

Interdental Cleaners

Many hygienist & periodontists recommend interdental brushes in addition to dental floss. These tiny brushes are gentle on the gums and very effective in cleaning the contours of teeth in between the gums. Interdental brushes come in various shapes and sizes.

Mouth Rinses

There are two basic types of mouth rinse available: Cosmetic rinses which are sold over the counter and temporarily suppress bad breath, and therapeutic rinses which may or may not require a prescription. Most dentists are skeptical about the benefits of cosmetic rinses because several studies have shown that their effectiveness against plaque is minimal. Therapeutic rinses however, are regulated by the FDA and contain active ingredients that can help reduce bad breath, plaque, and cavities. Mouth rinses should generally be used after brushing.

Oral Irrigators

Oral irrigators, like Water Jets and Waterpiks have been created to clean debris from below the gum line. Water is continuously sprayed from tiny jets into the gum pockets which can help remove harmful bacteria and food particles. Overall, oral irrigators have proven effective in lowering the risk of gum disease and should not be used instead of brushing and flossing. Professional cleanings are recommended at least twice annually to remove deeper debris.

Rubber Tip Stimulators

The rubber tip stimulator is an excellent tool for removing plaque from around the gum line and also for stimulating blood flow to the gums. The rubber tip stimulator should be traced gently along the outer and inner gum line at least once each day. Any plaque on the tip can be rinsed off with tap water. It is important to replace the tip as soon as it starts to appear worn, and to store the stimulator in a cool, dry place.

Tongue Cleaners

Tongue cleaners are special devices which have been designed to remove the buildup of bacteria, fungi and food debris from the tongue surface. The fungi and bacteria that colonize on the tongue have been related to halitosis (bad breath) and a great many systemic diseases like diabetes, heart disease, respiratory disease and stroke. Tongue cleaners can be made from metal, wood or plastic and shaped in accordance with the contours of the tongue. Tongue cleaning should be done prior to brushing to prevent the ingestion of fungi and bacteria.

Toothbrushes

There are a great many toothbrush types available. Electric toothbrushes are generally recommended by dentists because electric brushes are much more effective than manual brushes. The vibrating or rotary motion helps to easily dislodge plaque and remove food particles from around the gums and teeth. The same results can be obtained using a manual brush, but much more effort is needed to do so.

Manual toothbrushes should be replaced every three months because worn bristles become ineffective over time. Soft bristle toothbrushes are far less damaging to gum tissue than the medium and hard bristle varieties. In addition, an appropriate sized ADA approved toothbrush should be chosen to allow proper cleaning to all the teeth. Teeth should ideally be brushed after each meal, or minimally twice each day.

If you have any questions about oral hygiene aids, please ask your dentist or dental hygienist.

Panoramic X-rays (also known as Panorex® or orthopantomograms) are wraparound photographs of the face and teeth. They offer a view that would otherwise be invisible to the naked eye. X-rays in general, expose hidden structures, such as wisdom teeth, reveal preliminary signs of cavities, and also show fractures and bone loss.

Panoramic X-rays are extraoral and simple to perform. Usually, dental X-rays involve the film being placed inside the mouth, but panoramic film is hidden inside a mechanism that rotates around the outside of the head.

Unlike bitewing X-rays that need to be taken every few years, panoramic X-rays are generally only taken on an as-needed basis. A panoramic x-ray is not conducted to give a detailed view of each tooth, but rather to provide a better view of the sinus areas, nasal areas and mandibular nerve. Panoramic X-rays are preferable to bitewing X-rays when a patient is in extreme pain, and when a sinus problem is suspected to have caused dental problems.

Panoramic X-rays are extremely versatile in dentistry, and are used to:

  • Assess patients with an extreme gag reflex.
  • Evaluate the progression of TMJ.
  • Expose cysts and abnormalities.
  • Expose impacted teeth.
  • Expose jawbone fractures.
  • Plan treatment (full and partial dentures, braces and implants).
  • Reveal gum disease and cavities.

How are panoramic X-rays taken?

The panoramic X-ray provides the dentist with an ear-to-ear two-dimensional view of both the upper and lower jaw. The most common uses for panoramic X-rays are to reveal the positioning of wisdom teeth and to check whether dental implants will affect the mandibular nerve (the nerve extending toward the lower lip).

The Panorex equipment consists of a rotating arm that holds the X-ray generator, and a moving film attachment that holds the pictures. The head is positioned between these two devices. The X-ray generator moves around the head taking pictures as orthogonally as possible. The positioning of the head and body is what determines how sharp, clear and useful the X-rays will be to the dentist. The pictures are magnified by as much as 30% to ensure that even the minutest detail will be noted.

Panoramic X-rays are an important diagnostic tool and are also valuable for planning future treatment. They are safer than other types of X-ray because less radiation enters the body.

If you have questions or concerns about panoramic X-rays, please ask your dentist.

Dental Exam

A comprehensive dental exam will be performed by your dentist at your initial dental visit. At regular check-up exams, your dentist and hygienist will include the following:

  • Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
  • Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
  • Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
  • Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
  • Examination of existing restorations: Check current fillings, crowns, etc.

Professional Dental Cleaning

Professional dental cleanings (dental prophylaxis) are usually performed by Registered Dental Hygienists. Your cleaning appointment will include a dental exam and the following:

  • Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments.
  • Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
  • Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.

Dental radiographs (x-rays) are essential, preventative, diagnostic tools that provide valuable information not visible during a regular dental exam. Dentists and dental hygienists use this information to safely and accurately detect hidden dental abnormalities and complete an accurate treatment plan. Without x-rays, problem areas may go undetected.

Dental x-rays may reveal:

  • Abscesses or cysts.
  • Bone loss.
  • Cancerous and non-cancerous tumors.
  • Decay between the teeth.
  • Developmental abnormalities.
  • Poor tooth and root positions.
  • Problems inside a tooth or below the gum line.

Detecting and treating dental problems at an early stage can save you time, money, unnecessary discomfort, and your teeth!

Are dental x-rays safe?

We are all exposed to natural radiation in our environment. The amount of radiation exposure from a full mouth series of x-rays is equal to the amount a person receives in a single day from natural sources.

Dental x-rays produce a low level of radiation and are considered safe. Dentists take necessary precautions to limit the patient’s exposure to radiation when taking dental x-rays. These precautions include using lead apron shields to protect the body and using modern, fast film that cuts down the exposure time of each x-ray.

How often should dental x-rays be taken?

The need for dental x-rays depends on each patient’s individual dental health needs. Your dentist and dental hygienist will recommend necessary x-rays based on the review of your medical and dental history, dental exam, signs and symptoms, age consideration, and risk for disease.

full mouth series of dental x-rays is recommended for new patients. A full series is usually good for three to five years. Bite-wing x-rays (x-rays of top and bottom teeth biting together) are taken at recall (check-up) visits and are recommended once or twice a year to detect new dental problems.

A beautiful, healthy smile that lasts a lifetime is our ultimate goal when treating patients. Your personal home care plays an important role in achieving that goal. Your personal home care starts by eating balanced meals, reducing the number of snacks you eat, and correctly using the various dental aids that help control the plaque and bacteria that cause dental disease.

Tooth brushing – Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste.

  1. Place the brush at a 45 degree angle to the gums and gently brush using a small, circular motion, ensuring that you always feel the bristles on the gums.
  2. Brush the outer, inner, and biting surfaces of each tooth.
  3. Use the tip of the brush to clean the inside of the front teeth.
  4. Brush your tongue to remove bacteria and freshen your breath.

Electric toothbrushes are also recommended. They are easy to use and can remove plaque efficiently. Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.

Flossing – Daily flossing is the best way to clean between the teeth and under the gumline. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.

  1. Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
  2. Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
  3. Curve the floss into a “C” shape around each tooth and under the gumline. Gently move the floss up and down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Rinsing – It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush. If you are using an over-the-counter product for rinsing, it’s a good idea to consult with your dentist or dental hygienist on its appropriateness for you.

Use other dental aids as recommended by your dentist or dental hygienist: Interdental brushes, rubber tip stimulators, tongue cleaners, irrigation devices, fluoride, medicated rinses, etc., can all play a role in good dental home care.

Brushing and flossing are of paramount importance to oral hygiene. Though bi-annual professional dental cleanings remove plaque, tartar and debris, excellent homecare methods are equally valuable. Proper brushing and flossing can enhance the health of the mouth, make the smile sparkle and prevent serious diseases.

Reasons why proper brushing and flossing are essential:

  • Prevention of tooth decay – Tooth decay is one of the leading causes of tooth loss, and its treatment often requires complex dental procedures. Tooth decay occurs when the acids found in plaque erode the natural enamel found on the teeth. This phenomenon can easily be prevented by using proper home hygiene methods.
  • Prevention of periodontal disease – Periodontal disease is a serious, progressive condition which can cause tooth loss, gum recession and jawbone recession. Periodontal disease is caused by the toxins found in plaque, and can lead to serious health problems in other parts of the body. Removing plaque and calculus (tartar) from the surface of the tooth using a toothbrush, and from the interdental areas using dental floss, is an excellent way to stave off periodontal problems.
  • Prevention of halitosis – Bad breath or halitosis is usually caused by old food particles on or between the teeth. These food particles can be removed with regular brushing and flossing; leaving the mouth healthier, and breath smelling fresher.
  • Prevention of staining – Staining or the yellowing of teeth can be caused by a wide variety of factors such as smoking, coffee and tea. The more regularly these staining agents are removed from the teeth using brushing and flossing techniques, the less likely it is that the stains will become permanent.

The Proper Way to Brush

The teeth should be brushed at least twice a day; ideally in the morning and before bed. The perfect toothbrush is small in size with soft, rounded-end bristles and no more than three months old. The head of the brush needs to be small enough to access all areas of the mouth, and the bristles should be soft enough so as not to cause undue damage to the gum tissue. The American Dental Association (ADA) has given electric toothbrushes their seal of approval; stating that those with rotating or oscillating heads are more effective than other toothbrushes.

Here is a basic guide to proper brushing:

  1. Place the toothbrush at a 45-degree angle where the gums and teeth meet.
  2. Use small circular motions to gently brush the gumline and teeth.
  3. Do not scrub or apply too much pressure to the teeth, as this can damage the gums and tooth enamel.
  4. Brush every surface of every tooth, cheek-side, tongue-side, and chewing surfaces. Place special emphasis on the surfaces of the back teeth.
  5. Use back and forth strokes to brush the chewing surfaces.
  6. Brush the tongue to remove fungi, food and debris.

The Proper Way to Floss

Flossing is a great way to remove plaque from the interdental regions (between the teeth). Flossing is an especially important tool for preventing periodontal disease and limiting the depth of the gum pockets. The interdental regions are difficult to reach with a toothbrush and should be cleansed with dental floss on a daily basis. The flavor and type of floss are unimportant; choose floss that will be easy and pleasant to use.

Here is a basic guide to proper flossing:

  1. Cut a piece of floss to around 18 inches long.
  2. Wrap one end of the floss around the middle finger of the left hand and the other end around the middle finger of the right hand until the hands are 2-3 inches apart.
  3. Work the floss gently between the teeth toward the gum line.
  4. Curve the floss in a U-shape around each individual tooth and carefully slide it beneath the gum line.
  5. Carefully move the floss up and down several times to remove interdental plaque and debris.
  6. Do not pop the floss in and out between the teeth as this will inflame and cut the gums.

 

If you have any questions about the correct way to brush or floss, please ask your dentist or dental hygienist.