Routine Cleanings & Prevention

Dental Hygiene & Periodontal Health

In addition to the meticulous cleaning, polishing, and examination of your teeth, we also take the time to help our patients develop proper oral hygiene habits at home. We will evaluate your hygiene techniques and make adjustments to your routine where needed. Our doctors and hygienists will also make suggestions for preventative measures such as dental sealants or nightguards to protect against bruxism & TMJ.

If we feel that you are suffering from gingivitis or more severe gum disease, we may recommend a root scaling or planing. These measures can be instrumental in preventing bone loss and helping you to keep your natural teeth.

Oral Cancer Screenings

During a dental exam, the doctor will check your neck and oral tissues for lumps, red or white patches or recurring sore areas.

Screening for early changes in the oral tissue can help detect cancer at a stage when it can be more successfully treated.

Smoking, especially combined with heavy alcohol consumption (30 drinks a week or more), is the primary risk factor for oral cancer. In fact, this combination is estimated to be the most likely trigger in about 75 percent of oral cancers diagnosed in this country. Other lifestyle and environmental factors also may increase your risk of developing oral cancer.

Scaling & Root Planing

Scaling and root planing is a non-surgical procedure in which the hygienist removes plaque and tartar from below the gum line. Root surfaces are cleaned and smoothed with specially designed instruments. It is important to remove the plaque and tartar from the pockets, because aside from the bacterial toxins that irritate the gums, plaque and the rough surfaces of tartar make it easier for bacteria to gain a foothold.

Invisalign

Invisalign is a new system of straightening teeth without the use of conventional braces. A series of clear plastic aligners are utilized to create tooth movement. Moving teeth with removable aligners is not new. However, the computer program, which can generate a series of aligners with small changes is the new part. Invisalign is recommended for orthodontic situations with mild to moderate spacing or crowding. They are virtually undetectable, easy to use and comfortable to wear.

Frequently Asked Questions

What are the primary benefits of Invisalign?

Invisalign aligners are practically clear. No one may even notice that you’re wearing these virtually invisible “braces,” making Invisalign a seamless fit with your lifestyle and day-to-day interactions with others.

Invisalign is removable. Unlike braces, you have the flexibility to eat and drink what you want during treatment by simply removing the aligners. And you can also remove the aligners to brush and floss as you normally would for fresh breath and good oral hygiene.

Unlike braces, there are no metal brackets or wires with the Invisalign system that could cause irritation to your mouth. Plus since your office visits during treatment don’t involve metal or wire adjustments, you’ll likely spend less time in the doctor’s chair.

How many patients are being treated with Invisalign?

More than 2,000,000 patients worldwide have been treated with Invisalign. The number of Invisalign smiles grows daily.

How will Invisalign effectively move my teeth?

Like brackets and arch wires are to braces, Invisalign aligners move teeth through the appropriate placement of controlled force on your teeth. The main difference is that Invisalign not only controls forces, but also the timing of the force application. During each stage, only certain teeth are allowed to move. These movements are determined by your doctor as he or she maps out your unique Invisalign treatment plan.

What are aligners made of, and what do they look like?

The virtually invisible aligners, which are made of a thermoplastic material uniquely developed for the Invisalign treatment plan, look similar to tooth-whitening trays. Invisalign aligners are custom-made for you and only you to move your teeth in the sequence determined by your doctor. Invisalign aligners and Vivera Retainers do not contain Bisphenol-A or phthalate plasticizers.

Since having my braces removed, my teeth have shifted. Can Invisalign correct this?

A number of Invisalign patients have undergone a previous treatment involving braces at some point in their past, often during their youth. Invisalign can usually correct the shifting that occurs after braces, and do so without having to go through the trauma and social awkwardness of wearing metal braces.

Will wearing Invisalign aligners affect my speech?

Similar to other orthodontic treatments, Invisalign aligners may temporarily affect the speech of some people, and you may have a slight lisp for a day or two. However, as your tongue gets used to having aligners in your mouth, any lisp caused by the aligners should disappear.

Are there restrictions on what I can eat while in treatment?

No. Thanks to the removable nature of the aligners, you can eat and drink whatever you want while in treatment. In fact, you’re required to remove your aligners to eat and drink. So, unlike undergoing traditional treatment using wires and brackets, there is no need to restrict your consumption of any of your favorite foods and snacks unless instructed otherwise by your doctor. Also, it is important that you brush your teeth after each meal and prior to re-inserting your aligners to maintain fresh breath and proper hygiene.

Will smoking stain the aligners?

We discourage smoking while wearing aligners because it is possible for the aligners to become discolored.

Can I chew gum while wearing aligners?

No, gum will stick to the aligners. We recommend removing your aligners for all meals and snacks.

Will Invisalign treatment be painful?

While Invisalign moves your teeth without the pain and anxiety of metal braces, some people will experience temporary discomfort for a few days at the beginning of each new stage of treatment. This is normal and is typically described as a feeling of pressure. It’s also a sign that Invisalign is working, as it moves your teeth to their final destination. This discomfort typically goes away in a couple of days.

What’s the best way to clean my aligners?

The best way to clean your aligners is to use the Invisalign cleaning kit, available for order at www.invisalignstore.com. As a secondary method, however, your aligners can also be cleaned by brushing them and rinsing them in lukewarm water.

How often must I wear my aligners?

We find aligners are most effective if worn 20 to 22 hours per day – and removed only for eating, brushing, and flossing.

How often must I see the Invisalign doctor?

Your doctor will schedule regular appointments – usually about once every four to six weeks. The goal of these visits are to ensure that your treatment is progressing as planned.

What is the minimum age of a patient that a doctor can treat with Invisalign®?

Invisalign Teen is appropriate for patients who have shed all of their baby teeth and have second molars at least partially erupted – this includes most teens.

How long will treatment take?

The length of treatment depends on the severity of your case and can only be determined by your doctor; however the average case takes about 12 months.*

What happens after treatment to prevent my teeth from moving again?

This varies person to person and depends on the outcome of the treatment. Some patients might need a positioner, or conventional retainer. Other patients might need a clear plastic retainer similar to the ones Invisalign makes, such as Align Technology’s Vivera Retainer.

Will my insurance cover Invisalign?

Because medical benefits differ significantly from policy to policy, you should review your personal coverage plan. However, in general, if a patient has orthodontic coverage, Invisalign should be covered to the same extent as conventional braces.

Adult Orthodontics

We use various methods to achieve your adult orthodontic needs. From removable appliances to regular braces, we offer the most suitable methods for you.

Some of the examples are:

  • Simple removable Hawley appliance orthodontics Therapy
  • Invisalign®
  • Clearcorrect®
  • Smart Moves®
  • Powerprox six months braces®
  • And more…

Call our office (206) 554 7755 for free consultation to find out which is the best orthodontic option for you.

Dental Implants

Dental implants are a permanent and appealing solution to replace missing or extracted teeth. They are better than other alternatives like bridges because no additional teeth need to be altered to place the new tooth.

The entire implant process is performed over the course of a few months. The first part of the process is to install the implant itself, where a screw is placed into the jaw bone. An incision is made in the gum so that the implant can be inserted. Multiple implants can be placed at once if necessary. After the implants are placed the gums are sutured.

The implant must be allowed about 3-6 months to heal, and during this time the jaw bone will form around the implant in a process called osseointegration. During this healing time you can have temporary crowns installed so that you can eat and speak normally and maintain a proper aesthetic appearance for your smile.

After the implant has healed it is time to place an abutment on the implant. The abutment serves as the base for your new tooth. One this is placed an impression of the abutment is taken and is used to create your permanent restoration. Some offices have an onsite lab to create the crown, but others will have to send it to an outside lab. Once the restoration is completed you can return to the office to attach the restoration permanently. Your smile will look just like it used to, and after a short period of getting used to the implant it will feel just like one of your own teeth.

Snoring & Sleep Apnea

What Causes Snoring?

Snoring occurs when the soft tissue structures of the upper airway collapse onto themselves and vibrate against each other as we attempt to move air through them. This produces the sound we know as snoring. Large tonsils, a long soft palate, a large tongue, the uvula, and excess fat deposits in the throat all contribute to airway narrowing and snoring. Usually, the more narrow the airway space, the louder or more habitual the snoring.

Obstructive Sleep Apnea

Obstructive Sleep Apnea (OSA) occurs when the tongue and soft palate collapse onto the back of the throat. This blocks the upper airway, causing air flow to stop. When the oxygen level drops low enough, the brain moves out of deep sleep and the individual partially awakens. The airway then contracts and opens, causing the obstruction in the throat to clear. The flow of air starts again, usually with a loud gasp. When the air flow starts again, you then move back into a deep sleep. The airway muscles collapse, as you awaken with a gasp. The airway clears once again as the process repeats itself. This scenario may occur many times during the night. The combination of low oxygen levels and fragmented sleep are the major contributors to most of the ill effects that the sleep apnea patient suffers. In addition to excessive daytime sleepiness, studies show that sleep apnea patients are much more likely to suffer from heart problems (heart attack, congestive heart failure, hypertension), strokes, as well as having a higher incidence of work related and driving related accidents

Diagnosis of Obstructive Sleep Apnea

Since OSA is a serious medical condition, it must be diagnosed by a physician. Diagnosis is based on the results of an overnight sleep study, called a Polysomnogram (PSG). Other factors of determining OSA are patient evaluation and history.

Treatment Options

Good sleep hygiene, weight loss, and exercise are some helpful OSA treatments a patient can practice on their own. However, medical and dental treatments include Continuous Positive Airway Pressure, Oral Appliance Therapy, and surgery.

Continuous Positive Airway Pressure (CPAP)

Continuous Positive Airway Pressure (CPAP) is pressurized air generated from a bedside machine. The air is delivered through a tube, connected to a mask, covering the nose. The force of the pressurized air splints the airway open. The CPAP opens the airway like air into a balloon; when air is blown into the balloon, it opens and gets wider. This is exactly how CPAP clears the airway.

Oral Appliance Therapy

Oral appliances are worn in the mouth to treat snoring and OSA. These devices are similar to orthodontic retainers or sports mouth guards. Oral Appliance Therapy involves the selection, design, fitting and use of a custom designed oral appliance that is worn during sleep. This appliance then attempts to maintain an opened, unobstructed airway in the throat. There are many different oral appliances available. Approximately 40 appliances have been approved through the FDA for treatment of snoring and/or Sleep Apnea. Oral appliances may be used alone or in combination with other means of treating OSA. These means include general health, weight management, surgery, or CPAP. Oral appliances work in several ways:

  • Repositioning the lower jaw, tongue, soft palate and uvula
  • Stabilizing the lower jaw and tongue
  • Increasing the muscle tone of the tongue

Dentists with training in Oral Appliance Therapy are familiar with the various designs of appliances. They can determine which one is best suited for your specific needs. The dentist will work with your physician as part of the medical team in your diagnosis, treatment, and on-going care. Determination of proper therapy can only be made by joint consultation of your dentist and physician. Initiation of oral appliance therapy can take from several weeks to several months to complete. Your dentist will continue to monitor your treatment and evaluate the response of your teeth and jaws.

Surgical Procedures

In addition to Oral Appliance Therapy, dentists who are oral and maxillofacial surgeons may consider a variety of methods to evaluate, diagnose and treat upper airway obstruction. These dental specialists treat upper airway obstructive disorders by utilizing both minimally invasive procedures as well as more complex surgery, including jaw advancement. Additionally, an ENT specialist may evaluate you for other types of surgery, mainly the removal of the excess tissues in the throat. It may be necessary to remove tonsils and adenoids (especially in children), the uvula, or even parts of the soft palate and the throat.

contents from <American Academy of Dental Sleep Medicine>

Teeth Whitening

Whitening/Bleaching

Your smile is important. It’s one of the first things you notice when you meet someone. A whiter, brighter smile is beautiful – it can help you feel better about yourself and make a memorable impression. Your lifestyle and the aging process can stain and darken your teeth. Many things we do on a regular basis can contribute to stained teeth, such as drinking coffee, tea, cola and red wine or smoking.

Whitening can get your smile looking its best. You should look for a whitening procedure that is:

  • Fast and convenient
  • Long lasting
  • Low sensitivity
  • Proven to be safe and effective
  • Performed by a Dental Professional

Procedure

The first step in the whitening process is impressions. We will take full impressions of your upper and lower teeth. These impressions will be made into custom bleaching trays. The trays will fit onto your teeth perfectly so there is a small possibility of gum damage from the bleaching solution.

The second step is to place the bleaching solution in the trays and wear them for a few hours a day. Within 7-10 days, you will see a significant improvement in the color of your teeth. Your smile will look brighter and younger. We will take before and after photos so that you will be able to compare the amazing transformation.

Bleaching only works on natural teeth and may not be effective in all cases. We will inform you as to the potential whitening for your specific situation.

Post-Op Instructions

It is important to follow instructions after you have oral surgery to ensure proper healing and to avoid complications. As a rule of thumb, you should always wait two hours after surgery before eating to let the anesthesia wear off. Trying to eat before this could result in soft tissue damage because you are not able to feel all of your mouth. The instructions found below are guidelines. After your surgery the doctor or dental assistant will give you full instructions on how to properly recover from surgery.

Root Canal Therapy

You can expect soreness after a root canal procedure for a few days. You should avoid chewing on the side of your mouth where the procedure was performed so you do not irritate the area and also to ensure that the temporary restorative material properly sets. You will also need to take an antibiotic to treat any remaining infection in your tooth. If you notice an increasing amount of pain or tenderness, a reaction to the medication, or the loss of the temporary restoration (filling) call your dentist immediately.

Crowns and Bridges

Before you receive your permanent crown/bridge you will first receive a temporary restoration. This is not as sturdy as the permanent version, so you should be careful when cleaning and eating. You should brush the area gently and should not pull up on the tooth when flossing because it could become dislodged. The same goes for eating. You should avoid sticky or chewy foods while you have the temporary in.

There may be some sensitivity and irritation after the temporary or permanent is placed. This is normal and will subside after the soft tissue heals. A warm salt water rinse will help, and you can also take Advil or Tylenol if the pain does not go away.

When the permanent crown or bridge is placed it may feel a little awkward for a few days. Your mouth needs to adjust to the new tooth, and it should feel like one of your natural tooth in less than a week. If your bite feels abnormal in any way, you should let your dentist know. Caring for your bridge or crown is just like caring for your own teeth. You should brush and floss regularly.

White Fillings (Bonding)

After the anesthesia wears off your teeth will likely be sensitive. You should avoid hot and cold food or drink for the next few days. After that initial period, your treated teeth will feel as good as new. Continue your normal hygiene plan to ensure that your fillings last for a long time.

Scaling and Root Planing

After this procedure your gums will probably be slightly sore and irritated for a few days. You should rinse your mouth with warm salt water (1 tsp salt/8 oz water) 2-3 times a day. This will relieve the pain and cleanse the area. Brushing and flossing should be continued right after the procedure, but you should brush gently so that you do not further irritate the area. If you experience any swelling or stiffness in the area you can place a cold compress on the area and take some pain relieving medicine. Avoid any hard or chewy foods for 2-3 days after the surgery to ensure the area heals correctly. If you continue to experience pain or swelling after a few days contact your dentist.

Veneers

Before you receive your permanent veneer you will first receive a temporary restoration. This is not as sturdy as the permanent version, so you should be careful when cleaning and eating. You should brush the area gently and should not pull up on the tooth when flossing because it could become dislodged. The same goes for eating. You should avoid sticky or chewy foods while you have the temporary in.

There may be some sensitivity and irritation after the temporary or permanent is placed. This is normal and will subside after the soft tissue heals. A warm salt water rinse will help, and you can also take Advil or Tylenol if the pain does not go away.

When the veneer is placed it may feel a little awkward for a few days. Your mouth needs to adjust to the new tooth, and it should feel like one of your natural tooth in less than a week. If your bite feels abnormal in any way, you should let your dentist know. When brushing and flossing you should pay close attention to the area between the veneer and the tooth at the gum line.

Extractions

After the surgery you will need to rest. You need to be driven home by a friend or family member because of the anesthesia. You can expect for the extraction site to bleed for a little while after the surgery. Gauze will be applied at the completion of the surgery, and you will need to change it when it becomes soaked. If bleeding continues for longer than 24 hours you should call your dentist. Rest when you return home, but do not lie flat. This could prolong the bleeding. Prop your head up on a pillow when lying down. Your dentist will prescribe you pain medication, so if you become sore take as directed. You can also use an ice pack for the pain. Your dentist might also provide you with a cleaning solution to clean the extraction site.

You will be limited to soft foods for a few days after your surgery. Some recommended foods are:

  • Gelatin
  • Pudding
  • Yogurt
  • Mashed Potatoes
  • Ice Cream
  • Thin Soups
  • …and other food you can eat without chewing.

When drinking, make sure you do not use a straw. The sucking motion can loosen your sutures and slow the clotting process. The same goes for smoking. If you have prolonged pain, bleeding, irritation, or don’t feel that the extraction site is healing properly call your dentist for a follow up.

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