David A. Paulisin, DDS - Family Dentistry
 

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Services and Dental Definitions

Note: The purpose of this information to help you better understand dental procedures and conditions. The information is not intended to serve as delivery of dental or medical care or treatment. If you have specific concerns or questions, please contact us.

ORAL HYGIENE CARE
Maintaining good oral hygiene is one of the most important things you can do for your teeth and gums.  Healthy teeth not only enable you to look and feel good, they make it possible to eat and speak properly. Good oral health is important to your overall well-being. Daily preventive care, including proper brushing and flossing, will help stop problems before they develop.

In between regular visits to the dentist, there are simple steps that each of us can take to greatly decrease the risk of developing tooth decay, gum disease and other dental problems. These include:

  • Brush thoroughly twice a day and floss daily
  • Eat a balanced diet and limit snacks between meals
  • Use dental products which contain fluoride, including toothpaste
  • Rinse with a fluoride mouth rinse if advised to do so
  • Make sure children under 12 drink fluoridated water or take a fluoride supplement if they live in a non-fluoridated area
  • Visit your dentist regularly for professional cleanings and oral exams
  • Replace your toothbrush every 3-4 months

The following are indications of good oral hygiene:

  • Your teeth are clean and free of debris
  • Gums are pink and do not hurt or bleed when you brush or floss
  • Bad breath is not a constant problem

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X-RAYS
X-rays are a focused beam of x-ray particles passed through bone which produce an image on special film, showing the structure through which it passed. This provides the familiar black and white images doctors and dentists use to diagnose problems and disease. Without an x-ray of the whole tooth and supporting bone and gum tissues, there would be no way to detect infection or pathology that requires attention.  Back to top

DENTAL CLEANING
A dental cleaning is a professional cleaning you receive from a dentist or dental hygienist. Most dental cleanings take approximately 45 minutes. Cleanings should be performed every six months to prevent excessive plaque buildup.  Plaque left untreated can lead to unhealthy gums and tooth decay. During your routine cleaning we will remove excess plaque and polish your teeth. 

At times, due to the excess accumulation of plaque and calculus, a dental cleaning may take multiple appointments and will require a higher fee. Back to top

SEALANTS
Sealants are used to fill narrow grooves in a tooth that cannot be adequately cleaned by brushing. In some cases, the tooth structure has fine grooves or pits which accumulate plaque, not because the person doesn't brush, but because they're too narrow to allow even one bristle into them. To avoid cavities developing over time, the dentist will brush on a coating that seals the grooves and pits, making it possible to brush off all the plaque and keep your teeth healthy. Back to top

BONDING
Bonding involves adhering composite resin material that is matched to the color of the tooth, to the front of the tooth. This is performed to repair damage caused by decay, to alter the alignment of the tooth, close gaps between the teeth, or for other cosmetic purposes.

First the surface of the tooth is roughened in order to accept the bonding. A gel is applied so the resin will adhere to the surface of the tooth. The composite is then placed on the tooth and the bonding agent hardens with intense light. The last step is shaping and polishing to give a lustrous finish. 

FILLINGS
A filling is a way to restore a tooth damaged by decay back to its normal function and shape. If you have a tooth that requires a filling, the dentist will first remove the decayed tooth material, clean the affected area, and then fill the cleaned out cavity with a filling material. A filling helps prevent further decay by closing off any cracks or spaces where bacteria can enter.

There are a variety of filling materials available including gold, silver, plastic and porcelain. The dentist will work with you to determine which material is best, depending on the extent of repair, where in the filling is needed, and cost. Each filling material is briefly explained below:

  • Gold fillings are custom made in a laboratory and then cemented into place. While gold fillings are often the most expensive choice, many consider it the best filling material. Gold inlays are well-tolerated by gum tissues and may last more than 20 years.
  • Amalgam (silver) fillings are a more inexpensive choice and are tolerant to wear. However, due to their dark color they are more noticeable than porcelain or composite restorations and are not recommended for fillings in very visible areas such as front teeth.
  • Composite (plastic) resins are custom made to the exact color of your natural teeth, creating a more natural appearance. While white fillings may be less noticeable than other materials, they usually only last between 3 and 10 years and may not be ideal for large fillings as they may chip or wear over time. They can also become stained from coffee, tea or tobacco.
  • Porcelain fillings are called inlays or on-lays and are custom created in a lab and then bonded to the tooth. They can be matched to the color of the tooth, resist staining, and are about the same cost as gold fillings. A porcelain restoration generally covers most of the tooth, making the filling nearly undetectable.

If decay or a fracture has damaged a large portion of the tooth, a crown (or "cap") may be recommended. Decay that has reached the nerve may be treated through root canal therapy or through a procedure called pulp capping. Back to top

Nitrous Oxide Sedation/DENTAL ANXIETY
Nitrous oxide sedation is a technique that can be used when a patient suffers from dental anxiety or dental phobia. We are happy to offer a number of solutions for our patients to make their dental visit as comfortable as possible. Nitrous oxide sedation enables patients who might otherwise avoid the dentist, to receive dental treatment necessary for a healthy smile. Nitrous Oxide Sedation leaves your system before you leave the dental chair. Depending on the extent of the anxiety or phobia, varying degrees of dental sedation can be utilized as described below. Back to top

Oral Sedatives
This medication can be given to a patient the night before a dentistry procedure or 30 minutes to an hour prior to the dental appointment, depending on the severity of the anxiety. Oral sedatives do not provide pain relief, so an injection of local anesthetic will also be administered.  Patients who are treated with oral sedatives must not drive to our office. Please secure a ride from a relative or friend to and from our office. Back to top

CROWNS AND BRIDGES
Crowns and bridges are used to restore and enhance teeth that are damaged or to take the place of missing teeth. A crown (also referred to as a cap) is used to entirely cover a damaged tooth. A crown not only strengthens a tooth, but it can dramatically improve a tooth’s appearance, shape and alignment.

Crowns may be used to:

  • Replace a large filling when there is little tooth structure remaining
  • Protect a weak tooth from fracturing
  • Restore a fractured tooth
  • Attach a bridge
  • Cover a dental implant
  • Cover a discolored or poorly shaped tooth
  • Cover a tooth that has had root canal treatment

A bridge is an ideal method to fill the space created by missing teeth. A bridge is one or more artificial teeth cemented into place using the teeth on either side for support. This is an option for filling the space created by a missing tooth. Bridge work is as much an art as it is an exact science since it replaces a missing tooth both functionally and cosmetically. The materials used may be gold alloys, porcelain bonded to metal alloy, or all ceramic material made to match your natural tooth color. The choice of material depends on requirements for strength, wear, and aesthetics.

It is important that a missing tooth be replaced as soon as possible. If not treated, the teeth surrounding the gap begin to shift inward. Since teeth use their neighbors for support, if one is missing they begin to "fall” and shift into the open spaces. This may worsen the bite because of the changes in pressure and can eventually result in problems with the jaw such as TMJ.

Bridges and crowns are made by first taking an impression of your mouth. The impression is sent to a dental lab where your crown or bridge will be custom made to fit your mouth and match your natural tooth color. A temporary crown or bridge will be placed into your mouth until your permanent crown or bridge is ready and cemented into place.

Bridges and crowns are very durable and can last a lifetime with extra care and good oral hygiene. Back to top

TOOTH EXTRACTIONS
Good oral hygiene should always be practiced since the loss of a single tooth can have major impact upon your oral health and appearance. Although dentists will use every measure to prevent tooth loss, there are still sometimes necessary occasions when a tooth may need to be extracted.

A tooth may need to be extracted for the following reasons:

  • Severe decay
  • Advanced periodontal disease
  • Infection or abscess
  • Orthodontic correction
  • Mal-positioned teeth
  • Impacted teeth
  • Fractured teeth or roots

After careful examination and treatment, the dentist may advise to have a tooth extracted. Before a tooth is removed, the dentist will take an x-ray in order to understand the shape and position of the tooth and surrounding bone. Based on the degree of difficulty, we may refer you to a specialized oral surgeon.

For a simple extraction, we will first apply a local anesthetic to prevent pain and discomfort. The tooth will be loosened with a tool called an elevator and then removed with dental forceps. Once the procedure is complete, the area may be closed with one or two stitches. We will then provide you with care instructions to alleviate discomfort and ensure proper healing. Back to top

WISDOM TOOTH EXTRACTIONS
Wisdom teeth are the last molars or “third molars” that develop on each side of the jaws. Wisdom teeth usually emerge in the back of the mouth between the ages of 16-20.

Wisdom teeth are a valuable asset to the mouth when they are healthy and properly positioned. Often, however, problems develop that require their removal. When the jaw isn't large enough to accommodate wisdom teeth, they can become impacted (unable to come in or misaligned). Wisdom teeth may also grow in sideways, emerge only part way through the gum or remain trapped beneath the gum and bone. 

A wisdom tooth extraction is a relatively routine procedure. The dentist will numb the area in your mouth with a local anesthesia and when needed, Nitrous Oxide Sedation will be administered.
After the tooth is removed, we will provide care instructions to ensure proper healing. Some pain and swelling may occur but will normally subside after a few days. You should call your dentist if you have prolonged or severe pain, swelling, bleeding or fever. Back to top

ROOT CANAL TREATMENT
Root canal treatment (also referred to as root canal therapy or endodontic therapy) is made necessary when an untreated cavity reaches all the way to this pulp.  Treatment may also be needed when deep restorations or trauma to a tooth cause nerve damage. Once the pulp becomes infected, it can begin to eat away at the surrounding bone (this is known as an abscess).  If the pulp is infected, not only is it painful but it will require treatment as it cannot heal on its own. Symptoms that indicate the pulp has become infected may include sensitivity to hot/cold or sweets, pain, swelling, pain to biting or pressure, and a bad taste in the mouth. However, sometimes no symptoms are apparent and you may be unaware of any problem until a checkup.

A root canal is performed to clean out the infected tooth pulp and disinfect the canals of the tooth. Alternate treatment would be to extract the tooth. Once the infection is resolved, the canal is filled in to prevent any further infection. Usually a core build-up and crown is recommended for restoring a tooth that has undergone root canal therapy.  Back to top

DENTAL IMPLANTS
A dental implant is an ideal tooth restoration for people who are missing one or more teeth as a result of injury, periodontal disease, or any other reason. A dental implant is a metal post that a periodontist or an oral surgeon surgically positions into the jaw. Once in place and bone surrounding the implant has had time to heal, a replacement tooth is attached to the post. While implants are typically more expensive than other methods of tooth replacement, they provide superior benefits. Implants are stronger than natural teeth and generally last 10-20 years. They are also a more favorable approach than bridgework since they do not depend on neighboring teeth for support.

To receive implants, you need to have healthy gums and adequate bone to support the implant. You must also be committed to excellent oral hygiene and regular dental visits as these are critical to the long-term success of dental implants. Back to top

DENTURES
A denture is a removable replacement for missing teeth and surrounding tissues. There are two types of dentures available, including partial and complete dentures. Partial dentures are used when some natural teeth remain, while complete dentures are used to completely replace all teeth. Dentures are made to resemble your natural teeth so there should be no noticeable change to your appearance. In fact, dentures may even improve your smile!

This restoration method is used to restore your smile and mouth function if all your teeth have been lost. The dentures are custom created to resemble natural teeth and are positioned to take the place of natural teeth. Complete dentures are removable and may require adjustments in order to create a proper fit with the gums and mouth.

A removable partial denture is a device used when one or more natural teeth still remain in the upper or lower jaw. They usually consist of replacement teeth attached go a gum-colored plastic base which is held in place in the mouth. A fixed partial denture acts the same as a removable denture, but it is cemented into place using adjacent teeth for support.

New dentures may feel awkward or loose for the first few weeks until the muscles of your cheek and tongue learn to keep them in place and you are comfortable eating and speaking. Although this may require some practice you will adjust and enjoy the benefits a full mouth of teeth can provide. Back to top

NIGHTGUARDS AND MOUTHGUARDS
Custom designed mouth-guards and night-guards are made of flexible plastic and molded to fit the shape of your teeth. Mouth-guards are recommended to protect the jaw and teeth during physical activity and sports such as boxing, football, basketball, or other activities where your mouth may be hit. Guards also protect the soft tissues of your tongue, lips and cheek lining. Night-guards are recommended for patients who clench or grind their teeth at night as a way to protect their teeth and bite.

If you have decided a guard is right for you, we will take an impression of your teeth which will then be sent to a lab to make a custom fit guard. In most cases you can choose from a variety of colors and styles. On average, guards last between 3 and 10 years. Back to top

WHITENING
Tooth whitening is a popular procedure to make teeth whiter and brighter, and therefore more attractive. Bleaching can be used to whiten stained and discolored teeth, or simply to enhance a dull smile. Either way, tooth whitening is a safe and relatively painless procedure ideal for most patients. Our office offers two types of at-home whitening.

With custom tray whitening we will first take an impression of your mouth to create customized clear whitening trays for you to wear. Within a few days your trays will be ready to be picked up and we will show you how to apply the special bleaching material to the trays. Depending on which you choose, you will wear these trays for 15 minutes, twice a day or overnight while you sleep.

The other take-home whitening option does not involve impressions. The whitening gel trays should be worn 15-20 minutes per day.

Both whitening treatments can be used while in the comfort of your own home. The days needed for optimal whitening varies according to your individual smile. You will see maximum whitening results that are nothing short of dazzling.

Occasional re-treatment can be used at your convenience to maintain your new smile. Back to top

ORTHODONTICS
Orthodontics is the art of using appliances to straighten and align teeth. Most commonly it involves the use of braces to move teeth into proper positing. In this method, brackets are bonded to the teeth and arch wires are threaded through the brackets. The arch wires act as a track, guiding each tooth to its proper position. There are several types of orthodontic braces available to patients, including traditional metal braces, ceramic "tooth colored" braces, as well as clear plastic braces. Metal Braces are the most economical and traditionally used braces. Metal braces are also ideal for those with more extensive realignment needed.

As needed, we will refer you to a local orthodontist for a consultation. During Orthodontic treatment it is important to maintain your teeth and gums by scheduling regular visits to your general dentist. Dr. Paulisin will continue to provide cleanings, exams and any needed restorations and extractions while you are under the care of an orthodontist. For your information, we have included some of the common methods.  Back to top

ORTHODONTIC RETAINERS
Orthodontic Retainers are appliances made from plastic and stainless steel to custom fit your mouth.  They act as a guide to hold your teeth into place after braces are removed. The retainer holds your teeth in place so your surrounding gums and bone can adjust around them – allowing you to maintain your realigned smile. Although the time you must wear a retainer will vary, many orthodontists recommend retainers are worn into the early 20s until the bone in your jaw and mouth has stopped growing. Back to top

VENEERS AND LUMINEERS
Veneers are a dental procedure in which a covering is placed over the outside (visible area) of the tooth. Veneers are usually only applied to the part of the tooth that is visible when talking or smiling. The procedure can be direct or indirect.

The direct technique usually involves placing composite resin on the outside of the tooth using bonding. This method is usually referred to as bonding.

The indirect technique usually involves two appointments because the veneers will be fabricated at a dental laboratory. At the first appointment the teeth are prepared, impressions taken, and the teeth are given a temporary covering. In two to three weeks the veneers are back from the laboratory, the temporaries are removed and the veneers are bonded to the teeth. The laboratory fabricated veneers are usually made using porcelain or pressed ceramic and are very aesthetic.  Back to top

APPOINTMENT REMINDER
We attempt to confirm appointments the day before your scheduled visit. If you are not home, a message will be left on your voicemail.  Back to top

ELECTRONIC CLAIM PROCESSING
Our office utilizes electronic claims processing. This means that rather than sending your dental claim through the mail, it is sent electronically to your insurance company with the click of the button. By filing your claim electronically, information is submitted more efficiently and with fewer errors. This benefits our patients because the turn around time on claims is faster and fewer claims are returned or denied. We are happy to submit your dental claims to your insurance company on your behalf. Back to top