Phone: 918-743-9275

Dental Procedures

Facts on Dental Crowns (Caps)

Facts on Dental Crowns (Caps) 
Dental crowns are tooth-shaped restorations (replacements) placed over the healthy remains of tooth that is badly damaged, cracked, fractured or decayed. The crown, which some people call a “cap,” is made to restore the tooth to a healthy and functional situation. It will look like a tooth when completed.

Crowns are utilized in several instances, but generally the tooth has been extensively damaged by decay fracture, cracking, or breakage and there is insufficient tooth structure remaining to support a filling. A crown may hold together parts of a cracked tooth and can also be used to replace a missing tooth and support a bridge . Crowns can also be used for enhancing your appearance or for cosmetic purposes to close spaces and cover misshapen or discolored teeth. Crowns are also very useful in rebuilding the chewing mechanism (your occlusion). Crowns are strong themselves and can withstand the forces generated by your jaws.

Restorative crowns are custom made to fit your exact tooth in a dental laboratory. Crowns can be all gold, all ceramic or porcelain fused to metal (PFM). PFM metals include gold alloy, other alloys (palladium) or a base-metal alloy (nickel or chromium). The all gold or PFM crowns are stronger than the all ceramic due to the fact that the have a metal framework and are good choices for back teeth. All ceramics can be used on back teeth where the chewing mechanism (occlusion) is stable. PFM and all-ceramic crowns look just like your normal teeth and many times can be made to look far better than what you have. Gold crowns are gold in color and are very effective where the chewing forces are heavy as they resist breakage.

Temporary crowns used as interim restorations until a restorative crown has been custom made. Temporary crowns can be made of acrylic or stainless steel.

All ceramic crowns will last at least 5 years while gold crowns will last 7 years or longer. In cases where the chewing mechanism is stable, the patient receives consistent cleaning and check-ups as well and has good home care, crowns can last significantly longer. Well placed crowns made of high quality materials have been know to last decades. The good news for you is that crowns can help you save your own teeth and help you enjoy the benefits of long term dental health unlike our parents and grandparents who may time lost teeth to dental diseases.

Preparing The Tooth for Reconstruction with a Crown

If your tooth needs a crown, there may be enough damage that could cause the need for endodontic or root-canal therapy on the tooth, due to extensive decay or the risk of infection or injury to the tooth’s inside tissue, the pulp. Not everyone who requires a crown will also need root canal therapy, your dentist will assess your particular needs.

To support the crown, your dentist may need to build up a foundation to strengthen remaining tooth. A foundation would be used if large areas of the natural tooth structure were decayed, damaged, undermined or missing. If you are receiving the crown after root-canal treatment, your dentist may insert a post along with the foundation. To place a crown, your dentist must remove 1 to 2 millimeters of the tooth to make room for the crown to fit properly. If you are receiving an all-gold crown, less tooth structure may need to be removed because these crowns need less space than Porcelain Fused to Metal or all-porcelain crowns.

After shaping the tooth, your dentist will use a piece of thread or cord to move the gum tissue aside around the tooth, and to make room for impression material. The impression material sets in five or six minutes and is removed. This process will allow an very precise model of the tooth. Your dentist will also need to take an impression of the opposing teeth to make sure that the crown properly fits your particular bite.

The impressions are then sent to the dental laboratory, where the crown is fabricated. During the time the crown is being fabricated in the dental laboratory, you will have a temporary crown placed on the prepared tooth. These temporary crowns are usually made of an acrylic substance and are made in your dentist’s office on the day of your visit. They are not meant to last, only to protect the tooth. Temporary crowns left in the mouth over a long period of time, the cement will eventually wash out and the tooth can develop decay and cause significant problems.

At a second visit, your dentist will remove the temporary crown and check the fit and the bite relation of the permanent crown. New crowns may need additional polishing or glazing before they are placed. Once the crown is ready, it’s cemented to your tooth and you are ready to use the tooth as normal.

After A Crown

You shouldn’t feel any significant discomfort or sensitivity after a crown is placed, although if your tooth still has the nerve in it, you may have some hot/cold sensitivity for a while. If you notice pain or sensitivity when you bite down, you should contact your dentist. This may mean that your bite is not balanced. This can be easily fixed.

You may notice a dark line next to the gumline on your newly crowned tooth, if you have a PFM crown. This dark line is the metal of the crown showing and is a normal situation. A crown does not protect the tooth from decay or gum disease. You must continue practicing good oral hygiene to prevent further tooth destruction.

If you have a crown that breaks, chips, comes loose or falls off, call your dentist’s office immediately. You can replace the crown temporarily using denture adhesive or temporary cement sold for this purpose until you can get in to see your dentist.

A Root-Canal Treatment? Facts you should Know.

A Root-Canal Treatment? Facts you should Know.

When the inside of the tooth is infected or there is irreversible damage to the pulp, a Root Canal Treatment or what dentists call endodontic therapy is indicated. The common cause of pulp infection is dental decay or a cavity . Tooth decay erodes through the enamel and dentin layers of the tooth until it reaches the middle of the tooth, the pulp chamber. When this occurs, bacteria invade the pulp and infects it. Unfortunately, infections inside teeth don’t respond to antibiotic treatment. The infection causes inflammation which restricts the blood supply to the pulp so antibiotics in the bloodstream can’t reach the infection in adequate amounts and the infection continues.

There are other ways that the pulp can become irreversibly damaged. You can receive a blow to the tooth or teeth, such as in a fall or in an automobile accident. Sometimes a tooth has had decay and been fixed, then gets more decay, is fixed again, etc. and over time the trauma from treatment as well as the periodic decay put the tooth over the edge. A very common scenario is the cracking of part of the tooth or actually having part of the tooth break off. Silver-Mercury fillings tend to expand and crack teeth. This can cause tooth fracture and breakage or cracking. Occasionally the pulp of a tooth that needs a crown will die after the tooth is prepared. Nearly every tooth that requires a crown has had previous damage and bacterial invasion to the pulp. It is no wonder that occasionally the pulp can no longer survive and suffers irreversible damage. In many cases, when the pulp is inflamed, but not infected, it will heal and return to normal. Your dentist may want to monitor the tooth to see if this happens before doing a root canal. Sometimes, though, the pulp remains inflamed, which can cause pain and may lead to infection.

When the pulp of the tooth becomes infected, the infection usually has only one way to go, out the end of the tooth. The infection can spread to the bone around the tooth, which can cause an abscess to form. The pupose of root -canal treatment is to save the tooth by removing the infected or damaged pulp, treating any infection, and filling the now empty spaces (canals) with a special dental material designed to seal the infection out of the tooth. Should the root-canal treatment not be done, the infection persists, affecting not only the tooth and bone surrounding the tooth, but can spread to other areas in the head and neck region. One’s overall health and well being can be significantly affected. If the tooth is not treated promptly, it may need to be extracted, and the surrounding infection will still need to be dealt with.

If at all possible, it is far better to retain your own natural teeth. When a tooth is lost, the adjacent teeth can move into the space where the lost tooth was and can be overstressed. Replacing lost natural teeth requires more expensive and extensive treatments, such as implants or bridges. Attention to injured or infected teeth promptly can prevent tooth loss and prevent infection.

Thanks to endodontic treatment, millions of teeth that previously were removed are now able to be saved. The teeth that have had root canal therapy do become more brittle than other teeth and crack or break more easily. Properly restoring or rebuilding the tooth to protect it from breakage allows the tooth to last indefinitely.

Signs And Symptoms of Pulpal (Root Canal) Problems

You could have a pulpal infection and not feel any pain. You may have pain that is significant. Each case is somewhat different. Some signs and symptoms that a tooth may need root canal therapy are:

  • A tooth that hurts significantly when you bite down on it, touch it or push on it
  • Sensitivity to heat
  • Sensitivity to cold that lasts longer than a couple of seconds
  • Facial swelling near the affected tooth
  • A discolored tooth, with or without accompanying pain
  • A broken toothYour dentist has several methods to test and determine whether your tooth requires root-canal treatment. Depending on your particular situation, your dentist may use hot or cold tests, may tap on the tooth, may check areas around the tooth, may use a simple device (a pulp tester*) to test the inside or pulp of the tooth, etc. They will probably take a diagnostic x-ray. In some advanced cases, an x-ray may tell immediate indicate the damage.

Caution: *Please inform your dentist if you have a pacemaker or any other electronic life-support device. The dentist will not use the pulp tester if this is the case.

Rebuilding the Tooth After Root Canal Therapy

In most cases, the tooth that has had root canal therapy will require a crown.

To make sure the tooth is strong, your dentist will first rebuild the inside of the tooth (crown build-up or foundation) to strengthen it and to provide internal support for the crown.

With today’s materials that actually bond to the remaining tooth structure we can make the tooth as strong or stronger than it was in the past. The build up or foundation will be shaped to best suit the crown that will be made.

For teeth that need further reinforcement, a post may be placed inside the pulp chamber before the build-up or foundation is placed. This is similar to the practice of placing metal (rebar) inside concrete to reinforce and strengthen the concrete for roads or buildings. The crown that is made is cemented onto the foundation and whatever tooth is remaining.

When the Body doesn’t respond and additional Treatment is Required

Although no surgical procedure is always successful, in general, the success rate of a root canal therapy is in the 92 to 95 % range. That means there’s a small chance you may need a root canal therapy more than once in the same tooth.

Root canal therapy can fail to resolve the problem for many varied reasons. Occasionally, the anatomy of the tooth is abnormal and there is an unusual canal or canals present. Failure of the patient to promptly and properly restore the tooth that has had root canal therapy, can allow the bacteria to return and reinfect the tooth.

When the initial therapy does not resolve the problem. In a small percentage of the cases, initial therapy does not resolve the problem. Either re-treatment or a minor surgical procedure would be indicated.

Although the procedure itself is the same, re-treatment tends to more complicated and takes more time because the dentist must remove all the restorative materials before they can re-treat. That’s why re-treatments generally are more expensive than the initial root canal therapy.

Surgical Treatment:
Some teeth may also need root tip (periapical) surgery, either instead of or after re-treatment. If the tooth still is infected after retreatment, periapical surgery may be indicated. The surgery requires that a small incision is made in the gum near the tooth. Any infected tissue around the tip of the root is removed so that the body can heal naturally. The tip of the tooth is removed and the remaining tip is sealed to prevent re-infection inside or around the tooth. The periapical procedure is called an apicoectomy. The success rate for this surgery is 80 to 90 percent. If the surgery is not successful in removing the infection and the infection persists, the remaining alternative is to remove the tooth. This generally happens when the patient has had a chronic, long term infection and has not had treatment in the early stages.

Comfortable Root Canal Therapy is the Norm

With the new procedures, root canal therapy has become more predictable and far more comfortable than in the past. In normal situations, root-canal procedures are not uncomfortable. The tooth will be numbed. If it is not, please tell your dentist. Occasionally the tooth is “hot” (very inflamed) and a different approach to anesthesia will be required. If this is the case, please alert your dentist so they can address the situation. In addition to the normal anesthetic, you may have sedation as well.

Inlays & Onlays

An inlay or onlay rather than a filling is used when more than 1/2 of the biting surface of molar has decayed, broken or been undermined. An inlay is placed within the bumps (cusps), whereas an onlay covers (replaces and strengthens the tooth) on or more bumps (cusps) and is more comprehensive. Onlays and inlays typically require 1-2 visits to complete. These restorations can be made of composite resin, ceramics or gold. Dependent upon the material used, the location of the placement and the forces encountered, inlays and onlay restoration can last at least seven years, and often much longer.

Facts about Dental Implants

Facts about Dental Implants

How Do Implants Work?

Dental implants allow patients who have suffered tooth loss a fixed solution to tooth replacement. Often considered a more appealing option than conventional partials/dentures (removable solutions) and/or bridges, dental implants are A dental implant is a device that provides a solution to tooth loss other than a denture or bridge. It allows the single tooth to be replaced in most cases without disturbing the adjacent teeth. Replacing a natural tooth’s root, dental implants are placed in the jawbone. This allows the bone to grow around and bond with the implant, therefore securing it in place. This process is called osseointegration. As lower end of the implant lies below the gumline, the upper end of the implant becomes an abutment and serves as an anchor for which to hold a crown and/or a fixed denture. When completed, you have your own tooth back via the implant and the replacement tooth that attaches to it. It needs to be brushed and flossed to prevent gum disease and bone loss, but will never decay like your own tooth could.

Deciding If Implants Are Right For You

For patients who are missing one or more teeth, dental implants are often an option to consider. Patients of any age can be a candidate for implant dentistry. Patients who are in good health (meaning healthy enough to undergo routine dental procedures to remove teeth and or oral surgery) should at least consider implant dentistry as an alternative to tooth loss. Candidates who have uncontrolled chronic diseases, poorly controlled diabetes, systemic problems or present as heavy smokers may not be good candidates for this procedure. The first step in the decision is to make an appointment for an evaluation. A dentist who is well trained in dental implant placement and/or surgery (or both) will examine your mouth and teeth and take a thorough medical and dental history. You’ll receive X-rays and possibly a CT scan (the CT scan shows bone density and the shape of the jaw). Have the dentist trained with implants discuss the treatment possibilities available to you and see if implant dentistry is the right choice for you.

Root-Form Implants

One of the most popular types of implant’s today is the root-form implant. Root-form implants are placed within the bone. In order for these implants to be successful, the bone needs to be deep enough and wide enough to provide a secure foundation. These implants are usually made of titanium or a titanium alloy. Implant treatment is divided into three phases: surgical, healing and prosthetic.

The Surgical Phase 
In the surgical phase, the area is numbed with a local anesthetic and then, the bone is exposed. A small opening is then made in the bone where the implant will be placed. The implant is then inserted and the procedure is closed with a few small stitches which will be removed in 1-2 weeks.

The Healing Phase 
During the healing phase, surrounding bone fuses to the implant’s surface. Typically, implants placed in the lower arch of the mouth require 3-4 months to heal. Implants placed in the upper arch of the mouth often need 6-8 months to heal. Implant patients are not without teeth during the healing process! They are able to wear their own dentures and/or partials while the healing process is taking place. For a single tooth implant patient, a small appliance is made to wear in place of the missing tooth.

The Prosthetic Phase 
After the healing phase, the healed (osseointegrated) implant is then exposed and an abutment is place on the implant in order to anchor the tooth for a crown, a bridge, or a fixed denture.

Other Types Of Implants

Subperiosteal Implants 
Subperiosteal implants are custom-made to your jaw and are most commonly used in people whose lower jaws are not strong enough to support root-form implants. These implants support specially made dentures. Subperiosteal implants are used less often now. Due to the fact that patients are now able to receive bone transplants (grafts) to increase the volume of bone, the subperiosteal implant is used less often in today’s world of implant dentistry.

Ramus-Frame Implants 
A Ramus-frame implant can be used if the lower jawbone is too thin even for a subperiosteal implant. Dentures are made that can fit onto a bar within the Ramus-implant. Ramus-frame implants also stabilize weak jaws and help prevent them from fracturing.

Blade-Form Implants 
Also known as plate-form implants, blade-form implants are a type of endosseous implant. In the past, they were used when a person’s jawbone was not wide enough for root-form implants. Dentists today will often try to reestablish lost bone through grafting in order to use root-form implants.

Bone Grafting

Implant dentistry can sometimes require bone grafting. This procedure allows the dentist to build up the bone in the area in order to increase the success rate of the implant. Bone for the graft is generally collected from other areas of the mouth or body, such as the hip (in which case your dentist will employ the services of an orthopedic surgeon). Bone is also harvested under strict supervision at bone and tissue banks around the country from cadavers. It is very safe and used in many dental and medical procedures.

Possible Complications

Implant surgery holds a 90% success rate! Most implant surgery and restoration goes off without a hitch. However, a major cause of implant failure is nicotine, whether from smoke, chewing tobacco or gum. Certain medications may also affect integration. Titanium allergies are extremely rare, but they also could cause failure. Complications such as infection, can also result in the loss of the implant. If complications do arise all is not lost. A new implant usually can be placed within a few months.


Crown Lengthening...What's That?

Crown Lengthening…What’s That?

This common procedure is used to allow more solid tooth structure to be available for rebuilding a diseased or broken down tooth. The process involves the removal of gum tissue and/or bone or both so that more tooth structure is accessible.

Why is it necessary?

Crown lengthening is utilized when a tooth needs to be rebuilt or restored, but there is not enough tooth is left to support a secure restoration.

This can happen when a filling gets too big, when the tooth fractures or breaks off near the gumline, a tooth that has lots of decay under a old filling or crown and so on. If you desire to keep the tooth and avoid more problems in the future, crown lengthening will allow the dentist to properly restore the tooth and give you a predictable result.

In situations where a person has a gummy smile – where the gums are as prevalent or more so than the teeth are the excess gums can be treated using crown lengthening.

What’s Done

The tooth or teeth are numbed using local anesthesia. Although you may have one tooth that is the problem, crown lengthening typically includes adjacent teeth so that the gum tissues can have proper contour to avoid future problems. If only gum tissue is removed, it will generally take less time than if both gum tissue and bone are removed.

After the excess gum tissue and/or bone have been removed, they are reshaped. This results in more of the tooth or teeth being exposed. Depending on the method used to remove the gum and/or bone, your dentist may use a periodontal dressing, a type of bandage, to cover the area.

You may be given prescriptions for pain medication, possibly some antibiotics or a chlorhexidine (bacteria killing) mouth rinse. Your dentist will review how keep the area clean and may ask you to follow a somewhat soft diet. You can brush the teeth in the area that was treated, but you want to avoid the gums. You can remove excess food particles around the treated area with a gentle rinse, a toothpick or what ever device your dentist may recommend.

If the crown lengthening is done with laser therapy instead of the traditional surgical intervention, the healing will tend to be quicker and the procedure will have less swelling and discomfort as a rule. Not all lasers are appropriate for this procedure. Ask you dentist if laser therapy is available in your area and if it would be appropriate for your particular situation.

After treatment, what to do

For the first 48 hours, use ice on the affected area of your face to keep swelling down.

After the procedure, you will return to you dentist in a week to10 days to have any sutures removed if traditional surgery was done, and then return again a month to six weeks to evaluated healing. Your dentist will allow the gums to heal until they are stable before completing the tooth reconstruction process. In the interim time your dentist may rebuild the tooth and use a provisional restoration to protect the tooth and allow proper healing.

Possible Side Effects

Although the risks are few, the most common side affect of crown lengthening is prolonged bleeding or infection. Additionally, some patients will have increased sensitivity to temperature as when the roots of the teeth are exposed. This will go away when the roots are covered with a provisional restoration.

Since the damaged tooth has had crown lengthening it may look longer than the adjacent teeth. It can still be very healthy and probably will not be noticed by anyone other than the dentist as being different.

When To Call your Dentist

Contact your dentist if:

  • The bleeding from your surgery doesn’t stop.
  • You have pain that your prescription medication doesn’t alleviate
  • You believe that the area may be infected
  • You protective dressing (if used) gets loose or dislodged
  • Your neck or lymph nodes under your jaw become swollen
Gum Disease and Gum (Periodontal) Treatment

Gum Disease and Gum (Periodontal) Treatment

Gum disease is prevalent in one form or another in over 80% of the adult population. It is prevalent in children as well. With the high sugar, low nutritional diets of today’s children and their parent’s gum disease as well as overall health is getting worse rather than better. Gum health is often indicative of overall health. Let’s look at some of the gum (periodontal) conditions and their treatment.

Gum Disease- “My gums only bleed the normal amount”

The earliest stage of gum disease, gingivitis or gum inflamation, usually can be stopped before it causes significant destruction of soft tissue or bone. Sometimes the gums bleed when you brush. You should wet your toothbrush and brush your teeth and check the brush to see if there is any pink coloring on the bristles. If you see pink or red, you certainly have some form of gum disease. If nothing is present, you may have gum disease and it may have advanced to the point where it no longer bleeds easily…unfortunately this may be a worse sign than is there were pink present. Make sure to ask your dentist to assess the health of your gums and bone. Most cases of gingivitis (early gum disease) can be treated with a combination of special in the dental office gum therapy, therapeutic agents, advanced tooth and gum cleansing instruments. If you are a smoker, you create the environment for gum disease to flourish. Smokers are significantly more susceptible to gum disease, bone and tooth than non-smokers.

“I have noticed that my teeth have moved, have spaces between them or seem a little loose”

As gum disease progresses, conditions caused by infections of the bone and the surrounding soft tissue and gums that support the teeth in the jaw become prevalent. The big problem for you is that these conditions rarely hurt or are uncomfortable until it’s too late. The disease can progress unabated, causing destruction of the soft tissue and bone, which leads directly to unsightly teeth, bad breath, loose teeth, chronic infections and tooth loss. To combat this condition, an aggressive defensive attack of the contributing factors and the offending pathogens is necessary. Therapeutic treatment ranging from removing the calculus (tartar) and detoxifying the root surfaces along with anti-microbial (killing the germs) therapy to sophisticated periodontal (gum and bone) surgery, possible laser therapy. If you are fortunate enough to discover your periodontal conditions early enough, there may be an opportunity to replace lost bone and gum tissue to regenerate that which has been destroyed. Your dentist will be able to assist you in developing a plan to help you save your teeth if you haven’t waited too long.

Providing you haven’t waited too long, there are treatments available to you at various stages of periodontal disease can make you, you gums and the bone supporting the teeth healthier. In past generations, people felt that losing teeth was a normal part of getting older, much like losing hair and getting g wrinkles, but that does not have to be the case with your dental health. With the miracles of today’s dental treatments nearly everyone can keep their teeth if they are willing to seek the counsel of a dentist who helps people save their teeth. With appropriate support from your dentist to keep your gums and bone healthy, you should be able to keep your own teeth for the rest of your life. (If you have indeed waited too long, all is not lost. With the advent of implants and bone grafts, even if you have lost your teeth, you may be able to get new teeth back..Ask your dentist what’s possible for you.)

The main goals of periodontal treatment are to:

  • Create a healthy environment that is easy for you and your dentist to maintain.
  • Eliminate the infections and the pathogens that cause gum disease
  • Control the inflammatory processes that destroy the gums and bone holding the teeth in the jaw

My Gums have Receded and my tooth looks longer. Do I have gum disease?

Your gums can recede, shrink and make your tooth look longer even if there is no infection present. One of the most significant causes of receding gums is a malfunctioning bite. (Think of it as how your teeth fit together when you chew. If they fit together poorly, you can easily damage the tooth, the bone and the gum. Sometimes only 1 of them is affected, other times more than 1 or all are involved. The bone can literally destroyed by the abnormal, stressful forces on the teeth and the gum can recede down the root of the tooth when this occurs. Using a hard- or medium-bristled toothbrush can cause gums to be moved away. Applying too much force even with a soft bristled tooth brush can also cause gums to recede over time. The best brush to use is either a soft bristle manual brush with normal force or a dentist recommended electric tooth brush or cleansing device. The bad news is that when the gums recede, the roots of the teeth (softer and far less protected than the top part of the tooth) are exposed to all the elements that are present in the mouth. Teeth can become sensitive to hot and/or cold temperature changes. Some foods, particularly sweets can really cause sensitivity. On top of that, when gum recession is present, the root surfaces are more prone to developing root cavities. The good news is that many times this recession can be treated and reversed. Gum tissue grafts or regeneration procedures can cover the exposed root surfaces and return you teeth to a healthier situation.

When I smile, I show lots of gums. I have Gummy Smile.

Some people have what is known as a “gummy smile.” This condition is prevalent where the teeth look normal or smaller looking and the gums are more prominent. (It reminds people of the TV horse of years past, Mr Ed.) A dramatic change can occur when the excess gums are reshaped and redesigned to create a normal healthy appearance. Some people have this as a result of the way their face has grown. Other people who are taking prescription medications for medical problems that can stimulate gum growth and you can end up with an overgrowth of gum tissue. Excess gum tissue can be removed and the tissue can be properly reshaped to treat a healthier and more appealing smile.

Scaling And Root Planing (Smoothing and detoxifying the roots)

Scaling and root planning, as it is technically known, is a conservative and many times, a very effective form of treatment for gum disease. Especially in the early stages of gum disease, like gingivitis, scaling and root planning, along with an evaluation of contributing health factors that you may be causing, may be all that is needed to get the disease under control. With more advanced gum disease, this would be the preparatory phase or initial therapy before the corrective surgical treatment.

Why Scaling and Root Planing can help you save your teeth.

Scaling is the removal of calculus (tartar) and plaque from the tooth. Gum disease is particularly a problem when the calculus (tartar) gets below the gum on the root surface where you can no longer clean it. It becomes a haven for pathogens who are up to no good. Special ultrasonic scalers can be used to initially break down the hard calculus. Then, special hand-held instruments like scalers and curettes are used to do fine scaling. Bacteria is more likely to stick to the rough surfaces (the root). The root surface is smoothed in a process called root planing. This helps removes any remaining calculus or “contaminated” cementum on the root and leaves the surface less susceptible to the bacteria. If you have gingivitis or periodontitis that is localized to one part of your mouth, scaling and root planing can be done in just that area. However, if you have a more generalized form of periodontitis spreading throughout your mouth, your dentist typically will do a quarter(a quadrant) or half of the mouth at one time. This means that two to four visits may be necessary to complete the scaling and root planing.

Will this be uncomfortable to me?

For some patients, scaling and root planing could be uncomfortable without the area being numbed. Generally the dentist will numb the portion of the mouth being worked on. For two to three days after the treatment, you may have some tenderness and increased sensitivity to hot and cold temperatures, so you will want to avoid any drastic temperature deviations. To treat tenderness, warm salt water rinses or a special rinse recommended by your dentist will be very helpful. To relieve any discomfort an over-the-counter pain reliever like Advil or Aspirin will be useful.

What to do after treatment.

Patients may be asked to rinse with warm salt water periodically, about five times during the day, for the first day, to flush out any debris loosened by the treatment. Normal brushing and flossing should be continued. There may be some minor bleeding, but this is normal and will stop in a day or two. Some patients may be prescribed an antibiotic, an antimicrobial or a fluoride rinse. Your dentist will know what will be best in your particular situation.

Possible Side Effects Of Scaling and Root Planing Treatment.

One of the symptoms of some periodontal diseases is swollen gums. Treating gum disease decreases the inflammation and also gets rid of pockets (spaces where bacteria and debris can hide) that can trap plaque. Sometimes the pocket heals and shrinks and the gums will get less prominent or recede. It may be as little as one or two millimeters, or possibly more. There is always the possibility that due to the recession some of the root may be exposed, which will make the tooth look longer, make the tooth more sensitive to hot and cold temperatures and make root cavities more likely. This can be treated with a different type of gum therapy.

Antimicrobial Therapy

Because periodontal diseases are basically due to bacterial infections, your dentist may use antibiotics to treat them. Gum abscesses (“gum boils”) are probably the most common situation for which your dentist might prescribe antibiotics. Other circumstances that might warrant their use are severe forms of periodontitis or poor responses to conventional modes of periodontal therapy. If antibiotics are indicated, your dentist will prescribe one of the medications that are known to be effective against the bacterial organisms that cause periodontal disease. They may even culture the organism to determine what particular antimicrobial will be most effective in your situation. You should not take antibiotics left over from your last throat infection or any other prescription antibiotic that has not been specifically prescribed by the dentist to treat gum disease as the infection could get worse rather than better.

How antimicrobials can help and how they work

Periodontal antibiotic treatment can be administered two ways: locally and systemically.

Local antibiotic treatments are those that are applied directly to the infected area, much as you might put an antibiotic cream on a finger cut. Common reasons for the use of local antibiotic treatments include periodontal infections involving one or a few teeth in an otherwise healthy mouth or recurrence of disease following periodontal treatment. Because saliva would wash away any typical cream or ointment, the delivery methods for local antibiotics are cleverly devised. One of the more popular locally-delivered products is a gel that is injected into a periodontal pocket and then eventually hardens. Another way is to introduce a small string impregnated with a special antibiotic. Over the next seven to 10 days, the antibiotic is slowly released, helping to eliminate the bacterial infection. Typically, locally delivered antibiotics are inserted after the teeth have been treated with scaling and root planing .

Systemic antibiotic treatments are those taken by pill. They are called systemic because they affect the whole system (body). The pill is dissolved in the stomach and the antibiotics are absorbed into the bloodstream and circulated throughout the body. The benefit is that the antibiotic can kill bacteria anywhere in the mouth (as well as throughout the body), including any bugs hiding deep in the pockets or elsewhere in the mouth. Because there are several different types of bacteria in the mouth that can cause periodontitis, the doctor often will take a sampling of the plaque in your mouth, send it to a laboratory for testing, and then prescribe an antibiotic effective against the particular bacteria in your mouth.

Side Effects Of AntimicrobialTreatment

Antibiotics can cause side effects in some people. The most common side effects are nausea, diarrhea and stomach upset. An allergic reaction, mainly a rash and itching, can occur. Make sure your dentist is aware of any medication allergies you may have. If you are concerned about any side effects, contact your dentist.

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Dr. Craig E. Buntemeyer, DDS PC
Ashton Creek Office Park
9113 S. Toledo Ave.
Tulsa, OK 74137

Phone: 918-743-9275
Fax: 918- 743-9279

Office Hours:
Monday 7:30 am - 4:30 pm
Tuesday 7:30 am - 4:30 pm
Wednesday 7:30 am - 3 pm
Thursday 7:30 am - 4:30 pm
Friday Office Administration day