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Dr. Joseph Mirtaj’s practice places a special emphasis on the positive impact of preventative care, especially in the area of oral hygiene. One of the most common oral health problems is tooth decay, caused by the buildup of a clear, sticky film called plaque. In certain cases, the buildup of plaque can create a situation where bacteria can erode tooth enamel, cause gum irritation and infection, and even eat away at bone structures located under the teeth.

In addition to oral health-based dental care, Dr. Joseph Mirtaj and Pennridge Dental Associates, LLC offer patients the opportunity to improve the quality of their smiles. By using cutting-edge technology in the field of cosmetic dentistry, Dr. Joseph Mirtaj is able to improve the shade, shape, spacing, and size of teeth to carefully craft a beautiful smile.


Crowns and Bridges:

Bridges

Bridges are natural-looking dental appliances that can replace a section of missing teeth. Because they are custom-made, bridges are barely noticeable and can restore the natural contour of teeth as well as the proper bite relationship between upper and lower teeth.

Bridges are sometimes referred to as fixed partial dentures, because they are semi-permanent and are bonded to existing teeth or implants. Some bridges are removable and can be cleaned by the wearer; others need to be removed by a dentist.

Porcelain, gold alloys or combinations of materials are usually used to make bridge appliances.

Appliances called implant bridges are attached to an area below the gum tissue, or the bone.

Crowns

Crowns are synthetic caps, usually made of a material like porcelain, placed on the top of a tooth.

Crowns are typically used to restore a tooth's function and appearance following a restorative procedure such as a root canal. When decay in a tooth has become so advanced that large portions of the tooth must be removed, crowns are often used to restore the tooth.

Crowns are also used to attach bridges, cover implants, prevent a cracked tooth from becoming worse, or an existing filling is in jeopardy of becoming loose or dislocated. Crowns also serve an aesthetic use, and are applied when a discolored or stained tooth needs to be restored to its natural appearance.

Procedures

A tooth must usually be reduced in size to accommodate a crown. An impression is made of the existing tooth and an impression is made. The impression is sent to a special lab, which manufactures a custom-designed crown. In some cases, a temporary crown is applied until the permanent crown is ready. Permanent crowns are cemented in place.

Crowns are sometimes confused with veneers, but they are quite different. Veneers are typically applied only to relatively small areas.

Caring For Your Crowns

With proper care, a good quality crown could last up to eight years or longer. It is very important to floss in the area of the crown to avoid excess plaque or collection of debris around the restoration.

Certain behaviors such as jaw clenching or bruxism (teeth grinding) significantly shorten the life of a crown. Moreover, eating brittle foods, ice or hard candy can compromise the adhesion of the crown, or even damage the crown.

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Dentures:

A denture is a removable replacement for missing teeth and adjacent tissues. It is made of acrylic resin, sometimes in combination with various metals.

Types of dentures


Complete dentures replace all the teeth, while a partial denture fills in the spaces created by missing teeth and prevents other teeth from changing position.

Candidates for complete dentures have lost most or all of their teeth. A partial denture is suitable for those who have some natural teeth remaining. A denture improves chewing ability and speech, and provides support for facial muscles. It will greatly enhance the facial appearance and smile.

Complete or full dentures are made when all of your natural teeth are missing. You can have a full denture on your upper or lower jaw, or both.

Complete dentures are called "conventional" or "immediate" according to when they are made and when they are inserted into the mouth. Immediate dentures are inserted immediately after the removal of the remaining teeth. To make this possible, the dentist takes measurements and makes the models of the patient's jaws during a preliminary visit.

An advantage of immediate dentures is that the wearer does not have to be without teeth during the healing period. However, bones and gums can shrink over time, especially during the period of healing in the first six months after the removal of teeth. When gums shrink, immediate dentures may require rebasing or relining to fit properly. A conventional denture can then be made once the tissues have healed. Healing may take at least 6-8 weeks.

An overdenture is a removable denture that fits over a small number of remaining natural teeth or implants. The natural teeth must be prepared to provide stability and support for the denture.

Partial dentures are often a solution when several teeth are missing.

Removable partial dentures usually consist of replacement teeth attached to pink or gum-colored plastic bases, which are connected by metal framework. Removable partial dentures attach to your natural teeth with metal clasps or devices called precision attachments. Precision attachments are generally more esthetic than metal clasps and are nearly invisible. Crowns on your natural teeth may improve the fit of a removable partial denture and they are usually required with attachments. Dentures with precision attachments generally cost more than those with metal clasps.

How are dentures made?


The denture process takes about one month and five appointments: the initial diagnosis is made; an impression and a wax bite are made to determine vertical dimensions and proper jaw position; a "try-in" is placed to assure proper color, shape and fit; and the patient's final denture is placed, following any minor adjustments.

First, an impression of your jaw is made using special materials. In addition, measurements are made to show how your jaws relate to one another and how much space is between them (bite relationship). The color or shade of your natural teeth will also be determined. The impression, bite and shade are given to the dental laboratory so a denture can be custom-made for your mouth.

The dental laboratory makes a mold or model of your jaw, places the teeth in a wax base, and carves the wax to the exact form wanted in the finished denture. Usually a "wax try-in" of the denture will be done at the dentist's office so any adjustments can be done before the denture is completed.

The denture is completed at the dental laboratory using the "lost wax" technique. A mold of the wax-up denture is made, the wax is removed and the remaining space is filled with pink plastic in dough form. The mold is then heated to harden the plastic. The denture is then polished and ready for wear.

Getting used to your denture


For the first few weeks, a new denture may feel awkward or bulky. However, your mouth will eventually become accustomed to wearing it. Inserting and removing the denture will require some practice. Your denture should easily fit into place. Never force the partial denture into position by biting down. This could bend or break the clasps.

At first, you may be asked to wear your denture all the time. Although this may be temporarily uncomfortable, it is the quickest way to identify those denture parts that may need adjustment. If the denture puts too much pressure on a particular area, that spot will become sore. Your denture can be adjusted to fit more comfortably. After making adjustments, you may need to take the denture out of your mouth before going to bed and replace it in the morning.

Start out by eating soft foods that are cut into small pieces. Chew on both sides of the mouth to keep even pressure on the denture. Avoid sticky or hard foods, including gum. You may want to avoid chewing gum while you adjust to the denture.

Care of your denture


It's best to stand over a folded towel or a sink of water when handling your denture, just in case you accidentally drop it. Brush the denture (preferably with a denture brush) daily to remove food deposits and plaque, and keep it from becoming permanently stained. Avoid using a brush with hard bristles, which can damage the denture. Look for denture cleansers with the American Dental Association (ADA) Seal of Acceptance. Pay special attention to cleaning teeth that fit under the denture's metal clasps. Plaque that becomes trapped under the clasps will increase the risk of tooth decay.

Hand soap or mild dishwashing liquid to clean dentures is also acceptable. Other types of household cleaners and many toothpastes are too abrasive and should not be used for cleaning dentures. A denture could lose its proper shape if it is not kept moist. At night, the denture should be placed in soaking solution or water. However, if the appliance has metal attachments, they could be tarnished if placed in soaking solution.

Even with full dentures, you still need to take good care of your mouth. Every morning, brush your gums, tongue and palate with a soft-bristled brush before you put in your dentures. This removes plaque and stimulates circulation in the mouth. Selecting a balanced diet for proper nutrition is also important for maintaining a healthy mouth.

Adjustments


Over time, adjusting the denture may be necessary. As you age, your mouth naturally changes, which can affect the fit of the denture. Your bone and gum ridges can recede or shrink, resulting in a loose-fitting denture. Loose dentures can cause various problems, including sores or infections. Dentures that do not fit properly can be adjusted. Avoid using a do-it-yourself kit to adjust your dentures, as this can damage the appliance beyond repair. Glues sold over-the-counter often contain harmful chemicals and should not be used on a denture.

If your denture no longer fits properly, if it breaks, cracks or chips, or if one of the teeth becomes loose, see your dentist immediately. In many cases, dentists can make necessary adjustments or repairs, often on the same day. Complicated repairs may require that the denture be sent to a special dental laboratory.

Over time, dentures will need to be relined, re-based, or re-made due to normal wear. To reline or re-base a denture, the dentist uses the existing denture teeth and refits the denture base or makes a new denture base. Dentures may need to be replaced if they become loose and the teeth show signs of significant wear.

Common concerns


Eating will take a little practice. Start with soft foods cut into small pieces. Chew slowly using both sides of your mouth at the same time to prevent the dentures from tipping. As you become accustomed to chewing, add other foods until you return to your normal diet.

Continue to chew food using both sides of the mouth at the same time. Be cautious with hot or hard foods and sharp-edged bones or shells.

Some people worry about how dentures will affect their speech. Consider how your speech is affected when you have a number of your natural teeth missing.

Pronouncing certain words may require practice. Reading out loud and repeating troublesome words will help. If your dentures "click" while you're talking, speak more slowly. You may find that your dentures occasionally slip when you laugh, cough or smile. Reposition the dentures by gently biting down and swallowing. If a speaking problem persists, consult your dentist.

Denture adhesives


Denture adhesives can provide additional retention for well-fitting dentures. Denture adhesives are not the solution for old, ill-fitting dentures. A poorly fitting denture, which causes constant irritation over a long period, may contribute to the development of sores. These dentures may need a reline or need to be replaced. If your dentures begin to feel loose, or cause pronounced discomfort, consult with your dentist immediately.

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Flap Surgery:

Some people have problems with gums that don't conform to their teeth as well as they should. Gums should be snug around the base of teeth so the teeth can be anchored firmly and grow properly.

Conditions such as prolonged or untreated gum disease can actually cause gums to separate from teeth and form opportunistic pockets for bacteria and other debris; decay can also cause further deterioration.

Left untreated, these pockets can lead to serious infections that cause bone loss, making tooth extraction very likely.

A procedure called pocket reduction, or flap surgery, was developed to correct this problem. The procedure involves scraping away hard deposits such as tartar or calculus and reshaping damaged bone, with the eventual goal of reducing the size of the pocket and allowing the tissues to firm up around the teeth.

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Extractions:

General Procedure

When restoration procedures such as root canal therapy, crowns, or fillings are not enough to save a tooth, it may need to be pulled, or extracted.

Tooth extraction procedures today are far less painful than ever before, thanks to powerful anesthetics and sedatives. In many cases, a patient who has tooth pulled experiences little or no discomfort, and only minor bleeding.

Before a tooth is extracted, the area surrounding the tooth is numbed with a topical/and or injectable anesthetic such as Novocaine.

Patients with extracted teeth sometimes need to take an antibiotic, and at the very least, take precautions following the procedure to ensure that infection doesn't occur.

Smoking, vigorous brushing and rinsing, and drinking liquids through straws are discouraged during the post-operative period because they hinder healing and may cause the wound to open. Cold compresses applied to the outside cheek near the extraction area can help reduce any swelling and promote faster healing.

Wisdom Teeth

Wisdom teeth are the third and final set of molars that erupt in the back corners of the upper and lower normal adult mouth. Unfortunately, most people experience problems from wisdom teeth; in most cases, this is because the teeth erupt too close to existing permanent teeth, causing crowding, improper bites, and other problems.

If wisdom teeth are causing a problem and are not pulled, they can sometimes become impacted. Impacted wisdom teeth can be extremely painful, as well as harmful to your oral health. Symptoms are easy to spot: severe discomfort, inflammation, and some kinds of infections.

Many people need to have their wisdom teeth extracted to avoid future serious problems. In general, the lack of the four wisdom teeth does not hamper one's ability to properly bite down, speak or eat.

If you experience any of the following symptoms, you may have an impacted wisdom tooth:

  • Facial swelling
  • Infection
  • Pain
  • Gum swelling

POST OP INSTRUCTIONS

BLEEDING. Following extractions some bleeding is to be expected. If persistent bleeding occurs, place gauze pads over bleeding area and bite down firmly for one-half hour. Repeat if necessary. Biting on a wet Lipton tea bag for a few minutes is also effective.

SWELLING. Ice bag or chopped ice wrapped in a towel should be applied to operated area—one-half hour on and one-half hour off for 4-5 hours.

PAIN. For mild to average pain use any medication you would normally take for a headache or other pain. If a prescription for medication has been given to you, fill it at the pharmacy and start taking immediately. Remember to always take antibiotics until completion. All antibiotic pills must be taken as directed until the bottle is empty.

FOOD. Light diet is advisable during the first 24 hours. Stay away from spicy foods or acidic foods.

BONY EDGES. Small sharp bone fragments may work up through the gums during healing. These are not roots; if annoying return to this office for their simple removal. If any unusual symptoms occur, call the office at once. The proper care following oral surgical procedures will hasten recovery and prevent complications.

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Bonding:

An alternative to veneers is a process called bonding, in which a tooth-colored material that looks like the enamel of your teeth is molded and shaped, and then hardened and polished. Bonding can be used to improve the color of a tooth, or close unsightly gaps.

Bonding is generally not as permanent a process as veneers, and can be vulnerable to the same kind of staining your natural teeth are prone to. Bonding can also be more prone to chips and cracks than veneers.

Caps are generally preferred to bonding when such a procedure isn't deemed to be effective in the long run.

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Cosmetic Fillings:

There are alternative, natural-looking materials to conventional silver-colored fillings – materials made from porcelain and composite resins, which are colored to match natural tooth enamel. Unfortunately, few materials can match the strength and durability of dental amalgam and such, may need more frequent replacement. Common amalgam alternatives include:

  • Composite fillings -- As stated, composite fillings are just what the name implies: a mixture of resins and fine particles designed to mimic the color of natural teeth. While not as strong as dental amalgam, composite fillings provide a pleasing aesthetic alternative. Sometimes, composite resins need to be cemented, or bonded to a tooth to allow for better adhesion.
  • Ionomers -- Like composite resins, these materials are tooth-colored. Ionomers are made from a combination of various materials, including ground glass and acrylic resins. Ionomers are typically used for fillings near the gum line or tooth root, where biting pressure is not a factor. They are more fragile than dental amalgam, however. A small amount of fluoride is released by these compounds in order to facilitate strengthened enamel in the affected area.
  • Porcelain (ceramic) -- This material is usually a combination of porcelain, glass powder and ceramic. Candidates for porcelain fillings are typically crowns, veneers and onlays and inlays. Unlike ionomers, porcelain fillings are more durable but can become fractured if exposed to prolonged biting pressures.

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Crowns:

Crowns are synthetic caps, usually made of a material like porcelain, placed on the top of a tooth.

Crowns are typically used to restore a tooth's function and appearance following a restorative procedure such as a root canal. When decay in a tooth has become so advanced that large portions of the tooth must be removed, crowns are often used to restore the tooth.

Crowns are also used to attach bridges, cover implants, prevent a cracked tooth from becoming worse, or an existing filling is in jeopardy of becoming loose or dislocated. Crowns also serve an aesthetic use, and are applied when a discolored or stained tooth needs to be restored to its natural appearance.

Procedures

A tooth must usually be reduced in size to accommodate a crown. A cast is made of the existing tooth and an impression is made. The impression is sent to a special lab, which manufactures a custom-designed crown. In some cases, a temporary crown is applied until the permanent crown is ready. Permanent crowns are cemented in place.

Crowns are sometimes confused with veneers, but they are quite different. Veneers are typically applied only to relatively small areas.

Caring For Your Crowns

With proper care, a good quality crown could last up to eight years or longer. It is very important to floss in the area of the crown to avoid excess plaque or collection of debris around the restoration.

Certain behaviors such as jaw clenching or bruxism (teeth grinding) significantly shorten the life of a crown. Moreover, eating brittle foods, ice or hard candy can compromise the adhesion of the crown, or even damage the crown.

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Fillings:

What's in a Filling?

Fillings, known clinically as amalgams, are synthetic materials that are used to restore a portion of a tooth damaged by decay or traumatic injury. There are different types of materials used to fill cavities, including gold and metal alloys.

Conventional amalgams are the silver-colored material many people have had placed in their teeth following treatment of a cavity. Many amalgams are actually a combination of various metal alloys, including copper, tin, silver and mercury. Mercury, a binding agent used in amalgams, has come under scrutiny lately by some health officials who claim it may cause long-term health problems.

Is Mercury in a Dental Filling Safe?

The American Dental Association cautions that emotional reports claiming amalgam is responsible for a variety of diseases are confusing and perhaps even alarming people to the point where they will not seek necessary dental care. Moreover, the ADA maintains that there has been no scientific evidence to show that amalgams are harmful because the miniscule amounts of mercury are so stable, they present no risks to humans. There have been rare cases of patients developing allergic reactions to amalgams.

Alternative Materials

There are alternatives to conventional substances used in amalgams, such as gold and metal alloys. These include materials made from porcelain and composite resins, which are colored to match natural tooth enamel. Unfortunately, few materials can match the strength and durability of conventional dental amalgam and may need more frequent replacement.

Common amalgam alternatives include:

  • Composite fillings - As stated, composite fillings are just what the name implies: a mixture of resins and fine particles designed to mimic the color of natural teeth. While not as strong as dental amalgam, composite fillings provide a pleasing aesthetic alternative. Sometimes composite resins need to be cemented or bonded to a tooth to allow for better adhesion.
  • Ionomers - Like composite resins, these materials are tooth-colored. Ionomers are made from a combination of various materials, including ground glass and acrylic resins. Ionomers are typically used for fillings near the gum line or tooth root, where biting pressure is not a factor. They are more fragile than dental amalgam, however. A small amount of fluoride is released by these compounds in order to facilitate strengthened enamel in the affected area.
  • Porcelain (ceramic) - These materials are usually a combination of porcelain, glass powder, and ceramic. Candidates for porcelain fillings are typically crowns, veneers, and onlays and inlays. Unlike ionomers, porcelain fillings are more durable, but can become fractured if exposed to prolonged biting pressures.

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Implants:

Before development of dental implants, dentures were the only alternative to replacing a missing tooth or teeth. Implants are synthetic structures that are placed in the area of the tooth normally occupied by the root. Implants are anchored to the jawbone or metal framework on the bone and act as a foundation for an artificial tooth or permanent bridge. In some cases, implants can be used to attach dentures.

Not everyone is a candidate for a dental implant. For a successful implant to take hold, a candidate must have proper bone density and have a strong immune system.

Implants are so well-designed, they mimic the look and feel of natural teeth. Implants are usually made of titanium.

In general, good candidates who have dental implants can expect high success rates with the procedure.

The procedure can take several visits. During the first visit, an anchor is placed into the jawbone and the site is allowed to heal for several weeks or months. This gives your tissue time to grow around the anchor to more firmly hold it in place.

During a follow-up visit, an artificial, natural-looking tooth is fitted over the implanted anchor.

Types of implants

Various types of implants include full upper and lower, anterior, posterior, and single-tooth:

Full upper replacements

The upper set of teeth is replaced with implants. Procedure steps include:

• Missing tooth roots are replaced with implants, which are covered under the gum line.
• A healing period of up to six months allows implants to take.
• The implants are uncovered and extensions attached.
• Replacement teeth are affixed to the implants and extensions.

In some cases, full upper replacements can be removed.

Anterior replacement


Implants are used to replace the front teeth (also called incisors and cuspids). Procedure steps include:

• Missing tooth roots are replaced with implants, which are covered under the gum line.
• A healing period of up to six months allows implants to take.
• The implants are uncovered and extensions attached.
• Replacement teeth are affixed to the implants and extensions.

Full lower replacement

The lower set of teeth is replaced with implants. Full lower replacement usually only uses four to six implants (near the front), which are used to anchor a denture. This obviates the need for denture adhesive.

Posterior replacement

Implants are used to replace the bicuspids and molars (the back teeth). Procedure steps include:

• Missing tooth roots are replaced with implants, which are covered under the gum line.
• A healing period of up to six months allows implants to take.
• The implants are uncovered and extensions attached.
• Replacement teeth are affixed to the implants and extensions.

Single tooth replacement

Procedure steps include:

• Missing tooth root is replaced with an implant, which remains covered under the gum line.
• A healing period of up to six months allows the implant to take.
• The implant is uncovered and an extension attached.
• Replacement tooth is affixed to the implant and extension.

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Invisalign®:

Invisalign's® invisible, removable, and comfortable aligners will give you the beautiful straight teeth you've always wanted. And best of all, no one can tell you're wearing them. Invisalign is great for adults and teenagers.

What is Invisalign®?

  • Invisalign® is the invisible way to straighten your teeth without braces.
  • Invisalign® uses a series of clear, removable aligners to straighten your teeth without metal wires or brackets
  • Invisalign® has been proven effective in clinical research and in orthodontic practices nationwide.

How Does Invisalign® Work?

  • You wear each set of aligners for about 2 weeks, removing them only to eat, drink, brush, and floss.
  • As you replace each aligner with the next in the series, your teeth will move little by little, week by week - until they have straightened to the their final position
  • You'll visit us about once every 6 weeks to ensure that your treatment is progressing as planned.
  • Total treatment time averages 9 - 15 months and the average number of aligners during treatment is between 18 - 30, but both will vary from case to case.

How Are Aligners Made? You'd Be Amazed...

  • The aligners are made through a combination of our expertise and 3-D computer imaging technology.

Visit the Invisalign® website

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Maxillofacial Surgery:

When facial reconstruction, including procedures involving the oral cavity, is called for, a specialist is needed. Surgical procedures of the neck and head area are performed by a maxillofacial surgeon.

Common maxillofacial procedures include denture-related procedures and jaw surgery.

Jaw Correction

Protruding chins, crooked or buck teeth or misaligned teeth are good candidates for maxillofacial surgery.

In some people, jaws do not grow at the same rate; one may come in larger than the other, or simply not be aligned properly with other bony structures in the skull. This can cause problems other than appearance issues; an improperly aligned jaw can cause problems with the tongue and lips, and speech and chewing problems as well. Jaw surgery can move jaws into their proper place.

Other kinds of maxillofacial surgery can correct problems with upper facial features such as the nose and cheek.

In addition to correcting jaw problems surgically, orthodontic appliances such as braces may be needed to restore bite relationship and ensure continued proper alignment of the jaw. In some cases, tiny wires or small rubber bands may be needed to keep the jaws in place and promote faster healing. In other cases, small "fixation" screws or plates may need to be inserted in the jaws to facilitate easy movement of the jaws following surgery.

Denture Fatigue

People who have worn dentures for a long time can sometimes experience loss of gum tissue and even bone, mostly from the wear and tear of the appliance on the soft tissues of their mouth.

In extreme cases, maxillofacial surgery, including bone grafts, manipulation of soft tissues or even jaw realignment, may be performed to correct such problems.

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Root Canal Therapy:

Root canals are tiny passageways that branch off from beneath the top of the tooth, coursing their way vertically downward until they reach the tip of the root.

All teeth have between one and four root canals.

Many tooth problems involve infections that spread to the pulp, which is the inner chamber of the tooth containing blood vessels, nerves and other tissues. When the infection becomes worse, it can begin affecting the roots. A traumatic injury to a tooth can also compromise the pulp, leading to similar problems.

A diseased inner tooth brings a host of problems. Pain and sensitivity are some of the first indications of a problem, while inside, a spreading infection can cause small pockets of pus to develop, leading to an abscess.

Root canal therapy is a remarkable treatment with a very high rate of success. It involves removing the diseased tissue, halting the spread of infection, and restoring the healthy portion of the tooth. In fact, root canal therapy is designed to save a problem tooth; before the procedure was developed and gained acceptance, the only alternative for treating a diseased tooth was extraction.

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Scaling and Root Planing:

Advanced gum disease sometime requires the dentist to clean below the gum line to remove stubborn, crusty deposits called tartar or calculus, and to remove damage near the tooth root. This is done to prevent further damage and restore and stabilize the tooth.

For some patients, a local anesthetic is administered to the affected area. Then, a small scaling instrument and/or ultrasonic cleaning device are used to remove the deposits.

After cleaning, the root may need to be smoothed, or planed, to restore it as much as possible to its original shape. Planing also allows your gum tissue to better attach itself and heal properly.

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Sealants:

Sealants are liquid coatings that harden on to the chewing surfaces of teeth and are showing a great deal of effectiveness in preventing cavities-even on teeth where decay has begun.

The pits and grooves of your teeth are prime areas for opportunistic decay. Even regular brushing sometimes misses these intricate structures on the chewing surfaces of your teeth.

The sealants are applied to the chewing surfaces and are designed to prevent the intrusion of bacteria and other debris into the deep crevices on the tops of teeth.

Sealants actually were developed about 50 years ago, but didn't become commonly used until the 1970s. Today, sealants are becoming widely popular and effective; young children are great candidates for preventative measures like sealants (especially on molars) because in many cases, decay has not set in. Even on teeth where decay is present, sealants have been shown to fight additional damage.

Application

Sealants are applied by first cleaning the tooth surface. The procedure is followed by "etching" the tooth with a chemical substance, which allows the sealant to better adhere. After the sealant is applied, a warm light source is directed to the site to promote faster drying. Sealants usually need re-application every five to 10 years.

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Specialty Dentures:

Dentures are designed to replace missing teeth, and are worn by millions of Americans. Technological advancements have resulted in dentures that are lightweight and mimic the look and feel of natural teeth. Most dentures are made from a combination of metals and synthetic material such as acrylic resin.

Types of dentures

Dentures are generally classified as partial or full. Partial dentures are designed to replace a small section of teeth, and help prevent existing healthy natural teeth from shifting position; full dentures generally replace an entire set of teeth such as upper and lower dentures.

Many candidates for conventional dentures (also called “immediate” dentures) are able to wear the appliances immediately following removal of affected natural teeth.

Before immediate dentures are worn, a mold of the patient’s mouth – specifically the jaws – must be made in order for the dentures to be customized for the individual.

Partial dentures, also sometimes called “overdentures,” are designed to fit over a small section of implants or natural teeth. Partial dentures are characteristic by their pinkish gum-like plastic bases, on to which replacement teeth are attached. Small clasps are used to attach the denture to existing teeth. Some clasps, which can be more expensive, are made of natural-looking material that is hard-to-detect.

In some cases, a crown will be installed on an existing healthy tooth to facilitate a better hold for the clasp.

How are dentures made?

Denture candidates can expect to have their appliances fitted after about five visits. The process takes about a month.

During the first visit after diagnosis, your mouth and jaw are measured and an impression is made. The impression is critical for ensuring proper bite relationship, as well as the proper relationship of the appliance to the size of your face.

After the impression is made, a temporary set of dentures may be applied so the patient can ensure that the fit, color and shape are suitable.

Getting used to your denture

New dentures do take some time getting used to. Wearers can expect this period of adjustment to last as long as two months.

Some denture wearers need to wear their dentures without removing them for a certain period of time. This allows your dentist to make the critical initial adjustments for proper fit, and to identify any pressure points that may be causing discomfort.

Care of your denture

Dentures today are made from very advanced materials designed to give you a natural appearance.

However, keep in mind that just like your teeth, dentures should be cared for with diligence. This means daily brushing and regular visits to your dentist for minor adjustments.

Just like natural teeth, dentures need to be cleansed of plaque, food particles and other debris. Keeping your dentures in top shape will also help keep the soft tissues of your mouth healthy; an unclean or malformed denture can cause infections and irritation.

Remember to rinse and brush your dentures after every meal, and soak them in denture solution overnight. This also allows your gums to breathe while you sleep.

Here are some simple techniques for keeping your dentures clean:

• People can brush their dentures in a variety of ways. Some people use soap and water or a slightly abrasive toothpaste. Popular denture pastes and creams also can be used.
• Avoid using highly abrasive chemicals or pastes, or vigorously brushing with hard bristled toothbrushes. These can scratch or even crack dentures.
• Hold your dentures gently to avoid loosening a tooth.
• Clean your dentures with cool or tepid water over a water-filled sink. Hot water may warp a denture. A small washcloth placed in the bottom of the bowl will ensure that your denture isn’t damaged if it falls.
• Soak your dentures overnight in any commercially available product like Efferdent or Polident and remember to rinse your dentures before placing them back in your mouth.
• Remember to use a separate toothbrush to clean your own natural teeth, as well as all of your gum tissues. In lieu of a toothbrush, a soft washcloth may be used to wipe your gums.

Over time, even daily care of your dentures may require them to be cleaned by the dentist. A powerful ultrasonic cleaner may be used to remove hard accumulations of tartar and other substances.

Adjustments

People’s mouths undergo change all of the time. Gums change shape; in many cases, gums tend to shrink over time after teeth have been extracted.

Most denture wearers experience a break-in period of as long as two months, during which the tissues surrounding their extracted teeth must heal. Conventional denture wearers must periodically visit their dentist to have the appliances adjusted. This is because patient’s gums sometimes change shape or shrink; moreover, daily maintenance of the appliances over time may also obviate the need for minor adjustments.

Adjustments are critical because a loose-fitting appliance, or one that has not been adjusted to compensate for gum or jaw changes could cause pressure points, leading to mouth sores and possible infection. Regular dental visits also provide an opportunity to replace or repair loose teeth, or make small repairs to dentures that may have become chipped or cracked.

Over the long run, the base of a denture may need to be “re-lined” because of wear and tear from constantly rubbing against your soft palate or roof of your mouth.

Common concerns

Technology advancements have made dentures very natural looking; however, it is only natural for first-time denture wearers to be self-conscious about their appearance and speech. Over time, a denture wearer’s confidence level increases, and this usually ceases to be an issue.

Like any new thing, caring for dentures takes practice.

Under normal circumstances, denture wearers can eat most foods with confidence that their appliance will not shift. Caution must be taken, however, to avoid certain kinds of hot, hard, crunchy, chewy or sticky foods. During the break-in period, denture wearers are usually advised to eat on both sides of their mouth so the appliances don’t get out of balance, or tip to one side.

Denture adhesives

In general, dentures that fit well may still need a small measure of help staying put. A good quality denture adhesive is acceptable. Older, poorly fitting dentures may damage the soft tissues of the mouth, and should be replaced as soon as possible.

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Veneers:

In just two or three dental visits, a veneer can reverse years of stains caused by foods, caffeine and tobacco use.

Special thin laminates, called veneers, can often be used to correct discolored, worn down, cracked and chipped teeth. Veneers can also be used to close unsightly gaps between teeth.

An impression of the tooth must be made and a veneer molded by a lab technician. Because veneers require a small amount of enamel to be removed, they are permanent and non-reversible.

The process involves buffing the tooth, removing an extremely thin layer of the tooth to allow for the thickness of the veneer, an impression of the tooth, and final bonding of the veneer to the tooth with special cement. A special light is used to complete the process.

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