Family & Cosmetic Care in a Comfortable, Relaxed Environment.

Serving Las Vegas and Henderson, Nevada since 1999.

Most people overlook the role of the general dentist in the success or failure of orthodontics. Generally, the dentist is the first line of defense in diagnosing crowding of teeth or a malocclusion. The timing of when to see an orthodontist is critical for many of our younger patients. This timing can ensure a smooth transition into orthodontic treatment as well as utilize phases of growth to help with tooth movement. A good general dentist will also be able to find a well trained orthodontist with the skills and personality to fit your child’s needs.

When To Refer To An Orthodontist?

Many children are ready for an orthodontic consult by age 7. This could be even earlier if the dentist or parent have further concerns regarding development. By age 7 enough of the permanent teeth have erupted to gauge the need for early orthodontic intervention. Luckily, most children do not need early orthodontic intervention but for those that do it makes the seemingly impossible possible again. Severe crowding of teeth can be difficult to fix without removal of teeth, so it is essential to get an early look. Many people see orthodontics as simply a cosmetic procedure but it most definitely is more than that. The benefits go beyond cosmetic as they effect our occlusion, periodontal health, and prevent trauma due to misalignment.

Top Reasons For An Orthodontic Referral

-Insufficient Space For The Eruption Of Permanent Teeth.

-Anterior Or Posterior Crossbite.

-Primary Tooth Loss Timing. Early or late loss can have its own unique implications.

-Thumb Sucking or finger sucking habits.

-Speech Difficulty.

-Extreme protrusion of teeth. This can leave them at increased risk of trauma.

-Open Bite. This occurs when the upper front teeth do not cover the lower front teeth.

-Facial imbalance or facial asymmetry.

General Dentist Role Once Orthodontic Treatment Begins

Once the general dentist refers the patient to the orthodontist the co-treatment begins. The patient will continue to see their general dentist for routine dental work including dental examinations and professional cleanings every 3-4 months. The dentist and orthodontist will confer on the case and keep the parents updated.Without proper oral hygiene maintenance, and teamwork between the dentist and orthodontist, the entire orthodontic treatment can be placed in jeopardy.

The most preventable issues with orthodontic care are periodontal disease (inflammation of the gingival tissues), decalcification of the enamel (also referred to as white spot lesions), and cavities. Maintaining good oral hygiene during orthodontic treatment requires special tools and training. Simple tooth brushing is not enough to get the job done. Some of these tools include:

-Electric toothbrush with an oscillating head. This will ensure good coverage around orthodontic brackets to remove plaque and food debris.

-Waterpik. This is a fabulous tool to clean in and around the teeth but also around the brackets and wires. It has been shown that water flossing in orthodontic patients can remove as much as 3x the plaque and bacteria vs traditional flossing.

-Floss Threaders. This can help make flossing easier, and thus be done more often.

-Mouthwash. A good antibacterial mouthrinse will help kill bacteria where the toothbrush doesn’t reach.

-Interdental Brushes. These work great to remove large particles of food from between larger spaces, they are also recommended for brushing around molars that have not yet come all the way through the gum tissue.

-Fluoride Rinses. Rinsing with fluoride should help lessen the possibility of white spots on the teeth and decay.

Orthodontic Treatment Conclusion

Communication between patient, parent, general dentist, and orthodontist should be an ongoing process. All should be intimately involved to ensure that everything is going smoothly and to head off any trouble issues as soon as possible. A team approach only works when all parties communicate their needs and issues so they can be addressed properly. Maintaining oral hygiene can be challenging during orthodontic treatment but it can be overcome with the proper tools, techniques, and more frequent professional cleanings.

 

Dental implants have evolved over time and become an ideal replacement for a lost tooth or teeth. The long term success rate of dental implants is well over 95%. What once was a product offered to very few has now become a mainstream dental care service available to most.

Options For Dental Implants

Depending on each, unique, individual person, each dental implants case will be personalized. Depending on how many teeth are missing as well as the available quantity and quality of bone present. Below are some of the situations where dental implants can replace lost teeth:

-Loss Of A Single Tooth. At one time, this meant wearing a removable appliance (commonly called a “flipper”) or removing natural tooth structure from surrounding teeth to create a fixed bridge of dental crowns. The flipper tends to be uncomfortable to wear and may affect speech. The 3 unit bridge compromises the support teeth by having them do the work of the lost tooth, and by making them more susceptible to decay. The long term success rate is lowered due to difficulties in cleaning under and around the bridge. A single tooth dental implant, when completed properly, will last a lifetime and function just like a natural tooth.

-Loss Of Multiple Teeth. When missing multiple teeth in a single area, dental implants can be used to form a fixed bridge. The beauty of this arrangement is stability and the ability not to affect the natural teeth in any way.

-Replacing All Teeth. In the past, the only way to restore function was to fabricate a removable denture. With dental implants, dentists have the ability to restore natural function and esthetics.

Complementary Procedures To Dental Implants

There are times when other dental procedures are necessary to successfully complete the placement of dental implants. These include:

-Sinus Lift. When you have a large sinus area that impinges on available bone depth, the sinus lift is a common surgical procedure. Sinus lifts are needed to elevate the sinus membrane and thicken a part of the upper jaw with a bone graft. This helps give  a dental implant enough bone depth to place it properly in the area you need it. Dental implants need a good quantity of bone along with good, dense quality of bone to succeed. The upper jaw is known to have poorer quantity and quality bone structure as opposed to the lower jaw. The maxillary sinus also plays a role in increasing difficulty in this area. Sinus augmentation can remedy these issues by raising the sinus floor and placing bone grafts in the area to aid in dental implant placement.

-Bone Grafting. When the bone is not 100% adequate for dental implant placement, dentists are able to add to it by performing a dental bone graft. A bone graft is the placement of bone or bone-like materials in the jaw to to build it up. This gives an excellent platform for dental implants. Modification of the bone in this fashion has been shown to improve both appearance and long term success of dental implants. Typically, dentists try to place implants at least as deeply into bone as the crown or tooth will be above the bone. This is called a 1:1 crown to root ratio. This ratio serves as a guide for bone grafting in most situations.

Can A Dental Implant Fail?

It is quite rare for a dental implant to fail but when it does the dental implant must be removed. Then re evaluated as to why the failure occurred and to see if a new dental implant may be placed. Some of the common reasons for dental implant failure include:

-Failed Integration of Dental Implants - This occurs when the bone does not grow and fuse between the threads of the implant. This fusion of bone to dental implant is called osseointegration. If this does not occur, the dental implants will not function properly,will become uncomfortable, become loose, or come out completely. To reduce this risk, your dental surgeon will evaluate the quality and density of the jaw bone prior to surgery. This will help to only place dental implants in areas where there is a highly predictable success rate. If osseointegration does not take place, the dental implants can be removed, and surgery can be attempted again once the area has fully healed.

-Infection –  This is the most common complication of dental implant surgery. The surrounding bone and gums can get infected during the surgical procedure. This can happen due to non-sterile technique, a contaminated implant, poor healing ability(diabetic, smoker, osteoporosis medications), or pre-existing infection. The most likely time for this to occur would be during the surgical placement of the dental implant into the bone. Implant infection can occur after placement as well. Poor hygiene, too much force placed on the implant, or excess cement can cause the support tissue to breakdown. Implant infection is a condition referred to as peri-implantitis. Peri-implantitis is characterized by inflammation or swelling of the tissues surrounding the implant area. Peri-implantitis can also present as a secondary infection later on is a form of periodontal disease that can lead to inflammation, bone loss and implant failure if not treated quickly and properly. Although implant infections are usually caused by the presence of bacteria during or immediately after the oral surgery for the placement of the dental implants, an implant infection can occur months or years after surgery.

-Post Surgical Bleeding - Some bleeding following surgery is normal and should be expected for about 1-2 days. Biting gently on a gauze pad placed over the surgery area for 30 minutes should normally stop the bleeding. Excessive bleeding is not normal and you should notify your dentist immediately if you have concerns about your dental implants.

-Damage To Surrounding Tissues - Dental implant complications related with surgical errors affecting adjacent teeth, nerves or sinus are directly correlated with the experience and skills of the dentist or surgeon. An experienced and skilled implant dentist is able to identify potential problems by examining x-rays or CT scan (computer tomography), design the proper surgical plan for ideal location and angle, and execute it successfully without complications. Even with the most skilled implant dentist there is always a possibility of dental implant complications. The complications can be limited by choosing an implant dentist with the skills and experience necessary to handle any complications if they arise.

-Rejection – An extremely rare complication for dental implants but it has been noted in the research literature. The dental implants can sometimes be viewed as a foreign body.

-Unusable Dental Implants – An implant that has successfully integrated with bone, but the area or extreme angle of placement deem it unrestorable.

Dental Implants Conclusion

Dental implants have been the solution for many. They come with risks but with proper treatment planning from a well qualified dentist they can be a successful tooth replacement for a lifetime of smiles.

 

 

Many of us never think of the possibility of a dental emergency until it is upon us. One of the most critical aspects of choosing a dentist should be their emergency dental care policy. Will the dentist be available after hours to answer questions or to open the office? Will my family be prepared in case of a dental emergency? Do we know what number to call?

Fortunately, many dentists choose to give their patients 24/7 access via cell phone to at least give advice or prescribe medicine after hours. While others will even open the office after hours when needed. There are also, many who choose to use an answering service or not be available at all for an after hours dental emergency.

Common Dental Emergencies

-Chipped or broken teeth. This dental emergency may or may not be a painful event or it may be only cosmetic depending on the severity of the chip or break. Teeth can fracture or crack in all manner of ways and can create a true dental emergency. Your emergency dentist will be available to relieve pain and also restore your tooth to its natural form and function.

-Knocked-Out Tooth (also called a tooth avulsion). This occurs from direct trauma. Timing is everything!  The key here is to re-implant the tooth as soon as possible to give it the best chance for success over the long term. If it hasn’t fallen out completely, try pushing it immediately back in, your dentist can do any necessary tweaking. Retrieve the tooth, hold it by the crown or head (the part that is usually exposed in the mouth), do not touch the root. Rinse off the tooth root with water if it’s dirty. Do not scrub it or remove any attached tissue fragments. If possible, try to put the tooth back in place. Make sure it’s facing the right way. Never force it into the socket. If it’s not possible to reinsert the tooth in the socket, put the tooth in a small container of milk (or cup of water that contains a pinch of table salt, if milk is not available) or a product containing cell growth medium, such as Save-a-Tooth. Leave the rest to your emergency dentist.

-Toothaches/Infection. This can happen when tooth decay invades the nerve of the tooth, trauma causes the tooth to die, or periodontal disease is left untreated. The bacteria in the mouth invade the tooth and surrounding bone. This causes the body to respond, which leads to the swelling, pain, and infection. If left untreated this can be a life threatening situation. Call your dentist immediately for this dental emergency.

-Objects caught between teeth. This dental emergency may seem minor but it can be quite uncomfortable and scary. A dentist has the proper tools to remove any and all foreign objects in between teeth.

-Lost Dental Filling. This dental emergency usually occurs when there is tooth decay present in or around the restoration. The bond between dental material and the tooth will break down causing the restoration to break loose. Depending on how large the restoration is this can cause quite a bit of pain and discomfort.

-Broken Braces And Wires. This may seem like a minor dental emergency but a broken bracket or wire can be very uncomfortable and can even cause trauma to the oral tissues. Contact your dentist for advice in your particular situation.

Dental Emergency Conclusion

An emergency dentist that is available 24/7 is an important asset to have for you and your family. You never know when a dental emergency will arise and don’t you want the peace of mind to know your family is protected? Not all dentists make themselves available after hours for a dental emergency so it is important to ask your dentist if they will come to your rescue in the event of a dental emergency.

Choosing the right dentist or doctor is always a difficult thing to do. Some of us rely on friends and family for a referral, while many turn to internet reviews. There are over 150,000 dentists nationally, with new graduates added every year. Many of these dentists are not trained beyond general dental school knowledge to perform more complex dental procedures.

A recent survey revealed that this year about 10% of Americans (and the number grows every year) received at least one cosmetic dental procedure to transform their smiles. Receiving cosmetic dentistry from an experienced, skilled cosmetic dentist can transform your appearance, but poorly executed dentistry can prove to be a disaster.

A sobering statistic, well over 25%, (that is 1 out 4 procedures done) of all the money spent by Americans on cosmetic dentistry is spent re-doing and correcting poor dental work from previous visits.

Things That Can Go Wrong During Cosmetic Dentistry

-Restoration Failure - When any dentistry is done, there can never be decay from cavities left behind. Fillings must be properly shaped and hardened so that they do not cause new problems to arise. Improper technique will not only mean your new fillings,  porcelain veneers or dental crowns will eventually fail, it could also mean the possible need for root canal therapy or even potentially the loss of the tooth if left untreated.

-Pain and Discomfort - A skilled, experienced, dentist knows that  dentistry is about more than just appearances. If you do not plan to address bite issues, periodontal issues, and sensitivity problems, restorations will fail and cause pain and discomfort for the patient. If the bite is off, even slightly, the dental work and tooth will be prone to cracking, wearing, and pain. Root canals can be incomplete and cause reinfection, extractions of teeth can be improperly performed causing severe bone infection, fractures, and pain.

-Lost Time - Cosmetic dentistry is usually lengthy, necessitating multiple visits to the dentist. A typical cosmetic treatment takes at least 2-3 appointments, and can take 1 hour to more than 5-10 hours in the dentist’s chair. The work is an investment of your time and money. If this work is performed poorly and needs to be redone, patients will need to take off more time from work to have it repaired or redone elsewhere.

-Increased Cost - In addition to losing time, the original cost budgeted could explode to fix poor dental work. There is an old saying “You Get What You Pay For”. The same is true in cosmetic and traditional dentistry. It is smart to be cost conscious but many dentists who call themselves cosmetic dentists will offer inferior materials in order to cut costs and lower the price to the consumer. Using a poor dental lab or lower quality materials will cut into the longevity as well as the final appearance of any dental work. When dentistry goes bad, it usually needs to be redone from the beginning. This means losing what you initially invested and paying again for the re-do work.  It is not unusual to have a patient spend money initially only to have to spend a much higher amount to re-do all the work just a short time later.

Conclusion

Choosing a dentist is never an easy decision so do your best to get information from friends, family, and internet. Request a free consultation to tour the office and meet not only the doctor but the staff. Dentistry tends to be an intimate experience and you need to feel confident and comfortable in the dental chair. Choosing the right dentist will make all your dental work a breeze. Most importantly, good dentistry will keep you healthy and end up saving you money in the long run.