Dental Q & A - Colorado Springs Dental Society

By taking the time to learn more about dental health care you are on your way to a healthier, comfortable and pleasing smile. Good habits take time and bad habits are hard to break. Start today to improve your at-home dental care habits and see what is available in professional care from your Pikes Peak Region general dentist or specialist.

There are eight specialties in Dentistry. They are Endodontics (Root Canals), Oral Pathology (Biopsy), Oral Surgery (Extractions), Orthodontics (Braces), Pediatric Dentistry (Children), Periodontics (Gum Disease), Prosthodontics (Dentures/Crowns), and Public Health. Click on Specialties in Dentistry and we'll show you a table that explains each speciality.

If a tooth is completely knocked out of your mouth time is critical. If this occurs, pick the tooth up by the crown or chewing area. Avoid touching the root. If the tooth is dirty gently rinse in water. Do not use any cleaning agents. If possible, place the tooth back in the socket. Go to the dentistimmediately.

If you cannot put the tooth back in the socket make sure to keep it moist. The less time the tooth spends drying out, the better the chances for saving it. Solutions to keep the tooth moist are available in local drug stores. You can also put the tooth in milk or in a glass of water with only a pinch of salt. Bring your tooth to the dentist immediately.

During an injury a tooth can be simply loosened or it can be pushed into its socket, or partially out of its socket, or laterally toward the inside or the outside of the mouth. Some of these injuries can be fairly serious dental injuries. See a dentist immediately.

To understand a root canal it's helpful to know something about the anatomy of the tooth. Enamel is the hard outer white layer. The layer directly under the enamel is called dentin. The pulp is the next layer and it is normally soft tissue inside the tooth that extends from the crown or chewing portion of the tooth to the tip of the root.

Root canal treatment is the removal of inflamed or infected pulp. This condition might happen because of deep decay, repeated dental procedures on a tooth, or a blow to the tooth. The root canal process involves careful cleaning and scraping of the inside of the tooth with subsequent filling and sealing of the root canal space.

With the use of modern anesthetics and anesthetic techniques, many dental patients, who have had root canal treatment, reported that the procedure was pain free.

Ideally, your child's first dental visit should be by the first birthday. If you take your child to the dentist at an early age, your dentist can help you prevent many problems. Your dentist will check for decay and other problems, teach you how to clean your child's teeth daily and identify your child's fluoride needs. You will also be building a lifetime of good dental habits.

Yes. Begin cleaning your baby's mouth during the first few days after birth. After every feeding, wipe the baby's gums with a damp washcloth to remove plaque. This establishes at an early age the importance of oral hygiene and the feel of having clean teeth and gums.

Yes. As soon as teeth appear in the mouth, decay can occur. One serious form of decay among young children is "baby bottle tooth decay". This condition can occur when the infant is allowed to nurse continuously from a bottle of milk, formula, sugar water, or fruit juice during naps or at night. If these liquids pool around the teeth during sleep, the teeth will be attacked by acids for long periods of time, and serious decay can result. If you must give your baby a bottle as a comforter at bedtime, make sure it contains only water. And never dip a pacifier into sugar or honey.

Yes. When babies are teething, usually between the ages of four months and 2 1/2 years, they often have sore and tender gums. The pain can usually be soothed by gently rubbing the baby's gums with a clean finger, a cool, small spoon or a wet washcloth. A clean teething ring for the baby to chew is also helpful.

Children should have stopped thumbsucking by the time the permanent teeth are ready to erupt. Usually, children stop between the ages of two and four years old. Sucking often lessens as the child spends more of their waking hours exploring their surroundings. Peer pressure causes many school-age children to stop.

Periodontal disease, commonly called gum disease, is the cause of about 70 percent of adult tooth loss; affecting three out of four persons at some point in life.

The main cause of gum disease is bacterial plaque, a soft, sticky, colorless film that constantly forms on our teeth. If plaque is not removed, it hardens into a rough, porous deposit called calculus, or tartar. Toxins (or poisons) produced by the bacteria living in plaque irritate the gums and can make them red, tender, swollen and more likely to bleed easily. As gum disease progresses, the toxins can lead to destruction of the bone and soft tissues that support the teeth, forming pockets that fill with more bacteria, toxins, and tartar. Unless gum disease is diagnosed and treated, the bone loss will continue to progress, until the teeth become loose and eventually are lost.

Thorough removal of soft plaque by brushing & flossing, and professional "cleanings" to remove soft plaque and hard tartar deposits below the gumline, can minimize the risks and usually stop the progression of gum disease. However, other factors can affect the health of your gums, such as hereditary factors, stress, diabetes, pregnancy and genetics.

What are the signs of gum disease?
There are many signs of gum disease. You should contact your dentist if you notice any of the following symptoms:

NOTE: You may have gum disease and not have any warning signs. In most cases, gum disease is not painful until it reaches advanced stages. Gum disease often goes unnoticed - it is sometimes referred to as a "silent disease". It is important for you to have regular dental checkups, including a periodontal examination, to diagnose and treat periodontal problems before they become advanced.

What is the relationship between my general dentist and my periodontist?
Your dentist and periodontist (gum specialist) work together as a team to provide you with the best possible care. They will combine their experience to formulate the best treatment plan for you, while keeping each other informed about your progress.

After active periodontal treatment is completed, the periodontist will refer you back to your general dentist, but may also see you periodically for follow-up care and ongoing supportive periodontal care.

Does gum treatment hurt?
Improved equipment, local anesthetics and modern techniques make periodontal treatment more comfortable now than ever before. Effective medications (although usually not necessary) are available to optimize your comfort after treatment. As with other aspects of periodontal treatment, considerations for your comfort during and after treatment will be tailored to best suit your needs.

What can I do to help control gum disease?
Gum disease can and will recur if you do not follow a strict program of supportive therapy. You play the major role in preventing further outbreaks of disease. Nothing will help you maintain the results of professional treatment better than daily removal of soft plaque by proper brushing, flossing, and other plaque control methods recommended for you.

There are many benefits to safeguarding your periodontal health. By retaining your natural teeth, you can chew more comfortably and enjoy better digestion. You also keep a healthy smile, which is a natural asset to your appearance. For feeling good and looking good, nothing works better than your natural teeth. When your efforts are combined with regular visits to your dentist and periodontist, you have an excellent chance of keeping your teeth for a lifetime.

How is gum disease treated?
In the early stages of gum disease, treatment usually involves scaling and root planing. During scaling and root planing, soft plaque and hard calculus deposits are meticulously cleaned from above and below the gumline. At the same time, the root surfaces of your teeth are planed to remove diseased cell layers. The removal of bacteria and physical and chemical irritants helps to reduce inflammation. Usually this treatment allows the gum to adapt itself back to the tooth, as well as reduce the depth of the gum pockets. In most cases of early gum disease, "scaling", "root planing" and proper daily cleaning are all that are required for satisfactory results.

We now have means of placing antibiotic medications directly into the affected sites in your mouth. This can be very beneficial in treating localized spots of gum disease.

More advanced cases may require surgical intervention. Sometimes surgery is needed to gain better access to deep areas for removal of calculus from the deep pockets around the teeth, shrink the pockets, smooth the root surfaces and arrange gum tissue into a shape that will be easier to keep clean.

In advanced cases involving loose teeth, the dentist may need to treat the way your teeth fit together when you bite. For example, the teeth may be braced with temporary splints to reduce movements and increase comfort and function. Other possible treatments include a bite "adjustment", orthodontic treatment or the placement of a plastic bite plate (splint) appliance.

Other methods may be necessary in the treatment of gum disease, depending upon the condition of your mouth. Some may be quite complicated, especially in cases of severe oral neglect. The periodontist is trained to deal with many varieties of gum disease. Whatever your treatment plan entails, the periodontist's goal is to re-establish good oral health, and then help you maintain it. Although usually lost bone and support cannot be regained, modern periodontal therapy enables regeneration to be accomplished in some cases.

Orthodontics is a special discipline of dentistry concerned with aligning the teeth and jaws to improve one’s smile and overall oral health. “Ortho” means correct or straight, and “odont” means tooth. A dentist will recommend braces to improve the patient’s physical appearance and function of the teeth and jaws.

Are there age limits for orthodontic treatment?
As long as the teeth and gums are healthy, patients with orthodontic problems can benefit from treatment at nearly any age. An ideal time for placement of braces is between 7 and 14 years of age while the head and mouth are growing and teeth are more accessible to straightening. But braces aren’t just for kids anymore. More adults are also wearing braces to correct problems and to improve their smiles.

Why are so many children being treated with braces at such young ages?
Our social and professional standards have changed in the last 30 years and early intervention is now often indicated for some children as young as age 7. Problems such as severe crowding, speech problems, bad habits, deep bites, open bites, cross bites and some facial asymmetries can be address by early treatment. In addition to influencing jaw growth in a positive manner, braces may lower the risk of trauma to protruded teeth and will improve appearance and self-esteem.

Who provides orthodontic treatment?
Your family general dentist is responsible for coordinating your dental treatment and this may encompass any orthodontic treatment plan including diagnosis, examinations and some orthodontic procedures. However, for more extensive orthodontic treatment your general dentist may refer you to an “orthodontist” - a specialist with extra training in the development, prevention and correction of irregularities of the teeth, bite and jaws.

What is the purpose of orthodontic treatment or braces?
Dental problems can be corrected, such as: crooked teeth, crowded teeth, overbites, underbites, incorrect jaw size, incorrect jaw position, and disorders of the jaw joints due to a bad bite.

What should I do if I or my children need braces?
First see your family general dentist and talk to him or her about your concerns. Your dentist will evaluate the positioning of the teeth and jaws. This may require additional records be taken, such as x-rays and models of the teeth in order to evaluate the problem properly. Your dentist will then discuss their recommendations for treatment.

As part of your treatment, your dentist may refer you to an orthodontist for evaluation and treatment. Make an appointment for a consultation with the orthodontist. At the consultation appointment you will have an opportunity to ask questions about: what the treatment will involve; the length of time for treatment; financial arrangements; insurance coverage; office hours, etc. Consider wisely, because this is a long term commitment. Most orthodontic treatment take 18 to 36 months, followed by the wearing of a retainer.

While I am having orthodontic treatment with a specialist, do I still need to see my general dentist?
Yes! Have your teeth cleaned every six months to keep your gums and teeth healthy. Insufficient cleaning while wearing braces can cause enamel staining and cavities around the brackets, as well as periodontal disease.

With braces, oral hygiene is more important than ever. Braces have tiny spaces where food particles and plaque get trapped. Brushing carefully after every meal with fluoride toothpaste and a soft-bristled toothbrush is important. Flossing is more difficult because you must use a floss threader to thread the floss under the arch wire and around the brackets.

Are braces really worth all the trouble and expense?
Yes they are. There are many health reasons to consider in favor of orthodontic treatment, such as: Straight teeth are easier to brush and floss, allowing for a life time of better oral hygiene. Straight teeth are better supported by the surrounding gums and bones. Corrected bite and jaw relations allow muscles and the jaw joints to work more smoothly, reducing the risk of future dysfunction. The ability to chew food more thoroughly and comfortably aids in digestion. And nothing looks or feels quite like clean, white, straight teeth!

For more information about orthodontic treatment, visit the American Association of Orthodontics web site.

Cavity Risk Factors
Dental research has identified many factors which may estimate your risk in getting cavities in the future. We can control getting cavities behaviorally. Meaning, through our daily habits we can prevent most cavities from starting.

The good daily habits we should develop are: good oral hygiene habits of regular brushing and flossing, low sugar intake, limited snacking, and regular professional dental cleanings. However, the more cavities and fillings we have already had, the greater the risk of getting cavities again in the future. Check the list below of risk factors. The more factors which apply to you, the greater your chance of getting cavities again in the future.

Prior experience with cavities.
Enamel decay (white spots) detected during dental exam.
New fillings placed during the last 12 months.
Five or more missing or filled teeth.
Exposed molar root surfaces.
Large or rough fillings.
High snacking and/or sugar diet.
Problems with dry mouth
Poor oral hygiene.
Inadequate fluoride exposure.

If you have found that you have four or more of these risk factors, make it a point to have more frequent dental exams, professional cleanings (possibly every 3 to 4 months), and brush-up on your homecare techniques. Read on, because everyone c an benefit from a refresher on basic oral hygieneto help prevent cavities. For some reason, it is a popular notion that only children get cavities and as we get older we are not vulnerable to cavities anymore. This is not true! Matter of fact, current demographic research shows that the frequency of getting cavities goes up after the age of 65. So, spend a few minutes in “Dental Ed. 101", because nothing looks or feels quite like clean, white teeth and a bright wholesome smile.

Dental Ed. 101

HOW TO BRUSH
Brush twice a day for four to five minutes each time. The best times to brush are after breakfast and before bed. Use a timer, a clock, or egg timer! Brush only two teeth at a time, working your way from one side to the other, inside then outside, and lastly the biting surfaces. Be sure to brush all the way to the gum line, holding your toothbrush at a 45-degree angle. You should be able to feel the toothbrush on the edge of your gums when you brush. (Start brushing baby teeth after feeding, as soon as they appear in the mouth.)

HOW TO FLOSS
Flossing is the way to remove plaque between the teeth, where teeth touch. Wrap a long piece (about 18 inches) of floss around your fingers so your fingers are two inches apart. Then use your thumbs or third fingers to shorten it even more so you can scrape the floss up and down between the teeth. (Parents need to help children floss teeth which have tight contacts.)

WHY IS FLUORIDE IMPORTANT?
Fluoride is a mineral found in most of our tap water in the Pikes Peak Region and is added to many dental care products. Research has found that fluoride hardens tooth enamel and makes it more resistant to acid. However, there can be “too much of a good thing” when it comes to fluoride and children. Dental fluorosis, or brown and white spotting on the tooth enamel, occurs in children under the age of six who ingest too much fluoride. Dental fluorosis is a non-harmful cosmetic change which occurs while the teeth are forming under the gums. It is noticed when the permanent teeth grow in. Teeth that are already present in the mouth can not later develop staining from fluoride. Children under the age of six should not use fluoride mouth rinses and should only use a pea-sized amount of toothpaste on their toothbrush. Families who live in high fluoride areas of our community (e.g. Manitou Springs, central and southwest Colorado Springs) may want to use low-fluoride bottled water for drinking and cooking for their children until they are over the age of 12.

WHAT SNACKS ARE GOOD FOR TEETH?
Cut down on sweets and between-meal snacks. Remember, it’s these sugary and starchy treats that put your teeth at extra risk. Snacks that are good for your teeth are: Popcorn, cheese, yogurt, fresh fruit, vegetables, peanut butter, rice cakes, and whole grain crackers. Soda pop is not good because of the high amount of sugar and the increased acidity from carbonation and flavorings. Healthier drinks are: milk, water, iced herbal/fruit teas and seltzer waters.

SO WHAT IS A CAVITY, ANYWAY?
A cavity is a hole in your tooth caused by bacterial plaque. Plaque, which sticks to the teeth, produces acid as a by-product from sugar metabolism. The acids then dissolve the tooth enamel. Once the acids have dissolved a hole through the enamel; the underlying, softer dentin is exposed and the cavity will enlarge much quicker. Once a cavity reaches the dentin the spot needs to be cleaned out and filled by a dentist to keep the cavity from getting larger and causing more tooth destruction.

SEE YOUR DENTIST EVERY SIX MONTHS
You should make regularly scheduled appointments every six months with your dentist for checkups and professional cleanings. Because cavities can be difficult to detect, a thorough dental examination is very important. If you get a painful toothache, if your teeth are very sensitive to hot or cold foods, or if you notice signs of decay like white spots, tooth discolorations or cavities, make an appointment right away. The longer you wait to treat decayed teeth the more extensive and expensive the treatment will be. Left neglected, cavities can lead to root canal infection, permanent deteriorration of decayed tooth structure and even loss of the tooth itself.

Crowns and bridges are used to restore broken down, missing, or root canal treated teeth. A crown is a metal, porcelain, or porcelain covered metal tooth that covers an existing tooth. It is often necessary to place a crown on a tooth that is broken down so much that it can not be restored with a filling. Crowns are also often necessary to place over a tooth that has been treated with a root canal do to the lack of blood supply and brittleness of that tooth. Bridges are exactly the same as crowns, but cover or replace 2 or more teeth and are fixed (non-removable).

What is a crown and why do I need one?
A crown is a restoration that covers, or caps a tooth to restore it to its normal shape and size. Its purpose is to strengthen or improve the appearance of a tooth. A crown is placed for a number of reasons.

Why do I need a bridge?
Your appearance, dental health and the proper functioning of your mouth are all important reasons for wearing a bridge. A bridge helps support your lips and cheeks. The loss of a back tooth may cause your mouth to sink and your face to look older.

More importantly, though, your dental health may suffer when teeth are not replaced. Teeth were designed to complement each other. When a tooth is lost, the nearby teeth may tilt toward the empty space, or the teeth in the opposite jaw may move up or down toward the space. This places unusual stress on both the teeth and tissues in your mouth.

In addition, the gum tissues and the bone that hold teeth in place can break down, increasing the risk of gum disease. Teeth that have tipped are difficult to clean, making them more likely to decay. As a result, even more teeth may be lost.

Missing teeth can also affect the way you chew and speak. Chewing on only one side may cause stress to your mouth. You also need your teeth to speak properly, since they help you make the many sounds needed in speech.

If you need extensive fixed bridge work, your dentist may refer you to a prosthodontist. A prosthodontist is a specialist trained in restoring natural teeth and in replacing missing teeth.

How is a bridge attached?
A fixed bridge is commonly cemented to the natural teeth next to the space left by the missing tooth. A false tooth (called a pontic) replaces the lost tooth. The pontic is attached to the crowns (restorations that cover a tooth). Crowns, which are cemented onto the natural teeth, provide support for the bridge.

Are there different types of bridges?
Yes, Implants attach artificial teeth directly into the jaw or under the gum tissue. Because they require surgery, candidates for implants should have good general health and have adequate bone to place an implant.

In some instances, a resin-bonded bridge, frequently called a "Maryland Bridge", can be used to replace one or more missing teeth. Because the bridge is attached by a special procedure called bonding, it doesn't require the use of crowns or extensive tooth preparation. Your dentist can determine whether this treatment method is appropriate for you.

What materials are used?
Appearance and function are considered when selecting materials for bridges. Bridges are made from gold alloys, non-precious alloys, porcelain, or a combination of these materials. Porcelain is often bonded to either precious or non-precious metal. Your dentist will discuss which materials are best for you.

How do I take care of my bridge?
It is very important to keep your remaining teeth healthy. Brush twice a day, and clean between the teeth with floss or interdental cleaners (specially shaped brushes as well as rubber, plastic or wooden items). These measures help remove a sticky film of bacteria called plaque. Plaque causes gum disease and dental decay.

A bridge can lose its support if the teeth or the bone that holds it becomes damaged by dental disease. Be especially careful to clean the area under, around and between the bridge and your natural teeth. Dental floss threaders and special brushes can help you reach these areas. It is important to visit your dentist regularly.

Remember, the ultimate success or failure of a fixed bridge depends on its foundation. Help keep your gums and remaining teeth healthy. Your dental health and your appearance are worth the effort!

Which material is best?
Both the "look" and function of your crowns are considered when choosing the materials most suitable for you. Your dentist will consider the tooth location, the position of the gum tissue, the amount of tooth that shows when you smile, the color or shade of the tooth and the function of the tooth.

Crowns are made from a number of materials. Gold alloys or non-precious alloys, porcelain or ceramic, acrylic or composite resin or combinations of these materials may be used. Porcelain attached to a durable metal shell is commonly used because of its strength. Crowns made entirely of porcelain may look better, however, they usually aren't as strong. In the process of making the crown, the porcelain is colored to blend in with your natural teeth.

Several steps are involved in placing a crown. Usually at least two visits are necessary. The dentist will prepare the tooth to accommodate the thickness of the crown. If the tooth has a filling, part of the material may be left in place to serve as a foundation for the crown. An impression is made to provide an exact model of the prepared tooth. Your dentist or a dental laboratory technician, following the written instruction of the dentist, will then make the crown from the model.

"Temporary" crowns (often made of acrylic resins) are placed while the permanent crown is made. If the shape or length of your teeth are changed for cosmetic purposes, for example, temporary crowns will allow you to become accustomed to this change. They can also help you decide if you like what you see or if there are any changes that you would like made before the permanent crowns are placed.

When the permanent crown is ready, the dentist puts it in place and makes necessary adjustments. To see how your crown will look, you can use a large mirror held at arms length in various types of lighting. When you and your dentist are satisfied with your appearance, the crown will be cemented in place.

If you need extensive crowns, your dentist may refer you to a prosthodontist. A prosthodontist is a dental specialist trained in restoring natural teeth and in replacing missing teeth.

How do I take care of my crowns?
Brushing twice a day and cleaning between your teeth daily with floss or interdental cleaners (specially shaped brushes and sticks or picks) is especially important when you have crowns. These measures remove a sticky film of bacteria called plaque. It is especially important to remove plaque from the area where the gum meets the tooth (the sulcus). When plaque accumulates in the sulcus, it can cause dental decay or gum disease. To prevent damaging or fracturing the crowns, avoid chewing hard foods, ice or other hard objects. It is also important to visit your dentist regularly.

What will the finished crown look like?
One of the dentist's main goals is to create crowns that look like natural teeth. To achieve this, a number of factors are considered such as the color, occlusion or "bite," shape and length of both your natural teeth and of the artificial crown. Any one of these factors alone can significantly affect your appearance.

If you have a certain look in mind for your crown, discuss it with your dentist at your initial visit. When the procedure is complete, your teeth may not only be stronger, but they may be the attractive feature of your face -- your crowning glory.

The term 'partial denture' usually refers to a removable prosthesis (RPD) that replaces several teeth in an arch, upper or lower, but not all of the teeth. This can be an acrylic prosthesis with denture teeth, or it can have a metal framework that has clasps or attachments connecting it to some teeth.

The term 'complete denture' refers to a prosthesis that replaces all teeth in an arch, upper or lower. These are usually all acrylic with denture teeth, but can be made with metal substructures for additional strength if needed.

It is becoming more common now to use dental implants to partially or fully retain dentures and partial dentures with a variety of attachments and support mechanisms. Sometimes partials and dentures are used as transitional devices while other therapies are being done, such as bone grafts or implant surgeries.

'Dental Implant' is a very generic term, but it basically today refers to a root-sized and shaped titanium metal screw or cylinder that replaces a tooth root. The size and shape vary some, and there are many 'Brands' fabricated, but they are all used to help replace missing teeth. The teeth can be replaced individually with an implant and a crown, or in groups such as fixed bridges. Implants can also be used as retention elements for partials and complete dentures, or as craniofacial retentive elements to hold on a prosthetic eye, ear or nose. The long-term success of today's implants has made them a predictable and valuable treatment option for many patients and dentists.

Most forms of oral cancer have a multifactorial cause (many contributing factors). Some of these are genetic, environmental, behavioral, systemic or unknown. Specific causes for oral cancer are usually found in combination; the most common is smoking and drinking. Tobacco in any form will raise your cancer risk about four times, and combined with alcohol about ten times the risk. The average incidence of oral cancer in America is about 4-5%, but many people die of other related diseases before the oral cancer is a primary problem. The biggest problem with oral cancer is that it is very debilitating to ones quality of life. We use our mouth 24 hours a day to eat, talk, swallow, chew, breath, kiss, communicate- the list goes on and on. Avoidance and prevention of oral cancer is far preferable to any treatment that can be provided.

Eliminate any risk factors such as tobacco and alcohol and regularly visit your dentist. Periodic dental and oral exams allow early detection and appropriate treatment if cancer develops. If at any time you notice any changes in the appearance of your mouth, or any unusual signs and symptoms, such as;

Any mouth sores or changes that persist for more than one week should be examined by your dentist. "Leukoplakia " is a thick whitish patch that forms on the cheek, gums, or tongue and is caused by excess cell growth. It is common among tobacco users and can also be a result of ill fitting dentures, or habit of chewing on one's cheeks. The danger of leukoplakia is that it can progress to cancer. Your dentist can now do a simple painless biopsy of the area if the leukoplakia appears to be threatening.

For most of us, the only time we think of an oral surgeon is if our kids need their wisdom teeth removed. Today’s oral surgeon may be as adept at cosmetic surgeries like rhinoplasy (nose jobs) and eye lifts as they are at specific dental procedures like extractions and TM joint surgery.

What is Oral Surgery?
Oral and maxillofacial surgery is the specialty of dental practice that deals with the diagnosis and surgical treatment of diseases, injuries and defects of the mouth, jaws, face and related structures. This includes the removal of impacted and decayed teeth, placement of dental implants, biopsy and removal of cysts and tumors of the mouth and jaws, treatment of facial trauma and reconstructive jaw surgery.

What does maxillofacial mean?
Maxillofacial refers to the face and jaws, which along with the mouth comprise the areas of expertise of an oral and maxillofacial surgeon.

What does it mean to be Board Certified in Oral and Maxillofacial Surgery?
This means that the surgeon has graduated from an accredited dental school and has completed an oral and maxillofacial surgery residency program approved by the American Dental Association Commission in Dental Accreditation. This required thirteen years of post-high school education and training. The American Board of Oral and Maxillofacial Surgery is recognized by the American Dental Association as the specialty board for oral and maxillofacial surgery. The board is responsible for reviewing all applicants for board certification, as well as administering the examination involved in the certification process. One must pass both a thorough written qualifying examination and a rigorous oral certifying examination to become board certified as a Diplomate of the American Board of Oral and Maxillofacial Surgery. Diplomates are encouraged to maintain current competence by ongoing continuing education.

What are wisdom teeth?
The most common dental extraction is for wisdom teeth. Wisdom teeth, or third molars, are the last to come in and the most frequent cause of problems. Most often, they are trapped in the jawbone or gums and fail to come in at all. These impacted teeth can cause many problems: they may grow sideways, partially emerge from the gum, even remain trapped beneath the gum and bone.

Partial eruption can leave an opening around the tooth in which bacteria can grow and eventually cause infection. The result is swelling, stiffness, pain, and illness. If these teeth are not removed, they will continue to grow, damaging adjacent teeth. Tumors and/or cysts can form, infecting and destroying bone and the roots of healthy teeth. Most people don't have room for wisdom teeth, and their general dentist will often recommend removal for better oral health.

Do Oral Surgeons provide IV (intravenous) sedation?
Your oral and maxillofacial surgeon is not only a specialist in dealing with problems of the mouth, teeth, jaws, and face, but is also experienced in dealing with the control of pain and anxiety. The oral and maxillofacial surgeon possesses extensive clinical experience in all types of anesthesia techniques.

	Cosmetic dentistry is the fastest changing area in dentistry today. Research is developing new and better ways to repair damage to our teeth so fast that it is quite challenging just to stay abreast of the newest and best available.
It is part of the human condition to want to look and feel our best. Our smile has a tremendous impact on how we feel, how we view ourselves and on how others view us. Our smile is one of our most noticeable features Cosmetic dentistry can make changes in the shape and color of our teeth. Today dentists may be able to realign crooked teeth, brighten discolored teeth and repair damaged teeth, making them look better than new. Below you will see pictures of just a few of the kinds of changes that dentists can make in todays' world of comfortable dental care. Ask your dentist about what you can do to improve your smile.
Can you pick out the teeth that have crowns? Answer: the far left of the picture (patient's right side)
Complete mouth restorations
Before	After

1."...if they are discolored?"
Many patients have yellowing teeth that can easily be bleached in the dental office or at home. The material used most often is a low concentrate peroxide-type gel put in custom trays and placed on the teeth at night, taking several days or weeks to work. A higher concentrate gel with high-intensity light or heat can be used in the dental office for faster, more immediate results in one or a few applications. Some side effects are transient tooth or gum sensitivity, but more serious complications can occur if used on teeth with open cavities or on gum ulcerations. Excessively discolored teeth require more extensive treatment approaches.

2."...if they are chipped, irregularly shaped or have spaces?"
These areas can usually be improved with cosmetic recontouring, also known as selective grinding on the teeth. This is done in a very conservative manner so that the tooth is not functionally damaged but only cosmetically altered. Plastic 'bonding' can also be used to restore and reshape teeth for minor to moderate damage repair or cosmetics. This tooth-colored composite resin material is now very color-stable and has high bond strength. Minimal grinding on the tooth is required.

3."...if my teeth are too crowded and/or the bite is bad?"
Orthodontics is usually the best approach for these teeth. It is a conservative approach that does not cut the teeth down, but is a permanent, long-term solution to straighten the teeth. Crowding, spaces and poor coupling of the back teeth can lead to a 'bad bite' that can lead to long-term TMJ problems. When these are corrected as children it is usually easier and gives the person a healthy dentition for life. But even many adults are having orthodontics done to get the benefits that are still available, such as improved chewing function, easier and better oral hygiene, and better appearance.

4."...if I have several problems with my teeth?"
Some people have more than one problem with their teeth, and a combination of the above therapies can be used, as well as full veneers and crowns to better control the shape and fit of the prosthetic teeth. Many dentists have the knowledge and skills to deal with these situations, or a patient can look to dental specialists in these fields for second opinions or care.

Access the CDA site for answers to other frequently asked questions about records and procedures.

Dental Procedures FAQ's