Exams & Cleaning
A comprehensive dental exam is performed at your initial dental visit. Regular check-up exams include the following:
- Examination of diagnostic radiographs (x-rays): Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
- Oral cancer screening: Check the face, neck, lips, tongue, throat, and tissues for any signs of oral cancer. We also offer an additional aid, the VELscopeVx, to detect early oral cancer that is not visible to the naked eye.
- Head and Neck exam: Check these areas for any abnormal findings that could include lymph node swelling or unusual moles.
- The placement of the midline – do the front teeth meet where they should in relation to the rest of the facial structures?
- Gum disease evaluation: Check the gum tissue and bone around the teeth for any signs of periodontal disease.
- Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
- Examination of existing restorations: Check current fillings, crowns, etc.
Professional Dental Cleaning
Professional dental prophylaxis (dental cleanings) are performed by Registered Dental Hygienists. Your cleaning appointment will include a dental exam and the following:
- Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum tissue line and can only be removed with special dental instruments.
- Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gum tissue. This inflammation is the start of periodontal disease!
- Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.
Cleanings & Prevention
Always remember that carefully brushing, flossing, and consuming healthy foods can keep your smile healthy and beautiful. Dental cleanings and exams from your dental office can also prevent problems like cavities, tartar build-up, and periodontal disease. Dental cleanings help remove hardened deposits of tartar, and regular dental exams can catch the early signs of periodontal disease.
More preventative actions and treatments include sealants and fluoride. These can help protect teeth, and actually prevent cavities and other permanent damage to teeth. Prevention helps avoid serious and costly dental problems and is the key to having a healthy, confident, beautiful smile.
Periodontal Disease - What is periodontal disease?
The word periodontal means "around the tooth". Periodontal disease attacks the gum tissue and the bone that support the teeth. Plaque is a sticky film of food debris, bacteria, and saliva. If plaque is not removed, it turns into calculus (tartar). When plaque and calculus are not removed, they begin to destroy the gums tissue and bone. Periodontal disease is characterized by red, swollen, and bleeding gum tissue.
Four out of five people have periodontal disease and don't know it! Most people are not aware of it because the disease is usually painless in the early stages. Bad breathe is often caused by periodontal disease because of the bacteria and build up that has become hard to remove.
Not only is it the number one reason for tooth loss, research suggests that there may be a link between periodontal disease and other diseases such as, stroke, bacterial pneumonia, diabetes, cardiovascular disease, and increased risk during pregnancy. Researchers are determining if inflammation and bacteria associated with periodontal disease affects these systemic diseases and conditions. Smoking also increases the risk of periodontal disease.
Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.
Gingivitis is the first stage of periodontal disease. Plaque and its toxin by-products irritate the gum tissue, making them tender, inflamed, and likely to bleed.
Plaque hardens into calculus (tartar). As calculus and plaque continue to build up, the gum tissue begins to recede from the teeth. Deeper pockets form between the gum tissue and teeth which become filled with bacteria and pus. The gum tissue becomes very irritated, inflamed, and bleed easily. Slight to moderate bone loss may be present.
The teeth lose more support as the gum tissue, bone, and periodontal ligament continues to be destroyed. Unless treated, the affected teeth will become very loose and may be lost. Generalized moderate to severe bone loss may be present.
Periodontal treatment methods depend upon the type and severity of the disease. Dr. Garhardt and his dental hygienist will evaluate for periodontal disease and recommend the appropriate treatment.
Periodontal disease progresses as the sulcus (pocket or space) between the tooth and gum tissue becomes filled with bacteria, plaque, and tartar, causing irritation to the surrounding tissues. When these irritants remain in the pocket space, they can cause damage to the gum tissue and eventually, the bone that supports the teeth. If the disease is caught in the early stages of gingivitis, and no damage has been done, one to two regular cleanings per year will be recommended. You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings.
If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planing(deep cleaning) will be recommended. It is usually done two quadrants of the mouth at a time while the area is numb. In this procedure, tartar, plaque, and toxins are removed from above and below the gum tissue line (scaling) and rough spots on root surfaces are made smooth (planing). This procedure helps gum tissue to heal and pockets to shrink. Medications, special medicated mouth rinses, and an electric tooth brush may be recommended to help control infection and healing. If the pockets do not heal after scaling and root planing, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean. Dr. Garhardt may also recommend that you see a Periodontist (specialist of the gum tissue and supporting bone).
This type of X-ray uses a small digital sensor instead of film to allow us to analyze your teeth. A few of the advantages of digital X-rays when compared to conventional films are: you are exposed to much less radiation, better diagnostic ability due to better resolution, and seeing the image on a large screen. This also allows us to better show you where the dental disease is occurring. All this contributes to better care by your dentist and better understanding of why we need to do the work diagnosed.
When a tooth is damaged by decay a filling may be required to repair the tooth. This filling is composed of a material called composite resin. Composite resin comes in many shades so we can accurately match your tooth color. The diseased tooth structure is first removed; the tooth is then acid etched, and then a bonding agent is used to chemically bond the composite resin to the tooth. This type of filling material allows your dentist to conserve as much natural tooth structure as possible while only removing the diseased tooth structure.
Crowns completely cover the entire tooth which helps to restore the function of the tooth. Crowns are used when a tooth has very little tooth structure left due to dental disease or trauma and it is at risk for further fracture due to its weakened condition. If a tooth has a fracture line it can be painful or painless. Fractures get bigger and bigger every time you chew on your teeth. Eventually the fracture gets big enough where one of three things can happen:
- The tooth fractures above the gum tissue line and a crown can be used to restore the tooth back to normal function.
- The tooth fractures into the nerve chamber which requires a root canal before placing a crown on the tooth to restore function.
- The fracture is below the gum tissue line which necessitates extraction of the tooth. The tooth can then be restored to function with either a dental implant, bridge, or removable partial denture.
We believe it is important to take care of fracture lines and teeth before they become big problems like root canals, bridges, and dental implants.
What does getting a crown involve?
A crown procedure usually requires two appointments. Your first appointment will include taking several highly accurate molds (or impressions) that will be used to create your custom crown. A mold will also be used to create a temporary crown which will stay on your tooth for approximately two weeks until your new crown is fabricated by a dental laboratory.
While the tooth is numb, Dr. Garhardt will prepare the tooth by removing any decay and shaping the surface to properly fit the crown. Once these details are accomplished, your temporary crown will be placed with temporary cement and your bite will be checked to ensure you are biting properly.
At your second appointment your temporary crown will be removed, the tooth will be cleaned, and your new crown will be carefully placed to ensure the spacing and bite are accurate.
You will be given care instructions and encouraged to have regular dental visits to check your new crown.
When a tooth is lost due to decay, fracture, or trauma, a bridge is one way to replace that missing tooth. Your dentist will prepare the teeth on either side of the space for crowns. An impression of all your teeth is sent to the dental laboratory along with photos to get the color match. The lab then makes a restoration which spans the space and attaches to the adjacent teeth. The bridge is then custom fit and permanently cemented in place.
There are several types of bridges. You and Dr. Garhardt will discuss the best options for your particular case. The "traditional bridge" is the most popular type and is usually made of porcelain fused to metal. Porcelain fixed bridges are most popular because they resemble your natural teeth. This type of bridge consists of two crowns that go over two anchoring teeth (abutment teeth) and are attached to pontics (artificial teeth), filling the gap created by one or more missing teeth.
Root canals are performed by the dentist when the pulp of the tooth is dead or dying due to infection, decay, or trauma. The pulp chamber is accessed through the top of the tooth. The canals are then measured in length. Once the canal lengths are determined the Dr Garhardt uses a series of files to clean and shape the canals. Once the canals have been shaped the canals are disinfected with a sodium hypochlorite solution. Gutta-percha is then sealed in place to prevent a new infection of the canal space. A core buildup and crown are usually required after a root canal.
Dentures are replacements for missing teeth that can be taken out and put back into your mouth. While dentures take some getting used to, and will never feel exactly the same as one's natural teeth, today's dentures are natural looking and more comfortable than ever.
There are two main types of dentures: full and partial. During your examination appointment, we will discuss the type of denture that is best for you based on whether some or all of your teeth are going to be replaced and the cost involved.
How do Dentures Work?
With full dentures, a gum tissue-colored acrylic base fits over your gum tissue. The base of the upper denture covers the palate (the roof of your mouth), while that of the lower denture is shaped like a horseshoe to accommodate your tongue.
Dentures are custom-made in a dental laboratory from impressions taken of your mouth. Normally, you will have a series of appointments, including try-in appointments, to make sure that the fit, bite, and color of the dentures are as accurate as possible.
Conventional Full Denture
A conventional full denture is placed in your mouth after any remaining teeth are removed and tissues have healed. Healing may take several months, during which time you are without teeth.
Immediate Full Denture
An immediate full denture is inserted immediately after the remaining teeth are removed. The denture is fabricated by the laboratory prior to the surgical appointment. While immediate dentures offer the benefit of never having to be without most of your teeth, they must be relined several months after being inserted. Relines are done because the bone supporting the teeth reshapes as it heals, causing the denture to become loose. When a denture is relined, material is added to the inside of the denture were the bone and tissue had healed, making the denture fit better.
A partial denture rests on a metal framework that attaches to your natural teeth. Sometimes crowns are placed on some of your natural teeth and serve as anchors for the denture. Partial dentures offer a removable alternative to bridges.