Porcelain Inlays and Onlays

Porcelain

When a tooth has been moderately to extensively destroyed by decay, previous drilling, or fracture but there is still sufficient enamel remaining, one innovative way it can be restored is with a porcelain inlay or onlay. An inlay is a restoration in which a portion of occlusal (biting) surface is replaced with porcelain. An onlay will restore a larger portion of the biting surface of the tooth. These are considered very conservative restorations. The porcelain allows an excellent esthetic result. It is attached to the tooth using a bonding procedure, allowing it to become very strong. It can be used with wonderful results in small, medium, and even with large restorations lasting more than 12 years, relatively trouble free.

A dental laboratory is involved in the construction of the restoration. There is a 2- to 3-week delay while the inlay or onlay is being made, so the tooth must have a temporary restoration in place during that time.

They have some disadvantages. They are moderately to very expensive to make and place. They take two appointments to complete. They must be adjusted and polished well or they can cause wear of the opposing enamel, similar to a porcelain fused to metal crown. Of course, we make sure they are adjusted and polished to begin with. Porcelain biting surfaces cause more rapid wear of opposing natural teeth, especially in the posterior areas where a metal biting surface may be advised.

Advantages include the excellent esthetics, high strength, predicted longevity, and conservative preparation, 

that is, less drilling than a crown. If the porcelain does chip, it can be repaired. However, you should not chew ice cubes, “jaw breakers”, or any other hard candy with these or any other type of restoration.

For those who want the strongest, longest-lasting, conservative restoration that very closely matches a tooth, porcelain is possibly the best choice. Once it is finished, the tooth, if cared for properly, should not have to be restored again for years. It does allow the conservation of most of the natural tooth.

Resin

Resin inlays and onlays are used in the same areas as the porcelain inlays and onlays. They are very natural in appearance and, like porcelain, are bonded into place. They are considered an extremely conservative restoration. Two appointments, approximately 2 weeks apart, are required to fabricate the inlay/onlay. The tooth will be protected with a temporary filling while the final restoration is being made. The wear of the resin is similar to that of enamel. So unlike porcelain, it will not have a tendency to wear the opposing natural tooth structure.

The resin may be considered slightly “weaker” than the porcelain. However, porcelain is more brittle and more difficult to repair. The difference in strengths is not significant. The resin is more forgiving and is more easily finished or repaired and resin is easier to work on.

With both types of materials, porcelain or resin, you can develop decay on unrestored surfaces, so excellent oral self-care is required. Neither material is advised for patients who have a bruxing (grinding) or clenching habit unless a protective mouthguard is constructed for you.

Unless you have a preference, we will select the most appropriate material for your dental needs. Cost of each is comparable. Both types are excellent choices and are considered highly conservative in the amount of drilling needed.

If you have any questions about porcelain or resin inlays and onlays, please feel free to ask us at any of our office locations:

Hymeadow: (512) 250-5012

Jollyville: (512) 346-8424

West William Cannon: (512) 445-5721

Wisdom Teeth (Third Molars)

Human beings have more teeth than they actually need: four more teeth, to be exact. The third molars (wisdom teeth) are the last teeth on each side and in each arch of the mouth. If we don’t need them, why do we have them? Hundreds of thousands of years ago, our ancestors didn’t look a great deal like we do today. They had smaller bodies but larger and more powerful jaws. Their diet dictated this jaw structure and number of teeth. Our ancestors ate tougher and more abrasive types of food. It wasn’t cooked well, and it wasn’t ground up well. There were a lot of hard grains and foods that required lots of chewing. Big jaws were capable of holding more teeth for this chewing.

Today, we don’t need the heavy grinding capacity that early humans had. Food is easier to eat, less abrasive, and much softer. Evolution is reacting (slowly) to this fact by decreasing the size of our jaw bones and chewing muscles. The human jaw that once comfortably held 12 molars (32 teeth total) is now often only large enough to hold eight molars (28 teeth total). Unfortunately, our jaws are getting smaller faster than our wisdom teeth are disappearing. The wisdom teeth often do not have enough room to grow properly. Eventually, thousands of years from now, humans will not have wisdom teeth. They have lost their function and are gradually disappearing, just like the appendix.

Since the jaw is too small (for most people) to accommodate the third molars, they come into the mouth partially, poorly positioned, or not at all. They can be fully erupted, partially erupted, a soft tissue impaction, partial bony impaction, or full bony impaction. If teeth come in well and you are able to keep them clean, we leave them alone. If they are crowded or poorly positioned and cannot be kept clean, they are like an accident waiting to happen. Decay and gum infection are likely to result. These teeth are usually removed—ideally before they begin to cause big problems with the second molars that are directly ahead of them. Teeth that are partially erupted should always be removed: there is too much opportunity for gum infection to begin. If the teeth cannot be cleaned, chronic painful inflammation may occur (pericoronitis). The earlier they are removed, the better your healing will be.

Less complex extractions (fully erupted teeth or partial soft tissue impactions) can be done by a general dentist. We will refer difficult extractions to an oral surgeon for treatment. Depending on the type of extraction and the medical history of the patient, the extractions may be done in an office or in the hospital. This will be determined after viewing radiographs of the teeth. Having all four wisdom teeth out at the same time is a common practice. Postoperative discomfort can be minimal to extreme—in the case of difficult full bony impactions. Antiinflammatory and pain relief medications are prescribed appropriately.

We do not need wisdom teeth to eat well. If they need to come out, it is better they come out (1) before they cause problems with the adjacent teeth that you really need and (2) when you are younger and heal well. If you need to have one wisdom tooth taken out, also have the opposing wisdom teeth removed. When a tooth does not meet an opposing tooth, it “super erupts” or continues to grow out of the normal position. When left for some time, the remaining tooth can develop decay and gum disease and cause the same thing to happen to the tooth in front of it. 

Headaches: The Dental Connection

You probably remember the old song “…the knee bone’s connected to the leg bone; the leg bone’s connected to the hip bone…etc.” Your (lower) jaw bone actually is connected to your “head bone”—and it is connected by muscles, ligaments, and tendons. This area is known as the temporomandibular joint or the TMJ. When the lower jaw lines up perfectly with the upper jaw and everything functions normally, everything is fine. If the lower jaw does not line up properly or, perhaps more importantly, if there is abnormal stress present when the lower jaw contacts the upper jaw, problems can occur. The abnormal stress is usually clenching or grinding of the teeth and it can occur any time, day or night, awake or asleep. When this happens, a person can develop regular, chronic, or migraine headaches; muscle pain or tenderness in the jaw joint muscles; or the temporomandibular joint dysfunction (TMD). Forty-four million Americans suffer from chronic clenching and grinding, resulting in tooth damage and 23 million suffer from migraine headache pain.

While mouthguards have been used with some success to treat TMD patients, an FDA-approved device seems to offer a higher success rate in eliminating TMJ problems. This device has an additional advantage in that it was designed to reduce the clenching habits that often lead to chronic and migraine headaches. This device prevents the upper and lower teeth from coming into contact. By preventing high-intensity clenching (and the muscular irritation that leads to migraine pain, TMD, and chronic headaches), studies have shown that 82% of migraine and headache sufferers has a 77% reduction in the migraine incidents. In short, the frequency and intensity of headache episodes and muscle tenderness can be reduced with the use of a mouthguard.

A tension suppression system is another effective form of mouthguard that can treat TMD. This small removable device, made in the office, can be worn day and/or night and has been shown to reduce clenching intensity by 66%. It takes advantage of a naturally protective reflex that suppresses the powerful chewing muscles active in clenching. For those concerned about insurance coverage, the cost of this device is submitted first to medical insurance for evaluation of benefit coverage. Most insurance carriers do consider this device a payable benefit.

How important is the reduction of clenching stress? Try this simple demonstration. Put a pencil between the last top and bottom molars on one side and bite hard. Remember how hard you were biting. Then take the pencil and place it between the top and bottom front teeth and bite down hard again. You will not be able to bite down as hard when just biting on the front teeth. You should be able to detect a great difference between biting (clenching) on back teeth only and front teeth only. Try another test: lightly place your fingertips on either side of your head in the temporal area (above and in front of the ears). Clench your teeth and feel the muscles on either side of the head bulge out. Then take a pencil, place it between the top and bottom front teeth, and bite down again. You will easily feel that the temporal muscles do not (cannot) bulge out as much, meaning that not as much clenching compression is possible.

Source: Elsevier Mosby, Dental Practice Tool Kit: Patient Handouts, Forms, and Letters

6 Ways to Ease Your Child’s Anxiety at The Dentist

"It's time to go to the dentist," are seven words no adult or child wants to hear. While these are not words most people like to hear they are words you need to hear if you care about your smile. Sadly, many children are terrified by even the thought of going to the dentist. May officials have often encouraged the use of sedation dentistry even amongst small kids to help them deal with the nerves associated with visiting the dentist which has led to a widespread debate on if children should be allowed to take in such drug. Despite the debate one thing remains in order to keep healthy teeth your children must go to the dentist here are just a few ways you can help calm your toddler when it's time to go to the dentist:

Speak Positive Words

When it comes to going to the dentist it is terrifying for both children and adults. In order to eliminate anxiety before going to the dentist it is important that you let your child know that the visit will be an exciting one versus telling them they should be afraid.

Embrace Brushing Teeth at Home

It is recommended that you begin brushing your child's teeth once they start growing in. This not only encourages overall healthy teeth but it also helps children get used to having something on their teeth so that they are not paralyzed by fear when their first trip to the dentist arrives.

Start with a Pediatric Dentist

Pediatric dentists specialize in only children's teeth which may be the best bet for your little one as they get used to visiting the dentist. Not only is a pediatric dentist an expert in pediatric tooth care but he is also an expert in making sure your child does not have a full blown while getting take care of.

Play Pretend

Kids love playing pretend and using it as a tactic in overcoming fear will make playing pretend so much better. Set up a play date a few days before your child visits the dentist and have his or her room set up like a dentist office. Pretend to be the dentist and let them be the patient as you explore their teeth and gums. Your child is sure to love this game and most of all you are prepping them for their visits in a few days.

Don't Bribe Your Child

When taking your child to the dentist the last thing you want to do is bribe your child with things such as candy or other sweet treats. Bribing your child with sweets would be counterintuitive to what the dentists does for the teeth. It is best to simply calm your child's nerves. If you must bribe your child bribe them with stickers and or other fun activities.

Avoid Words that Promote Fear

Using the words "pain." "shot" or even "doctor" can be frightening for small children so try not to let your child know that they are going to see a doctor. Instead, share with them that they are going to see someone who cares about how strong their teeth and gums are. Using less fearful words could also help with decreasing anxiety.

By: Stephanie R. Caudle
http://www.huffingtonpost.com/stephanie-r-caudle/6-ways-to-ease-your-child_b_11549086.html

If you have questions or would like to schedule an appointment, please contact Omni Dental Group at one of our three office locations listed below:

North Austin on Hymeadow Drive: (512) 250-5012
Central Austin on Jollyville Road: (512) 346-8424
South Austin on William Cannon: (512) 445-5811

Tips For Oral Hygiene

A better, more confident you begins every morning and ends every evening if you stick with a consistent oral hygiene routine. This, in addition to regular dentist office visits, helps develop not only strong teeth and gums, but also overall good health. You'll feel good, look great, avoid unnecessary bills, and experience an improvement in many of your day-to-day social interactions. It's easy once you understand the basic routines required to maintain good dental hygiene. Get started with some basic dental education and a thorough awareness of the steps that should and should not be taken toward great, long-term oral health.

Oral hygiene benefits

Daily cleaning of your teeth, gums, and tongue, combined with annual check-ups helps ward off harmful bacteria and microbes that may cause tooth decay, bleeding gums, and oral infections. Proper oral hygiene is also important in helping you stay healthy, especially if you have risk factors such as diabetes and heart problems. Plus, oral hygiene elevates your sense of self-esteem. This is especially true for teenagers and adults who frequently interact with others at work or in social situations. Maintaining proper oral hygiene ensures that you won’t experience embarrassing conditions, such as plaque, tartar, and bad breath. It also lowers the need to treat dental problems that could otherwise be inexpensively prevented. For example, according to Kaiser Health News reports, dental costs make up approximately 20 percent of a child’s total health care expenses, and the costs are escalating rapidly.

Oral hygiene for kids

Enforcing good oral hygiene habits early in a child’s life is essential for his overall well-being. According to a 2007 Centers for Disease Control and Prevention (CDC), the number of cavities in children between the ages of two and five has escalated by 15 percent. Proper oral hygiene habits must start as early as the child begins to bottle feed. This is when babies are prone to tooth decay if they are given a bottle filled with sugary liquids, like milk or juice, when put to bed. While baby teeth should be cleaned using a washcloth, young babies should eventually have their teeth and tongues brushed using soft brushes. It is important for parents to teach children the proper way to brush their teeth with fluoride toothpaste, to take them for regular dental check-ups, and to serve foods that will help strengthen teeth. These include milk, cheese, and vegetables.

Oral hygiene for adults

Many adults experience significant dental problems that could be prevented through basic oral hygiene practices, like regular dentist appointments. For example, in 2009 alone, CDC data indicated that only 62 percent of adults surveyed had visited the dentist. To maintain optimal oral health, adults should brush their teeth at least twice a day, preferably after each meal and before going to bed. Flossing is also an essential part of an adult’s daily oral hygiene regimen. Regular brushing and flossing can prevent unpleasant conditions, such as plaque and bad odor. However, over-brushing or flossing may result in mouth bruises and bleeding, which can lead to infections. Adults should visit their dentist regularly for routine check-ups and before using over-the-counter medication.

Oral hygiene facts

Poor oral hygiene can increase your chances of developing heart disease. Professional teeth cleanings will reduce the bacteria that cause inflammation and eventually lead to heart disease (Veterans General Hospital in Taipei).
According to the American Dental Hygienists Association:

• A major cause of tooth loss in children is cavities; while periodontal (gum) disease is the leading cause of tooth loss in adults.
• Eating healthy snacks such as celery, carrots, or apples help clear away food loosely trapped in-between teeth.
• The leading oral health problem for infants is baby bottle tooth decay, which can be caused when babies are given a bottle filled with sugary liquids, like milk or juice, when put to bed.

Oral hygiene statistics

According to the Centers for Disease Control and Prevention:

• Roughly 78 percent of Americans have had at least one cavity by age 17.
• 80 percent of the U.S. population has some form of periodontal (gum) disease.
• In 2007, Americans made about 500 million visits to dentists and spent an estimated $98.6 billion on dental services.
• Between 2005-2008, 16 percent of children ages 6-19 and 23 percent of adults 20-64 had untreated cavities.
• Dental fluorosis (overexposure to fluoride) is higher in adolescents than in adults and highest among those aged 12–15.
• Most adults show signs of periodontal or gingival diseases. Severe periodontal disease affects approximately 14 percent of adults aged 45-54.
• 23 percent of 65-74 year olds have severe periodontal disease
• Men are more likely than women to have more severe dental diseases.
• Oral cancer occurs twice as frequently in men as women.
• Three out of four patients don’t change their toothbrush as often as is recommended. Toothbrushes should be changed every two to three months and after illnesses.

Oral hygiene greatly affects overall long-term health, and promotes a more confident you. When it comes to dental care, prevention through daily cleaning and regular visits to the dentist’s office is better not only for your health, but for your budget. That's why it's important for parents to play a key role in reinforcing smart oral hygiene habits. Kids are likely to follow in the footsteps of those who set positive examples and will carry those healthy habits through their own adult lives. Remember, whatever your age, it’s never too late to take a serious stand in keeping your teeth healthy and your smile confident.

Source: Humana
https://www.humana.com/learning-center/health-and-wellbeing/healthy-living/tips-for-oral-hygiene
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If you have questions or would like to schedule an appointment, please contact Omni Dental Group at one of our three office locations listed below:

North Austin on Hymeadow Drive:  (512) 250-5012
Central Austin on Jollyville Road:  (512) 346-8424
South Austin on William Cannon:  (512) 445-5811

8 Tips for a Brighter Smile

Want a brighter smile? Try these tips!

1. Avoid foods that stain
Avoid foods and beverages that are filled with sugar or are too acidic. If you're not careful, consuming these kinds of foods can damage and stain your teeth. It can be helpful to drink beverages that stain through a straw as well. This helps you circumvent those smile dulling liquids altogether! Brushing your teeth immediately after eating sugary foods may also help prevent staining. Be careful though, if a food is too acidic, you will want to wait at least thirty minutes before brushing your teeth in order to prevent enamel erosion. If you cannot brush your teeth for some reason, opt for swishing water in your mouth which is naturally filled with fluoride. (Water is not a substitution for your daily dental routine).


2. Use dental cleaners
Between brushing, use dental cleaners to minimize the food build-up between your teeth. These brushes are disposable and very handy if you find yourself away from home without a toothbrush. You can also use them to clean the areas between teeth and brace wires if you have braces. They're sold at most grocery stores and can even be found online. 



3. Try toothpaste for sensitive teeth
If your teeth are especially sensitive, try using a toothpaste created specifically for people with sensitive teeth. If you're wondering whether or not you have sensitive teeth, here's a simple way to tell: Do your teeth feel uncomfortable when they are exposed to extreme hot and cold temperatures? If so, be sure to ask your dentist for help and additional information. 

4. Regular dental checkups
This one might seem obvious, but it is so important! Be sure to visit your dentist regularly to have your teeth inspected and cleaned. Without regular dental checkups, you run the risk of facing disease and other problems in the future. Routine dental visits help prevent the advancement of such diseases and are always a good idea. 

5. Avoid chewing on hard foods
Ice cubes pose a particular threat to the safety of teeth. Never chew on ice. You could crack or chip your teeth! Be cautious when eating popcorn, nuts or any other tough to chew food. If you believe that your teeth are chipped or cracked, see a dentist immediately to prevent pain or even bacteria growth in the cracked tooth. 



6. Brush your teeth properly
Brush your teeth from the gum line moving towards the center of your mouth. This will help get rid of food bits that hide under your gums. Scrubbing side to side is always good, but don't forget to brush with an up and down motion as well. If your gums or mouth bleed while brushing, be sure to meet with a dentist or periodontist. Bleeding gums are often a sign of gum disease, which is a major issue when left untreated. 


7. Swirl that Mouthwash
One common misunderstanding regarding oral health is that brushing is all you need for a healthy mouth. Mouthwash is often neglected in daily dental practice, but it's an essential step towards your brighter smile. Mouth wash cleans, disinfects, and reaches places your toothbrush simply cannot. Rinse twice per day when you brush those pearly whites.




8. Drink your Milk! 
In addition to providing a good source of calcium, dairy has shown to help your teeth fight cavities. If you're lactose intolerant or simply dislike dairy products, don't worry! Dark leafy greens like kale or collards, broccoli, tofu, and even almonds are all excellent natural sources of calcium.



If you have any questions regarding the health of your teeth or simply want to see a doctor, call one of our three convenient locations to set up an appointment. We are here to provide excellent service in a friendly environment.  

North location on Hymeadow Drive: (512) 250-5012
Central location on Jollyville Road: (512) 346-8424
South location on William Cannon Drive: (512) 445-5811

X-Rays and the Dentist

If you've been to the dentist recently, then you have most likely had an X-ray done. While they aren't taken during every visit, they are very helpful for establishing a patient's oral health as well as predicting which areas need to be focused on. Today we are going to give a brief overview of what exactly they are and why they are necessary. 

1.  What are X-rays? 

In 1895, Wilhelm Conrad Roentgen was working in his lab conducting research when he accidentally discovered X-rays. Since then, science and technology have evolved to use X-rays in a beneficial manner. During an exam, a patient is exposed to short bursts of radiation. This allows the doctor to view teeth in a more thorough manner than an examination. Some people are nervous about getting X-rays, however, it is important to note that the doses of radiation are too minute to cause adverse effects. In fact, during a dental X-ray, patients are only exposed to the same amount of radiation as a short airplane flight. 

2. Do I have to get X-rays?

Whether you need to look for fractures in bone or simply to check in on teeth, X-rays are the best way to do it. Dentists rely on this technology because it allows them to perceive problems before the naked eye is able see them. Some examples include, but are not limited to: periodontal disease, bone infections, hard to see tooth decay, and even some tumors. X-rays are an important part of preventative care and are nothing to be afraid of.

3. What if I'm pregnant?
This is always a great question to ask! It is best to consult your physician before exposing yourself to small quantities of radiation. Informing your dentist of this is an absolute necessity, but there is no need to forgo X-rays altogether. With pregnant patients, a thyroid collar and a leaded apron are used to prevent radiation exposure.

Source: Mouth Healthy by the American Dental Association

If you have questions concerning X-rays and the health of your teeth, feel free to call one of our three offices to schedule a consult. We are here to address any of your concerns and to provide you with a stress-free dental experience.

North location on Hymeadow Drive: (512) 250-5012  
Central location on Jollyville Road: (512) 346-8424  
South location on William Cannon Drive: (512) 445-5811

Happy Valentine's Day!

Roses are red

Violets are blue

Watch out for gummy bears

and jaw breakers, too

Valentine's Day will be here in nearly a week! Whether you're spending the day with a loved one, having a fun party with your friends, or simply relaxing before the work week, you are sure to encounter a few yummy desserts and candies. While everyone enjoys something sweet once and again, it is always good to consider how they impact your health. Here are a few tips for keeping your mouth in good shape during Valentine's Day.

1. Not all candy is created equal. 

• Some candies are worse than others. Tough candy that stays in your mouth for a prolonged period of time such a jawbreakers and suckers can lead to cavities or even chipped teeth. The best option for this type of sweet is to opt for a sugar-free alternative. This way, you are satisfying your sweet tooth without the risk of tooth decay. 
• Also, be on the lookout for chewy candies like gummy bears, taffy, and caramel. Even though these treats are sure to satisfy, they are stubborn and tend to stick to your teeth. This makes these chewy confections more difficult to break down with saliva.  

2. Select your beverages with care.

• While they might be packed full of vitamin C, it is best to avoid drinks that have too much citrus like orange grapefruit juice. The acid from these beverages can erode away your enamel and weaken your teeth.  
• If you are wanting a soda with your meal, keep in mind that its carbonation and sugar can also damage your enamel. Sugar-free sodas are a better alternative, but water is always the best option. 
• Even though most people enjoy a nice cup of coffee in the morning, the caffeine coupled with its dark color can dry out your mouth and stain your teeth. Consume it in moderation and try drinking with a straw to avoid some of those stains. 
• If you find yourself wanting to a cold drink, try refrigerating it instead of adding ice. Chewing ice can lead to dental emergencies and isn't the safest way to go. 

3. Look out for your pearly whites.   

The best way to prevent cavities and other dental health diseases is to take care of your teeth. Remember to brush your teeth twice per day and floss once. If you decide to eat or drink anything too acidic, try waiting at least thirty minutes before brushing your teeth.



Source: Mouth Healthy by the American Dentist Association

Our aim is to treat all patients with respect and provide a stress-free experience for the whole family. If you would like to schedule a cleaning after eating Valentine's Day sweets or have any questions, feel free to call one of our three convenient locations.

North location on Hymeadow Drive: (512) 250-5012  
Central location on Jollyville Road: (512) 346-8424  
South location on William Cannon Drive: (512) 445-5811

Replacing Unesthetic Restorations

There are 2 types of life spans:
Everything has a life expectancy, even dental filling materials. Dental materials appear to have two different types of life spans - a functional life span and an esthetic life span. The better the original dental restorative material and the skills of the operator, the longer the restoration will last. Lab-processed materials will generally last longer than direct placement materials.

What is the functional life span?
The functional life span is defined as the length of time a material will last before it fails to function properly. This failure will either (a) weaken the tooth or (b) permit decay or gum disease to begin. For example, when a piece of the filling breaks off (or often in the case of an amalgam [silver metal] filling, it causes a piece of the tooth to break off), the tooth requires a new restoration.

How is the esthetic life span different from the functional life span?
An esthetic life span is somewhat different. In the case of bonded and tooth-colored restorations, it means that the material, while possibly still able to function, has begun to degrade. A filling may have matched the tooth beautifully when placed, but over time, the change in color of the filling material, as well as actually tooth color changes, cause an obvious mismatch between tooth and filling material. Since the restorative material does not have the same properties as tooth enamel, it will wear a little differently. The shape will change over time, too. Luckily, it is a very slow process.

With lab-processed restorations, crowns and bridges, the crown may still be working well, but age and changes in your mouth make it and the surrounding soft tissues look less acceptable that it was when first placed. Again, this happens slowly, over many years.

What other esthetic problems can be fixed? 
Other esthetic problems that can be corrected include notches in fillings or under crowns caused by improper brushing (or decay), recession of the gum tissue that exposes  darker root surfaces around crowns or fillings, porcelain crowns (caps) that no longer match the adjacent teeth, and metal margins of crowns that are visible due to gum recession (and this is quite common).

Why should you consider getting new dental restorations?
When you can see these types of changes, you can be sure that others who look at you when you are speaking or smiling will see them too. If you place a high value on your personal appearance, this is the time to consider having the restorations replaced with newer materials. Newer dental restorative materials look better, last longer, are more color-stable, and more wear-resistant than older-generation bonded materials. You can expect them to look good for many years.

What fillings look the best?
In our opinion, silver metal fillings never look "good." Even at this best, polished and shined, they do not represent a picture of health. As the metal ages, it corrodes, pits, and darkens. Its constant expansion and contraction due to hot and cold foods we eat weakens the tooth. The darkening of a filling can cause a darkening of the tooth itself. After time, the tooth will become permanently dark gray. The wider your smile is (and the more teeth you show when talking and smiling), the more of a problem this can be. The most esthetic filling are tooth-colored.

What happens if I choose to keep my old fillings?
Broken, stained, worn, and visible fillings detract from your appearance. When you look at a tooth (from about 2 feet away) that has been restored, you should not see the filling. While these types of problems are, of course, non life-threatening, consider attending to them before they get worse - and difficult and expensive to correct.

In our office, we place a high value on the appearance of your teeth and how you feel about your smile. We want you to look your best. We use the best materials and techniques available in dentistry today to ensure a healthy smile. We will be happy to evaluate your particular condition and discuss options with you.

If you have any questions about replacing unesthetic restorations, please feel free to call our office to discuss restoration options at 512-250-5012.

Scaling and Root Planing

What is scaling?
Scaling is a periodontal dental procedure in which plaque and calculus are removed from the tooth both above (supragingival) and below (subgingival) the gum (gingiva). 

What is root planing?
Root planing is a procedure in which diseased or altered portions of the root surface, the cementum, and dentin are removed and the resulting new surface is made smooth and clean. The more altered and damaged the root surface has been from calculus (tartar) accumulation, the more the need for root planing.

Why is it necessary?
The purpose of scaling and root planing is to remove all debris from the teeth. Any item that can cause inflammation of the gum tissue must be eliminated. The root surface must be made as smooth as possible. Irregularities in the root surface can contribute to gum inflammation. Irregularities are sites for bacteria and plaque buildup. The bacteria and the toxins they produce in the plaque are held against the tooth by the calculus. In this way, plaque and calculus on the teeth have been positively linked to gum disease.

What is the procedure like?
Depending on the severity of your particular periodontal problem, scaling and root planing may be the definitive treatment and no further procedures will be required. In many cases scaling and root planing are only a necessary part of the overall therapy. It is a demanding procedure. It requires much more time than the familiar adult prophylaxis (cleaning). It is usually done in multiple appointments, treating a quarter, half mouth, or your full mouth at each appointment. In this office we find that most patients are most comfortable if the area to be treated during the root planing procedure is anesthetized with a local anesthetic.

Recare
The scaling and root planing may have to be repeated in the future. It is customary to place the patient on a 3- to 4-month hygiene recare schedule. Scientific evidence clearly shows that for individuals who have demonstrated a predisposition to periodontal disease, an interval of 6 months is too long. We will determine the appropriate interval for you. As your situation changes, there may be changes in the length of these intervals as well.

What happens after treatment?
Other than the teeth being somewhat sensitive after the scaling and root planing procedure, there is little postoperative discomfort. The sensitivity will diminish with time. If you have been diagnosed as having severe periodontal infection, the sensitivity may remain for quite some time and further procedures may be needed to eliminate sensitivity. Although many procedures in dentistry can be considered elective, we consider scaling and root planing to be a necessity for your dental health.

Post-procedure Tips:

• If therapeutic prophylaxis has been completed because your gingival (gum) tissue showed signs of infection and inflammation, and if you had significant calculus (tartar) buildup:

• You may notice that your teeth feel different where the calculus was removed. The soft tissues may be sensitive or sore for approximately one day as they begin to heal. You may find that taking an over-the-counter pain reliever (aspirin, ibuprofen, etc.) will help during this 24-hour period. You may also rinse your mouth every few hours with warm salt water. Make sure that you brush and floss your teeth during this time period as you have been instructed. be gentle, because the brushed areas may be sore, but be thorough! You do not want to have the periodontal infection begin again.
• If scaling and root planing, or other more involved periodontal procedures has been completed:

• You can expected your gingival (gum) tissues to be quite sore. This is normal when the gum tissues have been infected and inflamed for some time. The more severely they have been affected, the more discomfort you can expect. This soreness should go away very quickly. You may rinse with warm salt water every few hours until the soreness is gone.
• If scaling and root planing has been completed:

• You may also notice that the teeth have become sensitive to temperature changes after the scaling and root planing. This sensation frequently occurs when the surfaces of the roots of your teeth have been cleaned. Removal of the debris covering the roots and attached to the roots leaves the roots open to temperature stimulus. If the problem persists, please let us know.
• When you examine your gums closely in a mirror, you will also observe that the color, texture, and position of your periodontal tissues will undergo a change as the healing takes place. The swollen, reddened gum tissue will shrink, become more firm, and return to a healthy pink color. Watch for these welcome signs of improvement and be encouraged by the healing process.
• Please do not forget to brush, floss, and use other periodontal cleaning aids as you have been taught. It is important that you begin establishing proper oral self-care habits immediately. If you find that the recently treated areas are sensitive to the brushing and flossing, be gentle - but be thorough! With proper technique you cannot damage the teeth or gingival tissues.
• Brush after ever meal with a fluoride-containing toothpaste. Rinse with a fluoride-containing mouthrinse once each day.

Preventing Recurrence
Once scaling and root planing has been completed, it is most important for you to practice the brushing and flossing techniques in which you will be instructed. If we have recommended any additional periodontal aids, you must use them, too. Your cooperation is vital if the procedures are to be successful. To remain disease-free, you will need to remain constant in your oral self-care regimen.

If you have any questions about scaling and root planing, please feel free schedule a comprehensive dental exam with our office at 512-250-5012.

Instruments of a Dental Office

When you go to your dentist, do you ever wonder what those tools going into your mouth are used for? They can be pointy, sharp, loud and very scary looking! We are here to put your fears to rest! These tools are simple and were made to make your dental visit pain-free.

The prophy cup polishes teeth after cleaning 

 An explorer detects breaks in enamel

A perio probe measures sulcus depth

 The high speed handpiece prepares teeth for fillings, etc

The slow speed handpiece removes soft decay

The sonic scaler cleans teeth quickly and easily

The Micro Air-Abrasion handpiece prepares teeth for fillings

 The high velocity suction removes water quickly

 The slow speed suction keeps the mouth dry

 The curing light is used to harden white fillings

The air/water syringe squirts air and/or water

Takes diagnostic x-rays of your teeth 

Click here to HEAR what sound each instrument makes!

These tools help make modern dentistry possible! You can come for your dental appointment without worry of pain!

Here are some antique dental tools that, thankfully, no longer are used!

Douglas Lever: a combination of elevator and forceps

Clockwork Drill: the first drill that could rotate continuously to remove damage from a tooth

Civil War era set of dental forceps: the drill in the center telescoped to work on the root of the tooth being extracted. Can you believe that during this time, the dental anesthetic still had not been popularized?! Ouch!

If you have any questions about what instruments Omni Dental uses or how we use it, please feel free to check out our website or give us a call at 512-250-5012

Check out this article for a more in-depth look at antique dental tools: http://gajitz.com/the-whole-tooth-5-truly-terrifying-antique-dental-tools/

Splinting Teeth

Healthy Teeth Are Strong and Steady
In their normal state, teeth surrounded by healthy supporting structures exhibit very little mobility. Mobility can be defined in this case as movement of the teeth. Pushing on the teeth with dental instruments may cause the tooth to be deflected slightly from the "at rest" position, but this movement will be very, very slight.

Why Teeth May Need To Be Splinted
When the supporting bone is compromised and affected by periodontal disease, the teeth will show more mobility. If the tooth or teeth are subjected to trauma, they can be loosened in their sockets. Bruxing and grinding habits can also loosen teeth.

Teeth that are not too severely damaged by trauma will return to their former stability. Temporary splinting of the loosened teeth to each other or to other undamaged teeth may be required.

If the mobility is caused by clenching or grinding of the teeth, adjustment of the bite (occlusion) and the fabrication of a protective antigrinding/bruxing appliance may be indicated. In this case, no splinting of the teeth would be required.

The most common reason for splinting teeth is mobility cause by periodontal disease. The teeth show more movement as the bone support for the teeth diminishes. Multi-rooted teeth (molars) often show less mobility than single-rooted teeth with the same amount of bone loss. But the need for treatment is just as important. The more mobile the teeth, the more damage has been done, and the more splinting will be necessary.




The Splinting Procedure

Fixing periodontal disease

The first step in elimination of tooth mobility is to begin to correct the periodontal problem. If the teeth are mobile, the periodontal problem is probably advanced and the corrective measures could be both involved and time-consuming. Splinting may be started immediately. It involves attaching the mobile and perhaps non-mobile teeth together with a wire, acrylic, or a combination of the two. Attaching the teeth together gives them all more strength. Splinting has a limited life expectancy and must be repaired or replaced periodically. There is often a fee separate from the initial splinting fee associated with these procedures. You will be informed as to what your particular condition requires for short- and long-term therapy.

A more extensive form involves splinting the teeth together with cast and cemented restorations - crowns, bridges, bonded metal retainers, etc. This type of splinting will last much longer and is more expensive. The purpose is the same as that of external splinting - to attach the mobile teeth together so that they derive more strength and move less.

Teeth that are splinted will also require different and more involved brushing and flossing on your part. We will demonstrate these procedures for you.

Fees
Costs for splinting procedures vary greatly. It will depend on the number of teeth to be splinted, severity of the mobility, prognosis of the teeth, and the type of splinting selected.

If you have any questions about splinting teeth, please feel free to ask us.

Dentin Decay

Detect decay by inspecting the color and hardness
Usually, dental decay is fairly easy to detect. When a cavity is just beginning, it is typically identified by a brown or white color or a change in the translucency of the enamel of the tooth. The dentist or dental hygienist uses a special dental instrument called an explorer to feel the suspect area and check its hardness. If the area is hard, in other words, if no break in the enamel layer is detected, we feel there is not a cavity present. If, however, the surface feels soft and the explorer "sticks" in the suspect site, we feel a cavity is present.

Fluoride makes our enamel stronger, but dentin decay is harder to detect Because of the widespread use and availability of fluoride in our drinking water, foods, and oral care products, we are seeing a different decay pattern. The appearance is different from the typical pattern of decay and more difficult to detect. As the outer surface of the enamel absorbs fluoride (from toothpaste, for example), the enamel becomes very resistant to demineralization and eventual decay. If there is a small break in the integrity of the enamel, a pit or groove where decay-causing bacteria can live, the bacteria can dissolve the enamel in such a way that the hole in the enamel cannot be detected. Once the decay-causing bacteria reach the underlying dentin, the acids eat away at that substance and quickly make a large cavity - but one that still cannot be easily seen or detected. In this way the enamel becomes undermined. A dentist looking at such a small cavity would think it very easy to restore. However, once the decayed portion of the enamel is removed and the dentin becomes visible, the true extent of the damage becomes obvious. The small cavity becomes a big cavity.

One of the major problems with decay that appears to occur only in the dentin is in the detection. If a radiograph is taken a part of the periodic examination process, we may be able to see dentin decay if it is moderate to extensive. Decay seen on radiographs is typically two to seven times greater in the tooth. Modern high-speed radiographic film and reduced x-ray exposure makes it more difficult to detect early decay on radiographs.

You can prevent decay by using fluoride
The conscientious application of a source of topical fluoride, through either an over-the-counter dentifrice or a prescription fluoride product, and thorough plaque removal are essential. Bonded sealants are also an effective protection against dentin decay. We strongly advice these procedures. Periodic examinations at intervals recommended by the dentist catch decay at the earliest possible time. This is the only way to keep small problems from developing into larger problems.

Click here to check out our blog post on foods that cause decay. 
Click here for our post on how to prevent decay.

If you have any questions about dentin decay, please feel free to ask us. 

Sealants and Fluoride: Benefit to Adult Patients

Dental decay can develop at any time, regardless of a person's age. A change in diet, change in lifestyle, change in oral self-care habits, the use of prescription medications, or a change in systemic health due to the normal aging process can all affect the caries (decay) susceptibility. Few people remain completely free of decay. Proper oral self-care on your part and properly spaced dental hygiene prevention appointments will go a long way to reduce the opportunity to have new decay to begin.

As you age, it is possible that some of your gum tissue will recede, exposing the root surfaces of your teeth. This gum recession can occur from improper brushing (brushing too hard with a hard toothbrush) or as a result of past periodontal problems. The more a tooth and root are exposed, the greater is the surface area you will have to keep clean. Sometimes the teeth with exposed roots are very hard to keep clean. These roots may be sensitive to temperature changes and are often times uncomfortable to brush. Decreased salivary flow (dry mouth) helps to create a breeding ground for bacteria to accumulate on the enamel and especially on the root surface. And root decay usually progresses quite quickly!

Goal of Prevention
Your goal should be to keep the dentist from drilling your teeth. Any reasonable preventive measure that is available should be seriously considered. When the dentist drills, you lose. When the dentist does not drill, you win.

                               
                                                         Dental Sealants

Please see our blog post on sealants. Although sealants are primarily designed for children, adults who have a history of active decay should consider having sealants placed on the posterior (back) teeth where indicated. We will tell you where it is possible to place the sealants. Even if you have not had a cavity for a long time, consider the application of a sealant as an inexpensive insurance policy for your teeth. Perhaps you would never get decay on the unsealed surfaces. But, just as you insure your home against destruction by fire, a sealant insures the tooth surface from decay. Preventive measures may allow you to avoid having your teeth drilled. You win! 

Topical Fluoride
For a similar reason, we advise the use of topical fluoride treatments for adults. The effectiveness of systemic and topical fluoride in preventing decay is well documented. When a cavity first starts, an application of fluoride might (depending on when it is used) reduce or eliminate the need for drilling.

Fluoride Varnish

An alternative to the fluoride treatment we can provide in our office is a daily rinse. If you can rinse with an over-the-counter mouth rinse containing fluoride every night as directed on the rinse label, you do not need the office topical fluoride treatment. If you cannot rinse daily as instructed, you will need the benefit from the strong office-applied topical fluoride treatment. Your oral health will benefit most from small increments of fluoride that are applied daily rather than one larger concentration every 6 months. However, only you know whether you will be faithful in your rinsing routine. When in doubt, let us do it here.

We stress prevention of dental disease above all else. Sealants and topical fluoride treatments are two of the more important preventive dental measures that we believe will significantly enhance your oral health.