Braces can either be fixed on the teeth or they can be removable. The removable type of braces usually are for more minor tooth movement so most orthodontic work is done with non-removable braces. If the orthodontist makes a removable appliance for you, you must still wear it almost all the time, except when eating, in order for it to create the tooth movement you want. Taking it in and out frequently lets the teeth move back and it will take a much longer time to get the results you want.
A typical orthodontic case takes around two years but can vary considerably due to the specifics of the individual case. Sometimes young children are treated in two stages, for example, with one to several years in between.
In the past, many patients had some permanent teeth removed in the process of braces. Now, modern orthodontic treatment prefers to keep all of the permanent teeth unless there is severe crowding and there is just no room for all of the teeth.
Braces do not cause decay. Too much sugar and plaque accumulation cause decay. However, braces make it a lot harder to effectively clean your teeth. As a result, we recommend adults and children with braces get their teeth cleaned every three months, use a Water Pik orHydrofloss irrigator to assist in home care and prescription strength home fluoride daily.
The objective of braces is to move teeth into a position where the bite is good, the smile looks great and the teeth are stable so they won’t shift back. Sometimes this is not done and long-term retainers need to be used or the teeth will tend to shift.
There is no easy way to keep teeth clean with braces. We recommend that anyone with braces come for professional cleanings every 3 months, and in addition to a special Prodentec tooth-brush, use a Hydrofloss irrigator.
Many people have strong fears associated with dental care that makes it hard for them to get their work done. Other patients need a lot of work and do not want to have to come for many visits. They want to get it done in the fewest visits possible. In either case, being sedated makes the patients unaware of what is going on and they can get through their appointments with ease and comfort.
Anyone who wants to have dental work done in a state of comfort and relaxation is a candidate for sedation dentistry. Here are some examples of pat
<strong>People who have:</strong>
<li>Had traumatic dental experiences</li>
<li>Difficulty getting numb</li>
<li>A bad gag reflex</li>
<li>Very sensitive teeth</li>
<li>Limited time to complete their dental care</li>
<li>Complex dental problems</li>
<strong>People who …</strong>
<li>Hate needles and shots!</li>
<li>Hate the noises, smells and tastes associated with dental care</li>
<li>Are afraid or embarrassed about their teeth</li>
<li>Disabilities that preclude them from receiving traditional dental services</li>
Oral conscious sedation dentistry works by taking a pill that relaxes you and puts you in a twilight state of consciousness. You alternate between being conscious and drifting off to sleep. And best of all, most people have very little if any memory of the entire dental visit. When you arrive in our office, you will be escorted into the sleep room, covered with a thick, warm blanket and placed on a monitor to watch your vital signs. After you are comfortable, the staff at Dental Care will take care of your dental needs. Then, when your treatment is completed your companion will return you home to finish your relaxing sleep.
With IV sedation our board certified dental anesthesiologist places a small IV in your arm. This allows the doctor to inject the anesthesia medicines that put you to sleep. Just like in a medical procedure, you will be sound asleep the entire time and safely monitored by our team. You are comfortable, pain free and you will have no memory of your dental visit.
With both oral conscious sedation (pill) and IV sedation you will need someone to drive you to our office and home again. They will also need to stay with you for several hours because even though you might feel awake you will be drowsy and if left alone might slip and fall.
You have nothing to eat or drink from midnight on the day prior to your visits. If you take routine medicines you MUST discuss this with the doctor at your consultation visit. Different medicines can interact with each other and it is important that we know anything you take. That includes all vitamins, mineral and herbal supplements of any kind and especially nicotine (in tobacco products) and caffeine (in tea or coffee). Grapefruit juice is to be avoided as well since it contains chemicals that interfere with sedation and many other medicines.
You will be brought to the office by your companion who will receive their instructions as well. They don’t have to stay at the office for the entire time but they will need to give us a phone number so we can call them to come and pick you up when your appointment is complete.
You will be escorted from the office directly home by your companion who must seat belt you into your car and take you into your home and get you comfortable and settled to sleep and rest for the balance of the day. You cannot be left alone because you will still be sleepy for several hours and might slip and fall if unattended. It is very important that you drink lots of water or fruit juice and when any numbness is gone, soft and easy to digest foods are suggested.
We will review the post operative instructions with your companion before you leave the office.
The medicines that we use for sedation are designed to make you comfortable and not aware of your environment. As such you cannot drive a car, operate machinery, stand on a ladder, ride a bicycle or any activity that requires fully conscious awareness or judgment until the next day after sedation dentistry.
That includes making important business or personal decisions. You will need to be accompanied to and from the office directly home where you will spend the remainder of the day sleeping and letting the sedation medicines pass out of your system.
When they return to the office, after the first visit for follow up care most of our patients say something like, “That was so amazing. If I knew it would be so easy, I would have done it years ago.” All of your work can be done with sedation if that is what you prefer. But we will say that many of our patients feel so much better after the first visit that they feel great about having subsequent visits done without sedation. That is of course entirely up to you.
Placing dental implants is a surgical procedure, so there is definitely some mild discomfort after the surgical phase, but generally less than a tooth extraction because it is a precise, gentle controlled procedure. After the initial healing phase passes, there is nothing to be fearful of in so far as pain is concerned.
Placing an implant requires one surgical visit and several follow up visits to check the healing and remove the sutures. The purpose of the dental implant(s) is to replace missing teeth, so in addition to the surgical placement of the implants, the patient must wait 3 to 6 months while the bone heals and then another month or two for the final dental bridgework.
You cannot be too old for dental implants. The issue is your health. As long as you are a candidate for elective surgery, you can have dental implants. A person with medical conditions such as uncontrolled diabetes, heart disease, severe hypertension etc., would not be an appropriate candidate for dental implants.
With regards to being too young, dental implants are usually done for patients whose jaw bones are fully formed, so that would be late teenage years. If you are not ready yet for implants there are temporary options so you don’t have to go without teeth
Medical conditions that would preclude the placement of dental implants would include people with problems healing, such as people with AIDS and people who are not candidates for elective surgery, such as people who have uncontrolled diabetes, severe high blood pressure or heart disease.
Placing dental implants and then putting a cap on it is a great way to replace a missing tooth if you do not want to put caps on the teeth adjacent to the missing tooth, or if there aren’t enough strong teeth to support a fixed bridge near the missing tooth. This is especially true if the adjacent teeth are perfectly healthy, straight, decay free-teeth and the patient would rather avoid capping them.
The disadvantage of the implant is that two surgical procedures need to be done to place the implant and then place the supporting post in the implant so that a cap can be placed to replace the missing tooth. This takes several months. And the cost for a dental implant, plus the post and crown, might be greater than a conventional fixed bridge. If the patient has perfectly good teeth adjacent to the missing tooth, the benefits of not having to cap those teeth may be worth the extra time and expense.
If the teeth adjacent to the missing tooth are crooked, decayed or already have big leaking fillings, and need to be capped anyway, it makes no sense to go through the time and expense of a dental implant and then have to cap the adjacent teeth anyway. Also, if there is not an adequate amount of jaw bone to hold the dental implant, bone grafting procedures may need to be done and the patient would need to evaluate the benefits of the implant approach versus the time and expense of the implants and bone graft.
Dental Implants are way to improve your comfort, health and appearance and that is why at Dental Care of Stamford we have a whole team of cosmetic dentists and surgeons to see what is best for your individual situation and why we offer free consultations. There are times when dental conditions such as bone loss or gum recession may allow a dentist to use a dental implant to adequately replace a missing tooth but not restore the normal shape and contour of the gum tissue. In the back of the mouth, where it doesn’t show, this may not matter. In the front of the mouth, it could result in a chewing success but an appearance failure. That is one reason why dental implants, as great as they are, are not a panacea for the replacement of all missing teeth.
Plaque is a film that accumulates on the teeth and contains bacteria, bacterial by-products and food particles.
Calculus or tartar are the same thing. If plaque builds up on the teeth and is not removed every day, calcium in the saliva may be deposited into the plaque, creating a hard layer on the teeth, not unlike barnacles on the bottom of a ship. If that is not cleaned off by your dentist or hygienist, it encourages more plaque to form and leads to gum disease.
The frequency of professional cleanings depends on the individual. Everyone is different. Some people need more sleep than others to be properly rested, and cleanings are no different. People with good plaque control, daily brushing and flossing and high natural resistance can have cleanings twice a year and still maintain optimal dental health. People with less effective plaque control at home and lower natural resistance need cleanings three or four times a year.
Unfortunately, dental insurance is not designed for optimal health for each person. Two cleanings a year is the insurance minimum. If you need to have four cleanings a year to maintain optimal health, you need to do what is best for you, not the insurance company. To put it into perspective, based on the cost of a typical periodontal cleaning visit, the two extra visits per year will cost less than two cokes or one Cafe Mocha Latte a week.
If you don’t stop the gum problems, it is likely that you will lose teeth. However, gum disease can be successfully treated and controlled with modern state-of-the-art periodontal care as long as you catch it soon enough. Do not wait till it gets so bad that it is too late.
Everything, to some extent, is hereditary including gum problems. But your parents probably didn’t get the best dental care either. Today much more can be done than years ago, so even if you inherited low resistance, you can have healthy gums.
Hormonal changes affect all of the body, including the reaction of our gums to the germs in plaque. In other words, the plaque causes gum problems. The hormonal changes lower the body’s resistance to plaque. Extra flossing and brushing should stop bleeding gums during menstrual cycles and pregnancy.
The best type of brush to use is a soft brush with round ended bristles in the case of a manual brush. Electric brushes are good too, such as the Rotadent. To learn more visit our recommended products for patients.
Today, the most effective toothpastes and mouth washes to fight periodontal disease are the ones that contain chlorine dioxide. There are several brands, most of which have been developed by a dentist and dispensed directly from dentist offices. They are designed to neutralize and break up the volatile sulfur compounds that are made by bacteria to break down the gum tissue. To learn more visit our recommended products for patients.
In the short run, especially for acute gum infections with abscess or pus, you can take antibiotics, but in the long run, antibiotics are not the solution. Effective brushing, flossing and, most importantly, regular dental care is the best answer.
Gum disease rarely hurts. In fact, sometimes the only sign of gum disease is when a patient notices a tooth has become loose or a bad taste develops in their mouth. At that point, it may be too late to save the tooth. Regular cleanings and check-ups are the key to discover these problems before they get too bad.
Yes, it could. Bacteria and bacterial products such as sulfur compounds can accumulate and putrefy. These compounds taste and smell like rotting meat – a most unpleasant taste and smell. Unfortunately, most people cannot smell their own breath and don’t notice the foul taste of gum disease because they get used to it.
Pain in the gums is the result of an acute gum infection. Causes could be gum abscess, or an abscess originating from a tooth. Virus infections such as herpes can make gums sore. Canker sores, cold sores and trench mouth (ANUG) can also make the gums hurt.
No, they don’t cause gums to bleed. Germs cause gums to bleed. However, certain medicines, like anti-convulsion drugs such as Dilantin and blood pressure drugs such as Norvasc, do make your gums more sensitive to plaque that is already there, resulting in more bleeding.
Bleeding gums is a sign of infection but bleeding gums alone do not tell us how extensive the damage is or what treatment is needed. Unless there is an acute abscess, we always start with cleanings, scaling and root planing and, especially, home care instructions. Sometimes that is all that is needed to treat the gum infection.
It could be a sign of a gum infection called ANUG. This also used be called Trench Mouth and typically occurs in teenagers and young adults who don’t brush and floss regularly when they are going through a period of high stress.
Gum recession can usually be prevented by detecting a condition that could cause the recession and then stopping it before recession occurs. Examples of causes of gum recession are gum inflammation that could lead to recession and bone loss, tooth clenching and grinding that can lead to bone loss, developmental defects in the gum tissue or cheek muscles and, rarely, people who brush compulsively with a very hard tooth brush.
Hard brushing with a hard toothbrush could cause gum recession over a long period of time but hard brushing is usually not the problem, especially if you use a soft brush. Gum recession is usually due to other factors such as tooth grinding. To learn more visit our recommended products for patients.
The sensitivity can be treated by fluoride treatment, repairing the gum recession or placing a bonded filling in the tooth, depending on the situation. Finding the cause of the recession is very important so the process can be stopped or it will continue.
Even if there is a filling in the tooth in the receded area, it probably can be fixed. You’ll need to consult with a Periodontist to be sure. The procedure is to remove the old filling or even a crown, graft the gum tissue to fix the recession and, in the case of a crown, make a new one. In the case of a filling, a replacement is usually not needed.
Gum disease can be controlled and slowed down, but in cannot be permanently cured. Anyone with teeth can develop gum disease. If you have already had problems with your gums, you know you have the potential for future problems. However, you do not need to lose your teeth because of it. If you can control the cause of gum disease, your gums can be returned to a state of health and you can consider yourself a “healed periodontal patient”.
Periodontal surgery is done in a case where there is extensive gum disease, bone loss or gum recession. In cases where the gum disease is more moderate, more conservative procedures such as scaling and root planing may be performed.
Loose teeth are a sign of bone loss. A tooth with healthy bone will never be obviously loose. If the damage is not too severe, especially if it is due to tooth clenching or grinding, the damage can usually be reversed by fixing the bite. If the tooth is moderately loose due to bone loss, it is often possible to join it to a stronger adjacent tooth, often with a cap to strengthen it. If it is very loose due to severe bone loss, it may not be treatable at all.
Headaches are a very broad category of problems and include dozens of potential causes. Dental causes of head, neck or facial pain could include cavities, abscessed teeth, gum infection, cysts, tumors of the jaw bones or swollen glands, broken or cracked teeth and TMJ dysfunction syndrome.
TMJ dysfunction is any pain that results from a conflict between the biting surfaces of the teeth and the jaw joints. It is only one specific problem that can occur with the jaw joint. Unless it can be proven that the pain is caused by a conflict between the teeth and jaw joint, it is not TMJ dysfunction.
It could be TMJ dysfunction, but it might not. The only way to be sure is to go to a dentist who has specific training in treating TMJ dysfunction and be tested. TMJ dysfunction is easy to misdiagnose and so you need to be sure the dentist has the pre-requisite training.
Stress does not cause TMJ dysfunction. A conflict between the biting surfaces of the teeth and jaw joint is the cause. Stress can take a patient, who has been tolerating this discomfort, and reduce their tolerance to the point that the pre-existing dental condition begins to cause pain.
Earaches have nothing to do with your teeth or TMJ dysfunction. However, if you put your finger in your ear, you can see how close it is to your jaw joint and teeth. If you open and close your mouth while your finger is in your ear, you can actually feel your jaw joint move. As a result, what may feel like a ear ache may in fact be a jaw joint problem.
If the dentist has ruled out tooth problems, then you need to be checked for TMJ dysfunction by a dentist who is specifically trained in the diagnosis and treatment of TMJ dysfunction. Most dentists have not had this training.
Braces are great but they have limitations. First, your teeth may be straight but there still could be a conflict between your teeth and jaw joints even after braces. Second, things may have shifted since the braces were taken off.
TMJ dysfunction is the pain that results, and can be proven to be caused, by a conflict between the teeth and jaw joints. The pain is actually muscle pain or cramping from the jaw muscles. These jaw muscles wrap around the entire head.
Taking a pill to mask the pain of a headache does nothing to solve the problem. Symptoms can continue to worsen even if it doesn’t hurt. Many patients who wind up with severe jaw problems that may require major surgery started out as a TMJ problem caused by the bite that was not properly treated.
You need to find a dentist with specific training in diagnosing and treating TMJ dysfunction. Most dentists do not have this training so you will need to be very specific in questioning the dentist to determine their qualifications.
If your bite is the problem, braces could be the solution but may not be needed. The objective is to eliminate the conflict between the teeth and the jaw joints and other methods include a bite splint as a temporary measure and reshaping the biting surfaces of the teeth (bite equilibration) as a long term solution.
A bite guard, if it is properly made, will definitely take away pain that is due to TMJ dysfunction, as long as it eliminates the conflict between the teeth and the jaw joint. However, it only works when you are wearing it. As soon as you take the bite splint out, your bite goes back to where it was before, so it is not a long-term solution.
The bite guard they sell in a sports store is designed to act as a cushion to protect your teeth in case of a blow to the face. The TMJ bite splint is not designed to act as a cushion but as a substitute for a properly fitting bite. A properly made bite splint is like when you have a wobbly table in a restaurant. The waiter puts a matchbook under the leg of the table so you have a temporarily stable table. However, when the matchbook is removed, the legs are not equal and the table will wobble again. The solution is to shorten the legs of the table until they are all equal. This is the equivalent of evening the bite by equilbration.