Deep Cleanings

If you're one of the millions of Americans with Periodontal Disease, there is a good chance you have either been offered or received a deep cleaning. You may also still be unclear on what this procedure can accomplish and why we do it. In this article, we hope to remove the mystery from this very beneficial treatment. 

For starters, periodontal disease refers to a state of gum health where the moucosal tissues and/or bone have shrunken away from the teeth. In most cases, this is due to accumulation of hard tartar around the necks of the teeth and down the roots. Patients are left with deep gum pockets that serve as protective space for more tartar to form. 

Healthy gum pockets range between 1-4 millimeters. With a toothbrush and floss, you can reliably clean to about three millimeters of depth. Beyond this, it takes a special set of skills and tools to get the teeth completely clean. If you have healthy gums or inflammation of the moucosal tissues only (gingivitis), a typical "prophy" dental cleaning will serve you well. However, generalized pockets of five millimeters or more will require a deep cleaning, also known as scaling and root planing. 

A quick infographic explaining the transition from healthy gums to disease. An important note- healthy gums can naturally have a pocket of 1-4mm. 

Scaling and root planing is a procedure that is administered to one quadrant of the mouth at a time, as opposed to the "whole mouth" approach of a normal cleaning. You may only have one or two quadrants of teeth that actually require a deep cleaning. To effectively provide this service, we need to numb your gums with some type of anesthesia. This may be in the form of a topical jelly or a traditional injection. We then use a combination of ultrasonic scalers and hand instruments to clean the teeth to the depths of their pockets, removing hard deposits and smoothing the tooth root surface. The ultimate goal of this treatment is to leave behind a healthy, bacteria-free root for new tissue to attach, thus creating a shallower pocket. 

Deep cleanings are ideally only administered once and followed with a tight recall cleaning schedule. However, this depends largely on you body's ability to heal and your own home hygiene practices. It is also important to understand the limitations of a deep cleaning. While you may have a decrease in pocket depth, new bone is impossible to reform without surgery. Additionally, no amount of cleaning will save teeth with severe periodontal damage. To fully appreciate what a deep cleaning can do for your mouth, a complete dental exam with x-rays is absolutely necessary. To schedule an appointment or find out more about the different types of dental cleanings, please give our office a call!

Oral Hygiene for Kids

We know that getting your young ones to keep their teeth clean can be a challenge. However, the effort is definitely worth it: healthy baby teeth assist in the proper positioning and development of the adult dentition. Not to mention starting your children off young sets them up for a lifetime of great oral health, often saving thousands of dollars in dental expenses. Read on to discover how to maximize the protective factors for your child's teeth!

The first baby teeth typically erupt into the mouth between 6 and 18 months. Prior to this, we suggest keeping your child's mouth clean with a wet cloth. Once the teeth erupt, you should start brushing twice a day with a rice-grain sized smear of fluoride toothpaste. After two teeth grow in next to each other, you can begin flossing in this area. At about three years, you can start brushing with a pea-sized portion of paste.  Remember, children typically lack the dexterity to brush and floss their own teeth until they can tie their own shoes. Be careful to monitor how much toothpaste that they are using and make sure they are not swallowing excessive paste. 

The bacteria responsible for tooth decay colonize children at a young age (usually under the age of three). New research suggests that sharing utensils or cleaning dropped pacifiers and bottles with spit during this period can prematurely introduce these bacteria to a child's mouth. While there is a near 100% chance that these bacteria will eventually colonize everyone, delaying them as long as possible may prevent the number and extent of cavities. Once your child is old enough to rinse and spit without swallowing, you can add a fluoride rinse like ACT brand to double down on cavity prevention. 

We recommend bringing your child in for their first dental visit at 12 months of age or when all four central incisors are erupted (whichever is first). This is a short appointment for a general exam and to introduce your child to the dental office setting. If you would like to know more about cavity prevention, children's oral health or dental development, please give our office a call!

Sports Mouth Guards

Nearly 40% of all dental injuries happen while playing sports. While contact sports like hockey and football are the worst offenders, other activities like cycling and skiing carry a certain risk as well. To help prevent or lessen the effect of sports related trauma, we recommend always using a custom mouth guard.

Mouth guards are semisoft retainers molded to either the maxillary or mandibular teeth. They are usually thicker than a nightguard but still soft and compliant when you bite down on them. If you are wearing a guard and fall or receive a blow to the face, it helps distribute the force of impact over a greater area, thus reducing the risk for chipped or cracked teeth. Likewise, the chance of biting through a tongue or lip is reduced by the blunting effect of the soft plastic. Some athletes also subconsciously grind their teeth in intense situations and these guards can protect against this abrasive enamel wear. 

You can buy mouth guards at almost any sporting goods stores. Most of them are of the "boil and bite" variety, where you heat the plastic in a pot of water and bite down on them. These usually work well enough, but we encourage you to bring the guard to your dental appointment and let us examine it. Misshapen guards can irritate the gums or cause mild orthodontic movement of the teeth.

For a "professional" fit, our office can make custom guards for any patient of record. We start by taking an impression of your teeth, create a stone model and vacuum form plastic over the model until a minimally effective thickness is reached. A short second visit is needed to deliver and adjust the guard to your comfort. If you would like to know more about mouth guards, dental trauma or other preventative oral health measures, please give our office a call!

Dental Questions: How Often are Dental X-rays Taken?

X-ray images of your teeth are part of a complete regular dental examination. There is no other way to fully visualize every surface of the tooth and catch cavities before they become big problems. Likewise, they are a crucial step in diagnosing tooth pain during an emergency appointment. In this article, we hope to shed some light on the frequency and number of x-rays we take at our office. Read on for the full story!

For starters, it is important to recognize the relative safety of dental radiographs versus their diagnostic benefits. A full mouth set of x-rays exposes a patient to the same amount of radiation as a trans-atlantic flight. Likewise, if you spent 2 hours in direct sunlight the day of your appointment, you have received the same amount of exposure as a single film. In short, the risk is nearly negligible. However, we still strive to take as few images as possible, only exposing the teeth that absolutely need to be pictured. 

A full mouth x-ray series is composed of about eighteen films (four bitewings and 14 periapicals) that capture every surface of every tooth. Bitewings are used to visualize the spaces in between the molars and premolars and record the bone height around the teeth. Periapicals provide imaging of the root systems, any possible infections and the spaces between the anterior teeth. We usually take a new full mouth series every three to five years and update bitewings every six to eighteen months. These schedules are not set by patient preference or convenience- rather, they are dictated by guidelines from the ADA in accordance with the patient's specific risk for developing new cavities or gum disease. 

Naturally, these guidelines are not hard rules. We may wish to take x-rays more often if we are monitoring a specific tooth or if you come to an emergency appointment in pain. We calculate the need for radiographs very carefully and only recommend taking them when it is crucial to making a proper diagnosis. If you have any further questions about dental x-rays, exams or cleanings please give our office a call!

Specialist Spotlight: Pacific Oral Surgery

At Thousand Oaks Family Dentistry, we are proud of the network of skilled dental specialists we have created. Whether you are in our office or one of our associates’ offices, know that you will be treated with respect, kindness and experience. Today, we would like to highlight Doctors James Jacobs and Sebastian Carlson of Pacific Oral Surgery!

Oral surgeons handle many dental treatments where the teeth and bones have to be modified or removed in an "operating room" environment. Most commonly, they are tasked with difficult extractions, implant placement and bone grafts. Beyond these, oral surgeons perform a wide array of corrective jaw surgeries for cosmetic and developmental concerns.  Doctors Jacobs and Carlson are well skilled in all these disceplines and bring both expertise and the latest technology to every procedure.

Doctors Jacobs and Carlson are both active members of the American Association of Oral and Maxillofacial Surgeons and the California Dental Association. They operate out of offices in Thousand Oaks, Simi Valley and Ventura to best serve you locally. With your referral, make sure to check out their website for a comprehensive list of pre-operative and post-operative instructions, along with articles on what to expect during your surgery. If you have any more questions or would like to know more about your referral, please give our office a call!

Website: http://www.pacificoralsurgeon.com/

Phone Number: 805-497-8571 (Thousand Oaks Location)

Address: (Thousand Oaks Location)

 

Crown Lengthening

A quick overview of crown lengthening. Once the Decay is acessable, a permanent crown or filling can be placed. 

Crown lengthening is a dental procedure most often performed by a periodontist where an incremental amount of bone and tissue is removed from a tooth's gum line. This is most commonly used to reveal more tooth structure and facilitate the placement of a crown. If a tooth has deep decay or a fracture to the bone level, creating a good seal between tooth and crown is impossible. In order to save the tooth, the "crown" (portion of tooth above the gum line) has to be "lengthened," at the expense of the root. Crown lengthening is also performed on the anterior teeth for esthetic reasons. Uneven gum lines and "gummy" smiles can sometimes be fixed through this procedure. Many times, this must be followed up with crowns or veneers to create a cosmetic appearance. 

While crown lengthening allows us to save teeth that would otherwise need to be extracted, it is not without potential drawbacks. Lowering the gum and bone level on a tooth can compromise its long term stability in the jaw. By gaining length in the tooth crown, the roots become gradually shorter and less anchored in bone. This procedure can also negatively affect the adjacent teeth as well. The periodontist needs to create a natural bone contour, and will often need to adjust around the neighboring teeth to make a smooth transition. 

Often times, crown lengthening is only one of a few treatment options. Teeth can also be extruded using orthodontics to create more crown structure. Likewise, a tooth with a questionable longevity can be replaced with a implant in many scenarios. Only a comprehensive dental exam will reveal what can and needs to be done to save a tooth. To schedule an exam or find out about more dental treatment options, please give our office a call!

How Can I Soothe a Toothache?

Note: Never start taking any medication for the first time (even OTC products) without consulting a medical or dental professional first. Never exceed the prescribed dosing for a medication or use it in a method for which it was not designed. 

Toothaches always seem to spring up at the least convenient times. Often enough, they show up 6pm on a Friday before a long weekend. When you can't get to a dentist right away, what should you do about your pain? In this article, we hope to give you some direction (and comfort) in helping your dental woes.

The first thing to do with any type of dental pain is give your general dentist a call. Even after hours, every office should have a means of getting into contact with either your own dentist or one of their associates. An exception to this would be excruciating pain, possibly combined with swelling, fever and warmth around a tooth. In these instances, your first choice should be to head to an emergency room, as this can be the sign of a serious infection. 

Beyond getting into contact with a dental professional, there are a few steps you can take to reduce your symptoms. If the pain feels like it is coming from a tooth directly, we suggest taking an NSAID medication like ibuprofen (Advil). Most dental pain comes from pressure inside the tooth or bones, and is best treated by drugs (such as ibuprofen) with anti-inflammatory properties. We do not suggest taking any left over narcotics you may have on hand, as they are potentially harmful and will not stop the pain as effectively as an NSAID. 

If your pain feels like it is coming from your gums, try flossing gently to see if you can dislodge any stuck food (popcorn kernels are the worst offenders). Beyond this, we recommend rinsing with warm salt water to soothe inflamed tissue. Never try to apply Asprin, Advil or other medications directly to the gums. This will only irritate the tissue and create more pain. We also suggest staying away from topical toothache creams/gels, due to their lack of effectiveness and potentially dangerous side effects.

If your pain has a specific trigger, make note of it and try to avoid using your teeth in that manner. Knowing what causes the tooth to flare up can be an important factor in diagnosing the exact problem. If you would like to know more about toothaches, dental pain or gum pain, please give our office a call! 

Specialist Spotlight: Dr. Lee of Thousand Oaks Endodontics

At Thousand Oaks Family Dentistry, we are proud of the network of skilled dental specialists we have created. Whether you are in our office or one of our associates’ offices, know that you will be treated with respect, kindness and experience. Today, we would like to highlight Dr. Jonathan Lee at Thousand Oaks Endodontics.

Endodontics is the subspecialty of dentistry focused on treating infections and injuries to the nerve of the tooth by performing root canals. here, the tooth nerve is removed and replaced with a resilient filling material called gutta percha. Endodontist may also perform surgical procedures to patch tooth roots or splint teeth after an injury. In his state of the art office, Dr. Lee performs all these procedures (and more!) with compassion and the highest levels of expertise. 

A Conejo Valley native, Dr. Lee completed dental school at USC and his residency at Temple University in Pittsburgh. If you would like to know more about Dr. Lee's office, root canals or why you are being referred to see a specialist, please give our office a call!

Website: http://www.thousandoaksendodontics.com/

Phone number: 805 370 0110

 

Dental Questions: Does the order of brushing and flossing matter?

One of the most common oral health questions dentists receive from patients is the proper order of brushing and flossing. We are here to assure you that there is no recommended order to a standard oral health regimen. As long as you are brushing twice a day for two minutes with fluoride toothpaste and flossing daily, you are experiencing all the benefits of basic home oral hygiene. Dentists typically recommend brushing once in the morning and (definitely) once right before going to sleep/after your last meal. Flossing can take place at any point throughout the day, so long as it happens before you go to sleep. 

Beyond these suggestions, you may want to consider these options as well:

-Brush in the morning before breakfast. Brushing right after a meal can actually damage dental enamel due to the acidic affects of digested carbohydrates and the abrasive nature of toothpastes. 

-Using an alcohol rinse like Listerine after brushing can limit the fluoride activity of toothpaste. If you are at a high risk for developing cavities, consider switching to a fluoride rinse like ACT. 

-Chronic non-flosser? Consider keeping a bag of handle flossers in your car. It's a great reminder to keep those teeth clean!

-While sugar-free chewing gum can help clean/protect teeth, it is no replacement for brushing and flossing. However, a sick of gum after lunch or dinner can help dislodge food and stimulate protective salivary flow. 

We hope you found this guide helpful! If you have any other questions on oral hygiene, flossing, brushing or toothpaste choices, please give our office a call.

Fruit Juice and Baby Teeth

In a recent article, the American Association of Pediatrics has announced that children under the age of 1 year should not be given fruit juice. They propose that juice "offers no nutritional benefits early in life" and that the process of making juice strips fruit of its natural fibers while concentrating sugars. From a dental perspective, fruit juice proposes many threats to developing teeth and can contribute to rampant decay. 

One of the biggest problems with childhood juice consumption is the misconception that fruit juice is "healthy." Whether natural, organic, unfiltered or cold pressed, all commercially available juices are high in dietary sugar. In fact, most rival the sugar content of colas and other soft drinks. This, combined with juice's typically acidic content, makes it a perfect fuel for tooth decay. Liquids are excellent at bathing the teeth, while the sugar content feeds bacteria and acidity weakens enamel. This perfect storm leaves many children with a tell-tale pattern of cavities sometimes known as "Mountain Dew Mouth." 

Small servings of juice once a day (particularly when served with a meal) are generally acceptable from a dental perspective. Multiple servings, putting children to sleep with bottles full of juice and sipping on juice all day (regardless of actual quantity consumed) put a child's dental health at jeopardy. Remember, tooth decay relates to the duration of time consuming a sugary beverage rather than the actual amount of sugar consumed. If you would like to know more about tooth decay, preventing cavities in baby teeth or pediatric dentistry, please give our office a call!