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Apart from the routine checkups, and cleanings we also offer the serves. Please click on the links below for more information.

This is an option for filling the space created by a missing tooth. It is formed to look like the missing tooth, and it takes its place in the mouth. The sides of a bridge use the two surrounding teeth for support, hence the name. A bridge replaces the missing tooth, both functionally and cosmetically. Bridge work is as much an art as it is an exact science. The materials used may be gold alloys, porcelain bonded to metal alloy, or all ceramic material. The choice of material depends on requirements for strength, wear, and/or esthetics.

It is important that a missing tooth be replaced as soon as possible for several reasons. If not treated the teeth surrounding the gap begin to shift inward, creating a whole chain reaction of bad things. Teeth use their neighbors for support, and, with one missing, they start to "fall." As this worsens the bite changes in response to the pressure. This can eventually result in problems with the entire jaw, e.g. TMJ. The surrounding teeth deteriorate and it is just a matter of time before them, too, are lost. Gum disease becomes a serious problem, with the difficulty of treatment increasing as the neglect continues.

Crowns are full coverage restorations that are used to cover a tooth that is likely to break, or is too broken down to be restored with a filling. They are most commonly done after root canal treatment, or when a large filling wears out. The larger the hole made by a cavity that has to be treated, the more likely a crown will be needed. Even after a filling is put in a large cavity, a tooth is more likely to break. Keep in mind that the jaw muscles are the strongest in the human body. Teeth are subjected to tremendous pressures. Crowns ride over the weakened tooth, providing strength and protecting the tooth against breakage. A broken or cracked tooth is a far more serious matter and much more difficult to treat. Crowns prevent this, as well as making for a nice smile.

It takes two appointments to restore a tooth with a crown. In the first any decay is removed from the tooth and it is shaped to accept the crown. Then an impression is made of the tooth for use in fabricating a crown. Between the two visits the crown is made, usually of high-strength porcelain over gold alloy, all ceramic material, or gold. During this time a temporary crown is worn. In the second visit this temporary is removed. Then the permanent crown is adjusted as needed and then cemented in place.

There are different types of dentures, but they share their common function. They replace teeth that have become loose or been lost due to bone loss. When bone loss around the roots of teeth is great enough to loosen them or let them fall out, it's time for dentures. Relax. No one enjoys losing their natural teeth, but you can still eat and talk regularly.

The entire mouth is examined and a determination is made as to which teeth will have to be removed, and which will remain. The loose teeth are then extracted. Dentures are fitted to go over or around whatever teeth remain in the mouth, depending on the type. There is an adjustment period after dentures are placed in the mouth, and it can take some getting used to. But once accustomed to the dentures, all the normal functionality and appearance return and one just carries on as usual. Often implants can be used to further stabilize the dentures.

Fillings are done to remove decay, and replace the affected tooth structure. It is called a filling because new material fills hole that decay left. Now a days most teeth are treated with bonded tooth colored composite resin fillings. Caught early enough, cavities can be treated easily and painlessly. If not treated decay can lead to tooth pain and/or infection, and the tooth would need root canal treatment or extraction.

A dental implant is an option to replace a missing tooth. In this procedure, a small titanium shaft is surgically implanted into the bone and allowed to set. The bone grows around it forming a tight connection, which additionally slows or stops the bone loss that occurs when the root of a natural tooth is missing. Once the implant is firmly set in the mouth, the dentist then works to attach the replacement tooth onto the top of the shaft. This permanent solution has the advantages over bridge work that it does not stress the surrounding teeth for support, and, should the tooth wear out, another can simply be replaced on the shaft.

Implants can also be used as support as part of an implant bridge. This is an alternative to partial dentures, and has several advantages. First, there is no adjustment period to acclimatize the patient who, once the work is done, only feels teeth, not metal supports intruding into the mouth. Second, this slows the bone loss occasioned by missing teeth. Third, there is no discomfort or difficulty in eating. And, best of all, of course, they don't have to be taken out all the time.

We also offer mini dental implants. These implants are about half the diameter of traditional implants are used mainly to stabilize lower dentures. These implants can be placed in one appointment and be immediately used. The cost is 50-70% of standard dental implants. Call for a free consult.

Now, this isn't really a service in itself, it's used to make other treatment more comfortable. This is the famous dental anesthetic. It's safe, has proven effective over a long period of time, and is pleasant. You will be given a mask that allows you to breathe in through your nose and out through your mouth. In about 30 seconds to 4 minutes you will notice a more sedate feeling, and your cheek and gums may go numb. After this any needed local anesthetic is applied and treatment begins. Afterwards, you will be given pure oxygen to breathe for about five minutes to dissipate the effects of the nitrous and return you to a normal state.

The gums, ligaments, and bone around the teeth form the foundation for ones teeth. All structures are also referred to as the periodontium. When the periodontium is not healthy, it jeopardizes the teeth just as a bad foundation would threaten the stability of a house. Signs of unhealthy periodontium (gum disease) may be as follows: gums that are red and bleed easily, persistent bad breath, gums that are pulled away from the tooth, loose teeth, and changes in the position or bite of the teeth. Any of these signs may mean something is wrong. With the proper care, however, it may be possible to return them to a healthy state. This is where appropriate gum treatments come in. If you're having a problem, come in and see us so we can take care of it right away. The treatment usually involves a deep cleaning or root planing done under a local anesthetic, along with local antibiotic agents. If the gum disease gets too severe it may need to be treated through surgery or extraction. This is why it is important to get it treated at the first sign of a problem.

Root canal treatment (also referred to as root canal therapy or endodontic therapy) is made necessary when a cavity is allowed, through neglect, to reach all the way to this pulp. (Regular cleanings and checkups prevent and detect problems early) Sometimes deep restorations or trauma to a tooth may cause the nerve to be damaged to the point it needs root canal therapy, also. Once this occurs the pulp becomes infected, and can even extend through the root tip and begin to eat away at the surrounding bone (this is an abscess). By the time the pulp is infected it must be treated, and cannot heal on its own. It can even weaken the entire immune system. This is dangerous, not to mention very painful. Symptoms that the pulp has become infected may include sensitivity to hot/cold or sweets, pain, swelling, pain to biting or pressure, and a bad taste in the mouth. Sometimes, however, no symptoms are apparent and the person is unaware of any problem until a checkup.

A root canal is then performed to clean out the infected tooth pulp, and disinfect the canals of the tooth. The only other treatment would be to extract the tooth. Once the infection is resolved, the canal(s) are filled in to prevent any further infection. Usually a core build-up and crown is recommended for restoring a tooth that has had root canal therapy.

This is used to fill in narrow grooves in a tooth that cannot be adequately cleaned by brushing. In some cases, the tooth structure has fine grooves or pits which accumulate plaque, not because the person doesn't brush, but because they're too narrow to allow even one bristle into them. These will develop cavities over time, and you don't want that. So the dentist will brush on a coating that seals the grooves and pits, making it possible to brush off all the plaque and keep your teeth healthy.

TMJ stands for temporal-mandibular joint. Temporal, as in temple area of skull; mandibular as in mandible, or lower jaw; joint as in it's where the head and jaw meet. Problems in this joint may be caused by a misalignment of the teeth, trauma, or excess muscle tension. Aside from the two bones that meet there, cartilage buffers them and five muscles are involved in the area. If something goes wrong a good deal of trouble can result.

Dental treatments for the condition can include replacing missing teeth, moving teeth, adjusting the bite, filling gaps between teeth, etc. There is no one solution that is right for all cases. Sometimes a plastic mouthpiece is used to prevent clenching or grinding that is contributing to the problem. If untreated and taken to extremes, surgery may be required to repair a badly damaged joint.

This is the procedure of making teeth whiter, and therefore more attractive. Our office uses custom whitening trays with inserts of a gel paste.

The tray method of whitening involves two separate appointments. At the first appointment, impressions of the teeth will be taken so that an identical model can be made. From this model, the laboratory can make vinyl whitening trays that are custom fit for each mouth, giving a more rapid and intense whitening result. During the second appointment, the trays are fitted and adjusted to comfort. The doctor or dental assistant will give proper instructions for safe use of the at-home whitening treatments also. A 36% carbamide peroxide gel is placed in the trays and the trays with gel are worn for about 30 minutes twice a day. The entire process takes 10-14 of daily use for maximum results. The higher the strength of a peroxide, the greater the likelihood of reactions or tooth sensitivity. The whitening method with custom trays uses a prescription amount of carbamide peroxide. This type of gel is only available through dental offices due to the fact that the process must be monitored by a doctor and instructions must be clearly stated to the patient. For maintenance of whitened teeth, the trays should be used every several months for a 30 minute period. Fluoride treatments following use of the whitening tray can also be used to reduce sensitivity reactions.

This is a focused beam of X-Ray particles through bone which produces an image on special film, showing the structure through which it passed. This gives the familiar black and white images that doctors and dentists use to diagnose problems. X-rays are a necessary part of the diagnostic process, and not to use them could lead to undiagnosed disease. Without an X-ray of the whole tooth, and supporting bone and gum tissues, there is no real way to detect infection or pathology that requires attention.

In our office we use digital radiography which allows us to take X-rays using 50-70% less radiation versus conventional X-rays. This digital technique also allows us to enhance the images for better diagnosis of any dental concerns.

Veneers are a dental procedure in which a covering is placed over the outside (visible area) of the tooth. Veneers are usually only done to the part of the teeth that are visible when talking or smiling. The procedure can be direct or indirect.

The direct technique usually involves placing composite resin on the outside of the tooth using bonding. This method is usually referred to as bonding.

The indirect technique usually involves two appointments because the veneers will be fabricated at a dental laboratory. At the first appointment the teeth are prepared, impressions taken, and the teeth are given a temporary covering. In two to three weeks the veneers are back from the laboratory, the temporaries are removed and the veneers are bonded to the teeth. The laboratory fabricated veneers are usually made using porcelain or pressed ceramic, and are very esthetic.

The advantage of veneers versus crowns is that much less tooth material is removed, and the procedure is less uncomfortable because there is no need for injections. Veneers are recommended for teeth that have large fillings or little tooth structure.

Arestin is an antibiotic placed in the pocket between a tooth and gums to fight infection. Arestin can stop or slow down gingivitis and periodontitis with regular checkups and cleanings. To learn more about this medication please visit:

Oraqix is a type of needle-free anesthesia used when just one area of the gum tissue is too sensitive for treatment. The anesthetic is place around the tooth under the gums and only takes a couple of minutes for full effect. To learn more about needle-free anesthesia please visit:

During their examination of your teeth and mouth it is possible that your dentist will be able to recommend to you various alternative treatments instead of just having a tooth extraction. While having a tooth extracted may be less expensive than the other options proposed it may not be the least expensive in the long run.

When a tooth is missing its neighboring teeth will tend to shift, possibly significantly. Any alignment changes that occur can have a major impact on your dental health. Removing even a single tooth can lead to problems associated with your chewing ability or jaw joint function. Teeth whose alignment has changed can trap food or be hard to clean thoroughly, thus placing them at risk for tooth decay or gum disease.

Take MOTRIN as soon as possible and then 6-8 hours later. TYLENOL #3 may be used in between MOTRIN doses for additional relief. TYLENOL #3 is a narcotic that will make you drowsy – do not drink alcohol or drive when taking it. Take medications with a full glass of water, juice, or milk.

4. Nutrition is very important to the healing process. EATING IS ESSENTIAL. Clear liquids, juice, jello, broth, and soup at room temperature are advised.

5. Refrain from vigorous activity for the first 4-5 days following surgery.

6. If problems out of the ordinary are encountered, please call the clinic.

7. If you have had sedation, please make sure someone is with you for the first 24 hours to take care of you.

24 Hours Following Surgery

1. Begin warm salt water soaks in your mouth, using ½ tsp of salt added to a glass of warm water. Do this 4-5 times a day and after meals for 4-5 days. A mouthwash may be added to the warm water.

2. Brush teeth, but avoid area of surgery for two more days.

3. Begin eating soft, nutritious foods. Resume normal diet as tolerated.

4. Begin mouth exercises, opening mouth as wide as possible about 50 times a day, continuing until normal mouth function returns.

Report any of the following:

1. Persistent bleeding over 24 hours after surgery.

2. Increase in swelling later than the second day following surgery.

3. Increasing discomfort, not relieved by medication.

4. Temperature over 100 degrees F.

FORUM DENTAL EMERGENCY LINE FOR AFTER HOURS: 573-578-0197

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Fluoride:

Fluoride is naturally occurring element found in rock, soil, air and all vegetation because fluoride is a naturally abundance substance in the earth's crust. Fluoride is nature's answer to tooth decay. Fluoride is found in some found in most of the foods that we eat on a regular basis. Many cities and towns are now adding fluoride to their drinking water for an inexpensive, effective way to slow tooth decay in a way that is available to all people of the community.

Discover more about fluoride at: http://www.ada.org/public/topics/fluoride/infantsformula.asp American Dental Association, Fluoride and Fluoridation

Also at: American Dental Hygiene Association, Fluoride Facts http://www.adha.org/oralhealth/fluoride_facts.htm

Fluoride Facts

Fluorine, from which fluoride is derived, is the 13th most abundant element and is released into the environment naturally in both water and air.
Fluoride is naturally present in all water. Community water fluoridation is the addition of fluoride to adjust the natural fluoride concentration of a community's water supply to the level recommended for optimal dental health, approximately 1.0 ppm (parts per million). One ppm is the equivalent of 1 mg/L, or 1 inch in 16 miles.
Community water fluoridation is an effective, safe, and inexpensive way to prevent tooth decay. Fluoridation benefits Americans of all ages and socioeconomic status.
Children and adults who are at low risk of dental decay can stay cavity-free through frequent exposure to small amounts of fluoride. This is best gained by drinking fluoridated water and using a fluoride toothpaste twice daily.
Children and adults at high risk of dental decay may benefit from using additional fluoride products, including dietary supplements (for children who do not have adequate levels of fluoride in their drinking water), mouthrinses, and professionally applied gels and varnishes.
Good scientific evidence supports the use of community water fluoridation and the use of fluoride dental products for preventing tooth decay for both children and adults.
Adjusting the level of fluoride in drinking water first used fluoride as a preventative for tooth decay in Grand Rapids, Michigan. Fluoridation of drinking water has been used successfully in the United States for more than 50 years.
Fluoridation of community water has been credited with reducing tooth decay by 50% - 60% in the United States since World War II. More recent estimates of this effect show decay reduction at 18% - 40%, which reflects that even in communities that are not optimally fluoridated, people are receiving some benefits from other sources (e.g., bottled beverages, toothpaste).
Fluoride's main effect occurs after the tooth has erupted above the gum. This topical effect happens when small amounts of fluoride are maintained in the mouth in saliva and dental plaque.
Fluoride works by stopping or even reversing the tooth decay process. It keeps the tooth enamel strong and solid by preventing the loss of (and enhancing the re-attachment of) important minerals from the tooth enamel.
Of the 50 largest cities in the United States, 43 have community water fluoridation. Fluoridation reaches 62% of the population through public water supplies, more than 144 million people.
Water fluoridation costs, on average, 72 cents per person per year in U.S. communities (1999 dollars).
Consumption of fluids--water, soft drinks, and juice--accounts for approximately 75 percent of fluoride intake in the United States.
Children under age six years may develop enamel fluorosis if they ingest more fluoride than needed. Enamel fluorosis is a chalk-like discoloration (white spots) of tooth enamel. A common source of extra fluoride is unsupervised use of toothpaste in very young children.
Fluoride also benefits adults, decreasing the risk of cavities at the root surface as well as the enamel crown. Use of fluoridated water and fluoride dental products will help people maintain oral health and keep more permanent teeth.

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Gingivitis:

Please visit www.mayoclinic.com to learn more about gingivitis

If your gums are swollen, tender and bleed easily when you brush your teeth, you're not alone — nearly 80 percent of American adults have some form of gum (periodontal) disease. One of the most common of these is gingivitis, which develops when bacteria build up between your teeth and gums, leading to irritation, inflammation and bleeding. If not treated, it can progress to more serious gum diseases such as periodontitis and eventually to the destruction of bone and to tooth loss.

Yet gingivitis is both preventable and treatable. Although factors such as medications and lowered immunity make you more susceptible to gingivitis, the most common cause is poor oral hygiene. Daily brushing and flossing and regular professional cleanings can significantly reduce your risk of developing this potentially serious condition. If you already have gingivitis, professional cleaning can reverse the damage.

Because early-stage gum disease is seldom painful, you can have gingivitis without even knowing it. Often, though, you're likely to have warning signs such as:

Swollen, soft, red gums.
Gums that bleed easily, even if they're not sore. Many people first detect a change in their gums when they notice that the bristles of their toothbrush are pink — a sign that gums are bleeding with just slight pressure.
A change in the color of your gums from a healthy pink to dusky red.

Gingivitis begins with plaque. This invisible, sticky film, composed primarily of bacteria, forms on your teeth when starches and sugars in food interact with bacteria normally found in your mouth. Brushing your teeth removes plaque, but it re-forms quickly, usually within 24 hours.

Plaque that stays on your teeth longer than two or three days can harden under your gumline into tartar (calculus), a white substance that makes plaque more difficult to remove and that acts as a reservoir for bacteria. What's more, you usually can't get rid of tartar by brushing and flossing — you'll need a professional cleaning to remove it.

The longer plaque and tartar remain on your teeth, the more they irritate the gingiva, the part of your gum around the base of your teeth. In time, your gums become swollen and bleed easily.

Although plaque is by far the most common cause of gingivitis, other factors can contribute to or aggravate the condition, including:

Drugs. Hundreds of prescription and over-the-counter antidepressants and cold remedies contain ingredients that decrease your body's production of saliva. Because saliva has a cleansing effect on your teeth and helps inhibit bacterial growth, this means that plaque and tartar can build up more easily.

Other drugs, especially anti-seizure medications, calcium channel blockers and drugs that suppress your immune system, sometimes cause an overgrowth of gum tissue (gingival hyperplasia), making plaque much tougher to remove.

Viral and fungal infections. Although bacteria are responsible for most cases of gingivitis, viral and fungal infections also can affect your gums. Acute herpetic gingivostomatitis, for instance, is an infection caused by the herpes virus that frequently leads to gum inflammation and to small, painful sores throughout your mouth. Oral thrush, which results when a fungus normally found in your mouth grows out of control, causes creamy white lesions on your tongue and inner cheeks. Sometimes these spread to the roof of your mouth, your tonsils and your gums.
Other diseases and conditions. Some health problems not directly associated with your mouth can still affect your gums. People with leukemia may develop gingivitis when leukemic cells invade their gum tissue, for example. Other conditions, such as oral lichus planus, a chronic inflammatory disease, and the rare, autoimmune skin diseases pemphigus and pemphigoid can cause gums to become so severely inflamed that they may peel away from the underlying tissue.
Hormonal changes. During pregnancy, your gums are more susceptible to the damaging effects of plaque. The problem is compounded if you have morning sickness — nausea and vomiting may make it hard to brush your teeth regularly.
Poor nutrition. A poor diet, especially one deficient in calcium, vitamin C and B vitamins, can contribute to periodontal disease. Calcium is important because it helps maintain the strength of your bones, including the bones that support your teeth. The recommended daily allowance for most adults is 1,200 milligrams a day — 1,500 milligrams if you are pregnant or are a postmenopausal woman not currently using HRT. Vitamin C helps maintain the integrity of connective tissue. It's also a powerful antioxidant that counters the tissue-destroying effects of free radicals — substances produced when oxygen is metabolized by your body. Although many fruits and vegetables are rich in vitamin C, you may have low levels of this vitamin if you smoke, you eat a limited diet, or you have an eating disorder such as anorexia nervosa. Infants fed only cow's milk or unfortified formulas are also likely to be deficient in vitamin C.

http://www.mayoclinic.com/health/gingivitis/DS00363/DSECTION=4

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