Author Archives: Debra Carneol

Tooth Whitening Treatments

Everybody loves a bright white smile, and there are a variety of products and procedures available to help you improve the look of yours.

Many people are satisfied with the sparkle they get from brushing twice daily with a fluoride-containing toothpaste, cleaning between their teeth once a day and the regular cleanings at your dentist’s office. If you decide you would like to go beyond this to make your smile look brighter, you should investigate all of your options.

You can take several approaches to whiten your smile:

  • At-home bleaching
  • Whitening toothpastes

What are at-home procedures and products?
There are several types of products available for use at home, which can either be dispensed by your dentist or purchased over-the-counter.

Bleaching solutions. These products contain peroxide(s), which actually bleach the tooth enamel. These products typically rely on percent carbamide peroxide as the bleaching agent, carbamide peroxide comes in several different concentrations (10%, 16%, 22% and 32%).

Peroxide-containing whiteners typically come in a gel and are placed in a mouthguard. Usage regimens vary. Some products are used twice a day for 2 weeks, and others are intended for overnight use for 1-2 weeks. If you obtain the bleaching solution from your dentist, she can make a custom-fitted mouthguard for you that will fit your teeth precisely.

You also may want to speak with your dentist should any side effects become bothersome. For example, teeth can become sensitive during the period when you are using the bleaching solution. In many cases, this sensitivity is temporary and should lessen once the treatment is finished. Some people also experience soft tissue irritation—either from a tray that doesn’t fit properly or from solution that may come in contact with the tissues. If you have concerns about such side effects, you should discuss them with your dentist.

Toothpastes. All toothpastes help remove surface stain through the action of mild abrasives. “Whitening” toothpastes in the ADA Seal of Acceptance program have special chemical or polishing agents that provide additional stain removal effectiveness. Unlike bleaches, these ADA Accepted products do not alter the intrinsic color of teeth. Before doing these, you should ask an expert who has undergone dental assistant training to know which are effective for your teeth.

Composite Fillings

Types of Dental Restorations

There are two types of dental restorations: direct and indirect.
Direct restorations are fillings placed immediately into a prepared cavity in a single visit. They include dental amalgam and resin composite fillings. The dentist prepares the tooth, places the filling and adjusts it during one appointment.
Indirect restorations generally require two or more visits. They include inlays, onlays, veneers, crowns and bridges fabricated with gold, base metal alloys, ceramics or composites. During the first visit, the dentist prepares the tooth and makes an impression of the area to be restored. The impression is sent to a dental laboratory, which creates the dental restoration. Those who need veneers to improve their smile may visit sites like https://www.gentrydentistry.com/veneers to explore their options.

composite filled toothComposite fillings are a mixture of glass or quartz filler in a resin medium that produces a tooth-colored filling. They are sometimes referred to as composites or filled resins. Composite fillings provide good durability and resistance to fracture in small-to-mid size restorations that need to withstand moderate chewing pressure. Less tooth structure is removed when the dentist prepares the tooth, and this may result in a smaller filling than that of an amalgam. Composites can also be “bonded” or adhesively held in a cavity, often allowing the dentist to make a more conservative repair to the tooth.
The cost is moderate and depends on the size of the filling and the technique used by the dentist to place it in the prepared tooth. It generally takes longer to place a composite filling than what is required for an amalgam filling. Composite fillings require a cavity that can be kept clean and dry during filling and they are subject to stain and discoloration over time.

Amalgam Fillings

Amalgam FillingUsed by dentists for more than a century, dental amalgam is the most thoroughly researched and tested restorative material among all those in use. It is durable, easy to use, highly resistant to wear and relatively inexpensive in comparison to other materials. For those reasons, it remains a valued treatment option for dentists and their patients.

Dental amalgam is a stable alloy made by combining elemental mercury, silver, tin, copper and possibly other metallic elements. Although dental amalgam continues to be a safe, commonly used restorative material, some concern has been raised because of its mercury content. However, the mercury in amalgam combines with other metals to render it stable and safe for use in filling teeth.

While questions have arisen about the safety of dental amalgam relating to its mercury content, the major U.S. and international scientific and health bodies, including the National Institutes of Health, the U.S. Public Health Service, the Centers for Disease Control and Prevention, the Food and Drug Administration and the World Health Organization, among others have been satisfied that dental amalgam is a safe, reliable and effective restorative material. One should also learn in prior about prostate cancer symptoms to be on the safer side.

Because amalgam fillings can withstand very high chewing loads, they are particularly useful for restoring molars in the back of the mouth where chewing load is greatest. They are also useful in areas where a cavity preparation is difficult to keep dry during the filling replacement, such as in deep fillings below the gum line. Amalgam fillings, like other filling materials, are considered biocompatible—they are well tolerated by patients with only rare occurrences of allergic response.

Are dental amalgams safe?
Yes. Dental amalgam has been used in tooth restorations worldwide for more than 100 years. Studies have failed to find any link between amalgam restorations and any medical disorder. Amalgam continues to be a safe restorative material for dental patients.

Gold Alloys

Gold Alloy filled toothGold alloys contain gold, copper and other metals that result in a strong, effective filling, crown or a bridge. They are primarily used for inlays, onlays, crowns and fixed bridges. They are highly resistant to corrosion and tarnishing.
Gold alloys exhibit high strength and toughness that resists fracture and wear. This allows the dentist to remove the least amount of healthy tooth structure when preparing the tooth for the restoration. Gold alloys are also gentle to opposing teeth and are well tolerated by patients. However, their metal colors do not look like natural teeth.

Porcelain-fused-to-Metal

porcelain fused to metal toothAnother type of restoration is porcelain-fused-to-metal, which provides strength to a crown or bridge. These restorations are very strong and durable.

The combination of porcelain bonded to a supporting structure of metal creates a stronger restoration than porcelain used alone. More of the existing tooth must be removed to accommodate the restoration. Although they are highly resistant to wear, porcelain restorations can wear opposing natural teeth if the porcelain becomes rough. There may be some initial discomfort to hot and cold. While porcelain-fused-to-metal restorations are highly bio-compatible, some patients may show an allergic sensitivity to some types of metals used in the restoration.

Bridges

BridgeIf you’re missing one or more teeth, you may notice a difference in chewing and speaking. There are options to help restore your smile.

Bridges help maintain the shape of your face, as well as alleviating the stress in your bite by replacing missing teeth.

Sometimes called a fixed partial denture, a bridge replaces missing teeth with artificial teeth, looks great, and literally bridges the gap where one or more teeth may have been. The restoration can be made from gold, alloys, porcelain or a combination of these materials and is bonded onto surrounding teeth for support.
Unlike a removable bridge, which you can take out and clean, a fixed bridge can only be removed by a dentist.

Sealants

Dental sealants are recognized as an effective approach to preventing pit and fissure caries in children. However, the Centers for Disease Control and Prevention reported in 2005 that among children aged 6–19 years, only 32 percent had received dental sealants. The national oral health objectives for dental sealants, as stated in the U.S. Department of Health and Human Services initiative Healthy People 2010, include increasing the proportion of children who have received dental sealants on their molar teeth to 50 percent.

Infection Control

The CDC Guidelines for Infection Control in Dental Health Care Settings—2003 are the standard of care for infection control in dentistry. This report provides recommendations regarding:
1) educating and protecting dental health-care personnel;
2) preventing transmission of bloodborne pathogens;
3) hand hygiene;
4) personal protective equipment;
5) contact dermatitis and latex hypersensitivity;
6) sterilization and disinfection of patient-care items;
7) environmental infection control;
8) dental unit waterlines, biofilm, and water quality;
9) special considerations (e.g., dental handpieces and other devices, radiology, parenteral medications, oral surgical procedures and dental laboratories).

Implants

Tooth ImplantCrowns and conventional bridges or dentures may not be your only options when replacing missing teeth. For some people, dental implants offer a smile that looks and feels very natural. Surgically placed below the gums over a series of appointments, implants fuse to the jawbone and serve as a base for individual replacement teeth, bridges or a denture. Implants offer stability because they fuse to your bone.

Integration of the implants into your jaw also helps your replacement teeth feel more natural and some people also find the secure fit more comfortable than conventional substitutes.
Candidates for dental implants need to have healthy gums and adequate bone to support the implant. A thorough evaluation by your dentist will help determine whether you are a good candidate for dental implants.

tooth implant inside view

What is involved in placing implants?
First, surgery is performed to place the anchor. Surgery can take up to several hours, and up to six months may be required for the bone to grow around the anchor and firmly hold it in place. Some implants require a second surgery in which a post is attached to connect the anchor to the replacement teeth. With other implants, the anchor and post are already attached and are placed at the same time.

After the gums have had several weeks to heal, the next step is begun. The artificial teeth are made and fitted to the post portion of the anchor. Because several fittings may be required, this step can take one to two months to complete.

Dentures

If you’ve lost all of your natural teeth, whether from periodontal disease, tooth decay or injury, complete dentures can replace your missing teeth and your smile. Replacing missing teeth will benefit your appearance and your health. Without support from the denture, facial muscles sag, making a person look older. You’ll be able to eat and speak — things that people often take for granted until their natural teeth are lost.

There are various types of complete dentures. A conventional full denture is made and placed in the patient’s mouth after the remaining teeth are removed and tissues have healed which may take several months. An immediate complete denture is inserted as soon as the remaining teeth are removed. The dentist takes measurements and makes models of the patient’s jaws during a preliminary visit. With immediate dentures, the denture wearer does not have to be without teeth during the healing period.

Even if you wear full dentures, you still must take good care of your mouth. Brush your gums, tongue and palate every morning with a soft-bristled brush before you insert your dentures to stimulate circulation in your tissues and help remove plaque.

Partial Dentures, Removable

Removable Partial DenturesRemovable partial dentures usually consist of replacement teeth attached to pink or gum-colored plastic bases, which are connected by metal framework.

Gum Disease

Gum DiseasePeriodontal disease is an infection of the tissues that support your teeth. Your gum tissue is not attached to the teeth as high as it may seem. There is a very shallow v-shaped crevice called a sulcus between the tooth and gums. Periodontal diseases attack just below the gum line in the sulcus, where they cause the attachment of the tooth and its supporting tissues to break down. As the tissues are damaged, the sulcus develops into a pocket: generally, the more severe the disease, the greater the depth of the pocket.

Periodontal diseases are classified according to the severity of the disease. The two major stages are gingivitis and periodontitis. Gingivitis is a milder and reversible form of periodontal disease that only affects the gums. Gingivitis may lead to more serious, destructive forms of periodontal disease called periodontitis.

It is possible to have periodontal disease and have no warning signs. That is one reason why regular dental checkups and periodontal examinations are very important. Treatment methods depend upon the type of disease and how far the condition has progressed, we suggest contacting your doctor to learn more about all the treatments available. Good oral hygiene at home is essential to help keep periodontal disease from becoming more serious or recurring. You don’t have to lose teeth to periodontal disease. Brush, clean between your teeth, eat a balanced diet, and schedule regular dental visits for a lifetime of healthy smiles.

Some factors increase the risk of developing periodontal disease:

  • Tobacco smoking or chewing
  • Systemic diseases such as diabetes
  • Some types of medication such as steroids, some types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers and oral contraceptives
  • Bridges that no longer fit properly
  • Crooked teeth
  • Fillings that have become defective
  • Pregnancy or use of oral contraceptives

Several warning signs that can signal a problem

  • Gums that bleed easily
  • Red, swollen, tender gums
  • Gums that have pulled away from the teeth
  • Persistent bad breath or bad taste
  • Permanent teeth that are loose or separating
  • Any change in the way your teeth fit together when you bite
  • Any change in the fit of partial dentures

Mouthguards

Use a mouthguard during any activity that could result in a blow to the face or mouth. A properly fitted mouthguard can help prevent broken teeth and injuries to the lips, tongue, face or jaw. It will stay in place while you are wearing it, making it easy for you to talk and breath.
Ask your dentist about having a custom mouthguard made specifically for you. This will fit well and offer the best protection for your smile.

Tooth Extractions

What should you expect when you are scheduled for a tooth extraction?
Your dentist will numb the area to lessen any discomfort. After the extraction, your dentist will advise you of what post extraction regimen to follow, in most cases a small amount of bleeding is normal.

Avoid anything that might prevent normal healing. It is usually best not to smoke or rinse your mouth vigorously, or drink through a straw for 24 hours. These activities could dislodge the clot and delay healing.

For the first few days, if you must rinse, rinse your mouth gently afterward, for pain or swelling, apply a cold cloth or an ice bag. Ask your dentist about pain medication. You can brush and floss the other teeth as usual. But don’t clean the teeth next to the tooth socket.

When having an extraction, today’s modern procedures and follow up care as recommended by your dentist are there to provide you the patient great benefit and comfort.

What should I expect as a new North Liberty Dental patient?

Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It also will help relieve any unnecessary anxiety you may be feeling. New patients can expect to fill out a patient history form as well as our Notice of Privacy Practices form. The information on these forms is necessary to provide the best dental care for you.

Please print off the following forms and fill out for your first visit to North Liberty Dental.

New Patient HIPPA Form
Patient Paperwork

Except for emergency visits, the initial visit is spent conducting a thorough examination which includes:

  • A complete medical history to protect your health.
  • Clinical exam of head and neck, including teeth and all soft tissues.
  • Oral cancer screening.
  • Create a baseline of existing restorations
  • X-rays to detect decay and to determine the condition of the supporting bone.
  • Addressing questions and/or concerns pertaining to your oral health

 

As a result of this careful examination, we can determine a practical treatment plan for you. This plan will tell you what treatment is needed, why it is needed, how much it will cost, and an estimate of how much insurance will cover (when applicable). If there is more than one case of treatment to be considered, each one will be discussed.

At North Liberty Dental, we make every attempt to make dentistry care affordable. We realize and recognize that our high-quality dentistry is not inexpensive, but we want to give every one of our patients an opportunity to say “yes to the best”, so we have set up several options to make comprehensive treatment more affordable for you!

  • Cash, Check
  • MasterCard, Visa, Discover Card and American Express
  • Insurance Assignment (as a courtesy, we will file your insurance claims for you)
  • Payment Plans

Please note that here at North Liberty Dental we collect payment for treatment the day of service. If you have dental insurance we will estimate your co-payment based on the information supplied by your insurance company. If there is a balance after insurance has paid their portion, we will bill you for the remainder, you are responsible for that amount, not your insurance company.

Dental Insurance and How It Works

Dental insurance is a highly complex area that creates confusion for many dental patients. The complexities of dental insurance and the lack of sufficient information provided by some insurance companies make it almost impossible for some patients to properly understand their benefits. Even more confusing is understanding how to properly work with your dental insurance company to achieve the highest level of benefits to which you are entitled.

Dental insurance even if it for cosmetic dentistry procedure is a contract between your employer and a dental insurance company. The benefits that you will receive are based on the terms of the contract that were negotiated between your employer and the dental insurance company and not your dental office. The goal of most dental insurance policies is to provide only basic care for specific dental services. The services selected are based on the cost of the policy to your employer and the negotiated arrangements with the dental insurance company.

Because the benefits you currently have are decided between your employer and the insurance company, many services are not covered. The selection of non-covered services is not based on what you need or want, but is based strictly on the contract with the insurance company.

Unfortunately, some of the services like services for better teeth that you may need or want will not be covered by your dental insurer. Our goal is to help you achieve and maintain optimal dental care, which is not necessarily the goal of your dental insurance company. The goal of the insurance company is to provide only the negotiated benefits for the specifically selected service.

The reimbursement mechanism from your dental insurance company is merely a mathematical formula as to which benefits you will receive and the percentage of the dentist’s office fee that will be paid. We do not want to compromise your care based on restraints placed by an insurance company.

Another fact that most dental patients do not realize is that each dental insurance plan has a dollar amount limitation (maximum) each year. Once this limit is reached, no other services will be covered by your dental insurance company regardless how essential the service may be to your dental health.

Some services are typically not covered by dental insurance companies. These include: cosmetic dentistry, implants, occlusion or bite redesign, and other services. Although these are important dental services that can greatly enhance the quality of life of our patients, dental insurance companies do not feel that they should have to pay for these services. That is why these services are rarely included in contracts with your employer. Although, we are seeing more insurance plans starting to include implant coverage as part of the covered services.

Any time you have a question about your dental insurance, please feel free to ask us. We recognize that dental insurance is becoming more complex and more difficult to understand everyday. This is often due to the quest by dental insurance companies to reduce costs through continual changes. Keep in mind that the dental insurance companies are not concerned about coverage for optimal dental care, but provide coverage for only a limited number of basic services.

Our office remains dedicated to providing optimal care for every patient and working with you to achieve that goal. We pride ourselves on helping you in any way and in continuing to provide the quality of care to which you have become accustomed.