Gum Disease/Periodontal Disease

Some form of gum and bone disease is present in most adult mouths.

Periodontal disease is unrecognized because the condition is generally painless and slow in progression. Symptoms include red, inflamed gums, which bleed easily with brushing and flossing, bad breath and teeth becoming loose as condition worsens.

The supporting structures of the teeth including the gums and bone are termed Periodontium.

Gum and bone breakdown begins at the gum line with gingivitis and progresses to the more severe periodontitis. When oral hygiene is neglected and poor over all health is encountered, gum disease begins.

Gingivitis is a mild inflammation of the gum tissue when food deposits, dental plaque or the more calcified calculus are allowed to remain on the teeth.

Periodontitis is when food deposits, plaque and calculus continue to remain on the teeth, over time the bone begins to degenerate. This condition is termed Periodontitis.

As bone surrounding the root degenerates, teeth loosen, drift, migrate eventually leading to the loss of tooth. Proper treatment can still save most teeth.

Gum Disease Treatment Alternatives:

The success of conservative gum disease treatments rests on significant coordination and cooperation between the patient and the dental professional. Periodontal health can be stabilized with conservative treatment alone but in some cases the more invasive conventional therapy is required.

Conventional Periodontal Therapy is usually surgical. It involves gently lifting away the gum tissue from the affected teeth, removing and root planing the calcified calculus, re contouring the irregularities on the root and bone surfaces and carefully placing back and securing the reflected tissue. After a healing period and maintenance of good oral hygiene, the periodontal condition can be improved or stabilized.

Prevention of gingival and periodontal disease only requires optimal oral hygiene practices, healthy diet and a restriction on tobacco and alcohol use.

Maintenance of periodontal health may require more frequent dental hygiene visits and adherence to individual hygiene recommendations made to you by the dental professional.

Oral Health is Important to Overall Health Maintenance. Let Smile Artistry, a trusted dentist in Chino, help you achieve your best smile yet!

Visit wwwsmileartistrychino.com for additional information

Cracked teeth

A good one third of the population has a problem with clenching and grinding of their teeth.

Human teeth are subjected to enormous forces in the mouth and as a result cracking teeth is unavoidable, especially as we age. Cracked teeth are painful and can occasionally cause loss of the tooth.

To understand the various types of cracks and appreciate the variations in treatment options, a basic understanding of the tooth anatomy will be helpful

Cracks in enamel only are generally asymptomatic and require no real treatment. Almost all adults have cracks in the enamel of teeth. These are caused by eating hard foods, biting accidents, contact sports and aging. Some preventative measures include softening hard foods before biting into them and avoiding hard and brittle foods like peanut brittle, corn nuts and chewing ice.

Cracks in dentin cause sharp pain when biting especially when there is contact on the cracked portion of tooth. Contact with sweets also causes lingering pain. Cracks in dentin above the gum line are easily corrected by removing the cracked portion of tooth and placing a crown covering the tooth including the cracked defect.

Cracks in dentin extending below the gum line require a surgical modification of the surrounding bone away from the fracture line and a subsequent placement of crown. This combination of treatment can become questionable if crack extends deep down into the root surface, especially when exact extent of crack cannot be determined. Tooth removal and replacement with implant or bridge can be an alternative.

Cracks into pulp can be very painful and usually need immediate attention. Conservative treatment options are of limited value and generally involve removal of tooth and replacement with a bridge, implant or removable prosthesis. Sometimes, a root canal therapy is performed and root temporarily restored and observed for several weeks and if asymptomatic, restored with a more permanent crown. If pain persists, an extraction becomes necessary.

Only superficial cracks can be left with no treatment. Most cracked teeth require treatment as soon as pain is experienced. Early treatment can mean less invasive and less expensive treatment. 

If you are concerned about a fracturing or a cracked tooth, feel free to call our office for a no obligation 10 minute consultation. Call 909 627 6699 or visit www.smileartistrychino.com

Our Raffle Winner is...

Congratulations Diane!!! 
You are the winner of our $100 VISA Gift Card Raffle! 

Envious???

Make sure you are receiving emails from our office so you are updated about our promotions and contests. If you don't receive emails from us, but would like to, please let us know so we can add you to our newsletter recipients list. You can add your email by submitting a request to 

lovemydentist@gmail.com or you may call our office and a team member will assist you.

Office Phone Number:  (909)627-6699

\

INVISALIGN

Invisalign  has revolutionized the world of Orthodontics by providing a virtually invisible, predictable and removable treatment option for straightening teeth.

Invisalign involves the use of a custom made series of aligners that gradually shift teeth into better positions in the jaws and mouth. There are no uncomfortable metal brackets to attach or wires to tighten. A new set of sequential aligners are changed every two weeks until the teeth have moved into the pre-planned desired position.

Advantages to Invisalign

Virtually invisible teeth straightening

Easy access to brushing and flossing

Less irritation to gums and cheeks

Minimal disruption to daily life activities and socializing

Attractive orthodontic option for all age groups

Disadvantages to Invisalign

Patient compliance is a huge component in the success of Invisalign treatment

Conventional treatment may work more effectively in some orthodontic cases

Discuss your best option with the dentist.

Benefits of having properly aligned teeth extend far beyond a confident and beautiful smile. Swollen, red gums are often a result of teeth crowding. Unfortunately, they are also signs periodontal disease.Properly aligned teeth allow the healthiest defense against potential periodontal problems and other overall health hazards.

Most dental insurances provide coverage for Invisalign treatment just as they would other orthodontic treatment. In addition, flexible and comfortable monthly payments are also available with Care credit and other third party financing agencies. with

Over three million individuals of all ages enjoying beautiful and confident smiles after Invisalign treatment is a positive testament of its popularity, versatility, comfort and convenience. 

Call Janice at 909 627 6699 to schedule a complimentary consultation

Visit www.smileartistrychino.com for additional practice information.

Teeth Whitening

Do you want your teeth to be whiter? Whitening of teeth is universally desirable and accepted well around the world. It is the most conservative and economical option of improving your smile and self esteem.

There are almost no side effects to this process if the whitening is carried out properly. There can however be too much whitening. A good rule to gauge an adequate white is to match to the shade of white in the eyes.

Some patients also experience sensitivity following whitening but this usually goes away within a few days.

Some tooth shades respond better to whitening than others do.

Discoloration due to a pulp breakdown does respond initially to whitening but the discoloration tends to return over time.

Internal tooth discolorations during tooth development in childhood can often be lightened with some degree of success.

Florosis (excessive floride) can be resistant to significant shade changes but can be aided by whitening

Staining of teeth from a diet comprised of dark color foods such as coffee, tea or chocolate is very easily removed.

Discolorations as a result of aging also noticeably respond to whitening.

Options for teeth whitening:

Veneers and Crowns are a great alternative when the internal discoloration in teeth is significant and whitening is unlikely to significantly lighten the shade. The restorative alternatives are more expensive and extensive but can also correct decay, misshapen and mal positioned teeth.

Bonding is the process of adding a thin layer of resin material over the surface of the tooth to improve shade and minor defects on the surface of the tooth. Although less expensive than a veneer or a crown, bonded restorations can significantly improve esthetics but may discolor over time needing replacement.

At Home Whitening This widely used and hugely successful whitening technique is the most popular one in dentistry. A flexible tray is custom made for your mouth. After adequate instructions are given by the dental staff, you are given hydrogen peroxide to take home with you. Each day you will place a small amount of material into the tray and seat in the mouth for various lengths of time as instructed. The progress is monitored by the dental staff to avoid unwanted effects. Several days later, a significant whitening of teeth is observed. There may be slight sensitivity with the procedure, which goes away in a couple of days.

In Office Whitening is a supervised whitening which takes place within the office. In office whitening uses higher concentrations of hydrogen peroxide compared to at home whitening. The major advantage to doing in office whitening is the result is accomplished much faster but the disadvantage is that there could be more tooth sensitivity because of the rapid pace of whitening. De sensitizers can be applied to the sensitive areas to reduce post -whitening sensitivity.

Cost is moderate for both the options.

A wide range of whitening products are available over the counter (OTC) that produce varying degrees of results. Some work better than others and depend on the degree and the nature of discoloration. In general, OTC products are less effective than the dentist supervised products. Do seek dental professional guidance in selecting the best OTC whitening products to help maintain a shade that blends with your natural teeth and dental restorations. OTC products however, do not have the predictability of professional whitening.

Some degree of whitening is reversed within days of the whitening procedure and stabilizes within a couple of weeks and only slowly progresses towards a darker color overtime. The whitening process may need to be repeated within a year and sometimes months.

Visit www.smileartistrychino.com for details or call 9-09 627 6699 for an appointment.

Snap ON Smile

Is a great smile make- over option that is affordable, easy, reversible and painless that can be used as a temporary or a more permanent enhancement.

Snap on Smiles offer an excellent alternative for missing, crooked, stained or discolored teeth, teeth with spaces where implants, bridges and other restorative alternatives are not an option.

Snap on smile is also a comfortable and affordable alternative to patients unhappy with the fit and feel of a removable partial denture.

Snap on Smile is manufactured using a proprietary dental resin that is thin, yet strong. The processing starts with taking precise impressions of the upper and lower jaw with instructions to the lab of the desired shade and other characteristics of the desired restoration. A second appointment about three weeks following the impression visit is for seating of the Snap on Smile.

Snap on Smiles can be made for upper or lower teeth and have proven to be a life changing and confidence building alternative to the more expensive and invasive restorative options. Maintenance is simple with some specially formulated cleaning and disinfecting solutions. 

Call 909 627 6699 for a free consultation of visit our website for more information www.smileartistrychino.com

MINI IMPLANTS or Small Diameter Implants

Dental Implants are small metal screws that are surgically placed in the bone and are considered the most important innovations in the history of dentistry. 

Many denture patients have difficulty holding their dentures securely in the mouth because of reduced bone quantity. Dental implants have allowed these patients to restore a good fit and function of the dentures.

Types of dental implants:

There are many types of implants and the ones most currently used are the ones in the shape of a root of tooth. Dental implants vary in length and diameter. Small diameter implants are only 2mm in diameter.

Small implants are needed in mouths with significant bone loss where very little jaw bone is remaining to place standard implants Alternatively, patient can undergo bone- grafting to surgically enhance bone formation but many patients prefer non traumatic procedures or overall health may limit surgical intervention.

Uses of small diameter implants:

Retention of Lower complete denture

Retention of Upper complete denture

Retention of Removable Partial dentures

Anchoring Fixed Bridges

Single tooth replacement

The number of small diameter implants necessary to facilitate the above functions depends on the quality and quantity of remaining bone and needs to be addressed on an individual basis.

Advantages of Mini Implant:

Surgery is minor and usually with no complications

Simple placement

Retention of dentures is immediate

Lower cost compared to standard implant options

Almost anyone with an ill-fitting denture is a candidate for mini implants. The difference in the fit and function is immediate and is a source of instant gratification for the patient and the dentist.

Call our office at 909 627 6699  if you would like to schedule a consultation.  Visit www.smileartistrychino.com for our practice information.

Antibiotics and Dental Procedures

The mouth is packed with various strains of bacteria, which in a healthy individual maintain optimal oral health. During daily routines like chewing, brushing or flossing, the bacteria can enter the blood stream but don’t present a problem for most of us  when the immune system is healthy. In compromised health, bacteremia (bacteria entering blood stream) can cause infections elsewhere in the body.

Specific heart conditions and orthopedic implants such as artificial joints have known to be the more vulnerable sites for potential infections. 

Antibiotic prophylaxis, or preventative use of antibiotics prior to a dental visit is recommended in conditions like-

-Artificial heart valves

-History of infection of the lining of the heart or heart valves known as Infective Endocarditis

-A heart transplant

-Congenital heart conditions like Cyanotic congenital heart disease

-Defects repaired with a prosthetic device

The criteria for antibiotic prophylaxis is periodically updated by the American Heart Association and the American Dental Association depending on current research and development. Currently, the AHA recommends prophylactic antibiotics only on patients with a history of endocardial bacterial endocarditis.

American Associations of Orthopedic Surgeons in their revised guidelines no longer recommend antibiotics for patients with artificial joints.

In an abundance of caution, our office coordinates with the patient’s physician to determine the appropriate antibiotic protocol. 

Visit www.smileartistrychino.com to E mail us at lovemydentist@gmail.com

Wisdom Teeth

Wisdom teeth are third molars that normally erupt between the ages of 17 and 21.  Since they are the last teeth to erupt into the mouth, usually at the time of young adulthood; an age associated with budding maturity and wisdom; they are more popularly known as "wisdom teeth".

Wisdom teeth, when properly positioned can add to being able to chew well but are not always necessary for optimal function.  Because of their position so far back in the mouth, they can be difficult to clean.

As we, as a society; evolve into consuming more refined foods, which require lot less vigorous chewing, the need for teeth and the corresponding jaw size diminishes. The Aborigines of Australia, supposedly still have their 42 teeth.!

 Wisdom teeth are often impacted  as a result of the discrepancy in the size of the jaws and the number of teeth.  When impacted, the third molars are trapped beneath the gum and bone and against the teeth in front of them.

 The 3 major categories of impaction are-

Horizontal Impaction or a sleeping tooth is where the third molar grows into the mouth horizontally , heading straight towards the root surface of the second molar. These teeth, unless symptomatic are best left alone.

Angular Impaction  is a third molar growing into the mouth at an angle, only partially erupting and trapping food deposits often resulting in pain, swelling  and infection. These are the teeth most likely to need removal to prevent  pain, infection and teeth migration.

Vertical Impaction is  less common and is generally found when the jaws are under developed. Often, these impactions do not cause any pain and are  discovered in dental exams with radiographs ( X rays).

Wisdom extractions can be  performed under local anesthesia and pain or anxiety- reducing medications are available when appropriate.

Teeth positions have a significant bearing on facial profile and timely removal of  impacted teeth is an important aspect of managing facial forms and dental health.

Visit www.smileartistrychino.com for information on additional services or to schedule an appointment.

Why does my filling need to be replaced?

A tooth that has decay or fractures will need either a filling or other restoration depending on the extent of decay.  Poor oral hygiene, a poor diet, gum recession or a lack of saliva can contribute to tooth decay. Para functional habits like clenching and grinding and traumatic occlusion are usually the cause of teeth fractures.

Choices of restorations

Composite filling: Is a tooth colored plasticed material that is bonded to the tooth when a small area of tooth that is decayed needs to be restored.  This is a popular option considering the capability of matching shades to the tooth, conservative prep design preserving natural tooth and affordability.

Amalgam filling: This option has fallen out of vogue because of potential mercury toxicity, silver color compromising aesthetics and the technique requiring removal of a lot of tooth structure to achieve mechanical retention. Many dental offices no longer offer this procedure.

Onlay/Inlay: Is a lab processed restoration usually chosen when a small area of the tooth needs to be restored with better seal and marginal integrity for long term success. It is a two visit procedure that entails a higher cost for lab fabrication. These can be processed in tooth colored porcelain or gold based on patient preference.

Full coverage crown: restores the entire coronal portion of the tooth and is usually indicated on endodontically treated teeth (root canal), extensive breakdown of tooth from fractures and/or decay. They are lab fabricated and also entail two visits.  Crowns can be fabricated in gold, non precious metal or various porcelains depending on patient preference, cost considerations and aesthetic demands.

 A dental filling usually lasts many years before it needs replacing. However, teeth are subject to constant stress from chewing, clenching and grinding. All of these can cause a filling to gradually wear away, chip, crack or fall out.

Reasons for replacement

Recurrent decay
Fracture of filling
Fracture of tooth
Material upgrade

Regular dental examinations are important to maintain soft tissue health, assess existing restorations and maintain bite and functionality of the mouth.  Detecting a failing filling early can reduce damage to tooth and eliminate the need for more invasive and complicated procedures.

Visit www.smileartistrychino.com or call 909 627 6699  for more information. Feel free to stop by our office on 10th street in Chino, California.

Preventing Bad Breath

Preventing and battling bad breath is essential to self -esteem. Halitosis or bad breath is an unpleasant condition that's a cause for embarrassment. Some individuals with bad breath are not even aware of the problem and interestingly, some who don't have bad breath are convinced that they do( a condition called halito-phobia).

Bacteria that reside in the mouth, especially on the back part of the tongue are primarily responsible for bad breath Teeth and dentures not cleaned properly harbor odor causing bacteria and produce the foul smelling compounds.

Certain foods like garlic and onions contribute to objectionable breath because they contain odor causing compounds that directly enter the blood stream and then transferred t the lungs where they are exhaled. Until the body eliminates these compounds, oral hygiene will only temporarily mask the odor.

Bad breath is also induced by tobacco products including cigarettes, cigars, pipes and smokeless tobacco.  These products also increase the risk for oral and lung cancer.

Dieters can experience bad breath a a result of the breakdown of reserve fat and protein for energy, releasing ketones (organic compounds) in the breath.

Dental and systemic disease are also causes of bad breath. Persistent bad breath and bad taste are warning signs for periodontal disease and may signal other medical disorders like chronic sinusitis, chronic bronchitis, diabetes, GERD ( frequent reflux of stomach contents), oral and pharyngeal cancer, liver and kidney disease.

Dry mouth is another condition associated with bad breath. Normal salivary flow cleanses the mouth and removes odor causing particles. Dry mouth occurs when salivary flow is reduced as a side effect of medications, salivary gland problems , auto immune conditions  and from mouth breathing.

TIPS for Preventing Bad Breath:

Avoid constant use of breath mints and other hard candies that temporarily mask malodor and lead to decay.

Discuss your medications with a pharmacist, physician and dentist to reduce dosage or substitute medications that cause drying of the mouth.

Adhere to dental hygiene recommendations made by dentist and hygienist.

Dental Veneers- Ceramic or Composite- What are the Considerations?

For a discolored tooth, chipped tooth, misshaped tooth or a tooth slightly out of alignment, a dental veneer may be an option.

 An explosion of dental materials and techniques have provided ample solutions to correct the condition and there are several considerations to assess to arrive at the best choice for you..

Age, cost and  durability are usually at the top of the consideration list. Location of the defect, is defect natural or acquired, oral habits, smile line, personality, occupation are other important considerations.

Veneer is a thin covering that is placed over the front of the tooth. Any stain or decay present on any additional surfaces will more likely be better served with a crown or other full coverage restorations making a veneer an inadequate choice.

The age of the patient is another important consideration. A conservative composite veneer is an excellent choice for a tooth is the developing stage. A developing smile which is constantly evolving is best fitted with a composite veneer that is economical and  can be easily modified with changes in shape, shade and configuration, unlike a lab fabricated ceramic veneer.

Ceramic veneers are thin shells made of a strong, stain resistant and durable dental ceramic. A very small amount of tooth structure is removed  to make room for a natural and ideal looking tooth form.This restoration involves more than one visit and is fabricated in the dental lab. Ceramic veneers are the most natural looking with customizable,  polychromatic shades to exactly match and compliment the adjacent teeth- an ideal option for highly visible smiles requiring a confidence boost. These are  the veneers that are highlighted in the much publicized smile make overs. A thorough understanding of the underlying design principles and identifying dental labs and technicians that are detail oriented and take pride in their creations is the key to achieving these results.

Teeth must be healthy and free of decay and active periodontal disease prior to veneer preparation. The process is irreversible once the enamel is removed.

Patients who clench and grind their teeth are not good candidates for veneers, because the thin veneers may chip or break. A plastic dental nightguard is usually recommended to help minimize the stress on the teeth.

No special maintenance is needed other than good oral hygiene each day. Avoid biting fingernails and chewing on hard objects such as pencils or ice to keep veneers well maintained.

Visit www.smileartistrychino.com or call our office at 909 627 6699 to schedule a cosmetic consultation. 

Smile, You're on Intraoral Camera

A tiny new camera allows patients to see the insides of their mouth by projecting the image on a TV monitor.  For many patients, this is the first time they have had a clear view of  the inside of their mouth. And what they are seeing is not always a pretty picture.  Many patients are surprised if not shocked by their oral condition.

An image can be worth a thousand words when motivating patients to improve their oral health.  Once an image is projected on the monitor, the dentist can easily discuss any problems and explain the treatment. 

Because oral conditions can be magnified, this method provides better visibility than direct vision.  Once on the screen, the image can be rotated, saved, printed and sent electronically to family, a specialist or submitted as supporting documentation.

Another valuable and common use of camera is helping patients make cosmetic decisions about their teeth.  The image of a patient's teeth can be projected onto the screen and manipulated to show how the person's smile might look after treatment. Patient's can get a good idea of what the recommended procedure will look like before it is even done.  

Call our office 909 627- 6699  or visit our website www.mydentistchino.com for more information.

Palliative Treatment for Frail and Older Adults (Article 4 of 4)

The goal of palliative treatment is to enhance the quality of life during a painful episode  or for someone with a terminal illness A dentist's role could greatly enhance patient comfort and quality of life as the mouth is often the first site on pain.

  The first step in  palliative oral care is establishing good communication with the patient. With a good understanding of the patient's health circumstance, conducting a thorough oral exam  and asking for symptoms, severity and frequency is very important to determine the most bothersome issue and dealing with it promptly.

The most common oral complaint is dry mouth  If possible increase water consumption or use ice chips if choking is not a concern.. Foam swabs are helpful with providing moisture although not effective for plaque removal.  The swabs can be soaked  in warm salt water or an alcoholfree mouth rinse prior to swabbing the inside of patient's mouth.
 Daily oral hygiene is essential with modifications as needed for the palliative patient. An ultra soft  small toothbrush head can be used to promote comfort.

Candidiasis or fungal infections are common in palliative patients.  Anti fungal gels can be applied if patient cannot rinse.  Dentures can be scrubbed with soap and water and antifungal gel applied on the under surface of denture.

Preserving dignity is important part of palliative care. Maintaining a satisfactory facial appearance may be important to some patients and dentures, if needed should be made.

This concludes the series on dental care for the older adults.  Call 909 627 6699  or visit www.mydentistchino.com for more information.

Prevention and Disease Management for Older Adults( Article 2 of 4)

The rapid growth of population that is 65 and older will profoundly affect dental care in a number of ways.
Risk assessment for this vulnerable group  will help develop the most appropriate prevention plan and treatment strategy.

 Prevention:

Majority of older patients suffer from hyposalivation or Drymouth

Simple preventative remedies  to alleviate drymouth include-

Regular sips of water throughout the day
Limiting number of alcoholic beverages and beverages
Limiting beverages high in sugar and caffeine particularly sodas,juices and sweetened coffee and tea
Avoid spicy and salty foods
Caution using mouth washes containing alcohol
Using  salivary substitutes  such as Oralbalance gel, Biotene Moisturing spray, liquid mouthspray etc
.
In extreme cases, a salivary stimulant may be prescribed which does require consulting with patient's physician. 
Discussion with physician and or pharmacist regarding substitution of medicines causing dry mouth can also be an option.

Caries:
For patients with an increased risk of caries or dental decay, an oscillating tooth brush is best.  Automated toothbrushes remove more plaque than manual brushing alone. It is particularly helpful for patients with limited dexterity and arthritis.

Use floridated toothpaste daily and floride rinses
 Periodic topical application of 5% sodium floride varnish in severe cases of caries.
  This mode is inexpensive, non invasive and shown to reduce decay.

As the old adage goes " an ounce of prevention is worth more than a pound of...."

Visit www.mydentistchino.com or Call 909 627 6699 to contact our office. We are more than happy to help you with your question.

Dentistry for the Elderly (1st of the series)

The aging population is the most important demographic trend.  Nearly 20% of the U S population will be older than sixty five by the year 2030.  As the age of the older adult is upon us, the services rendered should be age appropriate and have lasting value. 

Older adults have the most diverse clinical and physical presentation than any other age group. We could see fully functioning independent adults, frail older adults characterized by numerous medical conditions that impair mobility and dexterity and those who are dependent on help to carry out the normal daily activities.

.  Age is often a primary consideration when developing a treatment plan but it is important to assess each patient’s individual needs and capacities instead of relying on stereotypes of aging. 

The rapid growth of the elderly population affects dentistry in a number of ways. 

1/ the elderly are retaining teeth longer than the previous generation

        Approximately 90% of the seniors who have their natural teeth have    experienced decay with 64 % suffering from periodontal or gum disease.

2/ the body changes that occur with aging often make treatment planning more complex.

3/ medical problems and medications complicate and in some cases exacerbate dental disease.

Limitations in frail older adults create barriers to achieving and maintaining optimum oral health. 

 Visit our website www.mydentistchino.com or Call 909 627 -6699 for more information.

Revisit this site next week for more on prevention and disease management of this vulnerable group.