General Dental Procedures

Crowns:

A crown is a permanent covering that fits over an original tooth that is either decayed, damaged or cracked. Crowns are made of a variety of different materials such as porcelain, gold, acrylic resin or a mix of these materials. Porcelain generally has the most natural appearance, although it is often less durable. Zirconia allows more durability while also giving a pleasing aesthetic result.

Crown process:

  1. Numbing the tooth and removing the decay.
  2. Re-shaping the tooth to provide an ideal fit for the crown.
  3. Making an impression of your teeth in order to create a custom-made crown (usually takes two to three weeks).
  4. Making a temporary crown out of acrylic resin to wear while your permanent crown is being made.
  5. Applying the permanent crown (when received from the lab) by removing the temporary crown and fitting the permanent.
  6. After ensuring that the crown has the proper look and fit, the dentist cements it into place.

Bridges:

Sometimes called a fixed partial denture, a bridge replaces missing teeth with artificial teeth and literally “bridges” the gap where one or more teeth used to be. Bridges can be made from gold, alloys, porcelain or a combination of these materials and are attached to 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. Today, implants are also used where a bridge would have been used in the past. Dr. Alexander will discuss with you whether the best treatment for you is a bridge or an implant to replace your missing teeth.

What is involved in a bridge:

  1. Numbing the teeth.
  2. Re-shaping the teeth to provide an ideal fit for the crown and to remove any decay.
  3. Making an impression of your teeth in order to create a custom-made bridge (usually takes two to three weeks).
  4. Making a temporary bridge out of acrylic resin to wear while your permanent bridge is being made.
  5. Applying the permanent bridge (when received from the lab) by removing the temporary bridge and fitting the permanent one onto the teeth.
  6. After ensuring that the bridge has the proper look and fit, the dentist cements it into place.

TMD Treatment:

TEMPOROMANDIBULAR DISORDER (TMD)

Definition

The temporomandibular joint (TMJ) is the joint that connects the jaw to the temporal bones of the skull. Temporomandibular joint disorder, known more commonly as TMD, occurs when there are problems with the muscles and jaws in the face.

Some of the most common TMD symptoms include:

  • Pain in the face, jaw or ear area
  • Headaches (often mimicking migraines), earaches, and pain and pressure behind the eyes
  • A clicking or popping sound when opening or closing the mouth
  • Jaw that “gets stuck,” locked or goes out of place
  • Tenderness of the jaw muscles
  • Swelling of the face

Grinding your teeth and clenching your jaw are more than just anxious habits. In fact, according to the American Dental Association (ADA), teeth grinding — also known as bruxism — can create serious problems for oral health. People who grind their teeth may be unaware of the habit because it typically occurs while they sleep. Bruxism can have far-reaching effects on oral health, including tooth wear and the development of TMJ disorder, but a simple solution is to wear a custom-made mouth guard for teeth grinding. Fortunately, the simplest solution for preventing damage to teeth from bruxism is the use of a professionally made mouth guard. Tell your dentist if you or a family member is known to grind their teeth or clench their jaw. Even if you are unaware of the habit, your dentist may notice it during your oral exam because excessive wear on the back molars and enamel loss both indicate bruxism. A mouth guard for teeth grinding is a custom-fitted oral appliance that is made of plastic. This type of mouth guard is worn during sleep and prevents the teeth from scraping against each other. By addressing bruxism early with professional treatment, you can prevent widespread damage to your teeth. In addition to prescribing a mouth guard, Dr. Alexander may have to restore damaged teeth with crowns or fillings to improve oral function and maintain the proper shape and size of the teeth. Another newer treatment is Botox injections. These injections are outside of your mouth and virtually painless.

At Home Options:

  1. Moist Heat. Moist heat from a heat pack or a hot water bottle wrapped in a warm, moist towel can improve function and reduce pain. Be careful to avoid burning yourself when using heat.
  2. Ice. Ice packs can decrease inflammation and also numb pain and promote healing. Do not place an ice pack directly on your skin. Keep the pack wrapped in a clean cloth while you are using it. Do not use an ice pack for more than 10 – 15 minutes.
  3. Soft Diet. Soft or blended foods allow the jaw to rest temporarily. Remember to avoid hard, crunchy, and chewy foods. Do not stretch your mouth to accommodate such foods as corn on the cob, apples, or whole fruits.
  4. Over-the-Counter Analgesics. For many people with TMJ Disorders, short-term use of over-the-counter pain medicines or nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen, may provide temporary relief from jaw discomfort. When necessary, your dentist or doctor can prescribe stronger pain or anti-inflammatory medications, muscle relaxants, or antidepressants to help ease symptoms.
  5. Jaw Exercises. Slow, gentle jaw exercises may help increase jaw mobility and healing. Your health care provider or a physical therapist can evaluate your condition and suggest appropriate exercises based on your individual needs. A recent study found therapeutic jaw exercises bring earlier recovery of jaw function compared to splints!
  6. Relaxation Techniques. Relaxation and guided imagery can be helpful in dealing with the pain that accompanies TMJ dysfunction. Deep, slow breathing enhances relaxation and modulates pain sensations. Some have found yoga, massage, and meditation helpful in reducing stress and aiding relaxation.
  7. Side Sleeping. Sleep on your side using pillow support between shoulder and neck.
  8. Relax Facial Muscles. Make a concerted effort to relax your lips, and keep teeth apart.
  9. Yawning. Use your fist to support your chin as you yawn to prevent damage to the joint and prevent your jaw from locking open.

Activities to avoid:

  • Jaw clenching.
  • Gum chewing.
  • Cradling the telephone, which may irritate jaw and neck muscles.

Implants:

Dental Implants

A dental implant is an artificial tooth root that is placed into your jaw to hold a replacement tooth or bridge. Dental implants may be an option for people who have lost a tooth or teeth due to periodontal disease, an injury, or some other reason. Dental Implants can also be used to support complete dentures.

What is a Dental Implant Procedure Like?

This procedure is a team effort between you, Dr. Alexander and a surgeon. The periodontist or oral surgeon and Dr. Alexander will consult with you to determine where and how your implant should be placed. Implants are a multi-step process. Once the implant is placed, you will have a healing phase of 3-6 months before a crown can be made. Dr. Alexander can discuss options with you on how to temporarily replace a missing tooth while you are awaiting the permanent crown.

  • Replacing a Single Tooth – If you are missing a single tooth, one implant and a crown can replace it.
  • Replacing Several Teeth – If you are missing several teeth, implant-supported bridges can replace them.
  • Replacing All of Your Teeth – If you are missing all of your teeth, an implant-supported full bridge or full denture can replace them.
Dental Implants

Extractions:

An extraction means to have a tooth removed, usually because of disease, trauma or crowding.

If you need an extraction, Dr. Alexander will first numb the area to lessen any discomfort. After the extraction, we will advise you of what post extraction regimen to follow. In most cases a small amount of bleeding is normal. Your mouth will slowly fill in the bone where the tooth root was through the formation of a blood clot.

For the first few days, if you must rinse, rinse your mouth gently. If you experience swelling, apply a cold cloth or an ice bag and call our office right away. Ask about pain medication. You can brush and floss the other teeth like normal but be gentle around where the tooth was removed.

There are certain teeth and situations that require a referral to an oral surgeon. Dr. Alexander will evaluated prior to the tooth being extracted. If she feels that the tooth requires a referral, Dr. Alexander will explain to you why and get you an appointment with the oral surgeon.

Post Extraction Care:

  • Avoid anything that might prevent normal healing.
  • Don’t smoke or rinse your mouth vigorously.
  • Avoid drinking through a straw for 24 hours.
  • Follow the diet suggested by our office.

Dentures:

Dentures

Dentures are removable appliances that replace missing teeth and help restore your smile. If you’ve lost all of your natural teeth, whether from gum disease, tooth decay or injury, replacing missing teeth will benefit your appearance and your health. Dentures can make it easier to eat and speak than you could without teeth. When you lose all of your teeth, facial muscles can sag, making you look older. Dentures can help fill out the appearance of your face and profile. They can be made to closely resemble your natural teeth so that your appearance does not change much. Dentures may even improve the look of your smile. Dr. Alexander will discuss options with you if you are interested in a denture.

Types of dentures:

Conventional – This full removable denture is made and placed in your mouth after the remaining teeth are removed and tissues have healed, which may take several months.

Immediate – This removable denture is inserted on the same day that the remaining teeth are removed. We will take measurements and make models of your jaw during a preliminary visit. You don’t have to be without teeth during the healing period, but may need to have the denture relined or remade after your jaw has healed.

Overdenture – Sometimes some of your teeth can be saved to preserve your jawbone and provide stability and support for the denture. An overdenture fits over a small number of remaining natural teeth after they have been prepared by your dentist. Overdentures can also be made with implants supporting them. Your dentist can help decide if you are a candidate for implants.

Dentures

Partials:

Partials

Removable partial dentures are used to replace missing teeth. Dr. Alexander will design a partial denture for your needs. A partial denture may have a metal framework and clasps that connect to your teeth, or they can have other connectors that are more natural looking. Crowns on your natural teeth are sometimes needed to improve the fit of a removable partial denture.

Types of partial dentures:

  • Cast Metal Partial Denture – The cast metal partial denture is stronger, less bulky and offers a great fit. This partial has a metal framework to which our laboratory will attach denture teeth.
  • Flexible Partial Denture – The flexible partial is made from a special material that gives you added comfort and fit. It does not have the metal framework which can be more esthetic especially if replacing front teeth.
  • Acrylic Partial Denture – Acrylic partial dentures are more affordable. This partial has an acrylic base into which the denture teeth are set and is attached to your natural teeth with small metal clasps. This partial is also used often times in immediate cases where we are removing teeth and delivering a partial the same day.
Partials