New patients receive a comprehensive examination which includes a screening for oral cancer, gum and bone disease, blood pressure, and systemic disorders. A routine oral exam is performed on established patients to determine any changes in dental and health status since the previous visit.
Your gum tissue is measured with a fine instrument ruler to calibrate in millimeters pocket depth between the tooth and the connective gum tissue around the tooth. Pocket depths more than 4 millimeters, could indicate disease and infection. The deeper the pocket, the greater the extent plaque bacteria collects and infection in gum disease develop.
X-rays are taken as needed.
Tooth scaling and root planing occur as needed.
Routine cleanings also include a professional polishing (Prophy) that removes only the soft sticky plaque that is above the gum line.
Plaque is essentially the start of gum disease problems. Plaque is a build-up from bacteria in the mouth and particles from the foods you eat every day.
Once sugars are introduced to plaque, it turns into a tooth eating acid that sits just above the gum line. If regular oral care isn't standard, the acid will start eating at the teeth producing cavities and the plaque can cause gum disease.
Plaque that is allowed to sit for a prolonged period of time can cause cavities, gingivitis, and other problems in your mouth. If it's left longer than that, serious dental procedures may be required to restore your decaying smile.
Step 1 - Place bristles along the gum line at a 45 degree angle. Gently brush using a circular motion along the outer and inner tooth surfaces.
Step 2 - Brush each tooth individually. Tilt brush vertically behind the front teeth. Using the front half of the brush, use the same circular motion.
Step 3 - Place the brush against the biting surface of the teeth and use a gentle back-and-forth motion. Brush the tongue to remove odor-producing bacteria.
Break off about 18 inches of floss and wind some of it around your middle finger (3 turns). This finger will take up the floss as it becomes dirty. Shorten the length between the two fingers to 6 inches and wind some floss (1 turn) around the opposite middle finger. Hold the floss tightly between your thumbs and index fingers.
Guide the floss between your teeth using a gentle rubbing motion. When the floss reaches the gum line, curve it into a C shape against one tooth. Gently slide it into the space between the gum and the tooth. Hold the floss tightly against the tooth as you gently rub the side of the tooth with an up and down motion. Before retrieving it, clean the adjacent tooth surface.
As you finish cleaning each contact wind the dirty floss once around the first middle finger and slide more new length of floss to proceed to the next contact.
Fluoride is an important part of healthy tooth development and will help prevent cavities.
Fluoride can provide protection from tooth decay in a couple ways:
1) It helps to strengthen the tooth's enamel so it can repel the acid that is formed by plaque.
2) Teeth that have been damaged by plaque can repair and re-mineralize themselves with the help of fluoride.
Fluoride is incapable of repairing already formed cavities, but it does assist in reversing low levels of tooth decay and helps in preventing new cavities from forming.
In order to remove plaque, tartar and calculus deposits from your teeth, a tooth scaling must occur. In some cases plaque and tartar are present below the gum line and a sub-gingival tooth scaling must occur.
After scaling the teeth, roots may need to be planed to smooth the root surface. Soft tissue will re-attach itself to a smooth tooth surface.
Dr. Clements may also recommend medications to help control infection, pain, or to encourage healing.
Dr. Clements treats children. One of the best ways to keep a child cavity free is with proper home care instruction and with sealants. Sealants have been proven to prevent cavities but they do not replace proper hygiene. Ask Dr. Clements, your dentist in Danville if sealants are right for your child.
Looking for Teeth Whitening in Danville? Yearning for a bright youthful smile?
Dr. Clements offers a full range of cosmetic dentistry including professional teeth whitening. Teeth whitening is the #1 requested and performed cosmetic dental procedure. Teeth whitening (sometimes called teeth bleaching) is a procedure that brightens teeth and helps to remove stains and discoloration.
Throughout the day a thin coating of bio film collect on teeth, the bio film can attract stains that can be trapped in the pores of tooth's enamel.
Teeth whitening by a dental professional is key as cavities need to be treated before teeth are whitened. Cavities are problematic because whitening solution can penetrate the cavity allowing decay to reach inner areas of a tooth. People with good dental health may also use a kit to whiten teeth at home. However, in a single office visit, teeth whitening performed by a dental professional will produce brighter results that are more consistent in color across all teeth.
The most common type of home teeth whitening involves placing a gel-like whitening solution, which usually contains hydrogen peroxide, in a tray that resembles a Nightguard or mouth guard. Over-the-counter mouthpieces are unlikely to fit correctly and can cause gum irritation if the whitening agent seeps out. The tray is then placed over the teeth for a certain period of time, anywhere from an hour or two to overnight.
One of the least expensive cosmetic procedures is bonding. The materials used in bonding can be formed and polished to match neighboring teeth. It is most commonly used to improve the appearance of a chipped or discolored tooth or to close small gaps between teeth.
In order to make a filling appear almost invisible to the naked eye, composite fillings are often used. These fillings are designed to match your natural tooth color and are bonded to your teeth, which makes them less likely to fall out. These fillings are used to replace older fillings made of silver or gold. Tooth colored fillings have a more aesthetic appearance, can be completed in one visit, form a strong seal and are less likely to crack a tooth.
Lumineers porcelain veneers offer the painless way to a permanently whiter and perfectly aligned smile. Lumineers are a contact lens-thin 'smile shapers' that are applied to teeth without any grinding or shaving of your natural teeth. Lumineers transform teeth into a naturally beautiful appearing smile that looks perfect for every individual. Lumineers can even be placed over existing crown or bridgework without having to replace them.
- No shots
- No grinding away tooth structure
- Could be a reversible procedure
A veneer procedure is a popular cosmetic procedure. Porcelain is known as one of the best materials for esthetic dental procedures, because it mimics tooth enamel very closely. Veneers are extremely thin (usually less than 0.5 mm thickness), giving them enamel-like translucency, creating a natural appearance. They are about as thick as a contact lens. There is very little tooth preparation before the veneer application.
Porcelain veneers are attached to your teeth using a dental bonding glue or cement. Although veneers are very thin, once bonded to your teeth they become strong. The process is fast and conservative. First, your teeth are prepared and impressions are sent to a dental laboratory along with the design for your new smile. Veneers may be recommended along with other cosmetic procedures in order to produce optimum results.
There are four different choices that you have when it comes to filling a cavity.
1. Composite Fillings - Natural tooth colored filling, bonds to the tooth to provide added security.
2. Silver Fillings - Inexpensive and strong amalgam based filling.
3. Gold Fillings - More attractive than silver and provide for a better fit.
4. Porcelain Fillings - Also called inlays; the most attractive and durable of the tooth colored choices.
An inlay or onlay is a method of repairing a tooth that is somewhere between a filling and a crown. They are used when the tooth is unable to support a filling, but is not damaged to the point that it needs a crown. An inlay is much like a filling but is inserted into the ridges (cusps) of the chewing surface. An onlay is a little more extensive than an inlay and covers multiple cusps of the tooth. Inlays and onlays are commonly made with ceramic or composite materials but can also be made of gold. They are very durable and can last a long time depending on the material used and how well the patient takes care of them with regular brushing, flossing and visits to the dentist.
Crowns are used to restore a tooth to its natural size, shape and color after a large filling or crack in the tooth has compromised the tooth. Crowns are almost always placed after a root canal treatment because the tooth becomes weak and is likely to fracture. A crown will strengthen and protect what remains of the tooth and will improve your smile. Crowns are often made of all ceramic material and in some cases can be made in a single visit.
In order for the crown to be placed on the tooth, 1-2mm of the tooth must be taken away and an impression must be made of the tooth. If the office has the ability to make crowns in a day, it will be made and placed on your tooth in the same visit, otherwise the impression is sent to a lab and your crown is fabricated there. If you have to wait on your crown, a temporary is placed on your tooth and will be replaced with your crown when it arrives. When the crown is placed on your tooth, sometimes it needs to be adjusted a little to make the proper fit. After it is adjusted it is cemented to your tooth and is a permanent solution.
Dr. Clements, your Danville crown dentist will explain your crown options and answer your questions. There are three basic types of crowns:
1) Porcelain outer surface with a metal base crown.
2) Pure porcelain or composite crown.
3) All metal crown, which is usually gold. They all differ in durability, strength, appearance and cost. Select a crown below to learn more about it.
If your smile is in need of a makeover, crowns can provide predictable results. Crowns can give an unattractive tooth back its beautiful shape and color. For smaller or worn down teeth, a crown can restore the natural size of the old tooth. A crown can replace either part of or the tooth's entire structure. For procedures requiring only the areas visible from the outside, a veneer may be an alternative option.
The most conservative approach when attempting to replace a missing tooth is a bonded bridge. It is also often referred to as a Marilyn Bridge. An impression of the area is taken and a new tooth referred to as a pontic is formed. Attached to the pontic on either side are abutments or â€œwingsâ€ that will support the pontic. The most common type of Marilyn Bridge uses abutments that are cemented on the backside of the adjoining teeth and hold the pontic in place where the missing tooth used to be. The adjacent teeth may need to be slightly modified to accept the â€œwingsâ€ of the pontic. The advantage of this type of procedure is that you are not having to put full coverage crowns on the adjoining teeth.
An alternative to an implant is a fixed bridge. With this option it is necessary to grind down the teeth adjacent to the space in order to have caps fit onto the ground down teeth. The caps hold a fake replacement tooth in the middle. With this approach, the ground down teeth are more subject to dental decay and root canals. Furthermore, the teeth are connected together making daily hygiene more challenging. Unlike an implant, the bridge offers no additional biting support.
Dr. Clements, an Invisalign dentist in Danville, often recommends an Invisalign procedure rather than traditional braces. Invisalign is the breakthrough technology that lets you have the smile you've always wanted without the hassle of braces. By using a series of clear, removable aligners, Invisalign straightens your teeth with results you'll notice sooner than you think. The course of treatment involves changing aligners approximately every two weeks, moving your teeth into straighter position step-by-step, until you have a more beautiful smile. And unlike conventional braces, these clear aligners can be removed while you eat and brush your teeth as usual. An average Invisalign course of treatment takes about a year.
|Effectively treats a wide variety of cases, including crowding, spacing, crossbite, overbite and underbite.||X||X|
|Straightens your teeth||X||X|
|Average cost is about $5,000*||X||X|
|Allows you to eat whatever foods you enjoy||X||Â|
|Lets you remove the device when you want||X||Â|
|Lets you enjoy virtually invisible teeth-straightening||X||Â|
|Allows you to brush and floss your teeth normally for better periodontal health||X||Â|
|Consists of smooth, comfortable plastic instead of sharp metal that is more likely to irritate your cheeks and gums||X||Â|
|Frees up your busy schedule, with office visits only every four to six weeks||X||Â|
|Invisalign Teen: Provides up to six free replacement aligners if lost or broken.**||X||Â|
* November 2010 Invisalign Patient Survey
** Invisalign Teen Only
There are many benefits to receiving a dental implant over other forms of treatment:
- Neighboring teeth do not have to be compromised
- Implants allow you to keep your jaw structure
- They look and feel like natural teeth
- Dental Implants can replace partials and are used to secure loose dentures
Do you have missing teeth? It is critically important to replace missing teeth. Eating and chewing with missing teeth can sabotage your bite and lead to incessant discomfort. Missing teeth can give rise to a mouth rearrangement that often results in facial changes that look decrepit.
A single tooth implant procedure may be done if a tooth has been extracted or is missing. A titanium implant base is placed into the jawbone to resemble the tooth root. We allow a period of time for the jawbone to heal over the implant base before fitting for a crown.
Next, an abutment is screwed into the base of the implant to allow for a crown to be fitted on top. Finally, a custom fabricated crown is placed over the abutment to function like a real tooth.
When the extraction of a tooth is required:
1) An incision in the gums is made
2) The tooth is removed
3) The area is stitched up and is allowed to heal
During this time, it is important to think about a tooth replacement option. An extracted tooth leaves an open area in the jaw which, in time, allows the neighboring teeth to drift into the area where the tooth was extracted. This in turn, causes a chain reaction to all the surrounding teeth. Also, if you are considering placing an implant in the future, you should consider asking your dentist to place a bone graft at the time of surgery to preserve the bone width and height.
After tooth extraction, itâ€™s important for a blood clot to form to stop the bleeding and begin the healing process. We ask you to bite on a gauze pad in the tooth extraction area for 30 minutes after the appointment. If the bleeding or oozing persists, repeat the process. After the blood clot forms, it is important not to dislodge the clot. Do not rinse vigorously, suck on straws, smoke, drink alcohol or brush teeth next to the extraction site for 72 hours. These activities will dislodge the clot. Limit vigorous exercise for the next 24 hours as this will increase blood pressure and may cause more bleeding from the extraction site.
After the tooth is extracted you may feel some pain and experience some swelling. An ice pack applied to the area 20 minutes on, 20 minutes off, will keep swelling to a minimum. Take pain medications as prescribed by William H. Clements, D.D.S., Inc.. The swelling will usually subside in about 48 hours.
Use the pain medication as directed. Call the office if the medication doesn't seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time, even if signs and symptoms of infection are gone. Drink lots of fluid and eat nutritious soft food on the day of the extraction. You can eat normally as soon as you are comfortable.
It's important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least twice a day. This will speed healing and help keep your mouth fresh and clean.
After a few days you will feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, continued swelling after 2-3 days, or a reaction to the medication, call our office immediately at (925) 837-4275.
After the Removal of Multiple Teeth
BLEEDING. A small amount of bleeding is to be expected following the operation. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 minutes. If bleeding continues, a moist tea bag can be used for 30 minutes. If bleeding occurs, avoid hot liquids, exercise, and elevate the head. If bleeding persists, call our office immediately. Do not remove immediate denture unless the bleeding is severe. Expect some oozing around the side of the denture.
SWELLING. Use ice packs on the same side of the face of the surgical area. Apply ice 20 minutes on, 20 minutes off, during your waking hours for a maximum of 36 hours only. Ice does not have an effect after 36 hours. Call the office for further assistance.
DISCOMFORT. For mild discomfort use aspirin, Tylenol or any similar medication; two tablets every 3-4 hours. Ibuprofen (Advil, Motrin) 200mg can be taken 2-3 tablets every 3-4 hours. For severe pain use the prescription given to you. If the pain does not begin to subside in 2 days, or increases after 2 days, please call our office. If an antibiotic has been prescribed, finish your prescription regardless of your symptoms.
DIET. Drink plenty of fluids. If many teeth have been extracted, the blood lost at this time needs to be replaced. Drink at least six glasses of liquid the first day. Restrict your diet to liquids and soft foods, which are comfortable for you to eat. As the wounds heal, you will be able to advance your diet.
HOME HYGIENE CARE. Do not rinse your mouth for the first post-operative day, or while there is bleeding. After the first day, use a warm salt water rinse every 4 hours and following meals to flush out particles of food and debris that may lodge in the operated area. (One half teaspoon of salt in a glass of lukewarm water.). After you have seen your dentist for denture adjustment, take out denture and rinse 3 to 4 times a day.
WEARING DENTURES. The removal of many teeth at one time is quite different than the extraction of one or two teeth. Because the bone must be shaped and smoothed prior to the insertion of a denture, the following conditions may occur, all of which are considered normal:
- The area operated on will swell reaching a maximum in two days. Swelling and discoloration around the eye may occur. The application of a moist warm towel will help eliminate the discoloration quicker. The towel should be applied continuously for as long as tolerable beginning 36 hours after surgery (remember ice packs are used for the first 36 hours only).
- A sore throat may develop. The muscles of the throat are near the extraction sites. Swelling into the throat muscles can cause pain. This is normal and should subside in 2-3 days. - If the corners of the mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment like Vaseline. There may be a slight elevation of temperature for 24-48 hours. If temperature continues, notify our office.
If immediate dentures have been inserted, sore spots may develop. In most cases, William H. Clements, D.D.S., Inc. will see you within 24-48 hours after surgery and make the necessary adjustments to relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process.
It is sometimes difficult to get used to your newly placed dentures. They can feel bulky, loose and awkward. In order to make your adjustment period smoother, here are a few guidelines to follow:
- Wear your dentures all the time after you first receive them.
- Never use adhesives on your dentures unless instructed to by your doctor.
- When you go to sleep, remember to always remove your dentures.
- Always brush your dentures after removal and store them in a bowl of water. You can soak your dentures in a denture cleaner as well, but only after you have brushed them.
- If you experience any sore spots, looseness or discomfort please let your doctor know so they can help.
Never try to adjust your dentures on your own, each individual will have a different adjustment period and it will take time for you to become comfortable with your new teeth.
Approximately 40% of your jawbone structure will be gone after wearing your dentures for just six months. You will begin to notice that your dentures aren't fitting the way they used to after a few years of wearing them as well. This is because over the years, the structure of your jawbone becomes unable to support your denture. The same thing happens even if you are wearing a partial denture.
Once the structure of your jawbone is gone, your options for tooth replacement become very limited. Dental implants can stop bone loss and provide your mouth with natural looking teeth before the jawbone structure is completely lost.
Removable partial dentures are composed of a metal framework with plastic teeth and gum areas. The framework includes metal clasps or other attachments, which hold the denture in place. Partial dentures are removed easily for cleaning.
Clasps are C-shaped, I-shaped, and Y-shaped parts of the denture framework that fit around neighboring natural teeth. These teeth may require shaping to help hold the clasps and keep the denture securely in place.
A rather comfortable tooth replacement option is a flexible partial denture. These dentures are made from a composite plastic resin and can include a biocompatible metal for superior strength in some cases.
A precision partial is held in place by a specifically shaped extension that locks into an area on a natural tooth that has been crowned. This ensures that the denture will not slip or come out when speaking or chewing.
An Immediate Denture is designed to be placed in the mouth immediately after the extraction of your natural teeth. An Immediate Denture eliminates the embarrassment of having to go without teeth, while the gums are healing.
An Immediate denture is designed to fit your mouth at the time impressions are taken; however, after a few months your gums will change drastically due to "gum resorption." It's possible that the denture will rub against the gums when it is first placed, which may be very sore until it can be adjusted. Gums shrink the most within the first year of having teeth extracted. Most patients will require relines within a few months, to restore the fit of their dentures. Expect that the first year of wearing dentures will also be the most difficult and costly.
Since an Immediate Denture covers over the surgical site and the tooth sockets, it helps keep that tender surgical area from becoming irritated, much as a bandage would. Do not remove your denture by yourself, even for just a few minutes, until your dentist tells you it's all right. The gum tissue underneath the denture has a tendency to swell. If you take the denture out for very long, you may never get it back in again.
At times, it is necessary for all teeth to be removed due to extensive periodontal disease and/or due to decay. An alternative for the replacement of all the teeth is a complete upper and/or lower denture. These dentures require support from your gum pad and many times require the use of dental adhesive. Throughout life, the dentures require constant adjustment and refitting and can cause the jaw bone to melt away making the dentures loose and once again requiring continuous adjustment.
Research has shown that gum disease can influence heart disease and other health conditions in negative ways. They suggest that gum disease could even be a more serious factor in heart disease than smoking, cholesterol, hypertension and age. One reason for this is the fact that the bacteria found in diseased gums can come loose and move throughout the body. When this bacteria reaches arteries it can cause arterial plaque to build up and harden which in return adversely affect blood flow.
Healthy gums are generally pink and anchor the teeth firmly in place.
One of the earliest stages of gum disease is gingivitis. Gingivitis causes the gums to become swollen and bleed due to the toxins, enzymes and plaque byproducts that are created. In order for your gums to return to a healthy state, treatment from Dr. Clements is required in addition to proper oral hygiene.
When the bone tissue starts to deteriorate, this is known as a form of gum disease called Periodontitis. This happens when the byproducts of plaque attack the tissues that hold your teeth to the bone. The gums begin falling away from the teeth and form pockets in the gums which allows more plaque to collect below the gum line. When this occurs, the patient becomes more sensitive to hot and cold and the roots of the teeth are more vulnerable to decay.
Advanced periodontitis occurs when a major amount of gum and bone tissue has been lost and the teeth are losing more and more support due to the loss of periodontal ligament and bone. Some teeth are unable to be saved and must be extracted. If left untreated, advanced periodontitis can cause severe health problems elsewhere in the body.
Teeth that are suffering damage from gum disease will always be more sensitive to cold and if you avoid cleaning them due to this sensitivity, it can only make the problem worse.
After dental treatment, some teeth may be more sensitive because this is their way of dealing with injury. Injuries to teeth such as cavities, gum infection and jaw clenching can damage the nerves in a tooth. The sensitivity should not last long after treatment as long as your teeth are kept clean, otherwise the sensitivity is likely to get worse. If your teeth are ever extra sensitive, please consult with Dr. Clements as this could be a sign that you need a root canal or gum tissue treatment.
Please feel free to read the most frequently asked questions the we hear asked about pediatric dentistry.
Will you need to give my child a shot to do the dental work?
This is the one of the most commonly asked questions that we get from our patient's parents. We try to minimize the discomfort of the injection by placing a gel that works as a local anesthetic and numbs the tissue were the injection will be administered.
Profound local anesthesia is usually obtained five to ten minutes after the injection, depending on the area of the mouth where the anesthetic was placed. We always check to confirm that the area is numb before we begin to work. In cases of localized infection or trauma (like broken teeth) it is very difficult to obtain profound anesthesia, however we do have other means of supplementing the anesthetic
Younger children, particularly pre-schoolers may interpret the feeling of numbness as pain, and therefore cry. Please follow the postoperative instructions that we give you, in order to minimize complications such as lip biting.
When a baby-tooth changes color, it can mean many things. Baby teeth can and do normally change in color, particularly close to the time that they become loose, however, this change is minimal and should not be confused with a carious lesion (cavity).
The best way to determine if your child has a stain or a true cavity is to take him or her to a pediatric dentist.
Caries is an infectious disease; it progresses if left untreated, and usually is associated with pain (especially when the "cavities" are large). Teeth with cavities typically assume a darker (brown) discoloration, and depending on the extent, may exhibit loss of tooth structure.
Teeth that have been previously "bumped" may also change in color. Traumatized baby teeth can assume a yellow or a dark discoloration, which may or may-not be associated with pain.
Other less common causes of changes in color may be: Fluorosis, food staining (particularly tea or colas), systemic disease (hepatitis), etc.
One of our most common consults occurs when children around the age of 7 begin to lose their lower front teeth. Many of our parents become overly worried about this phenomenon. It is VERY NORMAL for permanent lower incisors (front teeth) to erupt behind their predecessors (baby teeth), however if a baby tooth is not loose by the time half of the permanent incisor has erupted, it may be necessary to pull it.
Crooked or crowded teeth are very common in the growing patient. Even patients that get braces may develop a minor degree of crooked (crowded) teeth, particularly in the front teeth of the jaws, as they grow old.
The first step in determining the need for treatment is what we call an orthodontic consult. During this appointment we may obtain special records and special x-rays of your child's jaw. This information will allow us to make a decision based on predicted growth patterns that your child may show later. In orthodontic terms we refer to this as Early Treatment.
Early treatment refers to ANY orthodontic (braces) or orthopedic appliances (like Headgear) treatment that begins when the child is in primary dentition, or in early mixed dentition (when the first permanent teeth begin to erupt).
Early treatment has been proven to be effective despite objections by some people in the orthodontic community.
The AAPD recognizes that early diagnosis and successful treatment of developing malocclusions can have both short-term and long-term benefits, while achieving the goal of occlusal harmony, function, and facial esthetics.
Baby teeth that have large caries (cavities) and some degree of pain occasionally require that the "coronal" (top) portion of that tooth's nerve be removed before a filling or a crown (preferably) is placed. The main goal of this procedure is to preserve the baby tooth, since baby teeth help to maintain adequate room for the permanent teeth. Pulpotomies have published success rates that range from 60% to 90% and represent a good and reliable way to save a badly decayed baby tooth.