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Bone loss in the jaws and around the teeth can be the result of missing teeth, periodontal disease, or trauma. This bone loss is more than a detriment to oral health and function; it can also alter facial appearance as the support for the natural contours of the face is diminished. 

 When a tooth is extracted, the natural stimulation to the underlying bone that is generated by the forces of biting or chewing is lost.  The fact of the matter is that bone width can be reduced by as much as 25% in the first year following tooth loss. 

By performing grafting procedures, the oral and maxillofacial surgeon can help restore the bone to its original dimensions to maintain facial esthetics, repair the damage caused by periodontal disease as well as facilitate the success of procedures such as the placement of dental implants.  A bone graft provides a platform or “scaffolding” for new bone growth and the material for a bone graft can be derived from the patient, other donor sources or be comprised of synthetic, bone-like materials. 

 Several types of grafting procedures are performed depending upon the particular needs of the case.

A bone graft can be placed immediately upon the extraction of a tooth or some time after tooth loss. Placing a bone graft at the time of tooth removal reduces the amount of bone loss in the area to maintain the hard tissue support that is required for the future placement of a dental implant. When a bone graft is placed awhile after tooth loss, a separate surgical procedure is required to reflect the soft tissue, expose the underlying bone, place a graft and then suture the soft tissue back into place.

For patients lacking a sufficient amount of bone for a dental implant to replace a maxillary back tooth (upper back tooth), a procedure, which is known as a “sinus lift” is performed. During this surgical procedure, the sinus membrane is lifted, and bone graft material is added between the jaw and the floor of the sinus to provide the needed bone height to support a dental implant successfully.

In addition to bone grafting for purposes of ridge preservation or augmentation to allow for dental implants, an aesthetic ridge augmentation procedure to restore the natural contours of the bone is sometimes performed in preparation for fixed bridgework to achieve a more cosmetically pleasing result.

To guide tissue regeneration as well as protect the graft and promote healing, the oral and maxillofacial surgeon may place specialized membranes and biologically active materials over the grafting material.

For patients lacking a sufficient amount of bone for a dental implant to replace a maxillary back tooth (upper back tooth), a procedure, which is known as a "sinus lift" is performed. During this surgical procedure, the sinus membrane is lifted, and bone graft material is added between the jaw and the floor of the sinus to provide the needed bone height to support a dental implant successfully.

Depending upon the needs of the case, one of two types of sinus lifts may be performed:

•  Lateral Window Technique- This method of care involves cutting out and pushing a defined section of the overlying dental bone against the sinus membrane to elevate it. The space that the dental bone and sinus membrane previously occupied is then filled with bone grafting material. Afterward, the area is given several months to heal before the implant is placed.
• Osteotome- With this approach to care, the sinus membrane is elevated, and a bone graft and implant are immediately placed. Following a sinus lift procedure, there may be some swelling and bleeding. Our office will provide complete information on post-op care, follow-up visits, and precautions to take to facilitate optimal healing. 

Dental or oral cysts are typically small saclike growths that can occur on soft tissues inside the mouth, in the jaw, at the base of a tooth root, or atop the crown of an unerupted wisdom tooth. While they may remain small and not cause any initial symptoms, cysts can get larger, become a source of discomfort and damage, or become infected over time. For all these reasons, it can be necessary to remove the cyst and have it evaluated to determine if any abnormal or cancerous cells are present. When a cyst gets infected, it’s considered an abscess. Characterized by pain and swelling, an abscess requires prompt attention and care.

You can feel confident your oral health is in the best of hands in our office. Our skilled and experienced oral and maxillofacial surgeons provide comprehensive care to address a broad spectrum of needs while protecting your health and well-being.

At the office of Dental Specialty Associates, we utilize the latest diagnostic and treatment technology to save teeth in which the dental nerve and vital inner tissues have been compromised. Our goal is to preserve the health and integrity of your natural smile while supporting your overall well-being.

You can rest assured that your oral health is in the best of hands at our office! As performed by our endodontist, a root canal procedure offers the best way to save your tooth, alleviate your discomfort, and get you back on the road to oral health. We utilize state-of-the-art technology to diagnose the underlying cause of your problem and deliver the highest quality of care.

In addition to using advanced 3D imaging systems that provide the most detailed views of your teeth and jaws, our endodontist performs procedures assisted by an operating microscope, which offers superior illumination and magnification of the inner portions of a tooth. By using this advanced equipment, our endodontist can visualize even the most complicated root anatomy and minute defects.

Providing Advanced Diagnostics And Precise, Gentle Care

As the first step in care, our endodontist thoroughly reviews your medical and dental histories and discusses the symptoms you’re experiencing and their location. A comprehensive clinical exam, including taking diagnostic images and performing other tests as indicated, follows next. Based on this thorough evaluation of your case, our endodontist provides an accurate diagnosis and presents your best treatment options.

If you have a referral form from another dentist, please bring it with you to the first appointment. We value patient input and encourage you to tell us if you have any particular concerns or any questions that you would like to discuss at this time.

Patient Care And Comfort Are Our Top Priorities

While all procedures are performed under local anesthesia, we also offer patients anxious about dental visits or particular procedures additional options in sedation dentistry. Dental sedation helps ensure a patient’s comfort while reducing anxiety and providing a more relaxing and comfortable experience.

At the office of Dental Specialty Associates, we’re dedicated to providing the highest quality of skilled and compassionate care. For more information on our office and the many services we provide, give us a call today.

What is a root canal?

Root canal therapy is a very common dental procedure. According to recent statistics in the United States alone almost 41,000 root canals are performed every day and close to 15 million are done over the course of a year. Because it has high success rate, a root canal procedure is considered one of the most effective methods of saving and retaining a tooth that has been severely compromised by dental decay or injury.

Your teeth are much more than just the hard outer biting surfaces and the roots. Inside of each one is a central chamber that contains connective tissue, a nerve supply, and blood vessels. Collectively these core tissues, known as the dental pulp, help your tooth to grow and mature before it emerges into the mouth. Once your tooth is in place, the dental pulp provides nourishment, keeps the tooth vital, and alerts you of problems. Having sensitivity to various stimuli like biting down and eating or drinking hot or cold items is a warning from the nerves inside your tooth that dental decay is present, dental trauma has occurred, or an infection is brewing. The degree of pain that you experience depends on the extent of the damage and nerve involvement.

If your dentist informs you that a tooth needs a root canal, it is because the dental pulp has become irreversibly damaged or has died. However, if enough intact tooth structure remains and there is healthy bone support around the compromised tooth, you do not need to have the tooth extracted. A fully developed tooth does not require the dental pulp to remain functional. You can preserve your natural tooth by having your dentist perform a root canal on the tooth.

It is important that when a root canal is recommended, you begin care promptly. Delaying the procedure increases the risk of more widespread symptoms developing. Left untreated a dental infection can develop or worsen and have serious consequences to your overall health

How is a root canal performed?

With the modern dental instruments and advanced techniques available today having a non-surgical root canal procedure is often as comfortable as getting a routine dental filling. While some root canals can be completed in one visit, others may involve 2 or 3 appointments. How long it takes depends on factors such as the number of canals in a tooth, their anatomyand whether an active infection is present. If it is determined that the tooth is not a candidate for a root canal procedure, or if complications develop during or after care that have an impact on the prognosis of your tooth, the dentist will inform you.

During a non-surgical root canal procedure your dentist will remove the diseased dental pulp, clean the internal portion of your tooth, and then fill all the prepared canals with a biocompatible filling material. Non-surgical root canal therapy is typically performed under local anesthesia, but additional options like nitrous oxide, IV and oral sedation are available to reduce any anxiety that may be associated with dental procedures.

What happens after treatment?

Once your root canal therapy is completed and the tooth is symptom free, you are to return to your restorative dentist. Our office will send your dentist a record of your endodontic care. Your restorative dentist may then recommend placing a permanent restoration like a crown on the tooth. This will protect the tooth and give it back its appropriate natural form and function.

How much will it cost?

While the cost varies depending on which tooth is involved and the complexity of the case, saving a tooth by means of a root canal procedure is a wise investment. With proper maintenance and care teeth that have been treated with root canals can last a lifetime.

If a tooth has been completely knocked out or avulsed from its socket, it's essential to contact our office as quickly as possible for care. With prompt treatment from our skilled professional team, an avulsed tooth can often be reinserted into the socket and saved.

Saving the tooth depends on proper handling and prompt care.

Rescuing an avulsed tooth depends largely upon the length of time it's out of the mouth and how the tooth is handled and stored. For one thing, the tooth must be handled carefully to prevent further damage. Try to handle the tooth by its uppermost portion, the crown, and avoid touching the root. If the tooth needs to be cleaned, hold it by the crown and ever-so-gently rinse it with milk or water. Do not attempt to dry the tooth manually.

While it's essential to handle the tooth carefully to avoid further damage, you also need to keep the tooth moist. You can place the tooth in milk or store it between your gums and cheek. If you're concerned that your child cannot safely maintain the avulsed tooth between the cheek and gums, have them spit some saliva into a cup and maintain the tooth that way.

Without forcing it, you can also try to place the tooth back into the socket gently. However, if you can't or are reluctant to do this, you can maintain the tooth as instructed above until you get to our office. Remember, time is of the essence. To re-implant and save the tooth requires immediate care.

Stabilizing the tooth as healing takes place

Once placed back into the socket, we typically splint the tooth to the adjacent ones to give it the stability required for healing. Since the tooth's nerve and blood supply is damaged when the tooth is avulsed, a root canal will be needed. Our endodontist will determine if a root canal procedure needs to be performed right away or later. Whatever the case may be, our office will schedule follow-up visits to closely monitor the tooth's health, stability, and healing.

Dental emergencies can come about in any number of ways. Your discomfort may be due to an injury to the oral facial area, the acute flare up of a longstanding problem, or the result of the sudden onset of seemingly inexplicable pain. Whatever the case may be, urgent dental care is needed to provide you with relief and to avoid any further consequences to your oral health or function, as well as your overall well being.

There are many reasons to seek emergency dental care, including severe toothaches, chipped or fractured teeth, a dental abscess, impacted teeth, loose or broken fillings, lost or dislodged crowns, broken dentures and more. While the pain of a toothache is one of the more common reasons that patients come to our dental office for emergency dental care, we also promptly treat emergencies that are not necessarily painful like crowns that have been dislodged and broken dentures that leave embarrassing gaps in one’s smile.

Whether your dental emergency is painful, if it affects the appearance of your smile, or if you suspect that an infection is present, contact our office immediately for care. We will make every effort to see you as promptly as possible.

Your first visit to our office is very important with regard to establishing your oral health baseline. We will begin by carefully reviewing your medical and dental histories and taking special note of all of your dental concerns, as well as any symptoms that you may be experiencing. This will be followed by a thorough clinical examination, including an oral cancer screening, periodontal evaluation, an analysis of your occlusion (bite) plus a thorough examination of your teeth, their supporting structures, and the complete orofacial area. Any needed diagnostic dental films will be taken at this time.

As part of your child's dental prevention program, dental sealants are often recommended to protect their permanent back teeth from developing dental decay. In fact according to the American Dental Association, dental sealants reduce the risk of cavities in molars by approximately 80%.

While establishing a good oral hygiene regimen, maintaining proper toothbrushing habits, and avoiding sticky sweets are essential for the prevention of dental decay, children's teeth often need more protection. The reason for this is that the deeply grooved chewing surfaces of the back permanent teeth can be difficult for a child to keep free of leftover food and cavity-causing bacteria. Moreover, young children do not always brush their teeth, as often or as thoroughly as they should, making them particularly vulnerable to dental decay.

Dental sealants afford additional protection from dental decay by providing a strong plastic-like protective coating for the chewing surfaces of a child's permanent back teeth. They basically fill in the pits, fissures and grooves on these teeth to seal out harmful bacteria and food particles. Beyond preventing the development of cavities, sealants may also be useful over areas of incipient dental decay to stop further damage from occurring.

Applying dental sealants is a relatively quick and painless process. They are simply brushed on in a series of steps during a child's dental visit and then cured (set) with a light wand. Sealants are strong and durable and can last for several years. The condition of your child's dental sealants will be evaluated at each checkup and reapplied if the need arises.

At our office, we take pride in creating and maintaining beautiful and healthy smiles for our younger patients in an environment that is lighthearted and fun. With an emphasis on establishing oral health habits that last a lifetime, we offer a comprehensive program of preventive care and closely monitor the dental health of our pediatric patients as they grow.

As an added level of protection to guard against childhood dental decay, we recommend periodic fluoride treatments and the application of dental sealants on the biting surfaces of the newly erupted permanent back teeth.

Orthodontic Treatment

A healthy, functional, and attractive smile requires teeth that are straight and jaws that are well aligned. While some people have a naturally well-aligned smile, many seek orthodontic treatment to correct overcrowded teeth, a gapped smile, or teeth that have drifted out of position due to extractions, harmful oral habits, and abnormal bite patterns. In some cases, orthodontic treatment goes beyond moving the teeth into their correct positions. Orthodontic care can also address the cosmetic and functional problems associated with skeletal discrepancies between the upper and lower jaws.

Orthodontic treatment utilizes customized appliances to apply controlled, incremental forces that gently move the teeth into proper alignment. While conventional metal braces were once the only option in care, patients today have several choices. Thanks to advances in technology and innovations in care, a wider selection of treatment systems is available. These days, orthodontic appliances are far less bulky, much less noticeable, and more comfortable than earlier generations of braces.

The type of orthodontic treatment and the length of time a patient undergoes care varies, depending on the nature of the case. Orthodontic treatment ranges from the minor movement of a single tooth to the alignment of an entire bite. Although certain corrections can be achieved in a few months, more extensive ones can take a couple of years.

At the office of Dental Specialty Associates, we understand all aspects of oral health and the cosmetic requirements of a beautiful smile. We’re passionate about what we do and remain dedicated to helping every patient enjoy the benefit of a great looking and healthy smile. We offer a comprehensive selection of dental services to help both adults and children improve the alignment, appearance, and health, of their smiles.

The Importance Of A Well-Aligned Smile

There’s more to a straight smile than the sheer beauty of it. Well-aligned teeth support good oral health, optimal jaw function, and contribute to your overall well-being. Although every smile is different, the potential consequences of teeth that are either overcrowded, have spaces between them, have shifted, or don’t come together in an ideal way remain the same.

Here are some reasons why a well-aligned smile is more than just an attractive asset:

1. Straight teeth are easier to keep clean. Simply put, it’s easier to brush and floss your teeth. With fewer inaccessible nooks and crannies for food to get trapped, your risk of tooth decay and gum disease is lower.
2. Teeth that meet correctly and are not crowded, stick out, or protrude, are protected, as they should be by the lips and soft tissues surrounding the mouth. They are less vulnerable to trauma, getting “knocked out” or damaging fractures.
3. Straight teeth make all manner of oral function easier. The result is that you can bite into your food, chew, and speak, without difficulty or impediment.
4. Teeth and jaws that are well-aligned mean less wear on the teeth. When teeth don’t line up or meet as they should, they often exhibit uneven and excessive areas of wear.
5. A good bite supports temporomandibular joint health and function. A less than ideal occlusion can affect your oral function and comfort. TMJ disorders are associated with a wide range of problems, including headaches, jaw pain, difficulty opening and closing your mouth, as well as other types of head and neck pain.
6. With good oral health and well-being mutually dependent upon each other, a well-aligned smile is essential to overall wellness.

What Type Of Braces Are Right For Your Smile?

At the office of Dental Specialty Associates, we provide integrated care to help children and adults enjoy the benefits a well-aligned, beautiful, and healthy smiles. Whether your visit to our practice is for a dental checkup or consultation visit, we’ll assess the look, health, and function of your smile and advise you if orthodontic treatment is right for your smile.

We also keep a very close watch on your child’s developing smile and will let you know the best time for an orthodontic consultation and care. From checking the emergence of the baby teeth, jaw development, and oral habits to the premature loss of a baby tooth and the eruption and alignment of the permanent teeth, we carefully monitor your child’s smile as they grow.

Even though the best time to begin care is as a growing child, the truth is that one is never too old for orthodontic treatment. Today more and more adults choose orthodontic care with successful, healthy, and satisfying treatment outcomes.

However, with all the choices in types of braces and systems of care marketed today, it can often feel confusing which approach is best. Whether or not fixed, conventional braces, aligners, removable appliances, or other care offer the best way to achieve optimal and timely results depends on several factors.

Which type of braces provide an effective approach for achieving healthy, attractive, and stable results depends on several factors, including: 

• The severity of the malocclusion or bite problem
• The degree of crowding or spacing of the teeth
• If dental extractions are required
• The relationship between the upper and lower jaws
• How long appliances are needed
• If any additional, supportive appliances are required

• Patient compliance with oral hygiene, appliance maintenance, and wear

Innovations And Advances in Care

As orthodontic treatment has become more widely available, and the appearance of braces has improved, the number of people getting orthodontic treatment has skyrocketed. Over four million people in the United States alone wear orthodontic braces, with 27% of this number being adults.

In the past few decades, advances in care have facilitated more precise treatment planning with appliances that are less bulky, more efficient, and increasingly cosmetic.

Some of the most notable innovations in care include the following:

• Smaller and streamlined bracket metal bracket design
• Clear, cosmetic brackets
• Self-ligating braces
• Lingual Braces
• Clear Aligners
• 3-D Imaging with CBCT
• Digital Impressions
• Intraoral Scanners and 3-D Planning Software
• Temporary Anchorage Devices (TADs
• Accelerated Orthodontics

Orthodontic Treatment With Clear Aligners

Since their arrival on the scene over two decades ago, clear aligners have revolutionized the delivery of orthodontic care. Continuing to soar in popularity, this innovative method of care offers many patients a more discreet, comfortable, and convenient solution for improving the alignment of their smiles.

Treatment that’s virtually invisible to the outside world

Custom-made to the exact specifications of a patient’s smile, clear aligners are designed to gently and incrementally move the teeth into their correct positions. As patients swap out one aligner for the next one in the prescribed series, they’re able to witness progressive improvements in their smiles. Best of all, with treatment that is virtually invisible to the outside world, no one but the patient knows they are undergoing orthodontic care.

Now that orthodontic care has entered the age of aligners, more patients are deciding it’s time to straighten their smiles.

By transforming smiles with minimal interference to daily activities, clear aligners allow patients to enjoy eating all of their favorite foods and engage in recreational activities without the fear of breaking their orthodontic appliances or sharp poking wires. Moreover, as the aligners are completely removable, there’s no need to struggle to brush and floss in between orthodontic brackets and wires. 

While clear aligner therapy is a solution for every type of malocclusion, orthodontic treatment with this innovative method of care offers an excellent option for many image-conscious teens and adults. 

At the office of Dental Specialty Associates, we maintain a position at the forefront of advances in care to provide patients with the highest quality services. Whether you are a candidate for treatment with clear aligners, or another method of orthodontic care, we’ll help you achieve a well-aligned and attractive smile.

Orthodontic treatment for children

While some children require early intervention or an initial phase of care, most youngsters begin orthodontic treatment between the ages of 9 and 14. At this time, they are generally in the mid to late mixed dentition stage. This means they have a mix of permanent front teeth, permanent molars, and some baby teeth.

The benefit of placing braces at this stage is that the orthodontist can improve the alignment of permanent front teeth, guide the incoming new adult teeth into position, and utilize the child’s growth and development to the best advantage.

Braces are generally worn for one to three years with an average treatment time of two years. If a child requires a space maintainer, habit control therapy, or exhibits significant jaw disharmony, treatment may begin earlier.

After orthodontic appliances are removed retainers are worn for a period of time to stabilize and maintain the results.

For adults seeking orthodontic care

With the wide variety of orthodontic treatment options available to adults, the process of wearing braces is more convenient, more comfortable, more efficient, and much less conspicuous than ever before. Bulky metal braces are truly a thing of the past. The latest generations of metal appliances are substantially smaller and less unsightly than their predecessors. Moreover, an adult interested in orthodontic care can select braces that are hardly visible at all. Today’s tooth-colored ceramic braces, lingual braces, or removable clear aligners can all effectively deliver treatment to achieve successful and pleasing outcomes of care.

For adults seeking orthodontic care, it’s essential to keep in mind that achieving a successful outcome relies on healthy teeth and supporting bone. Adults seeking treatment sometimes exhibit the damaging consequences of uncorrected bites and poorly aligned teeth. Because their teeth are so jumbled and hard to clean, they may have extensive dental decay, display signs of gum disease, exhibit bone loss, or even had extractions. They may also suffer from worn-down teeth or TMJ joint dysfunction.

While it’s critical to address outstanding dental issues before the start of orthodontic care, it’s also important to continue maintaining the health of the teeth and surrounding tissues both during and following treatment.

Although adult orthodontics requires an investment of time and resources, the payoff is well worth it. The value of a healthy and attractive smile is priceless. Thanks to modern orthodontics, having teeth that look good and function well is something that can be enjoyed at any age.

Maintaining A Beautiful Smile

Everyone who has worn orthodontic appliances can attest that the day their braces or appliances are removed is a happy and gratifying time. Achieving a beautiful, well-aligned, and functional smile is the ultimate reward for having made a commitment to orthodontic care.

Almost every individual who has undergone orthodontic care will need to wear some type of retainer for a prescribed period of time. Retainers help to protect the teeth from relapse.

One of the reasons retainers are needed is because the teeth have a tendency to move back towards their original positions. The delicate fibers connecting the teeth to the jawbones have elastic memory. Once orthodontic appliances are removed, these fibers want to rebound to their natural positions and move the teeth out of their new alignment. Wearing retainers allow these fibers to reorganize in their new positions and to reset their memory.

Retainers are also extremely important because the teeth are part of a complex masticatory system and subject to forces that cannot always be predicted or controlled. Even after orthodontic treatment, any number of things such as tongue or lips postures, unfavorable growth of the jaws, oral habits, and periodontal problems can disrupt teeth alignment.

Remember, the benefits of orthodontic treatment can last a lifetime. Committing to wearing retainers is the best way to preserve your smile and to keep your teeth as straight and beautiful as the day your braces were removed.

Preserving and stabilizing the result of your orthodontic treatment is known as “retention” and the appliances used for this purpose are called “retainers”.  Almost every individual who has undergone orthodontic care will need to wear some type of a retainer.

There are two major kinds of orthodontic retainers. A removable retainer is one that can be taken in and out of the mouth, while a permanent retainer is fixed or bonded to the back of the teeth. Before removing your braces our orthodontist will explain which of the available retainer options you will need to maintain your smile.

Removable retainers come in two forms. A Hawley retainer is the most traditional orthodontic retainer. It is typically an acrylic based appliance with a single wire that sits in front of the teeth to maintain the corrections along with some small clasps to stabilize it in the mouth. The other type of removable retainer is a vacuform “invisible” retainer, which is called an Essix retainer. This retainer looks similar to a clear custom bleaching tray or dental aligner. It is made of a thin transparent plastic that is fabricated to precisely fit over the teeth and prevent any unwanted shifting. While a Hawley retainer has the advantages of being quite durable and easy to adjust, an Essix retainer is less visible and can be easier to adapt to wearing.

In some cases a fixed retainer may be recommended to maintain a corrected smile. A fixed retainer is a special thin wire that is bonded to the back of the front teeth. It remains in place all of the time and does not show at all when you smile. This type of retainer is a good option when there’s a high risk that teeth could revert to their former position, especially the lower front teeth. A fixed retainer provides excellent stability, but requires extra care to keep the teeth and gums around the appliance clean.

At the time your retainers are inserted, we will provide you with detailed guidelines for wearing these appliances as well as directions as to how to clean and care for them.