Professional cleanings (dental prophylaxis) performed by your dentist or a certified hygenist form the foundation for preventing gum (periodontal) disease and tooth decay. In a professional cleaning, your dentist or hygenist will:

• Remove plaque from the teeth -- Plaque is a sticky substance that forms in the mouth from food, saliva and bacteria. Plaque sticks to teeth and causes tooth decay and gum (periodontal) disease.
• Remove calculus (tartar) above the gum line -- Calculus is plaque that has hardened on the tooth surface and is difficult to remove. (Calculus below the gum line indicates gum (periodontal) disease and requires a different procedure to remove it.)
• Polish and remove stains from teeth

Dental examinations help to diagnose disease before it becomes hazardous to your health. In addition, regular examinations can save you money by alleviating problems while they are small and before they become expensive to repair, or in some cases, impossible to repair. Your dental examinations generally include the following:

• Oral cancer screening
• Gum (Periodontal) disease evaluation
• Visual examination of tooth decay
• Examination of diagnostic x-rays to see cysts, tumors, invisible decay and other problems that can't be seen by the naked eye
• Evaluation of status of current restorations (fillings and others)

We cannot express enough how important it is to see your dentist regularly. Remember, preventing disease is always better than treating disease.

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Gum disease (Periodontal Disease) is responsible for about 70 percent of adult tooth loss. It is characterized by swollen, inflamed gums surrounding the teeth. Plaque, a sticky substance that forms in the mouth from food, saliva and bacteria gets inside the space between the gum line and the tooth. If not removed, plaque hardens into a substance called calculus or tarter that is very difficult to remove. Eventually, the bacteria in the plaque and tarter eat away at the fibers that hold the gums to the teeth, creating deep pockets. As bacteria spread, the pockets become deeper until the bacteria finally eat away the bone that holds the tooth in place.

Gum disease is diagnosed through a process that measures the depth of the pockets around each tooth. Pockets that are greater than 3 millimeters in depth are considered hazardous and will generally require treatment.

Gum disease is treated by carefully removing the bacteria and substances that form in the pockets around the teeth. The removal of this material occurs on a microscopic level and requires great skill. Our dental team has had advanced training regarding how to effectively remove all of the bacteria.

This process of removing the bacteria usually requires several visits to our office. Once the bacteria have been removed, the pockets must be cleaned and maintained on a regular basis by a certified dental hygienist. Otherwise, the bacteria will return.

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Our back teeth (molars and premolars) have deep grooves, called pits and fissures, which make them vulnerable to decay. These fissures can be so narrow that even a single toothbrush bristle is too big to fit and clean the grooves. And even with vigorous brushing, the acid from bacteria in the plaque attacks the tooth enamel and results in a cavity. Fortunately, dental sealants can help you prevent such cavities.

Dental sealants are thin plastic coatings that are painted on the chewing surfaces of permanent back teeth, bonding to the enamel and creating a smooth surface that is much less susceptible to decay. After this application a blue spectrum of natural light is shone on the applied material for a few seconds to cure the plastic.

Incredible pressures are placed on teeth during chewing. Although sealants can remain effective for five years or longer, they do wear away naturally and may need to be reapplied.

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Does your jaw feel stiff or do you have difficulty opening your mouth wide? Are your teeth sensitive to cold drinks? Do your jaw muscles feel tired in the morning? Do you suffer from headaches, neck pain, ear pain, jaw joint clicking and/or popping? You may be involuntarily grinding your teeth at night (a medical condition called bruxism) or you may be clenching your teeth.

During sleep your biting pressure can be up to six times greater than during eating and waking hours. This can result in broken teeth, loosening of fillings and potential loss of tooth enamel.

Protective nightguards are horse-shoe shaped and cover the biting surfaces of either your upper or lower teeth. After Dr. Best has made a simple impression of your upper and lower teeth a qualified laboratory will fabricate your customized nightguard from a variety of acrylics appropriate for your individual situation.

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According to the American Dental Association, more than 200,000 oral injuries are prevented annually in this country by sports mouthguards. Unfortunately, the National Youth Sports Foundation estimates that more than 5 million teeth will be knocked out in sporting activities this year. These oral traumas will happen to children, high school and college-level athletes and can result in lifetime dental costs of $10,000 - $15,000 per tooth, hours in the dentist's chair, and the possible development of other serious problems. That's why the value of an athletic mouthguard cannot be overstated.

Athletic mouthguards are plastic dental appliances that can help protect the hard (teeth and jaw bones) and soft (lips, cheeks, gums, tongue) tissues of the mouth from traumatic blows and collisions. They can also help prevent cerebral hemorrhage and neck injuries when the lower jaw gets jammed into the upper jaw. But not all mouthguards are created equal.

Beware of clever marketing schemes, claims, and promotions by stock or boil-and-bite mouthguard companies. These mouthguards can be uncomfortable, often do not fit correctly and may interfere with breathing and speaking. They may also provide a false sense of protection due to the dramatic decrease in thickness when the athlete bites it into place during its softened state. You and your family deserve better than that, and boil-and-bite mouthguards simply do not provide the best protection available.

Mouthguards must be professionally constructed and fitted to ensure that they stay in place at the moment of impact, cushion the mouth and teeth from direct blows and distribute the force of an impact over a greater surface area. Dr. Best will take a custom impression of your teeth and surrounding jaw bone, which a qualified laboratory will use to make your custom sports guard. The specific laminated materials and thickness of your guard will be determined by the sport: A hockey player will need more layers and a thicker guard than a mountain biker.

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Almost half of adults snore - just ask your spouse. Snoring occurs when the free flow of air through the mouth and nose is partially obstructed and loose structures in the throat, like the uvula and soft palate, vibrate as air passes over them. Snoring can get worse when the muscles in the back of the throat are too relaxed either from drugs that induce sleep or alcohol consumption.

A good nights sleep can help prevent heart disease, high blood pressure, stroke, diabetes, depression, and memory loss. It can also help prevent driving and work related accidents caused by excessive daytime sleepiness.

A Silent Nite appliance is custom-made to fit over the upper and lower teeth to position the lower jaw slightly forward, so that the loose soft tissues cannot vibrate on the back of the throat, yet allows for freedom of movement. It's flexible, thin, comfortable, aids in the dissolution of snoring and can make a great marriage even better.

This appliance is not effective for patients with diagnosed sleep apnea, a more serious condition requiring medical assistance.

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Smile whitening can dramatically change your smile. Plastic whitening trays will be made from models of your teeth. You will then place a special whitening gel in each tray and wear the trays in your mouth for several hours per day. (Many patients wear their trays after dinner and before bed.) A significant change in tooth color is usually seen in just four to six weeks.

Accelerated whitening is another option for some patients. This process can result in whiter, brighter teeth in just one office visit. Please consult with the doctor to see if this procedure may work for you.

Occasionally, teeth may be stained in a way that limits the effectiveness of tooth whitening. In those instances, porcelain laminates or crowns are an excellent alternative.

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A porcelain laminate (often called a veneer) is a thin shell of porcelain that covers the front of each tooth. They bond directly to the front of the tooth, similar to the way artificial fingernails work. Each porcelain laminate is a work of art, carefully crafted in a laboratory to fit your individual smile.

In the hands of a highly skilled dentist, porcelain laminates can provide you with an incredibly natural, beautiful smile. They are virtually undetectable and can dramatically improve your appearance. They are durable and long-lasting when compared to other cosmetic treatments.

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Snap-On Smile is a patented, revolutionary dental appliance that requires no prepping, no injections, and no adhesives. Its exclusive design is flexible, incredibly strong, and snaps right over a patient's natural teeth. Its retention is completely tooth-borne, so the appliance does not impinge on the gum tissue nor cover the palate, making it look and feel very natural. Snap-On Smile is easily removable, completely reversible and is an excellent option for patients looking for a non-invasive, affordable approach to restorative and cosmetic dentistry.

All it takes is a brief consultation in your dentist's office. The process is quick and painless. Your dentist will take photos and impressions of your teeth. You choose from different smile shapes and shades for your Snap-On Smile. In about two weeks, the exclusive lab at Snap-On Smile will create and send your dentist your new appliance for final insertion. Snap it in and wear it home.

Change your smiles. Change your life.

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A composite filling is a tooth-colored quartz-like material layered onto a tooth after the decay is removed and cleaned. Each composite layer is hardened or cured with an ultraviolet light, and the final surface is shaped and polished to match the tooth. The final restoration is virtually invisible.

Composite fillings are more than just attractive. They actually chemically bond to the tooth structure, providing further support to the tooth. Sometimes less tooth structure needs to be removed compared to other filling materials.

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Inlays and onlays are two methods of restoring a tooth after decay or some other damage. These restorations are known as indirect fillings because, unlike a standard filling done in a dentist's office, both are made in a laboratory and cemented or bonded to the surface of the tooth during a second visit to the dentist.

An inlay, which is similar to a filling, is used inside the cusps (points) of the tooth. An onlay is recommended when the extent of the tooth damage involves one or more cusps of the tooth or when full coverage of the biting surface is needed. Onlays can be a very good alternative when the damage to the tooth is not extensive enough to merit an entire crown.

During the first visit, the damaged or decaying area of the tooth is removed, and the tooth is prepared for the inlay or onlay. To ensure proper fit and bite, an impression of the prepared tooth is sent to a laboratory for fabrication. A temporary filling is made and temporarily cemented in or on the tooth. At the second appointment, the temporary is removed and the inlay or onlay is fitted correctly, then cemented or bonded in place and polished to a smooth finish.

Inlays and onlays can be made of porcelain, gold or composite resin. Porcelain inlays or onlays are more attractive because the material mimics the enamel's translucency and color, while gold inlays and onlays are more durable.

Traditional fillings can reduce the strength of a natural tooth by up to 50 percent. A tooth restored with an inlay or onlay can bear up to 50-75 percent more chewing force and can last from 10-30 years.

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A crown covers the tooth and restores it to its original shape and size. Decay is removed and cleaned from the tooth and a highly accurate impression or mold is made of the prepared surface. This mold is used to create a model of the tooth which is then sent to a special laboratory that will create a gold or porcelain (tooth colored) crown. The crown is then cemented onto the prepared surface of the tooth.

Crowns are incredibly strong due to the fact that they are created in a laboratory. This protects and strengthens the remaining tooth structure. In the hands of a skilled dentist, a crown will fit almost perfectly onto the prepared surface of the tooth, reducing the size of the seam between the crown and the tooth. This helps keep decay from eventually occurring under the crown.

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Splinting is a technique used to stabilize teeth that have become loose. When the supporting bone around the roots of teeth has been lost from advanced periodontal disease, teeth become mobile. Even comprehensive periodontal treatment cannot replace this missing bone, and the prognosis for these teeth is poor. Loose teeth can be painful to chew on and the constant movement can exacerbate the problem.

There are two basic types of periodontal splinting, with some variation. The first is extra-coronal splinting in which a stabilizing wire mesh, fiber-reinforced or cast-metal appliance, or a similar stabilization devise is bonded to the inside external surface of the teeth like a fixed orthodontic arch wire. The second is intra-coronal splinting, where a chamber is created inside the affected teeth and the stabilizing devise is inserted into the chamber and bonded into place. These splints are used in back teeth (molars and bicuspids). They are less visible, but accomplish the same goal of immobilizing the teeth.

Active periodontal disease must be under control before investing in splints. For long-term success the patient must be able to keep the splint, the gums, and involved teeth clean and disease free.

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Inside each tooth is a pulp chamber that contains the nerves and blood supply for the tooth. When the pulp becomes infected due to decay or injury to the tooth, the pulp must be removed from the center of the tooth and the canals of each root. Once the infected pulp is removed, the remaining chamber is filled with a rubber-based material to seal it off.

All teeth that have had root canal therapy must be protected with a tooth-like artificial covering known as a crown (see crown section.) This is because teeth that have had the pulp removed are more susceptible to fracture.

Root canal therapy is an excellent way to save a tooth that would otherwise die and need to be removed.

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A dental extraction is the removal of a tooth when all other treatment options are exhausted and the tooth is causing pain, swelling, or infection or when cavities or periodontal (gum) disease have progressed too far. Extractions of impacted or problematic wisdom teeth are routinely performed, as are extractions of some permanent teeth to make space for orthodontic treatment. Patients receiving medical radiation to the head and neck may need extractions in the field of radiation.

Dr. Best performs simple extractions on teeth that are visible in the mouth under local anesthetic. Surgical extractions involve the removal of teeth that cannot be easily accessed, either because they have broken under the gum line or because they have not erupted fully. In these cases, Dr. Best works with several oral surgeons who are qualified to perform surgical extractions.

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A dental implant is an appliance used to replace the roots of teeth. The implant is surgically attached to the jaw bone and an artificial tooth is attached to the top of the implant, creating a natural looking, undetectable replacement for the missing tooth. In the event that more than one tooth is missing, several implants may provide a base for a series of artificial teeth known as a fixed bridge (see fixed bridges.) Implants can even be used to secure a full set of removable dentures for people who have no remaining natural teeth. This can greatly improve chewing ability and reduce the risk of choking.

It generally takes about six months for the surgical implant to heal before the final installation of the artificial tooth or teeth can be finished.

Dental implants with artificial teeth are the closest thing to regrowing your natural teeth. They are strong, stable, durable and virtually undetectable. By filling gaps left by missing teeth, implants can provide better chewing ability and head off jaw joint problems. They are far superior to removable dentures.

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A bridge is a single appliance that is generally attached to two teeth on each side of the space where a tooth is missing. An artificial tooth attached in the middle of the bridge fills in the gap where the missing tooth was. The teeth on either side of the gap are prepared for crowns (see crowns) and a highly accurate impression or mold is made of the prepared area. This mold is used to create a gold or porcelain (tooth colored) bridge in a special laboratory. The bridge is then cemented onto the prepared surface of the teeth, effectively creating the appearance of a "new" tooth.

In some instances, a resin-bonded bridge may be used. In this case, the two teeth on each side of the gap are not prepared for crowns. Instead, the bridge consists of a false tooth with metal brackets on the back of each side of the gap. The brackets are attached to the backs of the real teeth on each side.

Unlike dentures, a fixed bridge is never removed. It is stable in the mouth and works very similar to natural teeth. By filling the gap and stopping the movement of other teeth, a fixed bridge is an excellent investment, providing better chewing ability, heading off jaw joint problems and saving money that might otherwise be spent on future dental treatment.

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If you've lost some or all of your natural teeth from periodontal disease, tooth decay or injury, dentures can restore your self-confidence, and give you your smile back. Studies indicate that individuals without teeth do not live as long as those with a full set of teeth, in part because of the dietary restrictions caused by missing teeth.

Made of an acrylic resin, dentures are removable replacements for missing teeth and provide support for the cheeks and lips and may incorporate porcelain or metal for additional structural support. There are several types of dentures, all of which are custom-fitted for each individual.

A conventional denture is made after all of the teeth have been removed and the tissues (gums) have healed completely. Their comfort and retention depends upon muscle, bones, tongue, and saliva flow.

An immediate denture is fabricated and inserted immediately after the teeth are extracted and the tissues are allowed to heal under the denture. The drawback is that an immediate denture may require more adjustments after the healing has taken place. Frequently this denture will need to be relined or completely remade 6 -12 months after the initial insertion to accommodate any postoperative bone resorbtion.

Over dentures are similar to conventional denture. The difference is that not all of the teeth are extracted and they are used to support the denture. These remaining teeth have had root canal therapy and are then sculpted to look like stumps, which the denture fits over to provide greater stabilization during chewing.

Complete dentures can be fabricated to fit over dental implants. This is the most stable and secure fitting denture.

Partial dentures fill in the spaces created by missing teeth and prevent other teeth from drifting. Metal or "gum-colored" attachments (clasp arms) fit around select existing teeth to give it support.

Following extractions, the bone and gum ridges naturally recede or shrink. Therefore, all dentures will wear over time and need to be relined or replaced to maintain normal jaw alignment. Regular dental examinations are still important to check the oral tissues for disease or change.

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