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Regular Exams, X-Rays and Cleanings
Regular exams are an important part of maintaining your oral health. During your holistic dental exam, we will:
- Find out what your concerns and preferences are for your teeth, gums, and jaw joints
- Check for any problems you may not see or feel
- Look for cavities or other signs of tooth decay or fractures
- Inspect your gums for gingivitis and signs of periodontal disease
- Take X-ray images, 2-D or 3-D cone beam, to check for hidden problems in the teeth, roots, bone and jaw joints
- Finally, we may perform a thorough teeth cleaning
If you are a new patient, your exam will take about 30-60 minutes. This may be the most detailed exam you've ever had! We will explain all things about your mouth from the holistic dentistry point of view, and answer your questions.
We will determine what type of cleanings or natural gum treatment you need, and how often you will need it. If you are due for a cleaning, we will either do this on the same day as your exam or set a separate appointment for this.
Ozone treatments are available to treat all infections, including gum disease and cavities. We also use ozone to assist healing from any oral surgery such as extractions. Teeth that have had root canal treatment are considered to be chronically infected, and can be temporarily treated with ozone. Some people do not wish to keep teeth that have had root canal treatment.
Dr Saepoff will look at each tooth and note the condition of any fillings, root canals and crowns. She will discuss your options for replacement of old metal restorations (including mercury amalgam fillings) and what to do with existing root canal treatments and nickel containing crowns.
The doctor will check your 'alignment' and make sure your teeth and jaw are aligned to minimize wear and tear for your teeth, TMJ and gums. Dr Saepoff will let you know what the least toxic and least invasive ways are to correct any problems you may have. You have choices!
Visiting our office every six months is recommended so that any problems can be discovered while they are still minor, and can be managed in the most conservative, least invasive and natural way possible.
Regular exams and cleanings are offered by appointment only, so please contact us to schedule your next dental exam and teeth cleaning.
BPA-free Cosmetic Dental 'Bonding'
'Bonding' is a term used to describe a conservative way to repair slightly chipped, discolored, or crooked teeth. During dental bonding, a white filling is placed onto your tooth to improve its appearance. The filling “bonds” with your tooth. Because it comes in a variety of tooth-colored shades, it closely matches the appearance of your natural teeth.
Bonding is less expensive than other cosmetic treatments and can usually be completed in one visit to our office. However, it can stain and is easier to break than other cosmetic treatments, such as porcelain veneers. If it does break or chip, let us know. The bonding can generally be patched or repaired easily in one visit.
These photos also show other new restorations and whitening. When a bridge is used to replace missing teeth, help maintain the shape of your face, or alleviate stress on your bite, it is bonded to the teeth on either side of the space.
When a bridge is replacing a front tooth, this is an opportunity to improve the other front teeth at the same time, but it is also possible to leave all other teeth as they are and have the new restoration match your original color and tooth shapes, even if they are a little bit stained or worn. Many holistic patients enjoy their original natural smile, and Dr Saepoff will make every effort to have all new restorations blend and match esthetically with your original natural smile.
A bridge replaces missing teeth with artificial teeth, looks great, and literally bridges the gap where one or more teeth may have been. Your bridge can be made from gold, porcelain, or a combination of these materials and is bonded onto surrounding teeth for support.
The success of any bridge depends on its foundation — the other teeth, gums, or bone to which it is attached. Therefore, it’s essential to keep your existing teeth, gums, and jaw healthy and strong.
Crowns are a restorative procedure used to improve your tooth’s shape or strengthen it. Crowns are most often used for teeth that are broken, worn, or have portions destroyed by tooth decay.
A crown is a “cap” cemented onto an existing tooth that usually covers the portion of your tooth above the gum line. In effect, the crown becomes your tooth’s new outer surface. Porcelain crowns are most often preferred because they mimic the translucency of natural teeth and are very strong.
Crowns or onlays (an onlay is a partial crown -more conservative with less drilling required) are needed when there is insufficient tooth strength to hold a filling. Unlike fillings, which apply the restorative material directly into your mouth, ceramic restorations are fabricated in a lab and are cemented or bonded into place on a second appointment.
Your ceramic is designed in a lab from models made using the impression, which allows a laboratory technician to follow Dr Saepoff's prescription instructions. Your restoration is then sculpted just for you so your bite and jaw movements function normally once the new ceramic is cemented.
Dentures are natural-looking replacement teeth that are removable. There are two types of dentures: full and partial. Full dentures are given to patients when all the natural teeth have been removed. Partial dentures are made to fit around your remaining natural teeth and are used to fill in where permanent teeth have been removed. Partial dentures can be an excellent temporary solution while you decide if you want a permanent cemented bridge or an implant.
Just like natural teeth, dentures need to be properly cared for. Use a gentle cleanser to brush your dentures, always keep them moist when they’re not in use, and be sure to keep your tongue and gums clean as well.
Root Canal Treatment
Root Canal Treatment is a controversial subject. Dr Saepoff believes that when any body part becomes necrotic, whether due to trauma or infection to the point of causing irreversible tissue necrosis, that it is best to remove that tissue.
When the pulp tissue inside the tooth becomes necrotic, either due to infection or trauma, the common practice is to extirpate (remove) the pulp tissue from inside the canals of the tooth and fill the canals with gutta percha and other material. It is believed that removal of the pulp and filling the canals will remove the infection, relieve pain and allow you to continue to use the tooth for many more years.
In fact, studies have shown that root filled teeth cannot be sterilized, only disinfected, and actually continue to harbor microbes in the microscopic tubules. This is usually painless and does not affect chewing, but there are many physicians and dentists that believe the entire tooth must be considered gangrenous and be removed rather than undergo root canal treatment.
Dr Saepoff always informs you if your tooth is in danger of becoming necrotic, and will offer referrals for root canal treatment or extraction according to your preference. There is a great deal of planning involved in replacing missing teeth, please see the next section, below, on extractions.
There are times when it is necessary to remove a tooth. Sometimes a baby tooth has misshapen or long roots that prevent it from falling out as it should, and the tooth must be removed to make way for the permanent tooth to erupt.
At other times, a primary or permanent tooth may have deep decay that invades and infects the pulp inside the canal (or 'nerve'). If root canal treatment is not preferred or not recommended then an extraction will be needed. it puts the surrounding teeth at risk, so Dr. Saepoff will recommend removal and replacement with either a bridge, a partial (one or more teeth) or complete removable denture, or perhaps a zirconia implant.
Infection due to decay or gum disease, deep cracks that cause irreversible nerve damage, or problems with a wisdom tooth can also require removal of a tooth.
When it is determined that a tooth needs to be removed, Dr. Saepoff will refer you to an oral surgeon, or an associate that performs surgery. Surgeons that we recommend for you are trained to remove the entire periodontal ligament that holds the tooth in the socket of your jawbone. This is a careful procedure to ensure that the bone can heal in solidly after the tooth is removed, not impeded by the layer of ligament that is no longer needed to hold the tooth in the bone. If this is not thoroughly cleaned out, then there may be an area in the bone that does not fill in and may become a cyst or necrosis, and may also harbor toxins and bacteria. These are known as Ratner Bone Cysts, but are called cavitations, which simply means 'holes'.
Once a tooth has been removed, neighboring teeth may shift, and cause problems with chewing or your jaw joint function. If you are at risk for these complications, Dr. Saepoff will recommend that you replace the extracted tooth and will explain all of your options to you.
Traditional dental restoratives, or fillings, may include gold, porcelain, or composite and as shown in the picture, mercury amalgam. Although mercury fillings are still legal, Dr Saepoff abandoned their use twenty years ago. When these are replaced at our office, biocompatible materials are selected and you are protected from exposure to the dust and vapor from your old mercury fillings as they are gently removed from your teeth. The teeth are restored to specifically strengthen your teeth if they have been weakened or cracked by the mercury amalgam material. Your new restorations will also be selected to look as natural and beautiful as possible.
To review: The two different kinds of fillings are direct and indirect. Direct fillings are placed into a prepared (shaped) cavity during a single visit. Indirect fillings generally require two or more visits due to being made in an outside dental lab. These fillings include inlays, onlays, crowns and cosmetic veneers fabricated with ceramics or composites.
If you are missing teeth, it is frequently necessary to replace them. Without all your teeth, chewing and eating can destabilize your bite and cause you discomfort. When teeth are missing, your other teeth can shift and cause a condition called bite collapse. Implants are one of the ways to replace your missing teeth. If properly maintained, they can last as long or longer than partials or bridges. However, many holistic-minded patients prefer to avoid this option due to the need for multiple surgeries in many cases. We understand that some patients do not want anything permanently implanted in their bone, and we offer other choices. Never let any dental office push you into treatment with implants. You have a right to know what all of your choices are.
An implant is a fake tooth root, usually made of metal and porcelain and coated with fluoride. Once it heals, a ceramic tooth can be place into the 'root'. These can look very lifelike but frequently the gum tissue recedes around the gumline and food can be caught there every time you eat. Most implant systems are composed of three main parts: the titanium or zirconia implant body that takes the place of the extracted root, an abutment portion that screws into the implant, and the tooth colored crown screwed in or cemented on top of the implant abutment.
One of the best uses for implants may be to anchor dentures, especially dentures that tend to shift when you talk or chew due to the shape of the gums and underlying bone that they are resting on. If the missing teeth are in the back of the mouth, then your only options may be the implant or a removable partial, or the very simple and economical choice of a retainer/bite guard to wear at night to prevent your other teeth from shifting.
If you often wake up with jaw pain, earaches, or headaches, or if you find yourself clenching or grinding your teeth, you may have a common condition called “bruxism.” Many people do not even know that they grind their teeth, because it often occurs during sleep. If not corrected, bruxism can lead to broken teeth, cracked teeth, or even tooth loss.
One of the first signs of clenching and grinding is temperature sensitivity due to 'micro trauma'. If bruxing is one of the causes for you, you will experience relief after just a few days of using a well fitting and correctly adjusted night guard!
The night guard is an easy and comfortable preventive treatment for bruxism, however some people who grind heavily also have a narrowing airway while they sleep. This can be a serious and life threatening condition known as sleep apnea. If Dr Saepoff feels that you are at risk for apnea, or narrowing of your airway while you are sleeping, then she will refer you to a sleep specialist to rule out sleep apnea and determine if your airway is remaining patent open enough during your sleep. Even partial closure of the airway is a health hazard due to reduced oxygen intake and interruped deep sleep. If your sleep specialist diagnoses obstructive sleep apnea, we will design a comfortable night appliance that actually supports your jaw to keep your airway open AND also prevents damage from grinding and clenching.
Nightguards and sleep apnea appliances are a simple way to prevent the wear and damage that teeth grinding causes over time. Custom made by our office (from BPA-free material) to fit your teeth, a simple nightguard is inserted over your lower teeth and prevents heavy contact with the opposing teeth. Dr Saepoff's bite guards are specially designed to avoid taking up any of the space your tongue uses. Therefore, there is no gag reflex and no aggravation of the airway. Our sleep apnea appliances are thin and comfortable and are worn on the upper and lower teeth to allow peaceful and quiet sleep all night.
Sometimes brushing is not enough. We believe that decay is usually preventable through nutrition and good oral hygiene. It can be difficult for your toothbrush to get into the small pits and grooves on your teeth and this is where decay sometimes gets started, especially in those who are susceptible due to other health problems which are in the process of being solved. Sealants do give your teeth, or your childrens' teeth some extra protection against decay and help prevent the start of cavities.
In most dental offices, 'sealant' material is usually cheap, fluoride containing plastic resins. At our practice, we have selected some longer lasting BPA-free and fluoride-free materials that can be used to seal pits and fissures in the molars. Dr Saepoff evaluates all resin, composite and glass ionomer materials before they are used in the office as sealants and restorations.
Sealants are typically applied to children’s teeth as a preventive measure against tooth decay after the permanent teeth have erupted. However, adults can also receive sealants on healthy teeth. It is more common to seal “permanent” teeth rather than “baby” teeth, but every patient has unique needs, and we will recommend sealants on a case-by-case basis. Dr Saepoff does not believe in plastic coating teeth (sealing) unless it is absolutely necessary due to decay risk for that individual.
Some of the cheaper types of sealant material can last from three to five years, but we expect our sealants to last much longer. A dental sealant only provides protection when it is fully intact, so if your sealants come off, let us know, and schedule an appointment for your teeth to be re-sealed.
With veneers, you can correct some of your teeth’s imperfections. Veneers are natural in appearance, and one of the options for patients who want to make minor adjustments to the look and feel of their smile. They are sometimes chosen as well as orthodontic treatment with invisalign if the teeth need straightening and improvement of shape and size of the teeth.
Veneers are very thin, custom-made shells made from tooth-colored materials, such as porcelain. They are designed to cover the front side of your teeth. To prepare for veneers, Dr. Saepoff will send an impression of your teeth to a dental lab to create your veneers. Dr. Saepoff may need to prepare your tooth (or teeth) with some light shaping to allow enough space for the new porcelain and so that the lab can make the flossing areas smooth and allow the final veneers to be shaped well and appear very natural.
When your veneers are placed, you’ll see that they look like beautiful new natural teeth. Although veneers are stain-resistant, we may recommend that you avoid coffee, tea, red wine, and tobacco to maintain the beauty of your new restorations.
Wisdom teeth are molars found in the very back of your mouth. They usually appear in the late teens or early twenties, but may become impacted (fail to erupt) due to lack of room in the jaw or angle of entry.
There is debate among professionals about why wisdom teeth are frequently too crowded to erupt correctly. There is also disagreement about how often they need to be extracted. Dr Saepoff will go over your case with you to help you make a decision about whether and when to remove wisdom teeth.
When a wisdom tooth is impacted, but not removed, you may develop gum tenderness, swelling, and even severe pain. Impacted wisdom teeth that are partially or fully erupted tend to be quite difficult to clean and are susceptible to tooth decay, recurring infections, and gum disease.
Dr. Saepoff will help determine whether your wisdom teeth can be kept healthy by giving you a thorough assessment and all the relevant information. If she feels removal of your wisdom teeth is the best course of action, she will refer you to an oral surgeon. If it is possible keep them clean and healthy, even if it is challenging, we will help you learn to keep them clean so that you can keep your wisdom teeth as long as possible.