At your first visit and every subsequent recall visit, several things will be performed and discussed.
For example, a thorough medical history listing all allergies, medications taken, and systemic problems will be required. Without complete knowledge, your care could be compromised. If medications change or problems arise between dental visits, Dr. Fiss should be notified immediately.
Recent diagnostic X-rays are always needed to access current and future care and serve as an educational tool for the doctor to demonstrate to the patient their dental needs.
The doctor will review any oral symptoms which exist, such as: teeth which are sensitive to pressure or temperature, and muscle pains of the head and neck.
Careful clinical exam for pathology in the head and neck area as well as cancer screening will be performed.
A clinical exam for decay and gum diseases should be reviewed with a discussion of home care, brushing and flossing, as well as diet. It is at this point that the frequency of professional cleanings are set so your dentist can help create a preventative versus systematic patient.
Early Diagnosis and Non-Surgical Treatment of Gum Disease
There are many factors which affect the health of gum tissue. These include home care like brushing, and flossing, diet, systemic problems and the medications taken to control them. Even people who regularly go to the dentist can have an easily reversible inflammation called gingivitis, at the time of their regular cleanings.
When their teeth are cleaned, this condition is generally resolved. People with gum tissue that bleeds on a regular basis, feels very tender or puffy may have moved into a more serious stage of periodontal disease called periodontitis. Using a periodontal probe, which measures pocket depth, and current X-rays, your dentist and hygienist can regularly monitor the health of your gum tissue and health of the supporting soft and hard tissue around your teeth. The perio-probe and X-rays demonstrate the difference in height between the tissue around the neck of your teeth and the bone underneath. When the pocket depth measured exceeds 4mm, the patient can no longer reach the depth of the pocket with dental floss, and the disease will progress without immediate care. Patients with pocket depth between 4 and 6mm usually receive excellent results when a non-surgical gum disease treatment called sealing and root planing or deep cleaning is performed.
Using local anesthetic, the hygienist goes below the tissue using an instrument which scrapes the tooth surface as well as the pocket lining. Once this occurs, the healthy tissue will reattach and shrink to the clean tooth, reducing the pocket depth.
Dietary restriction, special oral rinses, and home care after this procedure must be followed to provide successful results. To ensure continued health, these patients should be seen four times per year for cleanings and exams to ensure patient compliance and tissue health.
If you have areas that do not heal sufficiently or are deeper than 6mm in depth you should be referred to a specialist for care.
Beating Bad Breath
Halitosis - a serious problem.
For many people, bad breath can be a serious problem. It can affect social and business contacts, and even close relationships. A major turnoff in social situations is bad breath! If you have halitosis, it's easy to ignore, since you probably can't smell your own breath. If you are one of the millions of people who suffer from halitosis, you're not alone. It's been estimated that 65% of the population has chronic bad breath. What's more, halitosis gets worse as you get older.
Current Treatment Is Often Not Effective
Americans spend over one billion dollars each year for mouthwashes, mints, and sprays to treat bad breath, yet these products only serve to cover up the bad breath with a stronger, more pleasant odor. They do nothing for the cause and in some cases even make it worse.
The Cause of Halitosis
While tobacco and foods contribute to the odors of bad breath, up to 90% of bad breath is caused by mouth conditions. The odors of halitosis come from bacterial production of sulfur compounds. When these sulfur compounds are left untreated, or the bacteria are not properly removed, halitosis results. You are probably familiar with one type of these sulfur compounds hydrogen sulfide the same compound that causes the smell of rotten eggs. What's more, halitosis is sometimes caused by mouth conditions such as gum diseases and faulty fillings.
Research into the cause of halitosis has enabled us to develop new dental techniques and new products to eliminate bad breath at its source, not simply cover it up. A professional program of bacterial control and sulfur compound elimination is successful over 95% of the time in eliminating halitosis.
Up to 90% of halitosis comes from oral causes.
Over the counter mouthwashes do not destroy the odor causing molecules.
Food and tobacco contribute to halitosis but are not a primary cause.
Sulfur compounds cause halitosis.
Bacteria that live in the mouth produce sulfur compounds.
Halitosis is especially prevalent in gum disease.
Elimination of halitosis involves bacterial removal and destruction of the sulfur compounds.
Halitosis elimination is 95% effective when professionally treated.
Review of diet and medications
Use of chlorine dioxide toothpaste and mouth rinse
Use of a computerized probe, which measures "hot spots" within the gum tissue, called a perio temp.
Use of a halimeter, which like a breathalyzer- measures levels of sulfur compounds.
Office Infection Control
This issue, although rarely discussed, is on the minds of most patients. Knowledge of what to expect from your dental office is the first step in having confidence in your health professional. All the instruments should be ultrasonically cleaned and rinsed, autoclaved, and sealed in protective bags. The doctor and all assistants should wear masks and gloves, and wraps should cover the chair side workstation. Disposable products are used whenever possible. Currently, there are some offices that go beyond the guidelines of OSHA and the American Dental Association. These offices place all the disposable items, which usually arrive at a dental office in bulk, into pre-packaged, hospital-style sterile packs. The contents of these packs contain all the disposable items needed for that patient's appointment. Each patient has their own sterile pack, thereby reducing the risk of cross-contamination and creating complete peace of mind.
Dr. Benjamin S. Fiss - Teeth Whitening
Bleaching or tooth whitening is a simple procedure, which can be performed with your dentist's help, to provide a whiter smile. Avoidance of tooth whitening products sold over the counter is wise, for many of these do not work or can be harmful to your teeth and gums.
There are two forms of bleaching available:
The tray method, your dentist takes impressions of your mouth, from which carefully molded trays are formed. These trays are thin and light to wear. The patient adds a small amount of liquid to the tray and proceeds to wear them from two to six hours per day until the desired whitening is achieved. This process usually takes two weeks. The trays are kept and can be used again for touch-ups. The cost of this procedure is approximately $400.00.
We now offer ZOOM! Whitening in the office to compliment our bleaching services!
What is Zoom?
ZOOM! is a radically new chairside tooth whitening system that uses a full-mouth bleaching light combined with a revolutionary 25% Hydrogen Peroxide light activated gel to lighten teeth 6-10 shades in about an hour.
The ZOOM! Technology
ZOOM! is the culmination of extensive research into light technology, chemical reaction to light and years of traditional tooth whitening experience. Combining this proprietary light technology (specially designed for tooth whitening) with a specifically formulated hydrogen peroxide gel in a two part delivery system results in a tooth whitening system that significantly reduces the time it takes to achieve dramatically whiter teeth.
Why ZOOM! over Competitors?
ZOOM! was developed by the leader and pioneer in whitening products for professional use, Discus Dental. We believe ZOOM! is the best, most complete tooth whitening system available today.
The proprietary light technology and light activated gel were scientifically designed to work together for faster in-office whitening. Low sensitivity is an important aspect of the ZOOM! procedure.
General Facts about Bleaching:
Regardless of the type of bleach used, some general facts apply. All bleaching systems whiten your teeth, but when bleaching is over, the color will fade about half a shade. Using the tray method in conjunction with ZOOM.
Bleaching can only be performed on clean, healthy teeth and healthy gums.
Bleaching will not whiten existing fillings and crowns. The doctor must discuss with the patient their expectations and point out what work might need to be changed so as to achieve consistent color.
Bleaching only works on enamel. Teeth which have thin enamel due to chemical or physical abrasion will whiten poorly. This should also be reviewed prior to starting treatment.
Sensitive teeth are the most commonly reported side effect.
Fillings or Restorative Care
Many people feel that they should only go to the dentist when there is pain. However, problems may exist without any symptoms. During routine dental exams and cleanings, new decay or breakdown of existing fillings may be noted. There are many different kinds of filling materials. All dental fillings or restorations have an average life span. This life span is affected by both the provider's correct choice and placement of the materials as well as the patients home care and maintenance. Patients who chew ice or gum or eat excessive amounts of candy and have poor home care will be more prone to new decay as well as early failure of existing fillings. The choice or selection of materials used for fillings depends on the location of the tooth and the size of the fillings. Years ago only metal fillings were used. We now can provide metal-free dentistry. These new restorations now meet the hardness and wear resistance of metal fillings, along with satisfying patient's expectations for cosmetics. Most fillings can be completed in a single visit. As the size of the filling grows, sometimes multiple visits are needed. After a thorough clinical exam, your dentist can determine what is best for you.
A porcelain veneer is a thin porcelain covering placed over the facing of a tooth to enhance its color and shape. When veneers are placed on adjacent teeth, crowding and malalignment can be corrected or erased. Because veneers are carefully sculpted and shaped, many people feel they have gone through instant orthodontics. Veneers have a longevity of at least ten to 15 years due to the strength of the porcelain and the extreme thinness of the cement. To achieve the best depth of color translucency and iridescence, the structure of the teeth to be veneered must be reduced both facially and in length approximately half a millimeter. Veneers should wrap around the chewing edge and go interproximally between teeth to create life-like translucency and contour. If patients are interested in bleaching or tooth whitening, this should be achieved prior to veneering, as restorations will not whiten.
IPS Empress Porcelain Veneers
Discoloured or chipped teeth are repaired with veneers. True-to-nature IPS Empress veneers are used for the cosmetic correction of teeth. Dr. Fiss can help you enhance your smile with IPS Empress porcelain veneers. Contact him today!
The picture on the left demonstrates the
Crowded incisors with white spots. Note the picture on the right shows an aesthetically pleasing alternative:
IPS Empress veneers.
A crown is a full coverage restoration that is placed on a tooth to restore cosmetics and function. It is needed when severe breakdown due to fracture or decay in excess of two-thirds of the tooth is present. Porcelain crowns are also used to restore teeth that have previously had root canal or endodontic treatment. Years ago, crowns were only made of gold, providing strength but very poor cosmetics. Today, there is a wide selection of materials to choose from. The factors, which affect material selection, are the tooth location and forces of occlusion or the force of chewing the crown is to endure. Most cosmetic crowns are made from pressable ceramics. No metal is used, therefore, making this ideal for front teeth. Patients will no longer see gray or black lines at the gum line. Without metal, the natural translucency and light reflection of the porcelain create a life-like, beautiful smile. In the posterior areas of the mouth or in patients who exhibit problems with their bite or occlusion, there are several variations of porcelain fused to gold crowns. These are beautiful restorations needed for strength in areas where translucency is not an important factor. Crowns last an average of ten to 15 years, through constant home care and maintenance of the patient.
When people are missing one or more teeth, implants can be placed in these areas to replace the lost teeth, and restore both function and cosmetics. To anyone who has worn dentures or partials, there is nothing like your own teeth. Implants provide the best form of tooth replacement therapy available and should be considered first in treatment planning. The field of implants is constantly changing and many implant systems are available. Selection is based on location and function of the future implant. There are two phases of implant placement. The surgical phase performed by an implantologist, and the restorative phase performed by your dentist who creates the perio-prosthetic tooth above the bone. Prior to the selection of implant system, the dentist should have working study models of the patient and consult with both the lab technician and the implantologist to decide on the position and type of implant to be placed. Only then can optimal aesthetics and function be achieved. Implants maintain a very high success rate based on patient selection, implant selection, and patient maintenance with home care and regular checkups.
Prosthetic Dentistry (Bridges, Partials, and Dentures)
When patients are missing one or more teeth and the placement of implants has been ruled out or postponed, teeth can be replaced using different forms of prosthetic dentistry. Partials and dentures are removable appliances replacing some or all teeth. They are made of acrylic or combinations of metal with acrylic. Wearing something removable can compromise speech, cosmetics, and eating certain foods. With adjustments and some time to acclimate, patient acceptance is usually very good. A more permanent solution is fixed bridgework. A bridge consists of at least two natural teeth which have been reduced to accept a crown. These two crowns are connected by the pontic or missing tooth. Bridges can be various lengths depending on the number of natural teeth supporting it. A bridge resembles natural teeth in cosmetics and function, but because they are all connected, flossing and home care for the patient may be difficult. Patients with prosthetic dentistry should visit for regular cleanings three to four times a year to prevent failure.
For information on IPS Empress 2 Bridges click here
It is estimated that more than 80 million people in North America snore while sleeping. During sleep, the muscles and soft tissues in the throat and mouth relax, making the breathing airway smaller. This decrease in the airway space increases the velocity of the air flowing. As the velocity increases, the soft tissues surrounding the space vibrate, creating noisy breathing or snoring. Snoring also increases with excess body weight, alcohol consumption, and sedatives. Surgical techniques are available to remove this excess tissue, but with moderate success, twenty to forty percent. Dentists, with their knowledge of the oral cavity, are best equipped to create devices that move the lower jaw into a forward position, increasing the airway space and reducing the velocity and noise from snoring with success rates of seventy to a hundred percent. Severe cases of air blockage, where there are periods of asphyxiation lasting longer than ten seconds, are called Obstructive Sleep Apnea, or OSA. OSA can be a serious medical condition, and your dentist should refer you to a sleep center for further treatment.