Ultrasonic Dental Cleanings

Pictured: A cleaning done at Thousand Oaks Family Dentistry using an ultrasonic scaler. 

If you have had your teeth cleaned within the last decade, chances are your dentist or hygienist used a metal instrument that sprayed water and made a high pitched vibrating noise. These tools, called ultrasonic scalers, make dental cleanings quicker and more effective while reducing stress on the operator. Read on for the full story!

Before the age of ultrasonic scalers, teeth were typically cleaned using steel hand instruments. Hand instruments come in a number of sizes and have different shapes to reach all parts of all teeth. While these tools are still a very important part of dental cleanings, they put more stress on the users hands, can be uncomfortable for the patient and need to be sharpened consistently. An ultrasonic scaler uses high frequency vibration and a water jet to remove plaque and tartar quickly and (typically) with less discomfort to the patient. Additionally, the constant water flush provided by these instruments can aid in cleaning out deep periodontal pockets.

All cleaning are usually finished with hand instruments as they provide more tactile feedback and thus give the dentist/hygienist a better idea of how smooth the enamel is. Ultimately, every patient leaves their cleaning appointment with tartar free enamel regardless of instruments used! If you would like to know more about dental cleanings, preventative dental care or any other oral health topics, please give our office a call!

Dental Questions: What can I do if I have a cracked tooth?

Cracked teeth are notoriously painful and difficult to diagnose. They typically present as an ache when releasing your jaw from biting on something hard. The pressure of opening and closing the crack puts stress on the cells deep within the teeth and creates this painful sensation. You may also experience increased sensitivity to cold or a strange pushing or pinching sensation in your gums. 

If you think you have a cracked tooth, your first step is to schedule an emergency dental appointment. Here, X-rays, special lights and probes are used to identify the fracture and determine where it goes. Most often it is impossible to see the actual depth of the crack and the teeth must be treated based on their symptoms. Lowering the height of the tooth (so that the opposing tooth no longer puts pressure on it) is a typical first step. From there, a dentist may use a crown to provide extra coverage to the tooth or refer to an endodontist to take a CT scan or perform a root canal. 

If the crack goes down the length of the root and extends to one of the canals, the tooth is likely not savable. In these instances, we usually suggest an extraction to relieve pain and to prepare for an implant in the near future. For more information on emergency appointments, cracked teeth and dental pain, please give our office a call!

Dental Questions: What can a dentist do for tooth pain

At some time in their lives, everyone has experienced unexpected dental pain. It probably didn't show up at a convenient time (it never does) and you were probably willing to do anything to stop the pain. Fortunately, dentists are highly skilled in diagnosing and treating tooth pain. Read on to learn what we can do for patients in distress. 

As a disclaimer, this article will focus mainly on pain originating from the tooth nerve. An entire spectrum of problems can present as tooth pain (sinus infections, muscle spasms, gum disease, etc.), and a thorough exam with x-rays is the only way to confirm the source of your discomfort. 

The nerve in your tooth may become irritated for a number of reasons, ranging from exposure to extreme temperatures to decay and even fractures. Usually, this irritation is reversible meaning the nerve will calm down on its own. However, in certain cases the tooth can cross a threshold and become irreversibly inflamed, meaning the pain will persist until the tooth nerve dies. At this point, the nerve has to be taken out of the mouth- either via root canal or by extracting the tooth. 

At an emergency visit, a dentist will evaluate what is causing the pain, the health of the tooth nerve and if the tooth is overall "fixable." If the pain is coming from a tooth with a cavity or fracture that extends down the root and beneath the gums, it may be best to extract it and consider replacement options in the future. However, if the offending problem is well isolated and treatable, you will probably want to opt for a root canal. At most emergency appointments, a dentist will not complete a full root canal. Rather, they perform a procedure called a pulpectomy, where the nerve is removed and the roots are sterilized and filled with a temporary material. This procedure ends the pain and provides short term protection against bacterial invasion of the tooth. A full root canal will be required to reliably seal the nerve space and minimize risk of re-infection. 

If you can't get to a dental office right away and need relief from pain, over the counter NSAID medications like ibuprofen are excellent at treating dental discomfort. You may be tempted to request a prescription pain reliever, but these will not treat the inflammatory component of your pain like an NSAID. Before taking any medication for the first time, please consult with your dentist. If you have further questions on tooth pain, gum pain or emergency appointments, please give our office a call!

Dental Questions: Are dentures a good alternative to natural teeth?

For patients with lifetimes of dental problems, having all your teeth extracted and dentures made may seem like a reasonable choice. After all, the acrylic teeth and gums will be straight, white and won't be subject to cavities or gum disease. However, dentists have a saying: dentures aren't a replacement for teeth- they're a replacement for NO teeth. 

A complete denture is essentially a piece of hard acrylic that is contoured to fit against the upper and lower jaw bones on a patient with no teeth. On the upper arch, the denture creates a sort of "suction cup" against the hard palate. On the mandible, the denture simply rests on the residual ridge of bone. Hence, bottom (mandibular) dentures are unstable and initially difficult to use for eating and talking. Over time, denture wearers usually develop more control of these appliances with their tongue and lip muscles. 

The process of transitioning from natural teeth to dentures can be frustrating and disappointing. Eating with dentures is an entirely new learned skill. You can only generate about a fourth of the biting force you could make with natural teeth. Additionally, food has to be chewed in a specific way to keep the appliances from sliding out of place. For all these reasons, many patients are now opting to have implants placed to work in conjunction with the denture to develop more stability and usability. 

With all this being said, dentures can be a great solution for patients with advanced dental diseases. When faced with the prospect of having no teeth or severely compromised teeth, complete dentures are a lifesaver. For many, a positive attitude makes all the difference in the outcome of denture treatment. If you would like to know more about dentures, implants and other multiple tooth replacement options, please give our office a call!

Dental Questions: Does Charcoal Toothpaste Work?

Within the past year, ads for charcoal toothpastes and powders have taken over the internet. They promise everything from whiter teeth to stronger enamel and healthier gums. You may be curious if this paste can add extra power to your home dental care. Read on to see our professional evaluation of this new dental craze!

The most common versions of charcoal dental products are "tooth powders" sold for whitening purposes. According to the manufacturer, brushing your teeth with these powders daily for two weeks can produce a significantly white smile. Unfortunately, the best these products can probably achieve is removal of surface staining through their abrasive properties. Activated charcoal is great at filtering organic compounds out of fluids. However, intrinsic dental staining (the deep stains that are unsightly and hard to remove) reside mostly in the dentin layer beneath the tooth's enamel shell. As you may imagine, it would be impossible for charcoal to have any benefit in this area. 

Charcoal dental products also advertise their ability to heal gums and strengthen dental enamel. Currently, there is no scientific evidence to back these claims. Most studies show no significant reduction in tooth decay or improved gum health between charcoal paste users and the general population. On the contrary, patients who opt for charcoal products will likely see a decline in their oral health versus someone who exclusively uses fluoride toothpaste twice a day. Fluoride toothpaste is internationally recognized as the gold standard for remineralizing dental enamel and preventing tooth decay. Why try to improve on what we know works?

In short, charcoal dental products should be used at a patient's own risk. They are (generally) sold as supplements and do not disclose active ingredients in the same way a fluoride toothpaste would. If you notice any changes or deterioration in your oral health, discontinue their use immediately. Additionally, keep using your fluoride toothpaste, floss and any rinses on a daily basis along side the charcoal products. As with any dental health topic, give us a call if you have any questions or concerns. 

Gold Crowns and Fillings

Before the age of modern dental materials, metal played an important role in almost all types of restorations. Many dentists opted to use gold for fillings and crowns for it's durability and ease of use. If you have gold dental work, you may be concerned if it's utility has been surpassed by modern technology. On the contrary, gold still stands as one of the best materials available for dentistry today. Read on to learn how and why gold was (and continues to be) a popular dental material. 

Gold is a very malleable metal with a relatively low melting point and high polishability. These properties make it an ideal material for replacing lost tooth structure. Molten gold readily flows into complicated molds, allowing it to be cast into a variety of shapes- including tooth crowns. Once a crown is cast, it easily polishes to a high shine surface that deflects plaque and has great adaptation to tooth structure. Gold is also highly inert, meaning it will not rust or corrode over time. In dentistry, pure gold is mixed with a variety of other metals to better control the durability, color and resilience of the final product. 

Today, gold is used much less frequently than previous decades. However, it still has its place in restorative dental treatment. Gold can be an ideal material for creating a crown on a tooth when only a minimal amount of tooth structure needs to be removed. However, many modern tooth colored materials have met or surpassed the qualities of gold while providing better esthetics. 

In short, there is absolutely nothing wrong with gold as a dental material. Still, there are many newer materials available that mimic the benefits of gold, but with better cosmetic results. If you would like to know more about gold crowns, porcelain crowns or dental materials, please give our office a call!

Oral Hygiene for Kids

We know that getting your young ones to keep their teeth clean can be a challenge. However, the effort is definitely worth it: healthy baby teeth assist in the proper positioning and development of the adult dentition. Not to mention starting your children off young sets them up for a lifetime of great oral health, often saving thousands of dollars in dental expenses. Read on to discover how to maximize the protective factors for your child's teeth!

The first baby teeth typically erupt into the mouth between 6 and 18 months. Prior to this, we suggest keeping your child's mouth clean with a wet cloth. Once the teeth erupt, you should start brushing twice a day with a rice-grain sized smear of fluoride toothpaste. After two teeth grow in next to each other, you can begin flossing in this area. At about three years, you can start brushing with a pea-sized portion of paste.  Remember, children typically lack the dexterity to brush and floss their own teeth until they can tie their own shoes. Be careful to monitor how much toothpaste that they are using and make sure they are not swallowing excessive paste. 

The bacteria responsible for tooth decay colonize children at a young age (usually under the age of three). New research suggests that sharing utensils or cleaning dropped pacifiers and bottles with spit during this period can prematurely introduce these bacteria to a child's mouth. While there is a near 100% chance that these bacteria will eventually colonize everyone, delaying them as long as possible may prevent the number and extent of cavities. Once your child is old enough to rinse and spit without swallowing, you can add a fluoride rinse like ACT brand to double down on cavity prevention. 

We recommend bringing your child in for their first dental visit at 12 months of age or when all four central incisors are erupted (whichever is first). This is a short appointment for a general exam and to introduce your child to the dental office setting. If you would like to know more about cavity prevention, children's oral health or dental development, please give our office a call!

Dental Questions: How Often are Dental X-rays Taken?

X-ray images of your teeth are part of a complete regular dental examination. There is no other way to fully visualize every surface of the tooth and catch cavities before they become big problems. Likewise, they are a crucial step in diagnosing tooth pain during an emergency appointment. In this article, we hope to shed some light on the frequency and number of x-rays we take at our office. Read on for the full story!

For starters, it is important to recognize the relative safety of dental radiographs versus their diagnostic benefits. A full mouth set of x-rays exposes a patient to the same amount of radiation as a trans-atlantic flight. Likewise, if you spent 2 hours in direct sunlight the day of your appointment, you have received the same amount of exposure as a single film. In short, the risk is nearly negligible. However, we still strive to take as few images as possible, only exposing the teeth that absolutely need to be pictured. 

A full mouth x-ray series is composed of about eighteen films (four bitewings and 14 periapicals) that capture every surface of every tooth. Bitewings are used to visualize the spaces in between the molars and premolars and record the bone height around the teeth. Periapicals provide imaging of the root systems, any possible infections and the spaces between the anterior teeth. We usually take a new full mouth series every three to five years and update bitewings every six to eighteen months. These schedules are not set by patient preference or convenience- rather, they are dictated by guidelines from the ADA in accordance with the patient's specific risk for developing new cavities or gum disease. 

Naturally, these guidelines are not hard rules. We may wish to take x-rays more often if we are monitoring a specific tooth or if you come to an emergency appointment in pain. We calculate the need for radiographs very carefully and only recommend taking them when it is crucial to making a proper diagnosis. If you have any further questions about dental x-rays, exams or cleanings please give our office a call!

How Can I Soothe a Toothache?

Note: Never start taking any medication for the first time (even OTC products) without consulting a medical or dental professional first. Never exceed the prescribed dosing for a medication or use it in a method for which it was not designed. 

Toothaches always seem to spring up at the least convenient times. Often enough, they show up 6pm on a Friday before a long weekend. When you can't get to a dentist right away, what should you do about your pain? In this article, we hope to give you some direction (and comfort) in helping your dental woes.

The first thing to do with any type of dental pain is give your general dentist a call. Even after hours, every office should have a means of getting into contact with either your own dentist or one of their associates. An exception to this would be excruciating pain, possibly combined with swelling, fever and warmth around a tooth. In these instances, your first choice should be to head to an emergency room, as this can be the sign of a serious infection. 

Beyond getting into contact with a dental professional, there are a few steps you can take to reduce your symptoms. If the pain feels like it is coming from a tooth directly, we suggest taking an NSAID medication like ibuprofen (Advil). Most dental pain comes from pressure inside the tooth or bones, and is best treated by drugs (such as ibuprofen) with anti-inflammatory properties. We do not suggest taking any left over narcotics you may have on hand, as they are potentially harmful and will not stop the pain as effectively as an NSAID. 

If your pain feels like it is coming from your gums, try flossing gently to see if you can dislodge any stuck food (popcorn kernels are the worst offenders). Beyond this, we recommend rinsing with warm salt water to soothe inflamed tissue. Never try to apply Asprin, Advil or other medications directly to the gums. This will only irritate the tissue and create more pain. We also suggest staying away from topical toothache creams/gels, due to their lack of effectiveness and potentially dangerous side effects.

If your pain has a specific trigger, make note of it and try to avoid using your teeth in that manner. Knowing what causes the tooth to flare up can be an important factor in diagnosing the exact problem. If you would like to know more about toothaches, dental pain or gum pain, please give our office a call! 

Dental Questions: Does the order of brushing and flossing matter?

One of the most common oral health questions dentists receive from patients is the proper order of brushing and flossing. We are here to assure you that there is no recommended order to a standard oral health regimen. As long as you are brushing twice a day for two minutes with fluoride toothpaste and flossing daily, you are experiencing all the benefits of basic home oral hygiene. Dentists typically recommend brushing once in the morning and (definitely) once right before going to sleep/after your last meal. Flossing can take place at any point throughout the day, so long as it happens before you go to sleep. 

Beyond these suggestions, you may want to consider these options as well:

-Brush in the morning before breakfast. Brushing right after a meal can actually damage dental enamel due to the acidic affects of digested carbohydrates and the abrasive nature of toothpastes. 

-Using an alcohol rinse like Listerine after brushing can limit the fluoride activity of toothpaste. If you are at a high risk for developing cavities, consider switching to a fluoride rinse like ACT. 

-Chronic non-flosser? Consider keeping a bag of handle flossers in your car. It's a great reminder to keep those teeth clean!

-While sugar-free chewing gum can help clean/protect teeth, it is no replacement for brushing and flossing. However, a sick of gum after lunch or dinner can help dislodge food and stimulate protective salivary flow. 

We hope you found this guide helpful! If you have any other questions on oral hygiene, flossing, brushing or toothpaste choices, please give our office a call.