Office Spotlight: Hygienist Lori Dombroski

Lori and her husband

Lori's kids

At Thousand Oaks Family Dentistry, our team is what makes the experience special! We are fortunate to work with a dedicated group of dentists, hygienists, dental assistants and office staff that are passionate about excellent care. Today, we would like to honor Lori, one of our beloved hygienists. She has been an important part of our office for nearly a decade, with many patients attesting to her expertise and skill.

Lori Dombroski joined our team as a registered dental hygienist at Thousand Oaks Family Dentistry in February of 2008.  Lori is from Newbury Park and is a graduate of Newbury Park High School.  She furthered her education at Moorpark College and obtained her degree in dental hygiene from West Los Angeles School of Dental Hygiene in 1991.  Lori resides in Moorpark with her husband and has two grown children.  On the weekends you can find Lori antique shopping, going to the beach, spending time with her family, and enjoying area restaurants.

At our office, we pride ourselves in selecting staff members to suit a number of different dental needs and personality types. Our goal is to have every patient to feel like part of our "family." To schedule an exam and/or cleaning, please give our office a call at (805) 480-9820 today!

Dental Questions: Will my teeth be whiter after a dental cleaning?

Have you ever had your teeth cleaned only to see no noticeable difference in their appearance? Your mouth may feel cleaner, but the shade of your dental enamel probably didn't change too much. Read on to find out why this is the case, and what a routine cleaning actually achieves!

For the majority of the population, yellow and discolored teeth are caused by something called intrinsic staining. Here, the teeth pick up pigment in the dentin layer beneath the outer enamel. No amount of brushing, scrubbing or abrasive products will remove these compounds. A smaller portion of the population will be effected by extrinsic staining. This occurs when a combination of deeply colored foods, plaque and tartar discolor the surface of the teeth. This staining most commonly effects smokers, heavy coffee drinkers and those with deficiencies in their daily oral care. Because this staining only involves the outermost layer of the teeth, brushing and flossing will have some control over its presence.

As you can probably see, dental cleanings will have little to no affect on intrinsic staining. To take care of dentin layer staining, you will need to use a specific bleaching system like white strips, bleach trays or ZOOM whitening. However, extrinsic staining will be readily addressed by a routine "prophy" cleaning. Since these stains are adhered to the surface of the teeth, mechanical polishing and scaling will eliminate them with ease. 

Your routine cleaning serves three general purposes: to remove plaque and tartar from the teeth, allow a dental professional to asses changes in your oral health, and provide feedback on your home care between visits. The combined goal of these objectives is to protect the teeth from periodontal disease and the progression of tooth decay. Any improvements in the cosmetic appearance of the teeth after a cleaning is a celebrated secondary benefit. If you would like to know more about dental cleanings, dental staining or whitening, please give our office a call!

Lower Arch Reconstruction

Today's patient came to us with porcelain and metal crowns on all of their lower teeth. With time, these restorations had become chipped and worn, making it obvious that they were not natural teeth. Additionally, gum recession had revealed the dark metal collars around these crowns, creating an obvious transition from enamel to porcelain. Finally, porcelain and metal crowns are inherently opaque (do not transmit light) to block out the inner metal layer. This contrasts harshly with the natural translucency of dental enamel and makes the teeth look "old" or yellow. 

After considering the many options, Dr. Kari Ann Hong and the patient decided to replace the existing crowns with new Emax lithium disilicate restorations. Emax provides increased durability over porcelain and metal crowns with better esthetics and more design possibilities. The results speak for themselves! The new crowns have a much more natural shape and contouring, while the shade and translucency better matches natural enamel. Additionally, the increased wear resistance will help ensure these teeth for years to come. If you would like to know more about dental crowns, fillings and other cosmetic procedures, please give our office a call! 

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!

Cosmetic Gum Line Fillings

Another great cosmetic filling from Thousand Oaks Family Dentistry! Today's patient came to us with abfraction lesions on their upper premolars. These cavities are usually caused by the forces of biting, chewing and clenching causing stress on the enamel around the necks of the teeth. After an indentation develops in this area, it becomes a perfect trap for food and plaque. This often leads to decay, thus advancing the process of wear on the tooth. 

We repaired these teeth by removing any compromised enamel and smoothing out the cavity edges. They were then filled with a flexible and esthetic material that both seals out decay and restores the natural beauty of the teeth. While the upper premolars are not directly visible in the smile line, their profiles often contribute to smile "width." For this reason, a cosmetic filling is desirable in maintaining a natural appearance. If you would like to know more about tooth decay, fillings or other cosmetic dental procedures, 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!

Cosmetic Incisal Bonding

Today's patient came to us with a chipped maxillary central incisor that did not extend to the tooth's nerve. They had no symptoms of pain and simply wanted the tooth fixed. This is a very typical dental injury- particularly with young children and patients who play contact sports. The maxillary incisors are the most commonly chipped teeth due to their vulnerable position in the mouth and thin enamel edge. 

After discussing treatment options, we decided to solve the cosmetic concern with composite bonding. Here, filling material is added to the tooth using a special adhesive and bonding technique. Once the restoration was cured to the tooth, Dr. Kari Ann Hong reshaped it to match the contours and length of the neighboring incisor. Since this material closely matches the optical properties of natural teeth, the effect is a natural and unnoticeable restoration!

It is important to note that not every type of chipped tooth can be fixed with composite bonding. Chips extending to the tooth nerve will need a root canal and crown to treat any residual pain and remove the inflamed tissue. Larger chips will also require veneers to reliably replicate large amounts of tooth structure. Finally, certain types of occlusion (the way the teeth come together when you bite) will limit the amount of repair that can actually be done to the teeth. It is impossible to decide what treatment option is best without a complete examination. For more information on dental bonding, crowns, veneers and other cosmetic treatment, 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.