Cleaning & Prevention
Cleanings & Prevention with North Canyon Dentistry
A preventive program is a cooperative effort by the patient, dentist, and dental staff to preserve the natural dentition and supporting structures by preventing the onset, progress, and recurrence of dental diseases and conditions.
Preventing dental disease starts at home with good oral hygiene and a balanced diet. It is continued in the dental office by the efforts of your dentist and dental hygienist to promote, restore, and maintain your oral health.
Prevention also includes regular dental exams, cleanings, and x-rays. Sealants and fluoride are also great preventive treatments that help protect the teeth.
Prevention helps avoid serious and costly dental problems and is the key to having a healthy, confident, beautiful smile.
Dental Exam
A comprehensive dental exam will be performed by your dentist at your initial dental visit. At regular check-up exams, your dentist and hygienist will include the following:
- Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
- Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
- Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
- Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
- Examination of existing restorations: Check current fillings, crowns, etc.
Professional Dental Cleaning
Professional dental cleanings (dental prophylaxis) are usually performed by Registered Dental Hygienists. Your cleaning appointment will include a dental exam and the following:
- Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments.
- Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
- Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.
Diagnodent
Tooth decay can be extremely painful and puts the teeth at risk. Many extractions and restorative treatments are performed every single day because tooth decay has become too severe for the dentist to save the tooth. Diagnodent® is a safe fluorescent laser that detects hidden tooth decay accurately, quickly, and in its earliest stages.
All dentists are advocates for healthy, natural teeth. Restoration devices like crowns and bridges are popular because they allow the natural tooth to remain in the mouth. Diagnodent® accurately exposes areas of tooth decay without scratching, probing or “opening up the tooth.” This provides a greater chance of identifying, treating and retaining a natural tooth without the need for expensive and time-consuming restorations.
How can Diagnodent® help me?
Diagnodent® accurately exposes more caries than X-rays and examinations. In fact, this revolutionary diagnostic tool is over 90% accurate. Sometimes, caries “go underground” due to fluoridation. This essentially means that lesions that once lay on the surface of the tooth bed down, and remain invisible to the naked eye. Because Diagnodent® exposes caries earlier, more treatment options are possible.
Here are some of the other benefits associated with Diagnodent®:
- Allows dentists to perform treatment with greater confidence.
- Allows for the investigation of suspicious areas.
- Completely safe.
- Cost effective.
- Empirically measurable results.
- Helps reduce future dental procedures.
- More accurate than any other diagnostic tool.
- No exposure to X-rays.
- No need for invasive investigations.
- No pain or scratching.
What does the Diagnodent® process involve?
The Diagnodent® process is performed within the scope of a regular dental checkup. It is strikingly similar to having a laser pointer aimed at the teeth. Diagnodent® is a hi-tech tool, which first scans a clean tooth surface with a laser beam. This scanning procedure serves to calibrate the instrument by providing information about the tooth structure.
The Diagnodent® System is actually measuring the amount of laser fluorescence within the tooth. As each tooth is scanned, the amount of reflected laser light is recorded to produce a digital readout. If the tooth contains little or no decay, little or no laser light will be reflected back to the instrument. However, if a tooth contains caries of any significance, more laser light is reflected back. High readings (compared to the tooth originally scanned) indicate that caries are present within the structure of a particular tooth. The amount of laser light reflected back correlates with the amount of decay within the tooth.
Once the dentist determines which teeth are suffering from decay, a plan can be formulated and treatment options can be discussed. In most cases, the early detection of caries means more treatment options and a greater chance of saving the affected tooth.
If you have any questions about Diagnodent®, please ask your dentist.
Fluoride is the most effective agent available to help prevent tooth decay. It is a mineral that is naturally present in varying amounts in almost all foods and water supplies. The benefits of fluoride have been well known for over 50 years and are supported by many health and professional organizations.
Fluoride works in two ways:
Topical fluoride strengthens the teeth once they have erupted by seeping into the outer surface of the tooth enamel, making the teeth more resistant to decay. We gain topical fluoride by using fluoride containing dental products such as toothpaste, mouth rinses, and gels. Dentists and dental hygienists generally recommend that children have a professional application of fluoride twice a year during dental check-ups.
Systemic fluoride strengthens the teeth that have erupted as well as those that are developing under the gums. We gain systemic fluoride from most foods and our community water supplies. It is also available as a supplement in drop or gel form and can be prescribed by your dentist or physician. Generally, fluoride drops are recommended for infants, and tablets are best suited for children up through the teen years. It is very important to monitor the amounts of fluoride a child ingests. If too much fluoride is consumed while the teeth are developing, a condition called fluorosis (white spots on the teeth) may result.
Although most people receive fluoride from food and water, sometimes it is not enough to help prevent decay. Your dentist or dental hygienist may recommend the use of home and/or professional fluoride treatments for the following reasons:
- Deep pits and fissures on the chewing surfaces of teeth.
- Exposed and sensitive root surfaces.
- Fair to poor oral hygiene habits.
- Frequent sugar and carbohydrate intake.
- Inadequate exposure to fluorides.
- Inadequate saliva flow due to medical conditions, medical treatments or medications.
- Recent history of dental decay.
Remember, fluoride alone will not prevent tooth decay! It is important to brush at least twice a day, floss regularly, eat balanced meals, reduce sugary snacks, and visit your dentist on a regular basis.
A beautiful, healthy smile that lasts a lifetime is our ultimate goal when treating patients. Your personal home care plays an important role in achieving that goal. Your personal home care starts by eating balanced meals, reducing the number of snacks you eat, and correctly using the various dental aids that help control the plaque and bacteria that cause dental disease.
Tooth brushing
Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste.
- Place the brush at a 45 degree angle to the gums and gently brush using a small, circular motion, ensuring that you always feel the bristles on the gums.
- Brush the outer, inner, and biting surfaces of each tooth.
- Use the tip of the brush to clean the inside of the front teeth.
- Brush your tongue to remove bacteria and freshen your breath.
Electric toothbrushes are also recommended. They are easy to use and can remove plaque efficiently. Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.
Flossing
Daily flossing is the best way to clean between the teeth and under the gumline. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.
- Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
- Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
- Curve the floss into a “C” shape around each tooth and under the gumline. Gently move the floss up and down, cleaning the side of each tooth.
Floss holders are recommended if you have difficulty using conventional floss.
Rinsing
It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush. If you are using an over-the-counter product for rinsing, it’s a good idea to consult with your dentist or dental hygienist on its appropriateness for you.
Use other dental aids as recommended by your dentist or dental hygienist: Interdental brushes, rubber tip stimulators, tongue cleaners, irrigation devices, fluoride, medicated rinses, etc., can all play a role in good dental home care.
Brushing and flossing are of paramount importance to oral hygiene. Though bi-annual professional dental cleanings remove plaque, tartar and debris, excellent homecare methods are equally valuable. Proper brushing and flossing can enhance the health of the mouth, make the smile sparkle and prevent serious diseases.
Reasons why proper brushing and flossing are essential:
- Prevention of tooth decay – Tooth decay is one of the leading causes of tooth loss, and its treatment often requires complex dental procedures. Tooth decay occurs when the acids found in plaque erode the natural enamel found on the teeth. This phenomenon can easily be prevented by using proper home hygiene methods.
- Prevention of periodontal disease – Periodontal disease is a serious, progressive condition which can cause tooth loss, gum recession and jawbone recession. Periodontal disease is caused by the toxins found in plaque, and can lead to serious health problems in other parts of the body. Removing plaque and calculus (tartar) from the surface of the tooth using a toothbrush, and from the interdental areas using dental floss, is an excellent way to stave off periodontal problems.
- Prevention of halitosis – Bad breath or halitosis is usually caused by old food particles on or between the teeth. These food particles can be removed with regular brushing and flossing; leaving the mouth healthier, and breath smelling fresher.
- Prevention of staining – Staining or the yellowing of teeth can be caused by a wide variety of factors such as smoking, coffee and tea. The more regularly these staining agents are removed from the teeth using brushing and flossing techniques, the less likely it is that the stains will become permanent.
The Proper Way to Brush
The teeth should be brushed at least twice a day; ideally in the morning and before bed. The perfect toothbrush is small in size with soft, rounded-end bristles and no more than three months old. The head of the brush needs to be small enough to access all areas of the mouth, and the bristles should be soft enough so as not to cause undue damage to the gum tissue. The American Dental Association (ADA) has given electric toothbrushes their seal of approval; stating that those with rotating or oscillating heads are more effective than other toothbrushes.
Here is a basic guide to proper brushing:
- Place the toothbrush at a 45-degree angle where the gums and teeth meet.
- Use small circular motions to gently brush the gumline and teeth.
- Do not scrub or apply too much pressure to the teeth, as this can damage the gums and tooth enamel.
- Brush every surface of every tooth, cheek-side, tongue-side, and chewing surfaces. Place special emphasis on the surfaces of the back teeth.
- Use back and forth strokes to brush the chewing surfaces.
- Brush the tongue to remove fungi, food and debris.
The Proper Way to Floss
- Flossing is a great way to remove plaque from the interdental regions (between the teeth). Flossing is an especially important tool for preventing periodontal disease and limiting the depth of the gum pockets. The interdental regions are difficult to reach with a toothbrush and should be cleansed with dental floss on a daily basis. The flavor and type of floss are unimportant; choose floss that will be easy and pleasant to use.
- Here is a basic guide to proper flossing:
- Cut a piece of floss to around 18 inches long.
- Wrap one end of the floss around the middle finger of the left hand and the other end around the middle finger of the right hand until the hands are 2-3 inches apart.
- Work the floss gently between the teeth toward the gum line.
- Curve the floss in a U-shape around each individual tooth and carefully slide it beneath the gum line.
- Carefully move the floss up and down several times to remove interdental plaque and debris.
- Do not pop the floss in and out between the teeth as this will inflame and cut the gums.
- If you have any questions about the correct way to brush or floss, please ask your dentist or dental hygienist.
Physicians have relied on computerized axial tomography scans (CAT), for many years. CAT scans are an X-ray procedure that uses many different X-ray images with the help of computers to generate cross-sectional or even 3D views of internal organs and structures within the body. A knee replacement surgery, for example, would never be performed without first examining 3D imaging.
More recently however, dentists have begun to rely on 3D imaging techniques and i-CAT® scans to provide them with a detailed view of the mouth and skull. The advantage that 3D imaging holds over regular dental x-rays is that the bone structure, bone density, tissues and nerves can be viewed clearly.
i-CAT® scans can be completed in less than half a minute. This means that far less radiation enters the body than if a regular set of bitewing x-rays were taken. The main use for i-CAT® scans is as an aid to plan dental implant treatment and other oral surgery.
Dental implants are the most sophisticated replacement for missing teeth, but have historically proven to be time-consuming to place. i-CAT® scans vastly reduce the time it takes to implant teeth. It is thought that in the near future, implants will be placed in a single visit because of this unique type of imaging.
How are i-CAT® scans used?
i-CAT® scans are advantageous because they allow the dentist to magnify specific areas of the face. In addition, the dentist can easily view cross-sectional “slices” of the jaw, which makes planning treatment easier and faster.
Here are some of the main ways in which i-CAT® scans are used in dentistry:
- Assess the quality of the jawbone where the implant will be placed.
- Determine where nerves are located.
- Diagnose tumors and disease in the early stages.
- Measure the density of the jawbone where the implant will be placed.
- Pinpoint the most effective placement for implants, including the angle of best fit.
- Plan the complete surgical procedure in advance, from start to finish.
- Precisely decide on the appropriate size and type of implants.
- View exact orientation and position of each tooth.
- View impacted teeth.
How are i-CAT® scans performed?
i-CAT® scans are quick and simple to perform. A Cone Beam Imaging System is at the heart of the i-CAT® scanner. During the scan, the patient sits stationary on a designated seat. The cone beams are used to take literally hundreds of pictures of the face. These pictures are used to compile an exact 3D image of the inner mechanisms of the face and jaw. The dentist is able to zoom in on specific areas and view them from alternate angles.
Previous patients report the i-CAT® scanner is comfortable because they remain in a sitting position at all times. Additionally, the scanner provides an open environment, meaning that claustrophobic feelings are eliminated. The i-CAT® scan is an incredible tool that is minimizing the cost of dental treatment, reducing treatment time and enhancing the end results of dental surgery.
If you have questions or concerns about i-CAT® scans or 3D imaging, please contact our office.
Regular dental check ups are essential for maintaining excellent oral hygiene and diagnosing potential problems, but they are not a “fix-all” solution. Thorough oral homecare routines should be practiced on a daily basis to avoid future dental problems.
Periodontal disease (also called gum disease and periodontitis) is the leading cause of tooth loss in the developed world, and is completely preventable in the vast majority of cases. Professional cleanings twice a year combined with daily self-cleaning can remove a high percentage of disease-causing bacteria and plaque. In addition, teeth that are well cared for make for a sparkling white smile.
There are numerous types of oral hygiene aids on the supermarket shelves, and it can be difficult to determine which will provide the best benefit to your teeth.
Here are some of the most common oral hygiene aids for homecare:
Dental Flosses
Dental floss is the most common interdental and subgingival (below the gum) cleaner and comes in a variety of types and flavors. The floss itself is made from either thin nylon filaments or polyethylene ribbons, and can help remove food particles and plaque from between the teeth. Vigorous flossing with a floss holder can cause soft tissue damage and bleeding, so great care should be taken. Floss should normally be used twice daily after brushing.
Interdental Cleaners
Many hygienist & periodontists recommend interdental brushes in addition to dental floss. These tiny brushes are gentle on the gums and very effective in cleaning the contours of teeth in between the gums. Interdental brushes come in various shapes and sizes.
Mouth Rinses
There are two basic types of mouth rinse available: Cosmetic rinses which are sold over the counter and temporarily suppress bad breath, and therapeutic rinses which may or may not require a prescription. Most dentists are skeptical about the benefits of cosmetic rinses because several studies have shown that their effectiveness against plaque is minimal. Therapeutic rinses however, are regulated by the FDA and contain active ingredients that can help reduce bad breath, plaque, and cavities. Mouth rinses should generally be used after brushing.
Oral Irrigators
Oral irrigators, like Water Jets and Waterpiks have been created to clean debris from below the gum line. Water is continuously sprayed from tiny jets into the gum pockets which can help remove harmful bacteria and food particles. Overall, oral irrigators have proven effective in lowering the risk of gum disease and should not be used instead of brushing and flossing. Professional cleanings are recommended at least twice annually to remove deeper debris.
Rubber Tip Stimulators
The rubber tip stimulator is an excellent tool for removing plaque from around the gum line and also for stimulating blood flow to the gums. The rubber tip stimulator should be traced gently along the outer and inner gum line at least once each day. Any plaque on the tip can be rinsed off with tap water. It is important to replace the tip as soon as it starts to appear worn, and to store the stimulator in a cool, dry place.
Tongue Cleaners
Tongue cleaners are special devices which have been designed to remove the buildup of bacteria, fungi and food debris from the tongue surface. The fungi and bacteria that colonize on the tongue have been related to halitosis (bad breath) and a great many systemic diseases like diabetes, heart disease, respiratory disease and stroke. Tongue cleaners can be made from metal, wood or plastic and shaped in accordance with the contours of the tongue. Tongue cleaning should be done prior to brushing to prevent the ingestion of fungi and bacteria.
Toothbrushes
There are a great many toothbrush types available. Electric toothbrushes are generally recommended by dentists because electric brushes are much more effective than manual brushes. The vibrating or rotary motion helps to easily dislodge plaque and remove food particles from around the gums and teeth. The same results can be obtained using a manual brush, but much more effort is needed to do so.
Manual toothbrushes should be replaced every three months because worn bristles become ineffective over time. Soft bristle toothbrushes are far less damaging to gum tissue than the medium and hard bristle varieties. In addition, an appropriate sized ADA approved toothbrush should be chosen to allow proper cleaning to all the teeth. Teeth should ideally be brushed after each meal, or minimally twice each day.
If you have any questions about oral hygiene aids, please ask your dentist or dental hygienist.
Panoramic X-rays (also known as Panorex® or orthopantomograms) are wraparound photographs of the face and teeth. They offer a view that would otherwise be invisible to the naked eye. X-rays in general, expose hidden structures, such as wisdom teeth, reveal preliminary signs of cavities, and also show fractures and bone loss.
Panoramic X-rays are extraoral and simple to perform. Usually, dental X-rays involve the film being placed inside the mouth, but panoramic film is hidden inside a mechanism that rotates around the outside of the head.
Unlike bitewing X-rays that need to be taken every few years, panoramic X-rays are generally only taken on an as-needed basis. A panoramic x-ray is not conducted to give a detailed view of each tooth, but rather to provide a better view of the sinus areas, nasal areas and mandibular nerve. Panoramic X-rays are preferable to bitewing X-rays when a patient is in extreme pain, and when a sinus problem is suspected to have caused dental problems.
Panoramic X-rays are extremely versatile in dentistry, and are used to:
- Assess patients with an extreme gag reflex.
- Evaluate the progression of TMJ.
- Expose cysts and abnormalities.
- Expose impacted teeth.
- Expose jawbone fractures.
- Plan treatment (full and partial dentures, braces and implants).
- Reveal gum disease and cavities.
How are panoramic X-rays taken?
The panoramic X-ray provides the dentist with an ear-to-ear two-dimensional view of both the upper and lower jaw. The most common uses for panoramic X-rays are to reveal the positioning of wisdom teeth and to check whether dental implants will affect the mandibular nerve (the nerve extending toward the lower lip).
The Panorex equipment consists of a rotating arm that holds the X-ray generator, and a moving film attachment that holds the pictures. The head is positioned between these two devices. The X-ray generator moves around the head taking pictures as orthogonally as possible. The positioning of the head and body is what determines how sharp, clear and useful the X-rays will be to the dentist. The pictures are magnified by as much as 30% to ensure that even the minutest detail will be noted.
Panoramic X-rays are an important diagnostic tool and are also valuable for planning future treatment. They are safer than other types of X-ray because less radiation enters the body.
If you have questions or concerns about panoramic X-rays, please ask your dentist.
A sealant is a thin, plastic coating applied to the chewing surface of molars, premolars and any deep grooves (called pits and fissures) of teeth. More than 75% of dental decay begins in these deep grooves. Teeth with these conditions are hard to clean and are very susceptible to decay. A sealant protects the tooth by sealing deep grooves, creating a smooth, easy to clean surface.
Sealants can protect teeth from decay for many years, but need to be checked for wear and chipping at regular dental visits.
Reasons for sealants:
- Children and teenagers – As soon as the six-year molars (the first permanent back teeth) appear or any time throughout the cavity prone years of 6-16.
- Adults – Tooth surfaces without decay that have deep grooves or depressions.
- Baby teeth – Occasionally done if teeth have deep grooves or depressions and child is cavity prone.
What do sealants involve?
Sealants are easily applied by your dentist or dental hygienist and the process takes only a couple of minutes per tooth.
The teeth to be sealed are thoroughly cleaned and then surrounded with cotton to keep the area dry. A special solution is applied to the enamel surface to help the sealant bond to the teeth. The teeth are then rinsed and dried. Sealant material is carefully painted onto the enamel surface to cover the deep grooves or depressions. Depending on the type of sealant used, the material will either harden automatically or with a special curing light.
Proper home care, a balanced diet, and regular dental visits will aid in the life of your new sealants.
Oral cancer is often deemed the “forgotten disease,” because it kills more people than testicular cancer, cervical cancer and cancer of the brain each year and receives little publicity in return. Each year, over 30,000 Americans contract oral cancer, and only 57% of these people will live for more than five years without treatment.
Many people believe that if they abstain from tobacco and alcohol use, oral cancer will not affect them. Tobacco and alcohol use does contribute to oral cancer; however, 25% of those diagnosed abstain from both substances.
The best way to stay protected from oral cancer is to get annual oral cancer screenings. Most dentists perform an oral cancer exam during a regular dental checkup. The FDA-approved VELscope® offers dentists another examination tool to help detect oral cancer in its earliest stages. The VELscope® is a blue excitation lamp, which highlights precancerous and cancerous cell changes.
How does the VELscope® work?
The VELscope® uses Fluorescence Visualization (FV) in an exciting new way. Essentially, bright blue light is shone into the mouth to expose changes and lesions that would otherwise be invisible to the naked eye. One of the biggest difficulties in diagnosing oral cancer is that its symptoms look similar to symptoms of less serious problems. The VELscope® System affords the dentist important insight as to what is happening beneath the surface.
The healthy soft tissue of the mouth naturally absorbs the VELscope® frequency of blue light. Healthy areas beneath the surface of the soft tissue show up green, and the problem areas become much darker.
Here are some of the advantages of using the VELscope® System:
- Can be combined with digital photography.
- Detects lesions, white and red patches.
- Detects problem areas that cannot be seen under white light.
- Exposes precancerous and cancerous tissue.
- FDA-approved.
- Helps dentists check that diseased soft tissue is completely removed.
- Helps diagnose oral cancer in its earliest stages, exponentially increasing the chance of survival.
- Quick, painless examinations.
How is the VELscope® examination performed?
The VELscope® examination literally takes only two or three minutes. It is a painless and noninvasive procedure that saves many lives every single year.
Here is a brief overview of what a VELscope® examination is like:
Initially, the dentist will perform a regular visual examination of the whole lower face. This includes the glands, tongue, cheeks and palate as well as the teeth. Next a pre-rinse solution is swilled around the mouth for slightly less than a minute. The dentist provides special eyewear to protect the integrity of the retinas. The lights in the room are dimmed to allow a clear view of the oral cavity.
The small VELscope® is bent to project blue light inside the mouth. Lesions and other indicators of oral cancer are easily noticeable because they appear much darker under the specialized light.
If symptoms are noted, the dentist may take a biopsy there and then to determine whether or not this is oral cancer. The results of the biopsy dictate the best course of action from there. Otherwise, another oral cancer screening is performed in one year’s time.
If you have any questions or concerns about oral cancer screening or the VELscope® system, please contact our office.
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Dr. Thomas M. Mack, D.D.S., P.C.
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