We are not your regular, run-of-the mill dental clinic because we use the latest technology to deliver our dental services. To us at Dental Works, keeping your teeth and gums healthy are a reward in itself and giving you that perfect smile is simply a bonus.
What does your dentist mean when he says a Bone Graft is necessary to place your dental implant?
The success of a dental implant, it's ability to support a dental restoration, is very much dependent upon how much bone is available in the site where the implant is placed. There are lots of things that affect the bone volume including things like periodontal disease, trauma and infections and it is not unusual to open up a site in the mouth for implant placement and find out that some of the critical supporting bone is missing. No problem.... We, at Dental Works, have great techniques available to us to replace missing bone. We can increase the height of bone and the width of bone. We can fill in anatomical voids in bone thereby creating new bone and we can fill in all sorts of defects that develop when teeth are lost. We can even use grafting techniques to prevent the loss of bone in circumstances where bone would normally be lost like the extraction of a tooth.
Replacing missing bone or adding to existing bone is very often essential to the success of a dental implant and the ensuing restoration. The techniques to do this are well documented and should be used when indicated by the dentist who places dental implants. Most of us will have a good idea when additional bone or bone repair will be necessary before actually starting the placement of a dental implant and the patients should be informed of this possibility. Sometimes, however, we do get fooled and run into areas where unexpected bone grafting is indicated. As long as the dentist is prepared to replace or add to the existing bone and the patient understands the bone grafting procedure, there should not be any problem with these techniques...
Types of Bone Grafting:
There are many ways in which bone grafting can be done. Sometimes it is as simple as collecting bone when preparing an implant site and then reusing the bone for grafting purposes. Whenever we can use the patients own bone for repairs or additions, we will get the best results. In extreme cases, bone can be harvested from areas outside the mouth. The most common area is the hip. Needless to say, when this type of bone graft is done, everyone has to be fully prepared and you would usually find yourself in a hospital setting with a physician actually removing the bone from your hip and your dentist placing it in the appropriate areas of your mouth.
Very often, we can use "bone in a bottle" to do bone grafting for dental implants. This bone is specially prepared from cadavers or other sources and used to get the patients own bone to grow into the repair site. It is very effective and very safe. Sometimes synthetic materials can be used to stimulate bone formation and sometimes we even use factors from your own blood to accelerate and promote bone formation in graft areas.
Very often, bone grafting is done in combination with what dentistry refers to as a "Barrier Membrane Technique". Membranes made out of special materials are placed over bone graft sites to keep out the types of soft tissue cells we do not want and promote the growth and migration of cells which will turn into normal, healthy bone. These membranes are very successful and are used quite a bit these days to promote sound bone formation. The membranes are usually removed at a later date, but sometimes they can be resorbed by the body and disappear all on their own.
In addition, it is not uncommon to use "screws" and "tacks" to secure membranes and bone grafts at an implant site. Sometimes these pieces will also have to be removed at a later date, but rest assured that all of these components and grafting materials are safe and effective and their use has gone a long way in increasing the success rates of dental implants.
The Sinus Lift:
The human skull has several cavities or air spaces which are called "sinuses". They are part of the overall design of human beings to make the head lighter so that it can be supported on our neck. Sometimes the sinus are enlarged and intrude on areas where we want to place dental implants. We cannot place a dental implant into the sinus because we would just be placing it into an air cavity and nothing would hold it into place (although, very often, implants that are placed securely into solid bone will protrude a small way into the sinus) so when we encounter this problem, we place bone or bone growth stimulating material into the sinus.
This procedure really only affects the maxillary sinuses which are located just over the molar teeth in the upper jaw. There are no sinusesin the lower jaw. When the maxillary sinus prevents the placement of an implant, we merely open up the side of the sinus and raise the bottom portion of the sinus so it will fill in with bone. We can then go back several months later and place our dental implants in solid bone. Sometimes, there is enough bone to place the implants at the same time that you raise the floor of the sinus. This will save time.
There are some more conservative ways to grow bone in the sinus. We can do what is called an "Osteotome Lift" and just raise the floor of the sinus right over where we are placing an implant. This can be done without actually opening the sinus and healing and implant integration will then proceed as if the sinus was not in the way. Sinus lifts of all types have a high success rate and are commonly used today for promoting dental implant procedures.
Cosmetic Dentistry Back to Top
Repair or completely redesign your smile in as few as two office visits!
The immediate effects are so noticeable that many patients express life changing experiences, improving each day with the freedom to smile confidently.
Cosmetic and restorative dentistry is an amazing way to experience a complete smile makeover. Through his instruction and training at the University of Texas' Dental School, and further studies with the International Congress of Oral Implantologists in Munich, Germany and the Southern California Implant Institute of San Francisco, CA, Dr. Williams brings expert skill and artistry to his cosmetic treatments for both permanent and removable appliances.
Dental Works has successfully and fully treated and helped their patients back onto the road of good dental health and restore their confidence with a beautiful smile.
Contact us for more on the amazing benefits of cosmetic dentistry.
Dentures Back to Top
Dental Works can provide all of the information you need to make a well informed decision about your denture care, denture problems, and the possibility of a new denture. There is much to learn. Even though dentures may be the best possible solution for your oral well-being, they might never function as well as your original teeth. However, they will restore your youthful appearance. Proper denture treatment helps you feel better about yourself and will allow you to eat most of the foods you love. It will also help eliminate embarrassment by enabling you to speak more clearly. Good fitting dentures may even improve digestion! And did you know your dentures aren't meant to last forever? As you age, your mouth gradually changes, which makes you a candidate for a denture reline or a new denture in our on-site lab facility. You can expect a premium and personalized denture fabricated by our certified lab technician. You can expect high quality, well-fitting dentures at Dental Works.
Fillings Back to Top
A dental filling is a type of restorative dentistry treatment used to repair minimal tooth fractures, tooth decay or otherwise damaged surfaces of the teeth. Dental filling materials, which include composite, porcelain and silver amalgam, may be used to even out tooth surfaces for better biting or chewing.
Enamel loss is a common component of tooth decay, and may result in tooth sensitivity. In many cases, tooth sensitivity caused by enamel loss will be significantly improved or completely eliminated once an appropriate dental filling material is placed. But in some cases, depending on the extent of tooth decay or damage, the affected tooth may require additional or alternative procedures, including:
- Dental Crowns: Teeth requiring more support than offered by a traditional filling may require a dental crown.
- Dental Implants and Dental Bridges: Irreparable tooth damage requiring tooth extraction may require an implant or bridge.
- Root Canals (perhaps along with antibiotic treatment): Infected, abscessed or nerve damaged teeth may require a root canal procedure.
Dental Fillings: The Procedure
During preventative dental hygiene checkups, or dental emergency visits prompted by a toothache, Dr. Williams will evaluates your teeth, gums and supporting bone structure. He will identify the number of tooth surfaces affected by decay or damage, and then prepares the tooth and necessary surrounding areas in order to restore the damaged area. The decay or damage is removed with a dental hand-piece or laser, and the area is cleansed to remove bacteria or debris before the restoration is completed.
The first step in performing a composite filling procedure involves isolation of the tooth. Tooth isolation is critical in a composite restoration, because it prevents moisture from interfering with the bonding process. The bonding procedure requires the placement of various adhesives followed by the composite material, which is then hardened with a special bonding light. The completed composite restoration is both functional and natural looking.
On average, amalgam fillings are expected to last approximately 12 years, while composite fillings are expected to last five to seven years. This of course is dependent on your unique considerations, the care with which you treat your oral hygiene and your commitment to continued dental visits.
OraTec Bioscan Video Microscopy Back to Top
BioScan is the fastest chairside test available, just 1 minute from sampling to viewing.
Easy - Making a slide of plaque is extremely simple. Most plaque samples are taken and prepared by the hygienist or chairside assistant.
Diagnostic - The periodontal literature is replete with hundreds of citations supporting the diagnostic benefits of the microscopic examination of dental plaque.
Simple - Periodontal disease is typically caused by a mixed infection of predominantly anaerobic microorganisms. Fortunately, several of these organisms are easily seen with a phase contrast microscope and serve as ready markers for periodontal risk, including: Treponemes (spirochetes); gliding rods and protozoans. Periodontal inflammation is characterized by large numbers of WBC's, another cell type easily observed with a phase contrast microscope.
Inexpensive - BioScan Phase Contrast Video Microscopy is easily the least expensive microbial assessment technique on the market.
Motivational - The sight of the living `bugs` from their own mouths on a high-resolution, large screen monitor is, quite simply, the most powerful patient motivation tool ever developed. Once they've seen what's in their plaque, most patients want to be treated and work diligently at their home care. Patient motivation and effective home care, the hardest jobs in dentistry, just became a whole lot easier.
Placing Implants Back to Top
Before Placing an Implant
Not all people are good candidates to get dental implants. You must be in good health, have healthy gums, and have enough bone in your jaw to allow an implant to be placed in the jawbone. You will be examined by us at Dental Works and we can determine if you are suitable to get an implant.
Some people are interested in getting implants to replace teeth that have been missing for years. Others may need implants to replace teeth that were extracted recently because of severe decay, periodontal (gum) disease, infection or injury. In some cases, the teeth can be extracted and the implant placed at the same time. However, if you have a severe infection in a tooth root or your gums, your dentist may wait a few months after removing the teeth to allow the area to heal.
Before a dental implant is placed, you may need to have the bone in the area built up to increase the chance of success. This is a common procedure called bone grafting or augmentation. If a bone graft is done, you will need 4 to 12 months to heal before having the implants placed in your jawbone. You can wear dentures or a bridge during this time, so you won't be without teeth.
Placing the Implants
Most implants are placed using a two-step process, although some newer implants can be placed in one step. What follows, is a description of how the two-step process works.
First surgery
You may be given antibiotics and pain medication to take before the surgery. We will use local anesthesia for the procedure and will offer you sedation if you want it. You can be sedated by taking medication by mouth, or through an intravenous line (a needle attached to a small tube placed in a vein in your arm).
To place the implants, the surgeon first will make an incision (cut) in your gums to expose the bone. He then will drill a hole in the bone for the implant, and place the implant in the hole. The surgeon probably will take an X-ray of the area to make sure the implant is where it should be. The surgeon will then stitch your gum closed over the implant.
The time required for this procedure depends on the number of implants being placed and whether or not bone grafting is being done at the same time. In most cases, placing a single dental implant requires about one hour. You will feel some pain after this procedure. The level of discomfort depends on the person, but generally it has been described as relatively mild.
If the implant is placed in the front of your mouth, the dentist will give you a temporary denture or bridge so that you do not have to be without teeth. We will discuss options with you before the surgery.
After the surgery, your surgeon will give you antibiotics and pain medication. They also will give you instructions to follow. These will include:
- Don't spit, suck on straws or smoke. This can dislodge blood clots and slow healing.
- Eat only soft food to avoid injuring your gums.
- Don't try to clean the implant area for the next one to two weeks, but clean the rest of your mouth normally. Your dentist may give you an antibacterial rinse to help keep the area clean.
You will return to the surgeon 7 to 10 days later to have your stitches removed.
After the implant is placed in your jaw, you will have to wait several months for the bone to bond with the implant. This usually takes 3 or 4 months in the lower jaw and 5 or 6 months in the upper jaw. During this time, the head of the implant usually remains hidden under your gum.
Second surgery
After the implants have integrated (attached) with the surrounding bone, you are ready for the second surgery. After giving you local anesthesia, we will make a small incision in the gum to expose the implant. The dentist will remove a protective screw from the implant and replace it with a metal healing abutment (collar). The healing abutment looks like a small metal cylinder that sits above your gums in the area where your tooth would be. It maintains the space so that the gums heal correctly around the implant.
In a very small percentage of cases, the implants will not have successfully bonded with the bone. If this happens, we either can remove the implants and immediately replace them with slightly wider ones, or remove them and allow the area to heal for several months before making a second attempt.
In some cases we can now use one-stage implants. These implants are placed in the jaw and remain exposed in the mouth so that no second surgery is needed.
Restoration
Generally, you will come back to Dental Works two or three weeks after the second surgery to start the process of having your crown, bridge or denture made.
Root Canal Therapy Back to Top
What is root canal therapy?
Root canal therapy is designed to correct disorders of the dental pulp -- the soft tissue inside the tooth that contains nerves, blood vessels, and connective tissue. Teeth with abscessed, or infected, nerves were once removed with corrective therapy. But now, in 95 percent of these cases of pulpal infection, the natural tooth can be saved through modern endodontic procedures.
What causes pulpal nerve damage?
The most common causes of pulpal nerve damage are:
- Physical irritation - generally brought on by aggressive tooth decay (cavity) reaching down to the nerve or through deep fillings, which allows harmful bacteria to reach the nerve resulting in infection and decay
- Trauma - a blow to a tooth or the jaw can cause damage to sensitive nerve tissue within the tooth.
The following are the most common symptoms of pulpal nerve damage. However, each individual may experience symptoms differently. Symptoms may include:
- Pain in the tooth when biting down
- Tooth pain while chewing
- Oversensitivity of the teeth with hot or cold drinks
- Facial swelling
Why is root canal therapy necessary?
Without treatment, the infection of the dental pulp will spread to the bone around the tooth, making it no longer able to hold the tooth in place.
What does the root canal procedure involve?
Treatment begins with the initial removal of the tooth crown, or top, to allow access to the pulpal tissue. Once the affected pulpal tissue is exposed, the affected area is removed. The area surrounding and containing the pulpal tissue is carefully cleaned, enlarged, and shaped to provide a clean, bondable surface for filling with a permanent filler to prohibit any further infection and discomfort. After filling, a crown is fabricated to complete the rescue and restoration of the natural tooth. The procedure is generally spread over several visits to assure the infected pulp and associated bacteria have been adequately drained.
Post-Operative Care Following a Root Canal
Once the root canal therapy is completed, there will be changes to adapt to, including:
- Brittleness - a pulp-less tooth is more brittle than a non-treated tooth and great care should be used to avoid fracture and chipping
- Discoloration - a non-vital tooth may become discolored over time, which can be treated with bleaching. In most cases, the discoloration poses no threat to the health of the tooth.
Routine Cleanings Back to Top
Dental cleaning means the professional the cleaning you can only receive from a dentist or dental hygienist. A routine dental cleaning should include scaling root planning and polishing. These three important steps are outlined in detail below.
Scaling: This is the removal of plaque and tartar from all tooth surfaces with different types of scaling being used in relation to the amount of plaque and tartar.
Dental hygienists perform traditional scaling by hand. Advances in technology have led to more modern methods such as electric scalers which allow dental cleanings to be done in a much shorter period of time. However to achieve best results electric and manual scaling should be combined in dental cleaning.
Ultrasonic scaling uses a machine called a cavitron which uses sound waves to remove tartar. Ultrasonic scalers can only remove 50% of total tartar buildup so hand scaling must follow cavitron scaling. People who wear a pacemaker cannot get ultrasonic scaling because the ultrasonic sound can interfere with the function of the pacemaker.
Root planing: This is the cleaning of pockets to stop further gum problems.
Root planing is used to treat periodontal conditions which are moderate to advanced gum disease. When the gum is inflamed gum pockets become deeper and they lose bone connections inside. The deeper these pockets are the easier it is for them to trap plaque deposits and make the gum worse.
Root planing is usually done with local anesthesia and is a periodontal cleaning, deep into the boney pocket below the gum line.
Polishing: This is the final step of both regular and periodontal cleanings.
There are two kinds of polishing: the prophy jet polishing and rubber tip polishing with prophy paste. Prophy jet polishing works by spraying high pressured water mixed with baking soda paste onto the surface of your teeth. This powered water can wash away the residue and plaque while the baking soda removes the brown and yellow stains and neutralizes the acidic conditions in your mouth. Rubber cup polishing employs a low-speed hand piece with a rubber cup tip mounted on the top that contains a polishing paste that is made of abrasive ingredients ideal for removing stains.
The amount of time needed for dental cleaning depends on factors from tartar deposits, complications of dental restorations and your gingival health. People with more tartar and plaque buildup need longer appointments than those who have relatively cleaner teeth. Ideally in a moderate case, dental cleaning should take about 25 to 30 minutes. Cleaning should be performed every six months to prevent excessive plaque and tartar build up. Lack of cleaning allows the growth of plaque; which if left unchecked can lead to the various types of conditions allowing tooth decay and bone loss.
Sonicare Back to Top
Sonicare's patented sonic technology is proven to be powerfully effective, yet remarkably gentle. It generates high amplitude and high frequency bristle motion, creating dynamic cleaning action that drives fluid forces deep into interproximal spaces and along the gumline. The result is a superior clean that you can see and feel.
Sonicare believes in innovative technologies and products designed around the people who use them.
Sonicare achieves its bristle velocity through a combination of high frequency and high amplitude bristle motion. Dynamic cleaning action has been demonstrated in vitro to be gentler on dentin than a manual or an oscillating toothbrush. The power of dynamic cleaning action, coupled with the specially designed bristle orientation, results in deep penetration of interproximal spaces.
Treating Severe Gum And Bone Disease Back to Top
A majority of the adult population have some form of gum disease.
Diagnosed and effectively treated early with a large choice of products and services, mild cases of gum disease (gingivitis) can be successfully managed.
Severe cases of advanced gum disease, commonly known as Periodontitis, can be quite devastating and cause loss of critical bone structure and mass .... causing eventual loosening and/or loss of teeth.
A variety of interventions, nonetheless, can be performed in many cases where infected hard and soft tissues are removed and treated with different types of grafting products. Temporary implants and prosthetic products can be integrated into treatment that enables patients to NOT be without teeth during healing.
Tooth Extractions Back to Top
Why might a person require a tooth extraction?
There are a number of reasons why Dr. Williams might recommend that you have a tooth, or even several teeth, extracted. A tooth extraction might be indicated if repairing a damaged tooth is not practical. Also broken, cracked, or extensively decayed teeth can be extraction candidates.
Some teeth will have extensive decay (dental caries) or else will have broken or cracked in such an extreme manner that an extraction might be considered the best, or at least a reasonable, solution. Of course there will be a number of factors that will come into play with any specific situation. In some cases the obstacles that present themselves might be so formidable that a repair for the tooth is simply not possible. In other cases the cost of needed dental treatment or else a questionable long-term outlook for the success of the treatment may be the reason an extraction is chosen. Teeth that are unsuitable candidates for root canal treatment should be extracted.
Some teeth may require treatment of the nerve space that lies within them (root canal treatment) in order to make a repair. While most teeth typically are candidates for root canal treatment there can be complicating factors that remove this option. If this is the case and needed root canal treatment cannot be performed then the extraction of the tooth is indicated. Teeth associated with advanced periodontal disease (gum disease) may need to be pulled.
By definition, teeth that have experienced the effects of advanced periodontal disease (gum disease) are teeth whose supporting bone has been damaged. In general, as periodontal disease worsens, a tooth is supported by less and less surrounding bone, often to the point where the tooth becomes loose. In those cases where significant bone damage has occurred and a tooth has become excessively mobile, extraction of the tooth may be the only option.
Some teeth are extracted because they are malpositioned. As an example, sometimes when wisdom teeth come in they lie in a position that proves to be a constant source of irritation to the person's cheek (by either rubbing against the cheek or causing the person to bite it). As a solution, Dr. Williams may suggest that the offending wisdom teeth should be extracted.
Nonfunctional teeth are extraction candidates. Some teeth might be extracted because they provide very little service to the dental patient but do offer risk for becoming problematic. A common example is a wisdom tooth that has come in but has no matching tooth to bite against. Wisdom teeth are typically in a region of the mouth that is hard to clean, thus placing them and their neighboring tooth at greater risk for decay and periodontal disease. Depending on the precise circumstances that they find, we may advise the patient that removing a nonfunctional tooth might be in that patient's best long-term interest in regards to maintaining good oral health.
Impacted teeth are often extracted. Impacted teeth are teeth whose positioning in the jaw bone is such that they cannot erupt into normal alignment. So by definition, impacted teeth are malpositioned and because they are malpositioned they are often nonfunctional. This combination of factors makes impacted teeth common candidates for extraction.
When orthodontic treatment is performed for a patient the dentist is trying to perfect the alignment of the patient's teeth but they can only do so within the confines of the size of the person's jaws. Especially in those cases where a large discrepancy exists between the size of the patient's jaws and the needed space required for the improved alignment of their teeth, some strategically located teeth may need to be extracted.
When might a tooth extraction be a bad idea?
A missing tooth allows the neighboring teeth to shift. During their examination of your teeth and mouth it is possible that we will be able to recommend one or more alternative treatments to having a tooth extraction. While extracting a tooth might be less expensive than the other treatment options propose, it may not be the least expensive treatment in the long-run.
When a tooth is removed its neighboring teeth will tend to shift, sometimes significantly. Any alignment changes that do occur can have a major impact on your dental health. Removing even a single tooth can lead to problems associated with chewing ability or jaw joint function. Additionally, teeth whose alignment has changed can become traps for food or be harder to clean thoroughly, thus placing them at greater risk for tooth decay and gum disease.
So to avoid these types of complications, in most cases Dental Works dentists will probably recommend to you that you replace any tooth that has been extracted. Replacing a tooth after an extraction with an artificial one can easily cost more than the alternative of not extracting a tooth and instead rebuilding it.
Whitening Back to Top
Take a first step in feeling good and looking great with brighter, whiter teeth in less than an hour. Zoom! teeth whitening is safe, effective and very fast, and performed only by a dental professional.
Extensive research and clinical studies indicate that whitening teeth under the supervision of a dentist is safe. In fact many dentists consider whitening the safest cosmetic dental procedure available.
Q1: What is Zoom! tooth whitening?
A1: Zoom! is a bleaching process that lightens discoloration of enamel and dentin. You may have seen the Zoom! process used on ABC's Extreme Makeover.
Q2: How long does Zoom! Chairside Whitening take?
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A2: The complete procedure takes a little more than an hour. The procedure begins with a preparation period followed as little as by 45 minutes of bleaching. (A cleaning is recommended prior to the actual Zoom! whitening session.)
Q3: How does the Zoom! In-off ice system work?
A3: The Zoom! light activated whitening gel's active ingredient is Hydrogen Peroxide. As the Hydrogen Peroxide is broken down, oxygen enters the enamel and dentin, bleaching colored substances while the structure of the tooth is unchanged. The Zoom! light aids in activating the hydrogen peroxide and helps it penetrate the surface of the tooth. A study has shown that use of the Zoom! lamp increases the effectiveness of the Zoom! gel by 26% or more, giving an average improvement of up to eight shades.
Q4: What will I experience during the Zoom! In-Office Procedure?
A4: During the procedure, patients may comfortably watch television or listen to music. Individuals with a strong gag reflex or anxiety may have difficulty undergoing the entire procedure.
Q5: How long do the results last?
A5: By following some simple post whitening care instructions, your teeth will always be lighter than they were before. To keep your teeth looking their best, we recommend flossing, brushing twice daily, and occasional touch-ups with Zoom! Weekender or Nite White gel. These are professional formula products designed specifically to keep your teeth their brightest. They are available only through your dental professional.
Q6: Are there any side effects?
A6: Sensitivity during the treatment may occur with some patients. The Zoom! light generates minimal heat which is the usual source of discomfort. On rare occasions, minor tingling sensations are experienced immediately after the procedure, but always dissipate. You can also ask your dentist to supply you with anti-sensitivity toothpaste for use prior to treatment.
Q7: What causes tooth discoloration?
A7: There are many causes. The most common include aging and consumption of staining substances such as coffee, tea, colas, tobacco, red wine, etc. During tooth formation, consumption of tetracycline, certain antibiotics or excessive fluoride may also cause tooth discoloration.
Q8: Do many people whiten their teeth?
A8: More people than you might imagine. A bright sparkling smile can make a big difference for everyone. The Zoom! Chairside Whitening System makes it easier and faster than ever before.
Q9: Who may benefit from tooth whitening?
A9: Almost anyone. However, treatment may not be as effective for some as it is for others. Dental Works can determine if you are a viable candidate for this procedure through a thorough oral exam, including a shade assessment.
Q10: Is whitening safe?
A10: Yes. Extensive research and clinical studies indicate that whitening teeth under the supervision of a dentist is safe. In fact, many dentists consider whitening the safest cosmetic dental procedure available. As with any tooth whitening product, Zoom! is not recommended for children under 13 years of age and pregnant or lactating women.
Zimmer Implants Back to Top
The comprehensive line of implants and surgical products from Zimmer Dental provides a solution for every implant case. The AdVent® and Tapered Screw-Vent® systems raise the standard in implant dentistry with superior features that make the implant process efficient and predictable. The complete versatility of the system means there's an AdVent or Tapered Screw-Vent implant for any situation.
The single-stage Tapered SwissPlus® implant simplifies and accelerates the implant process to save valuable chairtime for the patient.
Zimmer Dental is committed to providing innovative surgical products that meet your needs and earn your trust for long lasting reliability.