Preventive Care

Regular Dental Checkup
In order to avoid lengthy procedures & maintain a healthy disease free mouth Dr. Lyle B. Borman in Rego Park, NY recommends re-care every 6 months. This allows us to detect early signs of disease & provide appropriate treatment, leading to a favorable prognosis.

Dental Sealants
Sealants protect the occlusal surfaces, inhibiting bacterial growth and providing a smooth surface that increases the probability that the surface will stay clean. The ultimate goal of sealants is penetrating into the pit and fissures of the tooth and sealing them from bacteria.

Indications for Use
Traditionally, sealants are thought of as a preventive measure for children and teenagers when they are in their “cavity prone years”. Patients who have xerostomia (decreased salivation), are undergoing orthodontic treatment, show evidence of incipient caries, or who are prone to caries should be evaluated as candidates for sealant placement. Primary molars also can benefit from the placement of sealants.

Fluoride Treatment
 

What is fluoride?
The fluoride ion comes from the element fluorine. Fluoride, either applied topically to erupted teeth, or ingested orally (called systemic fluoride) during tooth development, helps to prevent tooth decay, strengthen tooth enamel, and reduce the harmful effects of plaque. Fluoride also makes the entire tooth structure more resistant to decay and promotes remineralization, which aids in repairing early decay before the damage is even visible.

Where is fluoride found?
Topical Fluoride is found in products containing strong concentrations of fluoride (i.e., toothpastes, mouth rinses), fluoridated varnishes and/or gels either topically applied by a dentist or other oral health professional, or prescribed as an at-home regimen (particularly for persons with a high risk of dental caries). Systemic Fluoride can be ingested through public and private water supplies, soft drinks, teas, as dietary supplements, some bottled water supplies. Once ingested, systemic fluoride is absorbed via the gastrointestinal tract and distributed and deposited throughout the body via the blood supply.

What health risks are associated with fluoride uses?
In general, fluoride consumption is safe. Health risks associated with Fluoridation usually are limited to misuse and over concentration. To avoid misuse and over concentration: Avoid drinking overly fluoridated water – results of this may cause teeth to become discolored, and may cause the enamel of the teeth to look spotted, pitted, or stained (a condition known as dental fluorosis). Avoid swallowing toothpaste and other dental hygiene products. Call the local water department and/or the health department to evaluate the fluoride level in your local drinking reservoir. Children are especially vulnerable to dental fluorosis as their developing teeth are more sensitive to higher fluoride levels. Consult a pediatric dentist or other oral health care professional if you notice changes in the condition of your child’s teeth.

Periodontal Care (Gum Care)
 

For Americans in their 30s and beyond, the threat of gum disease (periodontal disease) is a very real and potentially dangerous condition. Gum disease is particularly dangerous because the progression of the disease is often painless, going undetected until it creates serious problems. Although genetics may play a small role in its development, doctors agree that gum disease is most often directly related to how well people care for their teeth and gums.

The Stages of Gum Disease
Periodontal disease is a gradual infection of the gums and the supporting bone. It is caused when the buildup of plaque on and around the teeth calcifies into tartar. This tartar is covered with plaque that contains micro- organisms which release toxins causing the first stage of gum disease known as gingivitis. Gingivitis is characterized by swelling, inflammation, and bleeding of the gums. In the advanced stage of gum disease (referred to as periodontitis), the toxins cause the bone to resorb or dissolve. The teeth having lost a part of their bone support begin to move & eventually with more bone loss there is tooth loss.

The Surgery
Treatments to alleviate the effects of gum disease include deep cleaning, localized delivery of antibiotics, home care & regular follow up care. The periodontist / Dentist begin by removing the diseased tissue, tartar, and plaque from the tooth’s surface and below the gum line. The root of the tooth may need to be planed and smoothed in order to allow gum tissue to heal properly. The periodontist may also advise bone grafts depending on the amount of bone that is lost due to
gum disease.

Prevention
The ravages of gum disease are best prevented by early detection and proper dental hygiene. Brushing your teeth twice a day helps to remove the thin layer of bacteria that release dangerous toxins into your mouth. Flossing or other interdental cleansing is also important to keep your mouth free from residual food and bacteria. Also, using a mouth rinse, prescription or over the counter considerably reduces the microbial count in your saliva. Finally, maintaining a balanced diet and scheduling regular dental appointments help stem the advance of gum disease and keep you healthy and smiling.

Arestin Therapy
This is a non-surgical treatment of periodontal disease. As the name suggests it arrests the progression of periodontal disease when used in conjunction with scaling and root planing (deep cleaning) ArestinTM is a locally delivered antimicrobial agent which consists of minocycline HCL microspheres. ArestinTM is intended to be used in pockets with a depth of 5 millimeters or greater. It can be used in one or any number of pockets in one or several visits. It is dispensed as a 1 mg powder and is placed directly into a cleaned periodontal pocket using a specialized delivery system. Following placement over the next several hours or days it will harden and stay within the pocket releasing Minocycline over a prescribed period of time (usually about 18 – 20 days), thereby providing the appropriate dose of antibiotic to the site and reducing the bacterial
count in the pocket.

Advantages of Arestin Therapy

• Studies have shown that there is a 2 mm reduction in the depth of the pockets when Arestin is used along with scaling and root planning
• Arestin therapy is effective in treating resistant sites which do not respond to cleaning alone such as in patients who are smokers, diabetics and have cardio-vascular disease
• Arestin is very easy to use; it is a safe and effective procedure

Frequently Asked Questions
 

Why would you use an antibiotic to treat periodontal disease?
Even though scaling and root planing (SRP) removes a great deal of the bacteria that cause periodontal infection, the instruments used during this mechanical procedure can’t always reach the bacteria that hide in the bottom of pockets or in difficult-to-reach areas. That’s why your dental professional may decide to add a locally administered antibiotic (LAA) such as ARESTIN®. ARESTIN® helps to kill the bacteria left behind by SRP.

What are the contra-indications to the use of Arestin?
Arestin should not be used if you are allergic to tetracycline or if you are pregnant or nursing as it might cause discoloration of the developing teeth in the fetus.

Can I resume normal brushing and flossing following Arestin Therapy?
Delay brushing the treated area for 12 hours after treatment with ARESTIN® and abstain from using interproximal cleaning devices around the treated area for 10 days. Patients should also avoid hard, crunchy, or sticky foods such as popcorn or caramel that could traumatize
the gingiva.

Restoractive Care
 

Tooth Colored Fillings
In the past, cavities could only be treated with unsightly metal fillings that are alloys for silver and mercury. These fillings, especially when close to the front of the mouth, are highly noticeable and unaesthetic. Sometimes, the filling is so large that it causes discoloration of the entire tooth. These fillings (or restorations) often weaken teeth due to the large amount of the original tooth that has to be removed. Also there is a risk of Mercury poisoning that is used in the filling. Modern dentistry has increasingly turned to Tooth colored or composite fillings as a strong, safe and more natural looking alternative. Composite fillings utilize a soft white plastic substance that is hardened with a blue light.

Crowns and Bridges
 

CROWNS: When a tooth is fractured, has a large old filling, or is severely damaged by decay, your dentist may recommend the placement of a crown. Crowns strengthen and protect the remaining tooth structure and can improve the appearance of your smile.
Types of crowns include the full porcelain crown, the porcelain-fused-to-metal crown (precious & non-precious) and the all-metal crown.

Fitting a crown requires at least two visits to the dentist’s office. Initially, the Dentist removes decay and shapes the tooth; makes an impression and fits a temporary or transitional crown of plastic or metal. In a subsequent visit, the dentist removes the temporary crown, fits and adjusts the final crown and cements the crown into place.

BRIDGES: Few incidents have greater impact on dental health and personal appearance than tooth loss. When one or more teeth are missing, the remaining teeth can drift out of position, which can lead to a change in the bite, the loss of additional teeth, decay and gum disease. When tooth loss occurs, your dentist may recommend the placement of a bridge. A bridge is one or more replacement teeth anchored by one or more crowns on each side.

Endodontics (Root Canal Treatment)
 

It is a field of dentistry that treats the root canal system. When decay extends to the pulp or the nerve inside the tooth, the person almost always experiences spontaneous throbbing pain. The pain increases at night and is aggravated with cold & sweet foods. The Dentist relieves the pain and pressure symptoms by treating the root canal system which houses the tooth nerve or pulp.

Treatment begins with profound anesthesia. The tooth nerve is accessed by drilling into the tooth, the infected nerve is removed, canals are cleaned and filled with a bio-inert material.

Following a root canal treatment, the tooth is fragile due to insults from decay and mechanical instrumentation and is prone to fracture. Overtime color changes are also observed. To protect the tooth from fracture your dentist will advise a crown. Sometimes depending upon the amount of tooth structure that is lost, a post ( a metal or a glass fiber pin ) will need to be placed for added retention of the crown. To learn more please call our office today.

Dental Implants
 

When a tooth is lost the specialized bony process that houses the tooth begins to resorb due to lack of stimulation. This causes a decrease in width and height of the bone in the area the tooth is lost. Neighboring teeth and opposing teeth begin to move into the space. This causes food lodgment, subsequent decay, gum disease and abnormal forces being transmitted to teeth leading to fracture of cusps which may necessitate root canal treatment or extraction. Loss of teeth can also cause the cheek and lips to collapse giving an aged look.

The consequences of tooth loss can be prevented by replacing the lost tooth in a timely manner. Although there are several options to replace a missing tooth the number one choice for replacing lost teeth are dental implants. Implants are tiny titanium screws or posts that are surgically placed in the bone. Once integrated into bone they act like roots onto which small posts are attached which protrude through the gums. These posts provide stable anchors to the replacement teeth. Implants maintain the bone height by stimulation and prevents unnecessary trimming of adjoining teeth for bridge placement. Since implants are titanium posts there is no chance for decay on implants. Implants can service you for several years with regular professional cleaning and proper home care.

Many people who are missing a single tooth opt for a fixed bridge; but a bridge may require the cutting down of healthy, adjacent teeth that may or may not need to be restored in the future. Then there is the additional cost of possibly having to replace the bridge once, twice or more over the course of a lifetime due to decay or gum problems affecting the anchor teeth.

Another option to replace missing teeth is a removable partial denture or complete denture depending on the number of teeth missing. The chewing efficiency with a denture is reduced to more than half of that of natural teeth. The teeth that support the partial denture are weakened due to the excessive loads acting on them and eventually are lost. The denture rests on the gum causing tissue abrasion and bone loss. Removable dentures may slip or cause embarrassing clicking sounds while eating or speaking.

Studies show that within five to seven years there is a failure rate of up to 30% in teeth located next to a fixed bridge or removable partial denture.

Who is a candidate for Implants?
Anyone who is missing one or several teeth is a candidate for implants. With the exception of growing children, dental implants are the solution of choice for people of all ages, even those with the following health concerns:

Existing Medical Conditions: If you can have routine dental treatment, you can generally have an implant placed. While precautions are advisable for certain conditions, patients with such chronic diseases as high blood pressure and diabetes are usually successful candidates for
dental implant treatment.

Gum Disease or Problem Teeth: Almost all implants placed in patients who have lost their teeth to periodontal disease or decay has been successful.

Currently Wearing Partials or Dentures: Implants can replace removable bridges or dentures, or they can be used to stabilize and secure the denture, making it much more comfortable.

Smokers: Although smoking lowers the success rate of implants, it doesn’t eliminate the possibility of getting them.

Bone Loss: Bone loss is not uncommon for people who have lost teeth or had periodontal disease. Oral and maxillofacial surgeons are trained and experienced in grafting bone to safely and permanently secure the implant.
Implant tooth replacement in children is usually deferred until their jaw growth is complete. There are, however, some instances when a dental implant may be appropriate, such as when it is part of the child’s orthodontic treatment plan. Your family dentist or orthodontist can guide you in
this instance.

Procedure

Dental Implant placement usually takes two surgical appointments:

1. During the first surgical appointment the implant site is prepared to receive the implant following strict aseptic procedures. The selected size of the implant is placed in the prepared site. The gum tissue is sutured over the implant. The implant takes 4- 6 months to fuse with the bone.
2. During the second surgical appointment the implant is uncovered and the appropriate post is attached to which the replacement tooth is anchored. An impression of the post is taken and sent to the lab for the fabrication of the implant crown. During this time a temporary crown is placed. Once the final crown is back it is cemented with permanent cement.

Dentures
 

These Dentures allows patients to have their Dentures on the same day their teeth are removed. This prevents the embarrassment of being without teeth. As the extraction sites heal & the bone remodels, the denture will require adjustments & relining to make it fit better. At the end of a year when the healing is complete your dentist may advise you to get a new denture.

Over Dentures

If the roots of a patient’s remaining teeth are strong, the dentist may suggest over-dentures. Over- dentures fit on top of the remaining natural teeth in the mouth. With over-dentures, the remaining teeth are re-sculpted and covered with metal caps to stop future decay. The advantage of over-dentures is that they do not have to be relined as frequently as a complete set of dentures because they cause less recession of the jawbone and gums. In addition, over- dentures create less occlusion (bite) problems than complete dentures.

Once Your Dentures Have Been Placed

At first, your dentures will feel uncomfortable because the gums and tissue are not accustomed to being in contact with man-made relining material. Once placed, dentures should be worn continually for the first few days to reduce the amount of swelling that may occur in the mouth. This swelling typically subsides in two to three days. Until patients adjust to their new set of teeth, the dentures may feel loose and awkward while chewing food. Eating soft food may be necessary for the first few days. Reading aloud helps to overcome any speech impediments that may occur from the new dentures. Typically, lower dentures take longer to get used to than upper dentures. The underlying jawbone may take several months to completely heal and become accustomed to the dentures. Once this occurs, the dentist removes the dentures and creates a permanent lining for your teeth (a denture lining is the soft material that cushions the contact between the denture and the gum tissues).

The Life of your Dentures

Although dentures typically last about five years, they can last longer with proper care and cleaning. Dentures should be cleaned daily with a normal or specially-made denture toothpaste. Once the swelling has reduced, it is advisable to leave one or both dentures out at night to allow the gum tissues to breathe. In order to prevent dentures from warping, they should be left in water overnight. Over time, the lining of the dentures may change, owing to the wear and tear of daily use. In the case of tissue/bone shrinkage, worn down teeth, or breakage, dentures may come loose and need to be remade.