Why am I getting "X-rayed" again?...

A toothache may feel like it popped up overnight but believe it or not, that usually is not the case. The most common toothache seen at our office is created by decay that has been left too long. Early detection would call for a filling with aftercare use of Clinpro 5000 toothpaste for extra protection instead of a root canal and crown, the treatment when a cavity grows too big. "X-rays" or radiographs are used to "see" areas on the teeth, gums and jaw bones that can not be seen with a visual examination as shown in the x-ray below.

Toothaches are obvious indicators of an issue but along with the toothache, signs of infection don’t show up overnight either.  X-rays may show abnormalities such as infection that are simply hanging out, waiting to strike as seen below. The patient didn't "feel" anything wrong with those teeth but leaving the infection could result in a painful toothache or more permanent consequences like bone loss and tooth loss.

We here at Avalon Dental promote prevention rather than treatment. We would rather prevent a root canal than treat one that wouldn't have been necessary 6 months ago. As a new patient, a full mouth set of x-rays are taken in order to establish a base line and to diagnose any existing conditions. A full mouth set of x-rays is taken about every 3 to 5 years to give an updated in depth view of the mouth as a whole. Every year a set of four "bitewing" x-rays are taken. Bitewings (the first example above) are a valuable tool in detecting cavities and bone loss. We love educating patients about their teeth so feel free to ask us to show you what we see on your next set of x-rays.

10 Common Dental Problems and How to Avoid Them by Catherine Pearson (The Huffington Post)

Catherine Pearson, writing for The Huffington Post, does a great job of helping to educate the common reader about 10 common dental health problems. We here at Avalon Dental see these problems on a daily basis, and can say Ms. Pearson's recommendations on how to avoid them are correct. She does a great job speaking in everyday terms what maybe causing these ailments and some good preventative measures. It's definitely worth a read, and if you feel if it's too late and you already suffer from some of these conditions, give us a call and we'd be happy to go into more detail and offer some corrective treatments.


 10 Common Dental Problems and How to Avoid Them by Catherine Pearson, The Huffington Post

America's Dental Health Crisis

Today, I came across this news article from CNN.com that restated something most dentists are already aware of. Most American's do not have easy access to dental care either through geography or financially.

Opinion: The Real Crisis in America's ER's by Dr. Charles H. Norman

Dr. Charles Norman authored this in depth and well written article about the epidemic of dental emergencies that are adding unnecesary work loads to our already over-worked ERs. With our governments concerns about the cost and access of medical care to our citizens, the role of dental health has been overlooked by our representatives. Dr. Norman makes a very important point that unlike medicine, dental health problems are easily preventable with easy access to preventative care and instructions. My team here at Avalon Dental in Sugar Land, TX, take great pride in emphasizing the importance of prevention through in depth oral hygiene instruction and careful regular screenings.

Your Team at Avalon

Since it's been awhile, I'd like to introduce your team at Avalon Dental in Sugar land. My office manager Leslie and I made sure to put together a caring and top notched team that understands our Guiding Principles and puts them into practice for every patient every day.

Dr. Mason and I, Dr. Yu, strive to provide all our patients with comprehensive, aesthetic, and compassionate care. We both dedicate many hours a month to improve our knowledge of the ever improving world of dentistry through study clubs and continuing education. Our personal and professional ethics are the backbone to our treatment philosphy and quality of care.

Our Guiding Principles are personified through the care and dedication of every member of your Avalon Team. Your cleanings and gum health are the responsibilities of our two gentle, caring and qualified Registered Dental Hygienists, Jenine and Rebecca. They bring years of experience and warm welcoming personalities to every one of your check ups. As your Patient Care Coordinator, Chea uses her many years of experience in the dental field to help coordinate your visit to make sure your dental care is provided and completed compassionately and efficiently. Our Insurance Coordinator Perla, makes every effort to help you maximize your dental insurance benefits. Our Registered Dental Assistant Jhoanna, brings her extensive training and experience to every patient visit to ensure you have a comfortable and safe visit. Of course our Office Manager Leslie is always supervising that our office and your team is working in concert to make your visit with us as comfortable and as perfect as possible. If you're a new patient, I welcome you to come experience Avalon Dental. We are working tirelessly to make sure your visit is a perfect one. If you're already in our patient family, thank you for your partnership with us and we look forward to seeing you soon at your next check-up! Sincerely, Dannie S. Yu, M.S., D.D.S.

How to choose the right toothbrush and toothpaste

A trip to the dental aisle at your local grocery store or pharmacy can be a bit dizzying because of the variety of products offered nowadays.
The best rule of thumb for toothpastes is to select any toothpaste that has the ADA seal of Approval on the back of the box. Keep in mind that most major brand toothpastes are acceptable (Crest and Colgate), and sometimes they may lack the ADA seal of approval because the newer formulations have yet to pass their approval process. For example, their “whitening” version may still be under study by the ADA to verify that it meets their claims on the box. But aside from the “extra” benefits these major brands may be marketing on the box, it is assumed that the toothpaste performs all the claims promoted by their basic formulation that already has the ADA seal.



For toothbrushes, it is important to find a head size that fits your mouth and always select the “soft” or “extra soft” bristles. For most adults a size 35 is sufficient. Remember it’s better to get a brush that’s a little bit smaller rather than one that is a bit larger so you can reach the back teeth comfortably. The “soft” bristles will prevent unnecessary erosion of your enamel from brushing. Remember, brushing longer is always better than brushing harder.

For help selecting between the different brands with the ADA stamp feel free to contact us via live chat on our website at http://www.thesugarlanddentist.com/
or feel to call us at 281-240-5559.

What is a Cavity Exactly?

Most people ask us here at Avalon Dental Group, “what exactly is a cavity?” Simply, as the name implies, a cavity is a “hole” in your tooth. Obviously that answer leads to the heart of the question which is, “how does it get there?”

A cavity, or dental caries, is actually a disease process that affects your teeth. Most cavities begin with the weakening of your teeth’s hard protective coating, the enamel. This weakening is caused by the waste products of certain bacteria that naturally live in your mouth. When these bacteria are fed sugars, or carbohydrates, they release acids as they digest the sugars. This acid over time weakens the enamel and creates the “hole.”



When these bacteria’s waste products reach the softer material, the dentin, under the enamel, the acids rapidly weakens even more of the tooth. It is at this stage of the process where a dental filling will be needed to heal the disease.
Untreated dentin cavities will rapidly progress to the heart, or pulp, of the tooth where the nerve and blood supply resides. When the waste products and bacteria reaches the pulp, a toothache occurs. At this stage the tooth must have a root canal procedure to heal the disease.



It is important to understand that cavities are serious, because as the bacteria reach the nerve and blood supply of the tooth, it allows bacteria to access your bloodstream and travel throughout your body. So all diagnoses of cavities should be taken seriously and corrected as soon as possible.

If you have any more questions about cavities or any other dental topic please feel free to visit us on the web and either call or chat with us live on the web!

http://www.thesugarlanddentist.com/

Learning How to Floss

As a valued partner in your oral health, we would like to take this opportunity to remind all our patient family how to floss correctly. Flossing is an integral part of the daily oral hygiene regimen. The action of flossing pulls bacteria, food debris, and irrigates the spaces between your tooth and the gums that surround it. Without flossing, your oral health will be susceptable to cavities and gum disease. For more information on flossing or any other oral healthcare question please visit us at http://www.thesugarlanddentist.com/. Feel free to use the Live Chat function to have all your questions answered. All of us here at Avalon Dental are available to answer your questions.

Like any new task, flossing can be a chore at first. Studies have shown that flossing is the only dependable way to maintain the health of your gums and the underlying bone that holds your teeth in firmly. If done properly and regularly, flossing can become as easy and productive as brushing.

Step 1: Use at least 18 inches of dental floss and wrap the floss around each of your middle fingers, leaving about 1-2 inches in between fingers.

Step 2: Press the tips of your index fingers on each end of the 1-2 inches of floss and make the floss taught between them.

Step 3: Gently guide this portion of the floss between your teeth and pull both index fingers in one direction to wrap the floss around one of the two teeth the floss is in between.

Step 4: Gently slide the floss down below the gums and back up. Repeat a couple of times and then wrap the floss around the other tooth and do the same.

Step 5: Repeat for every tooth using a clean portion of the floss. This usually requires you to unwind and rewrap your middle fingers with the next segment of floss.

Dental Emergencies for Kids

Sometimes even with the best preventative steps, your child may suffer a dental emergency. The Avalon Dental Team is always available to help your child in our office or over the phone, but just in case I have compiled the most common childhood dental emergencies and management recommendations for your quick reference.

For your reference, please keep our emergency contact number handy and you will be directed on how to contact us for emergency care during business hours or even after hours.

Emergency contact: 281-240-5559
Website: http://www.thesugarlanddentist.com/

Common Dental Emergencies and Recommendations for Care:

1) Q: What should I do if my child’s baby tooth is knocked out?

A: Contact us dentist as soon as possible. Do NOT attempt to replace the tooth into the socket.

2) Q: What should I do if my child’s permanent tooth is knocked out?

A: Find the tooth and rinse gently in cool water. (Do not scrub it or clean it with soap.) If possible, replace the tooth in the socket and hold it there with clean gauze or a wash cloth. If you can’t put the tooth back in the socket, place the tooth in a clean container with milk, saliva, or water. Contact our office immediately. Our emergency operator will contact us after hours if necessary. The faster you act, the better your chances of saving the tooth.

3) Q: What if a tooth is chipped or fractured?

A: If your child is in pain or if there is obvious bleeding from the chipped area, contact us immediately. Quick action can save the tooth, prevent infection and reduce the need for extensive dental treatment. Rinse the mouth with water and apply compresses to reduce swelling.

4) Q: What about a severe blow to the head or jaw fracture?

A: Go immediately to the emergency room of your local hospital. A blow to the head or jaw can be life threatening.

5) Q: What if my child has a toothache?

A: Call our office promptly. To comfort your child, rinse the mouth with room temperature water. Apply a cold compress to ease the pain. If your child can take children’s ibuprofen then administer the proper dose according to the manufacturer. Do NOT put heat or aspirin directly on the sore area.

6) Q: Can dental injuries be prevented?

A: Absolutely! First, reduce oral injuries in sports by wearing mouth guards. Second, always use a car seat for young children. Require seat belts for everyone else in the car. Third, child proof your home to prevent falls, electrical injuries, and choking on small objects. Fourth, protect your child from unnecessary toothaches with regular dental visits and preventative care.

Again, remember that time is of the essence in cases of dental emergencies, and your team here at Avalon Dental are ready to assist in the unfortunate event we are needed.

What About False Teeth?

In my office, I regularly field questions about “false teeth” and what to expect with them. Of course most people are referring to complete dentures and partial dentures when asking about “false teeth.”

A complete denture is an appliance that replaces either all your upper teeth or all your lower teeth. A partial denture is, as the name implies, replaces a few of the upper or lower teeth, and uses your remaining teeth to “anchor” the denture securely.

For all my denture patients, I always use the analogy of a dance partner when explaining what to expect from their denture. Your natural teeth can be thought of as a dance partner you have grown up with and practiced together with your whole life. You and your teeth move in rhythm when chewing without thought and rarely out of step with each other.

A new partial denture is like a new dance partner that has had some formal training and can usually follow your chewing rhythm with little or no growing pains because it uses your remaining teeth as a guide. A new complete denture is like a complete novice dance partner. For some it takes little time to get use to it and for others it can be a struggle for the rest of their lives.

For these reasons, if at all possible, I always attempt to design a partial denture rather than a complete denture.

For all denture patients I always recommend soft foods like pasta, eggs, and mashed potatoes for at least the first week. As is the case for most things in life, moving to more solid foods is a question of tolerance by each patient. Your gums will need to get used to rubbing against the hard material dentures are made of when chewing. Usually within 2-3 weeks most patients are well on their way to a regular diet. Of course with complete dentures every patient needs to “learn” a new way to chew harder foods like steaks and veggies, but necessity always breeds success in this regard.

Of course with modern dental advancements, there are treatment options available to patients today that can eliminate the need for dentures. The most talked about of course is the dental implant, and we will be discussing that in the future.

For any more questions about false teeth, please visit us at www.thesugarlanddentist.com. Please feel free to us the Live Chat function or give us a call at 281-240-5559.

Congratulations to Our Winners

We here at Avalon Dental would like to thank all the wonderful participants from the First Colony Montessori for taking part in the Avalon Dental Coloring Contest. We had no idea we had so many young artists in our community. Unfortunately, we couldn't award the two grand prizes to every deserving participant. But if your child would like to participate in our next coloring contest, please feel free to contact our office manager Michelle at 281-240-5559 for details on our next contest or visit us on the web at www.thesugarlanddentist.com.

So without further ado, we would like to congratulate the two Grand Prize winners, each of which received a $50 Gift Certificate to Toys 'R Us.

And the winners are...

Avery

and Allison

Congratulations!!!

First Colony Montessori: Oral Hygiene Day

Once again the Avalon Dental Team visited with the future of our community to help educate the importance of good oral hygiene and nutrition at First Colony Montessori. Lead by our hygienist Nguyet, office manager Michelle, and lead assistant Leslie, we helped the youngest members of our community learn about taking care of not only their teeth and gums, but also their bodies through good hygiene and nutrition.



Our team at Avalon Dental takes particular joy from meeting the community and educating everyone on good oral health. Although we are here to treat the various oral diseases, such as cavities and gum disease, we understand our value to our community lies in education to promote prevention.

During our trip to First Colony Montessori, we taught proper brushing and flossing techniques, components of a healthy diet, and what to expect a dental check-up.



We also invited the students to participate in our semi-annual coloring contest.

We would like to thank the wonderful team of teachers and administrators at First Colony Montessori for inviting us an accommodating us for this visit. To contact the school for enrollment please contact them via phone at:

First Colony Montessori
281-980-9744
2229 Settlers Way Blvd
Sugar Land, TX 77478

And if you have any questions, concerns, or would like to invite our team to your school, office, or organization please feel free to contact our office manager, Michelle at:

Avalon Dental Group PC
281-240-5559
2205 Williams Trace Blvd
Suite 108
Sugar Land, TX 77478

And the Winner Is....

Congratulations to our Missouri City SnowFest Prize Raffle Winner G.V.!

We would like to thank all of the hundreds that visited us at the Avalon Dental Prize Tent at the Missouri City Parks and Recreations' Winter Snowfest this year.

My wife and I enjoyed meeting and sharing oral hygiene awareness with our local community and also giving back to our neighbors with free prizes and toothbrushes.

In all there were 6 lucky winners of gift cards just in time for the Holidays and a Grand Prize winner of a Sonicare "Flexcare" mechanical toothbrush and accessories, a $200 value!

We would also like to take this time to thank the Missouri City Parks and Recreations Department again for inviting us to take part in their annual Winter SnowFest. There were fun activities for the whole family, like a snow slide, face painting, rock climbing, and a performance by professional loggers.






Here at Avalon Dental, we enjoy participating in all community events to help promote oral hygiene in our community and meet our neighbors.

2nd Annual Boo in the Run

On October 25th, the Avalon Dental Team participated in the Missouri City Parks and Recreation's 2nd annual Boo in the Run event at Buffalo Run Park.



The event created a safe and community-oriented opportunity for children in our community to enjoy the Halloween festivities a week before Halloween. The event brought together families, local businesses, and the Parks and Recreations department of Missouri City at the lovely Buffalo Run Park in Missouri City.

The Avalon Dental Team, which included my wife, passed out toothbrushes and reinforced the importance of good brushing to the kids in our community, especially after enjoying their Halloween candy. The kids and parents enjoyed the participation of the Avalon Tooth Fairies and of course our Fairies enjoyed the festivities, the parents' appreciation, and the opportunity to give back to our community.



A special thanks goes out to the Missouri City Parks and Recreations Department for their invitation, especially Jennifer Milam, and all the welcoming parents and kids of the community.

If your school or business would like a visit from the Avalon Dental Team to help with oral hygiene instruction or some Q&A with the Dentist, please feel free to contact us at 281-240-5559. Our whole team takes special enjoyment from meeting and making new friends in our community.

Austin Parkway Elementary

One of our guiding principles here at Avalon Dental is to "Prevent Disease Through Education." My team and I take this very seriously because we truly believe most dental problems can be prevented by good home care at an early age.

Recently, we had the opportunity to visit some of the younger members of our community here in Sugar Land at Austin Parkway Elementary.



Our Hygienist, Nguyet gave careful instruction to the kindergartners, first and second graders on how to correctly brush and floss their teeth, with the help of our Assistants Jenny and Michelle. The kids at Austin Parkway Elementary learned the importance of good nutrition and home care in maintaining a happy, healthy smile.



Our thanks go to Principal, Donna Whisonant and Kindergarten teacher, Joelyn Zamarron for their kind invitation and warm welcome.

If you are interested in having us over at your school or workplace for either dental education or some useful Q & A, please feel free to call us at 281-240-5559. Here at Avalon Dental Group, we strive to keep our community's smile happy and healthy!

How is Gingivitis Treated?

As I explained in an earlier post, gingivitis is the inflammation of your gums due to bacteria in plaque and tartar. Remember tartar is the hardened material caused by the mineralization of plaque left on your teeth for too long.

Treating gingivitis takes two approaches. The first is a professional dental cleaning completed by your dentist or dental hygienist. The second is your home care.

A professional dental cleaning's goal is to remove the hardened tartar above your gums and irrigate the bacteria off your teeth. Usually, the tartar can be removed with either special hand instruments or an ultrasonic cleaner that uses sound and water to shake the tartar off your teeth with little or no sensitivity. The water irrigates the pieces of tartar and bacteria off your teeth and underneath the gums. With the plaque and tartar removed from your teeth, you are now able to completely clean the teeth surfaces with good home care, ie. flossing and brushing.

Remember, a professional cleaning is also important to serve as a periodic check by a dental professional to make sure your home care is sufficient and that there are no other health issues developing. Did you know that many patients first discover they need to see a physician for diseases such as diabetes and hypertension after their visit to the dentist? Many diseases manifest symptoms in your mouth and a trained dental professional can recommend a physician's referral based on these findings.

The second and equally important treatment for gingivitis is good home care. During your cleaning visit, our team at Avalon Dental will spend as much time as needed to instruct you on how to maintain your home care. Usually, it is recommended to brush twice a day and floss once a day, but your dental professional will instruct you on not only frequency but certain problem areas you may have and need to pay special attention to. With proper home care, you will notice the symptoms of gingivitis (bleeding upon flossing and red swollen gums) gradually improve.

It is important to make sure see your dentist regularly to help make sure you have good oral health, but it is equally important to take proper care of your teeth and gums at home. For treatment of periodontitis, the process and treatment by your dental professional is different. We'll tackle that issue next.

My Kid's First Dental Visit

I get asked occassionally by friends and family, "when should lil junior get his first dental exam?" This is usually followed by, "I think he might have a cavity."

Actually, it is recommended that all newborns have their first dental visit within the first year and at least by the time their first teeth start erupting. The obvious question would be why would an infant with no teeth need to see the dentist? It's important to remember that the teeth are only half of what comprises a true oral exam. It is just as important for a trained professional to examine the head, neck, mouth, and gums for any diseases or problems.

Usually with infants, a simple exam with a mirror and cotton gauze is all that is necessary on the first visit. It is also important to tell the dentist if your child is drinking tap, bottled, or well water. This is important because some water from natural wells and most bottled waters will lack the necessary flouride to promote healthy tooth development. Most city treatment plants add the necessary flouride to help strengthen your childs teeth as they are growing. If your child does not have access to flouridate water than the dentist can prescribe some flouride supplements to help ensure your child is getting enough flouride fro their age.

For the actual exam, most dentist will utilize a "knee-to-knee" position for the exam. This is accomplished by having the child's parent hold the child facing the parent and sitting. The dentist then sits in front of the parent at the same height and touches "knee-to-knee." The parent then gently lays the childs upper torso on the dentist's lap. The dentist then has an excellent view of the head and neck, and the child has the comfort of the parent's touch as well.

Of course, most infants and young children will become anxious and unhappy in the dental office. Here at Avalon, I believe this first dental visit is the most important in shaping that child's view and behavior in all future dental visits for the rest of his or her life. Therefore, I emphasize to my team and the parent that we must take our time in introducing a new patient (regardless of age) to our office and dental care in general. For high anxiety patients, I recommend spending the first visit just introducing the patient to the sights, sounds, and smells of a dental office. This desensitizes the child to these new senses. Then I recommend bringing the child back within the next week to actually attempt an exam and cleaning. Of course, every patient is different, and we at Avalon Dental make sure we treat each patient individually.

What's Gingivitis?

So what is this gingivitis that the dentist keeps telling me about? And how is it different than periodontitis?

The simple answer would be that gingivitis is an inflammation of your gums, or gingiva. The long answer would be that gingivitis is the beginning of a disease process initiated by bacteria in your mouth, which has the potential to progress into periodontitis. I know... keep it simple right?

So to expand on the simple answer, it's important to state again that having bacteria in your mouth is normal. The first step to getting gingivitis is allowing plaque, that white stuff that forms along your gum line, to accumulate on your gums. This plaque allows the bacteria to live close to your gums and teeth. Some of these bacteria will eventually cause gingivitis and then periodontitis, and other types of bacteria will cause cavities.

Now you can see why your dentist and hygienist always stress keeping this plaque from accumulating on your teeth. The plaque itself is not particularly harmful but it allows these bacteria to stay on your teeth and gums.

Well, the bacteria that causes gingivitis start to overgrow within this plaque. Their waste-products begin to accumulate and your immune system starts to react to this build-up of bacteria and waste-products. The inflammation is actually your gums trying to fight off this bacterial infection.

If the plaque and its bacteria stay too long on your gums, the inflammation begins to spread to the bone underneath your gums. Once the inflammation reaches this stage, this bone under the gums start to recede away from their normal levels. This is basically a self-destruction of your jaw bone, that as it progresses causes your teeth to become loose. When the inflammation begins to affect the underlying bone, it is called periodontitis.

Not everybody with gingivitis will get periodontitis because this depends not only on plaque, but the person's genetics and the specific bacteria present in the plaque. Since it is nearly impossible to determine every patient's genetic make-up and its expensive to perform the lab tests necessary to identify specific bacteria in the plaque, we as dentist recommend everyone to keep plaque off their teeth and seek immediate treatment for gingivitis.

Next time, we'll get into the different treatments available for gingivitis and periodontitis.

Why A Specialist? Part II

So now I'd like to run down some common dental titles that are not true dental specialties. Remember that a true specialty requires extra schooling and a state certification. The following are just titles dentist use to describe their specific interest in the field of dentistry, but they are not allowed to imply they are "specialists" in these interests.

1) Implantologist: The implication is that they "specialize" in the placement of dental implants. Currently, there are no true specialty programs associated with US universities that teach a multi-year curriculum in only dental implants. There is no State licensing exams a dentist has to pass in order to call themselves an "implantologist."

2) Cosmetic Dentist: The implication here is that there is a difference between cosmetic and general dentistry. According to State and National licensing guidelines there is no difference. Every dentist should be a "cosmetic" dentist because all dental work has an aesthetic aspect to it. Now certain dentist have taken the time and effort to take extra continuing education programs in the field of cosmetic dentistry and expand their knowledge of this aspect of dentistry, but it is not implied that cosmetic dentistry is a separate entity from general dentistry.

3) "Practice limited to ...": Some general dentist have limited their practice to only provide treatments associated with any of the true dental specialties. For example Dr. Jon Doe whose practice is limited to endodontics, provides only root canals for his patients. It is important to note that Dr. Doe is actually a general dentist and cannot legally advertise himself as a specialist. A true dental specialist has a degree in the area of specialization and the degree would be listed in the letters following the "D.D.S. or D.M.D" in his/her title.

I should clarify that just because a dentist uses any of the titles listed above, he or she is trying to deceive the public. These are all accepted, legal titles a general dentist may use in the description of his or her practice. I am just listing these to distinguish them from the true dental specialists.

So in conclusion, why are you being referred to a specialist? Well just like our physician colleagues, there are situations where the best possible outcome available to our patients can only be achieved by a specialist in that particular field. A general dentist can legally provide treatment in all fields of dentistry, but the specialist is there as a resource for the dentist and patient for cases that are not considered "traditional" or "straight-forward."

As a general dentist, I see a wide variety of patients and every patient has a different set of dental needs. A specialist only provides one field of treatment so they have the experience and training to provide the best possible care in that field.

Why a Specialist?

There is an old adage that a smart person is not someone who knows everything but a person who knows he doesn't know everything. I truly believe this is the truth with being a dentist. A good dentist is not one that thinks he/she knows it all but a dentist that knows he/she doesn't know it all.

Now there comes a time with most dental patients that a dentist will refer the patient to a specialist. Usually, the patient's first question is, "Why?"

Before I explain why I think I should clarify the different dental specialties. The following are the nationally recognized specialties. I would also like to emphasize the ones that are NOT recognized as true dental specialties. All dental specialists attend certification programs that range in duration from 2 years to 7 years and must pass a state or regional licensing exam to be considered true specialists.

1) Periodontist: These are the "gum specialists." They concentrate on treating the structures that keep your teeth stable and healthy. These are the gums, periodontal ligament (ligament that holds your tooth to the jaw bone), and the bone surrounding each tooth. They are also fast becomming the specialist of choice for dental implant placement because the most important aspect of implant success is their ability to be stable in the jaw bone.

2) Prosthodontist: These are the "denture specialist." Although they are very knowledgable about dentures they also specialize in tough crown and bridge cases and full mouth reconstructions for those patients that have gone without teeth for a number of years.

3) Endodontist: These are the "root canal specialist." Endodontist specialize in performing root canal therapy for a tooth where the nerve has died and formed an abcess. Their specialized training allows for a better long term prognosis for root canals they perform compared to a general dentist. Although a general dentist can have great success on a straight forward root canal treatment, endodontist have much higher success with the tough ones.

4) Orthodontist: These are the "braces specialist." They have specialized training on straightening your teeth with braces and/or other appliances. Most general dentist can "move" teeth with braces, but orthodontists are the true specialist in "straightening" your teeth and giving you a healthy bite (the way your teeth come together when you close your jaw).

5) Oral Surgeon: These are the "wisdom teeth specialists." Oral surgeons have completed the four years of dental school and continued on to graduate from either 4 or 7 years of medical school. They are truly M.D.s as well as D.D.S.s. Although dentist usually refer to OS for tough wisdom teeth extractions, oral surgeons also specialize in any surgeries of the head and neck including cancer treatment and TMJ evaluation and treatment.

Next, I would like to expand on some titles for dentist that are NOT true dental specialties. To be continued...

What's in a checkup?

Many patients in the past have asked me, "So what's in a checkup?" I assume they mean what am I and my dental team looking at and looking for in a typical dental exam. I'll take this opportunity to let you know exactly what comprises one of my dental exams.

First, let me clarify that I'll be describing the makings of one of my initial exams. A comprehensive initial exam is given by my dental team when it is the patient's first introduction to our office. After this "initial" exam the patient receives "recall" exams or a condensed version of this initial exam on cleaning appointments.

The first task that is completed by my team is reviewing your medical and dental history. Here, the important point is making sure you are physically healthy and you do not have any contraindications to receiving dental care. Major issues we are looking for is a history of heart problems, high blood pressure, diabetes, siezures, and congenital defects. Although not specific to your mouth, these conditions can affect the timing or type of dental care you receive. An interesting factoid is that most cases of high blood pressure is indirectly or directly diagnosed during a dental check up. So this is a very important step for us and our patients.

At this point, the dental team will proceed to taking dental xrays that are necessary for the initial exam. This is also the time to notify the team if you have an urgency, such as toothache or sensitivity, because certain conditions may require another type of dental xray.

We then proceed to the head and neck exam. During this part of the exam, I am looking for any out of place or noticeable bumps, marks, and swellings. Your TMJ or Temporal Mandibular Joint will also be evaluated at this stage. This also serves as the first part of you oral cancer screening, which is the next step.

During your oral cancer screening, I examine all the tissues in and around your mouth. I'm looking for ulcers, colored marks, bumps, and white patches. Although most of the time these things are not cancerous, they should always be noted, measured, and recorded for specialist referral or future reference.

We then use the xrays and a visual exam to note the existing dental work and conditions of the teeth. Usually, I communicate with my team using dental terminology during this part of the exam, but we always explain our findings to you the patient after the visual exam. We are looking for failing dental work, cavities, loose teeth, staining, missing teeth, and fractured teeth.

The next step is to evaluate your periodontal health, which means the health of your gums and the bone underneath that hold your teeth in place. We do this by taking measurements of the gums itself and noting areas of inflammation and spontaneous bleeding. This is the step where it is determined what type of dental cleaning you will need.

Finally the last and most important step of the initial exam is presenting you our patient with our findings and reccomendations for treatment or maintenance (also known as the treatment plan). Our dental team makes a special effort to educate during this step and feel the exam is complete only when you are comfortable with all the aspects of your personal treatment plan.