General & Family Dentistry

Regular dental checkups are imperative to maintaining optimal oral health. In addition to a good home regimen, regular cleanings and exams will help to avoid tooth decay and gum disease and to prevent many expensive dental treatments.

Prevention starts with controlling plaque, a colorless bacteria that sticks to the surface of your teeth, and calculus, a harder mineral deposit. These are the main sources of decay and periodontal disease. By maintaining a proper routine of daily hygiene, you can prevent most oral disease. Our hygienists at Englander Dental are excellent and are available to assist you with your hygiene and management of your gums.

During your regular checkup, your hygienist will:

• Review your medical history
• Look for cavities or evidence of tooth decay
• Take necessary digital x-rays
• Check for any problems or oral cancer
• Inspect your teeth and gums for signs of gingivitis or gum disease
• Thoroughly clean and polish your teeth
• Provide fluoride treatment for prevention of decay

Gingivitis

Gingivitis is the early stages of periodontal disease, when only the soft tissues of the mouth are affected. Plaque buildup leads to tartar and bacteria below the gum line, which cause the gums to become inflamed, irritated, and bleed. A few of the common contributing factors include dry mouth due to medications or medical conditions, orthodontic braces, and mouth breathing. Fortunately, gingivitis is reversible! With good professional care, like the care you get here from the team at Englander Dental, followed by a good home care routine of regular brushing and flossing your gums can become healthy again.

Periodontitis

Periodontitis is a progressed stage of gum disease and is marked by the breakdown of the bone and gums that secure and support the teeth. Periodontal disease is the number one cause of tooth loss in adults. Though the main cause of gum disease is lack of oral hygiene, contributing factors include heavy smoking and diabetes. Unfortunately, bone that has been resorbed due to periodontal disease will not grow back, but aggressive professional treatment and thorough home care can prevent the situation from getting worse.

Diagnosis of Gum Disease

The early signs of gum disease include redness, swelling, or inflammation around the gum line. If these systems appear, your dentist will check for the build up of calculus (tartar) below your gum line. Your dentist or hygienist may use a tool called a probe to test your gums for bleeding and measure periodontal pockets. X-rays are also helpful in evaluating the bone level around your teeth.

Treatment of Gum Disease

Gingivitis, the early stage of gum disease, is easily treated with professional cleanings with a dental hygienist and proper home care to remove the plaque before it becomes calculus. Periodontitis, however, will require more aggressive treatment. Your dentist may recommend that you have a deep cleaning (called scaling and root planing) to remove the plaque and calculus below your gums. For your comfort, anesthesia is used and the procedure is broken up into two or more visits followed by a final polish visit where we remove any residual stain and check for persistent areas of inflammation. A slow-released antibiotic is often placed into deep pockets. You may also be prescribed mouth rinses. Patients in periodontal treatment frequently require cleanings and check-ups every three to four months to maintain their periodontal health.

Scaling & Root Planing

Patients with gum and periodontal disease require help in cleaning the deeper pockets found in the mouth. This deep tissue removal of calculus restores your mouth to health below the gums. If left untreated, calculus build up propagates periodontal disease and irreversible bone loss. Not only will your bone begin to recede leaving your teeth more fragile and prone to loosening, it is linked to a number of other diseases.

Your hygienist will spend a significant amount of time on each tooth that requires this deep cleaning. Usually, only one fourth of your mouth will be completed per appointment. You should expect to receive anesthetic during this procedure since a cleaning of this depth is often uncomfortable. There are three levels of pain management available during this procedure, from topical gel, to a gel that is placed in each sulcus (gums around each tooth), to local anesthetic injection. Your hygienist will help you to choose which form of anesthetic is most appropriate for your procedure.

Periodontal Maintenance

After successful scaling and root planing, your hygienist will recommend that your mouth require a little extra attention above and beyond what is provided at a regular cleaning appointment. By coming in for periodontal maintenance, your hygienist can keep the bacteria growing in your mouth under control and help you to avoid further periodontal disease and bone loss. Generally, periodontal maintenance patients are recommended appointments at intervals of every 3-4 months.

We love kids and believe it is important for their long-term health to give them a positive first experience in a dental office. The American Academy of Pediatric Dentistry recommends that your child have their first visit to the dentist by their first birthday (or when their first tooth erupts). Research shows that early detection and good oral health care impacts their general health and can help improve their school readiness. In addition, children benefit from early exposure to the dental office because it alleviates unnecessary future anxiety about the unknown and allows us to establish a relationship for the future.

When decay gets down below the surface enamel and into the dentin of the tooth, we must remove the cavity (also called caries) and fill that space with a restorative material to preserve the tooth. Common filling materials are silver amalgam and composite resin.

At Englander Dental, we use composite resin because of its ability to bond to the tooth and because it looks more natural. Dental composites are tooth-colored. In contrast to silver (amalgam), composite tooth-colored fillings are much more conservative because less tooth structure needs to be removed. Additionally, because the composite material bonds to the tooth it adds strength, making it less prone to fracture or breakage in the future.

A crown, or cap as some people call it, is a tooth restoration for many purposes. A crown is a tooth-like restoration that is used to cover up the tooth. The existing tooth is smoothed down on the top and sides to make room for a crown to fit. The dentist then takes an impression or model of the tooth. It is then mailed to a lab where the crown is made. In the meantime, the patient goes home with a temporary crown that looks and feels like the final crown. At a second appointment, typically two weeks later, the crown is cemented to the existing tooth. Crowns can be all porcelain, porcelain fused to metal, or gold. It is important to talk to your dentist to find out what is best for your mouth.

Crowns are recommended for a number of reasons. Broken teeth, misaligned teeth, root canal treated teeth, teeth badly worn, and enamel defects can all be corrected. The most common reason for a crown is for a tooth that breaks because of a large existing filling. When a large filling is placed, it compromises the strength of the tooth. To prevent it from breaking, a crown is placed that will protect the tooth. Crowns have been a common procedure for many years and they last a very long time with good home care and professional cleanings.

A bridge is used to replace one or more missing teeth in a patient’s mouth. A bridge is an extension of a crown because the procedure is a lot the same. A tooth on each side of the missing tooth space is smoothed down on the tops and side. An impression is taken from which a model is fabricated. The model is then used by the dental lab to fabricate the bridge. In the meantime, the patient is sent home with a temporary bridge. It is possible to replace numerous missing teeth, but the dentist needs to do a thorough exam to determine what the best option is.

A bridge is a fixed dental restoration used to replace a missing tooth by joining an artificial tooth permanently to adjacent teeth or dental implants. Types of bridges may vary, depending upon how they are fabricated and the way they anchor to the adjacent teeth. Conventionally, bridges are made using the indirect method of restoration. However, bridges can be fabricated directly in the mouth using such materials as composite resin.

Other tooth replacement solutions include:

• Dental implants
• Dentures

Sometimes the pulp inside a tooth becomes infected. When this happens, the infection must be removed with root canal therapy (also called endodontic therapy) to save the tooth. The nerve tissue and blood vessels are removed and the inside of the tooth is cleaned with tiny files and irrigating solutions. The decontaminated canals are then filled with a filling material. Root canal therapy both removes infection and protects the decontaminated tooth from future infection.

A dental extraction is the removal of a tooth and is performed for a wide variety of reasons, including tooth decay. Fortunately, modern dentistry makes routine tooth extractions relatively comfortable, painless procedures.

Simple extractions are usually performed under local anesthetic, and require only the use of instruments to elevate or grasp the visible portion of the tooth. Impacted or problematic wisdom teeth are routinely extracted, as are extractions of some permanent teeth to make space for orthodontic treatment. It the tooth cannot be easily accessed, either because it has broken under the gum line or because it has not fully erupted, it may require a surgical extraction. Dr. Manuel Englander can give you more information about your particular situation and will make sure you are comfortable throughout the process.

A removable denture is used to replace missing teeth in a patient’s mouth. The difference between a denture and a bridge is that a denture can be removed while a bridge is cemented in. Removable dentures are made of pink acrylic as a base and plastic teeth. The denture acrylic is very natural looking and the teeth used come in many different shades and shapes. Your dentist is trained to pick teeth that will be very unnoticeable. A denture can replace a couple teeth or all your teeth. Sometimes a fixed bridge is not an option because there is not a tooth available on each side of the area where teeth are missing. This is where a removable denture is a treatment option. There are two kinds of removable dentures, a partial or full denture.

A partial removable denture uses the existing teeth to help hold the denture into place. Metal arms are fabricated that hold onto the existing teeth to make it stable. The metal arms are hidden so that other people do not notice. If they can’t be hidden, there are techniques that can be employed to hide them so that no one knows you are wearing a denture.

A full removable denture is used when there are no existing teeth available. It stays in by using suction. The same acrylic and teeth used in a partial denture are used in a full denture. Typically, upper full dentures fit well because they suction to the palate. Lower dentures don’t fit as well because the tongue always pushes the denture around. Another contributing factor to the fit is the remaining bone. The more bone that remains creates more surface area for the acrylic of the denture to suction into place. If the denture doesn’t fit real well, sometimes adhesives can be used. If these don’t work, implants can be used to help hold the denture into place. It is very important to sit down with your dentist and discuss what the best treatment plan is for you.

Dentures are prosthetic devices designed to replace missing teeth. Conventional dentures are removable; however, there are many different denture designs, some which rely on bonding or clasping onto teeth or dental implants.

Removable Dentures

Removable partial dentures are for patients who are missing some of their teeth on a particular arch.

Fixed Dentures

Fixed partial dentures are made from crowns that are fitted on the remaining teeth to act as abutments and pontics made from materials to resemble the missing teeth.

Implant Dentures

An implant-retained denture is a denture held in place by implants. Usually two to four implants are surgically placed in the bone and become anchored as the bone heals and secures itself to the implant. Once the bone has healed, Dr. Manuel Englander can create an implant denture. An implant denture is a removable denture with attachments on the underside that clip onto a bar connected to the implants. The attachments and bar hold the denture in place and keep it from moving when chewing and speaking. Implant dentures can be classified into two groups: Implant Retained Dentures and Implant Supported Dentures. Implant Retained Dentures are held in place by the attachments, but are mainly supported by the bone and gum tissue as is a conventional denture. Implant Supported Dentures are for patients who do not have sufficient bone and supporting gum tissue. This denture is mainly supported by the bar attached to the implants.

Other solutions for tooth replacement include:

• Dental Implants
• Dental Bridges

Bruxism is a condition in which you grind or clench your teeth. Some people are not even aware that they do this and may unconsciously clench their teeth together during the day or at night while they are sleeping. The evidence is often visible from wear on their teeth, headaches or neck pain symptoms. Treatment can include appliances such as nightguards or jaw exercises. Our expert dentists will do an examination and find a comfortable and effective solution.

If you are an athlete, it is important to protect your teeth during both practices and games. Dental trauma occurs in 25% of children ages 7-14. While some of that injury is accidental, many injuries are sports related. A mouth guard can help protect your teeth from being broken, displaced, or damaged and requiring years of costly maintenance and restoration. Custom-fitted mouth guards are easier to wear and offer you the best protection for your smile. We can make that for you right here in our Edina office!