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prevention
There are four ways Progressive Dental and Dr. Salah can
help
you prevent dental problems and tooth loss.
The first way we can help you is through education. We
want
you to completely understand both the basics of the care we are
providing to you, and how you can maintain your dental health at home.
The staff of well educated dental hygienists will spend as much time as
necessary helping you learn to effectively use home dental care
products to maintain your smile. Aside from tooth brushes, toothpaste
and floss, there are many other devices now available to the dental
consumer. If you are having difficulty using what you have, we probably
have an alternative for you to try. We also want you to know the status
of your dental health. On every visit the hygienist or Doctor Salah
(usually both!) carefully look at every tooth in your mouth, looking
for decay, worn out or discolored restorations, periodontal disease and
other irregularities. After carefully examining your smile Dr. Salah
will inform you of everything he sees. If there are areas that
Dr. Salah feel require attention we can use digital imaging technology
to enlarge them and show them to you on a high resolution monitor. The
enlarged images both help us explain to you why treatment is sometimes
necessary to prevent further dental problems, and they often help us
detect problems while they are still small and easily treated.
The second way we help you prevent dental problems is
with
individually scheduled dental prevention visit intervals.
You are an individual with individual needs. The old fashioned "cookie
cutter" approach, that is: "see your dentist twice a year" has been
shown to be inappropriate for most adults. Although many adults have
excellent periodontal (gum) and dental health thereby keeping their
teeth longer than ever before, studies have indicated, and our
experience has shown us, that most adults over thirty years of age have
some form of gum disease. Periodontitis is the number one cause of
tooth loss in the United States today. People with any form of gum
disease, ranging from "a little bleeding when I brush" (gingivitis), to
severe bone loss and the loosening of teeth, require more frequent
professional cleaning and monitoring.
The third way we prevent dental problems is through the
controlled use of fluoride.
Dr. Salah recommends in office, TOPICAL fluoride treatments twice a
year for most of our patients who are under the age of 18 and TOPICAL
fluoride treatments for our adult patients annually.
Patients receive fluoride in two ways. The first way we get our
fluoride is SYSTEMICALLY. Systemic fluoride comes to us in our water,
(even well water often has naturally occurring fluoride) in some foods,
(green leafy vegetables, namely broccoli, are high in fluoride) and
some prescription pediatric vitamins are fortified with fluoride.
Systemic fluoride has been shown to reduce dental caries (cavities) by
making teeth more resistant to decay causing acids in the oral cavity.
Systemic fluoride has also been demonstrated to make the deep grooves
that develop in most "back" teeth smaller, and less deep.
Shallow, smaller grooves make the teeth less prone to decay, and easier
to keep clean.
Generally in homes with city water, most patients get plenty of
systemic fluoride and do not require supplements. Patients living with
well water should get their water tested before fluoride supplements
can be considered. Too much SYSTEMIC fluoride can permanently damage
adult teeth before they even erupt, by making white spots, or even
unsightly brown spots on the adult teeth.
TOPICAL fluoride is applied to the surface of the teeth. We receive
topical fluoride in a number of ways also. The first way most of us
receive topical fluoride is by brushing our teeth with commercially
available toothpastes. Practically all "brand name" toothpastes and
dentifrices have some sort of fluoride in them. There are also fluoride
rinses and gels, both by a dentist's prescription, and over the
counter. Dr. Salah may recommend either one, depending on the
individual patient's needs.
The second way we receive TOPICAL fluoride is through professional
application at the time of our regular dental visits. It was once
thought that only children needed the extra cavity protection given by
in office fluoride treatments. But in office fluoride treatments are
now known to provide the following benefits to adults and children
alike:
1. The reduction of smooth surface cavities. Most kids are cavity prone
due to diet, the lack of dexterity to keep things clean, and a lack of
understanding on how important dental health is to their overall
health. Adults however get cavities too.
2. When young people wear orthodontic appliances they often have a
difficult time keeping them clean. Fluoride helps prevent
decalcification around cemented on brackets and bands, making the teeth
look better when the braces are off, and preventing permanent damage to
the tooth surfaces
3. The reduction of root caries. Root caries (cavities on the roots of
teeth) are becoming a problem as our population ages and keeps their
teeth longer. As gums recede from abrasion, bruxism, periodontal
disease or other factors, the roots of the teeth often become exposed.
The dentin of the tooth (what roots are made of) is softer than enamel
and is far more prone to cavities. Professional topical fluoride
treatments can help prevent these, sometimes painful, cavities.
4. The reduction of sensitivity. Fluoride can remineralize exposed root
surfaces and provide protection against the sensitivity that many
adults have to cold beverages and foods.
5. The reduction of caries (cavities) under expensive, sometimes
difficult to clean dental restorations. The main reason crown and
bridge work fails is because of decay under the margins (edges) of the
restoration. Topical fluoride is a small investment in maintaining and
preserving the investment many of us have in our dental restorations.
Pit and fissure sealants are the fourth way Dr. Salah and
Progressive Dental prevent dental disease for you and your family. A
sealant is a white plastic material that is applied to the chewing
surfaces of the back teeth where decay most often occurs. When teeth
are developing depressions and grooves form in the chewing surfaces.
These features are called "pits and fissures" Because they are narrow,
and deep, they are impossible to keep clean.
In the photo you see the highly magnified end of a tooth brush bristle
trying to clean the depths of a fissure. Sealants are a plastic coating
that closes off those deep pits and fissures before bacteria has
a chance to colonize and decay the teeth from the inside.
Sealants are applied in four steps. First the tooth is
cleaned
with a powered brush and mild abrasive to scour any plaque off the
surface. Then a special dye is applied to the area being sealed. The
dye is designed to adhere to any tooth structure that is even
microscopically decayed. Sealants cannot be applied over dental decay.
If the tooth has a very tiny amount of decay, Dr. Salah can remove it
with a special diamond and the sealant can still be applied. If the
decay is more extensive, then a conventional restoration will need to
be done. When the tooth is shown to be free of decay, a special etchant
  is applied for a minute to condition the
surface of the tooth to accept the sealant material. After the
tooth is etched, the white plastic sealant material is applied, and
immediately cured with a very intense light. After a few seconds under
the curing light the sealant is fully cured and the procedure is
complete.

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