Teeth Cleaning

 

General Cleaning


Professional teeth cleaning by a certified dental hygienist aims to remove plaque, tarter and stains that have accumulated on the teeth. Even with routine brushing and flossing of your teeth and gums, tarter can develop. The professional cleaning of teeth is a crucial part of good oral hygiene and is needed periodically to maintain the health of your teeth and gums. Most dentists recommend having your teeth professionally cleaned every 6-12 months to reduce the likelihood of periodontal disease progressing. In between routine cleanings, good oral hygiene at home is vital to prevent tarter build-up and gum disease.

Dental cleanings are designed to remove plaque and tarter deposits that have built up on teeth over time. Plaque is the sticky, soft film that contains millions of bacteria. This bacteria found in plaque is what causes gum disease and tooth decay if not removed by daily brushing and flossing, as well as routine trips to the dentist. Tarter, or dental calculus, is a hard calcified deposit that forms on the teeth and can contribute to their decay. Dentists use specialized instruments to gently remove these deposits without causing harm to the teeth. All dental instruments are put through a stringent cleaning, disinfecting, and sterilizing procedure to ensure safety and quality control. A dental mirror will also be used to help the dentist inspect hard-to-see areas in the mouth. Dental mirrors feature elongated handles generally connected to round mirrors. A dental mirror can help the dentist observe the teeth and gums for signs of irritation, swelling, decay, tarter, or bleeding. The first tool that is generally used to clean teeth is an ultrasonic instrument. This device uses mild vibrations to loosen larger pieces of tarter. It also sprays subsequent mists of cool water to wash away loose debris. The tips of the ultrasonic instrument are rounded and curved, and kept in constant motion. The settings on the device can be adjusted for the patient’s comfort.

Once larger pieces of tarter are dislodged, the dentist will make the switch to finer hand-held instruments. Often referred to as curettes or scalers, these tools are designed to eliminate smaller deposits on the teeth and smooth the tooth surfaces. Each tooth must be scaled individually to ensure that all tarter is removed. Once the surfaces of the teeth are smooth, the dentist will polish the teeth. Using a slow-speed handpiece containing a soft rubber cup, the polishing device spins at the tip to smooth teeth. Prophylaxis paste, a gritty toothpaste-like solution, is put into the rubber cup. The cup containing the solution spins on the teeth to create a shiny, smooth surface. In some instances, your dentist may also apply fluoride as the final step in cleaning. Available in a variety of flavors, such as strawberry, chocolate, mint, and cherry, fluoride is placed in flexible foam trays and placed over the teeth. After 30 seconds of the fluoride treatment, the patient is asked to spit the remaining solution into a saliva ejector. Fluoride is used to strengthen teeth and protect them against dental plaque and tarter. 

The majority of dental patients find routine teeth cleaning to be painless. The cooling mist of water, mild vibrations, and the pressure felt during “scraping” does not generally caused discomfort. It’s important to let your dentist know if the cleaning is beginning to cause pain, so that they can recommend alterative options to make your teeth cleaning more enjoyable. Most dental cleanings last between 30 minutes to an hour on average, and are performed in a lying position in a comfortable dental chair. After a professional teeth cleaning, you may notice that your teeth feel fresher and look brighter. Teeth cleaning procedures are designed for more than just appearances. Professional teeth cleaning treatments are the primary means of preventing and treating periodontal disease and maintaining tooth health.

 

Dental Sealants (preventive care)


Brushing and flossing are the best ways to help prevent cavities, but it’s not always easy to clean every nook and cranny of your teeth – especially those back teeth you use to chew (called molars). Molars are rough, uneven and a favorite place for leftover food and cavity-causing bacteria to hide.

Still, there’s another safety net to help keep those teeth clean. It’s called a sealant, and it is a thin, protective coating (made from plastic or other dental materials) that adheres to the chewing surface of your back teeth. They’re no substitute for brushing and flossing, but they can keep cavities from forming and may even stop early stages of decay from becoming a full-blown cavity.

In fact, sealants have been shown to reduce the risk of decay by nearly 80% in molars. This is especially important when it comes to your child's dental health. In October 2016, the Centers for Disease Control released a report on the importance of sealants for school-aged children, of which only 43% of children ages 6-11 have. According to the CDC, "school-age children without sealants have almost three times more cavities than children with sealants."

You may have many questions about sealants, and we have answers for you below. Read on to learn more about sealing out tooth decay.

How Do Sealants Work?

Think of them as raincoats for your teeth. When the cavity-causing bacteria that live in everyone’s mouth meet leftover food particles, they produce acids that can create holes in teeth. These holes are cavities. After sealant has been applied it keeps those bits of food out and stops bacteria and acid from settling on your teeth—just like a raincoat keeps you clean and dry during a storm.

Who Can Get Sealants?

Children and adults can benefit from sealants, but the earlier you get them, the better. Your first molars appear around age 6, and second molars break through around age 12. Sealing these teeth as soon as they come through can keep them cavity-free from the start, which helps save time and money in the long run. Ask your dentist if sealants are a good option for you and your family.

How Are Sealants Applied?

It’s a quick and painless process. Your dentist will clean and dry your tooth before placing an acidic gel on your teeth. This gel roughs up your tooth surface so a strong bond will form between your tooth and the sealant. After a few seconds, your dentist will rinse off the gel and dry your tooth once again before applying the sealant onto the grooves of your tooth. Your dentist will then use a special blue light to harden the sealant.

Can Sealants Be Placed Over Cavities?

Sealants can be used over areas of early decay to prevent further damage to your tooth. Because some sealants are clear, your dentist can keep an eye on the tooth to make sure the sealant is doing its job.

Are There Any Side Effects?

With the exception of an allergy that may exist, there are no known side effects from sealants.

Is There BPA In Sealants?

Yes, there is a tiny amount of BPA in sealants but not enough to cause you or a loved one any harm. In fact, you get more exposure to BPA by simply touching a receipt, using cosmetics or coming in contact with dust.

Is There BPA in Sealants

How Long Do Sealants Last?

Sealants will often last for several years before they need to be reapplied. During your regular dental visit, your dentist will check the condition of the sealant and can reapply them as needed.

Are Sealants Covered By Dental Plans?

Some plans do cover sealants, so call your dental benefit company to find out what kind of coverage you have.

 

Periodontal Evaluation


Periodontal Checks and Their Importance

One of two adults over the age of 30 has periodontal disease. At the Santa Barbara Dental Spa we are committed to your dental and overall health. Of the different periodontal services we offer, once a year, our hygienists perform a periodontal evaluation for our patients as part of their regular hygiene cleaning and check up. We ask patients to Know Your Numbers.

What Causes Periodontal Disease? 

As plaque and calculus (also known as tartar, calculus is plaque that has hardened and it is what needs to be scraped off during a professional dental cleaning) builds up on teeth, the body reacts to it by becoming inflamed.  If the plaque and calculus is not cleaned off regularly, or there are other health factors affecting someone’s inflammatory response, the body will continue to fight the calculus build up like dirt in an unwashed cut.  This inflammatory response causes the bone and gum tissue to pull away from the tooth, which causes deeper pockets in which bacteria can flourish.

Sadly, there are also many factors that contribute to tipping the balance from a healthy mouth to a diseased state;

  • diabetes 
  • high blood pressure 
  • stress 
  • poor nutrition 
  • blood cell disorders 
  • poor sleep 
  • tobacco and alcohol 
  • genetics 
  • steroid treatment 
  • dry mouth syndrome 
  • not keeping your regular six month dental cleanings 
  • lack of adequate oral health care 
  • crowding of teeth 

Why Is It Such a Big Deal? Because of the potential averse health effects.

There are many reasons to keep your teeth clean and free of bacteria. If periodontal disease is not caught early you can end up losing bone and gum tissue – the support structure for your teeth. No treatment can lead to worsening of the problem and ultimately tooth loss. There is also very strong evidence linking the health of your mouth to your overall health throughout the rest of your body. For example, a link has already been made between severe gum disease, strokes, diabetes and heart attacks. 

Unfortunately, periodontal disease, like many other serious diseases such as diabetes, high blood pressure, and heart disease, have symptoms that are often absent or subtle and only become apparent after much damage is done.  The fact that symptoms are often not obvious is why we take annual measurements of your gum tissue and record bleeding so we can closely monitor changes and treat areas conservatively and early in the disease process.

What Exactly Happens During a Periodontal Check? 

A periodontal exam involves taking six measurements around each tooth to measure the depth of the space between the tooth and gums.  In addition to these measurements, we also measure any recession (movement of the gum tissue down the root of the tooth exposing the root), any loosening or mobility of the teeth, and if there are any visual signs of inflamed gum tissue.

Why Does My Hygienist Do Periodontal Checks? 

All of the information collected at your periodontal check helps us determine if someone has gum disease or even the very beginning stages of gum disease. We complete this exam once a year on our adult patients in accordance with the standards set by the American Dental Association and the American Academy of Periodontology, the body that makes recommendations and oversees the dental specialty of periodontics which focuses on diseases and conditions of the gums and bone in the mouth.

 

Periodontal Therapy


A Periodontal Therapy is a “conservative” (non-surgical) program consisting of a series of 2, 4, or 6 visits to control gum disease. ... Our goal is to eliminate bleeding and mouth odor, as well as reduce gum pocket depths to eliminate bacterial re-infection.

Preventing Periodontal Disease is Something That’s Necessary for Your Health

At the most, your toothbrush can only reach 2-3 millimeters below the gum tissue to effectively clean it out. This is why a professional cleaning is needed every 6 months and why a complete periodontal exam is needed to fully assess the health of the gums and bone in the mouth. Many other offices do only a quick spot check or no exam at all. We believe that you need to Know Your Numbers and a complete exam is the

only way to properly determine if you have gum disease. 
By doing this exam on a yearly basis, we can catch gum disease in its earliest stages when often time very small interventions are needed to halt or reverse it before permanent damage could occur.

Non-Surgical Treatments:

AAP treatment guidelines stress that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment.
Non-surgical periodontal treatment does have its limitations. When it does not achieve periodontal health, surgery may be indicated to restore periodontal health.

Scaling and Root Planing

Scaling and root planing is a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins. Scaling and root planing is sometimes followed by adjunctive therapy such as local delivery antimicrobials, systemic antibiotics, and host modulation, as needed on a case-by-case basis.

Most periodontists would agree that after scaling and root planing, many patients do not require any further active treatment. However, the majority of patients will require ongoing maintenance therapy to sustain health.

Tray Delivery Systems

A tray delivery system consists of a custom-fit tray made from impressions of the patient’s mouth. Patients use the tray at home to deliver medications that have been prescribed by their dentist. Tray delivery systems were cleared by the Food and Drug Administration (FDA) since they are similar to fluoride trays traditionally used to prevent tooth decay. However, the FDA clearance process did not determine that any specific medication delivered via tray delivery systems has been proven to be a safe or effective way to treat gum disease.

The AAP has reviewed several studies about the treatment of periodontal disease using tray drug delivery systems. The results of these studies, where tray drug delivery systems were used as adjunct to non-surgical periodontal therapy, provide no strong evidence that show adjunctive use of tray delivery systems is more effective than traditional non-surgical periodontal therapy alone. When determining the best course of treatment for your specific case, be sure to discuss the pros and cons of all available treatment options with your dental professional.

Gum Graft Surgery:

Exposed tooth roots are the result of gum recession. Gum graft surgery will repair the defect and help to prevent additional recession and bone loss. 

 Before Gum Graft Surgery
Before Gum Graft Surgery
After Gum Graft Surgery
After Gum Graft Surgery

Gum grafts can be used to cover roots or develop gum tissue where absent due to excessive gingival recession. During gum graft surgery, your periodontist takes gum tissue from your palate or another donor source to cover the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity.

What Are The Benefits Of Gum Graft Surgery?

A gum graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay. This may reduce tooth sensitivity and improve esthetics of your smile. Whether you have a gum graft to improve function or esthetics, patients often receive the benefits of both: a beautiful new smile and improved periodontal health – your keys to smiling, eating and speaking with comfort and confidence.

Laser Treatment:

Lasers can be used to treat periodontal disease. Current controlled studies have shown that similar results have been found with the laser compared to specific other treatment options, including scaling and root planing alone. Scaling and root planning is a traditional non-surgical therapy used to treat periodontal diseases. 

Can The Use Of Lasers In Periodontal Therapy Harm Patients?

Yes and no. Each laser has different wavelengths and power levels that can be used safely during different periodontal procedures. However, damage to periodontal tissues can result if a laser with an inappropriate wavelength and/or power level is used during a periodontal procedure.

Does The Research On Lasers Supprt Their Use In Periodontics At This Time?

At this time, there is insufficient evidence to suggest that any specific laser wavelength is superior to the traditional treatment methods of the common periodontal diseases, such as periodontitis.

Can I Trust the Claims In An Ad For Periodontal Therapy Performed With A Laser?

It is important to beware of advertising that sounds too good to be true because it very well may be. A dental professional can help you separate fact from hype.

Regenerative Procedures:

Procedures that regenerate lost bone and tissue supporting your teeth can reverse some of the damage caused by periodontal disease.

Your periodontist may recommend a regenerative procedure when the bone supporting your teeth has been destroyed due to periodontal disease. These procedures can reverse some of the damage by regenerating lost bone and tissue.

During this procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria. Membranes (filters), bone grafts or tissue-stimulating proteins can be used to encourage your body's natural ability to regenerate bone and tissue.

Eliminating existing bacteria and regenerating bone and tissue helps to reduce pocket depth and repair damage caused by the progression of periodontal disease. With a combination of daily oral hygiene and professional maintenance care, you'll increase the chances of keeping your natural teeth – and decrease the chances of other health problems associated with periodontal disease.

Dental Crown Lengthening:

You may have asked your periodontist about procedures to improve a "gummy" smile because your teeth appear short. Your teeth may actually be the proper lengths, but they're covered with too much gum tissue. To correct this, your periodontist performs a dental crown lengthening procedure.

During the dental crown lengthening procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be done to one tooth, to even your gum line, or to several teeth to expose a natural, broad smile.

Your dentist or periodontist may also recommend dental crown lengthening to make a restorative or cosmetic dental procedure possible. Perhaps your tooth is decayed, broken below the gum line, or has insufficient tooth structure for a restoration, such as a crown or bridge. Crown lengthening adjusts the gum and bone level to expose more of the tooth so it can be restored.

Dental Implants:

A dental implant is an artificial tooth root that is placed into your jaw to hold a replacement tooth or bridge. Dental implants may be an option for people who have lost a tooth or teeth due to periodontal disease, an injury, or some other reason.

Types of Dental Implants

Endosteal (in the bone): This is the most commonly used type of implant. The various types include screws, cylinders or blades surgically placed into the jawbone. Each implant holds one or more prosthetic teeth. This type of implant is generally used as an alternative for patients with bridges or removable dentures.

Subperiosteal (on the bone): These are placed on top of the jaw with the metal framework's posts protruding through the gum to hold the prosthesis. These types of implants are used for patients who are unable to wear conventional dentures and who have minimal bone height.

Are You A Candidtae For Dental Implants?

The ideal candidate for a dental implant is in good general and oral health. Adequate bone in your jaw is needed to support the implant, and the best candidates have healthy gum tissues that are free of periodontal disease.

Dental implants are intimately connected with the gum tissues and underlying bone in the mouth. Since periodontists are the dental experts who specialize in precisely these areas, they are ideal members of your dental implant team. Not only do periodontists have experience working with other dental professionals, they also have the special knowledge, training and facilities that you need to have teeth that look and feel just like your own. Your dentist and periodontist will work together to make your dreams come true.

What Is A Dental Implant Procedure Like?

This procedure is a team effort between you, your dentist and your periodontist. Your periodontist and dentist will consult with you to determine where and how your implant should be placed. Depending on your specific condition and the type of implant chosen, your periodontist will create a treatment plan tailored to meet your needs.

  • Replacing a Single Tooth   If you are missing a single tooth, one implant and a crown can replace it.
  • Replacing Several Teeth   If you are missing several teeth, implant-supported bridges can replace them.
  • Replacing All of Your Teeth   If you are missing all of your teeth, an implant-supported full bridge or full denture can replace them.
  • Sinus Augmentation   A key to implant success is the quantity and quality of the bone where the implant is to be placed. The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. Sinus augmentation can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants.
  • Ridge Modification   Deformities in the upper or lower jaw can leave you with inadequate bone in which to place dental implants. To correct the problem, the gum is lifted away from the ridge to expose the bony defect. The defect is then filled with bone or bone substitute to build up the ridge. Ridge modification has been shown to greatly improve appearance and increase your chances for successful implants that can last for years to come.

What Can I Expect After Receiving A Dental Implant?

As you know, your own teeth require conscientious at-home oral care and regular dental visits. Dental implants are like your own teeth and will require the same care. In order to keep your implant clean and plaque-free, brushing and flossing still apply!

After treatment, your periodontist will work closely with you and your dentist to develop the best care plan for you. Periodic follow-up visits will be scheduled to monitor your implant, teeth and gums to make sure they are healthy.

Pocket Reduction Procedures:

Mild Periodontitis
Mild Periodontitis
Advanced Periodontitis
Advanced Periodontitis

Your bone and gum tissue should fit snugly around your teeth like a turtleneck around your neck. When you have periodontal disease, this supporting tissue and bone is destroyed, forming "pockets" around the teeth.

Over time, these pockets become deeper, providing a larger space for bacteria to live. As bacteria develop around the teeth, they can accumulate and advance under the gum tissue. These deep pockets collect even more bacteria, resulting in further bone and tissue loss. Eventually, if too much bone is lost, the teeth will need to be extracted.

Your periodontist has measured the depth of your pocket(s). A periodontal pocket reduction procedure has been recommended because you have pockets that are too deep to clean with daily at-home oral hygiene and a professional care routine. 

During this procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria before securing the tissue into place. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone.

Reducing pocket depth and eliminating existing bacteria are important to prevent damage caused by the progression of periodontal disease and to help you maintain a healthy smile. Eliminating bacteria alone may not be sufficient to prevent disease recurrence. Deeper pockets are more difficult for you and your dental care professional to clean, so it's important for you to reduce them. Reduced pockets and a combination of daily oral hygiene and professional maintenance care increase your chances of keeping your natural teeth – and decrease the chance of serious health problems associated with periodontal disease.

Plastic Surgery Procedures:

Periodontists are often considered the plastic surgeons of dentistry. If you are looking to improve your smile, a periodontist may be able to help.

Gummy Smile Or Uneven Gum Line

Do you feel your teeth look too short and your smile is too gummy or your gums cover too much of some teeth while leaving the others the right length? If so, dental crown lengthening might be the solution for you. During this procedure, excess gum tissue is removed to expose more of the crown of the tooth. Then your gumline is sculpted to give your new smile just the right look.

Long Teeth/Exposed Roots

Sometimes gum recession causes the tooth root to become exposed, which makes your teeth look long and can make you look older than you are. This recession can happen as a result of a variety of causes, including periodontal diseases.

Gum graft surgery and other root coverage procedures are designed to cover exposed roots, to reduce further gum recession and to protect vulnerable roots from decay.

Indentations In The Gume and Jawbone

Tooth loss can cause an indentation in the gums and jawbone where the tooth used to be. This happens because the jawbone recedes when it no longer is holding a tooth in place. Not only is this indention unnatural looking, it also causes the replacement tooth to look too long compared to the adjacent teeth.

Ridge augmentation can fill in this defect recapturing the natural contour of the gums and jaw. A new tooth can then be created that is natural looking, easy to clean and beautiful.

 

Oral Cancer Screening 


After an informed public that is knowledgeable about the risk factors for oral cancer, the dental community is the first line of defense in early detection of the disease. Including both generalists and specialists, there are over 100,000 dentists in the US, each one seeing between 8 and 15 patients per day. If you include those patients who come to a practice and see someone other than the dentist, such as the hygienist, the number of patient visits is significantly higher. The American Dental Association states that 60% of the US population sees a dentist every year. Just doing “opportunistic” cancer screenings of the existing patient population which visits a dental office every day, would yield tens of thousands of opportunities to catch oral cancer in its early stages. One of our goals is to initiate an effort within the dental community to aggressively screen all of the patients who visit their practices. At the same time we are launching a public awareness campaign. This campaign is intended to drive public awareness of oral cancer, and to instill in the public’s mind the need for an annual screening for this disease. One only has to look at the impact of the annual PAP smear, mammogram, and prostate exam, to see how effectively an aware and involved public can contribute to early detection, when coupled with a motivated medical community. The dental community needs to assume this same leadership role if oral cancer is to be brought down from its undeserved high ranking as a killer.

Published studies (Horowitz et. al.  in two studies ten years apart) show that currently less than 15-25% of those who visit a dentist regularly report having had an oral cancer screening. Most frequently when it is done it is accomplished by the RDH in the office and not the doctor. RDH’s are qualified to do these screenings and bring suspect areas to the attention of the doctor in the office for further examination and potentially additional diagnostic procedures such as biopsy. This low percentage of patients screened is unfortunate, when you consider that historically, the greatest strides in combating most cancers have come from increased awareness and aggressive campaigns directed at early detection. It is now commonplace to annually get a PAP smear for cervical cancer, a mammogram to check for breast cancer, or PSA and digital rectal exams for prostate cancer. These screening efforts have been possible as a result of the increased public awareness of the value of catching cancers in their earliest forms, combined with effective technologies for conducting the examinations. Oral cancer is no different. Actually, it is potentially easier to obtain public compliance for oral cancer screenings, since unlike many other cancer screening procedures, there is no invasive technique necessary to look for it, no discomfort or pain involved, and it is very inexpensive to have your mouth examined for the early signs of disease. Education of the public regarding the risk factors which lead to oral cancer, and the development of public awareness, are primary responsibilities of the dental community.

It is important that both private individuals, and members of the dental community, realize that a visit to the dentist is no longer about a filling, a crown, or a postponable cleaning, but is actually a matter of life and death. Dental examinations, when properly done and which include a screening for oral cancer, will save lives.

Discovery and Diagnosis

Historically, it has been difficult to determine which abnormal tissues in the mouth are worthy of concern. The fact is, the average person routinely has conditions existing in their mouths that mimic the appearance of pre-cancerous changes, and very early cancers of the soft tissues. One study determined that the average dentist sees 3-5 patients a day who exhibit soft tissue abnormalities, most of which are benign in nature. Even the simplest things, such as apthous ulcers, herpes simplex, herpes labialis, the wound left by accidentally biting the inside of your cheek, or sore spots from a poorly fitting prosthetic appliance or denture, all at first examination, share similarities with dangerous lesions. Some of these conditions cause physical discomfort, others are painless. The question is which ones deserve action, and which ones bear watching and waiting?

There has been a tendency to watch these areas over an extended period to determine if they are dangerous or not. Unfortunately, this philosophy leads to a situation in which a dangerous lesion may continue to prosper and grow into a later stage, hard to cure cancer. Any sore, discoloration, induration, prominent tissue, irritation, hoarseness, which does not resolve within a two week period on its own, with or without treatment, should be considered suspect and worthy of further examination or referral. Besides a routine visit to the dental office for regular examinations, it is the patient’s responsibility to be aware of changes in their oral environment. When these changes occur, they need to be brought to the attention of a qualified dental professional for examination. The dental professional needs to be current in the knowledge base necessary to make a proper diagnosis, and be competent in the proper screening procedures to identify oral cancer.

How to know if you have had a proper oral cancer screening.

There are two separate issues, discovery and diagnosis. Discovery is the result of a thorough visual and manual examination. It includes a systematic visual examination of all the soft tissues of the mouth, including manual extension of the tongue to examine its base, a bi-manual palpation of the floor of the mouth, and a digital examination of the borders of the tongue, and the lymph nodes surrounding the oral cavity and in the neck. New diagnostic aids, including lights, dyes, and other techniques are beginning to appear on the marketplace. While making the discovery process more effective, it is still possible to do a comprehensive examination through a proper visual and tactile process.

Once suspect tissues have been detected, the only way a definitive diagnosis of oral cancer may be made is through biopsy. Any condition that has existed for 14 days or more without resolution should be considered suspect and worthy of further diagnostic procedures or referral. Certainly, it is common knowledge that two of the most prevalent lesions that mimic oral cancer, are the herpes simplex ulceration, and aphthous ulcerations, each resolving of their own accord in approximately 10-14 days. Perhaps that sentence should be underlined, since one of the most common diagnoses received with referred patients to a major university cancer pathology department is “an atypical herpetic/aphthous lesion” These all too frequently turn out to be squamous cell carcinomas, which have been under observation…. for several months.

Creating awareness, discovery, diagnosis, and referral. When it comes to oral cancer and saving lives, these are the primary responsibilities of the dental community. This is dentistry’s cancer. The most important step in reducing the death rate from oral cancer is early discovery. No group has a better opportunity to have an impact than members of the dental community.

 

Gum Disease


Gum Disease

Untreated gingivitis can advance to periodontitis and can eventually lead to tooth loss and other health problems.

Gingivitis

Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.

Factors that may contribute to gingivitis include, diabetes, smoking, aging, genetic predisposition, systemic diseases and conditions, stress, inadequate nutrition, puberty, hormonal fluctuations, pregnancy, substance abuse, HIV infection, and certain medication use.

Periodontitis

Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.

There are many forms of periodontitis. The most common ones include the following.

Aggressive periodontitis occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction and familial aggregation.

Chronic periodontitis results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingiva. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.

Periodontitis as a manifestation of systemic diseases often begins at a young age. Systemic conditions such as heart disease, respiratory disease, and diabetes are associated with this form of periodontitis.
Necrotizing periodontal disease is an infection characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly observed in individuals with systemic conditions such as HIV infection, malnutrition and immunosuppression.

 

Dr’s Comprehensive Oral Examination


No matter how vigilant one's oral care regime, the irrepressible development of plaque, and the porous  nature of teeth makes them prone to decay. To forestall the excessive development of plaque that can result in gum and tooth loss, routine prophylaxis (Adult Prophylaxis Dental Procedure Code and Child Prophylaxis Dental Procedure Code) is recommended for all individuals.  

Yet prophylaxis (a dental cleaning), is only part of the equation when it comes to our overall health. In fact, the mouth is often considered a window to the rest of the body because many other illnesses first represent themselves as changes within the mouth. As a result, a comprehensive oral dental exam is recommended each time you visit a new practice to serve as a benchmark of your overall health. It is also recommended if you have had a substantial change in your health history since your last regular visit, or if you have not been to your regular dentist in more than three years. 

During an examination, your dentist will perform a visual examination, as well as a more detailed dental examination using bitewing or 360° panoramic X-rays, and sometimes an intra-oral camera to detect: 

  • New cavities 
  • Weaknesses in already installed crowns, fillings and bridgework 
  • Gum or bone recession 
  • Teeth deterioration due to abnormal bite, bruxism or TMJ 

Your dentist will also perform a visual and digital examination of lymph nodes throughout the face and neck looking for any abnormalities, pain, or flexibility within the nodes that could be markers for disease.

Likewise, a similar examination of your lips, gums, tongue and other internal mouth surfaces will be conducted, again looking for various signs of illness or disease.

Since the comprehensive dental exam is designed to set a baseline of your health and to catch any early signs of serious illness that may be otherwise undetected, your dentist will be on the lookout for the following illnesses which can be detected during a comprehensive oral evaluation:

  • Diabetes
  • Leukemia
  • Blood pressure
  • Cardiovascular problems
  • Oral cancer
  • Immune abnormalities
  • Sinus problems
Dr. Rai is by far the best dentist I've ever experienced in my dental life. The dental treatment I had done was very extensive however the results are absolutely incredible. I can't stop smiling. I've always had a pleasant experience at Santa Barbara Dental Spa. The office is so relaxing, the staff is friendly and eager to make you feel as comfortable as possible and the technology is top notch. Dr. Rai has a very calm demeanor and you can tell he truly cares about his patients. He's knowledgeable and always openly communicates with me about the agenda for each visit, no surprises. I've referred him to all my co-workers and friends and they always seem to have the same feedback. I am very appreciative of all the services I've received and would continue to recommend him as a dentist!
L H. - Santa Barbara, CA

News

Happy Valentine’s Day from Santa Barbara Dental Spa!

Happy Valentine’s Day from Santa Barbara Dental Spa!
By BK Rai in Santa Barbara Dental News

Valentine’s Day is just around the corner, and you’ll want to look your best for the love of your life. One way to help you accomplish this goal is by having a better smile.

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Keep Your Pearly Whites In Check This St. Paddy's Day

Keep Your Pearly Whites In Check This St. Paddy's Day
By BK Rai in Santa Barbara Dental News

Happy St. Patrick’s Day from Santa Barbara Dental Spa! We all know that St. Patrick’s Day is notorious for one thing: parties. And if there’s a party, there’s bound to be lots of booze as well.

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Santa Barbara Dentist Offers Brighter Holiday Smiles

Santa Barbara Dentist Offers Brighter Holiday Smiles
By BK Rai in Santa Barbara Dental News

Thanksgiving is a time we all gather around the table for that big annual feast. Since getting all of the family together doesn’t happen often with everyone’s busy schedules, you’re bound to take a few family photos. Why not have a picture perfect smile?

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