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Technology in Dentistry

on January 7, 2014

We live in a very technological age, where cell phones and computers are common place. A dental office is no exception. As technology advances, so do the tools we are able to use to help you keep your mouth healthy and keep you smiling.

Our Evanston dentist office uses schick x-ray sensorsDigital X-rays

In the past, x-rays were taken using film. In order for the film to register the x-rays, the radiation exposure had to be set at a specific level. With the advent of digital x-rays, the exposure rate can be lowered. Digital sensors are more sensitive than film so the needed exposure is much less. This means that the radiation that you are exposed to is drastically reduced. At Stephens Dentistry, our Evanston dentist office, we use the newest Schick sensors to ensure a crisp clear image with less radiation. Additionally, digital x-rays allow for quicker processing – the x-rays appear on the screen right after they are taken. Once the x-ray is saved to your chart, the dentist can adjust the sharpness, brightness, and contrast to allow them to better diagnose any cavities, abscesses, or perio issues.

Intraoral Camera

Taking intraoral photos in the past involved using mirrors and cameras. Often there would be issues with getting a camera to focus, or the comfort of the patient while trying to get a good photo. Photography has advanced and digital cameras are better and smaller than ever before. Now there are specific digital cameras for use in the dental office. These cameras are small and lightweight. They can easily take intraoral photos without any discomfort. The new intraoral cameras have built-in LED lights to ensure that the photos are well lit. Furthermore, the intraoral cameras we use at our office here in Evanston have a fixed focal range that allows the clinicians to take clear images even in extreme close-up situations. With our intraoral cameras, we are able to show you why we recommend the treatment that we do, allowing you to take an active part in your oral care.

CAD/CAM imaging and CEREC milling

CAD/CAM imaging allows our dentists to take digital impressions of your teeth. Using the digital impressions, our dentists can design: crowns, onlays, inlays, bridges, and veneers that fit perfectly over your prepared teeth. Once your restoration is designed, it is sent to our CEREC milling machine where your restoration is milled out of a solid block of e.max porcelain.

With the combined power of CAD/CAM imaging and CEREC milling, we are able to create beautiful custom restorations for you in one day. Previously, these types of restorations required taking impressions of your teeth and then sending these impressions to a lab. This process use to be messy, time consuming, and less than ideal; as you would have a temporary placed while waiting for your final restoration.

As the software advances, we will be able to use the digital impressions for much more. In the future we will be able to send your digital impressions to Invisalign or to a lab, virtually eliminating the need for goopy, uncomfortable impressions.

Our Evanston dentist office uses a Picasso Diode Laser as well as an NV MicrolaserDiode Laser

Diode lasers have been used in a number of different periodontal procedures. The selective nature of laser absorption makes them great tools for dentists to remove small amounts of gum tissue without damaging enamel or restorations. Our lasers operate at 810 nm, which is ideal for absorption by soft tissues. Our dentists use lasers to remove gum tissue so that they can access decay at or just below the gum line. In the past, dentists would “pack the gums,” meaning; they would push the gums out of the way, which was often uncomfortable for the patient. Another option would be to use an electrosurge, which was less accurate and has the potential to harm hard tissues.

 

As technology advances, so does our ability to provide you with the best that dentistry has to offer. Through continuing education courses and seminars, our dentists and staff strive to stay on the forefront of dental care to ensure that we can provide you with the best care possible.

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Single Tooth Replacement: Titanium Style

on December 11, 2013

Have you ever thought about the changes you would have to make if you lost both of your thumbs? I am sure we all take our thumbs for granted every day, because they are just there. We never have to think about the changes we would need to make if they became nonexistent. For instance, we wouldn’t be able to grip things very well, or give someone the thumbs up sign.

Then why is it, when we lose an adult tooth; we don’t think about the consequences associated with the loss. For example: speech problems, continuation of bone loss, and the weakening of other teeth (due to there being fewer teeth to use when eating and lack of stabilization.) Over a period of time you may even start to see movement and inclination of other teeth and the possible loss of those teeth as well.

An implant's structure is similar to that of your natural tooth

An implant’s structure is similar to that of your natural tooth

Implants are a great option for replacing a missing tooth and if well taken care of, may last your lifetime. Implants are a device that is surgically placed into orofacial tissues and used for anchorage, function and/or esthetic purposes.

There are a few things that you as a patient will need before you can be a candidate for placement of implants. You will need to be a patient of good oral hygiene, meaning no current periodontal disease; and have adequate bone level. By visiting your dentist, you could have a complete exam to see if you are a candidate for dental implants. At your visit, you may expect a complete oral exam including: panoramic x-ray, periodontal exam, oral cancer screening, and a possible 3D imaging scan for ideal placement of implant.

If you are found to be a great candidate for implants there are a few different ways to proceed. If your tooth is not present and the bone level is adequate you could have the implant placed without much prep work. If the tooth is still present and needs to be extracted, you may be able to place the implant immediately after extraction or you may need to have bone grafting completed in order to build up your bone level. Having a bone graft completed will prolong the process a tad, but will be of great benefit in the long run. After having a bone graft, a patient will need to wait 3-4 months for the bone to regenerate and build itself to be a strong site for placement of an implant.

After your bone has reached a sufficient level, the implant is ready to be placed. Implant surgery consists of using a variety of different size diameter drivers to create a space for the titanium screw to be placed into the bone. Surgery will be finished by placing a healing cap, and sutures being placed.  You should expect to have a series of visits following placement, to make sure the site is healing well and bone is integrating itself with the implant.  After allowing 3-5 months of healing time and integration your implant is ready for the finishing process.

Your next step would be to have impressions taken for your new crowns. Your crown will be supported by an abutment that attaches to your new implant. Your doctor will take the time to check the shade to match the crown with your other teeth. After 2-3 weeks you can expect to have your crown and abutment fabricated and ready for delivery. Your hygienist and doctor will give you specific tools and instructions of how to care for your new addition to your smile.

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Advances in Preventative Dentistry

on December 11, 2013

Preventative dentistry has been around since before written history. We, as a species, have been keeping our teeth clean for thousands of years. Over the years our toothbrushes have evolved from simple chew sticks to nylon bristled toothbrushes and then to electric toothbrushes. Advancements in preventative dentistry are not limited to home care.

Where did the fluoride trays go?

Fluoride is one of the largest advancements in preventative dentistry. Throughout its history, fluoride has shown to help prevent cavities when applied to your teeth. In the past dentists used foam or gel fluoride placed in fluoride trays that you held in your mouth. Now, we use fluoride varnish; which can be painted on your teeth and sets quickly. This allows for a continuous uptake of fluoride throughout the day. Fluoride varnish has a higher concentration of fluoride than the trays, but as the varnish is painted directly where it is needed and sets, there is less chance of ingesting the fluoride and minimal chance of fluorosis.

Antimicrobial varnish

At our office we offer a product called Cervitec Plus. This is an antimicrobial varnish that can be used to disinfect and protect your teeth against bacteria. Oral bacteria is very opportunistic and will hide in deep grooves and fissures in your teeth as well as margins around crowns and bridges. Cervitec helps protect these areas. In the past, we may have recommended a chlorhexidine mouthwash to help you control the bacterial population in your mouth and protect your teeth. With Cervitec we can apply the varnish directly where it is needed and the chlorhexidine and thymol will provide long lasting protection for that area. Depending on your oral situation, we may still recommend a chlorhexidine mouthwash in addition to Cervitec to provide the best protection for smile.

PerioProtect

PerioProtect uses patented trays to deliver a prescription hydrogen peroxide gel directly into the periodontal pockets where bacteria live. PerioProtect helps you manage your periodontal disease from the comfort of your home between periomaintenance visits. Using PerioProtect reduces the size of your periodontal pockets and increases the health of your gums. With regular use, PerioProtect trays can lead our team at our Evanston dentist office, to where your periodontal disease is running rampant. This allows our team to better assess how to help you treat your disease – whether by extracting a problem tooth or by increasing at home care.

Learn more about PerioProtect in our services section.

Laser Treatments

Dental lasers can be used as an adjunct in the process of scaling and root planing. In this capacity, the laser treatment helps to disinfect below the gum tissue after the tartar and plaque has been removed. Combining laser treatments, scaling and root planing, and Cervitec varnish may greatly increase the health of your gums and will help combat periodontal disease.

Dental care has come a long way since the days of the chew stick. At Stephens Dentistry we work hard to make sure that you have the latest technology, products, and services available to help you take the best care of your smile. Making sure your smile lasts a lifetime is how we measure our success as a dental team.

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Dental Sealants for Children

on December 5, 2013

Permanent teeth begin coming in around 6 or 7 years of age and, if properly cared for, may last the rest of your child’s life. That’s 70 to 80 years (maybe more!) of wear and tear for those teeth to make it through. A great way to start protecting your child’s permanent teeth is to have sealants applied as they erupt.

Sealants are resin coatings that are applied to the pits and fissures on the biting surface of your child’s teeth. This coating creates a barrier to keep decay out of these hard to clean areas, thereby helping prevent cavities. By forgoing sealants, all those pits and fissures of your child’s teeth are exposed to wear, decay, and acid erosion which can weaken your child’s teeth and cause cavities.

Our Evanston dentists recommend having sealants applied to children’s permanent molars as each set of molars become fully erupted. This allows minimum time for the fissures and pits to be exposed to decay. If taken care of properly and monitored by a dental professional, these sealants should last between 5 and 10 years.

Drs. James and Robert Stephens clean the tooth or teeth to be sealed. Then they apply an etching agent to “rough up” the tooth.  This roughing helps the sealant bond with the tooth – similar to sanding a surface prior to painting. The doctors then apply a BPA-free sealant and use a curing light to harden the material. As the procedure is relatively easy, the doctors will usually do several teeth at the same time, sometimes doing as many as twelve in one appointment!

 

Links for more information about sealants:

American Dental Association: Dental Sealants

Center for Disease Control: Dental Sealant FAQ

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How can sealants help protect your teeth?

on December 5, 2013

Prevention is the best way to ensure you keep your teeth for your whole life. Home care is a large part of prevention, but there are procedures that can help protect your smile and increase the life of your teeth. One such procedure is dental sealants.

How Sealants Work

Dental sealants are clear or white resin material that is placed on the chewing surface of your teeth to protect against bacteria and decay. Sealants are a physical barrier between your natural tooth enamel and the bacteria in your mouth. Sealants are only applied to the chewing surfaces of your teeth, as these are the most susceptible to decay and the most difficult to clean due to their uneven anatomy.

At your appointment, one of our Evanston dentists will clean and prep your teeth. Then he will apply the resin material to the chewing surface of each tooth. Then the material is hardened using a curing light. Once the material hardens, it may protect your teeth for 5 to 10 years. Your hygienists will check your sealants at each hygiene appointment to make sure they are still intact. If a sealant begins to break down from wear, they can be reapplied.

The Need for Sealants

As your teeth form, the enamel is built up through mineralization. This process forms pits and grooves which are part of the natural anatomy of your tooth. These natural pits and grooves are ideal places for bacteria to live and food particles to get caught. This creates an ideal environment to promote tooth decay and cavity formation. As the bacteria metabolize the sugars from leftover food particles, they produce acids which decay and erode your tooth enamel, thus form cavities.

Normal brushing is not enough to thoroughly clean the pits and grooves of your teeth. Even toothbrushes with micro bristles, such as a Rotodent, are not always able to access the entire surface area of your teeth.

Who Can Have Sealants

Our Evanston dentistsrecommend sealants for children as soon as their adult teeth erupt. This provides the most protection for new teeth. Any tooth that has not been exposed to decay can be sealed. Once a tooth experiences decay, it can no longer be sealed. In that case, the decayed portion needs to be removed and a filling needs to be placed. There is no age restriction that limits sealants to children.

Dental sealants are an excellent way to protect your teeth, but they do not preclude you from visiting the dentist or taking proper care of your teeth. Sealants are just one of the tools our dental professionals use to help you protect your teeth. When combined with proper home care and regular dental visits, dental sealants can help you keep your teeth for your whole life.

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SDManageHow can sealants help protect your teeth?

Candy related dental emergencies

on November 20, 2013

As delicious a treat as candy can be, it can also be hazardous for some. This Halloween, keep your dental health in mind. Continue reading to find out what you should do if a dental emergency occurs while snacking on a sweet treat.

Chipping a tooth, crown, or veneer

Many candies can cause you to chip a tooth, crown, or veneer; not just hard candy. Especially if you have molars that have large restorations, as they are more susceptible to chipping or cracking. If you chip a tooth, crown, or veneer while eating candy, contact your dentist to have it repaired. Any tooth that has been previously filled should be fixed as soon as possible as well.

Small chips usually do not require immediate attention, as they are usually just a cosmetic issue. Larger chips should be attended to promptly as they weaken tooth structure and may create more problems the longer you leave them alone. In these cases, the longer you leave the chip, the greater the chance that the filling may come out. Depending on the size of the restoration and the size of the chip, a crown may be the best way to restore the tooth.

Pulling out a filling or crown

Taffies and other sticky candies have the potential to pull out a filling or a crown. When a filling or crown is pulled out by candy, it means that the restoration was most likely failing and needed to be replaced. When you pull out a filling or a crown, contact your dental care provider as soon as possible.

If you pull out a crown, keep the crown as your dentist may be able to recement it. If there is no post sticking out of the crown, you may use dental cement from CVS or Walgreens to place the crown back on your tooth until you can get in to see your dentist. Fillings, on the other hand, are not able to be placed back in teeth – the area will be cleaned and new material will be used to create a new restoration. Depending on the size of the filling that came out, an onlay or inlay may be needed. Avoid chewing on the side with the missing crown or filling until you can have it replaced.

Cracking a tooth

Hard candies, nutty candy, and candies that have been frozen have the potential to crack a tooth. Again, teeth that have large restorations are more prone to cracking than natural teeth. A cracked tooth may be hard to recognize as the pain from a cracked tooth may be intermittent. If you suspect that you have a cracked tooth, schedule an appointment with your dentist.

You should keep track of what causes your tooth sensitivity. Hot or cold temperatures, sweet or sour foods, and pressure may all cause tooth sensitivity. Let your dentist know what you find so that he can more accurately diagnose your condition. Our Evanston dentists also have tests they can run to help them diagnose a cracked tooth as well as intraoral cameras which may allow them to see the fracture. Depending on the size of the fracture, a cracked tooth can be repaired using an onlay or a crown.

Dental emergencies can happen at any time. Our Evanston dentists are always available through our emergency line at (847) 864-8151. Being aware of what can cause a dental emergency is one of the best ways to prevent them.

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Best candy choices for the health of your teeth

on November 20, 2013

Last week we discussed the candy that you should try to stay away from this Halloween. This week we’ll discuss “tooth friendly” candy. “Tooth friendly” candy is candy that is better for your teeth than some of the other options of candy on the market.

Xylitol Candy

Xylitol is a natural sweetener that can be used in place of sugar. Xylitol has a molecular structure similar to sugar. The bacteria in your mouth that normally metabolize sugar cannot metabolize xylitol. When you eat xylitol candy, the xylitol in the candy essentially starves your cavity causing bacteria. This process helps your teeth in several ways: for one, there are less cavity causing bacteria in your mouth. Additionally, the bacteria that cause cavities normally produce acid when metabolizing sugar. Without sugar, the pH in your mouth is not as low as it would be with normal sugar candy. Some studies show that xylitol helps raise the pH in your mouth as well as helping to remineralize your teeth. Our Evanston dentists recommend having a piece of xylitol candy after every meal to help raise the pH and help protect against enamel erosion.

Xylitol GumGum

Gum is a good candy choice for your teeth, as long as it is sugar-free or xylitol gum! Chewing gum helps stimulate saliva production. Saliva is your mouth’s best defense against cavities. Naturally occurring minerals that are found in your saliva help to remineralize your teeth. Also, increased saliva production helps raise the pH of your mouth and return it to a neutral state. Chewing gum after you eat can help prevent tooth decay. (Source)

Chocolate

Chocolate, especially dark chocolate, can be good for your teeth. The added sugar in chocolate candy is what may be harmful to your teeth. Xylitol chocolate is your best choice, as the xylitol, combined with the antioxidants in chocolate; help counteract the cavity causing bacteria in your mouth. There is even toothpaste that uses a compound from the cocoa bean to help strengthen tooth enamel.

 

No matter what candy you enjoy this Halloween, be aware of hard and sticky candy that can harm your teeth. Avoid snacking on candy throughout the day, as this doesn’t allow the pH in your mouth to return to neutral. Make sure you wait a half an hour after snacking on candy before brushing your teeth. Maybe, instead of snacking on candy; have a piece as dessert after your meal. This way you will not be subjecting your teeth to a decrease in pH between meals, which may cause additional enamel erosion. As we are a dental team with more than one sweet tooth, we know that candy is a delicious treat. Take the time to indulge sensibly to make sure your teeth and smile stay happy and healthy.

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SDManageBest candy choices for the health of your teeth

Worst Candies for Your Teeth

on November 20, 2013

Candy As October is upon us, the grocery store aisles are filling with candy. We thought we’d help encourage you to a more tooth friendly Halloween this year. We are starting this series of blog posts with a list of the worst candies for your teeth.

Sticky Candy

Sticky candies, such as caramel and taffy, pose a double threat to your teeth. These types of candies can pull out a filling, onlay, inlay or crown. Additionally, these candies stick to your teeth, especially in the grooves and pits. This means that the bacteria in your mouth can feed on the sugar that is stuck in your teeth for longer periods of time and can produce more acid. Both weaken your teeth and may cause cavities.

Nutty Candy

Candies that are filled with or contain nuts also have hazards, especially if you enjoy these candies better when frozen. When eating nutty candies, you have to watch out for the cracking of a tooth or a filling. These candies will commonly get stuck in the grooves and pits of your teeth as well.

Hard Candy

Hard candies bring about similar problems, as chewing them may crack a tooth. On the other hand, if you suck on them instead, you are increasing the length of time that the candy is in your mouth. This gives the bacteria in your mouth more time to feed on the sugars in the candy and lower the pH of your mouth to create an acidic atmosphere. The longer the pH of your mouth stays lowered, the more damage that is done to your teeth.

Sour Candy

Sour candy creates different conditions in your mouth that can harm your teeth. On average, sour candies are more acidic than other candy. The acidity of the candy combined with the sugar content, creates a very acidic environment in your mouth. Your saliva will naturally return the pH in your mouth to neutral, but sour candy may make it take longer than the standard 30 minutes, leaving your teeth more exposed to acid erosion.

As all candy increases the acidity of your mouth, it is best to wait for at least a half hour after eating before brushing your teeth. Brushing will help remove any excess food or candy that is stuck in your teeth. An acidic environment weakens your tooth structure and brushing before your saliva has restored the pH balance will cause enamel erosion.

The best way you can enjoy your Halloween treats is to be aware of the potential risks and harm that come with them. Our Evanston dentists encourage you to enjoy Halloween, but make sure you keep your teeth in mind when it comes to snack time. Make sure to visit our blog again next week and find out what are some of the more tooth friendly treats that you can enjoy this Halloween season.

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Why Dentists take Intra-Oral Photos

on November 20, 2013

At our Evanston dental office we practice evidence based dentistry. This means that when our dentists recommend treatment, they are recommending it based on actual evidence. One of the best tools we have for showing our patients their evidence is intra-oral photos.

 

An intra-oral camera is one of the best tools a dentist has.

An intra-oral camera is one of the best tools a dentist has.

What are Intra-Oral Photos

Intra-oral photos are photos that are taken of your teeth, gums and oral tissue. These photos may be of a single tooth, a group of teeth, or any area of your mouth. At our office, photos are taken with a small, high quality digital camera that moves comfortably within your mouth. As the photos are extremely close, our Schick camera has a fixed focal range to ensure a crisp, clear photo.

Creating a Baseline

Taking intra-oral photos helps our doctors and clinicians establish a baseline for all of the dental conditions in your mouth. We are able to monitor any recession or suspicious lesions that you may have in your mouth to discover if these conditions are getting better or worse.

Referrals

When we refer a patient to a specialist, we often send the corresponding intra-oral photos to the specialist ahead of time. This allows the doctors to see what our Evanston dentists saw when you were in our office. In this case, it supplies a baseline for our referring doctors to reference when you visit their office.

Another way we use intra-oral photos is for insurance purposes. Often insurance companies ask for supporting documents to help them identify the need for treatment. The most commonly requested documents are x-rays, but we often send intra-oral photos to help support the diagnosis as well. The intra-oral photos allow the dentists and doctors that review the information for the insurance company to get a better look at the conditions of your mouth.

Helping Diagnose

With the intra-oral camera, our Evanston dentists and clinicians are able to take close up photos of your teeth from angles that they would not normally be able to see. This helps them diagnose conditions more accurately. In some cases, the condition may have shown up on an x-ray, but in other cases (specifically fractures,) it is not as readily apparent.

You

The most important reason we take intra-oral photos is for you. Often you can’t see what the conditions are in your mouth. By taking the intra-oral photos, we are able to show you what we see and let you know your best treatment options. Intra-oral photos are also helpful to our hygienists. They are able to show you what they see, especially if they find an area of your mouth where there is a larger amount of tartar. This may indicate that you need to brush or floss more in one area of your mouth. Your hygienist will use intra-oral photos they have taken to help you maximize your home care.

Our staff is committed to helping you keep your smile healthy and intra-oral photos are one of the most useful tools we have. As one of our doctors says, his “photographic memory is much better with photos to back it up.” Taking intra-oral photos creates a complete picture of the condition of your mouth and helps us provide you with the best that dentistry has to offer.

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What is Tartar?

on November 20, 2013

For our first blog post after being on hiatus, we thought we would discuss the difference between plaque and tartar (also known as dental calculus.)

 

Tartar is the yellow buildup that occurs around and below your gumline.

Tartar is the yellow buildup that occurs around and below your gumline.

Plaque and Tartar

You may know that plaque is the build-up of bacteria on your teeth. When you brush your teeth, the plaque is what you are removing. When plaque is not removed, it hardens into tartar which cannot be removed by brushing alone. Tartar has a rough surface, which is ideal for further plaque formation. Once tartar begins to form, it becomes easier for more tartar to form if you do not keep up with your daily oral hygiene routine.

Tartar is easily identified. It appears as a yellow or brown substance or stain on your teeth. In some cases, tartar can be seen on x-rays as well. If your doctor or hygienist believes that you have tartar build up sub gingivally (below the gumline,) or interproximal (between your teeth,) they will take x-rays to confirm.

Removing Tartar

Plaque is relatively easy to remove – it can be removed through daily flossing and twice daily brushing. Tartar is firmly attached to your tooth enamel and is more difficult to remove. Tartar is what your hygienist removes at your re-care appointment. Your hygienist will use scalers to remove the tartar both above and below your gumline. If you haven’t seen your dentist in several years and you have not been keeping up with your at-home oral hygiene routine, a scaling and root planing or full mouth debribment may be recommended. These are deeper cleanings that are needed when the tartar has formed below the gumline and created large periodontal pockets. In these cases, you may be suffering from periodontal disease. The hygienist will use traditional scalers, as well as an ultrasonic scaler to remove all of the tartar.

Avoiding Tartar

The best way to avoid tartar is to keep up with your oral hygiene routine. As we said, tartar forms from plaque that remains on your teeth. If you brush twice a day and floss once a day, to remove the plaque that forms on and between your teeth, you will have less tartar to remove at your routine hygiene appointments.

For some individuals, plaque and tartar forms more quickly. This could be due to diet, genetics, age, or medication that you may be taking. If your plaque and tartar form faster, our Evanston dentists may recommend a shorter hygiene re-care schedule – perhaps every three or four months. For these individuals, this shorter re-care schedule combined with proper home care will keep you from developing periodontal disease.

If you are concerned about tartar forming on your teeth, call our Evanston dental office to set up an appointment with one of our dentists. At this appointment, they will be happy to review your oral health and address any concerns you have as well as recommend a hygiene treatment plan and re-care schedule to help you address any problems with plaque and tartar.

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