General Dentistry

A comprehensive dental exam will be performed by your dentist at your initial dental visit.
Regular dental exams and cleaning visits are essential in preventing dental problems and maintaining the health of your teeth and gums. At these visits, your teeth are cleaned and checked for cavities. Additionally, there are many other oral health safeguards that are checked and monitored to help detect, prevent, and maintain your dental health.

At Regular Checkup Exams, Your Dentist and Hygienist Will Include the Following:

• Examination of Diagnostic X-rays (Radiographs): Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
• Oral Cancer Screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
• Gum Disease Evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
• Examination of Tooth Decay: All tooth surfaces will be checked for decay with special dental instruments.
• Examination of Existing Restorations: Check current fillings, crowns, etc.

You should have your teeth checked and cleaned at least twice a year, though your dentist or dental hygienist may recommend more frequent visits.

Professional dental cleanings (dental prophylaxis) are usually performed by Registered Dental Hygienists.

Your cleaning appointment will include a dental exam and the following:

• Removal of Dental Calculus (Tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments.
• Removal of Plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
• Teeth Polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.

Periodontal disease is characterized by red, swollen, and bleeding gums.
The word periodontal means “around the tooth.” Periodontal disease attacks the gums and bones that support the teeth. Plaque is a sticky film of food debris, bacteria, and saliva. If plaque is not removed, it turns into calculus (tartar). When plaque and calculus are not removed, they begin to destroy the gums and bone. Periodontal disease is characterized by red, swollen, and bleeding gums.

Four out of five people have periodontal disease and don’t know it! Most people are not aware of it because the disease is usually painless in the early stages. Not only is it the number one reason for tooth loss, but research also suggests that there may be a link between periodontal disease and other diseases such as stroke, bacterial pneumonia, diabetes, cardiovascular disease, and increased risk during pregnancy. Researchers are determining if inflammation and bacteria associated with periodontal disease affect these systemic diseases and conditions. Smoking also increases the risk of periodontal disease.

Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease. When left untreated, gingivitis (mild gum inflammation) can spread below the gum line. When the gums become irritated by the toxins contained in plaque, a chronic inflammatory response causes the body to break down and destroy its own bone and soft tissue. There may be few or no symptoms as periodontal disease causes the teeth to separate from the infected gum tissue. Deepening pockets between the gums and teeth are generally indicative that soft tissue and bone are being destroyed by periodontal disease.

Signs and Symptoms of Periodontal Disease:

• Bleeding Gums – Gums should never bleed, even when you brush vigorously or use dental floss
• Loose Teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone)
• New Spacing Between Teeth – Caused by bone loss
• Persistent Bad Breath – Caused by bacteria in the mouth
• Pus Around the Teeth and Gums – Sign that there is an infection present
• Receding Gums – Loss of gum around a tooth
• Red and Puffy Gums – Gums should never be red or swollen
• Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth

Periodontal disease is most often preceded by gingivitis, which is a bacterial infection of the gum tissue. A bacterial infection affects the gums when the toxins contained in plaque begin to irritate and inflame the gum tissues. Once this bacterial infection colonizes in the gum pockets between the teeth, it becomes much more difficult to remove and treat. Periodontal disease is a progressive condition that eventually leads to the destruction of the connective tissue and jawbone. If left untreated, it can lead to shifting teeth, loose teeth and eventually tooth loss. Periodontal disease is the leading cause of tooth loss among adults in the developed world and should always be promptly treated.

Diagnosis

Periodontal disease is diagnosed by your dentist or dental hygienist during a periodontal examination. This type of exam should always be a part of your regular dental checkup. A periodontal probe (a small dental instrument) is gently used to measure the sulcus (pocket or space) between the tooth and the gums. The depth of a healthy sulcus measures three millimeters or less and does not bleed. The periodontal probe helps indicate if pockets are deeper than three millimeters. As periodontal disease progresses, the pockets usually get deeper. Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category below:

• Gingivitis – is the first stage of periodontal disease. Plaque and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed.
• Periodontitis – Plaque hardens into calculus (tartar). As calculus and plaque continue to build up, the gums begin to recede from the teeth. Deeper pockets form between the gums and teeth and become filled with bacteria and pus. The gums become very irritated, inflamed, and bleed easily. Slight to moderate bone loss may be present.
• Advanced Periodontitis – The teeth lose more support as the gums, bone, and periodontal ligament continues to be destroyed. Left untreated, the affected teeth will become very loose and may be lost. Generalized moderate to severe bone loss may be present.

Treatment

There are many surgical and nonsurgical treatments the periodontist may choose to perform, depending upon the exact condition of the teeth, gums, and jawbone. A complete periodontal exam of the mouth will be done before any treatment is performed or recommended. Here are some of the more common treatments for periodontal disease:

• Scaling and root planing – In order to preserve the health of the gum tissue, the bacteria and calculus (tartar) that initially caused the infection, must be removed. The gum pockets will be cleaned and treated with antibiotics as necessary to help alleviate the infection. A prescription mouthwash may be incorporated into daily cleaning routines.
• Tissue regeneration – When the bone and gum tissues have been destroyed, regrowth can be actively encouraged using grafting procedures. A membrane may be inserted into the affected areas to assist in the regeneration process.
• Pocket elimination surgery – Pocket elimination surgery (also known as flap surgery) is a surgical treatment that can be performed to reduce the pocket size between the teeth and gums. Surgery on the jawbone is another option that serves to eliminate indentations in the bone which can foster the colonization of bacteria.
• Dental implants – When teeth have been lost due to periodontal disease, the aesthetics and functionality of the mouth can be restored by implanting prosthetic teeth into the jawbone. Tissue regeneration procedures may be required prior to the placement of a dental implant to strengthen the bone.

Ask your dentist if you have questions or concerns about periodontal disease, periodontal treatment, or dental implants.

Maintenance

It only takes twenty-four hours for plaque that is not removed from your teeth to turn into calculus (tartar)! Daily home cleaning helps control plaque and tartar formation, but those hard-to-reach areas will always need special attention. Once your periodontal treatment has been completed, your dentist and dental hygienist will recommend that you have regular maintenance cleanings (periodontal cleanings), usually four times a year. At these cleaning appointments, the pocket depths will be carefully checked to ensure that they are healthy. Plaque and calculus that are difficult for you to remove on a daily basis will be removed from above and below the gum line.

In addition to your periodontal cleaning and evaluation, your appointment will usually include:

• Examination of Diagnostic X-Rays (Radiographs): Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
• Examination of Existing Restorations: Check current fillings, crowns, etc.
• Examination of Tooth Decay: Check all tooth surfaces for decay.
• Oral Cancer Screening: Check the face, neck, lips, tongue, throat, cheek tissues, and gums for any signs of oral cancer.
• Oral Hygiene Recommendations: Review and recommend oral hygiene aids as needed. (Electric toothbrushes, special periodontal brushes, fluorides, rinses, etc.)
• Teeth Polishing: Remove stain and plaque that are not otherwise removed during tooth brushing and scaling.

Good oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control.

Dental fillings or composite (tooth-colored) fillings are used to fill a cavity or repair teeth.
There are different filling materials, but the most common is either a mixture of composite and plastic resin or silver amalgam fillings. The composite filling has the advantage of being tooth-colored so is more aesthetically fitting for front teeth or more visible teeth.

Reasons for Dental Fillings:

• Cavities
• Cracked or Broken Teeth
• Closing a Gap Between Teeth
• Chipped Teeth
• Worn Teeth
• Decayed Teeth

What does getting a dental filling involve?

Dental fillings are usually done in one appointment. While the tooth is numb, your dentist will remove any decay. The space will be cleaned and prepared before the filling is placed on the tooth. If needed, medication can be used when the decay is close to the tooth nerve.

Dental fillings are precisely placed, shaped, and polished to restore your tooth to its natural shape. Initially, you may experience tooth sensitivity, but that should fade shortly after the procedure.

You will receive care instructions at the conclusion of your treatment. Proper dental hygiene, eating habits, and regular dental check-ups will help increase the life of the filling. Fillings are durable; however, they may need to be replaced someday due to wear and tear.

A dental bridge (porcelain bridge) is a fixed (non-removable) appliance and is an excellent way to replace missing teeth.
There are several types of bridges. You and your dentist will discuss the best options for your particular case. The “traditional bridge” is the most popular type and is usually made of porcelain fused to metal. Porcelain-fixed bridges are most popular because they resemble your natural teeth. This type of bridge consists of two crowns that go over two anchoring teeth (abutment teeth) and are attached to pontics (artificial teeth), filling the gap created by one or more missing teeth.

Dental bridges are highly durable and will last many years, however, they may need replacement or need to be re-cemented due to normal wear.

Reasons for a Fixed Bridge:

• Fill Space of Missing Teeth
• Maintain Facial Shape
• Prevent Remaining Teeth From Drifting Out of Position
• Restore Chewing and Speaking Ability
• Restore Your Smile
• Upgrade From a Removable Partial Denture to a Permanent Dental Appliance

What Does Getting a Fixed Bridge Involve?

Getting a bridge usually requires two or more visits. While the teeth are numb, the two anchoring teeth are prepared by removing a portion of enamel to allow for a crown. Next, a highly accurate impression (mold) is made which will be sent to a dental laboratory where the bridge will be fabricated. In addition, a temporary bridge will be made and worn for several weeks until your next appointment.

At the second visit, your permanent bridge will be carefully checked, adjusted, and cemented to achieve a proper fit. Occasionally your dentist may only temporarily cement the bridge, allowing your teeth and tissue time to get used to the new bridge. The new bridge will be permanently cemented at a later time.

You will receive care instructions at the conclusion of your treatment. Proper brushing, flossing and regular dental visits will aid in the life of your new permanent bridge.

A crown protects and strengthens tooth structure that cannot be restored with fillings or other types of restorations.
A crown (or cap) is a covering that encases the entire tooth surface restoring it to its original shape and size. Although there are several types of crowns, porcelain (tooth-colored crown), is the most popular because they resemble your natural teeth. They are highly durable and will last many years, but like most dental restorations, they may eventually need to be replaced. Porcelain crowns are made to match the shape, size, and color of your teeth giving you a natural, long-lasting beautiful smile.

Reasons for Crowns:

• Broken or Fractured Teeth
• Cosmetic Enhancement
• Decayed Teeth
• Fractured Fillings
• Large Fillings
• Tooth Has Had a Root Canal

Gold Crowns vs. Porcelain Crowns

While porcelain crowns offer a more aesthetically appealing solution, gold restorations are more conservative and better preserve tooth structure and natural tissues. While more expensive than porcelain, gold crowns offer a lifelong, permanent solution.

Gold is significantly more durable and doesn’t chip like porcelain does when clenching and grinding teeth. Gold crowns have the same hardness and wearability as your natural enamel. By nature, porcelain is more abrasive which will lead to increased wear of the opposing tooth structure and restorations.

Please consult with our dentists to see which crown solution will be best for your particular and unique case.

What Does Getting a Crown Involve?

A crown procedure usually requires two appointments. Your first appointment will include taking several highly accurate molds (or impressions) that will be used to create your custom crown. A mold will also be used to create a temporary crown which will stay on your tooth for approximately two weeks until your new crown is fabricated by a dental laboratory.

While the tooth is numb, the dentist will prepare the tooth by removing any decay and shaping the surface to properly fit the crown. Once these details are accomplished, your temporary crown will be placed with temporary cement and your bite will be checked to ensure you are biting properly.

At your second appointment, your temporary crown will be removed, the tooth will be cleaned, and your new crown will be carefully placed to ensure the spacing and bite are accurate. You will be given care instructions and encouraged to have regular dental visits to check your new crown.

Dental implants are a great way to replace missing teeth and provide a fixed solution to having removable partial or complete dentures. Implants provide excellent support and stability for these dental appliances.
Dental implants are artificial roots and teeth (usually titanium) that are surgically placed into the upper or lower jawbone by a dentist or Periodontist – a specialist of the gums and supporting bone. The teeth attached to implants are very natural looking and often enhance or restore a patient’s smile. Dental implants are very strong, stable, and durable and will last many years, but on occasion, they will have to be re-tightened or replaced due to normal wear.

Our team of dental implant specialists has received extensive training and mastership certification from the International Dental Implant Association. We are here to provide you with the best dental implant services in Front Royal, VA, and the surrounding Warren County area. To learn more about our experience and credentials, visit our Meet the Team page.

Reasons for Dental Implants:

• Replace one or more missing teeth without affecting adjacent teeth
• Resolve joint pain or bite problems caused by teeth shifting into missing tooth space
• Restore a patient’s confident smile
• Restore chewing, speech, and digestion
• Restore or enhance facial tissues
• Support a bridge or denture, making them more secure and comfortable

What Does Getting Dental Implants Involve?

The process of getting implants requires a number of visits over several weeks. X-rays and impressions (molds) are taken of the jaw and teeth to determine bone, gum tissue, and spacing available for an implant. While the area is numb, the implant will be surgically placed into the bone and allowed to heal and integrate itself onto the bone for up to six months. Depending on the type of implant, a second surgery may be required to place the “post” that will hold the artificial tooth in place. With other implants, the post and anchor are already attached and placed at the same time.

After several weeks of healing the artificial teeth are made and fitted to the post portion of the anchor. Because several fittings may be required, this step may take one to two months to complete. After a healing period, the artificial teeth are securely attached to the implant, providing excellent stability and comfort to the patient.

You will receive care instructions when your treatment is completed. Good oral hygiene, eating habits, and regular dental visits will aid in the life of your new implant.

Mini Dental Implants (MDIs) have changed the face of implant placement.
Unlike full implant placement where multiple dental visits are required, MDIs eliminate the need for surgery. The development of long-term MDIs now allows the dentist to place anchors in the jaw during one non-invasive treatment. The most common use for MDIs is the stabilization of dentures and overdentures. MDIs firmly anchor the dental prosthesis, which means there is no longer any need to suffer from ill-fitting, loose dentures.

MDIs are designed to eliminate bone grafting and expedite treatment. Full implants require significant bone grafting and a recovery period. The latent period allowed the anchor of the implant to properly embed itself into the jawbone. The smaller size of MDIs means that no recovery period is necessary, and the denture can be fitted on the same day.

What is the design of a mini dental implant?

An MDI is a tiny dental implant (similar to a screw) that is designed to act in place of a natural tooth root. MDIs are generally constructed from titanium and are either sprayed with calcium phosphate or contain it along the length of the screw portion. The design and structure of MDIs promote quick healing and long-lasting results. The head portion of the implant looks very much like a ball. This ball fits firmly into the retaining mechanism and together these structures hold the dentures at a designated level. The dentures sit comfortably on the gum tissue and can withstand significant amounts of pressure and natural force.

What are the advantages of MDI placement?

MDIs are a true innovation for people who are reluctant to have invasive dental surgery and for denture wearers. One significant advantage MDIs have over full implants is that they offer a viable treatment choice for patients who have experienced extensive bone loss. Depending on the quality and density of jawbone available at the implant site, four of these mini-implants may be implanted at one time. Unlike full implants, MDIs don’t require invasive surgery, which makes MDIs a gentler option. MDIs also minimize cost. Full-sized implants can be expensive to place, especially if many visits are required. The most common use for MDIs is to stabilize a lower denture, however, they can be placed anywhere in the mouth.

Other Advantages Associated With MDIs:

• Better Smelling Breath
• Clearer Speech
• Easier Chewing and Biting
• Easier Cleaning
• Firmer Denture Fit
• High Success Rate
• Less Discomfort
• No Cutting or Sutures
• No Need for Adhesives or Messy Bonding Agents
• No Rotting Food Beneath the Denture
• No Slipping, Wobbling or Discomfort
• Permanent Results
• Quick Treatment Time
• Reduced Costs

How are mini dental implants placed?

The whole mini dental implant placement procedure takes approximately one hour. Generally, in the case of lower jaw implants, four MDIs will be placed about 5mm apart. Prior to inserting MDIs, the dentist will use many diagnostic and planning tools to find the optimal place to implant them.

Here Is a Brief Overview of the MDI Placement Procedure:

1. A mild anesthetic is administered.
2. A small hole is drilled in the jawbone to situate each MDI.
3. Each implant is screwed into place and tightened with a winged wrench.
4. Finally, a ratchet wrench is used to fully stabilize the MDIs.
5. The denture is measured against the mini implants and marks are made to indicate where the MDIs will fit.
6. The denture is sent to the laboratory to have holes drilled to accommodate the MDIs.

Once the denture has been fully modified, it can be affixed to the MDIs. The rubber O-ring on each MDI snaps into the designated spot on the denture, and the denture then rests snugly on the gum tissue. MDIs hold the denture comfortably in a tight-fitting way for a lifetime.

In almost all cases, no stitching is required, and no real discomfort is felt after the procedure. After the denture placement procedure is complete, light eating can be resumed. The denture can be removed and cleaned at will. MDIs enhance the natural beauty of the smile and restore full functionality to the teeth.

If you have any questions or concerns about mini dental implants, please ask our dental team.

Oral Surgeons undergo advanced training and possess extensive expertise in diagnosing and treating complex oral health conditions.
Our dentists can diagnose and treat a wide variety of conditions. The following are just some of the many conditions, treatments, and procedures oral surgeons perform daily:

• TMJ, Facial Pain, & Facial Reconstruction
• Dental Implants
• Tooth Extractions & Impacted Teeth
• Wisdom Teeth Extractions
• Misaligned Jaws
• Cleft Lip & Palate
• Apicoectomy
• Oral Cancers, Tumors, Cysts, & Biopsies
• Sleep Apnea Treatment

Wisdom Teeth Extractions

Third molars, commonly referred to as wisdom teeth, are usually the last four of 32 teeth to erupt (surface) in the mouth, generally making their appearance between the ages of 17 to 25.

General Tooth Extractions

Sometimes teeth become completely deadened by decay and should be removed and/or replaced.

Mini Dental Implants

Mini Dental Implants (MDIs) have changed the face of implant placement. Unlike full implant placement where multiple dental visits are required, MDIs eliminate the need for surgery.

Sleep Apnea

Sleep apnea is a potentially life-threatening sleep disorder characterized by repeated pauses in breathing during sleep.

Tempro-Mandibular Joint Dysfunction (TMJ)

Tempro-Mandibular Joint Dysfunction Syndrome (TMJ) is a common condition affecting a wide variety of people. TMJ is characterized by severe headaches, jaw pain of varying degrees, grinding teeth, and an intermittent ringing in the ears.

Third Molars (Commonly Referred to as Wisdom Teeth)
Wisdom teeth are usually the last four of 32 teeth to erupt (surface) in the mouth, generally making their appearance between the ages of 17 to 25. They are located at the back of the mouth (top and bottom), near the entrance to the throat. The term “wisdom” stems from the idea that the molars surface at a time typically associated with increased maturity or “wisdom.”

In most cases, inadequate space in the mouth does not allow the wisdom teeth to erupt properly and become fully functional. When this happens, the tooth can become impacted (stuck) in an undesirable or potentially harmful position. If left untreated, impacted wisdom teeth can contribute to infection, damage to other teeth, and possibly cysts or tumors.

There are several types, or degrees, of impaction based on the actual depth of the teeth within the jaw:

• Soft Tissue Impaction: The upper portion of the tooth (the crown) has penetrated through the bone, but the gingiva (gum) is covering part, or all, of the tooth’s crown and has not positioned properly around the tooth. Because it is difficult to keep the area clean, food can become trapped below the gum and cause an infection and/or tooth decay, resulting in pain and swelling.
• Partial Bony Impaction: The tooth has partially erupted, but a portion of the crown remains submerged below the gum and surrounding jawbone. Again, because it is difficult to keep the area clean, infection will commonly occur.
• Complete Bony Impaction: The tooth is completely encased by the jawbone. This will require more complex removal techniques.

Reasons To Remove Wisdom Teeth

While not all wisdom teeth require removal, wisdom teeth extractions are most often performed because of an active problem such as pain, swelling, decay or infection, or as a preventative measure to avoid serious problems in the future. If impaction of one or more wisdom teeth is present and left untreated, a number of potentially harmful outcomes can occur, including:

• Damage to nearby teeth: Second molars (the teeth directly in front of the wisdom teeth) can be adversely affected by impacted wisdom teeth, resulting in tooth decay (cavities), periodontal disease (gum disease), and possible bone loss.
• Disease: Although uncommon, cysts and tumors can occur in the areas surrounding impacted wisdom teeth.
• Infection: Bacteria and food can become trapped under the gum tissue, resulting in an infection. The infection can cause considerable pain and danger.
• Tooth Crowding: It has been theorized that impacted wisdom teeth can put pressure on other teeth and cause them to become misaligned (crowded or twisted). This theory isn’t universally accepted by all dental professionals, and it has never been validated by any scientific studies.

What Does the Removal of Wisdom Teeth Involve?

Wisdom teeth removal is a common procedure, generally performed under local anesthesia, intravenous (IV) sedation (not currently offered at Apple Valley Dental Group), or general anesthesia by a specially trained dentist in an office surgery suite. The surgery does not require an overnight stay, and you will be released with post-operative instructions and medication (if necessary), to help manage any swelling or discomfort.

Wisdom Teeth Examination

As with any dental procedure, your dentist will want to initially conduct a thorough examination of the wisdom and surrounding teeth. Panoramic or digital x-rays will be taken so your dentist can evaluate the position of the wisdom teeth and determine if a current problem exists, or the likelihood of any potential future problems. The x-rays can also expose additional risk factors, such as deterioration or decay of nearby teeth.

Early evaluation and treatment (typically in the mid-teen years) is recommended in order to identify potential problems and to improve the results for patients requiring wisdom teeth extractions. Only after a thorough examination can your dentist provide you with the best options for your particular case.

Inlays can be utilized to conservatively repair teeth that have large defective fillings or have been damaged by decay or trauma.
An inlay restoration is a custom-made filling made of composite material, gold, or tooth-colored porcelain. It is made by a professional dental laboratory and is permanently cemented into the tooth by your dentist.

Inlays can be utilized to conservatively repair teeth that have large defective fillings or have been damaged by decay or trauma. Inlays are an ideal alternative to conventional silver and composite fillings. Also, they are more conservative than crowns because less tooth structure is removed in the preparation of inlays.

As with most dental restorations, inlays are not always permanent and may someday require replacement. They are highly durable and will last many years, giving you a beautiful long-lasting smile.

Reasons for Inlay Restorations:

• Broken or Fractured Teeth
• Cosmetic Enhancement
• Decayed Teeth
• Fractured Fillings
• Large Fillings

What Does Getting an Inlay Involve?

An inlay procedure usually requires two appointments. Your first appointment will include taking several highly accurate impressions (molds) that will be used to create your custom inlay and a temporary restoration.

While the tooth is numb, the dentist will remove any decay and/or old filling materials. The space will then be thoroughly cleaned and carefully prepared, shaping the surface to properly fit an inlay restoration. A temporary filling will be applied to protect the tooth while your inlay is made by a dental laboratory.

At your second appointment, your new inlay will be carefully and precisely cemented into place. A few adjustments may be necessary to ensure a proper fit and that your bite is comfortable.

You will receive care instruction at the conclusion of your treatment.  Good oral hygiene practices, a proper diet, and regular dental visits will aid in the life of your new inlay.

Onlays can be utilized to conservatively repair teeth that have large defective fillings or have been damaged by decay or trauma.
An onlay restoration is a custom-made filling made of composite material, gold, or tooth-colored porcelain. Porcelain onlays are popular because they resemble your natural tooth. An onlay is sometimes also referred to as a partial crown. Porcelain onlays are made by a professional dental laboratory and are permanently cemented onto the tooth by your dentist.

Onlays can be utilized to conservatively repair teeth that have large defective fillings or have been damaged by decay or trauma. Onlays are an ideal alternative to crowns (caps) because less tooth structure is removed in the preparation of Onlays. Onlays are essentially identical to inlays with the exception that one or more of the chewing cusps have also been affected and need to be included in the restoration.

As with most dental restorations, onlays are not always permanent and may someday require replacement. They are highly durable and will last many years, giving you a beautiful long-lasting smile.

Reasons for Onlay Restorations

• Broken or Fractured Teeth
• Cosmetic Enhancement
• Decayed Teeth
• Fractured Fillings
• Large Fillings

What Does Getting an Onlay Involve?

An onlay procedure usually requires two appointments. Your first appointment will include taking several highly accurate impressions (molds) that will be used to create your custom onlay and a temporary restoration.

While the tooth is numb, the dentist will remove any decay and/or old filling materials. The space will then be thoroughly cleaned and carefully prepared, shaping the surface to properly fit an Onlay restoration. A temporary filling will be applied to protect the tooth while your onlay is made by a dental laboratory.

At your second appointment, your new onlay will be carefully and precisely cemented into place.  A few adjustments may be necessary to ensure a proper fit and that your bite is comfortable.

You will receive care instruction at the conclusion of your treatment.  Good oral hygiene practices, a proper diet, and regular dental visits will aid in the life of your new onlay.

Root canal therapy is needed when the nerve of a tooth is affected by decay or infection.
To save the tooth, the pulp (the living tissue inside the tooth), nerves, bacteria, and any decay are removed, and the resulting space is filled with special, medicated, dental materials, which restore the tooth to its full function.

Having a root canal done on a tooth is the treatment of choice to save a tooth that otherwise would die and have to be removed. Many patients believe that removing a tooth that has problems is the best solution, however, extracting (pulling) a tooth will ultimately be more costly and cause significant problems for adjacent teeth.

Root canal treatment is highly successful and usually lasts a lifetime. Although, on occasion, a tooth will require retreatment due to new infections.

Signs and Symptoms for Possible Root Canal Therapy:

• An abscess (or pimple) on the gums
• Sensitivity to hot and cold
• Severe toothache pain
• Sometimes no symptoms are present
• Swelling and/or tenderness

Reasons for Root Canal Therapy:

• Decay has reached the tooth pulp (the living tissue inside the tooth)
• Infection or abscess have developed inside the tooth or at the root tip
• Injury or trauma to the tooth

What Does Root Canal Therapy Involve?

A root canal procedure requires one or more appointments and can be performed by a dentist or endodontist (a root canal specialist). While the tooth is numb, a rubber dam (a sheet of rubber) will be placed around the tooth to keep it dry and free of saliva. An access opening is made on top of the tooth and a series of root canal files are placed into the opening, one at a time, removing the pulp, nerve tissue, and bacteria. If tooth decay is present, it will also be removed with special dental instruments.

Once the tooth is thoroughly cleaned, it will be sealed with either a permanent filling or, if additional appointments are needed, a temporary filling will be placed. At the next appointment, usually, a week later, the roots and the inside cavity of the tooth will be filled and sealed with special dental materials. A filling will be placed to cover the opening on top of the tooth. Additionally, all teeth that have root canal treatment should have a crown (cap) placed. This will protect the tooth, prevent it from breaking, and restore it to its full function.

After treatment, your tooth may still be sensitive, but this will subside as the inflammation diminishes and the tooth has healed. You will be given care instructions after each appointment. Good oral hygiene practices and regular dental visits will aid in the life of your root canal treatment.

Sleep apnea is a potentially life-threatening sleep disorder characterized by repeated pauses in breathing during sleep.
The term sleep apnea is derived from the Greek etymology meaning “without breath.” Breathing pauses can last anywhere from several seconds to minutes and happen as often as 30 times or more per hour.

Ongoing disrupted breathing causes an imbalance between the carbon dioxide and oxygen levels in the bloodstream, as not enough carbon dioxide is exiting and not enough oxygen is entering the body.

Sensing this imbalance, the brain sends a message to the body, telling it to wake up to restart breathing the process.

People with sleep apnea will be partially awake as they struggle to breathe, and this is often accompanied by loud snoring or choking sensations. Because people with sleep apnea don’t always completely awake during the episodes, they are often unaware they have a sleeping disorder, and it can remain undiagnosed.

Types of Sleep Apnea

There are two main types of this disorder:

Central sleep apnea occurs when the brain fails to send important signals to the breathing muscles.

Obstructive sleep apnea occurs when air cannot flow through the nose or mouth even though the body is still trying to breathe. Obstructive sleep apnea is far more prevalent and easily treatable by the dentist. Common signs of obstructive sleep apnea can include severe early morning headaches, sleepiness in the daytime, and insomnia. Fortunately, the dentist is equipped with the necessary technology and expertise to treat sleep apnea in several different ways.

Reasons for Treating Sleep Apnea

It is very important to seek medical attention if sleep apnea is suspected. A sufferer can completely stop breathing numerous times per hour, and this can quickly turn into a deadly situation. Obstructive sleep apnea occurs when the soft tissue lying at the back of the patient’s throat collapses into the airway. The tongue then falls towards the back of the throat which tightens the blockage and prevents oxygen from entering the lungs.

The problem worsens when the chest region, diaphragm, and abdomen fight for air. The efforts they make to obtain vital oxygen only cause a further tightening of the blockage. The patient must arouse from deep sleep to tense the tongue and remove the soft tissue from the airway.

Because sleep apnea causes carbon dioxide levels to skyrocket in the blood, and oxygen levels to decrease, the heart must pump harder and faster to compensate for the lack of oxygen. Sleep apnea patients can technically “die” many times each night. Sleep apnea has been linked to a series of serious heart-related conditions and should be investigated by the dentist at the earliest opportunity.

What Does Sleep Apnea Treatment Involve?

Initially, our dentists will want to conduct tests to investigate, diagnose, and pinpoint a suitable treatment. We can offer many different treatment options which depend largely on the exact diagnosis and the health of the patient. The dentist may advise the patient to halt some habits that aggravate sleep apnea such as smoking, alcohol consumption, and tranquilizer use.

Sleeping masks were traditionally used to keep the patient’s airways open while they slept, but nowadays there are some less intrusive options. Dental devices that gently tease the lower jaw forward are very effective in preventing the tongue from blocking the main air passage. These dental devices are gentle, easy to wear, and often help patients avoid unwanted surgeries.

A more permanent solution is to have surgery that sections the lower jaw and helps pull the bone holding the tongue forward slightly. This surgery has an impressive success rate and is simple for the dentist or oral surgeon to perform. The dentist needs to formally make a diagnosis of each individual case before recommending the best course of action.

Sleep Apnea – Appliances

Sleep apnea appliances fall into two categories: fixed and adjustable.

The goal of most of these devices is to separate the jaws and push them forward slightly. This slight repositioning opens the airway and allows oxygen to flow freely again. Wearers of sleep apnea dental devices report that they stop loud snoring, feel more rested during the day, and are much more comfortable going to sleep. Sleep apnea appliances work best on patients who are not significantly overweight. They offer a viable alternative to Continuous Positive Airway Pressure (CPAP).

Below are brief descriptions of some commonly used sleep apnea dental appliances.

TAP^® 3 (Thornton Adjustable Positioner)

The TAP^® 3 is the smallest, most comfortable member of the TAP family. It is a two-part custom-created sleep apnea appliance that fits over the teeth in much the same way as a sports mouthguard. The TAP^® 3 projects the jaw forward to prevent the tongue and soft tissues from impeding the airway. The lower jaw positioner is adjustable, which means that it can be altered to suit the comfort level of the wearer. The TAP^® 3 appliance can accommodate the three main types of malocclusions (misaligned teeth) and allows the lips to fully close.

OASYS Hinge Appliance^™

The OASYS appliance is designed to move the base of the tongue toward the front of the mouth by gently repositioning the jawbone (mandible). This shift opens the oropharynx and strengthens the upper airway. An extension of the upper shield projects toward the nose, creating a larger nasal opening and less resistance to normal airflow. This adjustable appliance is comfortable to wear and extremely patient-friendly. 

Klearway^™ Appliance

The Klearway^™ Appliance is generally used to alleviate obstructive sleep disorder and eliminate snoring. The patient or dentist can project the jaw forwards in increments of .25mm at a time. This ensures maximum comfort for the sleeper. The Klearway^™ appliance is made from Variflex^™ heat softening acrylic, which makes it easier to insert. Running warm water over the appliance makes it pliable, but once placed in the desired position, the acrylic hardens again.

Herbst Telescopic Appliance

The Herbst appliance is held in the mouth by clasps and friction grips. It is made of acrylic and contains adjustable metal wiring. The advantage of this appliance is that the wearer can move vertically and laterally without dislodging the appliance. The Herbst appliance is usually used in mild and moderate cases of sleep apnea and can also alleviate loud snoring effectively.

A denture is a removable dental appliance replacement for missing teeth and surrounding tissue.
Dentures are made to closely resemble your natural teeth and may even enhance your smile. There are two types of dentures – complete and partial dentures. Complete dentures are used when all the teeth are missing, while partial dentures are used when some natural teeth remain. A partial denture not only fills in the spaces created by missing teeth but also prevents other teeth from shifting.

A complete denture may be either “conventional” or “immediate.” A conventional type is made after the teeth have been removed and the gum tissue has healed, usually taking 4 to 6 weeks. During this time the patient will go without teeth. Immediate dentures are made in advance and immediately placed after the teeth are removed, thus preventing the patient from having to be without teeth during the healing process. Once the tissues shrink and heal, adjustments will have to be made.

Dentures are very durable appliances and will last many years, but may have to be remade, repaired, or readjusted due to normal wear.

Reasons for Dentures:

• Complete Denture – Loss of all teeth in an arch
• Partial Denture – Loss of several teeth in an arch
• Enhancing smile and facial tissues
• Improving chewing, speech, and digestion

What Does Getting Dentures Involve?

The process of getting dentures requires several appointments, usually over several weeks. Highly accurate impressions (molds) and measurements are taken and used to create your custom denture. Several “try-on” appointments may be necessary to ensure proper shape, color, and fit. At the final appointment, your dentist will precisely adjust and place the completed denture, ensuring a natural and comfortable fit.

It is normal to experience increased saliva flow, some soreness, and possible speech and chewing difficulty. However, this will subside as your muscles and tissues get used to the new dentures.

You will be given care instructions for your new dentures.  Proper cleaning of your new dental appliance, good oral hygiene, and regular dental visits will aid in the life of your new dentures.

Dental emergencies are quite frightening and often painful. Try to remain calm, call us immediately.
Sometimes teeth become fractured by trauma, grinding, or biting on hard objects. In other cases, fillings, crowns, and other restorative devices can be damaged or fall out of the mouth completely.

If there is severe pain, it is essential to make an emergency dental care appointment with your Apple Valley Dental Group dentists in Front Royal as quickly as possible. The pain caused by dental emergencies almost always gets worse without treatment, and dental issues can seriously jeopardize physical health. Read more about different types of dental emergencies and what to do.

A preventive program is a cooperative effort by the patient, dentist and dental staff.
We preserve the natural dentition and supporting structures by preventing the onset, progress, and recurrence of dental diseases and conditions. Preventing dental disease starts at home with good oral hygiene and a balanced diet. It continues in the dental office by the efforts of your dentist and dental hygienist to promote, restore, and maintain your oral health.

Prevention also includes your regular dental exams, cleanings, and x-rays. Sealants and fluoride are also great preventive treatments that help protect the teeth. Prevention helps avoid serious and costly dental problems and is the key to having a healthy, confident, beautiful smile.

Learn More About Our Preventative Procedures Below:

Digital X-Rays

Dental x-rays are essential, preventative, and safe diagnostic tools that provide valuable information not visible during a regular dental exam.

Fluoride Treatment

Fluoride is the most effective agent available to help prevent tooth decay. It is a mineral that is naturally present in varying amounts in almost all foods and water supplies.

Oral Cancer

More than 54,000 cases of oral cancer are diagnosed each year. More than 10,000 of these cases result in the death of the patient. The good news is that oral cancer can easily be diagnosed with an annual oral cancer exam.

Sealants

A sealant is a thin, plastic coating applied to the chewing surface of molars, premolars, and any deep grooves (called pits and fissures) of teeth. More than 75% of dental decay begins in these deep grooves.

Dental Exams & Cleanings

Professional dental cleanings (dental prophylaxis) are usually performed by Registered Dental Hygienists. Your cleaning appointment will be followed by a comprehensive dental exam performed by your dentist for an initial exam.

Home Care Information

A beautiful, healthy smile that lasts a lifetime is our ultimate goal when treating patients. Your personal home care plays an important role in achieving that goal.

How to Properly Brush and Floss

Brushing and flossing are of paramount importance to oral hygiene. Though bi-annual professional dental cleanings remove plaque, tartar and debris, excellent home care methods are equally valuable.