General Services
• Crowns
• Bridges
• Root Canal Therapy
• Extractions
• White Fillings
• Full and Partial Dentures
• Sports Guards
• Teeth Grinding Relief
Cosmetic Services
• Invisalign (Clear Braces)
• Tooth Whitening
• Lumineers
• Cosmetic Bonding
Preventative Services
• Sealants
• Periodontal Therapy
• Home Care Instructions
• Preventative Recare Appointments
• Oral Cancer Screening
• Desensitizing Products (OTC, RX, In-Office)
• Fluoride Varnish Application
• Dry Mouth
Post-op Care
• Root Canal Therapy
• Extractions
• Scaling and Root Planing
• Gross Debridement
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GENERAL SERVICES
CROWNS
A crown, sometimes called a "cap" is a tooth-like covering placed over a carefully prepared existing tooth. Used to strengthen, restore or improve the appearance of your natural tooth, a crown is placed on an individual tooth. In addition to being used to strengthen a tooth to accommodate the attachment of a fixed bridge, crowns serve many functions. One of the most common is to support the tooth when there is no longer sufficient tooth structure left to place a filling. Crowns may also be used to protect the structure of a tooth that is fractured or broken. Crowns are recommended when teeth are fractured, broken, damaged by a large are of decay, previously root canaled, or when a tooth is discolored and needs to be aesthetically restored.
BRIDGES
A bridge is a custom made fixed appliance that is anchored to neighboring teeth that replaces one or more missing teeth. When a lost tooth is replaced with bridgework, the teeth on either side of the missing one must be prepared as crowns to serve as abutments to hold the prosthetic teeth in place. Crowns and bridges are most often made from superior material such as semiprecious or precious metals, porcelain or a combination of metal fused to porcelain. Both appearance and function are considered when selecting the material most suitable for you. Losing a permanent tooth can cause many serious problems for your neighboring teeth. Because the support and chewing forces are altered, the remaining teeth may begin to shift. The opposing tooth above or below the lost tooth can begin to move up or down and out of the socket, which can accelerate periodontal disease and further break down the bone structure. If the missing tooth is not replaced, more teeth may eventually be lost due to the improper forces exerted during chewing.
ROOT CANAL THERAPY
Root canal treatment, also called endodontics, treats disorders of the nerve. It used to be that a tooth with a diseased or infected nerve had to be removed. However, today this is no longer true. We make every effort to help you keep your natural teeth for a lifetime! The most common factors contributing to a need for root canal treatment are 1.) Trauma - such as a physical blow to a tooth or a constant striking of a tooth in the opposite jaw that traumatizes the tooth. 2.) Physical irritation - caused by a deep area of decay or a very large filling. 3.) Severe gum disease.
EXTRACTIONS
Dr. McCann and his staff take every step possible to help patients keep their permanent teeth. However, in some cases teeth need to be extracted (removed). Dr. McCann extracts, deciduous (baby) teeth, and permanent (adult) teeth. Depending upon the circumstances, a tooth is considered a simple extraction, a surgical extraction, or a root tip extraction. A simple extraction is performed when a tooth is mobile, has a large are of decay that cannot be restored, needs to be extracted before orthodontics, or several other reasons. A surgical extraction is performed mainly on third molars (wisdom teeth), teeth that have fractured or broken and need surgical means to be removed, or impacted teeth. A root tip extraction is performed when a tooth has broken at the gum margin and the root is left inside the socket. The piece of the tooth left is part of the root which must be extracted.
WHITE FILLINGS
Our office uses metal free fillings which are made of a durable, safe, tooth-colored resin. Patients don't have to worry about dark, unsightly fillings that were once used years ago. Dr. McCann does not use amalgam (silver) fillings in his practice because of the mercury this material contains. When placed, these tooth colored fillings are virtually undetectable, making your smile look flawless.
FULL AND PARTIAL DENTURES
Whether you are missing some or all of your natural teeth, you can get many benefits from replacing them with removable full or partial dentures. Replacement teeth help fill out your smile by giving support to the cheeks and lips. Replacement teeth create a more youthful, vibrant appearance by holding up facial muscles and aiding in speaking, chewing, swallowing, and smiling. A removable partial denture is an appliance that replaces one to many missing teeth in one arch, whereas a full denture replaces all the teeth in an arch. Partial dentures can be made of acrylic, cast metal, or Valplast (the newest brand of partials that are made of a very lightweight, flexible, and comfortable material.) These metal-free partial dentures do not have visible metal clasps. Instead they have a more natural looking plastic clasp that matches the inside tissues of the mouth but are as durable as metal clasps.
SPORTS GUARDS
We can make a variety of custom fabricated athletic sports guards. The type of sport being played usually determines the thickness that is needed for the guard. All patients participating in physical sports should protect their teeth with athletic guards at all times. Teeth can easily be chipped, fractured, broken or completely knocked out of their socket during any physical sport by baseballs, footballs, hockey sticks, boxing gloves, etc.
TEETH GRINDING RELIEF
Dr. McCann provides relief for patients who grind or clench their teeth. This very common habit can be caused from many different reasons such as stress, malocclusion, missing teeth, or TMJ dysfunction. Patients who grind their teeth cause wear patterns on the enamel of their teeth. Because of this wear, teeth can become sensitive, fractured, broken, or even mobile. One of the best ways to prevent teeth grinding and clenching is to wear a guard which prevents the motion of the jaws from sliding back and forth. These guards are usually worn at night while sleeping, but some patients may need to wear them during the day. They are made of either a hard or soft material. Dr. McCann will determine the type of guard needed by the wear on the teeth and by the health of the TMJ.
COSMETIC SERVICES
INVISALIGN (CLEAR BRACES)
Invisalign is an orthodontic technique that corrects malocclusion (crowding, overbite, spacing, etc) by using a series of custom-made, nearly invisible, comfortable, removable Aligners. Straightening your teeth with Invisalign can correct crowding and help you maintain your dental health. It can also help you get that smile you've always wanted. Invisalign treatment is a technique that straightens your teeth without traditional braces. Instead, we use a series of clear, comfortable aligners that are custom-molded to fit your teeth. You graduate to a new set of aligners about every two weeks, and your teeth are gradually repositioned into the smile that you want. The aligners are easy to remove which helps maintain gum health because you are able to brush and floss as you normally would. This treatment eliminates metal bands, brackets, and wires. Treatment time can be comparable to that of traditional braces, depending on your needs. Most cases are often completed in less than a year. Invisalign is generally covered by orthodontic insurance, and can cost less than traditional braces.
TOOTH WHITENING
Dr. McCann provides two types of whitening systems: an in-office whitening system and a take-home whitening system. Our in-office whitening system called ZOOM is a safe, effective, and very fast way of whitening your teeth. In just over an hour your teeth will become dramatically whiter. ZOOM whitening is ideal for anyone looking for immediate results. The procedure is simple. It begins with a short preparation to cover your lips and gums, leaving only your teeth exposed. The ZOOM clinician then applies the ZOOM whitening gel which was designed to be used with a specially designed light. The ZOOM light and gel work together to gently penetrate your teeth, breaking up stains and discoloration.
Our take-home system called VENUS WHITE is provided for our patients who would rather whiten their teeth in the privacy of their own home. Custom trays are made from impressions taken of your teeth. We provide you with whitening gel that you place in the trays and wear on your teeth for 1 to 2 hours per day for the next 10 to 14 days in a row. Visible results will be seen in days.
LUMINEERS
Now you can get the smile you've always wanted. Lumineers by Cerinate are contact-lens-thin veneers that can be done without removing tooth structure. They are bonded to the front of your teeth to create dramatic changes in your smile. Perfect smiles can be made painlessly and permanently with the technology behind Cerinate Porcelain. Lumineers can correct a wide variety of unsightly dental conditions such as: tooth discoloration, spaces between teeth, permanent stains, broken or chipped teeth, mis-shaped teeth, small or short teeth, and crooked teeth. Lumineers can even bond to existing crowns and bridgework without having to replace them. This procedure is easy for even sensitive patients because there is no removal of sensitive tooth structure, and in some cases there is no drilling, shots, or pain.
COSMETIC BONDING
Tooth bonding is a simple, effective way to eliminate minor chips, cracks and permanent discolorations on your teeth. During the procedure, a tooth-colored material is applied and bonded to the tooth, reinforcing the tooth structure. When the procedure is completed, the tooth looks and feels like your natural tooth, but without the unsightly problems that were once present.
PREVENTATIVE SERVICES
SEALANTS
A dental sealant is a protective, plastic coating applied to the chewing surface of the teeth. It is placed into the tiny pits and fissures where cavity-causing bacteria, foods, and acids live. Toothbrush bristles are too large to reach into the grooves, making sealant application one of the most important preventative treatments available. The sealant acts as a barrier, protecting the enamel from bacterial plaque in cavity prone areas. Children as well as adults can benefit from this easy and painless procedure. Sealants are placed on permanent molars as soon as they erupt to prevent decay. Sealants can last several to many years. During regular recare appointments, we will check the condition of the sealants and reapply them if necessary.
PERIODONTAL THERAPY
Periodontal disease (gum disease) is the single most common cause of tooth loss in adults. This inflammatory disease attacks the gums, bone, and other supporting structures of the teeth. Periodontal disease is an infection of the tissues that support your teeth. A person may have periodontal disease and not realize it because many cases have no pain associated with it. If the disease is caught in its early stages, periodontal disease can be treated with proper care. Periodontal disease is caused by plaque, a colorless film of bacteria that forms on the teeth. Plaque mixes with sugars and starches in the diet to form acids and other by-products in the mouth, irritating the gums and causing them to become red, tender, and swollen. It also causes the gums to bleed easily. If not removed daily, plaque hardens to form calculus (tartar) around the necks of the teeth. The tissue that attaches the gums to the teeth can be destroyed by the irritants in plaque. The gums pull away from the teeth and small pockets form between the teeth and gums. These pockets become filled with more plaque. As the pockets deepen, it becomes impossible for you to clean the plaque out with brushing or flossing. Eventually, the bone that supports the teeth can be destroyed. As the bone is destroyed, the teeth loose their supporting structure and they can become mobile if periodontal therapy is not started.
Signs of periodontal disease:
- Gums that bleed when you brush or floss your teeth.
- Red, swollen or tender gums.
- Gums that have receded or pulled away from your teeth.
- Pus between your teeth when the gums are pressed.
- Persistent bad breath or a chronic bad taste in your mouth.
- Teeth that are overly sensitive to hot and cold.
- Teeth that are loose, separating, or seem to be changing position.
- Pain when chewing.
- Changes in your bite.
Diagnosing periodontal disease will be done during a patient's initial cleaning. The hygienist will examine the tissues, take radiographs, and measure the gum pockets around the teeth. During this examination, measurements of the pocket depths will be recorded. Clinical examination and radiographs help us determine the precise location, extent, and severity of the disease. There are many other causes of periodontal disease: impacted food, tobacco products, alcohol, badly aligned teeth, poorly fitting bridges or partial dentures, defective fillings, teeth grinding, nutritional deficiencies, pregnancy, certain medications (anti-epilepsy drugs, steroids and cancer therapy drugs may have a negative affect), diabetes, anemia, and leukemia are just some of the common causes to periodontal disease.
Periodontal diseases are classified according to the severity of the disease. The two major stages of the disease are gingivitis and periodontitis. Gingivitis is a milder and reversible form of periodontal disease that only affects the gums. It develops as toxins in the bacterial film irritate the gums making them red, tender, swollen, and bleed easily. It can be eliminated by daily brushing, flossing, and regular dental cleanings. Periodontitis is the more serious and destructive form of periodontal disease. Gingivitis may turn into this if not treated. Periodontitis occurs when toxins, enzymes, and other plaque byproducts destroy the tissues and bone that anchor the teeth into the jaw. If treatment is not started, the teeth will become loose over time and will need to be extracted.
Early treatment is the most important step with patients who have periodontal disease. The type of treatment required depends on how advanced the particular case is. Individualized treatment may include any of the following:
- More frequent cleanings: Removing the bacteria from the gum pockets to prevent heavy build-up of plaque and calculus (tartar) that can destroy the gum tissue and supporting structures of the teeth.
- Scaling and Root Planing: Scaling is removing the calculus (tartar) deposits from the teeth. Root planing is the smoothing of the root surfaces so that the gum tissue can reattach to the tooth.
- Curettage: This is the process where the soft tissue lining is removed in the periodontal pocket. This helps the gums tissue to heal.
- Gingivectomy: This is the surgical removal of the periodontal pocket to allow easier access for cleaning around a tooth.
- Flap Surgery: This is performed by a specialist called a periodontist. This procedure allows access to the root of the tooth for removal of plaque, calculus (tartar), and diseased tissue. The gum is then surgically secured back into place.
You don't have to lose teeth to periodontal disease. Good oral hygiene at home is essential to help keep periodontal disease from becoming more serious or recurring. Brush, clean between your teeth, eat a balanced diet, and schedule regular dental visits. This can help you keep your teeth healthy for a lifetime.
HOME CARE INSTRUCTIONS
Giving proper home care instructions is one the most important things our dental hygienists do for our patients. Education is mandatory for healthy teeth and gums. At your cleaning appointment our hygienists will demonstrate proper brushing and flossing techniques. Many other oral hygiene products are also available that can help patients maintain optimal oral health, such as a rubbertip stimulator, proxabrush, go between brush, soft pick, brush pick, tongue scraper, end-tufted brush, waterpik, floss threader, superfloss, and mouthrinses (Act fluoride, Listerine, Crest Pro Health, Biotine, Gel Kam, Prevident - just to name a few). Our hygienists may demonstrate one or several of these products to their patients in addition to brushing and flossing. These products will be given to our patients depending on their needs. Electric toothbrushes are a must for most patients. Our favorites are the Sonicare and the Oral-B. These toothbrushes can also be demonstrated for our patients.
PREVENTATIVE RECARE APPOINTMENTS
Our hygienists will determine the best recare schedule for our patients depending on their oral health. Most commonly patients are seen for a dental cleaning every six months, but in many cases, patients need to be seen more frequently. Some patients are seen for cleanings every three or four months. This will be discussed between the patient and the hygienist and a recare schedule will be made depending on the patient's needs. Patients who may need to be seen for dental cleanings more often are those with orthodontics, periodontal disease, diabetes, and patients that are pregnant.
ORAL CANCER SCREENING
During comprehensive oral exams, Dr. McCann does an oral cancer screening. Precancerous oral lesions are abnormal cell growths in or around the mouth. They may become cancer. Cancerous oral lesions are life-threatening cell changes in or around the mouth. These lesions need to be detected early to give you a better chance for a cure. Signs and symptoms of precancerous and cancerous oral lesions may include: a sore in the mouth that doesn't heal within 3 weeks, white or red lesions or ulcers on the tongue, gums, under dentures and partials, or lining of the mouth that don't go away, and tenderness or pain in the mouth that persists. A biopsy is the best way to find out if a lesion is precancerous or cancerous. During a biopsy, the area around the lesion will be numbed. A part of the lesion will then be removed and send to a lab to be examined under a microscope. This process is done by an oral surgeon. Treatment of the lesion depends on the nature of the lesion. Types of treatment are surgery to remove the lesion, radiation therapy, or chemotherapy. Prevention is the best way to catch lesions before they become a problem. Regular oral exams are a must. Limiting things such as tobacco products (cigarettes, cigars, pipes, and smokeless tobacco) and alcohol are also ways to decrease the risk for oral cancer.
DESENSITIZING PRODUCTS (OTC, RX, IN-OFFICE)
Tooth sensitivity is a growing problem among dental patients. With the widespread use of whitening and abrasive toothpastes on the market, tooth sensitivity is becoming very common. Abrasive toothpastes such as baking soda pastes, pastes with breath freshening crystals, tartar control pastes, and whitening pastes can cause root sensitivity in some patients. Root sensitivity can also occur from using medium or hard toothbrushes or scrubbing the teeth back and forth. This can cause gum recession which leaves the roots exposed and can then lead to sensitivity to hot, cold, or sweets. Other common causes of gum recession are patients who have had past orthodontics, patients with periodontal problems, and patients who have had extractions (the gum shrinks around the extraction site). We offer several products for desensitizing sensitive teeth. Over the counter Sensodyne toothpaste and Act fluoride rinse is an easy solution to minor tooth sensitivity problems. More severe sensitivity may require prescriptions such as Prevident toothpaste or rinse, or Gel Kam toothpaste or rinse. We also offer our patients immediate sensitivity relief with the application of a desensitizing resin called Vanish XT Extended Contact Varnish. This is a protective barrier that immediately relieves sensitivity and delivers fluoride and lasts up to 6 months. It can be applied during a cleaning appointment. This virtually invisible product is applied and then cured with a light.
FLUORIDE VARNISH APPLICATION
Fluoride therapy is beneficial to not only children, but also adults. With our fast-paced life-style, on the go eating habits, and bottled water which is not fluoridated, we are facing an increase in carious lesions (cavities). Fluoride not only strengthens the enamel and exposed root surfaces, it also helps to prevent cavities. We routinely use fluoride varnish on children and teens, and are strongly recommending it for most of the adult population as well. One reason is because more and more adults are taking prescription medications that dry out the mouth, which causes an increased risk of cavities. As we age, root surfaces are exposed from aggressive brushing, hard toothbrushes, acid erosion from our love of colas and acid reflux disease. These things can cause the teeth to become sensitive to cold and sometimes sweet. For these reasons fluoride therapy is highly recommended for over-all tooth health.
DRY MOUTH
Millions of people are affected with a dry mouth, also called xerostomia. People who do not produce enough saliva can have difficulties in speaking, swallowing, chewing, and tasting food. A chronic dry mouth can lead to tooth decay, gingivitis, and oral infections. Saliva moistens the tissues in the mouth helping to prevent tooth decay by limiting the growth of bacteria and washing away food debris and plaque. Saliva provides enzymes that begin the food digestion process. Saliva lubricates food to allow for easier swallowing. The most common symptoms of a dry mouth is bad breath, bleeding gums, cavities, mouth sores, and cracked lips. There are many causes of a dry mouth including: diabetes, Sjogren's Syndrome, HIV/AIDS, parkinson's disease, radiation therapy, chemotherapy, stress, and medications. There are more than 400 prescription and over-the-counter medications that can cause a dry mouth. Some of the most common are antihistamines, antihypertensives, anti-inflammatory, diuretics, antianxiety, and antidepressants. Treatment of dry mouth depends on the cause Treatment may be as complicated as determining if salivary glands are not functioning properly, or as easy as changing medications that cause dry mouth. Sometime there may be no treatment other than to use oral products that help reduce the problems of a dry mouth. If you have a dry mouth avoid smoking, alcohol, caffeine, spicy, sugary or salty foods, and citrus fruits and juices.
POST-OP CARE
POST-OP INSTRUCTIONS FOR ROOT CANAL THERAPY
1. Post-operative discomfort is sometimes experienced after a treatment visit. This is due to irritation of the bone surrounding the tooth and may range from a mild discomfort in the area to an occasional episode of considerable pain. This discomfort will usually maximize in approximately 48-72 hours and then subside. Please avoid chewing on the treated tooth for a few days.
2. If a throbbing sensation occurs, please keep your head elevated as much as possible and place extra pillows under your head when lying down. Avoid any strenuous activity as well.
3. If swelling of the gum is present or should appear after a treatment visit, please rinse the area every 1-2 hours with a solution of warm salt water prepared by adding 1/2 teaspoon of regular table salt to an 8 oz. glass of warm water.
4. If swelling of the face is present or should appear, apply an ice pack to the area for 5 minutes every 1/2 hour for 2 hours.
5. If antibiotic medication has been prescribed, please take it as indicated until you have finished ALL of the medication. If you encounter any difficulty in breathing, a skin rash, or if gastric disturbances should occur, please discontinue the medication and call our office.
6. If pain medication has been prescribed, please take it as indicated. It is important to bear in mind that narcotic medications such as Codeine, Vicodin, Percodan, and Demerol may make you drowsy. Therefore, caution should be used in operating any potentially dangerous machinery or an automobile.
If any additional questions should arise after your visit, please do not hesitate to call our office.
POST-OP INSTRUCTIONS FOR EXTRACTIONS
DO NOT DISTURB THE WOUND: In doing so you may invite irritation, infection and/or bleeding. Be sure to chew on the opposite side for 24 hours and keep anything sharp from entering the wound (eating utensils, etc.).
DO NOT SMOKE FOR 24 HOURS: Smoking will promote bleeding and interfere with healing.
DO NOT SPIT AND DO NOT SUCK THROUGH A STRAW: This will promote bleeding and may dislodge the blood clot, causing a dry socket.
BRUSHING: Do not brush your teeth for the first 8 hours after surgery. fter this time period, you may brush your teeth gently, but avoid the area of surgery.
MOUTH WASH: Avoid rinsing for 24 hours after extractions. This is to insure the formation of a healing blood clot which is essential for proper wound healing. Disturbance of this clot can lead to increased bleeding or the loss of the blood clot. If the clot is lost, a painful condition called a dry socket may occur. After 24 hours, RINSE WITH WARM SALT WATER. A solution may be made by adding 1/2 teaspoon of regular table salt to 8 oz. warm water. This will speed the healing process. Rinse 3-4 times per day for the next 3-4 days, especially after you eat to keep food from getting caught in the extraction site.
POST-OP INSTRUCTIONS FOLLOWING SCALING AND ROOT PLANING
1. Until anesthesia subsides (the feeling of numbness is totally gone) be very careful not to bite your cheek, tongue, or lips. The effects of the anesthesia may last 2-6 hours. Soft foods are best until feeling is restored.
2. If any areas in your mouth continue to bleed after you leave our office, apply pressure to that area with gauze or a tissue. Be aware of where the bleeding occurs, especially if it continues with brushing, flossing, or other stimulation to the tissues. Make your hygienist aware of this when you see her at your next visit.
3. Take tylenol or any non-aspirin product if you experience any discomfort. Aspirin acts as a blood thinner and could prolong bleeding.
4. Rinse with warm salt water 3 times per day for at least 3 days. A solution of warm salt water can be prepared by adding 1/2 teaspoon of regular table salt to an 8 oz. glass of warm water.
5. Follow your hygienist's instructions for improving home care. Use the accessories (end-tufted brush, proxabrush, stimudents, rubber tip, sulcus brush, etc.) given to you. They are intended to help with your specific needs in reducing irritation, inflammation, and bleeding brought on by periodontal disease. your commitment to better oral health will help to speed the reversal of periodontal disease.
As you are aware, periodontal disease is usually a slow, sometimes painless, progressive disease. Left untreated, it will lead to eventual tooth loss. Although scaling and root planing is a somewhat invasive procedure, it is our hope to initiate a reversal of the disease present in your mouth. If the stage of disease has been diagnosed as being more moderate to advanced, other methods of treatment may be necessary to help reverse the disease process.
POST-OP INSTRUCTIONS FOLLOWING A GROSS DEBRIDEMENT
1. Rinse with warm salt water 3 times per day for at least 3 days. Use 1/2 teaspoon regular table salt to one 8 oz. glass of warm water each time you rinse.
2. Increase your intake of vitamin C either with foods high in vitamin C (orange juice, leafy green vegetables, tomatoes, broccoli...) or with a supplement. This helps to boost the immune system and aid in healing.
3. Take Tylenol or any non-aspirin product if you experience any discomfort. Aspirin acts as a blood thinner and could prolong bleeding.
4. If any areas of your mouth continue to bleed after you leave our office, apply pressure to that area with gauze or a tissue.
After a few days, you should see an improvement in gum tissue (the color should lighten). You may have a better taste in your mouth and you should experience less bleeding when brushing or flossing.
A gross debridement is done when there is evidence of gingivitis (inflammation of the gums) and more advanced stages of gum disease (bone loss) as well. Usually it has been a while since a routine cleaning has been done. Symptoms of gum disease can include red, bleeding, and swollen gums, odor and bad taste. Although scaling in the presence of inflammation (gross debridement) is somewhat invasive, our hope is to initiate some healing so that a complete exam can be done and health restored to the gums and teeth. If more advanced disease is suspected, an evaluation and diagnosis can be made with a full mouth series of radiographs and full mouth pocket readings. It is our expressed desire to practice the best in dental health and educate our patients in all aspects of oral health and prevention.
If any questions arise, feel free to contact anyone in our Dental Hygiene Department. Our phone number is 410-546-9940.
Julie P. Joudrey, RDH
Missy M. LeCates, RDH
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