FAQs

  1. What is Dental Anxiety and Phobia? 
  2. Anxiety & Phobia Causes 
  3. I have Dental Phobia is Sedation the Answer?
  4. Symptoms 
  5. What is Sedation Dentistry? 
  6. How can Sedation Dentistry help me?
  7. Who is a candidate for Sedation Dentistry?
  8. Is Sedation Dentistry safe? 
  9. My teeth are very sensitive when the dentist uses the sonic cleaning method. Would the new sonic toothbrushes that one can purchase help with that condition if I used one regularly? Or would a toothpaste for sensitive teeth be more effective?
  10. How durable are porcelain veneers?
  11. What are inlays and onlays?
  12. How are they applied?
  13. What is Bonding?
  14. What are Dental Implants?
  15. What is a Bridge?
  16. Why do I need a bridge?
  17. How is a bridge attached?
  18. What materials are used for a bridge?
  19. How do I take care of my bridge?
  20. What causes Periodontal disease?
  21. Why Should I Remove My Wisdom Teeth?
  22. How do I take care of my mouth after an extraction?
  23. Does smoking increase my risk of Gum Disease?
  24. How many times a day should I brush my teeth?
  25. Does flossing fight periodontal disease?
  26. Can my diet affect my teeth?
  27. What is gum irrigation and Ultrasonic therapy?
  28. What is Arestin®?
  29. Who can benefit from Arestin® (minocycline HCl 1mg)?
  30. Is treatment with Arestin a new procedure?
  31. Does Arestin work?
  32. How long does treatment with Arestin take?
  33. Will I have to return to the dentist to have Arestin removed?
  34. Does treatment with Arestin hurt?
  35. Are there any side effects with Arestin?
  36. How much does Arestin cost?
  37. How does Arestin® work?

1. What is Dental Anxiety and Phobia?

Some people don’t look forward to dental appointments any more than they look forward to visits to a physician. Most dental procedures aren’t painful, but just being examined can make people feel stressed. Some anxiety about going to the dentist can be considered acceptable. For those with dental phobia, however, the thought idea of going to the dentist is terrifying. They may be so frightened, in fact, that they’ll do just about anything to avoid a dental appointment. A phobia is an intense, unreasonable fear of a specific activity, object or situation. People with dental phobia routinely put off routine care for years or even decades. Rather than make an appointment, they’ll put up with gum infections (periodontal disease) , pain, or even broken and unsightly teeth. Dental anxiety and phobia are extremely common. It has been estimated that 9 to 15 percent of Americans about 30 to 40 million people avoid seeing the dentist because of anxiety and fear. A survey commissioned by the British Dental Health Foundation found that 36 percent of those who don’t see a dentist regularly cite fear as the main reason. People often use the words “anxiety” and “phobia” interchangeably, but they aren’t the same thing. Those with dental anxiety will have a sense of uneasiness when it’s time for their appointments. They’ll have exaggerated or unfounded worries or fears. Dental phobia is a more serious condition. It’s characterized by objectively morbid fear or dread. People with dental phobia aren’t merely anxious, but terrified or panic-stricken. People with dental phobia have a higher risk of periodontal disease and premature tooth loss. Apart from the physical consequences of avoiding the dentist, there may be emotional costs as well. Discolored or damaged teeth can make people self-conscious and insecure. They may smile less or keep their mouths partly closed when they speak. Some people can become so embarrassed about the cosmetic qualities of their teeth that their personal and professional lives begin to suffer. There may be a serious loss of self-esteem. There are varying degrees of dental anxiety and phobia. At the extreme, a person with dental phobia may never see a dentist. Others may force themselves to go, but they may not sleep the night before. It’s not uncommon for people to feel sick or, in some cases, to actually get sick while they’re in the waiting room. Dental phobia, like other mental disorders, can be treated. Without treatment, dental phobia is likely to get worse over time, in part because emotional stress can make dental visits more uncomfortable than they need to be. People who are unusually tense tend to have a lower pain threshold, which means they may experience pain at lower levels than other people. They may need additional anesthetic or other pain treatments. They may even develop stress-related problems in other parts of the body, such as headaches or muscle stiffness in the neck or back.

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2. Anxiety & Phobia Causes

There are many reasons why some people develop dental anxieties and phobias. A few common themes emerge. Pain. In a survey of people who had not seen a dentist for 12 months, 6 percent reported fear of pain as the main reason. The fear of pain is most common in adults 24 years and older, probably because their early dental experiences predated many of the advances in “pain-free” dentistry. Feelings of helplessness and loss of control. Many people develop phobias about situations — like flying in an airplane — in which they feel they have no control. When they’re in the dental chair, they have to stay still. They may feel they can’t see what’s going on or predict what’s going to hurt. It’s common for people to feel helplessness and a loss of control. Embarrassment. The mouth is an intimate part of the body. People may feel ashamed or embarrassed to have a stranger looking inside, especially if they’re self-conscious about the appearance of their teeth. Also, the physical closeness that occurs during dental treatments — the dentist’s face may be just a few inches away — often makes people anxious and uncomfortable. Negative past experiences.Anyone who has had pain or discomfort during previous dental procedures is likely to be more anxious the next time around, as is someone who has been told how painful dental procedures are. Most dental procedures aren’t painful, but just being examined can make people feel stressed. Some anxiety about going to the dentist can be considered acceptable.

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3. I have Dental Phobia is Sedation the Answer?

If a bad experience in the past made you afraid of seeing your dentist, sedation may help you get the treatment you need. Pain is among the main reasons people go to the dentist. It’s also what keeps them away: Some 35 million Americans are so afraid of pain that they won’t go anywhere near a dentist’s chair until a toothache gives them no other choice. “I was probably 10 or 11 years old when I had a tooth pulled and it was excruciating,” recalls Jim, 56, an account executive “After that, I never went to a dentist unless I was in pain.” It took Jim more than four decades — and a push from his daughter, who wanted to see him smiling in her wedding photos — to get some long-needed dental work done. Most people don’t wait that long to have cavities filled or their teeth repaired, but the anxiety they experience is no less severe. More and more dentists have begun offering some form of sedation to make the experience a little easier. Less Pain and Stress People who have had painful experiences in the past will understandably be dubious when they’re told that most dental procedures today are nearly pain-free. A shot or two of novocaine will make your jaw or teeth numb, but there’s no getting around the fact that it’s an uncomfortable experience. And the more apprehensive people feel, the more uncomfortable the procedure is likely to be. Sedation can make a difference. Apart from the fact that sedating drugs have some analgesic (pain-killing) effects, they also reduce fear and anxiety. It’s an option for people who are too afraid to go to the dentist any other way. Types of SedationGetting sedated doesn’t necessarily mean that you’ll be “out” for the duration of the procedure. This is certainly an option, but most dentists prefer “conscious sedation,” in which patients are awake, but relaxed or drowsy. Some people have no anxiety undergoing treatment. Others find it difficult to even enter the dentist’s office. If you are nervous or fearful about dental treatment, sedation can help relax you, making your experience easier and more pleasant. Although your dentist may explain the procedures to you and ask if you have questions, he or she may not perceive or understand your fears. Also, if your dentist doesn’t know you are anxious, he or she may not suggest sedation as an option. Talk to your dentist about your anxiety. That may be enough to relax you. If not, there are many anti-anxiety drugs that can be used during dental treatment. Your dentist can even give you one before your appointment, to use if you have trouble sleeping the night before. If you are given an antianxiety drug to take the night before, you should arrange to be driven to and from the office. Also, avoid alcohol and over-the-counter sleep aids, because they can react with sedating medications.

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4. Symptoms

There isn’t a clear boundary that separates “normal” anxiety from phobia. Everyone experiences various fears and concerns and copes with them in different ways. However, the prospect of dental work shouldn’t fill you with terror. If it does, then you may need some help overcoming the fears. Some of the signs of dental phobia include:

  • You feel tense or have trouble sleeping the night before a dental exam.
  • You get increasingly nervous while you’re in the waiting room.
  • You feel like crying when you think of going to the dentist.

The sight of dental instruments — or of white-coated personnel in the dentist’s office — increases your anxiety.

  • The thought of a dental visit makes you feel physically ill.
  • You panic when objects are placed in your mouth during a dental appointment or you suddenly find it difficult to breathe.

Nitrous oxide is a common inhaled anti-anxiety drug given just before treatment starts. Diazepam (given in pill form) and other similar drugs can be given 30 minutes to an hour before treatment or the preceding night. Diazepam and other oral sedatives do not provide pain relief. You also will receive a local anesthetic injection. Children often receive antihistamine-type sedatives (such as hydroxyzine), which can cause significant dry mouth. Depending on the doses and types of sedatives used, different levels of sedation are achieved. Dr Perry might consider deeper levels of sedation for complex procedures or if you are more anxious.

  • Anxiolysis. Very light sedation, usually induced by nitrous oxide. It provides a feeling of having no worries.
  • Conscious sedation. Medium sedation induced by nitrous oxide or intravenous drugs. Your gag reflexes still work and you can respond to commands.
  • Deep sedation. You are somewhere between conscious and unconscious, but closer to unconscious. You experience a partial loss of your gag reflex and you cannot respond consistently to stimulation or commands. You may also be unable to keep your airway open for breathing independently under deep sedation.
  • General anesthesia. You are unconscious and cannot keep your airway open for breathing or respond to commands or stimuli. Usually, an endotrachial tube will be used to assist with breathing. If you will be receiving nitrous oxide, eat lightly before and after your appointment. After your dental procedure is over, you will receive oxygen for several minutes to clear the nitrous oxide from your system. If your dentist just takes off the mask without giving you oxygen, you can experience headache or other side effects. These are rare, however, with the 25 to 40 percent concentration of nitrous oxide typically used by dentists. If you are taking medication for psychiatric conditions, talk to your dentist before receiving any sedative.

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5. What is Sedation Dentistry?

Sedation dentistry means that you will be sedated during your dental treatment. Sedation is provided by either a sedation dentist or an M.D. anesthesiologist who works side-by-side with the dentist during your care. All of your dental treatment is performed while you are in a safe, painless, twilight sedation. Sedation dentistry with Dr Perry is performed in our state-of-the-art dental office. The result is that you feel no anxiety, no fear, no pain, and then wake up after the work is completed. In less than an hour you are ready to leave the office. And best of all, you feel like you had a pleasant nap with little or no memory of the dental appointment. It’s safe, it’s effective, and it makes possible the care that you so desperately need. All types of dentistry can be done while you are sedated, from simple cleanings to complete smile makeovers. It’s not just the dentistry that you need; it’s also the cosmetic dentistry that can make for beautiful and healthy smiles. And it’s not just about helping fearful patients. For those who want to avoid the inconvenience of scheduling multiple regular dental appointments, or those who simply find it difficult to sit for long appointments, sedation dentistry is the answer because all your dentistry can be completed in only one or two appointments.

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6. How can Sedation Dentistry help me?

Sedation Dentistry is the answer if you have:

  • Fear and anxiety about going to the dentist.
  • Difficulty getting numb by regular ‘Novocaine’.
  • Uncontrollable gagging
  • Difficulty sitting still for a long time.
  • Time constraints making multiple dental appointments difficult to schedule.
  • Fear of injections and needles
  • Fear of the feeling and noise from the dental drill.
  • Your safety and comfort is our first concern.
  • Combine all appointments into fewer visits.
  • Dental care while you are comfortably sedated.
  • The highest infection control standards.
  • Variety of payment options available.

Sedation If you’ve been hiding your smile, putting up with pain, or putting off going to the dentist because you’re too anxious or afraid, your life is about to change! New and safe sedation techniques mean you can have years of dental treatments done quickly, with no discomfort while you sleep. Cosmetics Now a movie star smile is as close as your mirror. Starting with healthy teeth and gums, we can greatly improve your smile through porcelain restorations, veneers, whitening, and other state-of-the-art treatments. Implants For those who wish to replace missing teeth, dental implants may be an effective solution. Implants act as the artificial root to which new teeth are attached. Periodontal DiseaseUnhealthy gums are a red flag, warning of future tooth loss and the potential for stroke and heart disease. A periodontal assessment is one of the most important things you can do for yourself and your family.

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7. Who is a candidate for Sedation Dentistry?

Is it right for me?If you are anxious or concerned about visiting a dentist, sedation dentistry is a great choice. Your dentist can answer any questions you may have about this easy and painless treatment option. People who have…

  • Simple anxiety or extreme fear about going to the dentist and a wish to be sedated.
  • Hate the noise, smell, feel of the dental drill.
  • Embarrassment about the extent of their dental problems brought about by fear.
  • Hate getting the ‘Novocaine’ shot at the dentist.
  • Difficulty getting numb.
  • Time constraints that would be helped by having longer dental appointments where more treatment is accomplished at each visit.
  • Severe gag reflex.
  • Very sensitive teeth.
  • Children who are too anxious to sit still.
  • Handicapped individuals who have difficulty holding still for dental treatment.

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8. Is Sedation Dentistry safe?

This is the safest type of sedation dentistry. You are sedated and completely comfortable while being cared for by a highly trained sedation dentist and an M.D. anesthesiologist. Your level of sedation is monitored and adjusted throughout your dental appointment so that you have no pain or awareness and no memory of the procedure when its over. Will I need to be accompanied by someone to and from my dental appointment? Yes, someone must bring you to the office and take you home at the end of your appointment. At home you will relax and rest comfortably for the rest of the day. How long will I be sedated?It depends on the extent of your dental treatment. It can be as short as 1 hour or as long as 3 to 4 hours. Your dentist will tell you the details of your treatment and the length of time needed to complete it.

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9. My teeth are very sensitive when the dentist uses the sonic cleaning method. Would the new sonic toothbrushes that one can purchase help with that condition if I used one regularly? Or would a toothpaste for sensitive teeth be more effective?

Ultrasonic scalers generate a high frequency vibration to remove tartar from your teeth during cleanings performed at your dentist’s office. While sensitivity to such scaling is common, the sonic toothbrushes sold for at-home use are set at a much lower power and shouldn’t irritate your teeth. However, if you have sensitive teeth, using a sonic toothbrush may not alleviate the problem. There are two primary reasons for tooth sensitivity. Dentinal sensitivity occurs when the middle layer of a tooth is exposed. This layer, known as dentin, lies below the gumline. The dentinal layer consists of fine tubules, which contain nerves that branch from the tooth’s pulp chamber. When the dentin is exposed, the nerves can be stimulated by pressure of temperature changes, resulting in sensitivity that can affect any number of your teeth. In contrast, pulpal sensitivity is a reaction of the pulp to infection, recent dental treatment, or excessive pressure from biting or grinding. Pulpal sensitivity is usually confined to an individual tooth. There are several treatments available for dentinal sensitivity, all of which aim to block the tubules in the dentin, preventing the stimulus from reaching the nerves. In the dental office, your dentist or hygienist may use higher-strength fluoride varnishes and other products that are painted on the tooth to reduce sensitivity. At home, you can use any number of widely available toothpastes and fluoride rinses for sensitive teeth. Look for products that include potassium nitrate or stannous fluoride, which have been proven to reduce dentinal sensitivity in the roots. You should discuss treatment options with your dentist. Happily, tooth sensitivity is usually easily remedied.

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10. How durable are porcelain veneers?

With proper care, porcelain veneers will brighten your smile for well over a decade. Dr. Perry will ensure that your veneers are crafted from the highest quality porcelains and are bonded with the most advanced and proven materials available. Refraining from using your veneers as tools to open and cut things will prolong their life, and if accidental breakage or damage occurs, it is usually possible to replace only the veneer involved.

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11. What are inlays and onlays?

Inlays and onlays can be made of porcelain, gold, or composite resin. These pieces are bonded to the damaged area of the tooth. An inlay, which is similar to a filling, is used inside the cusp tips of the tooth. An onlay is a more substantial reconstruction, similar to the inlay but extending out over one or more of the cusps of the tooth. Traditionally, gold has been the material of choice for inlays and onlays. In recent years, however, porcelain has become increasingly popular due to its strength and color, which can potentially match the natural color of your teeth.

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12. How are they applied?

Inlays and onlays require two appointments to complete the procedure. During the first visit, the filling being replaced or the damaged or decaying area of the tooth is removed, and the tooth is prepared for the inlay or onlay. To ensure proper fit and bite, an impression of the tooth is made by the dentist, and sent to a lab for fabrication. The dentist will then apply a temporary sealant on the tooth and schedule the next appointment. At the second appointment, the temporary sealant is removed. Dr. Perry will then make sure that the inlay or onlay fits correctly. If the fit is satisfactory, the inlay or onlay will be bonded to the tooth with a strong resin and polished to a smooth finish. Traditional fillings can reduce the strength of a natural tooth by up to 50 percent. As an alternative, inlays and onlays, which are bonded directly onto the tooth using special high-strength resins, can actually increase the strength of a tooth by up to 75 percent. As a result, they can last from 10 to 30 years. In some cases, where the damage to the tooth is not extensive enough to merit an entire crown, onlays can provide a very good alternative. Indirect fillings or restorations. These are usually done by making and impression or your tooth and sending out to the labe to have a piece custom made and placed into your tooth at a second visit. These types of restorations are usually more durable and last longer. Direct fillings or restorations are usually done chairside in one visit but have the tendency to leak or crack causing the need for further treatment and possibly tooth loss. You have the choice! Ask your dentist or Dr Perry to give you a choice in treatment options when it comes to replacing your old broken restorations/fillings. Only your dental professional can help you make the proper treatment choice.

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13. What is Bonding?

Bonding is an alternative to veneers, and can be used as a restorative procedure for teeth that are chipped, cracked, discolored or misarranged. The tooth is prepared for the procedure by lightly etching the surface and applying a bonding liquid. Once the liquid sets, a plastic resin is applied and sculpted into the desired shape by the dentist. Once set, the resin is trimmed, smoothed and polished to a natural appearance. The bonding procedure can often be completed in a single office visit, and can improve the appearance of a tooth significantly. However, since the plastic resin used is not as strong as your natural tooth enamel, it is more likely to stain, chip or break than natural teeth. Bonding typically lasts three to five years before need of repair.

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14. What are Dental Implants?

Dental implants are designed to provide a foundation for replacement teeth that look, feel and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything and can smile with confidence, knowing that teeth appear natural and that facial contours will be preserved. The implants are tiny titanium posts which are placed into the jawbone where teeth are missing. The bone bonds with the titanium, creating a strong foundation for artificial teeth. In addition, implants can help preserve facial structure, preventing the bone deterioration which occurs when teeth are missing. Dental implants are changing the way people live! With them, people are rediscovering the comfort and confidence to eat, speak, laugh and enjoy life. Dental implants are metal anchors, which act as tooth root substitutes. They are surgically placed into the jawbone. Small posts are then attached to the implant which protrude through the gums. These posts provide stable anchors for artificial replacement teeth. For most patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jawbone. For the first three to six months following surgery, the implants are beneath the surface of the gums, gradually bonding with the jawbone. You should be able to wear temporary dentures and eat a soft diet during this time. At the same time, your restorative dentist designs the final bridgework or denture, which will ultimately improve both function and aesthetics. After the implant has bonded to the jawbone, the second phase begins. The surgeon will uncover the implants and attach a small healing collar. Dr. Perry can then start making your new teeth. An impression must be taken. Then posts or attachments can be connected to the implants. The replacement teeth are then made over the posts or attachments. The entire procedure usually takes six to eight months. Most patients do not experience any disruption in their daily life.

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15. What is a Bridge?

A bridge — a device used to replace missing teeth — attaches artificial teeth to adjacent natural teeth, called abutment teeth. Bridges are either permanently attached (fixed bridges), or they can be removable. Fixed bridges are applied by either placing crowns on the abutment teeth or by bonding the artificial teeth directly to the abutment teeth. Removable bridges are attached to the teeth with metal clasps or by precision attachments. If you’re missing one or more teeth, you may be aware of their importance to your appearance and dental health. Your teeth work together for many daily functions from eating to speaking. With missing teeth, it’s difficult to do these things. Missing teeth can and should be replaced. Fixed bridges are a great way to restore your dental health and appearance.

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16. Why do I need a bridge?

Oral functionality and appearance are important reasons for wearing a bridge. A bridge helps support your lips and cheeks. The loss of a back tooth may cause your mouth to sink and your face to look older. Dental health is the most important reason for a bridge. Teeth were designed to complement each other. Unusual stresses are placed on the gums and other oral tissues when teeth are missing, causing a number of potentially harmful disorders. Increased risk of gum disease has proven to be one of the worst side effects of missing teeth and can be minimized with a bridge. Missing teeth can cause speech disorders as they are used to make many of the sounds we use to speak clearly.

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17. How is a bridge attached?

The attachment procedure usually takes two or three appointments to complete. At the first appointment Dr. Perry will prepare the teeth on either side of the gap by removing a portion of the enamel and dentin. Since the bridge must be fabricated very precisely to ensure correct bite and to match the opposing tooth, impressions of the teeth are taken and sent to a lab where the bridge will be constructed. Fixed bridges are typically cemented to the natural teeth next to the space left by the missing tooth. A pontic (false tooth) replaces the lost tooth. Crowns, which are cemented onto the natural teeth, provide support for the bridge.

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18. What materials are used for a bridge?

Bridges can be constructed from gold alloys, non-precious alloys, porcelain, or a combination of these materials. Porcelain is often bonded to either precious or non-precious metal.

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19. How do I take care of my bridge?

A strict regimen of brushing and flossing will keep the bridge and surrounding teeth clean. This is of critical importance as the bridge relies on the neighboring teeth for support.

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20. What causes Periodontal disease?

Periodontal disease is caused mainly by bacteria contained within dental plaque, the sticky substance that normally forms on your teeth. Interestingly, it is your body’s response to the bacterial infection that causes most of the problems. In an effort to eliminate the bacteria, the cells of your immune system release substances that cause inflammation and destruction of the gums, periodontal ligament or alveolar bone. This leads to swollen, bleeding gums, signs of gingivitis (the earliest stage of periodontal disease), and loosening of the teeth, a sign of severe periodontitis (the advanced stage of disease. Practicing good oral hygiene and visiting your dentist regularly (about once every six months) can prevent periodontal disease). Daily brushing and flossing, when done correctly, help remove most of the plaque from your teeth. Professional cleanings by your dentist or dental hygienist will keep plaque under control in places that are harder for a toothbrush or floss to reach. If oral hygiene slips or dental visits become irregular, plaque builds up on the teeth and eventually spreads below the gumline. There, the bacteria are protected because your toothbrush can’t reach them. Good flossing may help dislodge the plaque; but if it is not removed, the bacteria will continue to multiply, causing a more serious infection. The buildup of plaque below the gumline leads to inflammation of the gums. As the gum tissues become more swollen, they detach from the tooth forming a space, or “pocket,” between the tooth and gums. In a snowball effect, the pockets encourage further plaque accumulation since plaque removal becomes more difficult. If left untreated, the inflammatory response to the plaque bacteria may spread to the periodontal ligament and alveolar bone, leading to destruction of these structures. Another problem is that if plaque is allowed to build up on teeth, over time it becomes calcified, or hardened, and turns into calculus (commonly called tartar). Since calculus is rougher than tooth enamel or cementum, even more plaque attaches to it, continuing this downward spiral. And don’t think tartar-control toothpaste will protect you. Although it may help slow accumulation of calculus on the teeth, it can’t do anything for tartar that has already formed below the gumline. Periodontal disease is a serious infection of gums and other tissue surrounding teeth. Millions of Americans have periodontal disease left untreated, welcome the news that periodontal treatment can make your mouth healthier and help you keep your teeth. If any of the following applies to you; please contact your dentist immediately.

  • Gums that bleed when you brush or floss.
  • Red, swollen, or tender gums.
  • Persistence Bad breath or bad taste.
  • Formation of deep pockets between teeth and gums.
  • Loose or shifting teeth.
  • Changes in the way teeth fit together when you bite.

You may have periodontal disease without noticing any symptoms. There are three main stages: Gingivitis, periodontitis, and advanced periodontitis. Early detection and treatment can help keep periodontal disease from progressing. Gingivitis Bacteria and plaque have caused the gums to become inflamed and to bleed easily. Plaque gets in the space between the gum and tooth, causing “pockets”. Good home care and professional cleaning are usually enough to restore healthy gums. Periodontitis, high levels of bacteria initiate a release of tissue destroying enzymes. These enzymes start a process which results in deeper pockets and bone loss. Treatment is aimed at stopping further damage and reversing the progression of the disease. Advanced periodontitis, bacteria and enzymes have caused gum and bone to degrade further. At this stage, tooth loss is possible, and immediate treatment is critical to avoid this outcome.

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21. Why Should I Remove My Wisdom Teeth?

Wisdom teeth are the last teeth to erupt within the mouth. When they align properly and gum tissue is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen The extraction of wisdom teeth is necessary when they are prevented from properly erupting within the mouth. They may grow sideways, partially emerge from the gum and even remain trapped beneath the gum and bone.Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to erupt successfully. These poorly positioned impacted teeth can cause many problems. When they are partially erupted, the opening around the tooth allows bacteria to grow and will eventually cause an infection. The result: swelling, stiffness, pain and illness. The pressure from the erupting wisdom tooth may move other teeth and disrupt the orthodontic or natural alignment of teeth. The most serious problem occurs when tumors or cysts form around the impacted wisdom tooth, resulting in the destruction of the jawbone and healthy teeth. Removal of the offending impacted tooth or teeth usually resolves these problems. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure. All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort. Dr. Perry has the training, license and experience to provide various types of anesthesia for patients to select the best alternative. Removal In most cases, the removal of wisdom teeth is performed under local anesthesia, laughing gas (nitrous oxide/oxygen analgesia) or consious sedation. These options as well as the surgical risks (i.e. sensory nerve damage, sinus complications) will be discussed with you before the procedure is performed. Once the teeth are removed, the gum is sutured. To help control bleeding, bite down on the gauze placed in your mouth. You will rest under our supervision in the office until you are ready to be taken home. Upon discharge, your post-operative kit will include postoperative instructions, a prescription for pain medication, antibiotics and a follow-up appointment in one week for suture removal. If you have any questions, please do not hesitate to call us at Frank C Perry DDS PC Phone Number 631-654-0707. Our services are provided in an environment of optimum safety that utilizes modern monitoring equipment and staff that are experienced in anesthesia techniques.

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22. How do I take care of my mouth after an extraction?

A. DO NOT RINSE MOUTH TODAY. Tomorrow, rinse mouth gently every 4-6 hours using ¼ teaspoon of salt to a glass of warm water. Continue rinses for several days. B. BLEEDING. Following extractions, some bleeding is to be expected. If persistent bleeding occurs, place gauze pads over bleeding occur, place gauze pads over bleeding area and bite down firmly or 1-2 hours. Repeat if necessary. Some oozing of blood can cause pink saliva for several days. DO NOT SLEEP WITH GAUZE. You might want to place a towel on your pillow to protect your sheets. C. SWELLING. Ice bag or a cold moist cloth should be applied to area outside the mouth. Ten minutes on and ten minutes of for the first 12-24 hours. D. PAIN. For mild to average pain take over the counter Tylenol or Advil or Motrin the same as you would for a headache. You can refer to the directions on the bottle from the manufacturer. E. FOOD. Light diet is advisable during the first 24 hours. F. BONY EDGES. Small sharp bone fragments may work up through the gums during healing. These are not roots. If annoying, return to this office for their simple removal G. If any unusual symptoms occur please call Frank C Perry DDS PC Phone Number 631-654-0707 at once. H. Simple care is required for an immediate recovery. I. Soreness or pain can be for up to 2 weeks in some cases depending on the difficulty of the extraction. J. SMOKING. You should refrain from smoking for up to 72 hours after your extraction. Smoking will often triple the time it takes to heal and can cause damage and destruction to the healing site. This can cause more pain. K. MEDICATIONS. Please take all your medications as directed. If you have any questions please call the office at Frank C Perry DDS PC Phone Number 631-654-0707. L. NO SPITTING OR USING STRAWS FOR DRINKING FOR 24- 48 HOURS. M. YOU SHOULD REFRAIN FROM EXCERCISE OR HEAVY LIFTING FOR 24- 48 HOURS AFTER YOUR EXTRACTION. DO NOT EVER SLEEP WITH GAUZE IN MOUTH

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23. Does smoking increase my risk of Gum Disease?

The chemicals in cigarette smoke have been shown to harm the “helpful” bacteria that keep your gums strong. Cigarettes also lower HDL or your “good cholesterol,” which can lead to artery damage and to the decreased flow of nutrients to your gums. If you smoke, it’s probably a good idea to try and quit.

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24. How many times a day should I brush my teeth?

The American Dental Association recommends that you brush your teeth at least 2 times every day. This will help to cleanse your teeth of unwanted bacteria or the food bits on which they can feed.

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25. Does flossing fight periodontal disease?

The American Dental Association recommends that you floss at least once every day. Flossing helps stimulate your gums to rebuild themselves. Also, by scraping away plaque and other material, flossing stimulates your body’s immune system to take care of any invading bacteria, thereby helping to keep gums healthy.

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26. Can my diet affect my teeth?

A healthy diet helps your body stay in top physical condition. If you do not eat well-balanced meals every day, you may be missing important nutrients that your teeth and gums need to fight invading bacteria. Talk to your dentist or physician about how you can improve your diet for peak physical condition. If you are concerned that any of these factors could use improvement, call your general dentist or periodontist today for a checkup. Your health care provider will be better able to help you if you come to his or her office prepared with a list of things to discuss. Periodontal Treatments for Periodontal Disease Today there are several ways in which dentists and periodontists are helping patients overcome periodontal disease. Old and new therapies used together often help dental professionals address the various factors that contribute to periodontitis.

27. Gum Irrigation and Ultrasonic Therapy

  • Gum Irrigation: Dentists often use a strong stream of water to help wash plaque and bacteria off of teeth. This is done by directing the water so that it penetrates below the gum line. As the body responds to this pressure, the bond between tooth and gum is made more solid.
  • Ultrasonic Therapy: This procedure uses an instrument that directs ultrasonic vibrations through the gums and teeth. Similar to gum irrigation, this procedure strengthens tooth and gum stability and encourages your own immune cells to destroy harmful bacteria. Scaling and Root Planing (SRP) is a type of professional tooth cleaning. It removes plaque and tartar from the teeth and smoothes the root surfaces.

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28. What is Arestin®?

Arestin® (minocycline HCl 1mg) microspheres is a treatment for chronic periodontitis, an infection of the gums that can lead to tooth loss. Research has shown periodontitis may be linked to other serious diseases such as cardiovascular disease, osteoporosis, and diabetes. Microsphere technology enables extended release of the antibiotic minocycline to effectively kill the germs that cause periodontal disease.

The Arestin® Facts

  • Treatment with Arestin® (minocycline HCl 1mg) microspheres is fast, easy and doesn’t cause discomfort.
  • Treating periodontal disease with Arestin and scaling and root planing will help you manage chronic periodontist more effectively than scaling and root planing alone. You’ll also be less likely to lose your teeth.
  • Patients treated with Arestin experience minimal side effects.
  • Arestin does not require bandages or stitches.
  • Arestin is bioadhesive and bioresorbable. It will not leak, fall out, or leave anything to be removed by the dentist or hygienist in a follow-up visit.
  • Treating periodontitis with Arestin plus SRP can keep this chronic disease from progressing to the point where surgery is needed.
  • Arestin doesn’t require anesthesia because application is comfortable.

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29. Who can benefit from Arestin® (minocycline HCl 1mg)?

Most patients with periodontal disease can benefit from Arestin. However, Arestin should not be used on children and pregnant or nursing women.

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30. Is treatment with Arestin a new procedure?

The use of a locally administered antibiotic is not a new concept. For years, dentists have used antibiotics in conjunction with scaling and root planing treatments. However, Arestin, which was FDA-approved in February 2001, is the first locally-administered time released antibiotic encapsulated in microspheres to make Arestin a fast, easy treatment that doesn’t cause discomfort and has been shown to be more effective than SRP alone.

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31. Does Arestin work?

Yes, Arestin plus scaling and root planing is an effective treatment for periodontal disease compared to scaling and root planing alone. Clinical studies show that patients who received a combined treatment of scaling and root planing and Arestin maintained healthier gums and pockets versus those who were treated with scaling and root planing alone.

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32. How long does treatment with Arestin take?

In clinical trials, investigators were able to treat an average of 30 periodontal pockets, in less than ten minutes. That’s up to three sites in one minute! Treatment time for placement depends on the location and the number of periodontal pocket sites, but generally the procedure is fast, easy and comfortable.

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33. Will I have to return to the dentist to have Arestin removed?

No. Arestin does not require bandages and won’t leak or fall out. It is naturally absorbed into the gums, leaving nothing that needs to be removed by your dentist.

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34. Does treatment with Arestin hurt?

Treatment with Arestin is easy and doesn’t cause discomfort. There is no need for anesthesia, and that means no needles.

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35. Are there any side effects with Arestin?

In clinical studies, minimal side effects were reported. Those that were reported were similar to those in the placebo group. Arestin does not alter taste buds, cause teeth staining, or upset stomach.

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36. How much does Arestin cost?

The cost of Arestin treatment will vary depending upon your treatment needs. After your dentist has evaluated your oral health and discussed the treatment options, he or she can provide you with an estimate of the cost. Keep in mind that treating your gum disease today is less costly and better for your health than waiting to treat symptoms at a more advanced stage.

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37. How does Arestin® work?

Arestin® (minocycline HCl 1mg) microspheres provides dental professionals with a fast and easy way to treat periodontal disease. Arestin uses microsphere technology that delivers minocycline, a potent but low-dose antibiotic that kills the bacteria that cause periodontal disease. Minocycline is placed painlessly under the gum, directly to the infected site.If you could see them, these microspheres would look like tiny beads of many different sizes. However, they are smaller than a grain of sand and look like a yellow powder to the naked eye. Administered as a powder, the microspheres become moist from various fluids beneath the gums, they stick to the infected sites around your teeth. The moisture causes the release of the antibiotic minocycline, which can then access the bacteria in the intricate sites around your teeth, including the sites that are difficult to reach with other methods of treatment. The different sizes of the microspheres enable the medication to be continually released and fight the infection for at least 21 days. This helps control periodontitis for at least 12 months when used with SRP. Arestin is administered quickly and easily. Application is comfortable and no anesthesia is needed. Arestin does not require bandages and won’t leak or fall out or leave anything to be removed by your dentist.

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