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General Dentistry

Dental Exam

The secret to a bright, healthy smile is actually no secret at all: brush, floss and get a professional dental exam at least once every six months. 

Professional dental exams are all about prevention – preventing existing problems from getting worse and preventing dental problems from developing in the future. Regular dental exams make it possible to identify and treat a problem in its earliest stage – which is not only good for your oral health but also good for your budget!

There's nothing to fear with a dental exam with Dr. Mohindra. Your teeth will be visually examined for signs of plaque, tartar and tooth decay. Your gums will also be examined for puffiness or discoloration, which are signs of gum disease. A full set of dental X-rays may also be taken during your dental exam, to enable your dentist to see below the surfaces of your teeth. Dental exams typically end with a dental cleaning, to remove surface stains and buildup.

 

Teeth Cleanings & Preventions

No matter how often you brush and floss, plaque and tartar deposits can still build up on your teeth. A professional teeth cleaning is the single most effective way to remove these deposits and prevent them from causing more serious problems in the future. While a traditional teeth cleaning involves manually scraping away these deposits with special dental tools, advances in dental technologies now give you more options for teeth cleanings.

A deep cleaning may be recommended if excessive plaque and tartar deposits have developed below the gum line. Deep cleanings, also known as scaling and root planing, involve a two-part process: first, the stubborn deposits are removed, and then the root surfaces are smoothened. A deep cleaning helps prevent periodontal disease and restores gum tissues to a healthy state.

Knocked out Tooth

 

With timely action and some knowledge, a tooth that has been completely knocked out of its socket often can be successfully reimplanted and last for years. However, you need to know what to do in case this happens to you or someone with you. Time is of the essence so act quickly but knowledgeably. Please follow these few steps if a tooth gets knocked out:

Pick up the tooth by the crown, which is the chewing surface, and not by the root. If the tooth is dirty, hold it by the crown and rinse it gently with water. Your goal is simply to remove the dirt from the surface of the tooth. Do not use any soap or chemicals, do not scrub or dry the tooth and do not wrap it in a tissue.

Next, place the tooth back in the socket as soon as possible. The sooner the tooth is back in its original position, the better the chances it will have to survive. Place the tooth back in the socket with your fingers or place it above the socket and slowly close your mouth. Hold the tooth in place with gentle biting pressure or with your fingers.

If you can't get the tooth back in the socket, the tooth must be kept moist by placing it in either milk, inside your cheek or you can use a tooth preservation kit available at your pharmacy. The last option is to place the tooth in water with a little pinch of salt.

Call us right away! If we can see you within 30 minutes, we can begin the process of trying to save the tooth.
 

Scaling and Root Planing

We remove the plaque through a deep-cleaning method called scaling and root planing. Scaling means scraping off the tartar from above and below the gum line. Root planing gets rid of rough spots on the tooth root where the germs gather, and helps remove bacteria that contribute to the disease.
 

Medications

Medications may be used with treatment that includes scaling and root planing, but they cannot always take the place of surgery. Depending on the severity of gum disease, we may still suggest surgical treatment. Long-term studies will be needed to determine whether using medications reduces the need for surgery and whether they are effective over a long period of time. Here are some medications that are currently used:

Medication What is it? Why is it used? How is it used?
Prescription antimicrobial mouthrinse A prescription mouthrinse containing an antimicrobial called chlorhexidine To control bacteria when treating gingivitis and after gum surgery It's used like a regular mouthwash.
Antiseptic "chip" A tiny piece of gelatin filled with the medicine chlorhexidine To control bacteria and reduce the size of periodontal pockets After root planing, it's placed in the pockets where the medicine is slowly released over time. 
Antibiotic gel A gel that contains the antibiotic doxycycline To control bacteria and reduce the size of perodontal pockets We place it in the pockets after scalin and the root planing. the antibiotic is realeased slowly over a period fo about seven days. 
Antibiotic micro-spheres Tny, rund particles that contain the antibiotic minocycline To control bacteria and reduce the size of periodontal pockets We place it in the micro-spheres in the pocktes after scaling and root planing. The prticles realease minocycline slowly over time. 
Enzyme suppressant A low dose of the medication doxycycline that keeps dextrutive anzymes in check To hold back the body's enzume response -- If not controlled, certain enzymes can break down gum tissue This medication is in pill form. It is used n combination with scaling and root planing. 

 

Bone Grafting

  

Bone grafts are used to fill in a defect where the bone is missing around the teeth or where bone is needed for implants. The catch 22 with dental implants is that you need bone to support the implant but the reason must people need an implant is that they lost their tooth or teeth due to a lack of bone. In cases where there is a lack of bone, it is necessary to create bone through bone grafting. Bone grafting procedures can be used to build up or fill in jawbone defects allowing the placement of dental implants. These techniques represent some of the greatest advances in modern dentistry. There are generally four types of bone grafts used:

Autografts

Autografts are those where the bone to be grafted to the jaw is taken, or harvested, from your own body. The donor site, which is where the bone is harvested from, is usually the mouth or the hip. This is your own bone and is very compatible with your body. Autografts are generally the best graft technique and usually result in the greatest regeneration of missing jawbone.

Allografts

Allografts are taken from human donors. Many countries have donor programs where you can specify that in the event of your death, parts may be harvested from your body to save or improve the life of others. Heart transplants are one type of allograft. This can represent one of the greatest "gifts" you can ever give. Bone obtained in this manner undergoes rigorous tests and sterilization. Your body "converts" the donor bone into your natural bone, thereby rebuilding your resorbed jawbone.

Alloplastic

Alloplastic grafts are inert, manmade synthetic materials. The modern artificial joint replacement procedure uses metal alloplastic grafts. For bone replacement a man made material that mimics natural bone is used. Most often this is a form of calcium phosphate. Depending on how it is made, it may be "resorbable" or "non-resorbable." That is, your body may or may not replace the alloplastic graft with your natural bone. In those cases where it is not replaced it acts as a lattice or scaffold upon which natural bone is built. In either case, the end result is to create enough bone for the placement of dental implants.

Xenografts

Xenografts are harvested from animals. The animal bone, most commonly bovine (cow), is specially processed to make it biocompatible and sterile. It acts like a "filler" which in time your body will replace with natural bone. After this replacement process is complete dental implants may be placed to support the missing teeth.

Crown Lengthening

This procedure is typically needed for one of two reasons; either cosmetic or restorative. Crown lengthening can cosmetically improve the smile line by eliminating the "gummy" smile look. The restorative reason is to provide more tooth to be visible in the mouth so the tooth can be properly restored. When a tooth breaks off near the gum line or when decay occurs on the root surface crown lengthening is needed to properly restore the tooth. Crowns and/or bridges cannot be cemented with the edge of the crown near the bone, which is why crown lengthening is needed.

When performing a crown lengthening procedure, the gum and bone around the area needing treatment is reshaped to expose more of the natural tooth. For cosmetic procedures, one tooth can be treated to provide an even appearance at the gum line, or what we call the whole smile line can be treated to create a natural smile line.

If the procedure is needed to restore a tooth that is decayed or fractured near the bone, then the area around the defect is treated. The only other option would be extraction of the involved tooth.

Please see the Periodontal Gallery (links to: http://smileworks.dds.com/smile-gallery/periodontal-gallery/) for the types of treatment that can be accomplished.
 

Gum Disease Treatment

Root Canal

Pericoronitis

Pericoronitis is a common problem that occurs around an erupting wisdom tooth that typically does not have enough room and it most commonly occurs on lower wisdom teeth. It literally means inflammation around the crown. A piece of gum tissue appears over the biting surface of the tooth, which is very difficult to clean. Debris collects under the flap and, when the debris is not removed, the gum becomes inflamed. The gum can also become inflamed if the top tooth catches the flap of tissue during chewing. In most cases pericornitis is treated with an antibiotic for a few days and when the infection has decreased, the wisdom tooth is removed.

Pediatric Dentistry

What is pediatric dentistry?
    Do you have to be a pediatric dentist to treat children?
    Do I need to brush my children's teeth?
    When should I take my child to the dentist for the first time?
    If baby teeth eventually fall out, why are they important?
    How do thumb sucking and pacifier habits harm teeth?
    I did not give my baby candy but he still has decay. How did that happen?
    How often do children need to visit the dentist?
    Is toothpaste good or bad for children?
    Should baby teeth be sealed?
    What should I do if my child has an accident and knocks out a tooth?

What is pediatric dentistry?

Pediatric dentistry is the branch of dentistry that deals with infants, children and adolescents including those patients with special care needs.

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Do you have to be a pediatric dentist to treat children?

No you don't. However, a pediatric dentist attends a post graduate program after dental school for two to three years to learn more about the specific needs of young dental patients.

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Do I need to brush my children's teeth?

Yes because children develop plaque just like adults do and it must be removed on a daily basis so it does not lead to tooth decay. Use a soft-bristled toothbrush that will fit into the child's mouth at least once a day to begin with when they are very young and at least twice a day by the time most of the baby teeth have erupted.

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When should I take my child to the dentist for the first time?

You should schedule an appointment around the first birthday so that we can check for good oral hygiene, cavities and any developmental or congenital abnormalities.

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If baby teeth eventually fall out, why are they important?

Baby teeth are very important because they serve many of the same purposes of adult teeth such as tearing and chewing food and helping the child speak properly. Additionally, they hold the place for adult teeth. If baby teeth are lost prematurely, an appliance called a space maintainer is needed to prevent the remaining teeth from shifting into the space of the lost tooth.

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How do thumb sucking and pacifier habits harm teeth?

There is not much difference between the two habits and they only become a problem if the baby teeth start to get displaced or if the habit continues after the adult teeth have erupted. Read more about thumb sucking and pacifiers.

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I did not give my baby candy but he still has decay. How did that happen?

Decay is not only caused by candy; it can be caused by most foods or liquids other than water that do not get removed from the surface of teeth. Infants and children are at the mercy of their parents. If a toddler is continuously given a bottle with almost anything other than water at bedtime, they will probably develop baby bottle caries, which is decay on the front teeth. Do not give a bottle with anything other than water and get in the habit of brushing your child's teeth on a regular basis.

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How often do children need to visit the dentist?

Children should visit a dentist every six months. We like to catch anything when it is small and by seeing the child every six months gives us the best chance to keep an eye out for any signs of early decay. Additionally, since teeth start coming and going, we like to have a history of each patients dental development.

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Is toothpaste good or bad for children?

Fluoridated toothpaste should not be used for children under age 2. After that time, parents should be in charge of dispensing the toothpaste and the amount to be used each time should not be bigger than the size of a pea. Make sure the children spit the toothpaste out instead of swallowing it. It is not dangerous if they swallow it once or twice but do not let it become a habit.

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Should baby teeth be sealed?

Baby teeth should be sealed if they have deep pits and fissures meaning that they will probably decay without a sealant. Read more about sealants.

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What should I do if my child has an accident and knocks out a tooth?

Please read how to save a knocked out tooth.

Flouride Treatments

Dental decay is a common condition all over the world. One way to help prevent cavities from occurring is through the use of fluoride.

Fluoride helps harden the tooth enamel and make it more resistant to tooth decay. A small cavity can be stopped and even reversed by the remineralization process enhanced by fluoride.
Fluoride can be delivered to the teeth in 2 ways: topically (direct contact on the teeth) and systemically (enters the blood stream).

 

Systemic Fluoride

Systemic fluoride is delivered to the tooth surface via the bloodstream. Systemic fluoride can be derived from a food source, water source, or dietary supplements (pill, tablet, lozenge, drop). Fluoridated water is an effective way to reduce the problem of dental decay. It has been shown that fluoridated water and dietary supplements can reduce up to 60% of tooth decay.
Some water supplies naturally contain fluoride, but for others fluoride is added to the water supply. If you would like to know if your community's water supply contains fluoride, call your local water or health department.

Children from birth to 16 years of age will benefit the most from systemic fluoride. Sixteen is currently the age at which the American Dental Association recommends children can discontinue fluoride vitamin supplements. This is because when fluoride is ingested, it circulates through the bloodstream and into developing teeth. The fluoride is then built into the enamel structure of the developing tooth, making the tooth more resistant to acids.

 

Topical Fluoride
Even though the benefits of fluoride are maximized before the teeth erupt (come in), fluoride is still very beneficial for children and adults after the teeth are fully erupted. Topical fluorides are applied directly to the tooth structure to delay or slow down the tooth decay process.

Topical forms of fluoride include:

 • Toothpaste - used daily, must have an ADA or CDA Seal of Acceptance on the label .
 • Professional fluoride application - this is a gel that is applied for 1 to 4 minutes, usually in a tray at the end of a dental appointment. Not everyone is given a professional fluoride application; it depends on your oral health needs.
 • Fluoridated home mouthrinses - can be purchased over-the-counter and used for children over 6 years of age and adults who are susceptible to cavities.
 • Home care fluoride gels - applied by trays or by brush, these gels are for those who are highly susceptible to cavities. These people would include:

 • Adults with a high incidence of root cavities.
 • Those who experience an extremely dry mouth.
 • People who wear braces or orthodontic appliances.
 • Those who have rampant or excessive cavities.

Even though the benefits of fluoride are maximized before the teeth erupt, fluoride is still very beneficial as a daily defense against decay. Fluoride gels can be purchased over-the-counter or by prescription. Ask us for a daily home fluoride program that is individualized for your needs.

 

Fluoride Safety
 • Fluoride is very effective in controlling dental decay when used properly. If not used in the proper doses, fluoride toxicity and dental fluorosis can occur.
 • Fluoride toxicity occurs when large amounts of fluoride are ingested over a short period of time. This can be dangerous to your health.
 • Symptoms of fluoride toxicity may include nausea, diarrhea, vomiting, abdominal pain, increased salivation or increased thirst.
 • These symptoms generally begin 30 minutes after ingestion and can last up to 24 hours.
 • Depending on the amount of the toxic overdose of fluoride, certain emergency procedures should be implemented. If you feel nausea, drink milk or try to induce vomiting and call us or physician. If these symptoms do not subside, or the conditions worsen (difficulty breathing), call an emergency service to transport you to the hospital.
 • Dental fluorosis is an excess of fluoride intake during the stages of tooth development. Dental fluorosis ranges from mild (white specks on teeth) to severe (brown staining and pitting of enamel).

To ensure your child does not experience any adverse effects from fluoride, follow these basic rules:

 • Fluoridated products should not be swallowed.
 • Only a small amount of toothpaste, the size of a small pea, is needed for a child.
 • Fluoridated products, especially mouthrinses should not be given to a child under 6 years of age, or to anyone who cannot rinse and spit ( those you suspect are swallowing some of the product).
 • Keep fluoridated products out of reach of children.
 • Parental supervision is needed for children when brushing or using any fluoridated substances.

Bruxism & Mouthguards

Sealants

  Sealants are thin plastic coatings applied in the dental office on the chewing surfaces of back teeth, which are prime spots for cavities. Sealants act as a barrier to prevent bacteria and food from collecting and sitting on the grooves and pits of teeth.
    • Sealants are best suited for permanent first molars which erupt around the age of 6 and second molars that erupt around the age of 12. It is important to have the sealant applied as soon as the tooth has fully come in. They are also indicated on the pre-molars if there are deep pits and fissures present.

    • Before the sealant material is applied, the tooth surface is prepared by cleaning with a dental solution that helps the sealant stick to the tooth by penetrating the enamel.

    • Sealants may last for several years once applied, but should always be examined at the child's regular checkup. Even if the sealant becomes lost, the material that has penetrated the enamel will still provide protection. Sealants are easily replaced if lost.

    • Sealants are nearly 100% effective in preventing decay in the chewing surfaces of the back teeth. Fluoride helps fight decay on the smooth surfaces of the teeth.

In-Office CT Scan (3D Cone Beam)

More and more orthodontists, oral surgeons and other dental specialists are using a new dental imaging technology called 3D cone beam scans – and for good reason. 3D cone beam scans produce high-quality 3D images of teeth, teeth roots, jaws and even the skull. These 3D images allow dental professionals to identify potential problems that oftentimes go unnoticed with traditional dental images. 3D cone beam scans have benefits for patients, too: they emit far less radiation than traditional dental X-rays!

In-Office CT Scan (CAD CAM)

Dental visits will never be the same, thanks to the development of high-tech dental technologies such as the CAD CAM (Computer Aided Design/Computer Aided Manufacturing). With CAD CAM technology, dentists can take high-quality images of the teeth and use those images to design a premium dental restoration on a computer – all in one visit! CAD CAM takes less time, reduces discomfort and produces outstanding results.