Services

Gum Disease (Periodontal) Therapies

What is periodontal disease?
Periodontal disease is a bacterial infection of the gum tissue surrounding the tooth, resulting in destruction of the supporting bone and attachment fibers. The earliest stage of periodontal disease, known as gingivitis, is probably the most common disease affecting the human body. At Sonne and Shapiro Dental, we take periodontal disease VERY seriously! In fact, we now have a periodontist (Gum Specialist), Dr. Mark Isler in our office to help provide the best possible care.

Periodontal disease and your health
Periodontal disease may affect more than just your teeth; it may affect your overall health! Many recent studies have indicated a very strong correlation between the severity of periodontal disease and risk for cardiovascular disease. In fact, according to the American Academy of Periodontology, “researchers have found that people with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without periodontal disease.” In addition, periodontal disease has been shown to have a strong correlation to the incidence of:

Heart Attack
Stroke
Adult onset diabetes
Preterm, low birth weight infants

Previously, treatment of periodontal disease focused solely on maintaining a healthy dentition. Now, treatment may be just as important to maintain your overall health!

For more information on the influence of periodontal disease and your health, please visit the American Academy of Periodontology at www.perio.org.

Treatment of Periodontal disease
At Sonne and Shapiro Dental, we focus on the early detection and treatment of periodontal disease. When diagnosed early, treatment is relatively simple, and involves removing the harmful bacteria from the tooth surface (in the form of plaque and tartar), providing proper oral hygiene instruction, and by treating conditions that encourage gum disease. It may also be necessary to replace defective dental restorations to allow the gum therapy to be successful. When periodontal disease becomes advanced to the point that gum attachment is lost, further procedures are required.

Scaling and Root Planing
At Sonne and Shapiro Dental, scaling and root planing is the primary non-surgical therapy for periodontal disease. During this procedure, the root surface of the tooth is carefully cleaned to remove bacterial toxins, plaque and calculus (tartar) from the depth of the periodontal pocket. This can then be followed by the use of our dental laser and often with the placement of local antibiotics into the affected area.

Laser Assisted Periodontal Therapy (LAPT):
The use of the Dental Laser in periodontal therapy is a causing tremendous excitement in the dental profession! Using our dental laser, Dr. Sonne and Dr. Shapiro can more effectively destroy the harmful bacteria responsible for periodontal disease. This often results in dramatic improvements in reduction of pockets and bleeding around teeth, that otherwise would not be seen without surgery!

Antibiotics
It is important to remember that periodontal disease is a bacterial disease and the key to controlling or eliminating it is the effective reduction or elimination of the harmful bacteria. An adjunctive option to scaling and root planing and LAPT may be provided in the form of an antibiotic, known as Arestin, applied painlessly under the gums directly to the affected area. When used together with scaling and root planing and the dental laser, Arestin significantly reduces the depth of infected pockets and helps prevent disease progression. A combined therapy of Arestin plus scaling and root planing and the dental laser is more effective at fighting periodontal disease than scaling and root planing alone. Arestin has been shown to be particularly even effective in the more difficult to treat patients such as smokers or people who have cardiovascular disease.

To learn more about Arestin, please visit: http://www.arestin.com/c_about.asp

Bite Splint Therapy
Studies have shown that night time grinding and clenching (bruxism) can deliver up to 9 times the amount of force than that exerted to the teeth during the day. These excessive forces result in gum recession, tooth wear and failure of restorations. When combined with periodontal disease, bruxism can accelerate destruction leading to premature tooth loss. To prevent the damage caused by bruxism (and daytime clenching), a custom bite guard or splint can be fabricated. Bite splints are removable devices that fit over upper or lower teeth, protecting teeth surfaces and relaxing tense jaw muscles.

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An antibacterial mouth rinse also may be prescribed to help control the harmful effects of and reduce bacterial plaque.

Sleep Apnea and Snoring Treatment

Do You Snore? Do You Always Feel Exhausted? Do You Suffer From Frequent Headaches? Do You Grind Your Teeth? You Might Suffer From Sleep Apnea!

Now, Oral Sleep Appliances Can Offer A Way to Save Your Life…And Your Marriage!

Obstructive Sleep Apnea (OSA) affects more than 20 million Americans can be life threatening! IOSA occurs when the soft tissues surrounding the airway collapse, resulting in a cessation of breathing often lasting several seconds at a time. In an amazing life saving maneuver to prevent suffocation and death, the oxygen deprived brain arouses the individual from sleep to take a massive, loud gulp of air, allowing the individual to fall back to sleep. For those that suffer from OSA, this cycle can occur as many as 100 times an hour, resulting in severe sleep deprivation, and daytime exhaustion! If left untreated, OSA can result in: high blood pressure, heart attack, stroke, depression, muscle pain, fibromyalgia, morning headaches, and excessive daytime sleepiness.

Unfortunately, while most people with sleep apnea are aware that they snore and feel overtired or fatigued, most are completely unaware of potentially serious medical problems which may exist. Indeed, OSA is often mistaken for excessive snoring and is ignored for years!

Excessive snoring or OSA also has a tremendous impact on one’s spouse. Recently, a condition known as "secondary snoring" has been researched, and has been shown to cost the bed partner of a snorer an average of 1.5 hours of sleep each night. Snoring, in fact, has also been shown to be a leading cause of divorce!. In fact, snoring is so common that about 30% of American couples sleep in separate beds!!!

Click here to read more.

Cosmetic Makeovers

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Veneers

Porcelain veneers are thin shells of ceramic that bond directly to the front surfaces of the teeth. This procedure requires little or no anesthesia, and can be the ideal choice for improving the appearance of the front teeth. Porcelain veneers are placed to mask discolorations, to brighten teeth, and to improve a smile. Highly resistant to permanent staining from coffee, tea, or even cigarette smoking, the wafer-thin porcelain veneers can achieve a tenacious bond to the tooth, resulting in an esthetically pleasing naturalness that is unsurpassed by other restorative options.

Case 1

Before After

Patient presented with large discolored fillings, misaligned teeth and unsightly white spots. The teeth were also rather dark in color overall, necessitating whitening.

Before After

After veneers are placed. The color, shape and alignment of the teeth are dramatically improved!

Why a porcelain veneer?

Veneers are a fantastic way to fix front teeth. You can whiten your teeth, close spaces, and create a great smile. We can even do virtually instant orthodontics to straighten crooked teeth.

Spaces between the teeth (diastemas)
Broken or chipped teeth
Unsightly, stained or washed out fillings
Permanently stained or discolored teeth
Misshapen or crooked teeth
Whiten dark yellow or stained teeth

Have you ever wished you had better-looking teeth without all the hassle of braces (orthodontics) or crowns (caps)? NOW YOU CAN! Porcelain veneers are the answer for instant orthodontics to straighten smiles, close spaces, reshape, and accomplish minor realignment of your teeth. You can even have that "Hollywood" smile you've always wanted.

Porcelain veneers are an excellent alternative to crowns in many situations. They provide a much more conservative approach to changing a tooth's color, size, or shape. Porcelain veneers can mask undesirable defects, such as teeth stained by tetracycline, by an injury, or as a result of a root-canal procedure, and are ideal for masking discolored fillings in front teeth. Patients with gaps between their front teeth or teeth that are chipped or worn may consider porcelain veneers.

Generally, veneers will last for many years, and the technique has shown remarkable longevity when properly performed, often far surpassing the longevity of traditional white filling materials.

Placing custom veneers requires a high degree of technical skill as well as attention to cosmetic detail. We place veneers routinely, and design each case individually to match and enhance the characteristics of each patient's smile.

Case 2

Prior to preparation, this patient presented with a large, yellow filling on her upper left lateral incisor, uneven tooth lengths and uneven colour patterns patterns. After carefully sculpting the gum tissues to lengthen the teeth, four veneers were fabricated, immediately improving the appearance.

Before After

What happens during the procedure?

Patients need three appointments for the entire procedure: diagnosis and treatment planning, preparation and temporization, and bonding.

Diagnosis and treatment planning: It's critical that you take an active role in the smile design. We spend time in the decision-making and planning of the smile, determining what your esthetic goals are and discussing all treatment options. Often, we make impressions (molds) of your teeth and create a mock-up on stone models to help determine the appropriate treatment.

Preparation of teeth: This appointment will usually take from one to two hours, during which time the teeth are lightly buffed to allow for the small added thickness of the veneer. Usually, about a half a millimeter of the tooth is removed, sometimes necessitating the use of local anesthetic. At this appointment, an impression is made of the teeth, which is sent to the laboratory for the fabrication of the veneers. In order to give the laboratory the greatest amount of information, and ensure the best possible result, we also send digital photos demonstrating the color and translucencies of the teeth.

Temporization: We believe that from the moment we prepare your teeth you should see a dramatic improvement in your appearance. Therefore, after preparation, we take time to carefully craft provisional or temporary veneers using tooth colored acrylic materials. This serves to not only protect the teeth and prevent sensitivity but also to enhance your smile, and help provide you a preview of the final result, demonstrating the shape, size and color. Once the provisional veneers are crafted, we often make an impression of these and take digital photographs to communicate our desires to the laboratory.

Bonding of veneers: This appointment will take about one or two hours. After carefully removing the provisional veneers, we try on the new porcelain veneers, assessing their fit, shape, and color. After making any adjustments, the veneers are bonded to the teeth using the appropriate color, and are polished to a high shine. Once bonded, the veneers are incredibly strong, permitting you to eat and drink immediately.

Root Canals

Root canal therapy is one of the most common procedures in dentistry today, and is a means of saving teeth that were once extracted. Our office uses the most advanced technology and techniques available to make root canal therapy comfortable and predictable.

Root canal therapy is necessary when the pulp (nerve and blood supply which resides in the roots) of the tooth becomes infected or inflamed. The most common cause of inflammation is bacteria, which may enter a tooth through decay or a crack. Pulpal inflammation often results in a severe tooth ache as the damaged nerve tissue swells within the tooth. Swelling and discomfort may also occur as the bacterial toxins escape into the surrounding ligament and bone, causing bony destruction, and may spread to other areas of the head and neck. For these reasons, once a diagnosis is made, it is critical to initiate root canal therapy as quickly as possible.

While bacterial infection often causes dental pain, it is also common for infected teeth to exhibit no painful symptoms. In many cases, the only sign of infection is bony destruction found on an X-Ray.

During root canal therapy, the infected pulp is carefully removed and the inside of the tooth is disinfected. Once this is completed, the root canals are sealed with a special filling material. As a final treatment, a crown restoration is usually placed to prevent fracture of the tooth. While some discomfort may occur after root canal therapy, it is usually minor and diminishes within a few days of the procedure.

Once a feared procedure, root canal therapy is now a comfortable, safe and predictable means of saving teeth.

Crowns

Crowns, often called “caps”, are dental restorations that are placed over the tooth. As such, crowns can greatly increase the strength of the tooth. Crowns can be made of a variety of materials, including porcelain or gold, with the choice of material for the crown selected specifically according the patient’s esthetic and functional needs.

BEFORE	AFTER

Crowns are recommended for a variety of reasons:

Large failing restorations- as a general rule, when more filling material is present than sound tooth structure, a crown is often required to prevent tooth fracture. Large, old silver feelings are very typical of this
Fractured or cracked teeth – teeth that have already suffered a fracture usually require a crown to properly restore the tooth to its proper form and function and prevent further propagation of the crack
Root canal therapy – teeth that have had root canal therapy usually require a crown to prevent fracture of the tooth
Severely worn teeth – crowns can easily restore worn teeth to their natural length and appearance

BEFORE	AFTER

BEFORE	AFTER

Partial Crowns and Onlays

Because it is always preferable to preserve healthy tooth structure, we often recommend partial crowns (also called ¾ crowns or onlays) rather than full crowns. Partial crowns are ideal when large fillings compromise only a specific area of a tooth, or when a small amount of tooth breaks off. Like full crowns, partial crowns can be made of porcelain or gold.

BEFORE	AFTER

Bridges

A bridge is a dental device that fills a space that a tooth previously occupied. A bridge may be necessary to prevent:

Shifting of the teeth that can lead to bite problems (occlusion) and/or jaw problems and resultant periodontal disease.
Bridges safeguard the integrity of existing teeth and help maintain a healthy, vibrant smile.

There are three main types of bridges, namely:

Fixed bridge- this is the most popular and consists of a filler tooth that is attached to two crowns, which fit over the existing teeth and hold the bridge in place.
The “Maryland” bridge is commonly used to replace missing front teeth and consists of a filler that is attached to metal bands that are bonded to the abutment teeth. The metal bands consist of a white-colored composite resin that matches existing tooth color.
The Cantilever bridge is often used when there are teeth on only one side of the span. A typical three-unit cantilever bridge consists of two crowned teeth positioned next to each other on the same side of the missing tooth space. The filler tooth is then connected to the two crowned teeth, which extend into the missing tooth space or end.

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An antibacterial mouth rinse also may be prescribed to help control the harmful effects of and reduce bacterial plaque.