Preventive Dentistry

Comprehensive Exams:

A comprehensive dental exam is a special extended exam completed by your dentist prior to your dental cleaning appointment. It is designed to develop a complete picture of your dental health, as well as how your dental health may be influencing your overall health. A comprehensive dental exam is health-focused instead of problem-focused, looking beyond obvious areas of concern. Within this health focus, we will discuss the appearance of your teeth, their function and how this fits into your overall health. This comprehensive approach lets us learn much more about your oral health and have the time to discuss possibilities for maintaining and improving it.

Your comprehensive dental exam will begin with a discussion with one of our dentists, Dr. Youseph Kassar or Dr. Jordan Snyder. It is important for them to understand your questions, interests and concerns and to learn about your overall health and past dental experiences. Dr. Kassar or Dr. Snyder will then thoroughly examine your joints, muscles, tongue, gums and teeth.

• Any necessary digital X-rays
• Digital photos of your teeth
• TMJ joint screening
• Muscle screening
• Periodontal exam
• Tooth exam
• Oral cancer screening
• Cosmetic dental evaluation
• Medical history review
• Dental history review

Dental Cleanings:

Keeping your teeth and gums healthy requires cleaning and flossing them regularly at home and partnering with a dental hygienist to professionally clean your teeth. Professional dental cleaning is necessary because there are some important elements of oral hygiene that can’t be accomplished effectively at home. The bacteria that live in your mouth are responsible for gingivitis, cavities and bad breath. The hygienist will remove and disrupt the bacteria and plaque attached to your teeth below the gum line, remove hard deposits called tartar or calculus and remove food, beverage or other stains from your teeth that brushing alone won’t resolve.

• What can I expect during my dental cleaning?
  Your dental cleaning appointment will begin with a conversation so you can share any concerns or questions with one of our dental hygienists, Roger, Nicole or Whitney. We will update your medical history and any medications you are taking and take your blood pressure. Any routine and necessary digital X-rays or photographs will be taken. At every other cleaning appointment, the health of your gums will be checked by measuring the distance from the top of the gum tissue to where it attaches to the tooth, a process known as “perio charting.” The bacteria, stains and hard deposits will be removed from your teeth during several different steps. If needed, an ultrasonic scaler will be used to remove the plaque, tarter and stains gently. The ultrasonic action mechanically removes the deposits and also disrupts and kills the bacteria without damaging the tooth structure. The hygienist will also use hand instruments to continue the process of removing bacteria and stains and will also floss and polish your teeth. During this appointment, your teeth will be thoroughly checked for any dental concerns that have developed since your last visit. Based on an assessment of your risk of developing cavities or gum disease, we will make recommendations for fluoride or other special preventive treatments, as well as make recommendations for how to take care of your teeth at home.

Oral Cancer Screenings:

Oral cancer has been on the rise for several decades. For years, we assumed it mostly occurred only if you had a family history, poor nutrition or were a tobacco user. Today we understand that even the healthiest of us can get oral cancer. The most common cause of oral cancer is a virus that 95% of adults have been exposed to. The good news about oral cancer is that if detected early, most forms respond very well to treatment.

• Preventive Oral Cancer:
  There are two keys in the battle against oral cancer: Prevention and early detection. The virus that causes most oral cancers is the human papillomavirus (HPV), which can be prevented with a vaccine. Children and teens today should be vaccinated against the HPV virus. This vaccine is available at MCHD Clinical Services, and an appointment can be made by calling 304-598-5119.
  
  After vaccination, the most important thing we can do is increase early detection. At your dental exam and professional cleaning appointments, we will complete an oral cancer screening.
• Oral Cancer Screening:
  Oral cancer strikes three times as many victims as cervical cancer. It is one of the few types of cancer that has not seen a significant reduction over the past thirty years. Recent research has shown a strong association with human papillomavirus (HPV), which can be sexually transmitted. For this reason, many oral health care professionals now believe that all individuals over the age of 18 should have at least an annual comprehensive oral examination and ideally at every dental hygiene visit.
• What if a suspicious area is detected?
  A referral to an oral surgeon for further diagnosis and treatment will be given if a suspicious area is detected during your oral cancer screening.

Fluoride Treatments:

Everyone’s risk of developing cavities is different. Your risk depends on many factors, such as genetics, diet, home care, age, medications and overall health. Some of these factors are within your control and others are not. Preventing cavities is really a balancing act of managing the risk factors and increasing prevention.

Fluoride treatment is a very effective way to prevent cavities. On a microscopic level, fluoride actually replaces calcium in your teeth and is much harder for the bacteria to dissolve, making your teeth stronger. Many of our patients of all ages find they are getting new cavities despite good home care and regular cleanings. When this happens we work with them to add more preventive measures until the scale tips in their favor. A fluoride treatment after your dental hygiene visit is a highly effective and economical way to reduce your risk of getting new cavities. When you are in our office, we will help determine whether the application of fluoride is appropriate to combat your risk factors.

• What to expect with a fluoride treatment
  A fluoride “varnish” will be applied to your teeth at the end of your professional dental cleaning using a small brush. The fluoride should be allowed to stay on your teeth for several hours to allow maximum effectiveness.
• Following a fluoride treatment:
  You will be instructed not to brush or floss for four-six hours following the application of fluoride varnish. You can drink water and other cold beverages, but maintain a soft diet and avoid hot liquids and beverages containing alcohol, including mouthwashes and rinses, during the treatment period. It is also important not to eat hard, crunchy or sticky foods that will displace the fluoride from your teeth.

Dental Sealants:

Despite our ability to treat cavities, preventing them from occurring is a better approach. We have many ways to help you assess your risk of getting a cavity as well as prevent them. A dental sealant can prevent the most common type of cavity which forms in the grooves of a tooth.

As teeth form, the enamel folds into grooves on the chewing surface. These grooves are a place where the bacteria can hide from our toothbrushes and cause a cavity even when we have very good home care. When we place a dental sealant on your tooth, the surface is etched and a plastic resin flows into these grooves. The resin is then hardened with a UV light and the groove is sealed against the bacteria.

• Who should have dental sealants?
  Sealants are for anyone who has grooves in their teeth that can harbor the bacteria and present a risk of getting a cavity. We will discuss with you your cavity risk level and whether the grooves in your teeth are deep enough to warrant sealants. Most insurances cover the placement of sealants for children, but adults can benefit as much as children.
• How long do dental sealants last?
  The answer is different for everyone, but they do have a predictable lifespan from about three to 10 years, depending on the patient. They normally wear down, so they do not disappear all at once. At the end of the lifespan of your sealants, we will reassess your risk level for cavities and whether replacement sealants are recommended.

Digital X-rays:

How often do I need X-rays?
Our office uses the latest low-exposure digital radiograph technology and we take only the minimum X-rays necessary to effectively diagnose your oral health. There are many types of dental X-rays and they each have different diagnostic purposes. A panoramic X-ray is excellent for making sure all of the teeth are in place in growing children, looking at wisdom teeth and checking the upper and lower jaws for fractures or tumors. A “periapical” X-ray is used to show the dentist the entire tooth, including the root, to check for cavities, infections and root fractures. “Bitewing” X-rays show only the portion of the tooth visible in your mouth and are used to check for cavities between the teeth. The loss of supporting bone from periodontal disease is also visible. While we use the lowest radiation levels possible, patients can feel reassured when having digital X-rays taken because our providers place a lead apron over you before exposing your teeth.

Which X-rays you need and how often they are taken is determined on an individual basis. Factors such as your age, the health of your mouth, your risk of cavities and gum disease and your current dental work determine what is needed. Sometimes your insurance will need a certain image to determine coverage for a procedure. During your initial comprehensive exam appointment and subsequent dental cleaning appointments, we will recommend any necessary X-rays and discuss the reasons with you to ensure you are fully informed.

Custom Mouth/Night Guards:

Custom mouth guards are a device worn over the teeth that can serve numerous purposes. Many athletes wear a mouth guard to protect their teeth during athletics. You may also wear a custom mouth guard as a treatment for TMJ/TMD, sleep apnea or to protect your teeth from grinding (bruxism) at night. There are many types of mouth guards that can be purchased in drugstores and sporting goods stores. But there are many advantages to having a mouth guard custom-made by a dentist.

• Why choose a custom mouth guard over a store-bought?
  A dentist can help you make sure a mouth guard is the right treatment for you and that the fit is correct and won’t cause joint, muscle or teeth problems. Most of the mouth guards you purchase in a store are fit to your teeth after softening the plastic in hot water and then biting into the material as it cools. Often this results in a very poor fit. This poor adaptation to your teeth can make the mouth guard uncomfortable to wear and ineffective. Custom mouth guards will fit precisely over your teeth and stay in place during sports or while you are sleeping. Most patients report that they find store-bought mouth guards uncomfortable and bulky in comparison to a custom-made device.
• How is a custom mouth guard made?
  At your appointment, impressions of your teeth will be taken so that we can create a model of your teeth. This model has then been used to custom-form the mouth guard material. Either at the same time or at a separate appointment (depending on the type of mouth guard), the mouth guard is fitted to your teeth and adjusted so that your other teeth can rest comfortably against it.
• How long do they last?
  Custom mouth guards are very durable and can last for years. They only require simple cleaning using a toothbrush with mouthwash or water. Toothpaste should not be used to clean your mouth guard, as it can break down the plastic.

Silver Diamine Fluoride (SDF)

Silver diamine fluoride (SDF) is an antibacterial liquid that is applied to the tooth surface to stop the tooth decay process. SDF can also be used to treat tooth sensitivity. SDF application every six to 12 months is necessary to make sure the decaying process and sensitivity have stopped completely.

SDF application:

1. Dry the affected area.
2. Place a small amount of SDF on the affected area with a small brush.
3. Allow SDF to dry for one minute.
4. Rinse.
5. Treatment with SDF does not eliminate the need for dental fillings or crowns to repair function or esthetics. It only bides some time for an adolescent patient to mature in age or for the primary tooth to exfoliate on its own.

• Contraindications:
  Your provider will make sure that SDF is not contraindicated for application. If you have an allergy to silver, SDF cannot be applied. Also, if the patient has any painful sores or raw areas anywhere in the mouth, SDF will not be applied until the sores have healed.
• What will my tooth look like after SDF is applied?
  Once SDF is applied your tooth will turn a dark almost black color. This is good as it means the decay process has stopped or that the cavity has been arrested. When the tooth is restored with a crown or filling, you will never know that SDF was applied. Sometimes the dark color can transfer to the gingival tissues and other tooth surfaces that are not decayed during application. This will wear off with time and is no cause for alarm.