Below are many of the services we will offer at Canyon Family Dental. The list is by no means exhaustive and, depending on the complexity of the patient's treatment or case, may be subject to referral to a specialist.
X-rays and Consultation
The most basic of services is also the most important. This is the "getting to know you" visit where such items like medical history is reviewed, any necessary X-rays are taken, and a treatment plan with options is discussed. It is the best time for patients to note any dental problems they have been concerned about as well as other needs and desires they may have for treatment. If needed, impressions for diagnostic study models are taken. We will have digital X-rays which will deliver significantly less radiation to patients than traditional X-rays.
Often going hand-in-hand with X-rays and consultation, the cleaning of teeth is the most basic preventive service. Other than cavities, a significant reason for tooth loss is the loss of gum and bone tissue around each tooth, commonly called gum disease or periodontitis. There are many factors involved in gum disease, but bacterial infection is a central cause. At this visit, the patient will receive a professional cleaning, a fluoride treatment, and guidance on how to improve their dental home care to help stave off gum disease. For patients in good dental health, this may in fact be their only visit to the office every six months as recommended. There are, however, cases where patients may have active gum disease and the cleaning may be less than routine. Such cases will play a larger role in the treatment plan and discussed with the patient.
The simplest treatment for cavities is the common filling. Here the bacteria-laden tooth structure is removed and replaced by a filling material to bring the tooth back to form, function, and often esthetics. Today in cosmetic dentistry, composite (or tooth-colored) filling materials are most frequently used and have come a long way in terms of characteristics, such as strength, from the days when amalgam (silver fillings) were more the norm. We will also offer amalgam as an alternative and slightly less expensive option due to the fact that it is still approved by such organizations as the American Dental Association.
Sometimes a cavity becomes too large to adequately treat with a filling over the long term. Other situations can arise as well such as chipped teeth missing large areas of enamel, or the need to restore and partly strengthen a tooth for function after root canal treatment (see below). In these cases a crown (also called a "cap") is recommended. Here the tooth is prepared to accept such a cap, an impression is made, and the tooth given a temporary crown until a second visit when the new permanent crown is placed and glued to the tooth. There are a number of different crowns and materials now in the dental world, but they generally can be separated into porcelain and gold. Porcelain is most often utilized in the cosmetic world and can vary in composition as well as whether to utilize a metal backing that will not be visible in the patient's mouth. Gold crowns are the more traditional standby and have characteristics very similar to natural tooth structure, but the cost of gold has skyrocketed in recent years and does not provide a natural, esthetic look that many patients desire. Please note that sometimes additional procedures may be needed prior to crown treatment. A filling-like procedure called a build-up may be required to build the crown prep to ideal form before the impression. If root canal therapy (see below) was undertaken, it is sometimes necessary for a post to be placed inside the root canal to hold the build-up (here the build-up is called a "core")--hence the post and core. It should also be noted that crowns may be attached to implant fixtures placed into the jaw bone. At this time, Canyon Family Dental will not be placing these implant fixtures and will refer them out, but we will make crowns to attach to the implants. In these cases, the preparation appointment is much simpler and without some of the procedures listed above.
Treatment for One or More Missing Teeth
There are a number of options for patients that are missing at least one tooth yet maintain a number of natural, healthy teeth. The most popular and ideal treatment today are implants. As mentioned above, these metallic structures are placed into the jawbone and resemble a tooth root on X-rays. For a single missing space, a crown can be easily made and attached to the implant, also in two appointments. However, to qualify for implants, a patient must be carefully screened for the proper bone quality and quantity, and adequate space must be available for a crown. The alternative for a single space is a fixed bridge. Here, teeth on both sides of the empty space are prepared like for crowns (the procedures and materials used are very similar) and a replacement tooth (called a pontic) is attached to each crown (called a retainer) with the pontic being in the middle. The teeth are temporized and, at the next appointment, the final bridge is glued to the prepared teeth as a single unit. Sometimes more than one pontic can be attached, but too many can render a bridge flexible. If several teeth are missing, whether in adjacent spaces and/or on the other side or the jaw, a removable partial denture is another alternative. In many ways resembling a complete denture, this device attaches most often to the natural teeth by clasps and can be removed unlike the fixed bridge. Some varieties of removable partial exist such as those with a metal framework for strength, while others are made entirely of denture resin. Several visits are usually required to make a partial and adjustments for comfort may be needed after delivery. It should be noted that implants can be used to hold fixed bridges and removable partials in place depending on the patient's case.
Bleaching and Veneers
Bleaching and veneers are the ultimate treatment in cosmetic dentistry. Most patients can bleach their teeth provided they have had a regular check up and cleaning, and have had no excessive tooth sensitivity to any prior attempts at bleaching. Some impressions are taken, bleaching trays made, then the trays and bleaching gel are given to the patient. The trays are worn for short periods during the patient's free time and results are often seen within 1-2 weeks. Veneers are essentially thin, tooth-colored porcelain shells applied most often to the front of upper anterior teeth after a minimum amount of tooth preparation. Like crowns and bridges, the teeth can be temporized and a second visit is made for final delivery. For adequate shade matching, usually 4 or 6 veneers are placed at one time. Also important to note with shades is that bleaching is highly recommended prior to placing several tooth-colored restorations. This is especially true with veneers but is also often the case with porcelain crowns, bridges, and composite fillings. These restorations will not change shade with bleaching after their placement. However, natural teeth can revert back to their old shades, so subsequent bleaching will be of use with them.
Root Canal Therapy
Deep within each tooth is its own blood and nerve supply (called the pulp) which, in health, is encased in a sterile environment away from outside insults. But in certain situations such as a deep cavity or tooth trauma, the blood and nerve supply is breached and the tooth will eventually die. The rate at which it dies and how much pain goes with it depends on the insult (and sometimes certain procedures can "buy time" for the minimally-invaded pulp), but at this point the tooth is fated to either a root canal procedure or an extraction in the long term. In root canal therapy, the tooth is opened, the diseased pulpal tissues are removed and the root canal(s) shaped with files, and then filled permanently with a rubbery material called gutta percha. The remaining natural enamel and dentin of the tooth is weakened as a result of a root canal, therefore crowns and related procedures are highly recommended in teeth bearing large chewing forces (most often premolars and molars) or any tooth with minimal remaining chewing structure. With this in mind, it must be noted that a root canal procedure can only be done if there is a reasonable chance of restoring the tooth to proper health and function.
There are many times when teeth cannot be restored back to health and function, and therefore the tooth must be extracted or "pulled". Conceptually, extractions are simple procedures as the dentist removes the tooth while protecting its surrounding tissues as much as possible. With proper post-operative and home care, the patient's body will heal the extraction socket(s). Subsequent replacement of one or more extracted teeth depends on the patient's particular case and desire.
Complete dentures (sometimes called "plates") are for patients who have no remaining teeth in the upper and/or lower jaws, or whose remaining teeth in each jaw are not fixable, suffer from advanced gum disease, or have too few remaining teeth left to support a removable partial denture. Dentures are made with either plastic or porcelain teeth bonded to a pink resin base resembling the gum tissues (similar materials and steps are used in partials). There are several appointments involved in the making of dentures, and with some variation based on immediate vs. traditional dentures, there is an impression appointment, a measurement appointment, a try-in appointment, and a delivery appointment. Many people today desire immediate dentures that are delivered right after the teeth are removed so they need not go without teeth. These can be great from a cosmetic and functional point of view, but the gum and bone tissue often require more healing time and more post-delivery care/adjustment is needed for these dentures. A traditional denture procedure incorporating the above steps can be done for patients whose teeth have already been pulled or simply desire/need a new set. A traditional route may also be taken for patients in need of extractions, but about 6 weeks of healing is recommended before impressions. If the teeth are pulled in our office or elsewhere, additional surgical procedures may be needed for the mouth to comfortably accept dentures.
While discussing some supplemental procedures involving dentures, it is important to note what dentures are and are not. It is true that a large number of people will reach a stage in their lives where complete dentures are their only viable treatment option, and dentures can indeed improve the quality of a patient's life. However, they are not a dental panacea. If the patient's natural teeth were problematic, it is quite possible that dentures will only present a new set of problems for him/her. Plates are not at all like real teeth (other than in terms of the new natural looks they give) as they are hard plastic resting on top of the soft gums and hard bone of the mouth, and there is no "feel" when chewing even if dentures are held by implants. After adequate healing time, the jaw bones continue to shrink (albeit at a slower rate) following the first 6 months to 1 year after tooth removal. The dentures then become loose, and this may require what is known as a reline (or occasionally a rebase) procedure where an impression is taken and the denture base is brought back into contact with the oral supporting tissues. While an upper denture is usually able to stay in place due to suction at the top of the mouth, lower dentures cannot do the same due to the tongue and tend to move around or "float". This may require the use of dental adhesives, especially in patients who don't desire or qualify for implants. The placement of dental implants, incidentally, not only can help both upper and lower dentures to stay in place, but also "trick" the body in thinking that teeth may still be present in the jaws. This helps maintain the supporting jaw bones and make the need for a reline much less likely while eliminating any need for adhesives. Please note that although implants are an ideal treatment for many denture patients, Canyon Family Dental will not be placing the fixtures into bone at this time, but rather referring them out. We will, however, be glad to make the dentures that snap on to such implants. With or without implants, dentures do have a tendency to rub as hard plastic comes into contact with soft gum tissue, or the bite may be a little off. Most of the time this is easily remedied through an adjustment to the denture. Of all procedures done after denture delivery, routine adjustments are very common and the patient should expect these on occasion. Dentures also wear out after a time, especially the denture teeth, and need to be remade. Ideally they should last at least five years, but there are many variables involved in denture longevity. Lastly, dentures (and implants, if applicable) require regular cleaning and general TLC, much like caring for a new crown, bridge, filling, or the natural teeth through daily hygiene procedures. Complete and partial dentures should both be removed for around 8 hours a day (usually when the patient sleeps) to allow oral tissues to rest. Experience has shown that a successful and happy denture patient is one who has not only accepted their need for dentures, but is determined to make dentures work for them despite all of the possible drawbacks.
At Canyon Family Dental, we realize that going to the dentist is not the most anticipated activity in your life. Dental anxiety also remains as common as ever. Therefore to combat this we offer laughing gas (a mixture of nitrous oxide and oxygen) inhalation and one other method by taking tablets orally. In some cases, it is permissible to combine both methods for a greater effect. Medical histories, food intake that day, and whether the patient brought someone to drive them home, etc. will need to be considered beforehand, but there are few reasons against using sedation. In rare cases, there are patients whose anxiety levels are so great that they may need to be referred to another dentist (e.g. an oral surgeon) for a higher level of sedation just so he/she can be treated, but the vast majority can relax with these simple methods. Please note that "sedation" simply allows the nervous patient to relax in the dental chair and sometimes to go into a light sleep. In most cases and situations it does not replace the need for local anesthetic injection, which removes feeling in the teeth and associated tissues, as required with many of the above procedures.
Children are welcome at Canyon Family Dental. Most pediatric procedures are variations on those listed above. The primary focus is to help children develop good lifelong dental attitudes and habits, and to maintain the health of the baby teeth and space available in the mouth for the permanent teeth to come in. Preventive services like sealants on permanent molars are emphasized. Some very limited orthodontic services (the straightening of teeth) are available as well. We do ask that children be as cooperative and communicative as possible in the dental chair or referral may be necessary.
There are few things more frustrating (and oftentimes painful) than dental emergencies. Most of these situations will be related to one or more of the above categories. We welcome the opportunity to address your emergencies at Canyon Family Dental.
Canyon Family Dental is proud to offer Six Month Smiles, a unique cosmetic system for straight teeth in less time. For more information, visit .
There are a couple of really good sources online for additional information on dental health and procedures, in many cases with pictures and videos. The American Dental Association has launched www.MouthHealthy.org, and the Academy of General Dentistry maintains an informative site at www.knowyourteeth.com among many other reputable sources online.