Dental Topics

An abscessed tooth is usually sensitive or painful. The discomfort is what normally alerts the patient to the problem. Occasionally, an abscess may be detected on an x-ray and treated before the patient experiences any discomfort. Left untreated, an abscess may compromise the immune system and in some cases may become life-threatening.

Tooth Knocked Out
Do not wipe the tooth clean. Place the tooth in a glass of milk, if possible. If milk is not available, use a wet napkin or cup of water. See a dentist immediately. Sometimes, if the tooth is placed back in its socket soon enough by your dentist, the tooth can be saved. Time is critical in this situation!

Broken and Chipped Tooth
Remove the fractured piece to prevent choking and don’t chew on anything hard. Call your dentist immediately. Some teeth can be filled. More severe cases may need to be crowned. If the tooth has broken into the nerve the tooth will need Root Canal Therapy and a Crown, or it will need to be extracted.

Loose Tooth
If you were hit by an object, call your dentist immediately. Depending on the severity of the blow, your dentist may let the tooth “tighten-up” on its own, or your dentist may bond the tooth to the uninjured teeth next to it for support until it heals. The tooth may turn dark and/or abscess after an accident. That may happen immediately, or it could be years later. If the tooth does eventually abscess, it will require Extraction or Root Canal Therapy and a Crown just like any other abscessed tooth.

Lacerated (Cut) Lip or Tongue
Apply pressure to stop or slow the bleeding. If the wound is severe or doesn’t stop bleeding, call your dentist or go to the Emergency Room at the hospital immediately. The wound may require stitches to stop the bleeding, prevent infection and to help it properly heal.

Many people have allergies to dust and pollen. Some people have specific allergies to certain medications or materials. You will be asked about any specific allergies you may have on your new-patient questionnaire. Be sure to let us know prior to treatment if you have allergies to any of the following:

Allergies to Medications
If you have ever had an allergic reaction to any medication, including dental anesthetics, please let us know. If you can’t remember the name of the medication, we can contact the health care provider that used or prescribed the medication to get the name. We have alternate anesthetics that can be used in case of allergies. There are also alternate drugs that can be prescribed in case of allergies to oral antibiotics or analgesics (pain relievers).

Allergies to Materials
If you are allergic to Latex, please notify us prior to treatment and we will be happy to use Nitrile gloves instead. If you have any other allergies we should be aware of, please let us know so we can provide a comfortable environment for you.

Attrition is the gradual loss of enamel through “wear”. A small amount of attrition may be caused by normal speaking and eating, but this typically doesn’t produce excessive wear. More extreme cases of attrition are typically caused by Bruxism, the grinding of teeth against teeth. Bruxism typically occurs at night while the patient sleeps, so often the patient is unaware of the grinding or enamel loss.

Teeth Whitening is actually a mild bleaching process that restores stained or discolored teeth to a healthy, natural color. Don’t be misled by unproven and ineffective over-the-counter whitening solutions. Our office uses an advanced procedure that is only available from your dentist.

Bonding is simply adding a little tooth-colored composite material to “fill in the blanks.” One of the most frequent uses of the bonding technique is to fill in a gap between front teeth.

When the damage caused by Periodontal Disease is significant, a Bone and Tissue Regeneration procedure may be necessary to save your teeth. During this treatment, Dr. Winegar gently folds back the gum and removes the disease-causing bacteria and infection. He will then place membranes, bone grafts and tissue-stimulating proteins to help your body naturally heal and regenerate bone and tissue.

A Permanent Bridge replaces one or more missing teeth. A Bridge will:

• Keep teeth from drifting into the space created from a missing tooth
• Help preserve normal function and normal bite for the jaw joint

A Permanent Bridge is usually anchored to the teeth on both sides of the space from the missing tooth. This gives the bridge strong support. Brushing a bridge is no different than brushing natural teeth, but special flossing instructions are given to keep the bridge and surrounding tissue healthy.

A Permanent Bridge is permanently bonded in place, unlike a Partial Denture (sometimes called a “Removable Bridge”), which is removable.

If you have a broken or chipped tooth that is not the result of a recent trauma, Dr. Winegar can evaluate the tooth for possible treatment. It is still important to have the tooth evaluated right away, because in some situations a minor procedure now can save you from a more significant procedure in the near future!

A very small chip may be corrected by enamel shaping. If the chip is a little larger, the best options may be bonding or a veneer. If the chip is on a molar, an onlay may be appropriate. Large chips and fractured teeth generally require a crown. If the fracture involves the nerve, Root Canal Therapy may be necessary before the tooth is crowned. It is important to have a broken tooth crowned before it becomes infected or abscessed!

In extreme cases, a broken tooth cannot be saved. In this case, an extraction is needed. The missing tooth can be replaced with a bridge or an implant.

Each case is unique. Only your dentist can properly diagnose the best course of treatment for your tooth.

Grinding of teeth, also known as Bruxism, occurs in children as well as adults. Grinding of teeth generally occurs during sleep. Sometimes, the damage caused by bruxism must be addressed first. Any malocclusion, sensitivity, brittle teeth, or TMJ problems should be discussed with Dr. Winegar first to be sure those problems are resolved and that the subsequent treatment for bruxism prevents a recurrence of those problems. Further damage from bruxism can be prevented with a mouth guard that is worn during sleep. This guard is comfortable and easy for most people to wear. Contact Us for an appointment to stop the damage caused by bruxism and correct any serious problems.

In cosmetic dentistry, crowns (sometimes called “caps”) are used less frequently since the advent of veneers, but in some cases a crown may be necessary for a particular tooth. A tooth with a bad fracture or a large filling may be a candidate for a crown instead of a veneer.

Tooth Decay begins when the protein of your saliva combines with the sugars and carbohydrates of food particles left on and between your teeth. This combination creates bacteria-laden plaque, from which acid is produced that eats away at the hard enamel shell around your tooth. Left unchecked, a hole will be created in the enamel and a cavity will rapidly form in the softer dentin which lies under the enamel. If the cavity is caught in time, usually a Filling will correct the problem. Larger cavities may require an Inlay or Onlay, or a Crown. However, if nothing is done and the decay spreads, the sensitive pulp (nerve) may become involved, often causing an Abscess, and Root Canal Therapy or Extraction may be required.

Your regularly scheduled check-up is often referred to as a “cleaning”, but there is much more to it than that! The technical term is oral prophylaxis, which means prevention of oral disease.

One way to prevent oral disease is to remove harmful plaque and tartar (calculus) both above and below the gum line. You may also be given special instructions on brushing or flossing to keep clean the areas where we found significant buildup. That is the familiar “cleaning” part of your checkup.

When a tooth is cracked, a filling may not seal the crack. A crown may have to be placed over the tooth to hold it and the crack together. If the crack is not restored, the tooth will become sensitive to chewing pressure, or will eventually break. It is important to restore a cracked tooth before it breaks, because in some cases a broken tooth cannot be filled or crowned and must be extracted.

A crown fits over the entire top of the tooth above the gum line. Crowns cover, protect, seal and strengthen a tooth. A crown is needed when a filling just will not work. A crown may be made of gold, white porcelain, porcelain fused to gold, ceramic (E-max), or zirconium (Zirconia).

In many cases of dental decay, tooth fracture, or even in instances where an individual has “short” teeth, a crown lengthening procedure will allow us to properly construct an esthetic and functional crown, bridge, or restoration.

Crown lengthening is a simple surgical procedure which adjusts the position of the gum around the affected tooth, thereby providing a more solid tooth on which to anchor the restoration of choice. A functional crown lengthening will help you regain a beautiful smile and allow you to eat and speak with comfort and confidence.

Tooth Decay begins when the protein of your saliva combines with the sugars and carbohydrates of food particles left on and between your teeth. This combination creates bacteria-laden plaque, from which acid is produced that eats away at the hard enamel shell around your tooth. Left unchecked, a hole will be created in the enamel and a cavity will rapidly form in the softer dentin which lies under the enamel. If the cavity is caught in time, usually a Filling will correct the problem. Larger cavities may require an Inlay or Onlay, or a Crown. However, if nothing is done and the decay spreads, the sensitive pulp (nerve) may become involved, often causing an Abscess, and Root Canal Therapy or Extraction may be required.

When most or all your natural teeth have been lost, dentures provide many benefits:

• Restore your self-esteem
• Regain your eating ability
• Aid speaking ability
• Give support back to the lips and cheeks
  (giving you a natural and younger appearance).

A Complete Denture is placed in the patient’s mouth after all the teeth have been extracted and the gum tissue has healed. Healing takes anywhere from a few weeks to a few months, depending upon the patient.

An Overdenture usually requires that at least 2 roots be kept. These roots may be used to hold the denture in place by placing inserts in the roots and in the denture. The denture then attaches to the roots. These roots also give support to the denture and help retain the ridge the denture sits on.

An Implant-Retained Denture is similar to an Overdenture, but uses implants as anchors.

An Immediate Denture is placed the same day the teeth are extracted. The advantage to an Immediate Denture is that the patient does not have to be without teeth during the healing period.

A Partial Denture or “removable bridge” replaces one or more missing teeth, but there must be teeth remaining for the partial to attach to. Unlike a Fixed Bridge, a partial is removable. A partial will prevent other teeth from shifting, preserving your remaining teeth.

Dr. Winegar will evaluate your condition and needs to help you determine the option that is best for you.

Loose Fit
Dentures rest on a ridge of bone and gum tissue. Over time, that ridge will shrink causing the dentures to no longer fit properly. If there are tooth roots that have been retained to hold the denture (Overdenture), or if implants have been placed to retain the denture (Implant-Retained Denture), or if it is a Partial Denture, the ridge will not shrink as rapidly as with a Complete Denture, but there will still be some change over time. This causes the denture or partial to become loose. Sometimes a denture or partial can be relined to make it fit properly. However, if the denture or partial is worn or brittle, or if the change in the ridge is significant, a new denture or partial may need to be fabricated in order to obtain a proper fit.

Sore Spot
As gums change over time, a sore spot will occasionally develop due to changes in how the denture or partial rests on the gums. If a sore spot develops, contact us for an adjustment or relining of your denture or partial.

Discolored Dentures
Dentures get bacteria build-up on them, just like natural teeth. Soak dentures and/or partials daily in a cleaning solution and brush daily as well. If all of the stain and bacteria can’t be removed, bring the dentures and or partials to our office to be professionally cleaned.

Bad Odor
Dentures can absorb bacteria and fluids that cause offensive odors to develop. If your dentures appear to be clean but have an odor, contact us for advice on some simple remedies for removing these odors.

Broken or Chipped Denture
Chips or fractures in your dentures or partials can sometimes be easily repaired. Bring them to our office for evaluation.

Teeth become discolored for different reasons:

• Drinking coffee, tea, or colas.
• Some antibiotics may darken developing teeth in children.
• Aging – The dentin underneath the enamel of a tooth gradually darkens with age.
• Use of tobacco products.
• Accidents – If a tooth has been traumatized, sometimes the nerve will gradually “die”, and the tooth becomes dark.
• After Root Canal Therapy, a tooth will generally darken.

Early Childhood Caries or Baby Bottle Syndrome is the rapid decay of baby teeth in an infant or child from frequent exposure, for long periods of time, to liquids containing sugars. The upper front teeth are most commonly affected.

The problem is usually caused by a baby falling asleep while nursing a bottle or while breast feeding. While the child is asleep, the sugary liquid pools around the front teeth. The bacteria living in every baby’s mouth then turns the sugars to acid which causes decay.

Tooth Knocked Out
Do not wipe the tooth clean. Place the tooth in a glass of milk, if possible. If milk is not available, use a wet napkin or cup of water. See a dentist immediately. Sometimes, if the tooth is placed back in its socket soon enough by your dentist, the tooth can be saved. Time is critical in this situation!

Broken and Chipped Tooth
Remove the fractured piece to prevent choking and don’t chew on anything hard. Call your dentist immediately. Some teeth can be filled. More severe cases may need to be crowned. If the tooth has broken into the nerve the tooth will need Root Canal Therapy and a Crown, or it will need to be extracted.

Loose Tooth
If you were hit by an object, call your dentist immediately. Depending on the severity of the blow, your dentist may let the tooth “tighten-up” on its own, or your dentist may bond the tooth to the uninjured teeth next to it for support until it heals. The tooth may turn dark and/or abscess after an accident. That may happen immediately, or it could be years later. If the tooth does eventually abscess, it will require Extraction or Root Canal Therapy and a Crown just like any other abscessed tooth.

Lacerated (Cut) Lip or Tongue
Apply pressure to stop or slow the bleeding. If the wound is severe or doesn’t stop bleeding, call your dentist or go to the Emergency Room at the hospital immediately. The wound may require stitches to stop the bleeding, prevent infection and to help it properly heal.

Erosion is the chemical wear of tooth enamel. Typically this kind of wear is caused by an acid. Citric acid is one of the most common agents. Citrus fruit (lemons, limes, oranges, grapefruit) contain citric acid, as do most soft drinks and citrus juices (like lemonade). Some candies also contain citric acid. Many soft drinks contain additional harmful acids. Coffee and tea also contain corrosive acids. Bulimic individuals (people who intentionally and repeatedly induce vomiting) also expose their teeth to very strong stomach acids.

Extraction is the complete removal of a primary or a permanent tooth. An Extraction can be surgical or non-surgical. This depends on the difficulty of the extraction and whether or not the tooth is impacted or erupted, and whether it has straight or curved roots.

An Extraction may be done by our office or you may be referred to an Oral Surgeon (someone who specializes in difficult or surgical extractions). No one looks forward to an extraction, but modern anesthesia will help keep you comfortable throughout the procedure.

Fillings are the most common restorative procedure.

Inlays and onlays: In addition to fillings, lab fabricated inlays and onlays are sometimes used. Although many patients think of these as fillings as well, they are actually different since they are laboratory fabricated.

Tooth Colored Restorations are an attractive, durable alternative to silver (amalgam) fillings. White fillings are made of a strong composite resin that is matched to the surrounding tooth color. In the past, white fillings were placed only on front teeth, but recently a stronger more durable material has been developed that can withstand the chewing pressure of back teeth.

Silver (amalgam) fillings: Typically, silver fillings are placed on back teeth (molars).

White Porcelain or Resin inlay or onlay: A porcelain or resin inlay or onlay is used when the cavity is too big for a filling, but isn’t so big that a crown is required. An inlay is a filling within the cusp tips of the tooth. Onlays (also known as overlays) will overlay one or more cusps in order to protect and strengthen the tooth.

In the past, cavities were a fact of life. But over the last several years tooth decay has been reduced dramatically due to fluoride. Fluoride is beneficial for adults as well as children. Research has shown that fluoride reduces cavities by up to 40% in children and 35% in adults.*
* Source: American Dental Association

The muscles of the cheeks and lips are attached to the gums and tissue of the mouth by a piece of soft tissue called a frenum. Sometimes a frenum can be attached too high on the gums causing either recession or spaces between teeth. In addition, there is another frenum under the tongue. If this frenum is attached too close to the end of the tongue it can adversely affect swallowing and speech. Sometimes this is referred to as being “tongue-tied”. A Frenectomy is a simple procedure where either part or all of the frenum in question is removed in order to return a healthy balance to the mouth.

Full Mouth Reconstruction is the optimal choice when several teeth are decayed or missing, affecting the occlusion (the way the teeth come together) and/or the appearance of the face. Full Mouth Reconstruction may involve bridges, veneers, and/or crowns. Most of the existing teeth require treatment in order to correct and restore balance to the occlusion (bite) and facial features.

According to the American Dental Association, at least 60% of adults in the United States have moderate-to-severe gum disease! No doubt, you’ve heard some of the terms: Plaque, Tartar, Calculus, Gingivitis, Bleeding Gums, Periodontitis, Pyorrhea, Periodontal Disease, Gum Disease. But what does it all mean? Quite simply, Gum Disease (Periodontal Disease) starts when plaque and tartar (calculus) are allowed to accumulate at the base of your teeth. The bacteria in the plaque leads to an infection in the gums (gingiva) called Gingivitis. Left untreated, the infection spreads to the tissue and bone that holds your teeth in place, a condition called Periodontitis (Pyorrhea). Because of the bacterial infection associated with Periodontitis, tooth abscesses are also common.

We are concerned foremost with your health. However, some of the procedures we perform are intended not only to control disease, but to provide you with a cosmetic benefit. Some patients may look older than their years because their teeth appear to be too long (“long in the tooth”). Soft tissue grafts and other root coverage procedures are designed to cover exposed roots and make the teeth look much better.

When gum tissue recedes due to periodontal disease, it pulls away from the teeth. Periodontal plastic surgery procedures can restore some coverage and dramatically improve a person’s smile.

Soft tissue grafts and other root coverage procedures cover exposed roots and restore healthy gum tissue. This will reduce further bone loss and recession, make the tooth less sensitive, protect the root from root cavities, and look more natural when you smile.

Grinding of teeth, also known as Bruxism, occurs in children as well as adults. Grinding of teeth generally occurs during sleep.

Children often grind their teeth when their teeth are erupting. This is not uncommon, nor is it a problem if it is mild. However, in more severe cases the child can develop a malocclusion. Malocclusion may then lead to TMJ problems or to a need for Orthodontics. If you have any concerns about your child’s Bruxism, be sure to have Dr. Winegar check for signs of excessive wear so that treatment options can be discussed and implemented to prevent serious problems.

Adults may grind their teeth at night due to:

• Malocclusion
• Stress

The result of bruxism can be:

• Worn spots (attrition) that can lead to:
  Malocclusion (if the patient doesn’t have already)
  Sensitivity
  Brittle teeth that require crowns
• TMJ problems
• Noise that sometimes disrupts the partner’s sleep

Sometimes, the damage caused by bruxism must be addressed first. Any malocclusion, sensitivity, brittle teeth, or TMJ problems should be discussed with Dr. Winegar first to be sure those problems are resolved and that the subsequent treatment for bruxism prevents a recurrence of those problems. Further damage from bruxism can be prevented with a mouth guard that is worn during sleep. This guard is comfortable and easy for most people to wear. Contact Us for an appointment to stop the damage caused by bruxism and correct any serious problems.

Some people have teeth that look too “short” due to the relationship between their teeth and gums. This creates a “gummy” smile. A procedure called “gum contouring” is often used to remove excess gum tissue and expose more of the crown of the tooth. In fact, your gum line can be carefully sculpted to create just the right proportion between gum tissue and tooth surface — and the result is a better looking smile.

If the gum is uneven around a tooth, gum contouring can smooth and balance the way your tooth and gum look. The procedure produces a consistent, even gum line that is esthetically pleasing.

According to the American Dental Association, at least 60% of adults in the United States have moderate-to-severe gum disease! No doubt, you’ve heard some of the terms: Plaque, Tartar, Calculus, Gingivitis, Bleeding Gums, Periodontitis, Pyorrhea, Periodontal Disease, Gum Disease. But what does it all mean? Quite simply, Gum Disease (Periodontal Disease) starts when plaque and tartar (calculus) are allowed to accumulate at the base of your teeth. The bacteria in the plaque leads to an infection in the gums (gingiva) called Gingivitis. Left untreated, the infection spreads to the tissue and bone that holds your teeth in place, a condition called Periodontitis (Pyorrhea). Because of the bacterial infection associated with Periodontitis, tooth abscesses are also common.

Gum treatment is the treatment of active gum and jaw bone disease. The treatment can slow or stop the progression of the disease. Since there are different stages of gum disease (from gingivitis to advanced periodontitis), there are different levels of treatment. In some cases, the patient may be referred to a specialist.

Quite often, recurring headaches are caused by a dental condition. Although other factors may be involved, it’s important to be screened for common dental causes of headaches, such as:

• Malocclusion
• Grinding Teeth (Bruxism)
• TMJ/TMD (Jaw Joint Problems

If you are experiencing frequent headaches you think may be linked to one of the causes above, contact us for an appointment.

Impacted teeth are unerupted or partially erupted teeth that cannot fully erupt due to:

• Lack of space (crowding)
• Misalignment (tooth is rotated out of position)
• Conflicting position (another tooth has erupted over that position)
• Ankylosis – when other causes of impaction are not corrected in a timely manner, the roots of the impacted tooth can fuse to the surrounding bone creating a tooth frozen in an unerupted or partially erupted state.

The teeth most likely to become impacted are the third molars, also known as “wisdom teeth.” The first molars are also known as the 6-year molars since they generally erupt at around age 6, and the second molars are also known as the 12-year molars since they generally erupt at around age 12. If the third molars erupted normally, they might be called 18-year molars. But there is rarely enough space to fit these last teeth into the small space left behind the second molars, so the third molars often become impacted.

The most important thing to know about impacted teeth is that they almost always require extraction. The longer the extraction is postponed, the longer the tooth roots grow. When the tooth roots of an impacted tooth are allowed to develop, the risk of complication due to extraction increases significantly because the tooth roots may “wrap around” sensitive facial nerves.

The risks of keeping an impacted tooth extend beyond the impacted tooth itself. Any impacted tooth will exert forces on the arch of your smile that may cause unnecessary crowding of your teeth. An impacted tooth below the gum surface may erode the roots of adjacent teeth. An impacted tooth above the gum line may create a “food trap” that is difficult to brush or floss and is likely to lead to decay.

If you have an impacted tooth and you are not FULLY aware of the risks and alternatives associated with keeping or extracting an impacted tooth, please Contact Us for an appointment.

Dental Implants have been used successfully for many years. The implant itself is a post that is surgically placed in the jaw. A prosthesis (artificial tooth or teeth) is then attached to the post. Dental implants may be placed in our office, but in some cases will involve cooperation between a specialist and our office. The surgical phase of treatment is completed by the specialist, and the restorative phase is completed at our office.

Dr. Winegar and Dr. Winegar share your concern about the spread of disease and works hard to safeguard his patients, and staff, against infection.

When you visit our office, you will see a clean office carefully maintained by well-trained staff. Our dental team always wear gloves, eye protection and complete protective wear during each procedure. After each patient, they discard those gloves, wash their hands and put on a new pair of gloves.

Your protection starts long before you ever enter the treatment room. Here are a few of the things that you don’t see: All surfaces are cleaned and disinfected, staff members sterilize all instruments after their use and dispose of anything that is potentially infectious.

Dr. Winegar and Dr. Winegar and their staff want you to know that your protection, care and comfort are our top priorities. That is why we meet, or exceed, the highest infection control standards.

TMJ is an acronym for temporomandibular joint, which is a fancy way of saying jaw joint. Clinically, we refer to problems associated with the TMJ (jaw joint) as TMJ Syndrome or TMD (disorder). But many patients just call it “TMJ”. Often, TMJ Syndrome presents itself as a popping sound and sensation near the jaw joint.

Dentures rest on a ridge of bone and gum tissue. Over time, that ridge will shrink causing the dentures to no longer fit properly. If there are tooth roots that have been retained to hold the denture (Overdenture), or if implants have been placed to retain the denture (Implant-Retained Denture), or if it is a Partial Denture, the ridge will not shrink as rapidly as with a Complete Denture, but there will still be some change over time. This causes the denture or partial to become loose. Sometimes a denture or partial can be relined to make it fit properly. However, if the denture or partial is worn or brittle, or if the change in the ridge is significant, a new denture or partial may need to be fabricated in order to obtain a proper fit.

Quite often, recurring headaches are caused by a dental condition. Although other factors may be involved, it’s important to be screened for common dental causes of headaches, such as:

• Malocclusion
• Grinding Teeth (Bruxism)
• TMJ/TMD (Jaw Joint Problems)

If you are experiencing frequent headaches you think may be linked to one of the causes above, contact us for an appointment.

Since most of the damage typically caused by bruxism is during sleep, a night guard can usually be made to stop further damage. A night guard is custom made to fit over the upper or lower teeth. With the night guard in place, the patient can’t grind their teeth together and cause further damage.

When describing orthodontics, most people just refer to braces. While the majority of orthodontic cases involve braces, there are alternatives that may be used for younger children or adults. Arch expanders for younger children can minimize or eliminate the need for braces when the problem is treated early enough. Invisible, clear plastic retainers, instead of braces, can be used by adults for mild to moderate crowding problems.

A Partial Denture or “removable bridge” replaces one or more missing teeth, but there must be teeth remaining for the partial to attach to. Unlike a Fixed Bridge, a partial is removable. A partial will prevent other teeth from shifting, preserving your remaining teeth.

According to the American Dental Association, at least 60% of adults in the United States have moderate-to-severe gum disease! No doubt, you’ve heard some of the terms: Plaque, Tartar, Calculus, Gingivitis, Bleeding Gums, Periodontitis, Pyorrhea, Periodontal Disease, Gum Disease. But what does it all mean? Quite simply, Gum Disease (Periodontal Disease) starts when plaque and tartar (calculus) are allowed to accumulate at the base of your teeth. The bacteria in the plaque leads to an infection in the gums (gingiva) called Gingivitis. Left untreated, the infection spreads to the tissue and bone that holds your teeth in place, a condition called Periodontitis (Pyorrhea). Because of the bacterial infection associated with Periodontitis, tooth abscesses are also common.

Normal, healthy gums have small pockets around each tooth. The bacteria and infection associated with periodontitis causes these pockets to become deeper, trapping more bacteria and causing more infection. When the pockets become too deep for scaling and root planing, a Pocket Depth Reduction procedure is often a solution. During a Pocket Depth Reduction procedure, Dr. Winegar gently folds back the gum and removes the disease-causing bacteria and infection. Dr. Winegar will then smooth the root surfaces and, if necessary, reshape the gum and bone. This will allow the gums to form smaller, healthier pockets.

Your regularly scheduled check-up is often referred to as a “cleaning”, but there is much more to it than that! The technical term is oral prophylaxis, which means prevention of oral disease. One way to prevent oral disease is to remove harmful plaque and tartar (calculus) both above and below the gum line. You may also be given special instructions on brushing or flossing to keep clean the areas where we found significant buildup. That is the familiar “cleaning” part of your checkup.

According to the American Dental Association, at least 60% of adults in the United States have moderate-to-severe gum disease! No doubt, you’ve heard some of the terms: Plaque, Tartar, Calculus, Gingivitis, Bleeding Gums, Periodontitis, Pyorrhea, Periodontal Disease, Gum Disease. But what does it all mean? Quite simply, Gum Disease (Periodontal Disease) starts when plaque and tartar (calculus) are allowed to accumulate at the base of your teeth. The bacteria in the plaque leads to an infection in the gums (gingiva) called Gingivitis. Left untreated, the infection spreads to the tissue and bone that holds your teeth in place, a condition called Periodontitis (Pyorrhea). Because of the bacterial infection associated with Periodontitis, tooth abscesses are also common.

When the nerve of a tooth becomes infected or abscessed, Root Canal Therapy is the only way to save the tooth. A tooth can become abscessed as a result of deep decay, a cracked tooth, or trauma to the tooth. The only alternative to Root Canal Therapy is an Extraction.

During Root Canal Therapy, the tooth is “numbed” (just like having a filling). Then the unhealthy nerve is removed and medication is placed in the tooth to treat the bacterial abscess (infection). After the infection is removed and treated, a filling is placed in the roots where the unhealthy nerve was.

A tooth that has undergone Root Canal Therapy is more brittle and must be crowned to give the tooth sufficient strength. The tooth is cared for in the same way as other natural teeth. Brush and floss daily, and visit your dentist for regular preventative dental check-ups.

Scaling and Root Planing is a common non-surgical treatment for periodontal disease. By using special instruments, we remove bacteria and infection from the unhealthy deep pockets around the teeth below the gum line. This is often referred to as a “deep cleaning”. First the tooth is scaled to remove the plaque and tarter that has accumulated on the tooth. Then the root is planed or smoothed. This eliminates any rough areas on the root that can easily trap plaque and bacteria. A smooth clean root provides a healthy environment to allow the gums to heal naturally and reattach to the tooth. This will create a reduced pocket, therefore eliminating areas for bacteria to hide and cause further disease.

Scaling and Root Planing combined with a strict home care routine and more frequent periodontal cleanings and exams will increase your chances of keeping your natural smile.

Scaling and Root Planing is a common non-surgical treatment for periodontal disease. By using special instruments, we remove bacteria and infection from the unhealthy deep pockets around the teeth below the gum line. This is often referred to as a “deep cleaning”. First the tooth is scaled to remove the plaque and tarter that has accumulated on the tooth. Then the root is planed or smoothed. This eliminates any rough areas on the root that can easily trap plaque and bacteria. A smooth clean root provides a healthy environment to allow the gums to heal naturally and reattach to the tooth. This will create a reduced pocket, therefore eliminating areas for bacteria to hide and cause further disease.

Scaling and Root Planing combined with a strict home care routine and more frequent periodontal cleanings and exams will increase your chances of keeping your natural smile.

Sealants are a white or tooth shaded material that is bonded to the chewing surfaces of the back teeth, sealing off deep grooves and pits. This makes the grooves of the teeth smoother so your toothbrush can more easily keep the tooth clean. Applying sealants is a simple procedure. The teeth are first cleaned, then etched with a solution to help the sealant adhere. Next, the sealant is brushed on, then a special light is used to harden the material. The procedure is “child-friendly” because there is no need for anesthetic or drilling.

Teeth can be sensitive for many reasons.

Sensitivity to chewing pressure can be caused by:

• Clenching/Grinding
• Decay
• Abscess
• Cracked tooth

Sensitivity to sweet foods is usually caused by decay.

Sensitivity to hot and/or cold foods usually indicates:

• Decay
• Abscess
• Worn Teeth (Attrition)
• Receded Gums

It is not unusual for recent dental restorations to be sensitive to hot, cold, or pressure. This sensitivity should decrease with time. If sensitivity from a recent dental restoration worsens or persists, contact your dentist.

Whitening can also temporarily cause mild sensitivity during treatment that disappears within a few days.

Sensitivity due to a dental problem will worsen with time and become a toothache. A toothache is not like a headache. It won’t just go away, even if the pain temporarily subsides. The problem that is causing the pain will just get worse, as will the pain, and simple treatment may no longer be possible.

Although the frequent subject of humor, in many cases, snoring is no laughing matter! Not only does snoring disrupt the sleep cycles of other family members, but in the case of sleep apnea, snoring can be a sign of a dangerous health problem. Sleep apnea actually cuts off the flow of oxygen to the brain, and in severe cases can cause serious damage. Even if sleep apnea is not indicated, the disruption of the sleep cycles of family members can create a hazard. Recent studies have indicated that repeated disruption of sleep patterns can cause sufferers to perform motor skills at or below the levels of individuals who are legally intoxicated! So even if your snoring is not a sign of sleep apnea, it is likely that your snoring could be a real threat to your loved ones, because impaired reaction behind the wheel of an automobile can lead to disaster regardless of the cause. Quite simply, snoring is caused by a partially obstructed airway. When you sleep, the soft tissue and muscles in your mouth and throat relax, causing your airway to become smaller. If your airway becomes small enough, your soft palate and uvula begin to vibrate when you inhale and exhale. These vibrations are the cause of the sound most people call snoring.

We are concerned foremost with your health. However, some of the procedures we perform are intended not only to control disease, but to provide you with a cosmetic benefit. Some patients may look older than their years because their teeth appear to be too long (“long in the tooth”). Soft tissue grafts and other root coverage procedures are designed to cover exposed roots and make the teeth look much better.

When gum tissue recedes due to periodontal disease, it pulls away from the teeth. Periodontal plastic surgery procedures can restore some coverage and dramatically improve a person’s smile.

Soft tissue grafts and other root coverage procedures cover exposed roots and restore healthy gum tissue. This will reduce further bone loss and recession, make the tooth less sensitive, protect the root from root cavities, and look more natural when you smile.

When a primary tooth is lost prematurely the teeth can drift into the new space crowding out the permanent tooth that is supposed to erupt into that space in the future. A space maintainer keeps baby teeth from shifting into the space where the tooth was lost so the permanent tooth can erupt in its natural proper space. As the permanent tooth erupts, Dr. Winegar will remove the appliance. Space maintainers can help eliminate the need for extensive orthodontics in the future.

A specially fabricated mouth guard can be made for your teeth. This guard fits over the upper or lower teeth to prevent broken or chipped teeth due to tooth-to-tooth contact. It is appropriate for sports where incidental contact with solid objects and other participants is common.

The smaller size and secure fit of a custom lab created mouth guard provides these advantages:

• Clearer speech – when communication with teammates is important
• More comfortable fit – so it’s less distracting
• Less restricted breathing – for improved performance

Dental injuries in sports are primarily due to tooth-to-tooth contact. Being accidentally bumped in the chin with an elbow is not what directly causes most dental injuries. It’s the collision of the lower teeth with the upper teeth after the bump that causes the damage. A mouth guard worn on the upper or lower teeth cushions the blow to protect both the upper and lower teeth.

Dr. Winegar and Dr. Winegar share your concern about the spread of disease and works hard to safeguard his patients, and staff, against infection.

When you visit our office, you will see a clean office carefully maintained by well-trained staff. Our dental team always wear gloves, eye protection and complete protective wear during each procedure. After each patient, they discard those gloves, wash their hands and put on a new pair of gloves.

Your protection starts long before you ever enter the treatment room. Here are a few of the things that you don’t see: All surfaces are cleaned and disinfected, staff members sterilize all instruments after their use and dispose of anything that is potentially infectious.

Dr. Winegar and Dr. Winegar and their staff want you to know that your protection, care and comfort are our top priorities. That is why we meet, or exceed, the highest infection control standards.

TMJ is an acronym for temporomandibular joint, which is a fancy way of saying jaw joint. Clinically, we refer to problems associated with the TMJ (jaw joint) as TMJ Syndrome or TMD (disorder). But many patients just call it “TMJ”. Often, TMJ Syndrome presents itself as a popping sound and sensation near the jaw joint. TMJ problems can afflict people of all ages, although patients under 40 are more susceptible and it occurs more frequently in women.

Teeth become discolored for different reasons:

• Drinking coffee, tea, or colas.
• Some antibiotics may darken developing teeth in children.
• Aging – The dentin underneath the enamel of a tooth gradually darkens with age.
• Use of tobacco products.
• Accidents – If a tooth has been traumatized, sometimes the nerve will gradually “die”, and the tooth becomes dark.
• After Root Canal Therapy, a tooth will generally darken.

The four most common remedies for tooth discoloration are:

• Bonding
• Whitening
• Veneers
• Caps (Crowns)

Sensitivity due to a dental problem will worsen with time and become a toothache. A toothache is not like a headache. It won’t just go away, even if the pain temporarily subsides. The problem that is causing the pain will just get worse, as will the pain, and simple treatment may no longer be possible. (See our pages on cavities, root canals, abscesses, and extractions to see how a cavity progresses from a minor to a major problem). At the first sign of a toothache, contact your dentist.

Tooth Knocked Out
Do not wipe the tooth clean. Place the tooth in a glass of milk, if possible. If milk is not available, use a wet napkin or cup of water. See a dentist immediately. Sometimes, if the tooth is placed back in its socket soon enough by your dentist, the tooth can be saved. Time is critical in this situation!

Broken and Chipped Tooth
Remove the fractured piece to prevent choking and don’t chew on anything hard. Call your dentist immediately. Some teeth can be filled. More severe cases may need to be crowned. If the tooth has broken into the nerve the tooth will need Root Canal Therapy and a Crown, or it will need to be extracted.

Loose Tooth
If you were hit by an object, call your dentist immediately. Depending on the severity of the blow, your dentist may let the tooth “tighten-up” on its own, or your dentist may bond the tooth to the uninjured teeth next to it for support until it heals. The tooth may turn dark and/or abscess after an accident. That may happen immediately, or it could be years later. If the tooth does eventually abscess, it will require Extraction or Root Canal Therapy and a Crown just like any other abscessed tooth.

Lacerated (Cut) Lip or Tongue
Apply pressure to stop or slow the bleeding. If the wound is severe or doesn’t stop bleeding, call your dentist or go to the Emergency Room at the hospital immediately. The wound may require stitches to stop the bleeding, prevent infection and to help it properly heal.

Veneers are custom, porcelain facings that are bonded to the front surfaces of teeth to whiten teeth, close spaces, straighten teeth, or repair chipped or worn teeth. The veneers are only about 1 mm thick (the thickness of a fingernail). That same thickness is “shaved” off the natural tooth surface so when the veneer is bonded to the tooth, the tooth doesn’t feel or look “thicker”.

Teeth Whitening is actually a mild bleaching process that restores stained or discolored teeth to a healthy, natural color. Don’t be misled by unproven and ineffective over-the-counter whitening solutions. Our office uses an advanced procedure that is only available from your dentist.

The teeth most likely to become impacted are the third molars, also known as “wisdom teeth.” The first molars are also known as the 6-year molars since they generally erupt at around age 6, and the second molars are also known as the 12-year molars since they generally erupt at around age 12. If the third molars erupted normally, they might be called 18-year molars. But there is rarely enough space to fit these last teeth into the small space left behind the second molars, so the third molars often become impacted.

When the enamel of a tooth is worn away, the tooth often becomes sensitive and is more susceptible to decay. Advanced cases often require crowns to save the teeth. Tooth enamel may be worn away in several ways. One or more of the following factors may cause premature wear:

• Attrition
• Abrasion
• Erosion