Common Procedures
Regular Exams and Cleanings
It is important to keep up with your regular exams and cleanings to prevent the build up of plaque and tartar. Cleanings are important in not only preventing decay and gum disease, but also preserving the oral restorations already present within your mouth. Accompanied with your cleaning appointment is a regular exam, Dr. Cynthia Skiba will:
- Inspect your teeth for any obvious signs of decay
- Examine a set of x-rays if performed at appointment, and diagnose what decay can not be seen by the human eye.
- Check your teeth and gums for signs of gingivitis and periodontal disease
- Dr. Skiba also checks for pre cancerous lesions and any lumps in your neck
You can expect your cleaning and exam to last about an hour. Each regular prophy appointment includes a thorough teeth cleaning, in which we will remove any tartar and plaque that has built up on the tooth’s surface. This will be followed by an extensive polishing.
It is important to schedule regular exams and cleanings with Dr. Cynthia Skiba every six months, keeping up on your oral hygiene will help prevent tooth, tissue, and bone loss. Regular exams are offered by appointment only, so please contact our practice today to schedule your next dental exam and teeth cleaning.
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Bonding
Composite fillings or bonding as some call it, is an effective way to repair teeth that are decayed, chipped, discolored or crooked. Dr. Skiba performs this procedure in a few easy steps. In the first step Dr. Skiba prepares the surface or structure of the tooth to give it the best anchorage to the original tooth structure. Once the tooth has been prepared Dr. Skiba will apply a liquid bonding agent, followed by the resin composite material, and then it is cured by a high intensity light. Dr. Skiba will then adjust and polish the bonded filling to look, feel and function like it did when the tooth was original. The composite material comes in a variety of shades to match your actual shade of teeth.
Bonded composite fillings can also be used in teeth where, in the past, silver or amalgam fillings were placed. In present day society these fillings are becoming more common. Many patients prefer the “white” fillings because the bonded filling material can match the shade of your teeth. Bonded fillings save more tooth structure than its counterpart the amalgam filling, as only the decayed area needs to be removed.
Bonding is much more cost effective in contrast to other cosmetic procedures such as porcelain veneers. Bonding can be completed in one or two visits to our office. However, the downside to bonding is over time the composite can stain and is not the most durable cosmetic solution. If it does break or chip, make sure to inform Dr. Skiba. The bonding can usually be repaired in one visit.
Bridges
A bridge is one option to replace a missing tooth. It is a cost effective way to replace one or two missing teeth. The obvious benefits of replacing a missing tooth are improved chewing function, preserving the other surrounding teeth and overall jaw structure. All of these things also affect your overall facial structure.
A bridge is a metal framework that porcelain is baked onto; it connects from one tooth to another with a space where a tooth is missing. Dr. Skiba will prepare the teeth on either side of the space for crowns. An impression is taken, and then sent to the lab. The lab will fabricate a metal substructure that spans the space from one tooth to the other. The technician will layer porcelain onto this metal substructure, shaping teeth, and then it is baked, shaped and polished. When the bridge is delivered it is cemented into place, there is a tooth in the missing area that is connected to the adjacent teeth. It looks feels and functions like a real tooth.
It is vital to the success of the bridge that the tissue in the surrounding area of the bridge is kept healthy, by brushing and flossing on a daily basis. Keeping up on regular prophy appointments will also help to preserve the bridge, by preventing any loss of tooth structure and bone that holds the bridge in place.
Crowns
A crown or cap as many people call it is a restoration that is used when the extent of decay to the existing tooth structure is too extensive that a filling will no longer be successful. A crown can also be used when a tooth has become fractured and is causing pain when functioning. The crown is placed over the tooth after it has been prepared to hold the tooth structure in place. Crowns can be made from several metals or porcelains, stainless steel (for primary teeth only), porcelain, porcelain over metal, and gold.
Dr Skiba will prepare your tooth by removing all existing decay and placing a core. A core is like a very strong filling, it is more resilient than a traditional filling. A core will not replace a filling in any circumstances; it is only used for under crowns and bridges. Dr Skiba will shape the core and existing tooth structure, reducing it in size by about 2 mm for the crown to fit over top. The surrounding tissue is prepared for an impression; after the
impression is taken it is shipped to a dental laboratory for the crown fabrication. The lab usually takes 1 to 3 weeks to fabricate your crown and ship it back to us. Meanwhile while your impression is at the lab, we will have fabricated and cemented a temporary resin crown in its place to hold the space for the permanent crown. Once the crown is received in the office, Dr. Skiba examines it to make sure all margins are smooth and there are no flaws in the porcelain. When you return to our office to receive your new crown, we just simply remove the temporary, try in and adjust (if necessary) the new crown and cement it into place. Your new crown will fit, feel and function like your tooth did before the restoration.
Dentures
Dentures are custom made prosthetic teeth that are removable. When a patient has lost all their teeth, dentures are made to replace all teeth. Dentures are made from acrylic. We will try to deter you from removing all your teeth. When you remove teeth the bone will gradually go away, your teeth are what hold the bone in place. When full dentures are placed we recommend that you have an exam once a year to make sure the dentures are fitting correctly.
If you have some teeth, Dr. Skiba can have the lab fabricate a partial denture. Partial dentures replace some teeth but not all of them. They are made from metal with acrylic and plastic teeth are attached to the metal framework.
Digital X-Rays
Our office is outfitted with state of the art digital x-ray equipment. This technology has made it possible for Dr. Skiba to diagnose decay much earlier than the x-rays from the past. The benefits of having digital x-rays are:
- Significantly much less radiation exposure.
- No development of x-rays, means immediate results.
- Digital x-rays are clearer; decay is more obvious than on old traditional x-rays.
- There is no need for chemicals to process x-rays, no need of disposal.
- Digital x-rays can be printed or emailed.
Our office has recently upgraded to a Plan Mecca panoramic and cephalometric unit. The benefits from this new unit are:
- Bitewing x-rays can be taken without even placing a sensor in the mouth. Meaning if you normally gag on x-rays, we have taken that sensation away.
- Extremely high resolution images with auto focus feature allows for very diagnostic images.
- Ability to detect infections, cysts, fractures very early in development.
- Ability to take TMJ x-rays for Dr. Skiba to diagnose TMJ disorder.
Extractions
In some cases removing a tooth can be necessary because it causes more harm than good. Some reasons that Dr. Skiba may recommend for a tooth to be extracted are:
- Root fracture
- Impacted wisdom teeth that will never erupt
- Orthodontic reasons such as needed space
- Periodontal bone loss
To remove a tooth Dr. Skiba will release the tissue around the tooth, Dr. Skiba will then use and instrument to loosen the tooth from the bone. This is called elevating, when the tooth is loose enough, Dr. Skiba will remove the tooth with a dental forcep. Sometimes the roots may separate from the top of the tooth and we may have to remove them surgically. If this happens, Dr. Skiba will use a surgical handpiece to remove bone from around the root tips to gain access. Once this access is available then she will use an instrument to elevate out the root tip.
Most times that a tooth is extracted it is recommended that you replace it. There are many reasons to replace a tooth:
- Your teeth constantly move throughout your life and will move into the space where the tooth was removed.
- The teeth above or below the space will erupt until they hit something. This is your body’s natural way of aligning your bite.
- Bone loss will occur. Your teeth hold the bone in place, once the teeth are gone the bone absorbs.
- The space causes a place where food can become trapped. It can cause areas of decay around surrounding teeth.
- Losing more teeth can cause problems with functions such as chewing.
Please talk with Dr. Skiba about any concerns or questions you may have prior to the procedure.
Fillings
Fillings are restorations that are needed to replace areas that have decay on a tooth. There are two types of fillings, silver amalgam or tooth colored composite. Once decay has been diagnosed, it is important to remove it before it reaches the nerve. Dr. Skiba will remove the decay and replace it with one of the filling materials of your choice.
The pros and cons of tooth colored fillings to silver amalgam fillings are:
AMALGAM FILLINGS (SILVER)
- Metal is denser and more resilient
- The tooth has to be prepped concave to prevent the amalgam filling from falling out. More tooth structure is removed.
- It does not bond to the tooth, which makes it prone to leaking.
- Contains mercury; however studies have not shown any significant health risks associated with the use of amalgam fillings. Dentists have been using amalgam fillings for centuries.
- More cost effective.
Tooth colored fillings
- Only the decay is removed, no healthy tooth structure is removed.
- Bonds to the tooth, no leaking.
- More aesthetically pleasing to the eye.
- Doesn’t contain mercury.
- Not as dense as silver fillings.
- More costly, some insurance companies do not cover posterior teeth.
Please inform Dr. Skiba or her staff prior to your appointment of the type of filling material you would prefer. In some instances after a filling appointment you may have some sensitivity for a few weeks. Whenever a procedure is preformed it can potentially bruise the tissue or ligaments surrounding your tooth. We recommend that you allow two weeks for healing after an appointment. However, if you are having extreme sensitivity to cold or lingering sensitivity after eating we recommend you come in to have Dr. Skiba adjust the fillings.
Fluoride
Fluoride treatments are recommended to everyone of any age. Fluoride has the innate ability to strengthen enamel. Fluoride is absorbed by the enamel and helps inhibit the acids ability to breakdown the enamel. There are several types of fluoride. Fluoride varnish, which is applied with a small brush, it is activated by your saliva and is active for 3 hours. Fluoride foam, this is applied in a tray on both upper and lower teeth for 1 to 3 minutes, with this fluoride it is recommended that you do not eat or drink for 30 minutes after application. Fluoride gel, this is used in custom made trays that you wear at night or a few hours a day. This is recommended for people that has high caries rate or are going through chemo or radiation treatments.
Mouthguards
Protecting your teeth while playing sports can prevent unnecessary harm from being done to your teeth, tongue, and gums. The American Dental Association and Dr. Skiba recommend’s that you wear a mouth guard when participating in any type of sport. There are three different types of mouth guards, prefabricated mouth guards, boil and bite mouth guards, and custom made mouth guards. Although prefabricated mouth guards and boil and bite mouth guards are less expensive they do not provide the same benefits as a custom made mouth guard.
Occlusal guards are fabricated for patients that have clenching, grinding and TMJ problems. The guards are made of hard acrylic and can be made for upper or lower teeth. Dr. Skiba will determine whether you’re a candidate for an occlusal guard.
Root Canals
When the extent of decay reaches the nerve, the tooth will become infected. There are only two ways to remove that infection. One way is to have the tooth extracted. Remove the tooth and remove the infection. If you would like to save the tooth, the other way is to have a root canal performed.
Root canals treatment is usually performed in one appointment. Dr. Skiba will access the nerve canal by prepping a small hole in the middle of the tooth. Once Dr. Skiba has that access she uses a small file that resembles a miniature wood rasp. She uses these files in a sequence of sizes to shape the canal into a cylindrical shape. When Dr. Skiba is finished with shaping the canal she will then fill it with a material called gutta percha. This material is inert to the body. Dr. Skiba will place a temporary filling in the tooth. Dr. Skiba waits 3 weeks for the tooth to settle down. After 3 weeks you, as a patient, will come back to have a crown placed over the tooth. Most root canal therapy patients have to take a course of antibiotics, it is beneficial that you take all of the prescription.
If you have any questions about this procedure please don’t hesitate to ask Dr. Skiba.
Sealants
All posterior teeth have what is called pits and fissures; these are small grooves in the biting surface of your teeth. Some people’s grooves are deeper than others; these grooves can make it difficult to keep clean with regular brushing. The deep grooves are prone to decay from plaque that can’t be removed by brushing. It is for these reasons that Dr. Skiba will recommend a sealant on the biting surface. Sealants are easily placed by etching to tooth biting surface to open the enamel tubules up, then a thin liquid resin is placed over the grooves, a high intensity light is used to cure the resin. Dr. Skiba recommends that all posterior permanent teeth are sealed as long as there are no fillings present. Sealants decrease the chance of decay in posterior teeth. Sealants have a life span of 3 to 5 years, but have been known to last for decades.
Veneers
A veneer is a thin piece of material that is placed over the front side of the front teeth. It can be fabricated from two different materials, composite or porcelain. Veneers are place to conceal tetracycline stain, chips, spaces, or to straighten out slightly crooked teeth. Veneers have the ability to give a patient an entirely different smile, while still looking entirely natural.
Porcelain veneers are fabricated in a lab from and impression that Dr. Skiba will take after she prepares the teeth. Porcelain veneers are a two appointment procedure. Once they are fabricated, Dr. Skiba will bond them to the front surface of your teeth that has been prepared. One of the downfalls to porcelain veneers is insurance considers them to be cosmetic and most insurance companies will not cover them.
Composite Veneers are done usually in one appointment depending on how many teeth are involved. Dr. Skiba will prepare the teeth for the composite veneer, once prepared; Dr. Skiba will place a thin layer of bonding solution to the tooth. Then the composite resin is layered over the preparation and cured by a high intensity light. Dr. Skiba will shape and polish the veneer. The only downfall to composite veneers is that they do stain. They are more cost effective than porcelain veneers.
Wisdom Teeth
Wisdom teeth generally begin to appear in your late teens to early twenties. At times wisdom teeth can grow in impacted or crooked pushing into the teeth in front of it. This can cause pain, swelling, and even infection and these teeth may never erupt. Wisdom teeth that are impacted and have erupted partially are at a higher risk of tooth decay, as they become harder to properly clean.
Removing wisdom teeth at an early age is suggested because the root structure has not yet fully formed, meaning the patient has to sacrifice less jaw bone in the extraction. The bone surrounding the wisdom teeth is not as dense.
To remove a wisdom tooth Dr. Cynthia Skiba will numb the area with a local anesthetic. If the wisdom tooth has not erupted Dr. Skiba will remove tissue and layers of bone until the wisdom tooth is exposed, if necessary she may section the wisdom tooth into several pieces to reduce the amount of bone she may have to remove to completely extract the wisdom tooth.
Common Procedures / Cosmetic Dentistry / Gum Disease / Braces / Pediatric Dentistry/Preventive Care / TMJ/TMD / Emergency Dental Care / FAQs
