Services

Over time, our teeth are exposed to many foods and drinks that can add stain to our teeth. We offer a few products to help with whitening. Our favorite product is our take home whitening kit. We have had very good results with it, patients love the convenience of it as well as the cost and the results are close to our in office whitening. Feel free to ask us about our products the next time you are in.

Do you have a missing tooth or many missing teeth? One way to replace them is with a dental implant. Dental implants serve as the basis for either crowns or bridges, or to help stabilize dentures or partials. We have attached a video to answer most questions patients have. Please feel free to call if you have any other questions or are ready to replace those missing teeth.

We use Botox to address the common issue of clenching and grinding as well as in esthetic locations like the eye, forehead and glabellar/eyebrow areas.

Veneers are a wonderful way to change your smile. With age and stress, we tend to grind away at our tooth surface and one of the areas most affected by this are our front teeth. As we wear away the enamel, we lose dimension or what we call a “smile line.” The smile line should mimic the curve of the lower lip, once that curve is lost, it affects how we look and can add the appearance of premature aging. Placement of veneers significantly helps reverse this wear, typically resulting in a more youthful appearance.

There are times when a tooth can be so badly decayed, traumatized or infected, that it will require an extraction. Some extractions are able to be handled in our office and there are times when the extraction may be referred out to an oral surgeon. Typically referrals to the oral surgeon are made if the tooth is impacted, too close to vital structures or simply appears too difficult to handle efficiently in our office setting. Another reason for referrals is if the patient desires IV sedation as that is not a service that we offer.

Once the extraction is performed, you will be given post operative instructions. It is important to review the instructions and to call if there are any questions remaining. Typically you will leave with gauze in place. The gauze is meant to help the clot to form. This clot will serve as scaffolding for the tissue and bone cells to grow into to start the healing in the area. If the clot is lost, the bone is then exposed and this can result in inflammation or infection of the bone. You will need to return to the office to have the area evaluated and possibly packed with a medicated gauze. It is important to avoid rinsing, spitting, sucking, carbonated beverages or hot liquids for 24 hours after the extraction to allow the clot to stay in place and help facilitate healing. Again, this and all instructions will be printed and given to you following the extraction and it is important for you to read them and call with any remaining questions.

It is normal to experience discomfort and some minor swelling following the extraction. It is important to let us know if you experience a moderate amount of swelling, where you can visualize that you are fuller in the area. This is when antibiotics may be necessary.

As always, if you have any questions or concerns, call our office. Dr. Swankhouse provides her cell phone on the answering service if you need to reach her after hours.

Crowns are typically performed on teeth the have large existing fillings and new decay as well as teeth that are fractured or broken. Simply replacing a large filling that has new decay with an even larger filling will likely result in the tooth fracturing. This fracture can either result in; losing more tooth structure, allow bacteria into the nerve resulting in the need for root canal therapy, or it can be so deep that it can not be repaired and the tooth is then extracted. A crown is intended to protect the tooth from occlusal forces while chewing. Maximum chewing forces on teeth can be upwards of 175 lbs per square inch, which is substantial and can wreak havoc on compromised teeth.

A bridge is simply 3 or more crowns fused together to span the area of a missing tooth. The teeth on each side of the space are prepared and the bridge seats over those teeth as crowns do, with a pontic or false tooth fused to them to fill the space. Bridges are not typically recommended if you are missing more than one tooth as there will be too much stress on the supporting teeth, which may result in the loss of the supporting teeth in the near future. A bridge will provide function to the area as you can chew with it. It also provides an esthetic component by filling the void and making it appear that there is a tooth where one was lost. However bridges are not done as frequently as they were in the past as implants are far more predictable and have a higher success rate. One of the biggest reasons for failure of crowns is the lack of proper care. Without proper brushing and flossing, decay can start at the margin where the tooth and bridge meet, resulting in the need for a new bridge and possibly root canal therapy if the decay extends to the nerve of the tooth.

There are numerous types of crowns, each having its own benefits in treatment. The best crown by far is a full gold crown. Contrary to its name, the crown is mixed with other metals to make it more dense and resistant to occlusal forces to prevent movement from the tooth. Gold crowns wear very well on opposing teeth and tend to last the longest. There are also full zirconia crowns, full porcelain crowns as well as crowns that are fused to metal. Typically we will used full zirconia crowns on molars and bicuspids as they wear well against opposing teeth. For the front teeth, full porcelain crowns are used, mainly for their esthetic qualities.

The process for a crown or bridge will typically take 2 appointments. The initial appointment is where the most work is performed. The tooth is prepared for the crown. An impression is taken of the prepared tooth and sent to the lab to have a crown custom made for you. In the interim, a temporary crown is fabricated and placed to be worn until the permanent crown is fabricated and seated. The temporary crown is meant to hold the vertical and horizontal space around the prepared tooth, without the temporary crown the tooth can move making the permanent crown not fit properly and may result in the need to reimpress and make a new crown.

Once the crown is seated, you can treat the crown as you would any other tooth in your mouth, making sure to properly brush and floss. With proper care, crowns and bridges can last on average of 10-15 years or more.

When you are missing a tooth or numerous teeth, one replacement option is a partial denture. A partial denture is something that is taken in and out and not worn while sleeping. There are many different types of partial dentures. Some are used only temporarily until you can have the tooth or teeth replaced with something permanent that is not removed. Some partials are made with a metal substructure with acrylic, some are made of only acrylic and some are made of a more lightweight, flexible material. Partial dentures can also be supported or stabilized with implants.

A full denture is custom fabricated with acrylic, to replace all missing teeth in an arch. Top or Maxillary dentures cover the entire palate and the bony ridge, this aids in retention as it provide more surface area for suction between the tissue and the denture. If you do not have enough of a bony ridge, then retention can be aided with implants.

Lower or Mandibular full dentures do not fit nearly as well as Maxillary dentures. They only sit on the mandibular bony ridge. Sometimes we are able to achieve suction with them, but typically it moves easily and can be fairly uncomfortable. Dr. Swankhouse will usually recommend placement of 2 implants to help with the retention and to help make the dentures more comfortable.

Full dentures, like partial dentures are meant to be taken in and out and not to be worn while sleeping. If you later choose to do implants to support a full arch bridge, a full denture can be converted to the initial bridge used following placement of the implants. This would be worn for approximately 6 months until a titanium reinforced bridge is fabricated and placed on the implants.

There is typically a great learning curve to functioning with both full and partial dentures. It affects both speech and how you chew your food. The more the denture is worn, the quicker you will learn to function with it.

The best way to know what is best for you is to schedule a consultation appointment with Dr. Swankhouse

Root canal therapy is needed when there has been bacterial contamination of the “nerve” or pulp of the tooth. Every tooth has a hollow center that is normally occupied by nerves and blood vessels. Once bacteria can enter the pulp, it will compromise the blood supply, eventually causing the nerve to recede away, thereby making the tooth non-vital or “dead”. Without the blood supply, the body is unable to defend itself from the bacteria and eventually cause an infection in the bone around the end of the roots.

Bacteria can enter the pulp or nerve via decay, as decay is caused by bacteria or through a fracture that extends deep enough to reach the pulp. Teeth can also become non-vital after a traumatic incident like a hit to the mouth.

Once your tooth is becoming non-vital or is already non-vital, the only way to save the tooth is with doing Root Canal Therapy, or as everyone calls it, a “Root Canal.” Root Canal Therapy simply cleans the already hollow portion of your tooth to remove bacteria, tissue or other debris then is filled to seal the now cleaned, hollow center. Our office uses gutta percha to seal the inside of the tooth. This is actually a natural form of rubber from a tree. Although it is a natural latex, it is inert and there has been no evidence showing any reactions in patients whom have a latex allergy or sensitivity. The filling is contained within the tooth and surrounded by sealer.

The stigma of having a Root Canal: Everyone has heard a horror story about a root canal or cringe at the mention of the procedure. Root Canal therapy is typically not an uncomfortable procedure, our goal if for you to not feel anything. We find the stigma surrounding Root Canal therapy comes from the pain that was experienced as the tooth was dying or when infection has set in. This pain can be excruciating but typically avoided if you follow up with routine cleanings and exams. There are cases when a tooth can be difficult to numb as a result of significant inflammation or infection. These teeth may require additional anesthetic, or in some cases, we will refer these teeth to an endodontist as they have other means to achieve profound anesthesia.

Once a root canal is completed, the tooth needs to filled and typically crowned to protect it from fracturing. If it were to fracture or not be filled, bacteria will get back inside the center of the tooth causing the tooth to become infected again or causing it to fracture beyond a point of repair resulting in the need to extracted.

Why is it important to have periodic exams or to follow through with scheduled periodontal care?

Periodic exams and periodontal care and cleanings are important to preserve the natural tooth structure and supporting structures by preventing the onset, progress and/or the recurrence of dental diseases and conditions.

Preventing decay and periodontal disease starts with you. Proper brushing and flossing along with a healthy diet and routine exam and cleanings, ensures that you will keep disease from occurring. This is continued at our office where we will promote proper care, restore diseased areas and help maintain your overall oral health. Not only do we focus on your teeth and gums, but we evaluate your oral and facial tissues for any abnormalities as an oral cancer screening.

Prevention helps to avoid serious and costly dental procedures and is the key to having a healthy, confident, beautiful smile.

Oral appliances can be made to help patients with obstructive sleep apnea. The appliance helps to prevent your mandible from falling back and blocking your airway. The appliance is sometimes all that is needed to help prevent airway obstruction. Dr. Swankhouse will work with your primary care doctor to order, fabricate, adjust and continue follow up care. If you have wondered what your alternative to obstructive sleep apnea treatments are, feel free to call our office to inquire or ask about oral sleep appliances with your primary care doctor.

Comprehensive exams are performed at each initial visit, followed by annual periodic exams. Exams will look not only for decay or gum disease, but also for any abnormalities in the hard or soft tissues of portions of the head or neck, as well as malocclusions or malfunctions of the teeth and/ or temporomandibular joints. We may also counsel you on diet as well as home care to ensure long lasting, beautiful teeth and great overall oral health.

Scaling and root planing, referred to as a ‘deep cleaning,’ is a procedure used to conservatively treat an infectious disease called periodontal disease.

What is Periodontal Disease?

Periodontal disease starts with the formation of plaque around teeth. Plaque is the soft film on your teeth caused by food and bacteria in your mouth. When plaque build-up mixes with the saliva, it hardens and turns into Calculus. Calculus contains bacteria which irritates the gum tissue by attaching to the outer surface of the teeth and releasing poisonous toxins. These toxins cause infection and inflammation of the gum tissue and if left untreated this can ultimately cause bone loss and eventually tooth loss. Keep in mind the lost bone will never grow back.
Fortunately, scaling and root planing can help. Scaling and root planing is a procedure that treats the infected area by meticulously cleaning the tartar, bacteria and dead cells from the root surface.

Detecting Periodontal Disease

Diagnosis of periodontal disease is performed by both taking dental x-rays to look for any bone loss as well as by by measuring the gap between the gum tissue and teeth as well as recording any recession or movement of the tissue from its normal location. Destructive bacteria contained in plaque and calculus cause attachment loss which will show as pocketing when taking these measurements. Any area that measures 4mm indicates the presence of gingivitis, any measurement greater than 4mm is usually an indication of periodontal disease

Scaling And Root Planing Treatment

At Swankhouse Dental, our dental hygienist performs scaling and root planning (deep cleaning) usually scheduled in two separate appointments. Prior to the procedure, we often numb the areas to be treated with local anesthesia making the procedure virtually painless. Because inflamed gum tissue is more sensitive than healthy tissue the anesthesia allows us to accomplish our goals by thoroughly removing the calculus, bacteria and toxins from the roots of the teeth.
The goal of the procedure is to eliminate the infection. We accomplish this by removing the calculus and bacteria that has attached to your teeth and their roots under the gum tissue.The deep cleaning is completed with hand instruments (scalers) and ultra-sonic instruments.

If at the re-evaluation appointment, pocketing remains, a referral to a periodontist may be given to you to have these persistent pockets evaluated. Pocketing allows for bacteria to continue the disease process and can result in tooth loss if not properly addressed. Sometimes periodontal surgery is needed to help facilitate in pocket reduction.

Follow- up Care (post Scaling and Root Planing)
Periodontal disease cannot be cured, it can only be controlled, so it is important to follow your hygienist’s recommendations for follow-up maintenance and treatment. In addition to routine check-ups, performing proper dental hygiene at home is the most important step you can take to help prevent the re-occurrence of this destructive disease.

Can You Get A Regular Cleaning Instead?

Unfortunately, no. The ADA (American Dental Association) recommends that once a patient has periodontal disease we cannot treat a periodontal patient as a healthy patient, thus, their recommendation is a deep cleaning followed by 3 month periodontal maintenance cleanings. We at Swankhouse Dental are committed to treating our patients as deemed appropriate by evidence-based literature and the ADA recommendation. Periodontal maintenance cleaning appointments are scheduled every 3 months with our dental hygienist to continually monitor the disease and stay abreast of any negative changes.

Digital x-rays allow for us to quickly capture and read images of your teeth and supporting structures. They require only 10-20% of the radiation used for traditional dental x-rays. The images can be manipulated to better diagnose disease as well as used as a tool for your education of your oral condition.

Digital x-rays are key to a thorough exam as they help in finding:

• Abscesses or cysts
• Bone loss
• Cancerous and non-Cancerous tumors
• Decay between teeth
• Developmental abnormalities
• Tooth and supporting structures’ location
• Conditions inside the tooth or bone

Are dental x-rays safe? We are all exposed to natural radiation in our environment. Digital x-rays produce a significantly lower level of radiation compared to traditional dental x-rays. Even though digital x-rays produce a low level of radiation and are considered very safe, we still take necessary precautions to limit your exposure to the radiation. These precautions include only taking those x-rays that are necessary, and using a lead apron shield with a thyroid collar to protect you.

The need for dental x-rays depends on each patient’s individual dental needs. We will only recommend necessary x-rays based upon the review of your medical and dental history, dental exam, signs and symptoms and your risk of disease. Typically we will take a full series of images at your first appointment and this is good for 5-7 years. In between that time, we will recommend that you have a series of 4 films that help detect decay in between your teeth every 12-18 months after the full series of x-rays depending upon your risk of decay.

Fluoride remains one of the most amazing discoveries in the dental profession. In 1901, in Colorado Springs, it was noted that the residents had very minimal decay and it was later found that the reason was a result of fluoride which was naturally present in their water. It was then added to water supplies nationally in areas where it did not occur naturally or was not present at helpful levels. The general population experienced a sharp decline in dental decay as a result. When some folks balked at what they perceived to be involuntary use of a chemical, some communities removed fluoride from the water source only to see a quick increase in dental decay. As a result, many communities made the decision to place fluoride back in the water supply. So, since 1945, people have been reaping the benefits of fluoridated water.

The main use of fluoride in the past has been to protect teeth during development and eruption, but research has now shown that fluoride helps protect erupted teeth in the battle against tooth decay. Although clinicians preach about the use of fluoridated toothpaste and fluoride rinses, in-office fluoride treatments are often overlooked, especially if patients are over the magical age of 18. The evidence is clear that professional topical fluoride applications provide an additional benefit (beyond fluoridated water and toothpaste) for all adult patients.

As adults, we tend to have a fairly acidic diet, that along with bacterial waste in plaque being acidic, creating an acidic oral environment, you tend to lose mineral from your tooth surface. Fluoride is an active ion that can be readily taken up into the tooth surface to replace the missing mineral, thereby reversing the initial stages of decay. Fluoride also inhibits the bacteria’s ability to utilize food, which helps inhibit their growth and reproduction. These are the 2 main benefits to fluoride.

Another benefit of fluoride treatment is to address tooth sensitivity. As we age and/ or brush aggressively, we lose some attachment of the gingiva (gum tissue) which exposes the 2nd layer of our tooth. This layer is called Dentin and Dentin is made up of microscopic tubes. As fluid and air move over the tubes, it can result in sensitivity. Fluoride has been shown to coat the ends of the tube and significantly decrease the amount of sensitivity that you feel in the area.

Typically in our office, we will place only composite or “white” fillings as they require less preparation then an amalgam or silver filling, this means less cutting of your tooth. We only need to remove the part of the tooth that is diseased.

Composite or tooth colored fillings are used to repair a tooth that may be affected by decay, fractures or missing tooth structure. The decayed or affected portion of the tooth will be removed and then prepared and filled with a bonded composite filling. The preparation includes disinfection of the tooth surface to remove bacteria then etching and bonding of the surface prior to the placement of the composite filling. A light is then used to activate the catalyst in the composite filling to set it. At this point the filling is fully set, there are no restrictions other than waiting for the numbness to wear off before attempting to chew.

A sealant is a thin, plastic coating applied to the chewing surface of molars, premolars and any other deep grooves of the teeth. More than 75% of dental decay begins in these deep grooves as they can actually be narrower than a tooth brush bristle, making them impossible to clean. A sealant protects the tooth by sealing the deep grooves, creating a smooth, easy to clean surface. Sealants can protect teeth from decay for many years, but need to be checked routinely at your regular dental visits for wear and chipping.

Sealants are easily applied and the process takes on a couple of minutes per tooth. The teeth to be sealed are thoroughly cleaned and then surrounded with cotton or isolated to keep the area dry. A special solution is applied to the enamel surface to help the sealant bond to the teeth. The teeth are then rinsed and dried. Sealant material is carefully painted onto the enamel surface to cover the deep grooves and depressions. Depending on the type of sealant used, the material will either harden automatically or with a special curing light.