So much more than general dentistry
When you need a filling, there is a spot on your tooth where acid has eroded your enamel and left a void of decay. The decay is removed (in order to prevent the spread of it) and the cavity is filled with either an amalgam or composite filling. Your dentist may decide one is better than other based on the size and shape of the filling, and its location in your mouth. Dr. Merlino will work with you to help you decide which filling is best for your situation. It's your mouth and she will always try to honor your request.
Composite vs. Amalgam fillings
There has been some controversy over the years between these filling materials. Nearly all dentists would agree that gold is the best filling material, but since cost is prohibitive, amalgam and composite are more commonly used. There are pros and cons to each. Where composite fillings look nice, are mercury-free, and are bonded to the tooth; they are also sensitive to temperature, are made of a variety of chemicals, and can fail if moisture is present at placement. Where amalgam fillings are strong, long lasting, and less costly; they are also very apparent and contain mercury. Sometimes one of these works better than the other in a certain situation. For example, if there is not much tooth structure left, the composite would be the best choice as it adheres to the tooth. Another example is if the cavity extends under the gum where there is a good chance that there will be moisture present (bleeding or saliva), then amalgam would be the better choice. Dr. Merlino does not advocate one material over the other. We are here to do our best to educate you and help you choose your dental treatment.
Air Abrasion - Drilless Dentistry
Air Abraision is a painless, quiet way to remove decay in small cavities or resurface older, discolored composite fillings. Our unit blows a high concentration of powder through a tiny nozzle onto the small area we want to clean. There is no friction on your teeth and therefore no need for anesthesia. We have also found that using air abrasion when placing sealants increases their retention.
Sealants are typically recommended for children who have a lot of deep grooves in their teeth. Most insurance companies will cover sealants on permanent molars until the age of 12 or 16, depending on the insurer. A composite material is affixed to the grooves of the teeth, filling in the space otherwise prone to catching food and causing decay.
Deep Cleaning - Scaling and Root Planning
If it's been a really long time since you've had your teeth cleaned, we may recommend you have a deep cleaning. More tarter and calculus have built up on your teeth and even below the gumline than we can remove at a regular dental cleaning appointment. The Doctor will numb one side of your mouth so the hygienist can remove the buildup without causing discomfort. The procedure typically takes two to three appointments to get all that off of your teeth and out of your gums. Once you have had a deep cleaning, we highly recommend you return at three month intervals for cleanings so that you can maintain a clean and healthy mouth again!
In addition to cleaning and examining your teeth every six months, there are many other services we offer to keep you smiling!
Before Treatment Prepared Tooth Temporary Crown Final Crown Insert
A crown is a custom-fit cap over an original tooth that has been damaged, cracked, decayed, or has a large cavity in efforts to prevent further cracks or damage. Crowns can be made of different materials including gold, porcelain, acrylic resin, or a combination of these materials. Porcelain has the most natural look, although it is not as strong as some of the other materials. Usually the process requires two to three visits over a three to four week period. Proper dental hygiene is required to maintain healthy gums, teeth, and crowns. Your crowns can last a lifetime given the proper care. Download the PDF.
A root canal is the removal of an infection and the infected nerve from the inside of your tooth. That space is then sterilized and filled so that no further infection can get in. You may already be experiencing pain, which is most likely due to the infection in your tooth. In some cases the dentist may prescribe antibiotics which, if taken as prescribed, should reduce your pain as the infection is taken away. Though the pain may subside, the cause of the infection is still there, which means that you still need the root canal. Your tooth will be numbed while we work on it so you should not feel anything during the procedure. You can expect some discomfort a day or so thereafter; remember, your tooth is attached to other nerves. Because of this, we prescribe very strong pain medication with most root canals. This should only be taken as needed and can help you sleep. Please don't take it when you need to drive or work, and don't combine medication with alcohol. You may take ibuprofen alone or in combination with Tylenol instead. After a few days, your tooth will feel a lot better. After we are sure that all of the infection has been removed, we fill your tooth with a permanent filling. If a large portion of your tooth has broken or has been destroyed by the infection or cavity, we will fit a crown to your tooth to protect it from further damage. Unfortunately, root canals don't always work, but our office has a very high success rate. In some cases, the infection may not clear up and we may need to send you to a specialist or extract the tooth. Download the PDF.
Dr. Merlino can do most simple extractions, which can be necessary for a variety of reasons including, but not limited to: orthodontic planning, periodontal issues, impaction, or extreme decay and infection. Complex extractions may be referred out to an Oral Surgeon.
Post-operative care is necessary to heal appropriately. Some bleeding is to be expected. You can help control bleeding by:
- Using the gauze provided:
- Fold gauze and roll.
- Place on extraction site and bite with pressure.
- Change as necessary - usually every 10 or 15 minutes during the first hour.
- Remember that your saliva will be mixing making it appear that you're bleeding more than you are.
- Cover your pillow with a towel.
- Do not rinse or use a straw. Refrain from blowing your nose. Do not smoke. All of these can dislodge the clot, causing dry socket which is very painful.
- Refrain from taking aspirin or other pain medications, as they may thin your blood and prolong bleeding.
- Take it easy! Don't do anything unnecessary that may get your blood pumping.
- Eat soft foods (ice cream is great!) Drink plenty of liquids. Do not drink beverages containing alcohol or caffeine.
- If bleeding persists, you can use a wet tea bag in place of the rolled gauze.
The day after your extraction, you may rinse with warm salt water. You may eat normally, but avoid that side as food will lodge in the socket. It is normal to feel some discomfort and soreness for the first day or two. If after a few days the extraction site seems softer and is not getting better, you may have a dry socket. Dr. Merlino may have to clean out the socket to let it heal properly. You may need an antibiotic. A dry socket is an extraction site that is not healing properly. This may occur more frequently in smokers or when the tooth has had a long standing infection. Try to refrain from smoking for a day or two. Download the PDF.
If you'd like your smile to be whiter, we can help! We offer customized at-home whitening kits made here at the office. We take molds of your teeth and make custom-fitting trays to hold the whitening gel against your teeth. At-home whitening is a two week regimen that gradually whitens your teeth.
Before whitening, brush and floss your teeth. Smile in the mirror, and take a note of which teeth you can see. Put a drop of whitening gel into the mold in the spaces that fit the teeth you can see when smiling. Push the tray onto your teeth until it fits firmly. The gel should cover your teeth, but not push out of the tray. If there is excess gel, wipe it away and be sure to use less next time. Temporary whitening of your gums may occur due to excess gel.
NiteWhite: Wear all night as you sleep. You can also wear the trays for about two hours once a day if you'd rather not sleep with them.
DayWhite: Wear for one hour two times a day; once in the morning and once in the evening. Be sure to use new gel every time you whiten.
When you take the trays out, rinse them in warm water. (Be careful; hot water may distort the trays.) Use the trays for two to three weeks for best results. This time may be longer or shorter depending on the original color of your teeth. Contact the office for more whitening gel if it is needed. Your teeth may be more sensitive during this time. If your teeth become too sensitive, you may need to wear the trays for shorter lengths of time. Consider using a toothpaste for sensitive teeth when you brush throughout the weeks you're whitening your teeth. Download the PDF.
A bridge is a one-piece, non-removable device that fills a space that one or more teeth previously occupied, consisting of crowns and artificial teeth. Aside from replacing teeth for obvious aesthetic reasons, a bridge may be necessary to prevent your teeth from shifting. Shifting can lead to bite problems or jaw problems and periodontal disease. Bridges also reinforce existing tooth structure where large fillings make up the majority of the tooth. A bridge feels more natural than a partial because it stays in your mouth. They are usually made with a metal base and a porcelain covering to match your other teeth. When completed, the teeth do not look like they are connected to each other, but in fact they are. Teeth that have lost bone support due to gum disease can get loose; dentists call this mobility. By connecting teeth by a bridge, they lose mobility because the connected teeth support each other, much in the same manner as posts support a fence. Adjacent teeth can be crowned and connected without replacing teeth in order to stabilize them. Dentists call this splinting. A bridge can replace many teeth, as long as there is enough strength in the existing teeth to support the crowns necessary to stabilize the bridge. Implants can be used to reinforce the bridge, or put in as free standing teeth. Download the PDF.
The term 'partial' is actually short for 'partial denture.' Partial dentures are removable, and with their framework, replace multiple missing teeth. A partial is typically recommended when there aren't enough good teeth to support a bridge. Many patients have had success with partials; they are usually the best treatment for people who are missing multiple teeth. There are three types of partials. One type is made of acrylic with wire clasps. Missing teeth are replaced by artificial teeth, and the acrylic base rests on the gums to support the replacement teeth. Clasps on partials engage adjacent teeth to stabilize the appliance. The second type of partial uses a framework of metal for the foundation. The use of metal allows the partial to be thin in areas supported by the gums, making it more comfortable. The third is a flexible denture, made of a thermoplastic material that is lightweight and does not require the use of metal. It adjusts to the contours of your mouth and blends in with the surrounding gums and teeth. Be sure to discuss with your dentist the benefits of each partial type to determine the best fit for your smile.
Periodontal disease, tooth decay, or injury can make you lose your natural teeth. Complete dentures are removable, cover your entire jaw, and can be made of the same materials as partial dentures. It can take time for you to get used to your dentures. Speaking and eating may feel different at first, but these regular activities will resume normally once you are accustomed to your dentures. Download the PDF.
Caring for your Denture.
Fillings - A Basic Restorative
Cosmetic dentistry includes a variety of services that we provide to improve the color and appearance of your teeth and smile. Teeth Whitening; Veneers, composite and porcelain; Enamelplasty, or reshaping of the teeth; White, composite fillings; and Hidden clasp partial dentures.
If we are in the office, we will make every effort to see a patient who is in pain - even if it means skipping lunch or running much later than closing time. There is nothing in the world like tooth pain. After hours, Dr. Merlino will see emergency patients as needed. Don't be suprised if she answers the phone at midnight!