Common Procedures
Regular Exams and Cleanings
Regular exams are an important part of maintaining your oral health. During your regular exam, we will:
- Check for any problems that you may not see or feel
- Look for cavities or any other signs of tooth decay
- Inspect your teeth and gums for gingivitis and signs of periodontal disease
- Provide a thorough teeth cleaning
Your regular exam can take anywhere from 20 minutes to 40 minutes. Each regular exam includes a detailed teeth cleaning, in which our hygienist will clean, polish, and rinse your teeth to remove any tartar and plaque that has built up on the tooth's surface.
Visiting our office every six months gives you the chance to talk with Dr. Bonn and receive answers for any questions you may have about your oral health. Regular exams are offered by appointment only, so please contact our practice today to schedule your next dental exam and teeth cleaning.
Bonding
Bonding is a conservative way to repair slightly chipped, discolored, or crooked teeth. During dental bonding, a white filling is placed onto your tooth to improve its appearance. The filling "bonds" with your teeth, and because it comes in a variety of tooth-colored shades it closely matches the appearance of your natural teeth.
Tooth bonding can also be used for teeth fillings instead of amalgam fillings. Many patients prefer bonding fillings because the white color is much less noticeable than the silver amalgam fillings. Bonding fillings can be used on front and back teeth depending on the location and extent of tooth decay.
Bonding is less expensive than other cosmetic treatments and usually can be completed in one visit to our office. However, bonding can stain and is easier to break than other cosmetic treatments such as porcelain veneers. If it does break or chip, tell Dr. Bonn. The bonding can generally be easily patched or repaired in one visit.
Bridges
A bridge may be used to replace missing teeth, help maintain the shape of your face, and alleviate stress in your bite.
A bridge replaces missing teeth with artificial teeth, looks great, and literally bridges the gap where one or more teeth may have been. Your bridge can be made from gold, alloys, porcelain, or a combination of these materials and is bonded onto surrounding teeth for support.
The success of any bridge depends on its foundation — the other teeth, gums, or bone to which it is attached. Therefore, it's very important to keep your existing teeth, gums, and jaw healthy and strong.
Crowns
Crowns are a cosmetic restoration used to improve your tooth's shape or to strengthen a tooth. Crowns are most often used for teeth that are broken, worn, or have portions destroyed by tooth decay.
Crowns are "caps" cemented onto an existing tooth which fully cover the portion of your tooth above the gum line. In effect, the crown becomes your tooth's new outer surface. Crowns can be made of porcelain, metal, or both. Porcelain crowns are most often preferred because they mimic the translucency of natural teeth and are very strong.
Crowns are often preferable to silver amalgam fillings. Unlike fillings which apply metal directly into your mouth, a crown is fabricated away from your mouth. Your crown is created in a lab from your unique tooth impression which allows a dental laboratory technician to examine all aspects of your bite and jaw movements. Your crown is then sculpted just for you so that your bite and jaw movements function normally once the crown is placed.
Extractions
There are times when it is necessary to remove a tooth. Sometimes a baby tooth has misshapen or long roots that prevent it from falling out as it should, and the tooth must be removed to make way for the permanent tooth to erupt. At other times, a tooth may have so much decay that it puts the surrounding teeth and jaw at risk of decay, so Dr. Bonn may recommend removal and replacement with a bridge or implant. Infection, orthodontic correction, or problems with a wisdom tooth can also require removal of a tooth.
When it is determined that a tooth needs to be removed, Dr. Bonn may extract the tooth during a regular checkup or may request another visit for this procedure. The root of each tooth is encased within your jawbone in a "tooth socket," and your tooth is held in that socket by a ligament. In order to extract a tooth, Dr. Bonn must expand the socket and separate the tooth from the ligament holding it in place. While this procedure is typically very quick, it is important to share any concerns or preferences for sedation with us.
Once a tooth has been removed, neighboring teeth may shift causing problems with chewing or with your jaw joint function. To avoid these complications, Dr. Bonn may recommend that you replace the extracted tooth.
Implants
If you have missing teeth, it is crucial to replace them. Without all your teeth, chewing and eating can destabilize your bite and cause you discomfort. When teeth are missing, your mouth can shift and even cause your face to look older. Implants are a great way to replace your missing teeth.
An implant is a new tooth made of materials that looks just like your natural tooth. Your implant is composed of two parts that mimic a tooth's root and crown. The implant's "root" is a titanium rod placed into the jaw bone to act as a root. Once the rod is in place, a porcelain crown is attached to replace the top part of your tooth.
Implants may also be used to anchor dentures, especially lower dentures that tend to shift when you talk or chew. Plus, for patients with removable partial dentures, implants can replace missing teeth so that you have a more natural-looking smile.
Fillings
Traditional dental restoratives (fillings) include gold, porcelain, and composite/amalgam. The strength and durability of traditional dental materials continue to make them useful for situations where restored teeth must withstand extreme forces that result from chewing, such as in the back of the mouth.
Newer dental fillings include ceramic and plastic compounds that mimic the appearance of natural teeth. These compounds, often called composite resins, are usually used on the front teeth where a natural appearance is important. They can be used on the back teeth as well depending on the location and extent of the tooth decay. Composite resins are usually more costly than the older silver amalgam fillings.
What's Right for Me?
Several factors influence the performance, durability, longevity and expense of dental restorations:
- The components used in the filling material
- The amount of tooth structure remaining
- Where and how the filling is placed
- The chewing load that the tooth will have to bear
- The length and number of visits needed to prepare and adjust the restored tooth
The ultimate decision about what to use is best determined in consultation with your doctor. Before your treatment begins, discuss the options with Dr. Bonn. To help you prepare for this discussion it is helpful to understand the two basic types of dental fillings: direct and indirect.
- Direct fillings are fillings placed immediately into a prepared cavity in a single visit. They include dental amalgam, glass ionomers, resin ionomers, and composite (resin) fillings. Dr. Bonn prepares the tooth, places the filling, and adjusts it during one appointment.
- Indirect fillings generally require two or more visits. They include inlays, onlays, veneers, crowns, and bridges fabricated with gold, base metal alloys, ceramics, or composites. During the first visit, Dr. Bonn prepares the tooth and makes an impression of the area to be restored. Dr. Bonn then places a temporary covering over the prepared tooth. The impression is sent to a dental laboratory which creates the dental restoration. At the next appointment, Dr. Bonn cements the restoration into the prepared cavity and adjusts it as needed.
Root Canal (Endodontic) Treatment
In the past, if you had a tooth with a diseased nerve, you'd probably lose that tooth. Today, with a special dental procedure called root canal treatment, you may save that tooth.
Inside each tooth is both the pulp and the nerve. The nerve is the vestige of the tissue that originally formed the tooth. Once the tooth has been in the mouth for a time, the functioning of the nerve is no longer necessary.
When a tooth is cracked or has a deep cavity, bacteria can enter the pulp. Germs can cause an infection inside the tooth. Left without treatment, pus builds up at the root tip in the jawbone, forming a "pus-pocket" called an abscess. An abscess can cause the pulp tissue to die. When the infected pulp is not removed, pain and swelling can result. Certain by-products of the infection can injure your jawbones and your overall health. Without treatment, your tooth may have to be removed.
Treatment often involves from one to three visits. During treatment, your general dentist or endodontist (a dentist who specializes in problems of the pulp) removes the diseased pulp. Next, the pulp chamber and root canal(s) of the tooth are cleaned and sealed. Often posterior teeth that have endodontic treatment should have a cast crown placed in order to strengthen the remaining structure. Then, as long as you continue to care for your teeth and gums with regular brushing, flossing, and checkups so that the root(s) of the restored tooth are nourished by the surrounding tissues, your restored tooth can last a lifetime.
Most of the time a root canal is a relatively simple procedure with little or no discomfort, involving one to three visits. Best of all, it can save your tooth and your smile!
Sealants
Sometimes brushing is not enough. Everyone has hard-to-reach spots in their mouth and brushing doesn't always fully clean those difficult places. When that happens, you are at risk of tooth decay. Using sealants on your teeth gives you an extra line of defense against tooth decay.
Dental sealant is a plastic resin that bonds to the deep grooves in your tooth's chewing surface. When sealing a tooth, the grooves of your teeth are filled and the tooth surface becomes smoother — and less likely to harbor plaque. With sealants, tooth brushing becomes easier and more effective against tooth decay.
Sealants are usually applied to children's teeth as a preventive measure during the years of most likely tooth decay. However, adults' teeth can also be sealed. It is more common to seal "permanent" teeth rather than "baby" teeth, but every person has unique needs. Dr. Bonn will recommend sealants on a case-by-case basis.
Sealants generally last from three to five years. However, it is fairly common to see adults with sealants still intact from their childhood. A dental sealant only provides protection when it is fully intact so if your sealant comes off you must let your dentist know.
Veneers
There's no reason to put up with gaps in your teeth or with teeth that are stained, discolored, badly shaped, chipped, or crooked. Today, a veneer placed on top of your teeth can correct nature's mistake or the results of an injury and help you have a beautiful smile. Veneers are a highly popular solution among dental patients because of their lifelike tooth appearance.
Veneers are thin, custom-made shells crafted of tooth-colored materials (such as porcelain) designed to cover the front side of your teeth. To prepare for veneers, Dr. Bonn will create a unique model of your teeth. This model is sent to the lab technition to create a mock up of your new smile. With the mock up as a guide, Dr.Bonn will then prepare the teeth either by reshaping the teeth, minimal reduction, or no tooth reduction at all. Temporaries will be fabricated so that you can see a preliminary view of the newly created smile and agree that this is the appearance that you like. A copy of the temporaries is sent to the lab to recreate this smile in porcelain. At the cementation appointment, the patient once again has a chance to view the veneers in the mouth prior to permanent placement. Every step is performed to ensure predictability and satisfaction.
Mercury-Free Dentistry
All restorative materials in this office are mercury-free. The advent of tooth colored composites and porcelains have made the use of mercury amalgams obsolete.
Holistic Dentistry
The placement of amalgam ( mercury containing) fillings has been under debate for some time now. Even though the FDA and the American Dental Association have voiced an opinion stating the lack of evidence supporting health risks to the patient via mercury containing fillings, there has been antidotal evidence reported by many regarding health improvements upon removal of existing amalgams. This article is not to debate the issue of usage of amalgams, which this author stopped placing in 1996, but rather the protective steps we implement to protect the patient from mercury aerosols created in the removal of amalgams.
Amalgams fillings have been utilized as a restorative material for dentistry since the 1920s . As with the majority of restorative materials, amalgams have a limited life expectancy. Clinical research has shown the amalgam fillings lasting between 12 to 15 years on average. The size of the restoration, as well as the oral hygiene of the patient, plays primary roles in their longevity. Removal of these fillings whether as a result of need or request is done thru the use of a high speed rotary hand piece which emaciates the amalgam. During the physical removal of the amalgam, mercury aerosols can be released.
There are a number of procedures that should be implemented for the safety of the patient. The removal of the amalgam should be done under copious amounts of cold water. To avoid any ingestion or aspiration of the amalgam, the use of a rubber dam is critical. A rubber dam will isolate the teeth where the amalgams are to be removed, and a high volume suction is utilized to capture all debris. A nose cap inhalation devise such as those used to deliver nitrous oxide can be used to prevent any inhalation of the freed mercury aerosols. The patient can either breathe clean air or oxygen administered through the nose hood.
By following these protective protocols, the removal of mercury containing amalgams can be accomplished comfortably and safely.
Dr Kevin T Bonn DMD PA
Non-Surgical Gum Treatments
Early detection and treatment is the key to preserving teeth for a lifetime. If gingivitis or periodontal is detected, more than 90% of the cases can be treated successfully by non-surgical means. This will involve visits with a hygienist who will perform comfortable and thorough cleanings utilizing hand instrumentation and ultrasonic instrumentation. Antibiotic mouth rinses will be used along with Oraquix, a numbing gel which is placed in the gum cuffs to be cleaned. Further adjunctive treatment may involve using Arestin, an antibiotic powder that can be placed in deeper pockets to aid healing.
Digital X-Rays
We offer digital x-rays which offers the latest technology in oral prevention and detection. With the digital systems we can reduce the amount of radiation exposure by over 75%.
Sleep Apnea Prosthetics
There are three types of sleep apnea: obstructive, central, and mixed; of the three, obstructive is the most common. Despite the difference in the root cause of each type, in all three, people with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer.
Obstructive sleep apnea (OSA) is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep. In central sleep apnea, the airway is not blocked but the brain fails to signal the muscles to breathe. Mixed apnea, as the name implies, is a combination of the two. With each apnea event, the brain briefly arouses people with sleep apnea in order for them to resume breathing, but consequently sleep is extremely fragmented and of poor quality.
Sleep apnea is very common, as common as adult diabetes, and affects more than twelve million Americans, according to the National Institutes of Health. Risk factors include being male, overweight, and over the age of forty, but sleep apnea can strike anyone at any age, even children. Yet still because of the lack of awareness by the public and healthcare professionals, the vast majority remain undiagnosed and therefore untreated, despite the fact that this serious disorder can have significant consequences.
Untreated, sleep apnea can cause high blood pressure and other cardiovascular disease, memory problems, weight gain, impotency, and headaches. Moreover, untreated sleep apnea may be responsible for job impairment and motor vehicle crashes. For many with sleep apnea there is an distessful side affect of snoring during sleep. This can become a source of contempt from one's spouse who many times becomes the instigator for the effected person to seek treatment. Fortunately, sleep apnea can be diagnosed and treated. Several treatment options exist, and research into additional options continues.
A night slumbering in a sleep lab, hooked to monitors that measure both breathing and brain waves while health workers watch, has long been the standard for telling who has sleep apnea or another disorder. While not a hundred percent perfect in diagnosis, these test can ascertain the severity of the sleep apnea and prescribe the recommended course of action.
But this lab-based polysomnography, or PSG, can cost $1,500. And while access has improved, there are swaths of the country where reaching a sleep lab can mean a few hundred miles' drive.
The most recommended treatment today is a CPAC machine. This machine delivers positive pressure oxygen thru the nose via a mask. While very useful, there have been complaints of discomfort, dryness, and noise.
Other options exists which have become prevalent in the dental communitiiy. Efforts of removing or recontouring the uvula ( the soft tissue appendate that hangs at the back of the soft palate) have been attempted. This procedure has not been widely accepted due to the post-operative discomfort and lack of successful outcomes. A prosthetic mouthpiece has been developed and used with a higher success rate. This laboratory constructed mouthpiece is fitted after molds of the patients teeth have been taken. The mouthpiece fits over both the upper and lower teeth simultaneously. The purpose of the prosthesis is to hold the lower jaw forward thereby keeping the patients airway open during sleep. The mouthpiece can be adjusted to three settings, each one holding the jaw a little farther forward. One typically begins with the lowest setting and adjusts forward if the apnea is not reduced. So a period of trial and adjustments may be required. While cumbersome at the onset, feedback from wearers have been positive over time.
The benefits of seeking and recieving treatment for sleep apnea can be a life altering event which in this practicioners views warrants continued research.
Laser Cavity Detectors
Through modern laser technology, we can detect the early presence of decay in the pits and fissures of the teeth. Before now, we used the pointed end of the explorer to detect decay. Typically, the decay would have to be of moderate size before a "stick" could be felt, denoting a cavity. With the advent of fluoride, the detection of decay though the traditional method has not been as reliable as the cavity may be present in the deep pits covered over by the fluoridated enamel. The laser can detect the depth of penetration well in advance of physical explorer detection.
Common Procedures
/ Pediatric Dentistry
/ Cosmetic Dentistry
/ Teeth Whitening
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