Arestin
Are harmful bacteria infecting your foundation? Your gums and underlying bone provide an important foundation for your teeth and dental work, so it is important to keep them healthy. And while every mouth contains both healthy and harmful bacteria, sometimes the harmful bacteria can infect the gums and forms spaces or gaps around the teeth, known as pockets. These pockets are a sign that you may have periodontal disease (gum disease)- the #1 cause of adult tooth loss in the United States.

Dental professionals commonly treat periodontal disease with a mechanical procedure known as scaling and root planning (SRP). Scaling removes plaque, tartar, and stains from the surface of teeth. Planing smoothes the rough areas on the roots of teeth to promote healing. While SRP has been shown to effectively remove many of the bacteria that cause the infection, the instruments used during SRP sometimes cannot reach stubborn bacteria that hide in the bottom of pockets. These stubborn bacteria could cause the infection to return.
Arestin is now available in our office to treat your periodontal disease. Combined with SRP, it can serve as a valuable tool to help you treat and control your periodontal disease. Arestin is applied directly to the site of infection where bacteria hide.

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Bleaching
Many patients find, as they get older, that their teeth start turning yellow. Thanks to continued development in peroxides, teeth whitening is much easier and more successful than ever. For best results, it is advised that you bleach your teeth immediately after a cleaning. It is also recommended that whitening be done before veneers or crowns are put on the teeth. This way, the restorations will be whiter and your smile will be enhanced.

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Bonding
Bonding is a procedure used to repair chipped teeth, fill in spaces between teeth, and cosmetically restore discolored or stained teeth. This procedure is a result of the development of modern composite resins. These resins have the strength to withstand the stress we place on our teeth in everyday life. The composite resin is bonded directly to the teeth.

Bonding is a simple procedure usually performed without anesthetic. First, the surface of the tooth is etched with a special liquid. Etching enhances the adhesive abilities of the bonding material. Next, an adhesive material is applied to the tooth. A bonding material, which has the consistency of toothpaste, is then applied to the tooth. This bonding material is shaped to resemble the original tooth. The bonding material is hardened by using the special and safe properties of an ultraviolet light. Sometimes, a veneer, a custom-shaped tooth covering, may be bonded to the surface of a tooth, much like a false fingernail, to enlarge and beautify the tooth.

Pros:
- No anesthesia required
- Little or no tooth reduction required
- Immediate esthetic results
- Color change possible
- Less expensive than crowning
- Can be a reversible process

Cons:
- Can chip or stain
- Has limited esthetic life
- May not work if insufficient tooth structure
- Limited ability to realign teeth
- Teeth may appear somewhat whiter

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Crowns
A crown may be recommended for a tooth that has been weakened by decay, fracture, or failure of a large, previous restoration. The advantages of a crown are derived from its more desirable physical properties. A crown can provide the strength necessary to withstand chewing forces. A crown can also return the tooth to its original and more natural size and shape.

The construction of a crown is very precise and generally requires at least two visits. During the first visit, the damaged tooth is prepared to accept the crown. An impression is taken and a temporary crown is put in place. At the second visit, the temporary crown is removed. The permanent crown is then cemented onto the prepared tooth.

Pros:
- Teeth can be lightened to any shade
- Some realignment of teeth is possible
- Can serve as abutment for fixed or removable restorations
- Longer esthetic life than bonding
- Offers greatest latitude in improving tooth form and proportion
- Most "natural" results

Cons:
- Can fracture
- Requires anesthesia
- Original tooth for altered
- Most costly than bonding
- Requires two appointments
- An irreversible procedure

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Debacterol
Stops cankersores in five seconds flat. Debacterol is a safe, topical therapeutic chemical curettage agent that stops canker sore pain, seals damaged tissue, kills infectious organisms, and aids the natural healing process.

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Dental Implants
Replacement of either a single tooth or multiple teeth has been made extremely easy and predictable with the arrival of Astra's Osseo integrated dental implants. Many problems that have plagued previous generations of dental patients now find a simple solution with the implant. Dentures that no longer stay put; bridgework that has gotten loose all too often, these can be resolved with implant anchorage. Dr Micoli and his staff have become trained in their placement, as well as restorations of them, to provide maintenance free replacements for lost teeth.

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Duraphat
Used in treating teeth with hypersensitivity. A fluoride varnish, this sodium fluoride displays a strong desensitizing effect when applied to the affected surfaces. It is recommended that you do not brush your teeth or eat hard foods for at least two hours following application.

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Crown Lengthening
At times, there is not enough tooth for the doctor to insert a crown or bridge because the tooth has decayed or perhaps broken below the gum line. Your teeth may actually be the proper length but they may be covered with too much gum tissue. To correct this, the doctor must perform crown lengthening.

During this procedure, excess gum and bone tissue are reshaped to expose more of the natural tooth and improve the periodontal health of the patient. This can be done to one of several teeth, depending on what the doctor deems necessary.

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Fillings
The resin material we use for fillings is a plastic with small "filler" particles of glass-like material. These restorations will serve you well for many years. However, you should be aware of the following information:

Chewing: As with natural teeth, avoid chewing excessively hard foods on the restored teeth (hard candy, raw carrots, ice, bones, etc.) because the resin material can be broken from the tooth with extreme force. In the event that a breakage occurs, replacement of a restoration is not difficult. Natural teeth can be broken also with similar forces.

Recalls: Visit us at regular six-month examination periods. Often problems that are developing around the restorations can be detected at an early stage and repaired easily. Waiting for a longer time may require redoing the entire restoration. We will contact you when it is time for your recall appointment.

The Future: We expect that you will receive many years of service from these restorations, usually about 7-12. However, after watching this type of restoration for so long, we have seen the following unavoidable situations occur which may require restoration replacement at a future time.

- Depending on the foods you eat and other factors, there may be a slight change in the color of the restorations over a period of years. If the color becomes objectionable to you, they should be replaced.

- Some restorations may demonstrate slight stains at locations around the edge. Please tell us if that occurs.

- The gums (gingiva) may recede from the veneers, displaying discolored tooth structure underneath. This usually takes place over several years and may require replacement.

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Flouride Treatment
Flouride is applied directly to the teeth to prevent tooth decay.

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Posts and Cores
Posts and cores are sometimes required to rebuild the proper support for a crown. A post is a metallic structure that is placed within the body of the root of a tooth that has had previous root canal therapy. In fabricating your post, we remove some of this plastic material, leaving the last two to three millimeters to seal the end of the root. This fabricated space is necessary to anchor the post within the root of the tooth.

The type of post you may need depends upon a number of factors. The post can either be prefabricated or it can be cast at a dental laboratory. In either case, the result of anchorage for a crown is the same.

The part of the post that shows is called the core. It is upon this core that we can anchor a crown. The post is cemented into your tooth usually separate from the crown providing the perfect surface for the crown to be placed.

Posts are not always necessary when a crown is required. The use of a post will be determined on an individual basis based upon support and structural requirements.

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Pulpotomy
When active decay in a tooth reaches the pulp (nerve), the inflamed part of the nerve is removed and a sedative medication is placed inside the tooth to prevent sensitivity and promote healing. The pulpotomy is done mostly in one visit and causes no more discomfort than placing a routine filling. After the pulpotomy is finished the tooth is restored with a crown to function normally again.

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Root Canal
Please refer to the figure below for this description.

The tooth receives nutrition from the pulp (1). The pulp is encased in the middle of the tooth and contains a blood supply and nerve network. If the pulp is damaged in any way (2), it may become infected and form an abscess (3). Root canal treatment may be recommended in this situation. Untreated, such a condition could lead to loss of the tooth and a serious infection.

A series of appointments is usually required for root canal treatment. At the first appointment, the diseased pulp tissue must be completely removed (4). The tooth is cleaned out to eliminate the infectious causing bacteria. At a subsequent appointment, the canal is completely filled and sealed (5). This is done only after the canal is completely free of bacteria. In many cases, root canal treatment is less costly than replacement with an artificial tooth. Proper home care of your teeth, along with regular dental checkups, may prevent a situation that requires root canal treatment.



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Sealants
Sealants are plastic-like coatings for the biting surfaces of molars. They are used to prevent bacteria from invading and causing decay in the grooves on the biting surfaces of teeth. They are applied to a newly erupted, decay-free tooth by being painted onto the tooth and then hardened through exposure to a high intensity light. The procedure is painless and takes about 15 minutes per tooth. Decay is never intentionally sealed into the tooth. The procedure is usually done between the ages of 6 and 12 which are the decay-prone years of childhood.

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