12131 Magnolia Blvd | Valley Village, CA 91607 | (818) 763-8999


Fillings

When tooth enamel becomes week due to decalcification or acid exposure due to inadequate oral hygiene, nutrition or medical conditions, it leaves what we call a carious lesion, or tooth decay. Symptoms of tooth decay typically include sweet sensitivity, but may also include sensitivity to hot, cold, pressure or problems with food collecting in the teeth.

When enamel is decayed, it lets bacteria like plaque and acids into the tooth, where the weaker structures become decayed as well. Fillings are performed by removing existing decay and placing a restoration into the tooth. Restorations can be made of amalgam (silver fillings) or tooth colored composite material. It is important to treat tooth decay while it is small and less invasive. Tooth decay never corrects itself. Allowing the decay to go untreated will cause more decay and possibly pain or abscessing of the tooth. Once decay reaches the nerve of the tooth, the only treatment option available is to clean out the nerve and perform a root canal procedure. Root canals must also have crowns placed on the teeth as part of their treatment plan. As you can see, early intervention is important when treating cavities and filling the teeth.

Fillings typically last for several years, but they eventually become worn down and may leak. When your dentist starts to see the signs of leakage, we will monitor the tooth closely until it is appropriate for replacing the filling with a new one.


Bonding

Bonding uses tooth-colored resin filling material to correct flaws and reshape teeth in order to improve their appearance and function. Commonly used to correct chips on the front teeth, it may also be used to close gaps between teeth or to cover exposed root areas that suffer from sensitivity due to gum recession. The material is closely matched to the shade of your natural tooth, so that it goes without notice during everyday conversation. Bonding is used for corrective and aesthetic dental treatments.

Bonding is applied to the teeth after gently etching the tooth, in order to improve the retention of the material on the tooth surface. After it is applied, an ultraviolet light cures the material into a hard restoration that is both functional and attractive. It is recommended that patients who eventually plan to whiten their teeth due so prior to the placement of the bonding, as whitening agents will not affect the shade of the restoration.

 

 

 

Bridges

A bridge is a fixed appliance that is used to replace one or two teeth that are missing. The bridge consists of multiple crowns fused together, with the one(s) in the middle acting as a pontic, or false crown. Length of the bridge depends on the health of the supporting teeth and how many teeth are missing. The crowns on the end of the bridge are cemented onto the supporting teeth. Prior to the bridge fabrication, the supporting teeth must be reshaped and have an impression made, which will then be sent off to the dental laboratory where the bridge is made. A bridge functions the same as natural teeth do, and is permanently cemented into the mouth. It also prevents adjacent or opposing teeth from drifting or shifting due to a missingtooth.

 

 

 

 

Crowns

Crowns are restorative treatments that cover the entire visible surface of the tooth above the margin of the gums. When dental decay or disease has extended to a certain point in the tooth, a filling is no longer a practical way to restore it. Crowns help maintain the structural integrity of a tooth that has experienced a root canal, large decay, fracture or the loss of a large filling. When there is no longer enough healthy tooth enamel to support a filling that can withstand normal functions, a crown is the next phase of treatment. Crowns can be made of porcelain, porcelain fused to metal, or precious metals like gold. The material of the crown will be determined by patient preference as well as where the tooth is located.

By completing crown treatments in a timely manner, they can help preserve the remaining tooth structure. Delaying crown treatment usually results in the fracturing of the remaining enamel and ultimately tooth loss. In some cases a tooth may not need a root canal, but delaying the crown could allow bacteria into the nerve of the tooth, which would result in the tooth abscessing and needing a root canal at that point. All root canal teeth also need a crown placed on the tooth to help the non-vital tooth function normally.



Dentures

Removable dentures are a common treatment option for people who are missing all of their upper or lower teeth (or both). Dentures may also be considered partial-dentures when replacing just a few teeth, rather than the entire arch. Usually they are made out of acrylic or a combination of metal and acrylic. In cases where a patient loses all of their teeth to gum disease, bone loss or tooth decay, dentures are a viable option for restoring their mouth to a point where they can eat, smile and talk correctly. Full dentures do cover a large surface area, so some time is needed for adjustment with speech and eating. They stay in place by suction and properly fitting dentures do not require the use of adhesive pastes or strips. Partial dentures use clasp systems that use other teeth to help hold the appliance into place. Dentures should be removed each night to allow for proper cleansing of the mouth and appliance as well as allow the tissues to “breathe.”

Some newer types of dentures are now using a “mini” implant system, which uses small implants to help hold the denture in place. These dentures do not cover the palate the way traditional dentures do.



Digital X-rays

X-rays reveal areas of the teeth that are not visible during a visual examination. Our office utilizes digital x-rays, which use a much lower dose of radiation than traditional dental x-rays. X-rays reveal areas of the teeth that are not visible during a visual examination. Areas of concern include decay between teeth, bone loss, infection or abscesses, missing or extra teeth and other pathology. Our office utilizes digital x-rays, which use a much lower dose of radiation than traditional dental x-rays. The films receptors are more sensitive to x-rays, making the exposure time shorter. Digital films also allow us to be more efficient with your appointment length and omit the need for hazardous chemicals, because there is no need to manually process films in a developer. Rather, the image is transferred directly into our software and is available for doctor and patient viewing for treatment plan purposes. The images are also easily transported electronically in cases of referrals to specialists or electronic filing of insurance claims. Three types of x-rays are usually needed in the dental office - these include panoramic, periapical and bitewing. Panoramic x-rays allow evaluation of surrounding structures such as the jawbone, TMJ, nasal sinuses and the wisdom teeth. Periapical (PA) films allow the inspection of the entire root structure to diagnose abscesses, gum disease or other infection. Bitewing x-rays are for screening for decay between the teeth, or to see how deep decay is that can be seen clinically prior to developing a treatment plan.

 

Implants

Dental implants replace single, several or all teeth. Progress with dental implants has progressed tremendously in the past several years. Implants work by placing a titanium post into the supporting bone which is allowed to heal and integrate into the bone until it is stable enough to support a crown, bridge or other fixed prosthesis. Dental implants are a great alternative to treatments like bridges, partials and dentures, because they do not require the preparation of adjacent teeth or the wearing of large removable appliances. In fact, dental implants are the most “natural” tooth replacement option there is.

To determine if you are a candidate for dental implants, a panoramic x-ray will be taken. This will allow us to evaluate the bone structure and other areas such as nasal sinuses, nerve canals and existing teeth. In some cases if there is not enough supporting bone, a bone graft may need to be performed.

Healing times vary, but almost all implant posts are firmly integrated into the bone within 6 months. By this point a custom crown will be made and placed on an abutment, which fits directly into the titanium post. It is essentially a tooth with a metal root. In the case of several missing teeth, the implants will be used to support a bridge. Some people even have complete implant-supported dentures, which are unique in that they do not cover the roof of the mouth, making eating and speech much easier and more natural.

 

Fluoride

We recommend that our pediatric patients receive a professional strength fluoride application during their biannual preventative care appointments. Professional grade fluoride is applied in a gel form or brush on varnish. For the gel form we recommend that patients wait at least half of an hour before eating or drinking afterward. This allows the tooth enough time to uptake the minerals. It should be noted that varnishes, when applied, might appear yellowish and sticky on the teeth, even after a cleaning. This improves the contact time of the fluoride with the tooth surface, and is proven to reduce the rate of tooth decay. (1)

In some cases children or adults may be at an increased risk of decay due to dry mouth, braces, nutrition habits, deep grooves in the teeth, gum recession or previous tooth decay. For these individuals a daily prescription strength fluoride may be recommended. Daily use of fluoride gels can remineralize tooth enamel, decrease sensitivity and stop tooth decay in its tracks.

 

Mouthguards

Drs. Michelle and James Grosleib are dedicated to help maintain healthy, natural teeth in patients of all ages. Part of an effective prevention plan includes creating customized sports mouthguards for athletes. Whether it’s baseball, gymnastics, soccer or just bicycling, protecting your teeth is an important step to take in preventing a dental emergency. The American Academy of Pediatric Dentistry estimates that up to 90% of all sports injuries include the head and affect the upper front teeth.

Why is it important to have a professionally made guard instead of using a store-bought stock guard? It comes down to fit. Should you happen to experience trauma of some sort, a stock guard does not fit accurately enough to always prevent tissue lacerations, fractures or loss of teeth. A custom sports mouth guard will fit perfectly and stay in place during all activities, so well that breathing, speech or drinking water will not be difficult to do. Unfortunately many stock guards do not fit well and usually wind up being taken out during the sporting activity at some point.

As children grow, their bite changes as well. Guards can be made to allow for the eruption of one or more teeth but they also need to be replaced every so often so that they fit a developing mouth. Investing in a mouth guard is like dental insurance!

Root canals

When tooth decay extends through the enamel into the nerve of a tooth, the nerve must be removed along with the decayed tooth structure in order to treat the condition. After the nerve is removed, a filling material is placed into the nerve canal. This is called root canal therapy. The exposed portion of the tooth is then treated and covered with a crown. Root canal therapy is an essential part of the final line of treatment when it comes to maintaining natural, healthy teeth.

When left untreated, bacteria travel through the nerve and will cause the tooth to abscess and possibly cause severe pain or other types of infection, some which are serious enough to require hospitalization. Antibiotics will help to clear up the initial infection, but it does not prevent the bacteria from traveling back through the nerve canal and forming another infection. If treatment is not completed in a timely manner, the tooth will begin to fracture and break down, even if there are no symptoms. Once a tooth has broken off to a certain point, there are no options available to restore it. By this point the only option left is to pull the tooth.

Root canals have a bad reputation, but the entire treatment isn’t too far off from having a routine cavity filled. Appointment length can be longer, which means most likely the most uncomfortable part of the procedure is having your mouth open for a longer amount of time. Drs. Michelle and James Grosleib ensure that each patient is as comfortable as possible throughout their entire procedure.

 

Sealants

Sealants are a preventative procedure that helps prevent tooth decay from developing in the deep grooves of the back teeth. The plastic-like coating is placed onto the permanent molars, which erupt around ages 6 and 12 (give or take a year or so). By doing this, it makes the grooves shallower and easy to clean during normal toothbrushing. This prevents decay from forming deep within the bottom of grooves and is an effective way to combat tooth decay in older children.

The application is very easy, and there are no drills, shots or uncomfortable instruments used during the process. For application the tooth is gently conditioned for the bonding of the sealant material. After thoroughly dried, the sealant material is painted into the grooves and then cured with an ultraviolet light until hardened. They are easily performed at routine preventative care appointments and take just a few minutes. Sealants are semi-permanent, in that they may last for several years, but sticky foods like taffy or caramel may pull them off of the tooth. Sealants do not protect the enamel between the teeth, so it is still important to floss each day as an effective part of your decay prevention.

 

Veneers

Dental veneers are a cosmetic treatment option that requires little to no tooth preparation and can transform the entire appearance of your smile. Made of a thin porcelain material, the veneer is shaped and colored to correct aesthetic concerns of the tooth that it is to be placed on. Veneers are usually placed together in groups of several teeth (depending on how wide your smile is) and cover the natural teeth. They omit the need for braces, whitening and crowns when it concerns the appearance of the teeth. Teeth appear whiter, straighter and help patients achieve the Hollywood smile that they’ve always wanted.

 

Veneers are minimally invasive and are easy to clean around. Teeth may be slightly skimmed or conditioned to aid in the bonding of the veneer to the natural tooth surface. Patients will need about 2 or 3 appointments for the entire process. During the first appointment an impression will be taken and sent to the dental laboratory. A wax-up may be made with the shape and size of the teeth for the patient to see and get an idea of how it will look. At the final appointment, the finished porcelain veneers will be delivered and placed in the mouth.

If you’ve always wanted to change your smile - be it minor tooth positioning, spacing, tooth size or color, but you didn’t want to commit to long-term therapy like braces or whitening, then porcelain veneers are a great option.

 

Wisdom teeth


The 3rd set of molars (which usually erupt between the age of 17 and 25) is usually referred to as “wisdom teeth.” While in the perfect world these teeth would come in nice and straight, the truth is that many people don’t have enough space in the jaw for them to erupt at all. This results in the teeth becoming impacted or only erupting partially into the mouth, and it is not even functional. If a tooth is impacted, it may cause damage to the adjacent tooth. Wisdom teeth that are only partially erupted are prime areas for tooth decay and gum disease to form. Unfortunately, the tooth decay and gum disease often affects the backside of the 2nd molar just next to the wisdom tooth.

Treating tooth decay and gum disease is important, because it prevents the conditions from spreading to adjacent teeth. But wisdom teeth are very difficult to keep clean, making them susceptible to recurrent decay and disease. In many cases this is the reason that it is more practical to remove the wisdom teeth than it is to keep restoring them.

The American Dental Association recommends extracting wisdom teeth when the following conditions exist:

  1. Pain
  2. Infection
  3. Tumors
  4. Damage to adjacent teeth
  5. Gum disease (periodontitis)
  6. Tooth Decay

 

 

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