Periodontal Disease Evaluation Procedures

During the periodontal portion of a comprehensive dental exam, the doctors or hygienists use an instrument called a “periodontal probe” to measure the depth of the gum “pocket” or sulcus circumfrentially around each tooth.  The pocket depth, in addition to other findings, can indicate several dental conditions, most significantly the periodontal status of your teeth.

Periodontal Pocket Depth Indicators

You may wonder what the numbers mean when your practitioner is calling them out to be recorded.  The number is the actual depth of the pocket from where the gums start to where the tooth is connected to the gums and bone within the pocket. In general, pocket depths in the 1-3 mm are considered healthy and normal, but many times there is still evidence of gingivitis with these depths.  Any pockets measuring 4mm in depth or greater can signify the start of the periodontal disease process, meaning the bone holding the tooth in the socket has become inflamed and may start to be resorbed.

Checking Teeth and Gums for Periodontal Disease

In addition to measuring pocket depths, Mt. Tabor Dental staff also record gum recession, which are areas that gum tissues have been lost around certain areas of teeth.  Gingivitis, or inflammation of the gum tissues, can also lead to bleeding in certain areas, so these “bleeding points” are recorded as part of the exam.  All teeth are checked for “mobility,” or movement, to ensure that the tooth roots are firmly anchored to the jawbones.

Finally, the exam includes detection of “furcations,” which is bone loss around the roots of the teeth, usually a sequela of more severe periodontal disease.  Using all of this information, Dr. Beck, Dr. Morrow, and the hygienists at Mt. Tabor Dental take pride in educating patients on their periodontal conditions.

Follow-Up for Periodontal Treatment

For conditions that would best be handled by a specialist, we have a number of trusted periodontist colleagues who take very good care of our patients.  Whether treated by a specialist or by our skilled hygienists in-office, our practice will provide customized periodontal treatment plans that will not only educate you, but help you overcome any problems you may have.  Please contact Mt. Tabor Dental if you have any further questions relating to your dental or periodontal health.

What is a Dental Rubber Dam?

A rubber dam is a simple piece of equipment in the form of a piece of latex or silicone. This material is then cut to fit around a patient’s teeth in order to provide necessary treatment. Although simple in form and practice, this important piece of rubber has many advantages.

Advantages of Dental Rubber Dams

Used in dentistry for over 150 years, using a dental rubber dam has three main advantages.  First, it helps improve patient safety and reduce dental anxiety by creating a physical separation between the patient and the dental procedure being performed.  Another advantage is that the rubber dam minimizes contamination of the root system by reducing the bacterial load in the operating field during endodontic therapy procedures. Last, dental dams keep the operating field isolated and dry, which is necessary for some dental procedures.  This advantage is especially important when placing composite (tooth-colored) restorations, which are technique sensitive and require a very dry field in order to achieve long term success.

Use of Dental Rubber Dams

Not all dental practices use rubber dams routinely, but Dr. Beck and Dr. Morrow take this extra step in order to protect our patients.  We spend a lot of time and put a lot of work into producing high-quality dentistry, and using  the rubber dam helps our restorations last longer.  Of course, not all situations necessitate the use of the rubber dam, but we always try our best to use them when indicated.  If you have any additional questions or concerns about the use of the rubber dam or about how it benefits our patients, please contact Dr. Beck or Dr. Morrow at South Waterfront Dental.

What Are Silver Fillings?

Silver fillings are not made of silver, but are called “amalgam,” and are used to fill cavities in teeth to prevent the

Image: Ambro / FreeDigitalPhotos.net

spread of tooth decay. Amalgam used for fillings is a mixture of metal, including alloy composed of copper, tin, silver and mercury. These are known as “silver” fillings because of their appearance after placement.

Silver, or amalgam, fillings usually require the removal of more tooth structure than white fillings and often can cause some staining of the remaining tooth structure over a number of years.  That being said, amalgam fillings can last for decades because of their strength and ability to withstand hard biting forces.

What Are White Fillings?

While amalgam has been used for over 150 years and is still recommended for very large restorations, huge strides in materials science have been made with white, or composite, fillings.  Composite fillings resemble the natural color and texture of your teeth, and are made from composite resins. These fillings insulate teeth from extremes of heat and cold, and require less invasive preparation than amalgam.

Dr. Beck prefers to use white fillings when he can with smaller cavities because of the superior esthetics and the fact that newer composite materials have better longevity and adaptation than ever before.

Which Filling Should I Choose?

Dentists have many years of training in dental school placing both types of restorative materials. The decision to use white or silver fillings is usually made between the dentist and the patient after a discussion of the risks and benefits of each type of filling.

Next time you visit our dentist office, please feel free to ask Dr. Beck if you have any questions about the different materials used to restore your teeth.

We also have nitrous oxide (laughing gas) available. Depending on your health, Dr. Beck may also prescribe an oral sedative to help you relax.
What are Dental Implants?
Dental implants are biocompatible metal anchors that are positioned in the jaw bone underneath the gums to support an artificial crown or bridge, as well as complete or partial dentures, where a natural tooth or teeth are missing. Dental implants are a great alternative to bridges because they feel and work most like our natural teeth.

Dental implants are usually done in two phases; first you will see an oral surgeon to have the implant placed. After 4-6 months of healing, Dr. Beck will fit a custom restoration on top of the implant post to replace your missing tooth or teeth. Every case is different, so you should ask Dr. Beck if you have any specific questions about your mouth and implants.
What is Root Canal Treatment?
The root of a tooth includes a nerve. When the nerve dies it can become infected and can cause discomfort, swelling and complications that if left untreated will cause long term damage to your mouth. Dead nerves are more commonly caused by deep decay in the tooth but can also be caused by an injury to the tooth such as getting hit in the mouth.

Root canal treatment requires removal of the nerve, which is done through the biting surface of the tooth. After root canal treatment the tooth will require a crown to function properly and to protect it from fracturing.
Can I Get Fillings that are Not “Silver”?
Yes! Dr. Beck places composite or tooth colored fillings that look natural. Silver or amalgam fillings expand and contract with variations in temperature, acting like a wedge in your tooth that can cause a fracture, composite fillings do not.
Do I Get a Cleaning on My First Visit as a New Patient?
Dr. Beck and his team are dedicated to your entire oral health. At your first visit we reserve 2 hours of our time so that we can do a thorough job of assessing your oral health. This first appointment will include a full mouth series of digital radiographs (X-rays), a periodontal evaluation by the hygienist (checking for the health of your gums) and a comprehensive examination. This will allow Dr. Beck and your hygienist to determine the type of cleaning that is best for you. We will try to complete a cleaning that day; however, depending on how long its been since your last cleaning and the condition of your teeth and gums, it may require additional appointments.
Do I Have to Have X-rays?
Just as lab work is often needed at your physicians office to fully assess your condition, radiographs (x-rays) are critical at the dental office to fully assess oral health. Please keep in mind that two thirds of your tooth (the entire root system) is located below the gum line and is not visible without radiographs. In addition, only a small amount of decay, infection and abnormalities are visible without radiographs.

We strictly adhere to the American Dental Association’s guidelines and never take radiographs unless they are needed for a proper diagnosis. We are also mindful of your concerns about radiation. That’s why our radiograph units are regularly inspected by the State. We also use the most advanced digital x-rays to further cut down on your radiation exposure. You get more radiation from being in an airplane for a few hours than you do from a complete series of dental radiographs.
Glossary of Terms and Helpful Links
Glossary of Dental Terms

American Dental Association

Academy of General Dentistry

OHSU School of Dentistry

…. there will be more links in the future.

During this exam we collect data, which will allow us to determine your level of gum disease, tooth decay, tooth trauma, TMJ health, occlusion and oral cancer screen. Radiographs are a critical part of this examination as they allow us to evaluate your jawbones, sinus cavities and the two-thirds of the tooth that cannot be seen in the mouth!

While we encourage all our new patients to have a comprehensive examination, if you are in pain we will do site specific exams to diagnose and treat the source of your discomfort.
Gentle yet Thorough Cleanings and Dental Hygiene
The best way to prevent tooth decay and gum disease is to have your teeth cleaned regularly. Our dental hygienists will remove plaque and tartar, keeping your teeth and gums healthy and clean.
Tooth Colored Fillings
Also called a “white” filling, these dental restorations are composite resins containing a mixture of acrylic plastics and quartz fillers.

These restorations differ from amalgam (silver or mercury) fillings in that they are held in place by a bonded resin rather than mechanical retention. These materials have evolved to the point that they will last as long and are as durable as sliver fillings.

Please take a few minutes before your visit to review and fill out the appropriate information. This not only helps us deliver the highest quality dental care, is also ensures you and others are seen on time.

You may download the forms below, print and complete prior to your visit:
New Patient Forms

New Patient Info
New Patient Dental History
New Patient Medical History

Consent Forms

Consent For Endodontic Treatment – Root Canal
Consent For Tooth Colored Fillings
Consent For Oral Surgery

A crown is usually required when a tooth is missing over 50% of the visible surface, when there are cracks in the tooth or when a tooth has had endodontic therapy, or “root canal”.

Crowns usually take two appointments to complete; during the first appointment the tooth is prepared, an impression taken and a temporary crown fabricated and placed; the second appointment (usually a few weeks later) is when the new crown is tried in, adjusted and permanently cemented.
Bridges
Also called a Fixed Partial Denture, this restoration is used to replace a missing tooth by joining or “bridging” the teeth on either side of the missing tooth, called “abutment” teeth.

The abutment teeth are prepared to accommodate the material used to restore the missing tooth. This is a two-appointment procedure as it takes the lab a few weeks to fabricate the final bridge restoration. In the meantime, an acrylic temporary bridge is placed.
Treatment for Gum Disease
Also known as “periodontal disease” this is a process caused by long-term build up of plaque and tarter that leads to the recession of gum tissue and loss of bone surrounding and supporting the teeth. If left untreated, periodontal disease will cause loosening and the eventual loss of teeth.

Plaque is full of microorganisms (bacteria). This sticky bio-film will remain attached to the teeth for around 24 hours before it is calcified and turns into a hard material called tarter. Tarter build up around teeth will attract more plaque and eventually grow in size causing the gums and bone to recede.

This process can be stopped early (before the tarter builds up below the gum-line) by brushing, flossing and regular dental cleanings. If the build up of tarter extends below the gum-line, more aggressive treatment, such as Scaling and Root Planning or Periodontal Surgery may be needed.

We eat food every day and not all of us are fastidious about keeping our teeth cleaned; everyone has gum disease to some extent. To determine the extent of gum disease and the appropriate treatment, you will need to have a complete examination with a full set of radiographs. It is important to know that periodontal disease is painless until near the end. Its very similar to high blood pressure; prevention and being pro-active is the BEST way to treat gum disease!
Endodontic Therapy – “Root Canal”
Each tooth has an internal chamber that begins just under the biting surface and extends down to the ends of each root. This chamber houses the “pulp” which is comprised of blood and nerve tissue and various other cellular entities which allow the tooth to sense the temperature of food and beverage.

When tooth decay (caries) or trauma of tooth structure (such as fracture) reach the pulp, the tissue becomes irreversibly inflamed and dies. When this happens there are only two choices for treatment; pull the whole tooth or salvage the tooth by removing the diseased pulp tissue.

Endodontic therapy, or a “root canal”, is a procedure that removes the infected pulp tissue, cleans and disinfects the chamber and seals it up with an inert material preventing further infection.

It is very important to know that almost every tooth that has had endodontic therapy will need a crown placed to keep it from fracturing. The reason; accessing the pulp chamber and removing the pulp tissue and reshaping the canal weakens the tooth and a crown reinforces the structural integrity and provides for normal esthetics and function.
Dental Implants
Implants are a wonderful option for replacing missing teeth, weather they be single teeth, multiple teeth or the entire dentition. Implants are also an excellent way to secure complete dentures from “flopping around” in the mouth. Implants are titanium posts that are placed into the upper or lower jaw and allowed to integrate with the bone.

After complete integration (usually a few months) the implants are “loaded” with the appropriate restorations, which allow for normal function and esthetics. Whether we are replacing a single tooth or restoring your entire mouth, implants require multiple appointments and several months to complete. The time and effort are worth it as these are the best restorations dentistry has to offer.
Oral Surgery
There are times when a tooth cannot be restored due to extensive decay or trauma. When this is the case, the tooth must be extracted. Depending on location and the extent of damage to the tooth, a surgical approach may be necessary.

After the area is thoroughly anesthetized, the gum tissue is reflected and bone removed from around the remainder of the tooth to facilitate its removal. The surgical area is cleaned and the gum tissue sutured back into place to allow complete healing.