Treating decay A gentler way...
Our office recently added the Microprep air abrasion cavity preparation system, an exciting new advance in dentistry. We hope the following information will help you better understand this instrument and its use.
What is the Microprep?
It's a new instrument that can be used as an alternative to the drill in some procedures. Minute particles almost too small to be seen with the naked eye are carried to the tooth by a stream of air, gently and precisely spraying away decay.
What are the benefits of the Microprep?
Thanks to its precision and gentleness, the Microprep allows us to treat decay at an earlier stage without as much removal of healthy tooth structure. Teeth treated this way may be less likely to require large fillings or crowns in the future. Smaller fillings are less susceptible to wear and may last longer, and are more comfortable immediately after the procedure. The Microprep system creates a cavity surface that is ideal for tooth-colored (composite resin) fillings, and it helps us place those fillings faster than before. In many cases, the Microprep actually allows us to complete treatment in fewer visits.
Will it hurt?
One benefit of the Microprep that many patients like is its comfort. The Microprep system reduces heat and vibration, two major sources of discomfort traditionally associated with fillings. That's why the Microprep can often be used without anesthetics such as xylocaine. This enhances our ability to treat children without the two things they fear the most - the needle and the drill. Most patients report the Microprep treatment feels similar to air being blown across the tooth.
Is it safe?
Absolutely. The tiny particles we use are alpha alumina, a pure biocompatible substance long used in medicine and food. In fact, it is a prime ingredient in several whitening toothpastes. Only a small amount is actually used in each procedure and most of it is immediately removed by our evacuation system. Laboratory tests show that patients would have to undergo about 28 typical 20-30 second Microprep procedures in order to inhale enough alpha alumina to equal the weight of one grain of table salt! This amount is below federal safety limits.
What can the Microprep be used for?
Besides the composite resin fillings, the Microprep is very useful in a number of esthetic veneers or fracture repairs. It also allows us to apply preventive sealants in a matter of seconds, well within the attention span of most youngsters.
What does the Microprep sound like?
The most noticeable sound a patient will hear is the evacuation unit which removes particles from the mouth. The Microprep itself makes a blowing sound similar to the air syringe we use to dry teeth. Most people find it preferable to the whine of the dental drill.
Are all patients treated with the Microprep?
Not necessarily. Though the Microprep is a wonderful instrument, it is not appropriate for every part of every procedure. For example, we will continue to use the drill to remove silver (amalgam) fillings and for crown preparations. Please ask us about the role the Microprep might play in your child's treatment.
What is tooth whitening? / How do I use the gel? / How long does the whitening last?
My teeth have tetracycline stains, can I still whiten my teeth?
What are some of the side effects of whitening?
Do the over the counter whitening products I see work the same?
Do I have any options other than wearing a tray at night?
What is tooth whitening?
Tooth Whitening has also been referred to as bleaching, although this is somewhat of a misnomer. The whitening gel is made of a peroxide compound rather than a chlorine bleach. At the first visit an impression is taken of each arch to be whitened. These impressions are then turned into small, clear, soft, plastic trays into which the whitening gel is dispensed by the patient. A small amount of the gel is placed into the built-in reservoirs in the tray and then the tray is worn for at least 4 hours, usually at night while the patient is sleeping.
How do I use the gel?
Usually most patients will use the gel every night for about 2 weeks. This will of course depend on the initial shade of that persons teeth and the desired result. An improvement can be seen in as short as a couple days with the at home whitening procedure, and tend to plateau after about 2 weeks. It is possible to continue to whiten for more than 2 weeks, but as teeth reach a certain shade it will take more time with the solution before any improvements are seen.
How long does the whitening last?
The length of time that teeth remain at their lighter shade is dependent upon many factors. If a person smokes, or drinks a lot of coffee, tea, or dark sodas, teeth will begin to darken earlier. Over time the teeth will slowly begin to darken just from a regular diet. Usually, doing a touch-up of a couple nights every 6 months is adequate to maintain the lighter shade.
My teeth have tetracycline stains, can I still whiten my teeth?
People with teeth stained by tetracycline may see some improvement in their teeth, but in most situations it is impossible to achieve a uniform result. Often the teeth will lighten to a certain extent, but the gray band will still be present, depending upon the extent of the staining at the start. Usually the best way to improve teeth stained by tetracycline is with esthetic restorative procedures.
What are some of the side effects of whitening?
Whitening hasn’t been shown to produce any systemic side effect, but there may be some minor local side effects. Some people may find that after using the gel the teeth being lightened may have an increased sensitivity to cold liquids and air. Often this can be remedied by using a toothpaste containing potassium nitrate, or by using the whitening gel every-other day for a longer period of time. Since the gel does contain a higher concentration of peroxide it can irritate the gums if left for an extended period of time. After the tray has been filled with the gel it is recommended that the excess is removed to prevent it from resting on the gums.
Do the over the counter whitening products work the same?
There are a large variety of over the counter products to help whiten teeth. Many of these may contain the same peroxide used in the gel given out with the whitening kits. However, these products do not contain the same concentrations as the whitening gel dispensed by the dentist. The delivery method is often different and sometimes less effective. Most whitening toothpastes are quickly washed off the teeth by saliva, and many other products don’t have the ability to release a peroxide gel over a period of time.
Do I have any options other than wearing the tray at night?
Some people prefer to wear the tray with the gel during the day, or while at work. This usually doesn’t adversely affect the procedure and is generally tolerable since the tray is clear, and is thin enough not to impede a person’s speech. There is also a procedure now available to whiten teeth at in office appointments. Teeth can be whitened with a couple 30 minute in office appointments using a higher concentration gel and a special blue curing light.
What are sealants and when should they be applied?
Sealants (also called occlusal sealants or pit and fissure sealants) are products of dental research which have been shown to be effective in protecting the pits and fissures without harming the tooth enamel or making any changes in the oral cavity. They exert their strongest influence on the rougher biting surfaces of the teeth and are usually applied twice; once to permanent first molars at age six to seven, and again to second molars which appear at age twelve to thirteen. This is especially important because the chewing surfaces of these first and second molars are quite vulnerable to decay.
How they are applied?
Teeth that have been selected for treatment are cleaned with a special conditioner solution, washed and dried. Then, with the tooth thoroughly dried, the sealant, in a liquid form, is painted on the biting surface of the molar. An ultraviolet light is used to harden the material after it has been applied to the tooth. As the sealant is hardening, it bonds to the enamel surface of the tooth and becomes a permanent barrier to food, debris and decay. The method is simple and painless because you are merely coating the teeth with a thin plastic film. There is no drilling necessary, no tooth structure is removed, and no anesthetic is required. After applying sealants, these teeth should be checked along with your child's other teeth at regular intervals. If wear or loss occurs, sealants can be touched up to insure that decay is avoided.
How effective are they in preventing decay?
Molar teeth are used for grinding food, making it easier to swallow and digest. When these teeth are developing, depressions and grooves form in the chewing surfaces of the enamel. These irregular formations are called pits and fissures and they help the food slide off the chewing surface of the teeth. The fissures have smaller sub-fissures and pits, some almost microscopic, which act as hiding places and traps for food and plaque. They are difficult and sometimes impossible to clean even with good brushing. It is also difficult for fluoride to penetrate these areas to aid in the prevention of decay. Fluoride helps fight decay on the smooth surfaces of the teeth, but it is least effective in pits and fissures. When sealants are applied to the teeth, they flow into the crevices of the chewing surface to seal it. Since sealants act as a barrier, food particles and plaque cannot penetrate the sealants and break down the enamel. Therefore, with the application of sealants, 45 to 60% of the decay for molar and premolar teeth could be avoided. Placement of sealants is easier, quicker and less expensive than filling a tooth, and the longevity of sealants compares favorably with that of conventional restorative materials.
Things to do:
- You are allowed to eat and drink after your sealant appointment.
- Please continue to brush and floss your teeth.
- When you close your teeth together, they will feel a little strange for a short time, but this feeling will go away.
Things not to do:
- DO NOT chew gum or candy for 24 hours.
- DO NOT chew any sticky, hard or crunchy foods for 24 hours.
- NEVER, EVER, CHEW ICE!!!
Sealants have been clinically proven to be one of the most effective methods of preventing tooth decay. Effectiveness is further increased by retention and maintenance of the sealants. Sealants can last a very long time, particularly when your child remains current with his or her six-month checkup. Touch up or repair of a worn or fractured sealant can ordinarily be done at routine recall appointments. Should the sealant fail and a restorative procedure become necessary, a full credit for the cost of the sealant will be allowed toward the cost of the restorative procedure if the child has been seen on a regular basis.
IV & Conscious Sedation
A variety of medications can be used for oral sedation. The doctor will prescribe the medication best suited for your child based on age, weight, health, and dental needs.
Oral Sedation is recommended for young, apprehensive children and children with special needs. It is used to calm your child and to reduce the anxiety associated with dental treatment. Your child may be drowsy and even fall asleep, but will remain responsive and not become unconscious.
I.V. Sedation is recommended for apprehensive or very young children and children with special needs that would not work well under oral sedation. The doctor performs the dental treatment in our office with the child anesthetized under I.V. sedation, which is administered and monitored by an anesthesiologist and nursing staff.
The decision to use anesthesia services to complete dental treatment is made through consultation between parents, pediatric dentist and the anesthesiologist. If unusual circumstances or medical conditions exist, hospitalization for dental treatment may be recommended.
Dental Health Education
What is a Dental Health Educator? If most people were asked this question they probably would reply, "That's a person who teaches you how to brush and floss your teeth." True, but this is only a small part of the whole picture! In reality, a Dental Health Educator is an individual who: Is an extension of the dentist's care and knowledge to patients, parents and other staff members in the office, and to the outside community.
- Teaches individualized programs on Preventive Dental Education to pre-kindergarten through high school.
- Produces educational materials for use in preventive dentistry.
- Counsels parents on nutrition , proper brushing and flossing techniques, and preventive education.
- Provides prenatal counseling for expectant parents.
- Provides career counseling for high school and college level students.
- Conducts in-service programs for nursing staff and individuals involved in the care of pediatric and handicapped patients.
- Offers programs for community and service groups and for scout troops.
Payment and Insurance
Payment is expected for services at the time they are rendered, to help control billing/accounting costs unless specific arrangements have been made prior to the appointment. The parent presenting the child for treatment is responsible for charges incurred.
McIlwain Family Dentistry is not a contracted provider with any insurance companies. If your insurance offers out-of-network benefits and allows you to choose your own dentist, we will be happy to assist you in completing and filing your insurance claims.
If you are planning to use insurance, please contact our office and we'll be happy to go over our policies to facilitate your claims.
Dental insurance coverage does not, however, relieve a patient of responsibility for full payment of treatment charges. We accept Visa, MasterCard, and American Express or payment plans can be arranged through other financing agencies.
About Dental Insurance
If you have dental or medical insurance, we are anxious to help you receive your maximum allowable benefits. We ask that you read your policy to be sure that you are fully aware of any limitations of the benefits provided.
The fees charged for services rendered to those who are insured are our usual and customary fees charged to all patients for similar services. Your policy may base its allowances on a fixed fee schedule which mayor may not coincide with our usual fees. Insurance companies reimburse a contracted amount commensurate with average quality from an average practitioner, in an average office with an average staff. We sincerely believe that our office operates far above those guidelines. You should be aware that different insurance companies vary greatly in the types of coverage available. Also, some companies pay claims promptly and others delay payments many months.
Because your insurance policy is a legal agreement between you and your insurance company, all patients/parents are directly responsible for all charges. Realistically and legally, your insurance company reimburses you for dental expenses. As a courtesy service to you, our patient, we will complete forms pertaining to your claims and send them promptly to you or to your insurance company. We will also be glad to send in a pre-authorization of benefits to your insurance company to let you know what your insurance reimbursement will be before care is started. This often involves detailed paper work, writing letters to insurance consultants, and making long distance telephone calls. We are happy to do this because we realize how important it is to you.
In our experience, it is not realistic to expect the insurance company to cover all services, irrespective of the premium the patient may be paying. Solid business principles tell us that you get what you pay for. It is our goal to help you obtain the insurance coverage to which you are entitled. This is why our Insurance Coordinator has spent many hours organizing insurance information. She will be happy to take time to work with you, and please remember it is the insurance company that dictates your coverage, not our dental office.
We require insurance deductibles and/or co-payments to be paid at the time of treatment, but for your convenience, will process your insurance forms to help you receive your insurance benefits.
Please feel free to ask questions. Our office and practice have been built on education, communication, integrity and sincerity.