General Dentistry

Introduction

General dentistry is the primary care in dental health. It involves the maintenance of your teeth, gums, and maxillofacial (face and jaw) region. General dentists are responsible for the prevention, diagnosis, and treatment of numerous conditions such as TMJ (temporomandibular joint) disorder, gum (periodontal) disease, and many others. A dentist’s work is highly influential since oral health oftentimes affects your global health.2 General dentists do not specialize in any specific service, but are trained in many procedures including cleanings, sealants, tooth restorations, cosmetic dentistry, and nutritional advice. In addition, they can create thoughtful, personalized and complete dental hygiene plans.1

Qualifications You Can Depend On

A general dentist has the title DDS (Doctor of Dental Science) or DMD (Doctor of Dental Medicine). A DDS degree and a DMD degree require similar levels of education and training. Becoming a dentist requires key education and examination requirements. After graduating from an undergraduate university, a candidate typically goes on to earn a DDS/DMD degree.5 This usually entails four years of challenging graduate work. With the education component in hand, one typically takes a state or regional board exam. Furthermore, national boards expect future dentists to pass a two-part, written exam, which covers subjects such as oral anatomy, biomedicine, ethics, and patient care. Once one successfully meets the education and examination elements, state boards sometimes implement additional requirements such as interviews, background checks, and special courses.6 This rigorous professional track helps guarantee the finest care from extremely driven, experienced, and knowledgeable doctors of oral health.

How Often Should I Get A Dental Check-Up?

Expensive, destructive, and painful problems can be lessened and avoided through routine visits to your dentist. Frequent dental appointments can help detect, stop and even reverse the damage of tooth decay. Pain is a weak indicator of the right time to see your dentist. Procrastinating until you feel pain may give a condition time to progress unnoticed. If you catch a tiny cavity early, you could diminish the necessity for techniques such as root canal or extraction later. Only a dentist should determine a treatment timeline.

Visiting the dentist a minimum of twice a year is a general rule, but your dentist will develop an appointment schedule uniquely for you.6 One should note that the regularity of visits is subject to change during the course of one’s life. While every six months is a good guideline, a visit every 3 or 4 months may be more appropriate if you are part of a high-risk category such as people who smoke, diabetics, and those with low resistance to infections. Moreover, you may consider coming in more frequently through times of heightened pressure or poor health. Conversely, consistent brushing and flossing may decrease decay, and thus your number of visits per year.6 Call your dentist to establish a routine right for you.

Appointment Preparation

Addressing your fears

Nervousness about the dentist is something most of us can relate to. Some may attribute this to traumatic events or fear of the unknown. In any case, dental anxiety can have serious ramifications such lack of sleep or lack of oral care. Fortunately, contemporary dentistry offers solutions to help you cope with your anxiety.

When booking your office visit, think about times when you are less likely to be under undue pressure. The ADA (American Dental Association) suggests scheduling your appointment for a low-stress time such as a weekend or morning. Make sure to get plenty of sleep the night before; you may also want to wear comfy clothes to the dentist to help you feel more relaxed.6

Moreover, a 2008 study implies that education about dentistry may help reduce dental anxiety. Try recording any uncertainties or reservations about dentistry. Then discuss them with a dentist or member of staff. Alternately, the dentist’s website may be a valuable resource to help address any questions or concerns.

Dental knowledge will usually dispel any fears about dentistry, but if you still feel nervous, ask your dentist about sedation. Not all dentists prescribe sedatives because they require great skill to practice properly. Dentists oftentimes prescribe capsule or liquid varieties. Other times intravenous injections (injected directly into the veins) and nasal-spray kinds for children are used. There are differing degrees of sedation therapy ranging from very light to very deep. The form and level of sedation depends on the severity of your anxiety, the reason for the visit, and the experience of the dentist. Under mild sedation (anxiolysis), you may remain fully aware while forgetting about your troubles.9 Thanks to advances in dentistry, you don’t have to be afraid to schedule your next appointment.

Regardless of the type of sedation you receive, you should NOT drive or operate equipment while under the influence of a sedative. Accordingly, you will need to be accompanied by a responsible caregiver who will need to drive you home after your treatment. If you took a sedative before arriving at our offices someone will also have to drive you to the appointment. Remember, when under the influence of a sedative you should NOT consume alcohol or take any sleeping aids or additional sedatives which are not approved by a qualified healthcare provider.

Taking Health Notes

Write down information about your overall health to help your dentist develop a course of action right for you. Since the body is a connected system, not just parts working by themselves, your oral health is linked to your global health. For instance, studies imply that those with periodontal disease may be more likely to suffer from diabetes 20 or heart disease.2 Moreover, issues in other areas of the body may help your dentist make decisions about anesthesia and other procedures. Thus, the value of keeping your dentist up-to-date on your whole health should not be underestimated.

Furthermore, it is beneficial to record all medications, vitamins and herbs you take. Some prescription drugs should not be mixed with certain dental medicines. Furnishing a copy of your current medicines and supplements at your appointment will help ensure optimum care for your needs.

Additionally, if this is your first visit, it may be advantageous to have previous x-rays forwarded to your new dentist.6 This will help the dentist and personnel use their time most effectively. And while x-rays are generally regarded as safe, this also minimizes needless contact with radiation. Keeping good records of your total health will help you make the most of your time with the dentist.

What to Expect

A dentist’s specific methods may depend on personal preference, training, and expertise. Opportunely, dentists usually have websites where you can learn about their unique styles. However, there are certain common components you should expect.

Forms

You may be given a clipboard and some paperwork to fill out as you wait to be seen. This will help your dentist get to know you better. You will want to budget enough time for this process (see Appointment Preparation).

X-rays

Since x-rays are a primary means of diagnosis and treatment planning, there is a good chance they will be part of your visit. If you are worried about radiation, rest assured that x-rays are typically considered safe because they release such low levels of this energy (see Digital Radiology).

Cleaning

The dentist or hygienist might clear away plaque stuck near your gums using hand-held instruments. This grime is tough to remove through brushing, flossing and other at-home methods.

Polishing

Your dentist or hygienist may polish away stains through a mildly abrasive substance, and a tool with rotating brushes. It is normal for the abrasive to feel a little gritty in our mouth, but don’t worry – you will likely have chances to rinse.9

Sealing and Fillings

If your teeth have cavities, you can probably count on sealants or fillings at your appointment. Cavities usually develop when acid produced by bacteria erodes tooth enamel. Sealants cover the grooves to halt cavity formation. Fillings, on the other hand, replace decay and mend damaged teeth. They may also decrease tooth sensitivity.

Maintenance Plan

Dentists or personnel may give instructions about home-care of your teeth. They may make recommendations for oral hygiene such as tips on brushing and flossing. Prevention is the ultimate goal of this plan.

Modern-Day Dentistry

The minimally-invasive approach

Minimally invasive methodology is a keystone of contemporary dentistry. This approach holds early detection and prevention of conditions, and conservation of healthy teeth as its core values. It also recognizes the importance of patient education. Air-abrasion, antiseptics, CAD/CAM technology, digital radiography, innovative filling materials, lasers, mouthguards, regenerative dentistry, topical fluorides and xylitol are just some of the exciting minimally invasive techniques. Not all dentists use these treatments since they tend to demand extra training and funds to practice. Nonetheless, minimally invasive methods are just some of the advances changing the face of modern dentistry.

Air-abrasion

People sometimes mention drilling and “shots” (anesthetic injections) when discussing their dental worries. Thanks to air abrasion, these techniques are not always necessary. Air-abrasion can replace the dental drill as a method of preparing cavities for fillings. It precisely cleans away tooth decay through pressurized air and aluminum-oxide pellets. Since air-abrasion typically works with more precision than the drill, it can be used to protect healthy parts of the tooth while reaching those tight places. Furthermore, air-abrasion is so gentle that it does not usually require anesthetic injection. Picture a visit with the dentist minus the noise, odor, and pain associated with the drill.18

Antiseptics

Antiseptics (such CH and PVP-I) can kill much of the bacteria that lead to cavities and infections. Thus, antiseptics help protect the teeth from demineralization, decay and disease. Dentists sometimes recommend combining fluorides with antiseptic treatments, employing the preventative properties of both methods.18 Antiseptic varieties include over-the-counter mouth rinses and prescription polishes.

CAD/CAM Technology

Computer-aided Design or Manufacturing or CAD/CAM is a method of creating tooth restorations such as tooth replacements (e.g. bridges) and coverings that repair teeth (e.g. crowns). Computer software assesses many factors about one’s mouth to determine the exact dimensions and location for the restoration. The designs can then be viewed in 3-D on the computer screen. Moreover, they can be reproduced in ceramic form by a CAD/CAM Machine. While earlier technologies such as molded impressions sometimes necessitate multiple visits, this efficient method typically requires only one day. Though dentists are not always trained in CAD/CAM technology, this innovation in tooth restoration promotes individualized, precise, and time-effective care.1

Digital Radiology

A radiograph, or x-ray, captures images of the inside of your mouth through energy waves. They help dentists diagnose dental conditions and plan treatments. Thus, the conventional 2-D radiograph is an invaluable tool; however it can sometimes blur images reducing the accuracy of predictions. Digital technology can increase the precision of dental care.

Digital radiology holds greater capacity to view, archive, and share images. This software can be used to illustrate clear, complete, and 3-D pictures of the mouth, head, and neck. Dentists or technicians can easily expand, clarify or sharpen images to reveal the minutest details. Digital radiology also allows dentists to store, send, and print data for greater collaboration among dentists, their personnel, and patients.14 And although earlier radiographs are considered safe, digital methods greatly minimize radiation exposure.9

Filling Materials

White Composite Fillings

Silver amalgam fillings are valued for their durability and strength, and are regarded safe.6 However, silver fillings tend to stand out against white teeth, leading some to consider more aesthetic options. White composite fillings blend with the color of your teeth. They are usually made of plastic and glass components. Composites are generally stronger than other amalgam alternatives because of their ability to bond with teeth. One of their great advantages over amalgams is that they generally do not require tooth preparations to be as large. Less drilling means greater protection of the tooth’s original structure. Moreover, white composites promote a more natural-looking smile.

Glass Ionomer Cement (GIC)

These fillings are comprised of acrylic and glass. They match the color of teeth almost as well as composites, but serve a unique purpose.9 They are designed to transmit fluoride and other minerals into the teeth and saliva in order to prevent cavities and strengthen teeth. Amazingly, the cement can recharge itself by collecting fluorides from sources like toothpastes and water. In addition, GIC fillings sometimes make good fillings for children because they do not always necessitate drilling. Conversely, one drawback is their tendency to be more brittle than their counterparts. Thus, they should be used in places subject to less wear and tear.11

Ceramic Fillings

These fillings are generally composed of porcelain. They are tooth-colored just as composite and GIC fillings. However, their greatest virtue seems to be their stain resistance. Nevertheless, they are usually weaker than composite fillings.

Lasers

With the help of a power source and reflectors, lasers shoot beams of light that can be used to pierce through tooth decay while preserving the healthy tooth structure. Just like air-abrasion, lasers can replace the dental drill and rarely require anesthesia. Thus, lasers eliminate the need for noise, needles, and numbness. Lasers have many other uses as well, including disinfection of root canals and reduction of tooth sensitivity.18 On the other hand, lasers can be expensive, and demand great skill. Nonetheless, more and more patients are reaping the benefits of this revolutionary tool.

Mouthguards

Mouthguards prevent teeth, tongue, gums, jaw, and face injuries. They particularly profit athletes such as volleyball players, football players, and wrestlers. They may be purchased in three main varieties. The least expensive kind is a pre-formed, generic mold. However, some find this type bulky and awkward to use. Secondly, the “boil and bite” method is a relatively inexpensive option that can be soaked in warm water and shaped to your mouth. Finally, mouthguards can be professionally fitted to your mouth for improved wear-ability. While this may be the most elaborate and expensive option, many athletes appreciate the benefits of a snugly-fitting mouthguard.

Regenerative Dentistry

Sciences such as molecular and stem-cell biology have great implications for the future of tooth restorations. Though synthetic restorations like implants, dentures, and fillings work well, they are no match for your natural teeth. Think about the benefits of recreating authentic tooth cells. Envision replacing missing teeth with real teeth, or using actual tooth cells to fill cavities; the possibilities of regenerative dentistry seem virtually limitless.13

Topical Fluorides

Topical fluorides are a mainstay of contemporary dentistry. First recognized for their value in reducing tooth sensitivity, they were later praised for their ability to prevent tooth decay and strengthen teeth.17 One may obtain fluorides relatively cheaply and easily via prescription medicines, professional treatments, or over-the-counter toothpastes. Ordinary tap water may also be a good source of fluoride, thanks to the efforts of community health projects. Please note that the amount of fluoride in public water supplies depends on community regulations. If you get plenty of fluoride from drinking water, additional fluoride sources may be unnecessary. The dentist may help determine an amount of fluoride right for you.

Xylitol

Certain bacteria consume sugars and excrete an acid byproduct which corrodes enamel; this typically leads to the formation of cavities. Xylitol can replace sugars in daily habits like coffee, tea and chewing gum. One may also apply it directly over teeth. It is considered a safe technique that helps prevent and fight decay while strengthening and re-mineralizing teeth. Moreover, a study found xylitol instrumental in reducing cavities among mothers and their young children. For these reasons, the American Academy of Pediatric Dentistry advocates xylitol in chewing gum; but more research is needed.17


General Dentistry Treatments:

Cleanings and Examinations:

Regular dental checkups and cleanings help maintain proper oral hygiene and functionality. Depending on your individual needs you may be advised to visit us for cleanings and examinations at least once every 3 to 6 months. During the dental examination our team of professionals will use clinical expertise, dental imaging, instruments, and tests to identify dental conditions and disease. These regular oral health maintenance visits can help prevent the progression of dental conditions which may require more expensive treatments if left unchecked. So schedule regular dental checkups and enjoy a higher level of oral health.

Extractions:

Teeth which are broken or decayed beyond repair often require extraction (removal via minor dental surgery). Wisdom teeth (a.k.a. third molars) are commonly extracted either before or after they surface. This is because wisdom teeth often get stuck or impacted and do not come in completely. Impacted wisdom teeth can become painful or decayed and can also cause gum irritation and swelling. Accordingly, your dentist may recommend that your third molars be removed.

Fillings:

Fillings are a type of restorative dental treatment which is used to repair teeth that have decay, minor fractures, or surface damage. Filling materials may also be used to optimize tooth surfaces for improved chewing mechanics. Decay (a.k.a. dental caries) is commonly associated with tooth sensitivity. Often a correctly placed filling can significantly reduce or eliminate this sensitivity. However, with more extensive decay, your dentist may recommend additional or alternative treatments which may help decrease tooth sensitivity.

Laser Dentistry:

Since its introduction laser dentistry has evolved and progressed considerably. Today a skilled dentist can use lasers to provide a safe and effective alternative to traditional treatments. Dental lasers can be used to remove decay, prepare teeth for crowns or fillings, reduce tooth sensitivity, remove hard and soft tissues, treat root canals, and much more. Using lasers to perform some procedures can help reduce the need for anesthesia, kill bacteria at the treatment site, improve healing and outcomes, and decrease post-procedure pain.

Periodontal Treatment:

Scaling and root planing are common treatments for early-stage periodontal (gum) disease. Scaling is the process of removing plaque and tartar (a.k.a. calculus) attached to the tooth. This treatment typically focuses on plaque and tartar buildup that has occurred at or below the gum line. Since plaque is more likely to stick to irregular surfaces your dental professional may also smooth out the rough surfaces of your roots with a procedure known as root planing. For more advanced gum disease, your dentist may recommend deep-plane scaling or periodontal surgery.

Periodontal Treatment:

Scaling and root planing are common treatments for early-stage periodontal (gum) disease. Scaling is the process of removing plaque and tartar (a.k.a. calculus) attached to the tooth. This treatment typically focuses on plaque and tartar buildup that has occurred at or below the gum line. Since plaque is more likely to stick to irregular surfaces your dental professional may also smooth out the rough surfaces of your roots with a procedure known as root planing. For more advanced gum disease, your dentist may recommend deep-plane scaling or periodontal surgery.

Root Canals:

Root canal treatment (a.k.a. endodontic treatment) is the removal of pulp tissue which has become infected or irreparably damaged. The pulp is situated within canals that are located in the root of each tooth (called root canals) and is not essential to sustain a mature tooth. If left untreated, pulp that is infected or damaged can eventually affect the bone around the tooth and cause the formation of an abscess. A timely root canal treatment can save the tooth by eliminating diseased pulp tissue before an extraction is required.

Sealants:

Sealants are a protective coating that covers teeth to help prevent decay. Sealants are applied to the chewing surfaces of the back teeth (molars and premolars) where cavities frequently occur. Molars and premolars have many grooves and cervices (a.k.a. pits and fissures) in which food can get stuck and toothbrush bristles can’t reach. Accordingly, these grooves and crevices become the ideal environment for bacterial growth and cavity formation. By covering the grooves and cervices sealants can help prevent tooth decay. Applying sealants is quick and painless and can be done during a routine visit to your dentist.

Sedation Dentistry:

It should come as no surprise that many of us are afraid of receiving dental care. If you are one of the people who are nervous or fearful of dental treatments then professionally dispensed sedation may help you relax and make your visit to the dentist more pleasant. Talk to your dentist about your anxiety and fears. Your dentist may prescribe a sedative which you take either before you come to the office or during your treatment. Regardless of the type of sedation you receive, you should NOT drive or operated equipment while under the influence of a sedative. Accordingly, you will need to be accompanied by a responsible caregiver who will need to drive you home after your treatment. If you took a sedative before arriving at our offices someone will also have to drive you to the appointment. Remember, when under the influence of a sedative you should NOT consume alcohol or take any sleeping aids or additional sedatives which are not approved by a qualified healthcare provider.

References

  1. Academy of General Dentistry Website. 2010.
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  4. American Academy of Pediatrics Website. 2010.
  5. American Dental Association, Commission on Dental Accreditation.  Accreditation standards for advanced education programs in general dentistry. 2007:1-28. 
  6. American Dental Association Website. 2010.
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  14. Hazey MA, Ngan P, Reed H, Razmus T, Crout R, Kao E. Comparison of computer-generated, enhanced and conventional 2-dimensional radiographic imaging. Am J Orthod Dentofacial Orthop. 2009; 135(4): 463-7.
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  16. Kanegane K, Penha SS, Munhoz CD, Rocha RG. Dental anxiety and salivary cortisol levels before dental urgent care. Journal of Oral Science. 2009; 51(4): 415-420.
  17. Milgrom P, Zero DT, Tanzer JM. An examination of the advances in science and technology of prevention of tooth decay in young children since the surgeon general’s report on oral health. Academic Pediatrics, 2009; 9(6): 404-409.
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  19. National Electrical Manufacturers Association. Digital imaging and communications in medicine (DICOM). 2004: 1-21.
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