What We Do

Fluoride Treatment

Fluoride is the most effective agent available to help prevent tooth decay.  It is a mineral that is naturally present in varying amounts in almost all foods and water supplies.  The benefits of fluoride have been well known for over 50 years and are supported by many health and professional organizations. Fluoride works in two ways: Topical fluoride strengthens the teeth once they have erupted by seeping into the outer surface of the tooth enamel, making the teeth more resistant to decay.  We gain topical fluoride by using fluoride containing dental products such as toothpaste, mouth rinses, and gels. “Fluoride Varnish” is relatively new and our hygienist loves it calling it “Magic.” The “Varnish” stays on your teeth between six and eight hours dispensing fluoride during that time. We generally recommend that children have a professional application of fluoride twice a year during dental check-ups. Remember, fluoride alone will not prevent tooth decay!It is important to brush at least twice a day, floss regularly, eat balanced meals, reduce sugary snacks, and visit your dentist on a regular basis.

Dental Implants

Dental implants are a great way to replace missing teeth and also provide a fixed solution to having removable partial or complete dentures.  Implants provide excellent support and stability for these dental appliances.

Dental implants are artificial roots and teeth (usually titanium) that are surgically placed into the upper or lower jaw bone by Dr. Francis or a Periodontist.  The teeth attached to implants are very natural looking and often enhance or restore a patient’s smile!

Dental implants are very strong, stable, and durable and will last many years. Reasons for dental implants:

• Replace one or more missing teeth without affecting adjacent teeth.
• Resolve joint pain or bite problems caused by teeth shifting into missing tooth space.
• Restore a patient’s confident smile.
• Restore chewing, speech, and digestion.
• Restore or enhance facial tissues.
• Support a bridge or denture, making them more secure and comfortable.

You will receive care instructions when your treatment is completed.  Good oral hygiene, eating habits, and regular dental visits will aid in the life of your new implant.

Dentures & Partial Dentures

A denture is a removable dental appliance replacement for missing teeth and surrounding tissue.  They are made to closely resemble your natural teeth and may even enhance your smile.

There are two types of dentures – complete and partial dentures.  Complete dentures are used when all of the teeth are missing, while partial dentures are used when some natural teeth remain.  A Partial denture not only fills in the spaces created by missing teeth, it prevents other teeth from shifting.

Dentures are very durable appliances and will last many years. Reasons for dentures:

• Complete Denture – Loss of all teeth in an arch.
• Partial Denture – Loss of several teeth in an arch.
• Enhancing smile and facial tissues.
• Improving chewing, speech, and digestion.

Inlay Restorations

An inlay restoration is a custom made filling made of composite material, gold, or tooth-colored porcelain.  Inlays can be utilized to conservatively repair teeth that have large defective fillings or have been damaged by decay or trauma.  Inlays are an ideal alternative to conventional silver and composite fillings.  Also, they are more conservative than crowns because less tooth structure is removed in the preparation of inlays.

As with most dental restorations, inlays are not always permanent and may someday require replacement. Reasons for inlay restorations:

• Broken or fractured teeth.
• Cosmetic enhancement.
• Decayed teeth.
• Fractured fillings.
• Large fillings.

Onlay Restorations An onlay restoration is a custom made filling made of composite material, gold, or tooth-colored porcelain.  An onlay is sometimes also referred to as a partial crown. .

Onlays like Inlays can be utilized to repair teeth that have large defective fillings or have been damaged by decay or trauma.  Onlays are an ideal alternative to crowns (caps) because less tooth structure is removed in the preparation of onlays.  Onlays are essentially identical to inlays with the exception that one or more of the chewing cusps have also been affected and need to be included in the restoration.

As with most dental restorations, onlays are not always permanent and may someday require replacement. Reasons for onlay restorations:

• Broken or fractured teeth.
• Cosmetic enhancement.
• Decayed teeth.
• Fractured fillings.
• Large fillings.

Periodontal Disease

• Diagnosis
• Treatment
• Maintenance
• Causes of Periodontal Disease
• Types of Periodontal Disease
• Signs & Symptoms of Periodontal Disease
• Mouth – Body Connection
• Periodontal Disease and Diabetes
• Periodontal Disease, Heart Disease and Stroke
• Periodontal Disease and Pregnancy
• Periodontal Disease and Osteoporosis
• Periodontal Disease and Respiratory Disease

The word periodontal means “around the tooth”.  Periodontal disease attacks the gums and the bone that support the teeth.  Plaque is a sticky film of food debris, bacteria, and saliva.  If plaque is not removed, it turns into calculus (tartar).  When plaque and calculus are not removed, they begin to destroy the gums and bone.  Periodontal disease is characterized by red, swollen, and bleeding gums.

Four out of five people have periodontal disease and don’t know it!  Most people are not aware of it because the disease is usually painless in the early stages.

Not only is it the number one reason for tooth loss, research suggests that there may be a link between periodontal disease and other diseases such as, stroke, bacterial pneumonia, diabetes, cardiovascular disease, and increased risk during pregnancy.  Researchers are determining if inflammation and bacteria associated with periodontal disease affects these systemic diseases and conditions.  Smoking also increases the risk of periodontal disease.

Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease. Signs and symptoms of periodontal disease:

• Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.

• Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).

• New spacing between teeth – Caused by bone loss.

• Persistent bad breath – Caused by bacteria in the mouth.

• Pus around the teeth and gums – Sign that there is an infection present.

• Receding gums – Loss of gum around a tooth.

• Red and puffy gums – Gums should never be red or swollen.

• Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.

Diagnosis

Periodontal disease is diagnosed by Dr. Francis and/ or his dental hygienist during a periodontal examination. This type of exam should always be part of your regular dental check-up.

A periodontal probe (small dental instrument) is gently used to measure the sulcus (pocket or space) between the tooth and the gums.  The depth of a healthy sulcus measures three millimeters or less and does not bleed.  The periodontal probe helps indicate if pockets are deeper than three millimeters.  As periodontal disease progresses, the pockets usually get deeper.

Dr. Franics or the hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category below: Gingivitis Gingivitis is the first stage of periodontal disease.  Plaque and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed. Periodontitis Plaque hardens into calculus (tartar).  As calculus and plaque continue to build up, the gums begin to recede from the teeth.  Deeper pockets form between the gums and teeth and become filled with bacteria and pus.  The gums become very irritated, inflamed, and bleed easily.  Slight to moderate bone loss may be present. Advanced Periodontitis The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed.  Unless treated, the affected teeth will become very loose and may be lost.  Generalized moderate to severe bone loss may be present.

Treatment

Periodontal treatment methods depend upon the type and severity of the disease.  Dr. Francis and his dental hygienist will evaluate for periodontal disease and recommend the appropriate treatment.

Periodontal disease progresses as the sulcus (pocket or space) between the tooth and gums gets filled with bacteria, plaque, and tartar, causing irritation to the surrounding tissues.  When these irritants remain in the pocket space, they can cause damage to the gums and eventually, the bone that supports the teeth!

If the disease is caught in the early stages of gingivitis, and no damage has been done, one to two regular cleanings will be recommended.  You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings.

If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planing (deep cleaning) will be recommended.  It is usually done one quadrant of the mouth at a time while the area is numb.  In this procedure, tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planing).  This procedure helps gum tissue to heal and pockets to shrink.  Medications, special medicated mouth rinses, and an electric tooth brush may be recommended to help control infection and healing.

Maintenance

It only takes twenty four hours for plaque that is not removed from your teeth to turn into calculus (tartar)!  Daily home cleaning helps control plaque and tartar formation, but those hard to reach areas will always need special attention.

Once your periodontal treatment has been completed, Dr. Francis and the  hygienist will recommend that you have regular maintenance cleanings (periodontal cleanings), usually four times a year.  At these cleaning appointments, the pocket depths will be carefully checked to ensure that they are healthy.  Plaque and calculus that is difficult for

In addition to your periodontal cleaning and evaluation, your appointment will usually include:

• Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss.X-rays also help determine tooth and root positions.

• Examination of existing restorations: Check current fillings, crowns, etc.

• Examination of tooth decay: Check all tooth surfaces for decay.

• Oral cancer screening: Check the face, neck, lips, tongue, throat, cheek tissues, and gums for any signs of oral cancer.

• Oral hygiene recommendations: Review and recommend oral hygiene aids as needed. (Electric toothbrushes, special periodontal brushes, fluorides, rinses, etc.)

• Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.

Good oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control!

Periodontal (gum) disease, which is also known as periodontal disease and periodontitis, is a progressive disease which if left untreated may result in tooth loss.  Gum disease begins with the inflammation and irritation of the gingival tissues which surround and support the teeth.  The cause of this inflammation is the toxins found in plaque which cause an ongoing bacterial infection.

The bacterial infection colonizes in the gingival tissue and deep pockets form between the teeth and the gums.  If treated promptly by a periodontist, the effects of mild inflammation (known as gingivitis) are completely reversible.  However, if the bacterial infection is allowed to progress, periodontal disease begins to destroy the gums and the underlying jawbone; promoting tooth loss.  In some cases, the bacteria from this infection can travel to other areas of the body via the bloodstream.

Common Causes of Gum Disease

There are genetic and environmental factors involved in the onset of gum disease, and in many cases the risk of developing periodontitis can be significantly lowered by taking preventative measures.

Here are some of the most common causes of gum disease:

• Poor dental hygiene – Preventing dental disease starts at home with good oral hygiene and a balanced diet.  Prevention also includes regular dental visits which include exams, cleanings, and x-rays.  A combination of excellent home care and professional dental care will ensure and preserve the natural dentition and supporting bony structures.  When bacteria and calculus (tartar) are not removed, the gums and bone around the teeth become affected by bacteria toxins and can cause gingivitis or periodontitis, which can lead to tooth loss.

• Tobacco use – Research has indicated that smoking and tobacco use is one of the most significant factors in the development and progression of gum disease.  In addition to smokers experiencing a slower recovery and healing rate, smokers are far more likely to suffer from calculus (tartar) build up on teeth, deep pockets in the gingival tissue and significant bone loss.

• Genetic predisposition – Despite practicing rigorous oral hygiene routines, as much as 30% of the population may have a strong genetic predisposition to gum disease.  These individuals are six times more likely to develop periodontal disease than individuals with no genetic predisposition.  Genetic tests can be used to determine susceptibility and early intervention can be performed to keep the oral cavity healthy.

• Pregnancy and menopause – During pregnancy, regular brushing and flossing is critical. Hormonal changes experienced by the body can cause the gum tissue to become more sensitive, rendering them more susceptible to gum disease.

• Chronic stress and poor diet – Stress lowers the ability of the immune system to fight off disease, which means bacterial infections may possibly beat the body’s defense system.  Poor diet or malnutrition can also lower the body’s ability to fight periodontal infections, as well as negatively affecting the health of the gums.

• Diabetes and underlying medical issues – Many medical conditions can intensify or accelerate the onset and progression of gum disease including respiratory disease, heart disease, arthritis and osteoporosis.  Diabetes hinders the body’s ability to utilize insulin which makes the bacterial infection in the gums more difficult to control and cure.

• Grinding teeth – The clenching or grinding of the teeth can significantly damage the supporting tissue surrounding the teeth.  Grinding one’s teeth is usually associated with a “bad bite” or the misalignment of the teeth.  When an individual is suffering from gum disease, the additional destruction of gingival tissue due to grinding can accelerate the progression of the disease.

• Medication – Many drugs including oral contraceptive pills, heart medicines, anti-depressants and steroids affect the overall condition of teeth and gums; making them more susceptible to gum disease.  Steroid use promotes gingival overgrowth, which makes swelling more commonplace and allows bacteria to colonize more readily in the gum tissue.

Common Signs & Symptoms

It is extremely important to note that periodontal disease can progress without any signs or symptoms such as pain.  This is why regular dental checkups are exceptionally important. Described below are some of the most common signs and symptoms of periodontitis.

If you have any of these signs or symptoms, the advice of a general dentist or periodontist should be sought as soon as possible:

• Unexplained bleeding – Bleeding when brushing, flossing or eating food is one of the most common symptoms of a periodontal infection.  The toxins in plaque cause a bacterial infection which makes the tissues prone to bleeding.
• Pain, redness or swelling – A periodontal infection may be present if the gums are swollen, red or painful for no apparent reason.  It is essential to halt the progression of the infection before the gum tissue and jaw bone have been affected.  It is also critical to treat the infection before it is carried into the bloodstream to other areas of the body.
• Longer-looking teeth – Periodontal disease can lead to gum recession.  The toxins produced by bacteria can destroy the supporting tissue and bones, thus making the teeth look longer and the smile appear more “toothy.”
• Bad breath/halitosis – Although breath odor can originate from back of the tongue, the lungs and stomach, from the food we consume, or from tobacco use, bad breath may be caused by old food particles which sit between the teeth and underneath the gumline.  The deeper gum pockets are able to house more debris and bacteria, causing a foul odor.
• Loose teeth/change in bite pattern – A sign of rapidly progressing periodontitis is the loosening or shifting of the teeth in the affected area.  As the bone tissue gets destroyed, teeth that were once firmly attached to the jawbone become loose or may shift in position.
• Pus – Pus oozing from between the teeth is a definitive sign that a periodontal infection is in progress.  The pus is a result of the body trying to fight the bacterial infection.

Treatment of Periodontal Disease

It is of paramount importance to halt the progression of periodontal disease before it causes further damage to the gum tissues and jawbone.  Dr. Francis will initially assess the whole mouth in order to ascertain the progress of the disease.  When a diagnosis has been made, he may treat the bacterial infection with antibiotics in conjunction with nonsurgical or surgical treatment or both.

In the case of moderate periodontal disease, the pockets (under the gumline) of the teeth will be completely cleared of debris using a procedure called scaling and root planing.  The pockets may

Orthodontics

What is Orthodontics? Orthodontics is specifically concerned with diagnosing and treating tooth misalignment and irregularity in the jaw area.

There are many advantages to well-aligned teeth, including easier cleaning, better oral hygiene, clearer speech and a more pleasant smile.  Though orthodontic treatment can be effective at any age, the American Dental Association suggests that an orthodontic assessment should be performed around the age of seven.  The earlier orthodontic treatment begins, the more quickly the problem can be successfully resolved.

Here are some of the common conditions treated with orthodontics: Orthodontic Solutions Dr. Francis will generally perform a visual examination, panoramic x-rays and study models (bite impressions) in order to assess the exact nature of the discrepancy.

When a diagnosis has been made, there are a variety of orthodontic treatment options available.

Here is an overview of some of the most common treatments:

• Fixed orthodontic braces – A metal or ceramic dental base is affixed to each tooth, and a dental wire is inserted through each base.  The teeth are gradually trained into proper alignment by regularly adjusting the wire.  When the desired results are achieved, the fixed dental braces are completely removed.

• Invisalign^®  – This is a newer, removable type of dental aligner that is completely transparent.  Invisalign^® does not interfere with eating because of its removable nature, and mechanically works in the same way as the traditional metal dental braces.  Not all patients are candidates for Invisalign^®.

• Retainers – After the teeth have been realigned using dental braces, removable devices such as a retainer will then be provided to ensure that the teeth do not begin to move back toward their original positions.  Retainers are generally worn until the underlying bone has reformed into the correct position.

Whether it’s traditional braces or custom made removable appliances, orthodontics can help you have the healthy, straight, beautiful smile you’ve been waiting for! If you have any questions about orthodontists and the treatments they provide, please contact our office.

Periodontal Treatment

Periodontal treatment cares for the soft tissues of the mouth and the underlying jawbone which supports the teeth.

We are mainly concerned with preventing the onset of gum disease (periodontal disease), diagnosing conditions affecting the gums and jawbone, and treating gingivitis, periodontitis and bone loss.  Periodontal disease is a progressive condition and the leading cause of tooth loss among adults.

The most common conditions we treat are:

• Gingivitis – This is the mild inflammation of the gums which may or may not be signified by pain and bleeding.

• Mild/moderate periodontitis – When the pockets between the teeth and the soft tissues are measured to be between 4-6mm it is classified as moderate periodontitis (gum disease).

• Advanced periodontitis – When the pockets between the teeth and the soft tissues in general exceed 6mm in depth, significant bone loss may occur; causing shifting or loss of teeth.

• Missing teeth – When teeth are missing as a result of bone loss, the periodontist can implant prosthetic teeth.  These teeth are anchored to the jawbone and restore functionality to the mouth.

Periodontal Treatments

Dr. Francis is able to perform a wide range of treatments to halt the progression of gum disease, replace missing teeth and make the appearance of the smile more aesthetically pleasing.

• Implant placement – When a tooth or several teeth are missing, Dr. Francis is able to create a natural-looking replacement by anchoring a prosthetic tooth to the jawbone.

• Gingivoplasty (soft tissue recontouring) – As gums recede due to periodontitis, the teeth may appear longer; causing a “toothy” smile.  Dr. Francis can remove tissues or straighten the gum line to make the teeth look more even.

• Bone grafting – Dental implants can only be positioned if there is sufficient bone to attach the prosthetic tooth to.  If bone loss has occurred, bone grafting is an excellent way to add or “grow” bone so that an implant may be properly secured.

• Deep pocket cleanings – As gingivitis and periodontitis progress, it becomes more difficult to cleanse the pockets between the soft tissues and the teeth.  Dr. Francis or our hygienist can scale and root plane the teeth (sometimes under local anesthetic) to remove debris and infection-causing bacteria.
• Crown lengthening – In order to expose more of the natural tooth, Dr. Francis can remove some of the surrounding gingival tissue.