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ORAL HYGIENE CARE
Maintaining good oral hygiene is one of the most important things you can do for your teeth and gums.  Healthy teeth not only enable you to look and feel good, they make it possible to eat and speak properly.  Good oral health is important to your overall well-being. Daily preventive care, including proper brushing and flossing, will help stop problems before they develop.

In between regular visits to the dentist, there are simple steps that each of us can take to greatly decrease the risk of developing tooth decay, gum disease and other dental problems. These include:

  • Brush thoroughly twice a day and floss daily
  • Eat a balanced diet and limit snacks between meals
  • Use dental products which contain fluoride, including toothpaste
  • Rinse with a flouride mouth rinse if advised to do so
  • Make sure children under 12 drink fluoridated water or take a fluoride supplement if they live in a non-fluoridated area
  • Visit your dentist regularly for professional cleanings and oral exams
  • Replace your toothbrush every 3-4 months

The following are indications of good oral hygiene:

  • Your teeth are clean and free of debris
  • Gums are pink and do not hurt or bleed when you brush or floss
  • Bad breath is not a constant problem
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DENTAL CLEANING

A dental cleaning is a professional cleaning you receive from a dentist or dental hygienist. Most dental cleanings take approximately 30 minutes.  Cleanings should be performed every six months to prevent excessive plaque buildup.  Plaque left untreated can lead to unhealthy gums and tooth decay.  During your routine cleaning we will remove excess plaque and polish your teeth.  Back to top

 

SEALANTS
Sealants are used to fill narrow grooves in a tooth that cannot be adequately cleaned by brushing.  In some cases, the tooth structure has fine grooves or pits which accumulate plaque, not because the person doesn't brush, but because they're too narrow to allow even one bristle into them.  To avoid cavities developing over time, the dentist will brush on a coating that seals the grooves and pits, making it possible to brush off all the plaque and keep your teeth healthy.  Back to top

BONDING

Bonding involves adhering composite resin material that is matched to the color of the tooth, to the front of the tooth. This is performed to repair damage caused by decay, to alter the alignment of the tooth, close gaps between the teeth, or for other cosmetic purposes. 

First the surface of the tooth is roughened in order to accept the bonding.  A gel is applied so the resin will adhere to the surface of the tooth.  The composite is then placed on the tooth and the bonding agent hardens with intense light. The last step is shaping and polishing to give a lustrous finish.  Back to top

FILLINGS
A filling is a way to restore a tooth damaged by decay back to its normal function and shape.  If you have a tooth that requires a filling, the dentist will first remove the decayed tooth material, clean the affected area, and then fill the cleaned out cavity with a filling material.  A filling helps prevent further decay by closing off any cracks or spaces where bacteria can enter.

There are a variety of filling materials available including gold, silver, plastic and porcelain. The dentist will work with you to determine which material is best, depending on the extent of repair, where in the filling is needed, and cost.  Each filling material is briefly explained below:

· Gold fillings are custom made in a laboratory and then cemented into place.  While gold fillings are often the most expensive choice, many consider it the best filling material.  Gold inlays are well-tolerated by gum tissues and may last more than 20 years.

·Composite (plastic) resins are custom made to the exact color of your natural teeth, creating a more natural appearance. While white fillings may be less noticeable than other materials, they usually only last between 3 and 10 years and may not be ideal for large fillings as they may chip or wear over time.  They can also become stained from coffee, tea or tobacco.

· Porcelain fillings are called inlays or onlays and are custom created in a lab and then bonded to the tooth.  They can be matched to the color of the tooth, resist staining, and are about the same cost as gold fillings.  A porcelain restoration generally covers most of the tooth, making the filling nearly undetectable.

If decay or a fracture has damaged a large portion of the tooth, a crown (or "cap") may be recommended.  Decay that has reached the nerve may be treated through root canal therapy or through a procedure called pulp capping.  Back to top

 

NON-SURGICAL GUM TREATMENT
The gums, ligaments, and bone around the teeth form the foundation for  teeth. All structures are also referred to as the periodontium. When the periodontium is not healthy, it jeopardizes the teeth just as a bad foundation would threaten the stability of a house.  Signs of unhealthy periodontium include: gums that are red and bleed easily, persistent bad breath, gums that are pulled away from the tooth, loose teeth, and changes in the position or bite of the teeth.  With proper gum treatments,  it may be possible to return gum tissue to a healthy state.  If you're having a problem, come in and see us so we may treat it right away. The treatment usually involves a deep cleaning or root planing done under a local anesthetic, along with local antibiotic agents.  It is important to have gum problems checked promptly, as gum disease left alone may eventually need treatment through surgery or extraction.  Back to top

 

CROWNS AND BRIDGES
Crowns and bridges are used to restore and enhance teeth that are damaged or to take the place of missing teeth. A crown (also referred to as a cap) is used to entirely cover a damaged tooth.  A crown not only strengthens a tooth, but it can dramatically improve a tooth’s appearance, shape and alignment.

Crowns may be used to:

                • Replace a large filling when there is little tooth structure remaining
                • Protect a weak tooth from fracturing
                • Restore a fractured tooth
                • Attach a bridge
                • Cover a dental implant
                • Cover a discolored or poorly shaped tooth
                • Cover a tooth that has had root canal treatment

A bridge is an ideal method to fill the space created by missing teeth. A bridge is one or more artificial teeth cemented into place using the teeth on either side for support. This is an option for filling the space created by a missing tooth.  Bridge work is as much an art as it is an exact science since it replaces a missing tooth both functionally and cosmetically. The materials used may be gold alloys, porcelain bonded to metal alloy, or all ceramic material made to match your natural tooth color.  The choice of material depends on requirements for strength, wear, and aesthetics.

It is important that a missing tooth be replaced as soon as possible.  If not treated, the teeth surrounding the gap begin to shift inward. Since teeth use their neighbors for support, if one is missing they begin to "fall” and shift into the open spaces. This may worsen the bite because of the changes in pressure and can eventually result in problems with the jaw such as TMJ.

Bridges and crowns are made by first taking an impression of your mouth.  The impression is sent to a dental lab where your crown or bridge will be custom made to fit your mouth and match your natural tooth color.  A temporary crown or bridge will be placed into your mouth until your permanent crown or bridge is ready and cemented into place.  Bridges and crowns are very durable and can last a lifetime with extra care and good oral hygiene.

Crowns Before & After

   

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TOOTH EXTRACTIONS

Good oral hygiene should always be practiced since the loss of a single tooth can have major impact upon your oral health and appearance.  Although dentists will use every measure to prevent tooth loss, there still sometimes necessary occasions when a tooth may need to be extracted.  A tooth may need to be extracted for the following reasons:

                • Severe decay
                • Advanced periodontal disease
                • Infection or abcess
                • Orthodontic correction
                • Malpositioned teeth
                • Fractured teeth or roots
                • Impacted teeth

After careful examination and treatment, the dentist may advise to have a tooth extracted.  Before a tooth is removed, the dentist will take an x-ray in order to understand the shape and position of the tooth and surrounding bone.  Based on the degree of difficulty, we may refer you to a specialized oral surgeon.

For a simple extraction, we will first apply a local anesthetic to prevent pain and discomfort. The tooth will be loosened with a tool called an elevator and then removed with dental forceps. Once the procedure is complete, the area may be closed with one or two stitches.  We will then provide you with care instructions to alleviate discomfort and ensure proper healing.  Back to top

WISDOM TOOTH EXTRACTIONS
Wisdom teeth are the last molars or “third molars” that develop on each side of the jaws.  Wisdom teeth usually emerge in the back of the mouth between the ages of 16-20.

Wisdom teeth are a valuable asset to the mouth when they are healthy and properly positioned.  Often, however, problems develop that require their removal. When the jaw isn't large enough to accommodate wisdom teeth, they can become impacted (unable to come in or misaligned). Wisdom teeth may also grow in sideways, emerge only part way through the gum or remain trapped beneath the gum and bone. 

A wisdom tooth extraction is a relatively routine procedure.  The dentist will numb the area in your mouth with a local anesthesia or use IV sedation so you are asleep during the procedure.

After the tooth is removed, we will provide care instructions to ensure proper healing.  Some pain and swelling may occur but will normally subside after a few days.  You should call your dentist if you have prolonged or severe pain, swelling, bleeding or fever.  Back to top

ROOT CANAL TREATMENT
Root canal treatment (also referred to as root canal therapy or endodontic therapy) is made necessary when an untreated cavity reaches all the way to this pulp.  Treatment may also be needed when deep restorations or trauma to a tooth cause nerve damage.  Once the pulp becomes infected, and can begin to eat away at the surrounding bone (this is known as an abscess).  If the pulp is infected, not only is it painful but it will require treatment as it cannot heal on its own.   Symptoms that indicate the pulp has become infected may include sensitivity to hot/cold or sweets, pain, swelling, pain to biting or pressure, and a bad taste in the mouth.  However, sometimes no symptoms are apparent and you may be unaware of any problem until a checkup.

A root canal is performed to clean out the infected tooth pulp and disinfect the canals of the tooth.  Alternate treatment would be to extract the tooth.  Once the infection is resolved, the canal is filled in to prevent any further infection. Usually a core build-up and crown is recommended for restoring a tooth that has undergone root canal therapy.  Back to top

 

DENTAL IMPLANTS
A dental implant is an ideal tooth restoration for people who are missing one or more teeth as a result of injury, periodontal disease, or any other reason.  A dental implant is a metal post that  Dr. Palmisano surgically positions into the jaw.  Once in place and bone surrounding the implant has had time to heal, a replacement tooth is attached to the post.  While implants are typically take more time to complete than other methods of tooth replacement, they provide superior benefits.  Implants are stronger than natural teeth and generally can last a lifetime.  They are also a more favorable approach than bridgework since they do not depend on neighboring teeth for support.

To receive implants, you need to have healthy gums and adequate bone to support the implant.  You must also be committed to excellent oral hygiene and regular dental visits as these are critical to the long-term success of dental implants.  Back to top

DENTURES
A denture is a removable replacement for missing teeth and surrounding tissues.  There are two types of dentures available, including partial and complete dentures.  Partial dentures are used when some natural teeth remain, while complete dentures are used to completely replace all teeth.  Dentures are made to resemble your natural teeth so there should be no noticeable change to your appearance. In fact, dentures may even improve your smile!

This restoration method is used to restore your smile and mouth function if all your teeth have been lost.  The dentures are custom created to resemble natural teeth and are positioned to take the place of natural teeth.  Complete dentures are removable and may require adjustments in order to create a proper fit with the gums and mouth.

A removable partial denture is a device used when one or more natural teeth still remain in the upper or lower jaw.  They usually consist of replacement teeth attached go a gum-colored plastic base which is held in place in the mouth.  A fixed partial denture acts the same as a removable denture, but it is cemented into place using adjacent teeth for support.

New dentures may feel awkward or loose for the first few weeks until the muscles of your cheek and tongue learn to keep them in place and you are comfortable eating and speaking. Although this may require some practice you will adjust and enjoy the benefits a full mouth of teeth can provide.  Back to top

NIGHTGUARDS AND MOUTHGUARDS
Custom designed mouthguards and nightguards are made of flexible plastic and molded to fit the shape of your teeth. Mouthguards are recommended to protect the jaw and teeth during physical activity and sports such as boxing, football, basketball, or other activities where your mouth may be hit.  Guards also protect the soft tissues of your tongue, lips and cheek lining.  Nightguards are recommended for patients who clench or grind their teeth at night as a way to protect their teeth and bite.

If you have decided a guard is right for you, we will take an impression of your teeth which will then be sent to a lab to make a custom fit guard.  In most cases you can choose from a variety of colors and styles. On average, guards last between 3 and 10 years.  Back to top

TMJ TREATMENTS
TMJ stands for temporal-mandibular joint.  Temporal, as in temple area of skull; mandibular as in mandible, or lower jaw; joint as in where the head and jaw meet.  Problems in this joint may be caused by a misalignment of the teeth, trauma, or excess muscle tension. Cartilage buffers the two bones and five muscles that meet in this area, but any problems in this area can create quite a bit of pain and biting difficulties.  

Symptoms of TMJ include:

  • Headaches
  • Earaches
  • Trouble/soreness in opening and closing the mouth
  • Clicking or popping of the jaw
  • Pain in the jaw muscles
  • Soreness in the area, sometimes extending to the face

Dental treatments for the condition can include replacing missing teeth, moving teeth, adjusting the bite and filling gaps between teeth. There is no one solution that is right for all cases. Occasionally a plastic mouthpiece is used to prevent clenching or grinding that is contributing to the problem. If untreated and in severe cases, surgery may be required to repair a badly damaged joint. Back to top

WHITENING
Tooth whitening is a popular procedure to make teeth whiter and brighter, and therefore more attractive. Bleaching can be used to whitening stained and discolored teeth, or simply to enhance a dull smile.  Either way, tooth whitening is a safe and relatively painless procedure ideal for most patients.  Our office offers two methods of whitening: Zoom! in-office whitening and tray whitening.

Zoom! whitening is ideal for anyone wanting immediate results.  The entire process takes place in our office in about an hour, making it the perfect choice for busy individuals.  In this process, a protective gel is applied to your gums to protect the soft tissue.  A special light-activated gel is then applied to your teeth and a special light or laser is used to enhance the action of the agent - making your teeth whiter and brighter.  As a final step, we take impressions of your teeth to create custom trays for at home touch-ups, and give you instructions for keeping your smile bright. The result is dramatically whiter teeth that will last for years.

Tray whitening is a less expensive whitening treatment you can use while in the comfort of your own home.  We will first take an impression of your mouth to create a customized clear whitening trays for you to wear.  Within a few days your trays will be ready to be picked up and we will show you how to apply the special bleaching material to the trays.  The whitening gel trays should be worn 30-60 minutes up to twice a day.  At the end of this period, you will see maximum whitening results that are nothing short of dazzling.  Occasional treatment can be used at your convenience to maintain your new smile. 

Whitening Before & After

 

 

VENEERS & LUMINEERS
Veneers are a dental procedure in which a covering is placed over the outside (visible area) of the tooth. Veneers are usually only applied to the part of the tooth that is visible when talking or smiling. The procedure can be direct or indirect.

The direct technique usually involves placing composite resin on the outside of the tooth using bonding. This method is usually referred to as bonding.

The indirect technique usually involves two appointments because the veneers will be fabricated at a dental laboratory.  At the first appointment the teeth are prepared, impressions taken, and the teeth are given a temporary covering. In two to three weeks the veneers are back from the laboratory, the temporaries are removed and the veneers are bonded to the teeth. The laboratory fabricated veneers are usually made using porcelain or pressed ceramic and are very aesthetic.

The advantage of veneers versus crowns is that much less tooth material is removed, and the procedure is generally less uncomfortable. Veneers are recommended for teeth that have large fillings or little tooth structure.

Veneers Before & After

 

LUMINEERS
Lumineers are porcelain veneers that offer the painless way to a permanently whiter and perfectly aligned smile. Your LUMINEERS dentist can apply these contact lens-thin "smile shapers" to teeth without any grinding or shaving, transforming teeth into a naturally beautiful smile that looks perfect for every individual. LUMINEERS can even be placed over existing crown or bridgework without having to replace them.

LUMINEERS are contact lens-thin and are placed over existing teeth without having to remove painful tooth structure (unlike traditional veneers.) LUMINEERS is the painless, permanent cosmetic solution for stained, chipped, discolored or misaligned teeth.

LUMINEERS can only be made from patented Cerinate porcelain unavailable anywhere other than the Cerinate Smile Design Studio. In just 2-3 visits to your LUMINEERS dentist, you can have a custom-made smile that is clinically proven to last over 20 years - and it is completely reversible since your natural tooth structure is still intact! Get your perfect smile today! 
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DIGITAL X-RAYS
X-rays are a focused beam of x-ray particles passed through bone which produce an image on special film, showing the structure through which it passed.  This provides the familiar black and white images doctors and dentists use to diagnose problems and disease.  Without an x-ray of the whole tooth and supporting bone and gum tissues, there would be no way to detect infection or pathology that requires attention. 

In our office we use digital radiography which allows us to take x-rays using up to 90% less radiation than conventional film x-rays.  Using this technology, we are able to take an x-ray of your mouth by using a small sensor which records the image of your teeth and sends it to a computer.  The result is a highly detailed image of your mouth that can easily be enhanced to better diagnosis dental concerns and determine the very best treatment for each case. Back to top

 

PAPERLESS CHARTING
Our office is a completely digital (paperless) dental office. This means all x-rays and charting are made and recorded with the aid of the computer. This technology allows us to maintain your dental records electronically, and cuts down the unnecessary paperwork used with traditional paper charting.  Traditional paper charting is difficult to keep standardized from doctor to hygienist to assistant.  Even handwriting differences and coding make the charts look different. The computer eliminates this problem by using consistent charting methods that are accurate and precise, making it easy to read your dental chart and see up-to-date information.  Digital charting standardizes the charting process so it is clear, easy to understand, and enables us to provide on the most accurate and precise care to our patients. When needed, this method also allows us to quickly and securely share information with your other health care providers. Back to top

 

 

 

DIGITAL IMAGING SOFTWARE
We use digital imaging software in our office, which allows us to take a digital picture of you and use our imaging system to predict how a particular treatment or cosmetic procedure would change the appearance of your teeth. This software is beneficial for patients who are considering cosmetic procedures but are not sure if they’re ready for dramatic changes. Digital imaging also allows us to document your dental case and procedures very well.We take digital images of your face, teeth and smile to provide us with a permanent dental record and to provide a visual documentation of treatment. Back to top

 

ELECTRONIC CLAIM PROCESSING
Our office utilizes electronic claims processing. This means that rather than sending your dental claim through the mail, it is sent electronically to your insurance company with the click of the button. By filing your claim electronically, information is submitted more efficiently and with fewer errors.This benefits our patients because the turn around time on claims is faster and fewer claims are returned or denied. We are happy to submit your dental claims to your insurance company on your behalf.  Back to top

INTRAORAL IMAGING
We use small cameras about the size of a pen, called intraoral cameras, to help clearly see the condition of your teeth and gums.  With this advanced technology we can zoom in on small diseased areas, cracks, chips and worn metal fillings with extreme precision. The full-color images taken with the intraoral camera are sent to a computer screen so we can clearly see and diagnose dental problems much earlier than with traditional dental technology. Because images are displayed on our screens, patients will also be able to see areas being worked on and are able to gain a better understanding of dental procedures being performed.  Back to top

TELESCOPIC LOUPES
The dentist performs most of his dental procedures while wearing a pair of funny looking glasses called surgical telescopes. These powerful glasses have magnifiers on them, allowing the dentist to see fine details that would go unnoticed to the naked eye.
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2020 Dickory Ave. , Suite 104 • River Ridge, LA  70123 
t. 504.733.0871
  •  f. 504.734.0098 •  palmisanodental@gmail.com

 

© 2008 Warren J. Palmisano III, DDS