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Contact the BravoSmile dental clinic in Portland, Oregon.

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Glossary of Dental Terms

To help you understand, so you can make your own decisions.

Amalgam

a filling containing silver and mercury.

Autoclaved

Dental instruments cleaned by equipment that uses super heated high pressure steam.

Bruxism

grinding the teeth.

Crown

A full covering for a tooth using gold or porcelain. Used when the tooth cannot be restored by a filling.

Cusp

The high points on the chewing surfaces of the back teeth (posterior teeth).

Decay

Tooth decay or cavities. The gradual erosion of the enamel (the protective covering of the tooth) and dentin (the substance beneath the enamel).

Disinfecting

A cleaning procedure accomplished by using a chemical disinfectant according to the directions on the product label. A chemical agent for disinfecting (other than sodium hypochlorite) in the dental setting must be registered by the Environmental Protection Agency (EPA) as a hospital disinfectant, and must be tuberculocidal. Virucidal efficacy must include, as a minimum, both lipophilic and hydrophilic viruses.

Endodontics (endo)

The treatment of diseases or injuries that affect the root tip or nerve of the tooth. The most common procedure that you will deal with is a root canal.

Implant

A post that is implanted in the bone. A crown, bridge or denture is then placed over the implant.

Local anesthesia

Relieves the sensation of pain in a localized area.

Nightguard

A removable appliance custom made to lay over your teeth which may alleviate or reduce symptoms from the jaw joint created by grinding while you sleep. This additionally prevents wearing down of the teeth. An orthotic in comparison is exactly fabricated at the position in space that will make the muscles more relaxed and help remove biological waste products (i.e. lactic acid). An orthotic is worn in many cases during the day as well (not during meals).

Onlay

A laboratory processed restoration made of metal, porcelain or acrylic that replaces one or more of the highest points of the tooth (cusps).

Perio charting

Measures the depth that the gums have detached from the side of the tooth forming a pocket (perio pocket).

Periodontal maintenance

Cleaning of the teeth following periodontal treatment, includes perio charting.

Periodontics (perio)

The treatment of diseases of the gum or bone (supporting structure).

Perio pocket

The pocket that forms when the gums detach from the side of the tooth.

Plaque

A sticky film on the teeth. If it is not removed by brushing, it can harden into calculus and eventually cause cavities.

Proxabrush

a small, nylon filament brush used for cleaning hard-to-reach spaces between teeth and around crowns, bridges, implants or orthodontic appliances.

Pulp

The soft tissue in the middle of each tooth that receives a rich supply of blood vessels and contains nerves that respond to heat, cold, pressure, and pain.

Root canal

A procedure performed to save a tooth in which the pulp (the living tissue within a tooth) has died or become untreatably diseased, usually as a result of cavities. The nerve of the tooth is removed from the canal inside the root and replaced with a filling material.

Root planing

Deep cleaning of the teeth to remove calculus below the gumline. This is not a prophylaxis. This is a periodontal procedure and is usually performed one quadrant at a time.

Sealant

Clear application of acrylic placed over the biting surface of the tooth to prevent decay.

Sterilization

The process by which all forms of microorganisms — including viruses, bacteria, fungi and spores — are destroyed. Suitable methods of sterilization include the use of steam under pressure (autoclave), dry heat, chemical vapor and ethylene oxide gas (only for instruments that can be thoroughly cleaned and dried).

Tempromandibular joint (T.M.J.)

This is the connecting hinge between the lower jaw and base of the skull.

Tooth Margin

the contact between a restored surface and the natural tooth structure.

Topical Fluoride

Application of a gel or liquid that may help in preventing decay and does help in desensitizing roots that are exposed.

Veneer

Custom-made pieces of porcelain that have the effect of re-enamelizing the teeth and returning them to their original beauty. The preparation is much less invasive than for a crown, and preserves more of your natural tooth structure.



Image used with permission from DENTSPLY International, Trubyte.
Contact the Bravo Smile office for the best dental care in Portland, Oregon.

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Antiseptic Procedures

Up to date equipment, procedures, and knowledge to ensure your health and safety

Facts about Infection Control Work Space Sterilization and Disinfection
Barrier Techniques Limiting Contamination Continuing Education

Facts about Infection Control

There is much concern about cross contamination of disease from patient to patient in dental offices. We at BravoSmile want to assure you that your health and safety is always our primary concern. These are some of the up-to-date procedures we use to protect your health.

  • We use an advanced, state of the art Sterilization Center, built for efficiency and convenience in dental health practices.
  • All equipment is sterilized either by steam autoclave, chemical disinfecting, or use of disposable equipment.
  • Cross contamination from person to person is prevented by the use of disposable gloves and masks.
  • Surface areas that have been touched during patient treatment are wiped off with a mild chemical solution before the next patient.
  • Bravo Smile staff participate in Continuing Education to keep up with the latest developments in patient safety practices.

Work Space

Our Sterilization Center is a self contained unit that facilitates the sterilization of dental instruments. It has solid surface countertops, an ultrasonic cleaner, a hospital grade sterilizer and an area for “cold sterile” solutions.

Sterilization and Disinfection

Instruments and handpieces are cleaned in a number of ways depending upon their structure:

1. Autoclaving – In this process, dental instruments are cleaned by equipment that uses super-heated high-pressure steam.

First, instruments undergo an ultrasonic treatment to remove any debris. They are then wrapped in surgical wrap and placed in the autoclave. Once sterilized, they are stored, still wrapped, and only opened shortly before the patient is seated.

Monitors are used weekly to verify the adequacy of sterilization cycles, and the autoclave is checked monthly for efficiency by an outside service.

2. Disinfecting – If the instrument could be damaged by heat, it is immersed in an EPA-registered chemical sterilant. This includes dental instruments that may be exposed to spatter or spray of body fluids or that may have been touched by contaminated hands.

3. Disposable instruments are used if the above cleaning techniques cannot be used.

Barrier Techniques

Gloves are worn when skin contact with body fluids or mucous membranes is anticipated, or when touching items or surfaces that may be contaminated with these fluids. After contact with each patient, gloves are removed and hands are washed and then regloved before treating another patient.

Protective clothing (gowns or similar outer garments, either reusable or disposable) is worn when clothing or skin is likely to be exposed to body fluids. Protective clothing is changed when soiled or penetrated by fluids. It is removed after use and placed in laundry bags or containers that are properly marked.

Surgical Masks are worn to protect the face, the oral mucosa and the nasal mucosa when spatter of body fluids is anticipated. Masks are changed when soiled or wet.

Protective eyewear, fitted with solid side shields, is worn to protect the eyes when spatter or splash of body fluids is anticipated. Eyewear is cleaned as necessary.

Limiting contamination

Hand washing is always done at the start of each day, before gloving, after removal of gloves, and after touching inanimate objects likely to be contaminated by body fluids from patients. For routine dental procedures, such as examinations and nonsurgical procedures, hand washing is done with plain soap, since soap and water will remove transient microorganisms acquired directly or indirectly from patient contact. For surgical procedures, an antimicrobial surgical handscrub is used.

Handling of sharp instruments and needles. Sharp instruments are handled carefully to prevent injuries. Syringe needles are recapped after they are used. These sharp items are discarded into puncture-resistant biohazard (sharps) containers that are easily accessible.

Surface Decontamination – Countertops and dental equipment surfaces such as light handles, X-ray unit heads, cabinet and drawer pulls, tray tables and chair switches, which are likely to become contaminated with potentially infectious materials are either covered or disinfected. All surfaces are not only cleaned after each patient, but plastic coverings are placed over surfaces for each new patient.

We use water bottles with distilled water for the spray in the handpieces and for rinsing. All water lines are cleaned daily, as is the vacuum system.

Housekeeping surfaces, including floors, sinks and related objects, are not likely to be associated with the transmission of infection, and extraordinary attempts to disinfect these surfaces are not necessary. However, the removal of visible soil is undertaken on a routine basis using cleaners with germicidal properties.

We take great pride in making our treatment rooms in our Portland, Oregon dental clinic safe so you can receive quality treatment.

Continuing Education

We at Bravo Smile believe in taking the extra steps to stay informed about the the most advanced infection control procedures to ensureyour health and safety.

We closely follow the guidelines of the American Dental Association. Much of the above information comes from their sources.

More information online…

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Potential Crown Problems

If the decay has barely begun, this should be fairly easy to fix with a filling.

More progressed potential problems

If the cavity is between the teeth, this is an area that cannot be easily accessed to repair the tooth with a filling. If the cavity penetrates the protective hard layer of the tooth and involves the softer dentin layer, it can cause an infection in the inner pulp layer affecting your tooth’s nerves and blood vessels. This can progress very rapidly if not treated.

Treatment of potential problems

Unless the decay is minimal, needing only a filling, the crown has to be removed along with the decay beneath it. We will then replace the old crown with a new crown which will reseal the tooth and protect from decay and infection. If the inner pulp layer is affected, a root canal may be needed to remove all the infected tissue. A new crown is then placed over the tooth.

The images below show two FAILING CROWNS, the first with margin decay and the second after a root canal needed because of decay involving the pulp of the tooth (white plug is temporary). Both crowns will have to be replaced.

 

Crown after a root canal from extensive margin decay.
Crown with margin decay.

 

If these problems are not treated

The infection will spread within the tooth, and could pass into the jawbone causing an abscess. This can be very painful and can damage the bone surrounding your tooth.

Preventive care to help you avoid these problems includes:

  • Thorough toothbrushing
  • Using dental floss to reach areas between the teeth
  • Use of a Proxabrush to remove plaque and food debris between the teeth
  • Regular dental checkups and cleanings

More information online:

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Failing Amalgam

If the decay has barely begun, this should be fairly easy to fix with a filling.

More progressed potential problems

If the cavity is between the teeth, this is an area that cannot be easily accessed to repair the tooth with a filling. If the cavity penetrates the protective hard layer of the tooth and involves the softer dentin layer, it can cause an infection in the inner pulp layer affecting your tooth’s nerves and blood vessels. This can progress very rapidly if not treated.

Treatment of potential problems

Unless the decay is minimal, needing only a filling, the crown has to be removed along with the decay beneath it. We will then replace the old crown with a new crown which will reseal the tooth and protect from decay and infection. If the inner pulp layer is affected, a root canal may be needed to remove all the infected tissue. A new crown is then placed over the tooth.

The images below show two FAILING CROWNS, the first with margin decay and the second after a root canal needed because of decay involving the pulp of the tooth (white plug is temporary). Both crowns will have to be replaced.

 
Crown after a root canal from extensive margin decay.
Crown with margin decay.
If these problems are not treated

The infection will spread within the tooth, and could pass into the jawbone causing an abscess. This can be very painful and can damage the bone surrounding your tooth.

Preventive care to help you avoid these problems includes:

Thorough toothbrushing
Using dental floss to reach areas between the teeth
Use of a Proxabrush to remove plaque and food debris between the teeth
Regular dental checkups and cleanings
More information online:

Dental Crowns by Animated-Teeth.com
Answers.com
American Dental Association
Academy of General Dentistry
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Care of Your Crown

Now that you have your new crown, know how to take care of it!

A crown is used to cover a tooth that has been broken or decayed extensively. It also strengthens and improves the cosmetic appearance of the tooth. It is usually made of gold or porcelain.

The area between the crown and your tooth is a difficult, but important area to keep clean because it is very prone to develop plaque and potential decay.

Preventive care, including the following, should help you avoid problems:

  • Thorough tooth brushing
  • Using dental floss to reach areas between the teeth
  • Use of a Proxabrush to remove plaque and food debris between the teeth
  • Regular dental checkups and cleanings

Read about potential problems with crowns…

More information online:

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Improving Your Oral Health

Top ten things you can do to improve your oral health

  1. See your dentist and hygienist regularly.
  2. Use floss, Proxabrush, and Sonicare daily.
  3. If you clench or grind your teeth, get fitted for a professional nightguard.
  4. If you have exposed roots, decalcification or sensitive teeth: Use a TOPICAL fluoride toothpaste and have a TOPICAL fluoride treatment at your preventive appointments.
  5. See a naturopath and get your nutrition improved.
  6. Do not smoke.
  7. If a spouse or close family member has periodontal disease, get them to handle their dental health. Periodontal disease is communicable.
  8. When you see the hygienist, ask for the number of bleeding points and compare to your last visit.
  9. If pockets are deepening or the tissue collar around the teeth is not improving (getting firmer), ask for a referral to the specialist.
  10. Understand that periodontal disease is painless (until advanced stages), and regular checkups are needed to become aware of this problem.
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What are the best alternative sweeteners?

What alternatives to sugar do you like to use?  Here are a few that Dr. Tim recommends to help prevent tooth decay and make your life a little bit sweeter.

1.  Stevia: Up to 300 times as sweet as table sugar, powdered stevia extract is derived from the leaves of subtropical shrubs that have been consumed by indigenous South Americans for centuries. Yet it has virtually no calories and doesn’t raise blood-sugar levels or promote tooth decay.

2. Lohan:  Industry insiders predict that monk fruit, aka lohan guo, is on the verge of becoming stevia’s fiercest new rival. Calorie-free, aftertaste-free and non-glycemic but about 300 times sweeter than sugar, liquid and powdered lohan guo concentrate is derived from the antioxidant-rich, lemon-sized fruits of trees that thrive in the hot, misty mountains of southern China and northern Thailand and were allegedly first cultivated by Buddhist monks 800 years ago.

3.  Xylitol: Xylitol is a naturally occurring carbohydrate, that looks and tastes just like regular table sugar. It is a natural sweetener that can be extracted from any woody fibrous plant material. Commercially it is extracted from renewable resources such as corn cobs, and also from less environmentally sustainable sources such as hardwood. Xylitol also occurs naturally in our bodies – in fact, an average size adult manufactures up to 15 grams of xylitol daily during normal metabolism.  Best yet, xylitol doesn’t cause tooth decay and is often used  in toothpaste and mouthwash.

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Teeth Whitening

Let’s face it: one of the first things you notice about people is their smile. When you meet someone with a bright, natural smile, it catches your attention. However, over time, the natural aging process and your lifestyle (smoking or drinking coffee, tea, or wine) can stain your teeth. To get your smile back to looking its best, you should choose a whitening method that:

  • Achieves the longest-lasting results
  • Gives you the most naturally brilliant and uniform look
  • Is clinically proven to be safe and effective
  • Is administered by dental professionals

A teeth whitening can make you look and feel younger, more attractive and more confident. Request an appointment or call our office to schedule a personal consultation during your next visit.

Sincerely,

Dr. Tim Chapman

 

P.S.  BravoSmile only uses natural, non-toxic whitening that is safe for everyone!

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Veneers – Improving Your Smile

There’s no reason to put up with gaps in your teeth or with teeth that are stained, badly shaped or crooked. Today a veneer placed on top of your teeth can correct nature’s mistake or the results of an injury and help you have a beautiful smile.

Veneers are thin, custom-made shells crafted of tooth-colored materials designed to cover the front side of teeth. They’re made by a dental technician, usually in the dental lab, working from a model provided by your dentist.

Your dentist may recommend that you avoid some foods and beverages that may stain or discolor your veneers such as coffee, tea or red wine. Sometimes a veneer might chip or fracture. But for many people the results are more than worth it.

Request an appointment or call our office to schedule a personal consultation during your next visit.

Sincerely,

Dr. Tim Chapman

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