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Dentist in  Grymes Hill
DiBona & Scamardella Dental Studio
646 Willowbrook Road
Staten Island, NY 34102
(718) 502-9006

Cosmetic Dentist in Grymes Hill

Services

From a routine exam and cleaning to full-mouth rehabilitation, our practice is equipped to handle all of your dental needs. To help you understand more about our office, we have included brief descriptions of some of our most common services on this page.

Cosmetic Services

Metal-free fillings (tooth colored composite resin fillings)

When the structural integrity of a tooth has been compromised, be it from dental decay, cracks or fractures, restoring the damaged area with a filling serves to rebuild the tooth’s natural form and return it to full function.

Up until recent decades, most dental fillings have been composed of amalgam, which is a mixture of metals. While amalgam fillings are very effective and durable, newer materials offer the benefits of being both mercury and metal free as well as much more aesthetic. These “tooth-colored or white fillings” invisibly restore the form and function of the involved tooth, while seamlessly blending in with the remaining tooth structure as well as the individual’s overall smile.

Tooth colored fillings are made out of the latest generation of composite resin materials in which filler particles are bound together by a hard matrix material. Strong and durable, tooth colored fillings are chemically bonded to fill and rebuild a tooth once the decayed or damaged tooth structure has been removed. With a low potential for expanding and contracting at different temperatures, composite fillings are less likely than traditional amalgam fillings to damage the remaining tooth structure over time.

In addition to restoring teeth affected by injury or decay, composite resins can also be used to cosmetically change the size, color or shape of teeth with imperfections or minor alignment issues such as spacing.

Metal-free crowns (ceramic crowns)

When the natural structure of a tooth has been extensively damaged or compromised due to dental decay, damaged fillings, root canals, or habitual clenching or grinding of the teeth, a dental filling may not be adequate for its repair. In such cases, dental crowns, also commonly referred to as caps, can be placed to effectively restore the natural integrity, function and appearance of the affected tooth.

Out of all of the materials that are available today for this type of full coverage restoration, metal-free crowns, also known as all ceramic crowns, offer most lifelike and biocompatible results. Strong and durable, ceramic crowns are lighter in weight than dental crowns that incorporate a metal substructure and are also kinder to the surrounding soft tissues. Furthermore, ceramic crowns present no problems for individuals with sensitivities to various metals. Since they are fabricated of the highest grade of dental ceramics, ceramic crowns most closely approximate the natural translucency of your own teeth.

Custom modeled for the optimal health and aesthetic of a patient’s smile, ceramic crowns can also be indicated for an array of dental treatments, ranging from the cosmetic restoration of discolored teeth, to the coverage of a structurally damaged tooth, dental implant, or as the supporting ends of a dental bridge.

Metal-free Bridges

When teeth are missing a series of changes that can impact your overall dental health and jaw function may be initiated. The adjacent teeth may start to drift or tilt into the space, and teeth in the opposing jaw may start to shift toward the area of the missing tooth. It is therefore important to replace the single tooth or multiple teeth that have been lost. One of the best options to prevent the consequences of shifting teeth and to restore full function to a small edentulous section in the mouth is a dental bridge.

A dental bridge replaces the missing teeth with artificial teeth called “pontics,” and is supported on the ends by prepared natural teeth. Once fabricated and fitted a dental bridge will be permanently “fixed,” or cemented into place.

Veneers

If your teeth suffer from gaps, chips, stains, or discolorations you may be a candidate for porcelain veneers, a highly effective and minimally invasive cosmetic procedure that can achieve beautiful results.

Porcelain veneers are thin facings custom-made of the highest quality ceramic materials that are designed to fit perfectly over the front of your teeth. One of the most conservative cosmetic treatments available, veneers can mask a host of dental imperfections to give you the smile that you have always wanted. Porcelain veneers not only enhance and improve the shape of your teeth, they are able to create an overall whiter and brighter smile.

One of the most appealing aspects of the process of fabricating porcelain veneers is that they involve minimal tooth preparation and take just a few visits. Porcelain veneers, once they are fabricated and fitted, are permanently bonded to the underlying teeth. The result is a naturally pleasing smile that is both strong and durable.

Bonding

Dental bonding is procedure that is often used to restore teeth affected by decay as well as repair chipped or fractured teeth and mask a range of dental imperfections such as stains, discolorations, gaps, misshapen, or undersized teeth. A popular method for restoring and improving the appearance of a person’s smile, dental bonding qualifies as a cosmetic procedure by virtue of the fact that the composite resins used for the procedure are tooth-colored and come in a range of shades that blend seamlessly with natural tooth structure.

A dental bonding procedure, which is performed to fill a cavity or to cosmetically repair a chip, fracture, enamel defect or gap between teeth is known as a “direct composite restoration.” For a direct composite restoration, both artistry and precision are required as the dentist places the selected shade of composite resin and carefully sculpts it to rebuild or improve the appearance of a tooth.

In terms of the cosmetic repair of dental defects, the masking of discolorations or the closure of gaps between teeth, a dental bonding procedure is considered the most economical and quickest method of care out of all the cosmetic solutions available for these types of corrections. Unlike porcelain veneers or ceramic crowns, dental bonding is a minimally invasive, one-visit cosmetic procedure. Moreover, unless a cavity is being cleaned and prepared prior to a dental bonding procedure, no drilling of tooth structure and no anesthesia is required.

How is a dental bonding procedure performed?

When performing a bonding procedure, it is important to enable the composite resin to firmly adhere to the underlying tooth structure. To do this the surface of the tooth is etched and then painted with a liquid bonding agent just prior to the placement of the filling or cosmetic bonding. As the dentist places the composite resin, it is carefully sculpted to achieve the desired shape and then cured it with a special light or allowed to set. Once hardened, the newly bonded restoration is polished and buffed for a smooth finish. Some dentists may offer composite veneers as an alternative to porcelain veneers, artistically bonding and blending successive layers of composite resin to transform the appearance of a tooth.

Caring For Bonded Teeth

While a bonding procedure offers an excellent and cost-effective method of care for the treatment of minor cosmetic dental issues, there are a couple of considerations with this approach. Teeth that are restored or cosmetically enhanced with a dental bonding procedure are as a rule more susceptible to staining and chipping than with other types of cosmetic treatments. For this reason, highly pigmented foods and drinks are to be avoided along with tobacco products. As dental bonding can easily chip and break, it is also important not to bite into hard objects or foods and to avoid oral habits such as biting one’s nails or chewing on pens. However, with proper hygiene and care, a bonded restoration can last for many years.

Preventive Services

Brushing & Flossing Instruction

Brushing

Maintaining a healthy smile depends upon keeping your teeth and gums clean with a daily routine of brushing and flossing. According to the recommendations of the American Dental Association, it is important to brush your teeth at least twice a day for two minutes each time with a soft bristled toothbrush. Remember to use a soft bristled toothbrush and apply gentle pressure so as not to cause damage to your teeth or gums. Brushing your teeth with a fluoride containing toothpaste that has been awarded American Dental Association seal of acceptance helps to keep your smile healthy and vibrant. Remember to change your toothbrush every three months or when the bristles are frayed.

To brush your teeth:

  • Place your toothbrush at a 45-degree angle to the gums. While maintaining this angle, move your toothbrush back and forth in short strokes. Make sure to along the outsides and insides of the teeth as well as the biting surfaces of the back teeth.
  • To brush behind the upper and lower front teeth, tilt your toothbrush vertically and brush in up and down strokes.
  • It is a good idea to brush your tongue at the completion of your routine to help keep your mouth fresh and clean.

Flossing

To help prevent tooth decay and gum disease, it is also important to remove plaque and food particles from between the teeth and under the gumline on a daily basis. By taking a few minutes to gently floss the teeth once a day, children and adults can reduce their risk of dental disease.

At a routine checkup visit, the dentist or dental hygienist will demonstrate the proper technique for flossing between the teeth. There are a number of varieties of dental floss and all can effectively remove plaque and food from between the teeth. According to a study published in the Journal of Periodontology, the type of dental floss selected is often a matter of personal choice. However, in certain circumstances one kind of dental floss may be preferable over another. In cases where the teeth are crowded, a waxed dental floss may work best. However, if there are spaces between the teeth, dental tape or super floss may be more comfortable and effective. Some people prefer disposable flossers with a plastic handle and a section of attached dental floss, while others use floss threaders or electric flossers to clean between the teeth.

The Proper Technique For Flossing Your Teeth:

Whatever type dental floss is selected, proper technique is important to effectively remove plaque and food particles without injuring the delicate tissues around the teeth.

For floss that is taken off a roll or from a dispenser, a good length to use is about 18 inches.

  • Wind the floss around the index fingers of each hand until a few inches of floss remains between them.
  • Holding the floss between the index finger and thumb, glide it gently between the teeth and down to the gumline. Hugging the side of one tooth in a “C” shape, slowly move the floss up and down along the base of the tooth to remove any trapped plaque and food particles.
  • Do the same to the adjacent side of the next tooth and continue around the mouth until all of the teeth as well as the space behind the last tooth are all flossed.
  • Release clean floss from one hand, while winding the used floss around the index finger of the other hand.
Gentle Cleaning

A routine dental cleaning as performed by the dentist or dental hygienist involves the thorough removal of any accumulated plaque and tartar from areas that your toothbrush and floss have not reached. Since dental plaque harbors the bacteria that are responsible for cavities and gum disease, its removal prevents these disease processes from occurring. Following a dental cleaning and polishing, which is performed to remove any superficial stains from your teeth, your mouth will feel fresh and clean.

Checkup and cleaning visits also represent an important opportunity to educate patients in the best oral hygiene homecare methods and routines to maintain a healthy smile. Your dental team will carefully explain and demonstrate proper techniques for brushing, flossing and other oral care practices at your initial dental appointment and subsequent recall visits.

Fluoride Treatments

According to the National Institute of Dental and Craniofacial Research, tooth decay is the single most common chronic childhood disease. Over 50 percent of 5 to 9 year old children have at least one cavity or filling, with that proportion increasing to 78 percent among 17-year-olds. Additionally, more than 51 million school hours are lost each year to dental-related illness.

As an added level of protection against dental decay, it is recommended that children receive periodic fluoride treatments as part of a program of preventive dental care. Fluoride is a naturally occurring mineral that helps to prevent cavities by making the hard outer enamel of the teeth more resistant to the acids produced by the harmful sugar processing bacteria in dental plaque. It can also help to remineralize the teeth to reverse incipient decay.

During a periodic checkup visit, the dentist may recommend the application of a topical fluoride to help strengthen and protect both a child’s baby teeth and the permanent ones. Topical fluorides can be applied as a foam, gel or varnish. Whatever type is selected, the procedure is quick and painless. Once the teeth are cleaned the fluoride is simply painted on the surfaces of the teeth or placed in a small tray to sit over the teeth for a brief period of time. Some types of fluoride treatment require no eating or drinking for half an hour as the fluoride is absorbed into the surface of the teeth. The dentist and dental hygienist will provide specific and detailed instructions as needed.

Fluoride treatment may also be indicated in adults who are at a higher risk for developing tooth decay.

Dental Sealants

As part of a pediatric dental program of preventive care, the dentist may recommend the application of dental sealants. These thin, plastic-like coatings painted onto the biting surfaces of the newly erupted permanent back teeth provide your child with an added level of protection through the cavity-prone years. Covering the pits, fissures and grooves in the hard to reach back teeth, dental sealants prevent decay-causing bacteria and food particles from accumulating in these vulnerable areas. Sealants may also be useful in areas of incipient dental decay to stop further damage from occurring.

The value of dental sealants is well documented. According to the American Dental Association, they reduce the risk of cavities in school-age children by approximately 80%. Furthermore, children who do not receive dental sealants develop almost three times more cavities than children who do have them.

Having a healthy smile is essential for your child’s comfort, function, self-image and overall well being. Good dental routines established in youngsters provide a strong foundation for maintaining a lifetime of optimal oral health.

Oral Cancer Screening

Oral cancer accounts for 2.9% of all diagnosed cases of cancer in the United States. According to the American Cancer Society it is estimated that 51,000 people across the country will develop oral cancer this year and that 10,000 fatalities are expected from the disease.

Oral cancer can occur anywhere in the orofacial complex but is most often found on the tongue, the tonsils and oropharynx, the gums, floor of the mouth, lips, cheek lining or the hard palate. While the disease can affect anyone, men are twice as likely to develop oral cancer as women. Those particularly at risk for oral cancer are men over the age of 50 who are heavy smokers and frequently drink alcohol. Additional risk factors may include UV exposure from the sun or sunlamps, GERD (gastro-intestinal reflux disease, prior head and neck radiation treatment, exposure to certain chemicals and poor diet. While the death rate from oral cancer has been decreasing in the past several decades thanks to early detection and advanced methods of treatment improving the outcomes of care, there has been a recent rise in the incidence of oropharyngeal cancer due to increased transmission of the sexually transmitted human papillomavirus (HPV).

What are some of the signs and symptoms of oral cancer?

As part of a comprehensive exam, the dentist will perform a screening for oral cancer. To start, the dentist will review the patient’s medical and dental histories and ask if there have been any changes to his or her oral health or overall health. The dentist will then carefully check in and around the oral cavity as well as the head and neck area for any of the following signs or symptoms that may indicate the presence of a problem:

  • Mouth ulcers or sores that do not heal
  • Lumps
  • Red or white patches
  • Persistent swelling of unknown origin
  • Pain when swallowing, a painful tongue or a continuing ear or neck ache
  • A constant feeling that something is stuck in the throat
  • Tenderness or numbness in the mouth or lips
  • Loose teeth
  • Jaw pain or stiffness

If a suspicious lesion, tissue abnormality or unusual symptoms are present, the dentist will refer the patient for a more comprehensive assessment. Early detection of oral cancer offers the most favorable outcomes of care.

ViziLite® Plus

The ViziLite® Plus system provides your dentist with an additional and effective mechanism for identifying, evaluating, monitoring and marking abnormal lesions in the mouth that may be indicative of the dysplastic changes that are associated with the development of oral cancers. Since early detection and diagnosis of oral cancer can significantly improve the outcome of treatment, ViziLite is considered an important adjunct to periodic, conventional head and neck examinations.

A painless and fast oral cancer screening with the ViziLite Plus system may be combined with your regular checkup visit. After rinsing your mouth with a special cleansing solution, the dentist will simply pass the ViziLite Plus light over the tissues in your mouth. If there are any abnormal changes to the mucous membranes lining the mouth and throat, the area will appear in a different color from the surrounding healthy tissues. In the event that anything is detected, further diagnostic assessments will be recommended as needed.

Invisalign®

Invisalign®* is a form of orthodontic treatment that works to correct many different types of malocclusions through the use of a series of clear plastic trays called aligners. In many cases it provides an excellent treatment alternative to traditional orthodontic braces and metal wires.

Invisalign utilizes 3-D computer imaging technology to correct problematic bites or malocclusions by planning a complete sequence of custom-made clear aligners. This series of clear aligners, each of which is worn for a couple of weeks, incrementally move the teeth into place until the final desired corrections are reached.

The advantage and appeal of Invisalign appliances is that they are more cosmetic and more comfortable than most other orthodontic appliances With Invisalign appliances orthodontic treatment is practically “invisible.”

*Invisalign is a registered trademark of Align Technology, Inc.

Sports Mouthguards

Every year millions of cases of dental and facial injuries occur as the result of sport-related trauma. While all sports have some risk of oral injury, it is especially prevalent in recreational activities that involve frequent body contact with other players or the ground, as well as the possibility of being struck by other objects such as, balls, bats, or sticks.

One way to significantly reduce the risk of damage to your teeth, cheeks, lips, tongue, face, or jaw as the result of a sports-related injury is to wear a mouthguard. A mouthguard is a removable appliance made of a sturdy plastic that sits comfortably over your teeth. Typically, mouthguards are designed to cover just the top teeth but may also be fabricated to include the lower teeth as well depending on your particular situation. Individuals who wear braces or have some types of dental work may require a specific type of mouthguard that provides more coverage.

There are three types of sports mouthguards on the market, including pre-formed and ready to wear stock mouthguards, boil and bite mouthguards, and custom mouthguards fabricated by your dentist. Our office will help you to select just the right sports mouthguard to protect your smile. While the first two choices offer some level of protection, the best and most comfortable mouthguards to safeguard your smile are the ones individually designed and customized by your dentist.

Digital Radiography

Digital radiography utilizes computer technology and digital sensors for the acquisition, viewing, storage, and sharing of radiographic images. It offers several advantages over the older traditional film based methods of taking x-rays. The most significant of these advantages is that digital radiography reduces a patient’s exposure to radiation. Other benefits are that images can be viewed instantly after being taken, can be seen simultaneously as needed by multiple practitioners, and can be easily shared with other offices. Digital x-rays are also safer for the environment as they do not require any chemicals or paper to develop.

An electronic pad, known as a sensor is used instead of film to acquire a digital image. After the image is taken, it goes directly into the patient’s file on the computer. Once it is stored on the computer, it can be easily viewed on a screen, shared, or printed out.

Peridontal Services

Non-Surgical Periodontal Treatment

When periodontal disease is detected early in its onset, conservative or non-surgical methods of care in combination with improved hygiene routines can restore periodontal health. While periodic, professional cleanings are sufficient to maintain periodontal health in patients that do not have gum disease, once gingivitis is present, deeper cleanings and possibly other non-surgical methods of care are recommended to treat the condition.

The American Academy of Periodontology emphasizes achieving periodontal health by means of the least invasive and cost effective treatment approaches to care. Deeper cleanings, which include Scaling and Root planing, are non-surgical procedures that are considered the first line of defense against the progression of periodontal disease.

With scaling and root planing, any plaque and tartar (hardened dental plaque) that have accumulated below the gumline are carefully removed and then the root surfaces of the teeth are smoothed. Since, periodontal disease is an inflammatory response to plaque, tartar and bacterial toxins, by simply mechanically eliminating these agents, the progression of gum disease can be halted. In addition to removing plaque and tartar with a scaling and root planing procedure, antimicrobial medication placed under the gumline or systemic medications can be used as adjuncts to care to further reduce the bacterial population.

If non-surgical approaches to managing periodontal disease do not achieve the desired outcome, surgery may be recommended to halt its progression and repair damage as possible.

Antibiotic Gum Therapy

Periodontal disease is a bacterial disease and the key to controlling or eliminating it is the effective reduction or elimination of the harmful bacteria. An adjunctive option to scaling and root planing may be provided in either pill form or applied directly to the infected area (gum pocket) in the form of antibiotic powder. An antibacterial mouth rinse also may be prescribed to help control the harmful effects of and reduce bacterial plaque.

Traditional Gum Therapy

Non-surgical therapy removes plaque and calculus by controlling the growth of harmful bacteria and by treating conditions that encourage gum disease. This type of treatment may be all that's needed, especially when periodontal disease is caught early. You may also need to have certain procedures, such as replacing worn fillings or crowns with overhanging margins that can accumulate plaque, taken care of before periodontal therapy can begin.

Scaling and Root Planing

Scaling is a type of cleaning that removes plaque and calculus from the teeth at and slightly below the gumline. Root planing smooths root surfaces, so the supportive tissues can better reattach to the tooth surface. Often, this will be done with local anesthesia so you can relax and feel nothing as we rehabilitate your gums.

Implant Dentistry

Implant Placement

Losing a tooth due to injury, dental decay, or gum disease can happen. However, in order to avoid causing problems for the adjacent teeth and your overall dental health, it is important to replace the tooth that has been lost. This can be done a number of ways including fixed bridges, removable partial or full dentures as well as a more recent procedure known as dental implants.

One of the most significant dental innovations in recent times, an implant is a small surgical fixture made of biocompatible metal or ceramic materials that is placed into the jawbone and functions in the same manner as the root of a tooth. In the same way that natural root supports the natural crown of your tooth, an implant once it fully integrates with the surrounding bone, provides a stable and durable foundation for a replacement tooth. Implants often support a crown for an individual tooth, but can also be used as abutment teeth for a dental bridge, or strategically placed to help stabilize a denture.

Out of all of the restorative choices available today an implant comes the closest to replicating the look, feel and function of a natural tooth. Furthermore, it is the only method of tooth replacement that does not require the involvement or preparation of the adjacent teeth. A dental implant also stimulates bone remodeling to prevent shrinkage in areas where teeth are missing and helps to restore facial contours in areas where significant bone loss has occurred.

Mini Implants

One of the dental solutions available for the treatment of multiple lost or missing is a removable denture. While a removable denture is an effective prosthetic appliance for restoring one’s smile, there can be issues with stability that affects the comfort and function of the denture. However, there is a way to effectively address these problems with the placement of mini dental implants.

Mini dental implants are narrower in diameter than traditional dental implants. This makes them an excellent option for providing added denture stability in cases where a grafting procedure to create enough bone volume for the placement of full size implants would otherwise be needed. Furthermore, mini implants can be placed in a less invasive manner, making them an easier procedure to tolerate for people with certain medical conditions.

An implant-supported denture is fitted with special housings that allow the denture to essentially snap on to the head of the mini implant to provide the needed denture stabilization.

Implant-anchored Dentures

When all the teeth in the upper or lower jaw are missing, dental implants offer comfortable, stable and cosmetically pleasing solutions to restore a functional smile.

An implant-anchored overdenture is essentially a removable denture that clips on to either a ball or bar attachment in the front part of the jaw. The implant supported attachments help to provide added stability to the denture, keeping it in place to ensure optimal comfort as well as function. Because the dental implants keep the denture from slipping or dislodging, there is no need to deal with any messy denture adhesives.

Implant-anchored Crowns & Bridges

As opposed to a traditional crowns and bridges, an implant-supported crown or bridge preserves the integrity of the adjacent teeth and virtually stops the bone resorption process that naturally occurs where teeth have been lost. By maintaining the bone in the edentulous areas (the space without teeth), normal facial contours are supported and a sagging or caved in look is avoided. As they are permanently anchored in the jawbone, implant supported crowns and bridges fully restore one’s natural biting and chewing capacity.

Children's Dentistry

Treasure chest surprise - We love Kids!

Complete dental treatment for all ages

At our office we take pride in creating and maintaining beautiful and healthy smiles for our younger patients in an environment that is lighthearted and fun. With an emphasis on establishing oral health habits that last a lifetime, our primary tools are education and a comprehensive preventive care program.

As part of an effort to guard against childhood dental decay we recommend periodic fluoride treatments and dental sealants placed on the biting surfaces of the back teeth.

Teeth Whitening

Zoom! Teeth Whitening, Whitening for Life Trays and Custom-made take home whitening trays

About Whitening

Teeth that have been stained or darkened by food, tobacco use, age, medications or injury can be lightened and brightened by means of a non-invasive process known as teeth whitening.

Teeth whitening or bleaching simply refers to any process that will make the teeth appear whiter. While there are many over the counter options for teeth whitening, the most effective and safest teeth whitening systems are the professional strength ones available at the dentist’s office. A dental professional whitening system offers a higher concentration of whitening components and delivers them to the teeth in the most efficient manner to achieve optimal results.

At our office we offer two exceptional options for tooth whitening. You can choose either an in-office tooth whitening procedure or a professional take home system. Both of these are top-of the-line systems. However, the biggest advantage of the in-office procedure is that in as little as one hour you can achieve a smile that is several shades whiter and brighter than the original color of your teeth.

Our professional strength take home system also produces excellent results. However, this is achieved by way of a more gradual process. Our take home kit may be prescribed alone, or after an in-office treatment to perfect or maintain the in-office result.

Orthodontics

Invisalign®

Invisalign®* is a form of orthodontic treatment that works to correct many different types of malocclusions through the use of a series of clear plastic trays called aligners. In many cases it provides an excellent treatment alternative to traditional orthodontic braces and metal wires.

Invisalign utilizes 3-D computer imaging technology to correct problematic bites or malocclusions by planning a complete sequence of custom-made clear aligners. This series of clear aligners, each of which is worn for a couple of weeks, incrementally move the teeth into place until the final desired corrections are reached.

The advantage and appeal of Invisalign appliances is that they are more cosmetic and more comfortable than most other orthodontic appliances With Invisalign appliances orthodontic treatment is practically “invisible.”

*Invisalign is a registered trademark of Align Technology, Inc.

Treatment for TMJ Pain

TMJ

The Prevalence of Temporomandibular Joint Problems

According to the National Institute of Dental and Craniofacial Research (NIDCR), temporomandibular joint disorders (TMJ), also referred to as temporomandibular disorders (TMD), are the most common source of chronic facial pain and jaw dysfunction. It is estimated that more than 10 million people in the United States are affected by temporomandibular joint problems.

What is the Temporomandibular Joint?

There are two temporomandibular joints that connect the left and right sides of the lower jaw to the temporal bone. Both joints and their associated muscles, ligaments and tendons work together to allow for all manner of oral function as the jaw moves up and down, front to back and from side to side. Containing a shock-absorbing, soft disc that sits between the rounded condyles of both sides of the lower jaw and the corresponding concavities in the skull’s temporal bone, the TMJ makes chewing, speaking, yawning and all jaw movements possible.

Since the TMJ is a joint with both up and down hinge-like movements, as well as side to side and front to back sliding motions to perform, it is often considered one of the most complicated joints in the body and one of the most difficult to treat when problems arise.

Types and Symptoms of TMJ Disorders

TMJ disorders can fall into one or more of the following three categories:

  • Myofascial pain- Refers to pain in the area of the jaw joint due to various causes of increased muscle tension and spasm
  • Internal derangement-Involves displacement of the disc, jaw dislocation or trauma to the condyles of the jaw
  • Degenerative joint disease -Arthritis

The risk for developing a TMJ problem is greater in the presence of long-term teeth grinding or bruxism, a jaw injury or various types of arthritis such as rheumatoid arthritis and osteoarthritis. Furthermore, the manifestations of a TMJ disorder can vary from person to person with a wide range of symptoms possible, including earaches, ringing in the ears (tinnitus), headaches, back and neck pain, vertigo, muscle spasms and joint tenderness as well as jaw pain, popping or grating sounds with jaw movement, jaw locking and limited jaw movement. For some people a TMJ disorder can be resolved within a relatively short period of time, while for others it will continue to persist despite extensive therapy.

Diagnosis and Treatment

When evaluating for the presence of a TMJ disorder, the dentist will perform a thorough clinical assessment of joint symptoms and function. Special radiographic imaging and other diagnostic tests will be ordered as needed. The treatment of a TMJ disorder may include oral appliances such as night guards or stabilization splints to alleviate strain on the joints. Other types of therapy may include steroid injections, occlusal adjustments as well as orthodontic or prosthodontic treatment to improve occlusion. In cases of persistent and serious TMJ problems, surgery may be recommended.

Methods of self-care can be helpful in alleviating some of the symptoms of a TMJ disorder. Patients are typically advised to eat soft foods, avoid extreme jaw movement such as wide yawning and gum chewing, to practice stress reduction and relaxation techniques and applying ice packs or moist heat as directed. If recommended, a patient should follow the dentist or therapist’s instruction for gentle stretching exercises. The short-term use of over-the-counter, non-steroidal, anti-inflammatory drugs and pain medications may provide relief. If not the dentist or physician may prescribe stronger pain or anti-inflammatory drugs, muscle relaxants or anti-depressants.

Dentures

Full Dentures

Full dentures, which can also be referred to as, “complete Dentures,” are designed to replace all of the upper or lower teeth. A complete maxillary denture, more commonly known as a, full upper denture, typically consists of a base that covers the roof of the mouth with a full complement of artificial teeth set around the section covering the dental arch. On the other hand, a complete mandibular denture, or full lower denture, is designed to accommodate the tongue and is horseshoe shaped with teeth set along the portion that covers the underlying dental arch.

  • Conventional Full Denture- A conventional full denture is fabricated and placed after all of the remaining teeth have been removed and the tissue is healed. It takes several weeks for extraction sites to heal and for all of the surrounding bone and gum tissues to fill in and remodel. By allowing this process to reach completion before taking the final impressions for a new denture, the most precise and comfortable fitting prosthesis can be fabricated.
  • Immediate Denture- An immediate denture is one that is inserted on the day the remaining teeth are removed. With this method of care, a patient does not have to be without teeth while waiting for complete healing of the extraction sites. Immediate dentures offer the distinct cosmetic advantage of not having to be without teeth. However, since the healing of the extraction sites is occurring while wearing the denture, a reline or new denture may be required later for improved comfort and fit.
  • Overdenture- An overdenture is a type of complete denture that receives added stability and support from special attachments that are secured to the remaining underlying teeth or strategically placed dental implants.
Partial Dentures

A partial denture is a type of removable prosthesis that is designed to restore a complete and functional smile in cases where multiple teeth are missing or require extractions, while some healthy teeth remain in the dental arch. Custom fabricated for a precise fit and cosmetically pleasing appearance, partial dentures are typically secured and stabilized with clasps or precision attachments to select teeth adjacent to the edentulous areas. Depending upon the number of teeth being replaced as well as the functional and aesthetic requirements of the case, a partial denture can be fabricated from a combination of cast metal and acrylic materials, acrylic alone, or thermoplastic resins such as ValplastTM, Flexite®, Duroflex® and tcs®.

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