Services | Diamond Head Dental

Our examinations begin with an extra-oral exam to evaluate the muscles of mastication and temperomandibular joint. We then move into the mouth to look at the oral soft tissue, the occlusion (bite), and finally, the teeth. We use all of the diagnostic tools at our disposal, such as radiographs and intraoral cameras. The images procuced from these are displayed on a screen in front of you so that you can stay informed about the health of your oral cavity and its surrounding tissues.

X-rays, or radiographs are a necessary part of a complete dental check-up. Dentistry is one of the only branches of healthcare where radiographs are indicated in absence of any signs or symptoms of disease. The reason for this, is that cavities are asymptomatic up until the point when they are quite deep and often require additional treatment, such as a root-canal, and that until they reach this point, some cavities are not visible with the naked eye. We do, however, use digital x-rays which contain only about 10% of the radiation of traditional x-rays. You would also receive more radiation taking a cross-country flight than you would be having a traditional ‘full-mouth series’ of twenty x-ray exposures

We also have the capability to take intra-oral photographs. These are useful both in patient education, and also in tracking changes within the mouth. It is a very valuable communication tool to actually show someone what you are talking about rather than just explaining with words.

Scaling and root planning is the removal of hard calculus or tartar deposits from the teeth. Once plaque had been left on the tooth for a period of time, it becomes calcified and adhered to the tooth surface. At this point no amount of brushing or flossing will remove it, and special instruments must be used. If left on the teeth, gum disease might progress and lead to irreversible loss of the bone support around the teeth. For most people, cleanings are recommended once every six months. However, some people benefit from cleanings on a more frequent basis, such as every three to four months, while others can sometimes get away with yearly cleanings. As part of the cleaning, we also polish the teeth to remove extrinsic stains and generally do a fluoride treatment, as well.

Restorations, or fillings as they are commonly known, do just that. They restore or replace missing/damaged/diseased tooth structure. They can also be used to reshape teeth in the absence of disease. There are three main materials that are used. The traditional silver amalgam, composite resin (white) fillings, and also a material called glass ionomer which is able to store fluoride and is useful in specific situations, particularly in pediatric or geriatric dentitions.

A sealant is a preventative measure that can be taken on teeth that may be prone to cavities. The surface of the tooth is cleaned and then a plastic coating is place within the grooves of the teeth. This covers over surface irregularities where plaque might be missed when cleaning.

Crowns, inlays, and onlays are all lab-fabricated restorations. They are very strong and durable ways to fix teeth that are structurally compromised. In cases where teeth have large fillings (extending over 2/3 of the biting surface or replacing cusps of teeth), when teeth have been root-canal treated, or when teeth are cracked these types of restorations are indicated over traditional fillings. Not only do they provide a great seal to prevent further infection or decay, they also structurally reinforce the teeth, preventing further cracking or breaking, can still function well under normal biting forces, and best restore the original or ideal shape of the tooth. There are generally three types of materials used for these restorations. They are gold, porcelain-fused-to-metal, and all-ceramic. The gold provides the best in terms of strength and durability, but lacks esthetics. The all-ceramic variations are very esthetically pleasing, having no dark metal components, but like all ceramics/porcelains can be prone to fracture if not thick enough or when exposed to shearing forces. The PFM crown has a metal coping or core and porcelain layered on top and forms sort of a compromise between the other two types.

Veneers are conservative restorations that are often used to change the esthetics of teeth. With veneers you can alter the shape and colour of teeth, without removing a lot of tooth structure in the process. Essentially, thin pieces of porcelain are bonded onto the front surfaces of the teeth, almost like a false-nail would be on a fingernail. The main disadvantage is that they are entirely reliant on the strength of the cement, so if you are a grinder/bruxer you may also need to wear a nightguard to prevent placing too much lateral force on the veneers.

Bleaching is a method of intrinsically changing the colour of a tooth. There are several different methods, including over-the-counter products, take-home bleaching kits, and in-office whitening procedures. They all use bleach to lighten the colour of teeth. The differences are in the concentration of bleach that are used, and also the ability to bleach all of the contours of a tooth. Some 'strips' will only whiten the flat, front surfaces of the teeth. There is also a way to internally bleach discoloured teeth that have been root-canal treated that works on the same principles. Currently it is thought that the bleach causes no long-term damage to the teeth, although temporary sensitivity might occur and it can be an irritant to the soft tissues of the mouth.

Dentures can be used to replace missing teeth. There are both complete dentures, for people missing all of their teeth, and removable partial dentures, for people who still have some teeth remaining. They are typically made of metal, acrylic, or a combination of the two. They are not ideal as they can be quite bulky and cover over a significant amount of the soft tissue in the mouth. There is often quite a long adjustment period when first wearing dentures, too. While they are not optimal, they can be used to successfully replace missing teeth and restore some form and function.

Bridges can be used to replace missing teeth. A bridge is essentially where you crown the tooth or teeth on either side of an area where a tooth, or several teeth, is missing. The replacement teeth are fixed to these 'abutments', forming a bridge between them. They are useful as, unlike a denture, they are fixed in place. The disadvantages in having a bridge placed are that you have to crown teeth which may or may not have otherwise required crowns. Everything is connected, so you can’t floss around the teeth without threading the floss underneath the bridge, and if something happens to one of the teeth, often the whole unit is impacted. It also puts a lot of pressure on the supporting teeth as they now have to take the extra biting force of the newly replaced tooth or teeth. Also, over time, the bone where the missing tooth once was will slowly resorb, possibly resulting in a larger space beneath the bridge or limiting future restorative options.

Implants are currently the best option for replacing missing teeth. Essentially, a titanium implant is placed in the bone where the tooth's root used to sit, and a crown is placed on top of the implant. Unlike a denture, it isn't bulky and is fixed in place. Unlike a bridge it doesn't affect the neighboring teeth and replaces both the crown and root of the tooth, helping to maintain bone in the area. Implants aren't just limited to single teeth, either. They can also be used to stabilize dentures or for replacing multiple teeth.

Sometimes it is necessary to extract teeth. This is often a last resort when the tooth is lacking supporting tissue, or if the tooth is very heavily restored, cracked or infected. Sometimes teeth can be extracted electively to create space, or sometimes teeth that haven't erupted properly, or are impacted, are extracted, as well.

A root canal is indicated when the soft tissue inside the tooth, or pulp, is either inflamed to the point where it is unable to heal itself (often due to infection), or when that tissue is actually necrotic, or dead. The procedure involves removing this dead, inflamed or infected tissue and, once sufficiently cleaned, placing a filling down into the roots of the tooth to fill the void where that tissue used to reside. Once a root canal treatment has been performed, it is beneficial to follow-up with a crown to best seal the tooth and prevent the weakened tooth from fracturing and to prevent it from getting re-infected.

Periodontal surgery can be indicated for a variety of reasons. It is basically a surgery involving the surrounding tissues of the tooth. The most common ones would be a soft-tissue graft or crown-lengthening. Grafting is indicated when gum tissue is lost around the side of a tooth, often due to a process called recession. Gum tissue can be taken from other areas of the mouth to augment the deficient tissue. Crown-lengthening is a procedure in which there is a crack/decay/filling well below the gum-line. In order to prevent chronic inflammation, and an irregular pattern of bone loss, the gums and bone are re-contoured in a controlled manner to achieve a stable, healthy situation.

Orthodontics is the specialty of dentistry involving the bite, or occlusion, and also the spacing of teeth. Orthodontic treatment usually involves appliances that can control or influence the natural growth and development of the tissues or ones that are used to move teeth through the alveolar bone. This can mean braces, removable appliances (similar to retainers) or sometimes appliances that are fixed/cemented in the mouth. There are also newer, more esthetic, treatment options available such as Invisalign, where clear mouthguards replace braces, or lingual braces, where the brackets are on the back surface of the teeth instead of the front.

Pediatric dentistry involves the treatment of children's teeth. Primary or baby teeth are important as they hold the space for the adult teeth and can get cavities or infections, just as adult teeth can. They can be difficult to treat, as the teeth are small; so cavities tend to progress rapidly, and behavior can also be an issue. Due to this, often times if extensive treatment is needed, a sedative may be indicated, or the work may be done in a hospital under anesthesia. We recommend a first visit to the dentist at around a year and a half or two years old. It is a valuable time as the posterior primary teeth are beginning to erupt and it is a good time to get children comfortable with the environment of a dental office. It is also a great time to speak with the parents about the care of their children's teeth and answer any questions that they may have.

Geriatric dentistry is dentistry for elderly patients. More and more these days, people are maintaining their natural dentition until very late in life. As people get older and their cognitive function and dexterity decrease, proper hygiene and maintenance can be difficult. This population of people also has a higher incidence of conditions which can affect the dentition, such as type II diabetes and xerostomia (dry mouth). Due to this, oftentimes extra preventative measures, such as prescription strength toothpastes or saliva substitutes, are indicated.

The bite is not a simple two-dimensional motion of teeth opening and closing on one another. With the lower jaw able to move side-to-side and front-to-back, it is actually a complex three-dimensional system. During some of these sideways motions, or excursions, unfavourable parts of the tooth may come in contact and lead to soreness in the teeth or jaw, as well as irregular wear patterns or chipping of the teeth. Sometimes, in relatively straightforward cases, these interferences can be adjusted and the bite equilibrated.

The temperomandibular joint is the joint connecting your mandible (lower jaw) with the base of the skull. Sometimes people can have problems with the function of this joint and these problems can usually be separated into a couple of categories. These would be muscular problems or problems involving the bone/cartilage. Sometimes people can even have a combination of both. Treatment protocols can vary and often include behavior/habit modification, wearing a specially designed mouthguard as you sleep, physio- or massage-therapy, and in severe cases, even surgery.

Sometimes patients, especially for longer or more involved procedures, will opt to take a sedative. There are several different options for oral sedatives, and these can be discussed with the dentist. While they won't do anything for pain (you will still have to receive local anesthesia/freezing), they can make patients more relaxed and some even have some amnesic properties, causing you to partially forget the experience afterward.

Custom-made sports mouthguards can be fabricated for you at a dental lab. They have several advantages in comparison to over-the-counter guards. They are much thinner, while still maintaining strength, and also are custom-fit to your mouth.