Dental Implants

Using the most recent advances in dental implant technology, our doctors are able to place single stage implants. These implants do not require a second procedure to uncover them, but do require a minimum of 8-10 weeks of healing time before artificial teeth are placed.

There are even situations where the implants can be placed at the same time as a tooth extraction further minimizing the number of surgical procedures.

What Are Dental Implants?

A natural tooth consists of a root and a crown. If you compare natural teeth to implant-supported replacement teeth, you’ll see they have the same basic parts. Both have a crown (the visible part used to chew food). Both have a root that holds the tooth securely under the gum and is anchored into the jaw. The difference is that the implant is made of titanium – the same time-tested material used by surgeons for artificial joints. When you lose a tooth, you lose both the root and the crown. To replace the tooth, the Doctor first replaces the root with a small dental implant.

Time is allowed for bone to heal and grow around the dental implant. The bone bonds with the titanium, creating a strong foundation for artificial teeth. A support post (abutment) is then placed on the implant and a new replacement tooth (crown) is placed on top of the abutment.

When Are Dental Implants Placed?

Implants are can be placed several months after extraction or immediately after extraction of a tooth. This may involve a little more risk, but it simplifies the process—you won’t have to wait for another appointment to place the implant. When infection or other problems with the bone are present, immediate implant placement is not the best treatment.

If your tooth has been missing for some time, the adjacent support bone is likely to become thinner and shrink. This occurs because the root of the natural tooth has to be present to stimulate the bone. As much as one third of your jaw’s thickness can be lost in the year following tooth extraction. If you are missing enough bone, you may benefit from having additional bone grafted into the area. This ensures the implant will be adequately supported when it is placed in the jaw.

How Long Will the Implants Last?

Implants usually last a long time. When patients are missing all of their teeth, long-term studies (more than 30 years) show an 80 to 90 percent success rate. For patients missing one or several teeth, recent studies show a success rate of greater than 95 percent, which compares favorably with other areas in the body that receive implant replacement (such as hips or knees). However, if one of your dental implants either doesn’t heal properly or loosens after a period of time, you may need to have it removed. After the site heals (or on occasion at the time of removal), another implant usually can be placed.

When Are the Replacement Teeth Attached to the Implant?

The replacement teeth are usually attached to the implant when adequate healing has occurred and your jaw bone is firmly fused to the implant. Depending on a variety of factors, it may be possible to begin this phase of your treatment immediately or shortly after implant placement. We will review the most appropriate treatment sequence and timing for your particular situation.

The number of appointments and the amount of time required for each appointment is different for each patient. No two cases are exactly the same and regardless of the number of teeth replaced, the work must be completed with great precision and attention to detail. If you are having only a few teeth replaced, as few as three short appointments may be required. teeth.

Potential Consequences of Teeth Loss

• Problems with remaining teeth, including misalignment, drifting, loosening, and loss
• Collapsed facial profile
• Limited lip support
• Skin wrinkling around the mouth
• Distortion of other facial features
• Jaw (TMJ or temporomandibular joint) pain, facial pain, and headaches
• Difficulty speaking and communicating
• Inadequate nutrition as a result of the inability to chew properly and painlessly
• Sinus expansion

What Are the Potential Problems With Implants?

Although it is natural to be concerned about the pain that may be caused by these procedures, most patients do not experience severe or significant post-operative pain. Pain medication and antibiotics will be prescribed for you to make your recovery as easy as possible. Occasionally, some people develop post-operative infections that require additional antibiotic treatment. Even though great care is taken to place the implant precisely, occasionally adjacent teeth are injured in the placement process. In addition, there is a chance that the nerve in the lower jaw, which provides sensation to your lower lip and chin, may be affected. If you are missing quite a lot of bone, it might be difficult to place an implant without infringing on the nerve space. Although we take great care to avoid this nerve, occasionally it is irritated during the procedure, resulting in tingling, numbness or a complete lack of sensation in your lip, chin or tongue. Usually these altered sensations will resolve within time, but they can be permanent and/or painful. If you notify us of post-operative numbness as soon as possible, it will allow us to manage your care in the most appropriate way.

Extractions and Wisdom Teeth Removal

Impacted Wisdom Teeth

Although most people develop and grow 32 permanent adult teeth, many times their jaws are too small to accommodate the four wisdom teeth. When inadequate space prevents the teeth from erupting they are called impacted. This indicates their inability to erupt into the proper position for chewing and cleaning.

Types of Impactions

We will need to see you for a consultation to determine if you will benefit from wisdom tooth removal. A special x-ray of your mouth and jaws (panorex) will be taken to determine if your wisdom teeth are impacted, if there is room for them to erupt, and how difficult it will be to have them removed.

• Soft Tissue Impaction:
  There is not enough room to allow the gum tissue to retract for adequate cleaning of the tooth.
• Partial Bony Impaction:
  There is enough space to allow the wisdom tooth to partially erupt. However, the tooth cannot function properly in the chewing process, and creates cleaning problems, among others.
• Complete Bony Impaction:
  There is NO space for the tooth to erupt. It remains embedded in the jaw bone or if even partially visible requires complex surgical techniques for removal. The impacted wisdom tooth may also be in an unusual position and difficult to remove. This situation can also arise when the shape or size of the jaw bone and other facial structures make removal of this tooth significantly more complex.

Why Should I Have My Wisdom Teeth Removed?

If you do not have enough room in your mouth for your third molars to fully erupt, a number of problems can happen. Impacted wisdom teeth should be removed before their root structure is fully developed. In some patients it is as early as 12 or 13, and in others it may not be until the early twenties. Problems tend to occur with increasing frequency after the age of 30. Some of the possible problems related to not removing your wisdom teeth include:

• Infection:
  The most frequent clinical problem we see is pericoronitis, (a localized gum infection). Without enough room for total eruption, the gum tissue around the wisdom tooth can become irritated and infected, resulting in recurrent pain, swelling, and problems with chewing and/or swallowing.
• Cyst Formation:
  Non-infectious diseases may also arise in association with an impacted wisdom tooth. Cysts are fluid-filled “balloons” inside the jaw bone that develop as a result of impacted teeth and slowly expand destroying adjacent jaw bone and occasionally teeth. They can be very difficult to treat if your wisdom teeth are not removed in your teenage years. Although rare, tumors can be associated with the delayed removal of wisdom teeth.
• Possible Crowding:
  Impacted wisdom teeth may contribute to crowding of your teeth. This is most noticeable with the front teeth, primarily the lower front teeth and is most commonly seen after a patient has had braces. There are a number of factors that cause teeth to crowd after braces or in early adulthood. Retained, impacted wisdom teeth may be a contributing factor. Unless you have an active problem when you see the oral surgeon, the reason for removal is primarily to prevent long-term damage to your teeth, gums and jaw bone.
• Damage to Adjacent Teeth:
  If there is inadequate room to clean around the wisdom tooth, the tooth directly in front, the second molar, can be adversely affected resulting in gum disease, bone loss around the tooth, and/or decay.

Bone Graft/Sinus Lift

Different bone-grafting materials are available, including the patient’s own bone.

1. A socket grafting procedure is recommended after extraction to maintain bone height and width for several months.
2. Bone grafting may be necessary before implant placement if there is inadequate bone for the procedure, especially if the tooth was removed many years ago.
3. A sinus grafting procedure is required if the sinus cavities in the upper jaw are very large or low and extend into the tooth-bearing areas. This is often the case when teeth in the back of the upper jaw have been removed many years before and the amount of available bone for implant placement is limited.

Diagnostic Digital X-Rays

Intraoral, Panoramic, and 3D Conebeam

Diagnostic digital X-rays are a type of imaging technology used by dental professionals to view the inside of a patient’s mouth and teeth. There are three main types of diagnostic digital X-rays that we offer at Vancouver Dental Care: intraoral, panoramic, and 3D conebeam.

Intraoral X-rays are taken by placing a small digital sensor inside the patient’s mouth, close to the area being imaged. These X-rays provide a detailed view of individual teeth, the surrounding bone, and any decay or other dental problems.

Panoramic X-rays provide a wider view of the entire mouth, including all the teeth, the jaws, and other structures such as the sinuses.

3D conebeam X-rays use advanced technology to produce a three-dimensional image of the patient’s mouth, allowing for detailed analysis of the bones, teeth, and surrounding tissues. This type of X-ray is often used for planning dental procedures such as implants or orthodontic treatment.

All diagnostic digital X-rays use less radiation than traditional film X-rays and provide clearer, more detailed images, helping dental professionals to diagnose and treat dental problems more effectively.

Dental Veneers

Dental veneers (sometimes called porcelain veneers, dental porcelain laminates or lumineers) are wafer-thin, custom-made shells of tooth-colored materials designed to cover the front surface of teeth.

These shells are bonded to the front of the teeth changing their color, shape, size or length, resulting in an improved appearance.

Dental veneers can be made from porcelain or from resin composite materials. Porcelain veneers resist stains better than resin veneers and better mimic the light reflecting properties of natural teeth.

Veneers are used for teeth that are:

• Discolored because of large resin fillings, root canal treatment, stains from excessive fluoride, tetracycline and other drugs.
• Chipped, broken or severely worn down
• Misaligned, uneven, or irregularly shaped (for example, have craters or bulges in them)

Dental Crowns

When are crowns needed?

• To restore a badly broken teeth or a teeth that has been severely worn down
• To protect a weak tooth from breaking or to hold together parts of a cracked tooth
• To restore a dental implant
• To cover and support a tooth with a large filling when there is not enough tooth structure

Permanent crowns can be made from all metal, porcelain-fused-to-metal, or all ceramic materials (porcelain):

• Metals used in crowns include gold, platinum, and palladium. Compared with other crown types, less tooth structure needs to be removed with metal crowns, and tooth wear to opposing teeth is kept to a minimum.
• Metal crowns withstand biting and chewing forces well and probably last the longest in terms of wear down
• The metal color is the main drawback
• Metal crowns are a good choice for out-of-sight molars
• Porcelain-fused-to-metal dental crowns, unlike the metal crowns, can be color matched to your adjacent teeth
• All-ceramic crowns, porcelain-fused-to-metal crowns look like natural teeth. However, sometimes the metal underlying the crown’s porcelain can show through as a dark line, especially at the gum line and if your gums recede
• These crowns can be a good choice for front or back teeth.
• Ceramic (porcelain) ceramic crowns are becoming increasingly more popular because of their excellent esthetics and ability to create a more beautiful and natural smile

At Vancouver Dental Care we use the latest computer added technique to design our ceramic crowns to cover and support a tooth with a large filling when there is not enough tooth structure to protect a weak tooth (for instance, from decay) from breaking or to hold together parts of a cracked tooth.

Dental Bridges

If you lost one or more teeth, you will notice a difference in smiling, chewing and phonetics. There are different options to help restore your smile that Vancouver Dental Care would be happy to offer. 

In addition to implants or a removable partial denture or a bridge may be an available option that should be discussed with your clinician.

A bridge replaces missing teeth with artificial teeth, looks like teeth, and literally fills the gap where one or more teeth may have been. We can perform the restoration that can be made from different materials such as gold, alloys, porcelain or a combination of these materials and is attached onto supporting teeth.

A fixed bridge should only be removed at a dental office like ours.

What are the benefits of a Dental Bridge?

• Long term replacement option for replacing missing teeth
• Once the bridge is prepared it is attached to adjacent teeth
• It prevents surrounding teeth from moving or drifting
• It requires less time to complete than an implants

Tooth Fillings

Advances in dental materials and techniques, enabled dentists and patients today and  have various choices when it comes to selecting materials to of dental restorations. These factors include: the patient’s oral as well as general health, the components used in the tooth filling material, where and how the filling is placed, the chewing load that the tooth will have to bear, and the length and number of visits.

Composite or tooth-colored fillings:

Composite fillings are a mixture of glass or quartz filler in a resin medium that produces a tooth-colored filling. They are sometimes referred to as composites or filled resins. Composite fillings provide good durability and resistance to fracture in small to mid-sized restorations that need to withstand moderate chewing pressure.

Root Canal Treatment

In the past, if you had a tooth with a diseased or irritated nerve, you would probably lose that tooth. Today a special dental procedure called a root canal may save your tooth. Inside each tooth is the pulp which provides nutrients and nerves to the tooth, it runs like a thread down through the root.

When the pulp is diseased or injured, the pulp tissue dies. If you don’t remove this pulp tissue, your tooth can become infected and you could lose your tooth.

Root canal treatment typically involves one to two visits to our Vancouver Dental Care clinic. Throughout a root canal procedure, we will most likely take several x-rays.

What are the steps for a root canal?

• First, an opening is made through the tooth, and the pulp is accessed
• Next, the pulp tissue is removed, and the root canals are cleaned, shaped and sealed. With a root canal filling
• If necessary, medications may be put directly in the pulp chamber and root canals to help treat some infections
• A temporary filling may be placed in the access opening to protect the tooth between dental visits.  
• We might also offer an antibiotic medication depending on the severity of the infection
• Finally, a more permanent filling material, called a post-and-core, may be placed along with a crown restoration to provide optimal long term stability for your tooth

Sedation Dentistry

At Vancouver Dental Care we can help a patient virtually sleep through their dental procedures. This treatment option may help those with dental fears (phobia), turn multiple appointments into a single visit, and even help patients who have difficulty with conventional local anesthesia. Sedation is a wonderful option for so many patients — ask us about incorporating sedation into your next appointment.

How does it help?

• Do you have excess fear and concerns about dental appointments (dental phobia)?
• Do you have difficulty getting numb?
• Do you have adverse reactions to local anesthetics?
• Do you have a strong gag reflex?
• Do you have highly sensitive teeth?
• Don’t like the noises and smells associated with the dental drill?

If you relate yourself for any of the above, Vancouver Dental care is the place for you!

Teeth Whitening

• Whitening is accomplished by inserting plastic trays containing a bleach gel over your teeth.
• Vancouver Dental care whitening procedure usually requires two visits.
• During the first visit, impressions are made of your teeth.
• These impressions will be used to fabricate your custom – made plastic trays.
• During the second visit, we will check the trays for appropriate fit and provide you with the bleaching gel that is placed in the trays.
• Then, you may wear the trays containing the bleaching gel at your convenience.

Periodontics

It is important to think of the periodontal structures (such as bone and gums), like you would think of the foundation supporting a house. Without this solid foundation, the house is much more likely to have problems that need to be fixed.

• Dental Cleanings These regular cleaning (prophylaxis or prophy) appointments allow our dental team to keep a watchful eye on any changes that can be occurring within your mouth. The American Dental Association (ADA) recommends a patient be seen at least twice a year (every six months) for regular dental cleanings. However, if signs of periodontal disease are present or the teeth are not adequately maintained with regular home care alone, a patient may need to be kept on a more frequent cleaning schedule (such as every 3 or 4 months).
• Periodontal Measurements or Probing Depths During your visits, our hygienist may use an instrument called a periodontal probe. These probes are placed beneath the gums and measure the depth at which the gums and tooth meet. In healthy, well-maintained teeth, a typical depth ranges from 1-3mm. A depth of over 4mm can indicate a possible problem area needing attention and possibly a deeper type of cleaning, called scaling and root planing.
• Scaling and Root Planing Sometimes referred to as a deep cleaning, this non-surgical treatment is performed when teeth have a periodontal probing depth of 4mm or more. By cleaning deeper beneath the gums, harmful bacteria and calculus (tartar) are removed, allowing this pocketed area to heal. If left untreated, a pocket can grow increasingly longer, trap even more bacteria, and lead to the progression of periodontal disease. More advanced stages of the periodontal disease may even require surgery to aid in the healing process.
• Periodontal Maintenance A periodontal maintenance visit is for a patient who may have had more extensive periodontal therapy in the past, like scaling and root planing. It is essential for these patients to have a maintenance schedule so that the condition of their periodontal tissues can be closely monitored.
• Oral Cancer Screenings Although oral cancer can occur at any age, it is more likely to strike after age 40, and in people who use any form of tobacco. Furthermore, only half of all patients diagnosed with oral cancer survive more than five years. It is important for patients to be aware of these facts and maintain their regularly scheduled appointments so that our dentists and hygienists can identify potentially problematic areas.

What are Teeth Sealants?

Teeth sealants are a thin, plastic coating that is applied to the surface of the molars in order to protect them from tooth decay.

During the procedure, the teeth are cleaned and prepared, and any rough or uneven areas on the tooth surface are smoothed out. The sealant is then applied to the tooth, and a special light is used to harden it. The entire process usually takes only a few minutes per tooth and can help protect the teeth from decay for several years!

The general process is as follows:

1. After the tooth is polished thoroughly, and the surface etched with a mild solution for adherence purposes.
2. The tooth sealant material is allowed to flow into the grooves of the tooth.
3. The sealant material is then light-cured until it becomes solid.

Children’s Oral Health

Regular dental visits may help your child stay cavity-free. Teeth cleanings remove debris that build up on teeth, irritate gums and cause decay. Fluoride treatments renew the fluoride content in the enamel, strengthen teeth and help prevent cavities. Hygiene instructions, provided during your child’s regular visits, help improve your child’s brushing and flossing, leading to cleaner teeth and healthier gums.

Tooth decay isn’t the only reason for a dental visit. Our Vancouver Dental care dentists provide an ongoing assessment of changes in your child’s oral health. For example, your child may need additional fluoride, dietary changes, or sealants for ideal dental health. We may identify orthodontic problems and suggest treatment to guide the teeth as they emerge in the mouth.

The following steps will help your child maintain good dental health:

• Seek regular dental check-ups
• Brush effectively twice a day with a fluoride toothpaste
• Floss once a day
• Have sealants applied when appropriate
• Avoid food & drinks containing excessive sugar
• Beware of frequent snacking
• Assure proper fluoride through drinking water, fluoride products or fluoride supplements