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Services

Tooth Fillings

Sedation Dentistry




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Smile Makeovers

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Teeth Whitening

Looking for Teeth Whitening in Eustis? Yearning for a bright youthful smile? Dr. Barr offers a full range of cosmetic dentistry including professional teeth whitening. Teeth whitening is the #1 requested and performed cosmetic dental procedure. Teeth whitening (sometimes called teeth bleaching) is a procedure that brightens teeth and helps to remove stains and discoloration.



Teeth whitening supervised by a dental professional is important to make sure it is safe. For example, cavities need to be treated before teeth are whitened. Cavities are problematic because the whitening solution can penetrate the cavity allowing decay to reach inner areas of a tooth. We can provide people with good dental health customized trays and a kit to whiten teeth at home.




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Home Whitening

Whitening your teeth at home often involves using a custom fitted mouth guard into which a whitening solution is placed. These custom fitted mouth guards will help protect your gums from irritation that occurs while using ill-fitted over-the-counter whitening mouth pieces. After the solution is placed in the mouth guard, it is placed over the teeth and left on for a few hours or overnight depending on the type of whitening solution. Ask Dr. Barr if home whitening is right for you.




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Single Visit Whitening

In our office we offer the Zoom Teeth Whitening system which can whiten your teeth up to eight shades lighter in about an hour. The in-office procedure uses higher bleaching concentrations to produce faster, more dramatic whitening results in a very safe, controlled procedure. A special whitening lamp is used to activate the whitening gel for approximately 60 minutes. You will also receive the custom bleaching trays to continue your bleaching at home or for future touch ups.


Zoom is only available at a dentist’s office to ensure optimum safety, and comes in different treatment types and strengths to fit your lifestyle and sensitivity.




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Bonding

One of the least expensive cosmetic procedures is bonding. The materials used in bonding can be formed and polished to match neighboring teeth. It is most commonly used to improve the appearance of a chipped or discolored tooth or to close small gaps between teeth.




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Tooth Colored Fillings

Tooth Colored Fillings

In order to make a filling appear almost invisible to the naked eye, composite fillings are often used. These fillings are designed to match your natural tooth color and are bonded to your teeth, which makes them less likely to fall out. These fillings are used to replace older fillings made of silver or gold. Tooth colored fillings have a more aesthetic appearance, can be completed in one visit, form a strong seal and are less likely to crack a tooth.




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Dental Veneers

What is a dental Veneer?

A veneer procedure is a popular cosmetic procedure. Porcelain is known as one of the best materials for esthetic dental procedures, because it mimics tooth enamel very closely. Veneers are extremely thin (usually less than 0.5 mm thickness), giving them enamel-like translucency, creating a natural appearance. They are about as thick as a contact lens. There is very little tooth preparation before the veneer application.

Porcelain veneers are attached to your teeth using a dental bonding glue or cement. Although veneers are very thin, once bonded to your teeth they become strong. The process is fast and conservative. First, your teeth are prepared and impressions are sent to a dental laboratory along with the design for your new smile. Veneers may be recommended along with other cosmetic procedures in order to produce optimum results.

Veneer Procedure Steps:

  1. Your teeth are cleaned so that only your natural tooth is exposed. Old surface restorations are removed.
  2. In some cases the tooth is etched so the veneers will adhere more easily.
  3. An impression is taken of the tooth area where the veneers are to be placed and sent to the lab for fabrication.
  4. When the veneers are ready, your dentist will check the fit along with its future appearance, then permanently bond them to your teeth.
  5. After the veneer is set, it is shaped and polished to look like a natural tooth and fall in line with surrounding teeth.

Veneer Procedure Benefits:

  • You can have your porcelain veneers and a beautiful new smile in as little as just two office visits!
  • Very little tooth alteration to your natural teeth and does not affect neighboring teeth.
  • Gap space between teeth can be closed without the use of braces.
  • Veneers can add tooth length to worn down teeth.
  • Veneers can add tooth shape and thickness.
  • Veneers can cover broken or chipped teeth so that they look like healthy normal teeth.
  • Veneers can renew the color of stained teeth.
  • There is no dark line at the base of the tooth like some dental crowns occasionally have.
  • The porcelain material is stain-resistant for lasting beauty and integrity.

Porcelain Veneers vs. Lumineers

  • Lumineers is a specific brand of porcelain veneers, which use a patented porcelain material known as Cerinate. They are even thinner than traditional veneers.
  • Lumineers require very little or no tooth reduction. They are a great choice if your teeth only need minor changes, to if they are set back slightly.
  • Traditional veneers may be a better choice if you are looking to make more dramatic changes.





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Crown Procedure

A crown is sometimes termed a "cap" or "jacket." A crown will restore a large filling or a cracked tooth to its original size, shape and tooth color. A crown may be recommended after root canal therapy has been completed, as the tooth tends to become brittle and is more likely to fracture. A crown can strengthen and protect the remaining tooth structure and improves the appearance of your teeth. With the advances in technology, we now have the ability to make ceramic crowns with no metal.


To place a crown, your dentist must reduce 1-2 mm of the tooth to make room for it. Your dentist will then use a piece of thread or cord or use a laser to push the gum down around the tooth, to take an impression of the tooth. The impressions are sent to the lab where the crown is made. During that time, you will have a temporary crown. These crowns are usually made of plastic and are made in your dentist's office on the day of your visit. They are not meant to last. If a temporary crown is left in the mouth, the cement eventually washes out and the tooth can decay. At a second visit, your dentist will remove the temporary crown and test the permanent one. Sometimes crowns need additional polishing, glaze or some other adjustment before they are placed. Once the crown is ready, it's cemented to your tooth.




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Fixed Bridge

An alternative to an implant is a fixed bridge. With this option it is necessary to grind down the teeth adjacent to the space in order to have caps fit onto the ground down teeth. The caps hold a fake replacement tooth in the middle. With this approach, the ground down teeth are more subject to dental decay and root canals. Furthermore, the teeth are connected together making daily hygiene more challenging. Unlike an implant, the bridge offers no additional biting support.




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Replacing Old Fillings

Dr. Barr is a cosmetic dentist in Eustis. Dr. Barr offers proven technology that allows you to replace old silver and gold fillings with a more natural looking, composite filling. Composite fillings are bonded to the tooth and research has proven them to be about 90% as strong and healthy as natural tooth material.

Other Benefits:
- Beautiful in appearance
- Completed in a single visit
- No filling leaks
- Less chance of tooth cracking




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Implant Placement

There are actually two phases to implant dentistry.


Phase 1: Using very accurate surgical techniques, an incision is made in the gum tissues and implants are placed into dimensionally controlled sites (depth and width) in the jawbone.


First, the gum tissue is opened and the jaw bone is tapped with a small drill and then drilled with a wider drill. The implant is inserted into place. The gum tissues are then closed and the healing phase begins. This may take anywhere from 3-6 months to ensure a strong base.


Phase 2: An abutment is secured to the top of the implant placing a new tooth crown onto the implant abutment. Implants can replace a single tooth, several teeth or your dentures.




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Single Tooth Dental Implant

Do you have missing teeth? It is critically important to replace missing teeth. Eating and chewing with missing teeth can sabotage your bite and lead to incessant discomfort. Missing teeth can give rise to a mouth rearrangement that often results in facial changes that look decrepit. If a tooth is missing or has been extracted for any reason, a single implant can be used to replace the missing tooth. The implant is placed into the bone of the jaw and acts as the new tooth root. After the bone has healed over the implant an abutment can be placed on the implant and a crown can then be attached. This method of tooth replacement looks and feels like natural teeth.




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Multiple Tooth Implants

Multiple tooth implants may be placed if you need or desire to permanently replace an extracted or lost tooth. Titanium implant bases are placed into the jawbone to replace the job of the tooth roots. We allow a period of time to allow for the jawbone to heal over the bases before fitting for a crown. Next, abutments are screwed into the bases of the implants to allow crowns to be attached. Finally, custom fabricated crowns are placed over the abutments and will function like a real tooth.




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Full Arch Implants

In many circumstances all of the upper or lower remaining teeth need to be removed due to advanced periodontal disease and/or dental decay. One approach is a full upper or lower plate; however, this treatment modality is not recommended. The treatment of choice is to replace the upper or lower teeth with caps that are in place permanently and supported by dental implants. A common goal of treatment is to have (twelve teeth-caps) supported by eight implants. The four caps that are not supported by the implants are connected to adjacent implant supported caps. With this optimal approach, the maximum amount of bone is preserved.




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Mini Implants

MDI mini implants were developed in order to provide greater denture stability for those patients who:
1) cannot withstand the rigors of conventional dental implant surgery,
2) do not have enough bone to allow full-size implants to be placed, or
3) are in on-going therapy from one prosthetic system to another.


The head of the MDI mini implants is shaped like a ball, and the retaining fixture acts like a socket that contains a rubber O-ring. The O-ring snaps over the ball when the denture is seated and holds the denture at a predetermined level of force.


Mini-implants can generally be placed start to finish in one to two visits. There is no waiting time for the bone to heal. In many cases mini implants are placed and the patient walks out with their dentures secured on the same day.




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Denture Instructions

Denture Instructions

Occasionally, it is difficult to adapt to full or partial dentures. At first they may feel loose, bulky and awkward while speaking. For a quicker adjustment period, follow these instructions:


1) At first, wear your dentures all the time.
2) Do not use adhesive unless Dr. Barr advises you to do so.
3) You should remove your dentures when you go to sleep.
4) After removing dentures, clean with a toothbrush and place in a bowl of water. They can be soaked in a commercial denture cleanser, but brushing them is essential.
5) Any signs of "sore spots," discomfort, or looseness that is causing you difficulty should be brought to our attention.


Never adjust the dentures yourself. Every person and every mouth is different; therefore, adjustment periods will vary.


Please remember that it will take time for you to become completely comfortable with your new teeth.




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Denture Resorption

Within 6 months of starting to wear a denture, you will have already lost about 40% of your jaw bone structure.


If you have worn a denture for a few years, you already know about bone loss. The reason your denture doesn't fit like a year ago, is that you don't have the same jaw bone structure to support it.


If you wear a partial denture, beware that you will have the same problem with bone loss.


Once the jaw bone structure is lost your options become limited. A dental implant is the logical choice to help stop bone loss, however, once the jaw bone structure is lost, your options become limited.




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Partial Dentures

Removable partial dentures are composed of a metal framework with plastic teeth and gum areas. The framework includes metal clasps or other attachments, which hold the denture in place. Partial dentures are removed easily for cleaning.


Clasps are C-shaped, I-shaped, and Y-shaped parts of the denture framework that fit around neighboring natural teeth. These teeth may require shaping to help hold the clasps and keep the denture securely in place.




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Flexible Partial Dentures

Flexible Partial Dentures

A rather comfortable tooth replacement option is a flexible partial denture. These dentures are made from a composite plastic resin and can include a biocompatible metal for superior strength in some cases.




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Immediate Dentures

An Immediate Denture is designed to be placed in the mouth immediately after the extraction of your natural teeth. An Immediate Denture eliminates the embarrassment of having to go without teeth, while the gums are healing.


An Immediate denture is designed to fit your mouth at the time impressions are taken; however, after a few months your gums will change drastically due to "gum resorption." It's possible that the denture will rub against the gums when it is first placed, which may be very sore until it can be adjusted. Gums shrink the most within the first year of having teeth extracted. Most patients will require relines within a few months, to restore the fit of their dentures. Expect that the first year of wearing dentures will also be the most difficult and costly.


Since an Immediate Denture covers over the surgical site and the tooth sockets, it helps keep that tender surgical area from becoming irritated, much as a bandage would. Do not remove your denture by yourself, even for just a few minutes, until your dentist tells you it's all right. The gum tissue underneath the denture has a tendency to swell. If you take the denture out for very long, you may never get it back in again.





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Overdenture

An overdenture fits on-top of natural teeth or dental implants. Many patients suffer with ill fitting and loose dentures that move or even fall out when speaking or eating. One way of solving this problem is to construct a dental plate that goes over and attaches to something underneath it. Keeping a few natural teeth or placing dental implants in the bone under the denture also helps keep the jaw bone healthy. This avoids much of the natural jaw bone loss often seen after teeth are removed. Traditional overdentures go over natural teeth. A denture can be made that goes over and attaches to one or both cuspids.


Implant supported overdentures fit on top of dental implants. A retainer bar or retention balls are placed on the implants and special attachments are inserted into the denture to grab onto these retention devices. A new method using mini implant dentures is becoming increasingly popular. Mini implants are very thin long titanium implants that screw into the jaw bone. They can be placed and old dentures can often be retrofitted to the implant.




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Full Arch Dentures

A full arch denture is a removable tooth replacement option for those who need all their teeth replaced. They can be crafted to provide the characteristics (tooth shape and color) the patient desires. Advances have been made in the materials used for dentures and in the way they are designed. If you already have dentures (partial or full arch) you may be experiencing a loose fit or denture slipping. This can lead to gum sores, can affect your chewing and your speech and decrease your confidence when speaking and/or laughing with others. We can help restore your dentures to the correct fit.




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Tooth Scaling

Tooth scaling removes plaque, tartar and hard, crusty calculus deposits, which are loaded with bacteria.


Sub-gingival tooth scaling is necessary when plaque and tartar are detected below the gum line.




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Root Planing

Sometimes after a tooth scaling, the roots of a tooth must be planed in order to create a smooth surface for the gum tissue to re-attach to. In addition to the planing, your dentist may also prescribe medication in order to control infection and pain.




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Periodontal Bone Regeneration

When a tooth is lost, both bone and gum tissue compete for the defect space. The gum tissue generates quicker than bone, thus assuming the space. With a membrane placement we can keep the gum tissue from the space, while the bone regenerates. Bone regeneration is often used to rebuild the supporting structures around the teeth which have been destroyed by periodontal disease. Bone surgery may be used to rebuild or reshape bone. Grafts of the patient's bone or artificial bone may be used, as well as special membranes.




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Functional Crown Lengthening

Decay can frequently be found below the gum line. In order to gain access to the decay, it is necessary to reduce some of the bone surrounding the area of decay so the gum tissue can be positioned either higher up or lower down on the tooth making access to repair decay feasible. In other circumstances, the tooth may fracture below the gum line. Often the tooth requires a crown (cap) to cover over the fracture line. In order for the crown to fit over the fracture line, it is necessary to raise or lower the gum and reshape the bone accordingly so that the fracture line now becomes visible above the gum. The tooth is now ready for a crown (cap). When smiling, ideally there should be a display of upper teeth and a slight amount of gum displayed as well. In many circumstances there is an excessive amount of gum displayed (this is known as a gummy smile). In order to reduce the gum display so that there can be an ideal amount of tooth and gum showing, it is necessary to move both the gum and bone higher up on the teeth. The bone is gently sculpted to create room for the gum tissue to be ideally positioned. Hence the correct proportions of the teeth and gum are now visible.




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Esthetic Crown Lengthening

When smiling, ideally there should be a display of upper teeth and a slight amount of gum displayed as well. In many circumstances there is an excessive amount of gum displayed (this is known as a gummy smile). In order to reduce the gum display so that there can be an ideal amount of tooth and gum showing it is necessary to move both the gum and bone higher up on the teeth. The bone is gently sculpted to create room for the gum tissue to be ideally positioned. Hence the correct proportions of the teeth and gum are now visible.




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Flap Surgery

When deep pockets between teeth and gums (6 millimeters or deeper) are present, it is difficult for a dentist to thoroughly remove the plaque and tartar. Flap surgery is a procedure where the gum flap is lifted away from the tooth. Diseased tissue and sometimes bone is removed. The rough surfaces of the tooth are then smoothed by root planing. The area is medicated and the gum flap is replaced and sutured allowing the bone and gum tissue to heal. One of the goals of flap surgery is to reduce the depth of the periodontal pockets to make them easier to keep clean.




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Frenectomy

If a patient has an excess amount of tissue that connects the lower and upper lips to the jaw and gum line, a frenectomy procedure is performed to remove the excess tissue.




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Soft Tissue Grafting

Soft Tissue Grafting

A frequent periodontal condition is known as gum recession. This means the existing gum tissue has receded up or down the root of the tooth exposing various amounts of the root. Root exposure can create root sensitivity especially to hot and cold, an increased potential for root decay, and/or esthetic concerns. Gum grafting procedures are the treatment of choice to prevent the recession from continuing further. There are many different types of recession and hence many different types of gum grafting. Some are aimed at covering the root of the tooth and other procedures are focused on providing an excellent new zone of gum tissue to halt the recession.




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Root Canal

Causes of a Root Canal
Root canals are necessary when a cavity that has been left untreated becomes larger. Once the cavity reaches the pulp of the tooth, an infection forms at the base of the root canal, causing an abscess. This abscess is generally painful and will need to be removed.

The doctors at Adam J. Barr DDS know that serious tooth decay can often lead to a root canal. A root canal may be needed if the decay has reached the tooth's nerve. Essentially, a root canal involves cleaning out a tooth's infected root, then filling and sealing the canal.

Root Canal Procedure:
1) An opening is made through the crown of the tooth into the pulp chamber.
2) The pulp is removed, and the root canals are cleaned, enlarged and shaped.
3) The infected area is medicated.
4) The root canals are filled.
5) The crown opening is filled with a temporary.

If you are experiencing severe tooth pain, you may need a root canal. The only sure way to know is to call our Eustis, FL dental office at (352) 357-7900 and setup an appointment with Dr. Barr.




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Post and Crown

When there is not enough tooth structure remaining after trauma, decay or a root canal procedure, then a post and crown will be utilized to restore the tooth to full form and function. A post is placed in the root canal and then a buildup composed of a bonded composite is used to provide proper support for the new crown. If a crown is placed on an unstable tooth foundation you will have a higher risk of having that crown fail.




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Tooth Extraction

When the extraction of a tooth is required:
1) An incision in the gums is made
2) The tooth is removed
3) The area is stitched up and is allowed to heal


During this time, it is important to think about a tooth replacement option. An extracted tooth leaves an open area in the jaw which, in time, allows the neighboring teeth to drift into the area where the tooth was extracted. This in turn, causes a chain reaction to all the surrounding teeth. Also, if you are considering placing an implant in the future, you should consider asking your dentist to place a bone graft at the time of surgery to preserve the bone width and height.




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After Extraction Care

After Extraction Care

1) DO NOT RINSE MOUTH TODAY
Tomorrow rinse mouth gently every 3 to 4 hours (especially after meals) using one quarter teaspoon of salt to a glass of warm water. Continue rinses for several days.


2) BLEEDING
Following extractions some bleeding is to be expected. If persistent bleeding occurs, place gauze pads over bleeding area and bite down firmly for one-half hour. Repeat if necessary.


3) SWELLING
Ice bag or chopped ice wrapped in a towel should be applied to the operated area; one-half hour on, and one-half hour off for 4-5 hours.


4) PAIN
For mild to average pain use any non-aspirin type of medication you like. If the doctor prescribes a specific pain medication, follow the instructions and do not mix with other medications unless approved by your doctor.


5) FOOD
Light diet is advisable during the first 24 hours.


6) BONY EDGES
Small sharp bone fragments may work up through the gums during healing. These are not roots; if annoying, return to our office for their simple removal.


7) If any unusual symptoms occur, call the office at once.


8) The proper care following oral surgical procedures will hasten recovery and prevent complications.




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Wisdom Tooth Positions

Wisdom Tooth Positions

Wisdom teeth under ideal circumstances should grow in straight like any other tooth. However, it is common for wisdom teeth to become impacted inside the jaw or just under the gums. If this occurs, your wisdom teeth should be removed.

Common Impactions:


  1. Horizontal Impaction
  2. Angular Impaction
  3. Vertical Impaction
  4. Soft Tissue Impaction




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Wisdom Tooth Problems

Wisdom Tooth Problems

The problems involving your wisdom teeth may be caused by the size of your jaw and/or by how crowded your teeth are. Common warning symptoms that there is an un-natural problem in the development of your wisdom teeth could be pain and swelling.

Symptoms can be caused by:
1) Infection to the gums
2) A crowded tooth displacing neighboring teeth
3) A decayed wisdom tooth
4) Poorly positioned wisdom tooth
5) A cyst that destroys bone




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Wisdom Tooth Removal

Wisdom Tooth Removal

Removal of wisdom teeth could be done while you are sedated and being carefully monitored.

1) An incision is made in the gums.
2) The overlaying bone is removed to
expose the crown of the tooth.
3) The tooth is then extracted as a whole or under certain circumstances, it may be necessary to be removed in pieces. This is generally done for severely impacted wisdom teeth.
4) The area is stitched closed and allowed to heal.




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After Extraction Care

After Extraction Care

1) DO NOT RINSE MOUTH TODAY
Tomorrow rinse mouth gently every 3 to 4 hours (especially after meals) using one quarter teaspoon of salt to a glass of warm water. Continue rinses for several days.


2) BLEEDING
Following extractions some bleeding is to be expected. If persistent bleeding occurs, place gauze pads over bleeding area and bite down firmly for one-half hour. Repeat if necessary.


3) SWELLING
Ice bag or chopped ice wrapped in a towel should be applied to the operated area; one-half hour on, and one-half hour off for 4-5 hours.


4) PAIN
For mild to average pain use any non-aspirin type of medication you like. If the doctor prescribes a specific pain medication, follow the instructions and do not mix with other medications unless approved by your doctor.


5) FOOD
Light diet is advisable during the first 24 hours.


6) BONY EDGES
Small sharp bone fragments may work up through the gums during healing. These are not roots; if annoying, return to our office for their simple removal.


7) If any unusual symptoms occur, call the office at once.


8) The proper care following oral surgical procedures will hasten recovery and prevent complications.




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Oral Sedation

Oral Sedation

Patients who are more anxious may need an oral medication that is stronger than nitrous oxide. With oral sedation, the patient may be sleepy but can be aroused if necessary and can respond to simple commands.


Minor side effects such as nausea or vomiting can occur with some medications. Before a visit in which a patient is to receive oral sedation, he/she should receive instructions about eating and drinking, what to expect and what to watch for after treatment. You may need assistance to get home after sedation. Patients may need to stay for a short observation after dental treatment has been completed.




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Oral Exam

New patients receive a comprehensive examination which includes a screening for oral cancer, gum and bone disease, blood pressure, and systemic disorders. A routine oral exam is performed on established patients to determine any changes in dental and health status since the previous visit.


Your gum tissue is measured with a fine instrument ruler to calibrate in millimeters pocket depth between the tooth and the connective gum tissue around the tooth. Pocket depths more than 4 millimeters, could indicate disease and infection. The deeper the pocket, the greater the extent plaque bacteria collects and infection in gum disease develop.


X-rays are taken as needed.


Tooth scaling and root planing occur as needed.


Routine cleanings also include a professional polishing (Prophy) that removes only the soft sticky plaque that is above the gum line.




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Plaque

Plaque

Dental plaque is a biofilm, usually a pale yellow, that develops naturally on the teeth. Like any biofilm, dental plaque is formed by colonizing bacteria that attach themselves to the tooth's smooth surface.



Once sugars are introduced to plaque, it turns into a tooth eating acid that sits just above the gum line. If regular oral care isn't standard, the acid will start eating at the teeth producing cavities and the plaque will cause gum disease.

Plaque that is allowed to sit for a prolonged period of time can cause cavities, gingivitis, and other problems in your mouth. If it's left longer than that, serious dental procedures may be required to restore your decaying smile.




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Flossing

In order to floss properly, begin by taking approximately 18 inches of floss and winding one end a few times around your middle finger. Leave approximately 6 inches of floss between your hands and wrap the opposite end of the floss around your other middle finger once. Put the floss between your thumbs and index fingers and hold tightly.

As you insert the floss between your teeth using a gentle rubbing motion, curve the floss in the shape of a C once it reaches the gum line. Move the floss up and down against the side of the tooth in a gentle manner, making sure you work the floss into the adjacent tooth before moving onto the next space. Before you move onto the next space, wind a little floss around your middle finger in order to get a new section of floss to work into your gums.




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Fluoride

Fluoride

Fluoride is an important part of healthy tooth development and will help prevent cavities.

Fluoride can provide protection from tooth decay in a couple ways:
1) It helps to strengthen the tooth's enamel so it can repel the acid that is formed by plaque.
2) Teeth that have been damaged by plaque can repair and re-mineralize themselves with the help of fluoride.

Fluoride is incapable of repairing already formed cavities, but it does assist in reversing low levels of tooth decay and helps in preventing new cavities from forming.




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Brushing

Proper brushing of teeth can be done in three steps:

1) Brush teeth gently using a circular motion along the outside and inside of the tooth surface while holding the brush at a 45 degree angle.

2) Make sure to brush each tooth individually and to use the front half of the brush in a circular motion vertically behind the front teeth.

3) Place the brush against the top of your teeth use a gentle back-and-forth motion to brush. After brushing all your teeth be sure to brush your tongue in order to remove odor-producing bacteria.




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Tooth Scaling

Tooth scaling removes plaque, tartar and hard, crusty calculus deposits, which are loaded with bacteria.


Sub-gingival tooth scaling is necessary when plaque and tartar are detected below the gum line.




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Root Planing

Sometimes after a tooth scaling, the roots of a tooth must be planed in order to create a smooth surface for the gum tissue to re-attach to. In addition to the planing, your dentist may also prescribe medication in order to control infection and pain.




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Sealants

Sealants

Sealants are a proven way to help prevent cavities. Although sealants do not take the place of proper oral hygiene, they do prevent bacteria from getting into the deeper crevices in a tooth's biting surface and therefore keeping the tooth cavity-free.




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Obstructive Sleep Apnea

Cervantes & Prado Dental Care works with sleep apnea dental patients in the Eustis area. Obstructive Sleep Apnea is very common and if left untreated can cause individuals to stop breathing during their sleep for a minute or more. Each time this happens the brain will wake a person up for a moment in order to get them breathing again, which results in sleep being interrupted frequently and leaving the individual tired throughout the day.




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Snoring Appliance

Stop Snoring! Snore guard is an oral appliance that resembles an athletic mouthpiece. Small and flexible, it has no moving parts, masks, hoses, or batteries. Generally made from sterile plastic it is easy to clean with a regular toothbrush.


Custom fit by a dentist in one simple, painless visit. Fit to the patient's teeth to keep the upper and lower jaw in position when the jaw and throat muscles relax during sleep. This keeps the airway open providing restful, quiet sleep.




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Snoring

Snoring is caused when the muscles and soft tissue in the throat and mouth relax making the breathing airway smaller. A relaxed and/or collapsed airway produces soft tissue vibrations during breathing and snoring is the result. Our office has provided oral appliances that can greatly reduce or stop snoring for most people.




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Causes of TMJ/TMD

TMJ and TMD Symptoms and Treatment Overview

Do you ever experience a clicking or popping sound when opening or closing your mouth? Have you been suffering from headaches or migraines and no one seems to be able to help you? Have you been taking pain medicine for years and would like to get off of it? Do you feel any clogging or congestion in one or both of your ears? These are just a few of many symptoms that might be associated with TMD, or Temporomandibular Dysfunction, a common condition affecting the jaw joint or Temporomandibular Joint (TMJ).

TMJ dysfunction, often referred to as TMD, is a disharmony between the way the jaw joint works in an unstrained position and the way the teeth and bite work during those movements. Possible causes of this disharmony include tooth loss, accidents (like whiplash), mal-positioned and/or underdeveloped cranial or jawbones, and perhaps habits like clenching or teeth grinding. Many people go through life suffering from headaches and a variety of facial and neck pains without knowing the ultimate cause, which in many cases is TMJ disorder.

Define TMJ and TMD

TMJ or The Temporomandibular Joint

They are the two joints which connect the lower jaw to the temporal bone at the side of the head. If you place your fingers just in front of your ears and open your mouth, you can feel the joint on each side of the head. Because these joints are flexible, the jaw can move smoothly up and down and side to side, enabling us to talk, chew and yawn. When the TMJ is not functioning normally and it is not within its physiological limits, it creates a condition called TMD, or Temporomandibular Dysfunction.

TMD is a group of conditions resulting from not having a normal function or "comfortable" positioning of the TMJ, and will present as a cycle of pain, muscle spasms and jaw problems. When teeth are missing, out of alignment, crowded or misshaped, chewing and biting cannot be achieved in a balanced way, so the TMJ and the muscles of chewing try to compensate for this unbalanced movement which results in symptoms that will confirm the presence of TMD.

Temporomandibular Joint Disorder (TMD) is not just a disorder, but a group of conditions, often painful, that affect the jaw joint or Temporomandibular Joint (TMJ) and the muscles that control chewing.

TMD falls into three main categories:
  1. Myofascial pain, the most common form of TMD, which is discomfort or pain in the muscles that control jaw functions and the neck and shoulder muscles.
  2. Internal derangement of the joint meaning a dislocated or displaced disc or injury to the condyle (the rounded part at the end of the jaw bone).
  3. Degenerative joint disease such as Osteoarthritis or Rheumatoid Arthritis in the jaw joint. Causes of TMJ/TMD
There are many causes for TMD such as:
  1. Unbalanced occlusion or "Bad Bite"
  2. Stress (emotional or work/school related)
  3. Injury or trauma (this could have been an injury as obvious as a blow to the jaw with a fist or something as subtle as a whiplash injury with direct trauma to the head or jaw.
  4. Teeth grinding or Bruxism
A "Bad Bite" could be caused by any of the following:
  1. Missing teeth
  2. Crowded or "crooked" teeth
  3. Worn down teeth
  4. Old crowns and bridges
  5. Unbalanced dentures

When teeth are missing, or out of alignment, it causes the jaw to shift positions and the muscles to work harder to chew, swallow, bite...etc and eventually will cause: muscle spasms, tension and pain.

Muscle tension and misplaced TMJ could cause the TMJ disc to be pulled out of place which will result in pain, clicking and popping in the TMJ.

If the disc is displaced for a long time, the bones will start rubbing against each other and some damage will happen to the bone, this is called Osteoorthrosis.

If there is inflammation in other joints or bones of the body, it is called Osteoarthritis (Arthritis) which may involve the jaw bone and the TMJ. Some damage to the bone may be evident on the x-rays.

TMD Symptoms
  1. Headaches, Migraines or tension headaches
  2. Worn or loose teeth
  3. Painful muscles in the neck and shoulders (muscle spasms)
  4. Pain behind the eyes.
  5. Clicking and popping of the jaw joint (TMJ)
  6. Locked jaw or restriction in opening or closing the mouth
  7. Earaches or a clogging feeling in the ears
  8. Tingling or numbness in the hands and the fingertips

TMJ Diagnosis

While recognizing TMJ problems is within the ability of most physicians and dentists, not all practitioners are qualified to diagnose it properly and treat it right. It is imperative that a trained practitioner in Craniofacial pain or Neuromuscular Dentistry give the final and definitive diagnosis, and suggest the most suitable treatment plan.

There is a lot of skepticism about TMJ treatment in the medical society, and that is simply due to the fact that physicians didn't receive the dental training and didn't acquire the knowledge required for such complicated diagnosis and treatment. Furthermore, many dentists rush into treating TMJ thinking that they can cure these problems, only to find that they lack the skill and experience to get the job done.

We have training and experience in the treatment of these problems with outstanding success rates. With highly advanced equipment and a high level of knowledge, we address your concerns and provide the best diagnosis for the optimal treatment.

Undiagnosed TMJ/TMD

Many patients who suffer from TMD symptoms, were never told that it is related to their TMJ problem, and were not aware that treating their TMJ could easily relieve their suffering. To explain this further...

Headaches and Migraines

If you suffer from headaches or migraines, TMJ dysfunction, could be the major and most likely cause of your suffering. Your doctors, including neurologists, have simply not received the dental training required to relate your migraine or headache pain to your TMJ problems. Once you rule out any brain tumors or aneurysms, TMJ should be checked and TMD should be treated to relieve the headaches and migraines.

Ear congestion

Due to the proximity of the TMJ to the ears, it is very common to feel ears congestion, or to have ringing in the ears when the TMJ bones move or dislocate from their place. In this case ENT's (ear doctors) won't find anything wrong with the ears, yet the patients keep complaining about their ears. Once the TMJ is put back into its natural position, the pressure put on the ears will be relieved and the congestion disappears.

Tingling or Numbness in the Fingers

When the TMJ is not in a balanced position, it affects the general posture of the body. When the posture is not straight and upright, the nerves coming out from the spine could be irritated, which could cause the numbness or tingling feeling in the fingertips.

Jaw Tracking

We use a state-of-the-art jaw tracking system that helps diagnose TMJ Dysfunction (TMD) by tracking the jaw movement. Research shows that there are certain jaw movements which show very specific types of TMJ dysfunction. For example, limited opening and closing or locking, jaw opening deviations and deflections, and restricted side-to-side jaw movements. All of these indications are widely accepted and published criteria for diagnosing TMD.

Joint Vibration Analysis (JVA)

The Joint Vibration Analysis (or JVA) has been accepted by the American Dental Association to help provide a fast, non-invasive method to accurately diagnose TMJ function and demonstrate the severity level of the problem.

Electromyographic Analysis (EMG)

We use an Electromyographic Analysis (or EMG) to measure muscle activity on head and neck muscles both at rest and in function. This is done by placing computerized sensors on the skin allowing us to accurately monitor muscle activity. Hyperactive muscles are common for patients experiencing pain symptoms associated with TMJ problems. Imbalances between right and left sides of the same sets of muscles are also typical. The EMG system is a safe and comfortable method do help detect such issues and getting to the root of a TMJ issue.

Neuromuscular TMJ Treatment

TMJ/TMD is treatable most of the time. Simple cases of TMJ can be treated with anti-inflammatory medications and a hot/moist compress.

Treatment for more complex cases usually consist of two phases:

Treatment of complex TMJ - Phase One:

Generally speaking, it includes the fabrication of an orthotic. An orthotic is an acrylic device that is worn on the lower teeth 24 hours a day. The orthotic is designed to reposition the jaw to the correct neuromuscular position. We analyze the bite, decide which muscles are causing the pain, and where the current position of the bone is and the disc. All this is done with the aid of advanced equipment like the TENS unit, K7 jaw tracking, Sonography, EMG's and advanced x-rays like Tomography, CT Scans and MRI's of the TMJ. This will help us determine the best and most comfortable position of the TMJ and the muscles. Once that position is determined, we place the orthotic on the lower teeth to keep the TMJ in that position. Orthotics usually are worn for 4-6 months or until most of the symptoms are relieved. Once an orthotic is in use, the symptoms start gradually disappearing until we reach a point that both the doctor and the patient are satisfied with. This concludes Phase I of the treatment.

Treatment of Complex TMJ - Phase Two:

After 4-6 months of relief and when the patient is no longer suffering from any TMD symptoms, Phase II will be considered. Phase II includes any of the following:

  1. Wearing a long term removable orthotic, full time or part time.
  2. Replace missing teeth.
  3. Orthodontic treatment (Braces).
  4. Restore all the lower and/or upper teeth with crowns and veneers to preserve the optimal occlusion (bite) that was achieved with the orthotic in phase I.

Most of the time, any of the above could be considered and chosen, depending on the patients' preferences and financial capability. If you are currently suffering from TMD, it is too early to think of phase II at this time, since it is important to get you out of your pain and symptoms.

Treating TMJ/TMD Caused by Dentures:

Many patients complain that when they received dentures, they noticed pain in the jaw, headaches, ear problems and other symptoms. Sometimes taking the dentures out will relieve those symptoms. If your dentures are not made to the correct bite, or vertical dimension, it will most likely cause these symptoms. Simple adjustments could get rid of these symptoms, but sometimes a whole new set of dentures need to be made according to the neuromuscular principles, to get rid of your headaches or jaw pain.

Orthotics or Bite Splints

An orthotic is an acrylic device that is worn on the lower teeth 24 hours a day. It is designed to reposition the jaw to the correct neuromuscular position.

An orthotic, sometimes called a Bite Splint, is a very effective method in relieving TMD symptoms. It provides an acrylic platform to bite against, sometimes moving the mandible to a new position that is more comfortable.




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Bite Splints

Bite Splints

Bite splints (plates) are effective in relieving TMD symptoms.


A bite splint provides an acrylic platform to bite against. Some bite plates move the mandible to a new position.


Generally, splints are worn part-time and for most people nighttime is best.





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