Using the most advanced dental technology possible is just as important as staying up-to-date on the latest treatment techniques. Because our practice is dedicated to providing you with the safest and most convenient treatment options available, we utilize advanced digital X-ray technology in our office. Digital X-rays provide several advanced imaging options designed to save time, provide clearer dental photos, and expose patients to 90% less radiation than with traditional X-ray technology.
The Diagnodent is a computerized fluorescent laser device that helps detect dental decay at the earliest possible stage so that the most appropriate treatment can be presented to you.
By using the Diagnodent we are able to find cavities which lie beneath the surface of the tooth. There are often cavities that cannot be seen using x-rays and an explorer alone. This advanced technology helps to preserve a greater amount of your tooth structure by uncovering dental decay before it progresses too far.
We find this device to be especially useful for detecting decay in the mouths of our youngest patients. After all, you cannot treat what can't be seen. If decay is found early on and treated, the preparation of the tooth will be very shallow with minimal removal of enamel. The longevity of teeth are directionally proportional to the original amount of tooth structure.
Dental sealant is a thin, plastic coating painted on the chewing surfaces of teeth -- usually the back teeth (the premolars and molars) -- to prevent tooth decay. The sealant quickly bonds into the depressions and grooves of the teeth, forming a protective shield over the enamel of each tooth.
Although thorough brushing and flossing can remove food particles and plaque from smooth surfaces of teeth, they cannot always get into all the nooks and crannies of the back teeth to remove the food and plaque. Sealants protect these vulnerable areas from tooth decay by "sealing out" plaque and food.
Because of the likelihood of developing decay in the depressions and grooves of the premolars and molars, children and teenagers are candidates for sealants. However, adults without decay or fillings in their molars can also benefit from sealants.
Typically, children should get sealants on their permanent molars and premolars as soon as these teeth come in. In this way, the sealants can protect the teeth through the cavity-prone years of ages 6 to 14.
In some cases, dental sealants may also be appropriate for baby teeth, such as when a child's baby teeth have deep depressions and grooves. Because baby teeth play such an important role in holding the correct spacing for permanent teeth, it's important to keep these teeth healthy so they are not lost too early.
Root Planing and Scaling for Gum Disease
Root planing and scaling is one of the most effective ways to treat gum disease before it becomes severe. Root planing and scaling cleans between the gums and the teeth down to the roots. Depending on the extent of pocket depth either a topical or local anesthetic will be used.
Some dentists and dental hygienists will use an ultrasonic tool for the planing and scaling. This tool is not as uncomfortable as a standard scraping tool, but not all cleanings require this type of tool.
Safe amalgam removal
Safety protocols are utilized when removing silver (mercury) fillings. Click here to read about the protocol Dr. Nikolovski utilizes for Safe Amalgam Removal.
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 size restorations that need to withstand moderate chewing pressure. Less tooth structure is removed when the dentist prepares the tooth, and this may result in a smaller filling than that of an amalgam. Composites can also be "bonded" or adhesively held in a cavity, often allowing the dentist to make a more conservative repair to the tooth.
There are a variety of composites on the market. Dr. Nikolovski uses dental composite materials in the office that show to be biocompatible with most people. (Through results of many bio-compatibility tests reviewed.) The office offers biocompatibility testing of materials through biofeedback and/or blood serum testing. Dr. Nikolovski’s office follows mercury free and mercury safe practices.
Crowns and Bridges
Crowns and bridges are used to restore and enhance teeth that are damaged or to take the place of missing teeth. A crown (also referred to as a cap) is used to entirely cover a damaged tooth. A crown not only protects a tooth, but it can dramatically improve a tooth’s appearance, shape and alignment. Crowns are a last resort for the tooth. With the newer dental materials, crowns are generally not needed.
A bridge is a method to fill the space created by missing teeth. A bridge is one or more artificial teeth cemented into place using the teeth on either side for support. This is an option for filling the space created by a missing tooth. Bridge work is as much an art as it is an exact science since it replaces a missing tooth both functionally and cosmetically. The materials used may be gold alloys, porcelain bonded to metal alloy, ceramic, or composite material made to match your natural tooth color. Dr. Nikolovski offers metal free crowns and bridges.
A denture is a removable replacement for missing teeth and adjacent tissues. It is made of acrylic resin, sometimes in combination with various metals.
Types of dentures:
Complete dentures replace all the teeth, while a partial denture fills in the spaces created by missing teeth and prevents other teeth from changing position.
Candidates for complete dentures have lost most or all of their teeth. A partial denture is suitable for those who have some natural teeth remaining. A denture improves chewing ability and speech, and provides support for facial muscles. It will greatly enhance the facial appearance and smile.
Complete or full dentures are made when all of your natural teeth are missing. You can have a full denture on your upper or lower jaw, or both.
Complete dentures are called "conventional" or "immediate" according to when they are made and when they are inserted into the mouth. Immediate dentures are inserted immediately after the removal of the remaining teeth. To make this possible, the dentist takes measurements and makes the models of the patient`s jaws during a preliminary visit.
An advantage of immediate dentures is that the wearer does not have to be without teeth during the healing period. However, bones and gums can shrink over time, especially during the period of healing in the first six months after the removal of teeth. When gums shrink, immediate dentures may require rebasing or relining to fit properly. A conventional denture can then be made once the tissues have healed. Healing may take at least 6-8 weeks.
An overdenture is a removable denture that fits over a small number of remaining natural teeth. The natural teeth must be prepared to provide stability and support for the denture.
Partial dentures are often a solution when several teeth are missing. Partial dentures can be made to be metal free in most cases.
There are many different varieties of periodontal disease, and many ways in which these variations manifest themselves. All require immediate treatment by a periodontist to halt the progression and save the gum tissue and bone. Here are some of the most common types of periodontal disease along with the treatments typically performed to correct them:
Gingivitis is the mildest and most common form of periodontitis. It is caused by the toxins in plaque and leads to periodontal disease. People at increased risk of developing gingivitis include pregnant women, women taking birth control pills, people with uncontrolled diabetes, steroid users and people who control seizures and blood pressure using medication.
Chronic Periodontal Disease
Chronic periodontal disease is the mos t common form of the disease, and occurs much more frequently in people over 45. Chronic periodontal disease is characterized by inflammation below the gum line and the progressive destruction of the gingival and bone tissue. It may appear that the teeth are gradually growing in length, but in actuality the gums are gradually recessing.
Aggressive Periodontal Disease
Aggressive periodontal disease is characterized by the rapid loss of gum attachment, the rapid loss of bone tissue and familial aggregation. The disease itself is essentially the same as chronic periodontitis but the progression is much faster. Smokers and those with a family history of this disease are at an increased risk of developing aggressive periodontitis.
Periodontal Disease Relating to Systemic Conditions
Periodontal disease can be a symptom of a disease or condition affecting the rest of the body. Depending on the underlying condition, the disease can behave like aggressive periodontal disease, working quickly to destroy tissue. Heart disease, diabetes and respiratory disease are the most common cofactors, though there are many others. Even in cases where little plaque coats the teeth, many medical conditions intensify and accelerate the progression of periodontal disease.
Necrotizing Periodontal Disease
This form of the disease rapidly worsens and is more prevalent among people who suffer from HIV, immunosuppression, malnutrition, chronic stress or choose to smoke. Tissue death (necrosis) frequently affects the periodontal ligament, gingival tissues and alveolar bone.
Nitrous Oxide SedationThe use of nitrous oxide (N2O), also known as laughing gas, is an inhalation sedation technique that can be used as a way of lowering anxiety and nervousness during dental treatment without making you completely unconscious. Nitrous oxide can be used for all routine dental procedures, including dental extractions, to “take the edge off” before the administration of local anesthetic and for the entire duration of your dental treatment.
Root Canal Extractions
The goal is to ensure that the tooth be removed safely. Alternatively, that no infected tissue be left behind to inhibit complete healing. Emphasis is placed on proper removal of the tooth, periodontal ligament and any cyst formation by cleansing and debridement of the surgical site after the tooth is removed. This process allows for the most complete bone healing.
The name 'wisdom teeth' is age related - third molars don't erupt until teenage years and beyond, when people theoretically are wiser to the world," says Trey Petty, DDS, FAGD, spokesperson for the Academy of General Dentistry.
Common reasons for wisdom teeth removal include impaction, pain and crowding of the other teeth, which are typical tooth growth characteristics.
"If wisdom teeth are not visible, they are impacted or unable to erupt due to space and size limitations," says Dr. Petty. "Impacted teeth don't have enough room to grow, and will lay beneath the gums, which may or may not be a problem."
Pain and tooth crowding are also top wisdom teeth problems. "Adults have forgotten what normal pain from a growing tooth feels like," says Dr. Petty. Complications also can arise when wisdom teeth partially erupt. The broken gum acts as a breeding ground for bacteria and germs.
"When wisdom teeth partially erupt, food gets caught in the gums and may cause an infection, swelling, growth of a tumor or cyst and pain. If this happens, consult a dentist before problems worsen and affect overall oral health."
"If wisdom teeth have erupted, the key to preserving them is maintaining good oral health by brushing twice a day and going to see a dentist twice a year.
Should a wisdom tooth/teeth need to be extracted, Dr. Nikolovski follows the same process as when removing a failed root canal which is after the extraction of the tooth he removes the periodontal ligament and then debrides the socket of any infected bone and tissue.
The term cavitation was coined in 1930 by an orthopedic researcher to describe a disease process in which a lack of blood flow into the area produced a hole in the jawbone and other bones in the body….
Dr. G.V. Black, the father of modern dentistry, described this cavitation process as early as 1915 when he described a progressive disease process in the jawbone, which killed bone cells and produced a large cavitation area or areas within the jawbones. He was intrigued by the unique ability of this disease to produce extensive jawbone destruction without causing redness in the gingiva (gums), jaw swelling, or an elevation in the patient's body temperature. Essentially this disease process, which produces osteonecrosis (dead bone) is actually a progressive impairment which produces small blockages (infarctions) of the tiny blood vessels in the jawbones, thus resulting in osteonecrosis, or areas of dead bone. These dead cavitational areas are now called NICO (Neuralgia Inducing Cavitational Osteonecrosis) lesions. In his book on oral pathology, Dr. Black suggested surgical removal of these dead bone areas.
When dentists speak of cavitations they are speaking of areas of the jawbone where the bone has been infected and the body has attempted to wall off the infection. The end result is a semi-contained “bubble” of infectious bacteria, dead (necrotic) bone material, and other toxins. This toxic sludge will slowly leak out (eventually), spreading to other areas of the body and can negatively impact the overall health of the patient – focal infection theory. These are all scientific facts that are taught to every medical doctor and dentist that graduates from an accredited medical/dental school in the United States.
What is a cavitation? A cavitation is a hole in bone which can come from incomplete bone healing after an extraction. While it is believed that after an extraction, the hole left behind completely heals, this is not always the case; a cavitation can be left inside the jawbone. These cavitation’s are a breeding ground for bacteria and toxins.
This type of sedation is very easy and straightforward and involves breathing in a mixture of nitrous oxide (often known as laughing gas) and oxygen. A small rubber inhaler is placed over the patient’s nose and adjusted so that the patient breaths through it. It begins to work within 3 to 5 minutes and at the end of the appointment the effect of N2O is reversed within minutes. Most patients experience an initial feeling of lightheadedness, which gradually leads to a feeling of overall relaxation and well- being.
The advantages of nitrous oxide are its rapid onset, quick recovery, and it is one of the safest forms of sedation available for both adults and children.
Our office is equipped with nitrous oxide and our doctors and staff is highly trained in the safe administration and management of nitrous oxide. Please feel free to discuss this option further with the doctor.
There are times when patients do request IV sedation (drugs that are given intravenously to place patient in a twilight sleep that causes little to no memory of procedure) for treatment, or it may be necessary depending on the treatment plan involved. When all treatment is completed in one-visit (as in the removal of all amalgams, metals, etc.), sedation would be utilized due to several factors which will be discussed during the initial consultation appointment.
IV Sedation can also be beneficial to people who are phobic or have anxiety issues when it comes to getting their dental treatment done. It is also recommended for surgical extractions of wisdom teeth.
Our office works directly in conjunction with Board-Certified Anesthesiologists for sedation procedures. All treatment is performed in the dental office.