Our Services

Please note that the detailed information on these pages graphically describe and illustrate, to some degree, surgical procedures. We offer this to you because we feel that you should be fully informed of all procedures, and that you will feel more comfortable with a better knowledge of exactly what is involved in the implant procedure.

Continue our Implant Patient Education.

RIDGE MODIFICATION

A key to implant success is the amount and quality of the bone where the implant is to be placed. Deformities in the upper or lower jaw can leave you with inadequate bone in which to place dental implants. This defect may have been caused by periodontal disease, wearing dentures, developmental defects, injury, or trauma. Not only does this deformity cause problems in placing the implant, it can also cause an unattractive indentation in the jaw line near the missing teeth that may be difficult to clean and maintain. To correct the problem, the gum is lifted away from the ridge to expose the bony defect. The defect is then filled with bone or bone substitutes to build up the ridge. Your dentist can tell you about your options for graft materials, which can help to regenerate lost bone and tissue. Finally, the incision is closed and healing is allowed to take place. Depending on your individual needs, the bone usually will be allowed to develop for about four to twelve months before implants can be placed. In some cases, the implant can be placed at the same time the ridge is modified. Ridge modification has been shown to greatly improve appearance and increase your chances for successful implants that can last for years to come. Ridge modification can enhance your restorative success both esthetically and functionally. 

SINUS AUGMENTATION

A key to implant success is the quantity and quality of the bone where the implant is to be placed. The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. If you have lost bone in that area due to reasons such as periodontal disease or tooth loss, you may be left without enough bone to place implants. Sinus augmentation can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants. Several techniques can be used to raise the sinus and allow for new bone to form. In one common technique, an incision is made to expose the bone. Then a small circle is cut into the bone. This bony piece is lifted into the sinus cavity, much like a trap door, and the space underneath is filled with bone graft material. Your dentist can explain your options for graft materials, which can regenerate lost bone and tissue. Finally, the incision is closed and healing is allowed to take place. Depending on your individual needs, the bone usually will be allowed to develop for about four to twelve months before implants can be placed. After the implants are placed, an additional healing period is required. In some cases, the implant can be placed at the same time the sinus is augmented. Sinus augmentation has been shown to greatly increase your chances for successful implants that can last for years to come. Many patients experience minimal discomfort during this procedure.
 

Latest Cosmetic Treatments
Please note that the detailed information on these pages graphically describe and illustrate, to some degree, surgical procedures. We offer this to you because we feel that you should be fully informed of all procedures, and that you will feel more comfortable with a better knowledge of exactly what is involved in the implant procedure.

Drs. Lee and Salem strive to employ the most up-to-date techniques to help you attain the smile you’ve always wanted. The contour, color, and alignment of your teeth can be improved with these new techniques such as bonding, porcelain veneers or porcelain fillings.
 

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Continue our Cosmetic Patient Education.
 

3 General Teeth Whitening Systems

	Over-the-Counter Whitening Strips
	Take Home Whitening Trays
	In-office One Hour

Before

After

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Composite and porcelain are tooth-colored restorations that are used on the chewing surfaces of the back teeth. They can be placed instead of silver fillings or to replace existing silver fillings.


Before

After

Bad breath (halitosis) can be caused by many things. It may be the result of odor-causing foods, tooth decay, periodontal (gum) disease, continued mouth dryness, use of tobacco products, sinus or respiratory infections, some medical disorders, inadequate oral hygiene or some medications. Your dentist can help identify the cause and, if it's due to an oral condition, can develop a treatment plan to eliminate this common source of embarrassment.

What Causes Bad Breath?

What you eat affects the air you exhale. Certain foods, such as garlic and onions, contribute to objectionable breath odor. Once the food is absorbed into the bloodstream, it is transferred to the lungs, where it is expelled. Brushing, flossing and mouthwash will only mask the odor temporarily. Odors continue until the body eliminates the food. Dieters may develop unpleasant breath from infrequent eating.

If you don't brush and floss daily, particles of food remain in the mouth, collecting bacteria, which can cause bad breath. Food that collects between the teeth, on the tongue and around the gums can rot, leaving an unpleasant odor. Dentures that are not cleaned properly can also harbor odor-causing bacteria and food particles.

One of the warning signs of periodontal (gum) disease is persistent bad breath or a bad taste in the mouth. Periodontal disease is caused by plaque, the sticky, colorless film of bacteria that constantly forms on teeth. The bacteria create toxins that irritate the gums. In the advanced stage of the disease, the gums, bone and other structures that support the teeth become damaged. With regular dental checkups, your dentist can detect and treat periodontal disease early.

Bad breath is also caused by dry mouth (xerostomia), which occurs when the flow of saliva decreases. Saliva is necessary to cleanse the mouth and remove particles that may cause odor. Dry mouth may be caused by various medications, salivary gland problems or continuously breathing through the mouth. If you suffer from dry mouth, your dentist may prescribe an artificial saliva, or suggest using sugarless candy and increasing your fluid intake.

Tobacco products cause bad breath, stain teeth, reduce one's ability to taste foods, and irritate gum tissues. Tobacco users are more likely to suffer from periodontal disease and are at greater risk for developing oral cancer. If you use tobacco, ask your dentist for tips on kicking the habit.

Bad breath may be the sign of a medical disorder, such as a local infection in the respiratory tract (nose throat, windpipe, lungs), chronic sinusitis, postnasal drip, chronic bronchitis, diabetes, gastrointestinal disturbance, or liver or kidney ailments. If your dentist determines that your mouth is healthy, you may be referred to your family doctor or a specialist to determine the cause of bad breath.
 

Treatment of Bad Breath & Caring for Your Smile

Eliminating periodontal disease and maintaining good oral health is essential to reducing bad breath. Schedule regular dental visits for a professional cleaning and checkup. If you think you have constant bad breath, keep a log of the foods you eat and make a list of medications you take. Some medications may play a role in creating mouth odors. Let your dentist know if you've had any surgery or illness since your last appointment.

Brush twice a day with a fluoride toothpaste to remove food debris and plaque. Brush your tongue, too. Once a day, use floss or an interdental cleaner to clean between teeth. If you wear removable dentures, take them out at night. Clean them thoroughly before replacing them the next morning.

Mouthwashes are generally cosmetic and do not have a long-lasting effect on bad breath. If you must constantly use a breath freshener to hide unpleasant mouth odor, see your dentist. If you need extra help in controlling plaque, your dentist may recommend using a special antimicrobial mouthrinse. A fluoride mouth rinse, used along with brushing and flossing, can help prevent tooth decay.

Bad breath (halitosis) can be caused by many things. It may be the result of odor-causing foods, tooth decay, periodontal (gum) disease, continued mouth dryness, use of tobacco products, sinus or respiratory infections, some medical disorders, inadequate oral hygiene or some medications. Your dentist can help identify the cause and, if it's due to an oral condition, can develop a treatment plan to eliminate this common source of embarrassment.

When a tooth is fractured, has a large, old filling, or is severely damaged by decay, the placement of a crown (or cap) may be recommended. Crowns strengthen and protect the remaining tooth structure and can improve the appearance of your smile. Types of crowns include the full porcelain crown, the porcelain-fused-to-metal crown, and the all-metal crown.  Fitting a crown requires at least two visits to the dentist's office.

	Decay is removed and the tooth is shaped to accept a crown.
	An impression of this section of the mouth is taken.
	A temporary (or transitional) crown of plastic or metal is formed and fitted to the reshaped tooth.
	During the next visit (usually a week later), the temporary crown is removed and the permanent crown is placed, adjusted, and cemented into place.

Few incidents have greater impact on dental health and personal appearance than tooth loss. When one or more teeth are missing, the remaining teeth can drift out of position, which can lead to a change in the bite, the loss of additional teeth, decay and gum disease.

When tooth loss occurs, your dentist may recommend the placement of a bridge. A bridge is one or more replacement teeth anchored by one or more crowns on each side.

	The teeth on each side of the space are prepared and shaped to receive crowns. An impression of the area is made.
	A temporary (or transitional) bridge is formed and fitted in the area.
	During the next visit (usually a week later), the temporary bridge is removed and the permanent fixed bridge is placed, adjusted and cemented into place

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Traditional Crowns, Bridges and Dentures

Please note that the detailed information on these pages graphically describe and illustrate, to some degree, surgical procedures. We offer this to you because we feel that you should be fully informed of all procedures, and that you will feel more comfortable with a better knowledge of exactly what is involved in the implant procedure.

Drs. Lee and Salem strive to employ the most up-to-date techniques to help you attain the smile you’ve always wanted. The contour, color, and alignment of your teeth can be improved with these new techniques.

Missing Teeth Replacement Options -

To View the following pages, you will need Macromedia Flash Player to Continue our Patient Education.

Gum disease (also called periodontal disease) is an infection of the tissues surrounding and supporting the teeth. It is a major cause of tooth loss in adults. In fact, after age 35, about three out of four adults are affected by some form of gum disease.

Gum disease is caused by plaque, a sticky film of bacteria that constantly forms on the teeth. These bacteria create toxins that can damage the gums. In the early stage of gum disease, called gingivitis, the gums can become red, swollen and bleed easily. At this stage, the disease is still reversible and can usually be eliminated by daily brushing and flossing.

Because gum disease is usually painless, however, you may not know you have it. In the more advanced stages of gum disease, called periodontitis, the gums and bone that support the teeth can become seriously damaged. The teeth can become loose, fall out or have to be removed by a dentist.
 

Signs of gum disease

If you notice any of the following signs of gum disease, see your dentist immediately:

• gums that bleed when you brush your teeth
• red, swollen or tender gums
• gums that have pulled away from the teeth
• bad breath that doesn't go away
• pus between your teeth and gums
• loose teeth
• a change in the way your teeth fit together when you bite
• a change in the fit of partial dentures

Normal, healthy gums Healthy gums and bone anchor teeth firmly in place. Periodontitis If not removed, plaque hardens into calculus  (tartar). As plaque and calculus continue to build up, the gums begin to recede (pull away) from the teeth, and pockets form between the teeth and gums. Advanced periodontitis The gums recede farther, destroying more bone and the periodontal ligament. Teeth — even healthy teeth — may become loose and need to be extracted.

Drs. Lee and Salem are hospital trained dentists.  They are both experienced in bone grafting, platelet's derived growth factors, biopsy, removal of teeth, implant surgery, etc. for patients of all age groups, and are prepared to manage patients within all ranges of medical conditions.

Contrary to popular belief, wisdom teeth do not make you smarter. Otherwise known as your third molars, they are simply your third set of molar teeth that develop around the age of 18- 21 in young men and women.

Why then do wisdom teeth cause so many problems and need to be  removed? Simply because in most people there is not enough room in the jaw bone for the wisdom teeth to erupt. One doctor put it best when he said that you are trying to put 32 teeth in an area where there is only room for 28.

Often times wisdom teeth become impacted in the jawbone. Impacted means that the tooth is either covered by your gum tissue called a soft tissue impaction, or covered by bone called a hard tissue impaction. Some of the problems wisdom teeth can cause include a common called pericornitis.

Pericornitis is an infection of the gum tissue around partially impacted (meaning only part of the tooth is visible above the gum line) wisdom teeth. Because only part of the tooth is sticking out of the gums, this causes an area where food and plaque build up.

Wisdom teeth are usually in an area where it is extremely difficult to clean. Therefore the gum tissue becomes inflamed and irritated. Symptoms of pericornitis include pain, swelling and inability to open the mouth (called trismus). Treatment includes first relieving symptoms with antibiotics and mouth rinses and then removal of the wisdom tooth.

Destruction of bone can occur when the wisdom tooth is partially impacted. Because you cannot clean the area, plaque and tartar buildup in the back of the mouth. This can result not only in destruction of bone around the wisdom tooth but also around the molar tooth in front of the wisdom tooth. Due to their place in the mouth, wisdom teeth are more difficult to clean. The lack of hygiene in the posterior portion of the mouth can lead to a buildup of plaque.

A tooth that is more difficult to clean results in the formation of a cavity or decay on the tooth. When a wisdom tooth develops a cavity, it is better to remove the tooth than try to restore it with a filling. Removal of wisdom teeth can range from being a simple extraction to a minor surgical procedure depending on how much the tooth is impacted. If the wisdom tooth is fully erupted, then the tooth can be usually removed in one piece. If it is a full bony impaction, then the gums must be moved out of the way, and the bone removed to gain access to the tooth. The tooth is then removed in pieces because there is not enough room to remove the tooth and its roots in one piece. The gum tissue is sutured back and the area allowed to heal. Sutures or stitches may or may not be placed depending on the need of the individual case.

With today's technology and innovations, the risk of caries and gum diseases can be significantly reduced with the proper preventative services such as sealants, interceptive orthodontics, fluoridation, and patient education.  Drs. Lee and Salem are very involved educating patients young and old the risk/benefits of each preventative procedures.

Prevention and Sealants

The first step in maintaining a healthy mouth is preventing tooth decay, and sealants can offer major protection against cavities. Your teeth are covered with a sticky film of bacteria, called plaque. When you don't clean your teeth after eating, plaque bacteria use sugar and starch in food as a source of energy. The bacteria convert the sugar or starch into harmful acids that attack tooth enamel for as long as twenty minutes or more. Repeated attacks may cause the enamel to break down, resulting in cavities.

How does a sealant help prevent decay?

A sealant is a plastic material that is usually applied to the chewing surfaces of the back teeth — premolars and molars. This plastic resin bonds into the depressions and grooves (pits and fissures) of the chewing surfaces of back teeth. The sealant acts as a barrier, protecting enamel from plaque and acids.

Thorough brushing and flossing help remove food particles and plaque from smooth surfaces of teeth. But toothbrush bristles cannot reach all the way into the depressions and grooves to extract food and plaque. Sealants protect these vulnerable areas by "sealing out" plaque and food.

Is sealant application a complicated procedure?

Sealants are easy for your dentist to apply, and it takes only a few minutes to seal each tooth. The teeth that will be sealed are cleaned. Then the chewing surfaces are roughened with an acid solution to help the sealant adhere to the tooth. The sealant is then 'painted' onto the tooth enamel, where it bonds directly to the tooth and hardens. Sometimes a special curing light is used to help the sealant harden.

As long as the sealant remains intact, the tooth surface will be protected from decay. Sealants hold up well under the force of normal chewing and usually last several years before a reapplication is needed. During your regular dental visits, your dentist will check the condition of the sealants and reapply them when necessary.

Sealants are just for kids, right?  No...

The likelihood of developing pit and fissure decay begins early in life, so children and teenagers are obvious candidates. But adults can benefit from sealants as well.

Key ingredients in preventing tooth decay and maintaining a healthy mouth are twice-daily brushing with an ADA-accepted fluoride toothpaste; cleaning between the teeth daily with floss or interdental cleaners; eating a balanced diet and limiting snacks; and visiting your dentist regularly. Ask your dentist about whether sealants can put extra power behind your prevention program.

Why Custom Fabricated Sports Mouth guards?

According to the American Dental Association, more than 200,000 oral injuries are prevented annually in the United States by sports mouth guards. Unfortunately, the National Youth Sports Foundation estimates that more than 5 million teeth will be knocked out in sporting activities this year. These oral traumas will happen to children, high school and college level athletes. In fact, dental injuries are the most common type of orofacial injury sustained during participation in sports.

Dental injuries could be significantly reduced if children, teenagers, and adults wore custom fabricated mouth guards while involved in such activities as football, basketball, soccer, volleyball, baseball, softball, rollerblading, skateboarding, martial arts, boxing, hockey, kickboxing, and mountain biking. 

Not All Sports Mouth Guards Are Created Equal

Comparing dentist-fitted multi-laminated sports mouth guards with stock or “boil and bite” type mouth guards, typically found in sporting goods stores, reveals significant differences. “Boil and bite” type mouth guards do not fit as accurately as custom fabricated types, so they often go unworn because they’re uncomfortable and frequently interfere with the athlete’s breathing and speaking ability. They may also give a false sense of protection due to the dramatic decrease in thickness when the athlete bites it into place during its softened state. Custom fitted mouth guards, however, have been shown to be far more effective than those offered in sporting goods stores.
 

At what age can people have orthodontic treatment?

The biological process involved in moving teeth is the same at any age. Children and adults can both benefit from orthodontics. It is recommended that every child receive an orthodontic evaluation by age seven. Treatment may take a little longer for adults. Because an adult's facial bones are no longer growing, certain corrections may not be accomplished with braces alone.

 

What causes orthodontic problems?

An orthodontic problem is called a malocclusion, meaning "bad bite." Some examples of causes of malocclusion are crowded teeth, extra teeth, missing teeth or jaws that are out of alignment. Most malocclusions are inherited, although some can be acquired. Acquired malocclusions can be caused by accidents, early or late loss of baby teeth, or sucking of the thumb or fingers for a prolonged period of time.

 

How are orthodontic problems corrected?

First, pretreatment records are made. These records are important tools for the dentist to use in making an accurate diagnosis. They include medical/dental history, clinical examination, plaster study models of teeth, photos of your face and teeth and x-rays of your mouth and head. This information will be used to decide on the best treatment.  A custom treatment plan is outlined for each patient. The specific treatment appliance best suited to correct the patient's orthodontic problem is constructed. There are a variety of different orthodontic appliances that may be used.  When the orthodontic appliances are in place, this is considered the "active treatment" phase. Appliances are adjusted periodically so that the teeth are moved correctly and efficiently.  The time required for orthodontic treatment varies from person to person. An important factor in how long a patient wears braces is how well the patient cooperates during treatment — for example, by following instructions to wear rubber bands or head gear.  After active treatment is completed, the "retention" phase begins. A patient will need to wear a retainer so that the teeth stay in their new positions. For severe orthodontic problems, surgery may be recommended.

 

Are there less noticeable braces

Today's braces are generally less noticeable than those of the past with technology such as Invisalign. Brackets, the part of the braces that hold the wires, are bonded to the front of the teeth. These brackets can be metal, clear, or tooth-colored. Wires that are used for braces today are also less noticeable.  Modern wires are also less noticeable than their predecessors. Today's wires are made of "space age" materials that exert a steady, gentle pressure on the teeth, making the tooth-moving process faster and more comfortable for patients.

 

How long will treatment take?

Although the average treatment time is about 24 months, this varies with individual patients. Usually, adult treatment takes a little longer than a child's treatment. Other things to keep in mind are the severity of the problem, the health of the teeth, gums and supporting bone and how closely the patient follows instructions. While orthodontic treatment requires a time commitment, most people feel the benefits are well worth the time invested.

The American Dental Association recommends that all children have an orthodontic screening no later than age 7.

Things have changed since you were growing up.  Orthodontic evaluation wasn't mentioned until you had all your permanent teeth. When you finally received a comprehensive orthodontic evaluation, you might have had teeth extracted because there was not enough room for all of them or may have had to wear braces for a long period of time.

There is a better way and Dr. Lee and Salem have been using it for years. It's called early treatment or interceptive orthodontics and in about 95% of the cases where teeth would have to be pulled it was avoid, by using safe, painless growth appliances.

There are a lot of growth issues that can be addressed while children are growing, when they hit puberty most of their growth is done and it is a missed opportunity to correct problems that will occur in the future.

Some things to look out for are:

• Overbite - upper front teeth overlap lower teeth
• Deepbite - upper front teeth cover up lower teeth when biting down
• Underbite - lower front teeth overlap upper teeth
• Openbite - upper and lower teeth do not come together when
  biting down
• Spacing - gaps between the teeth
• Midlines Off - the middles of the upper and lower front teeth
  do not line up
• Crossbite - lower teeth or tooth is on the inside of the upper teeth
• Crowding - crowding is when you see twist and turns of the teeth or teeth may come in front of or back of other teeth.

Benefits of early treatment can make an enormous difference of the overall outcome of your child's orthodontic experience and self-esteem. It encourages jaw growth in a safe, painless manor that allows a child to avoid extractions, improve oral hygiene, correct underbites and overbites with little effort on their part once they are use to the appliance and the routine of taking care of it.

Traditional Comprehensive Bracket Orthodontics

Traditional Orthodontics are performed with:

1)  Steel Metal Brackets

2)  Ceramic Plastic Brackets (Esthetics)

How do I ... ?

    Brush and Floss to maintain good oral health?

Like most people, you know that having a clean mouth is important. It makes you feel good about yourself. It gives you fresh breath and a nicer-looking smile. Since childhood, you've probably heard that brushing and flossing your teeth daily are necessary for good dental health. But like many people, you may not be sure why.

Brushing and flossing remove a thin sticky film of bacteria that grows on your teeth. This sticky film, called plaque, is the main cause of tooth decay and gum disease. How can bacteria cause so many problems?

The plaque problem

Many of the foods you eat cause the bacteria in your mouth to produce acids. Sugared foods, such as candy and cookies, are not the only culprits. Starches, such as bread, crackers, and cereal, also cause acids to form. If you snack often, you could be having acid attacks all day long. After many acid attacks, your teeth may decay.

Plaque also produces substances that irritate the gums, making them red, tender or bleed easily. After a while, gums may pull away from the teeth. Pockets form and fill with more bacteria and pus. If the gums are not treated, the bone around the teeth can be destroyed. The teeth may become loose or have to be removed. In fact, gum disease is a main cause of tooth loss in adults.

One way to prevent tooth decay and gum disease is by eating a balanced diet and limiting the number of between-meal snacks. If you need a snack, choose nutritious foods such as raw vegetables, plain yogurt, cheese or a piece of fruit.

Daily oral care

The best way to remove decay-causing plaque is by brushing and cleaning between your teeth every day. Brushing removes plaque from the tooth surfaces. Brush your teeth twice a day, with a soft-bristled brush. The size and shape of your brush should fit your mouth, allowing you to reach all areas easily. Use a toothpaste that contains fluoride, which helps protect your teeth from decay. When choosing any dental product, look for the American Dental Association Seal of Acceptance, an important symbol of a dental product's safety and effectiveness.

Cleaning between the teeth with floss or interdental cleaners removes plaque from between the teeth, areas where the toothbrush can't reach. It is essential in preventing gum disease.

By taking care of your teeth, eating a balanced diet and visiting your dentist regularly, you can have healthy teeth and an attractive smile your entire life. Follow these tips to keep your teeth and mouth clean:

Brushing Tips

• Place your toothbrush at a 45-degree angle against the gums.
• Move the brush back and forth gently in short (toothwide) strokes.
• Brush the outer tooth surfaces, the inner tooth surfaces, and the chewing surfaces of the teeth.
• Use the "toe" of the brush to clean the inside surfaces of the front teeth, using a gentle up-and-down stroke.
• Brush your tongue to remove bacteria and freshen your breath.

Flossing Facts

• Break off about 18 inches of floss and wind most of it around one of your middle fingers.
• Wind the remaining floss around the same finger of the opposite hand. This finger will take up the floss as it becomes dirty.
• Hold the floss tightly between your thumbs and forefingers. Guide the floss between your teeth using a gentle rubbing motion. Never snap the floss into the gums.
• When the floss reaches the gumline, curve it into a C shape against one tooth. Gently slide it into the space between the gum and the tooth.  
• Hold the floss tightly against the tooth. Gently rub the side of the tooth, moving the floss away from the gum with up and down motions.
• Repeat this method on the rest of your teeth. Don't forget the back side of your last tooth.
• People who have difficulty handling dental floss may prefer to use another kind of interdental cleaner. These aids include special brushes, picks or sticks. If you use interdental cleaners, ask your dentist about how to use them properly, to avoid injuring your gums.

Cavities used to be a fact of life. But over the past few decades, tooth decay has been reduced dramatically. The key reason: fluoride. Research has shown that fluoride reduces cavities in both children and adults. It also helps repair the early stages of tooth decay even before the decay becomes visible. Unfortunately, many people continue to be misinformed about fluoride and fluoridation. Fluoride is like any other nutrient; it is safe and effective when used appropriately. This article will help you learn more about the important oral health benefits of fluoride.

• Fluoride: Nature's Cavity Fighter
• Topical Fluorides
• Systemic Fluorides
• Conclusion
• Fluoride Supplement Dosage Schedule - 1994

Fluoride: Nature's Cavity Fighter

Fluoride is a mineral that occurs naturally in all water sources, even the oceans. The fluoride ion comes from the element fluorine. Fluorine, the 13th most abundant element in the earth's crust, is never encountered in its free state in nature. It exists only in combination with other elements as a fluoride compound.

Fluoride is effective in preventing and reversing the early signs of dental caries (tooth decay). Researchers have shown that there are several ways through which fluoride achieves its decay-preventive effects. It makes the tooth structure stronger, so teeth are more resistant to acid attacks. Acid is formed when the bacteria in plaque break down sugars and carbohydrates from the diet. Repeated acid attacks break down the tooth, which causes cavities. Fluoride also acts to repair, or remineralize, areas in which acid attacks have already begun. The remineralization effect of fluoride is important because it reverses the early decay process as well as creating a tooth surface that is more resistant to decay.

Fluoride is obtained in two forms: topical and systemic. Topical fluorides strengthen teeth already present in the mouth making them more decay-resistant. Topical fluorides include toothpastes, mouth rinses and professionally applied fluoride therapies.

Systemic fluorides are those that are ingested into the body and become incorporated into forming tooth structures. Systemic fluorides can also give topical protection because fluoride is present in saliva, which continually bathes the teeth. Systemic fluorides include water fluoridation or dietary fluoride supplements in the form of tablets, drops or lozenges.

As a result of the widespread availability of these various sources of fluoride, the decay rates in both the U.S. and other countries have greatly diminished.

The proper mix is key

It is important to note that the effective prevention of dental decay requires that the proper mix of both forms of fluoride (topical and systemic) be made available to individuals. Your dentist can help you assess whether you are receiving adequate levels of fluoride for all family members from the two forms (topical and systemic).

Topical Fluorides

Self-Applied

One method of self-applied topical fluoride that is responsible for a significant drop in the level of cavities since 1960 is use of a fluoride-containing toothpaste. The American Dental Association recommends that everyone use a fluoride toothpaste displaying the ADA Seal of Acceptance. Other sources of self-applied fluoride are mouth rinses designed to be rinsed and spit out, either prescribed by your dentist or an over-the-counter variety. The ADA recommends the use of fluoride mouth rinses, but not for children under six years of age because they may swallow the rinse.

Professionally-Applied

Professionally-applied fluorides are in the form of a gel, foam or rinse, and are applied by a dentist or dental hygienist during dental visits. These fluorides are more concentrated than the self-applied fluorides, and therefore are not needed as frequently. The ADA recommends that dental professionals use any of the professional strength, tray-applied gels or foam products carrying the ADA Seal of Acceptance. There are no ADA-accepted fluoride professional rinses for use in dental offices.

Systemic Fluorides

Systemic fluorides such as community water fluoridation and dietary fluoride supplements are effective in reducing tooth decay. These fluorides provide topical as well as systemic protection because fluoride is present in the saliva.

Community Water Fluoridation

Fluoride is present naturally in all water sources. Community water fluoridation, which has been around for over 50 years, is simply the process of adjusting the fluoride content of fluoride-deficient water to the recommended level for optimal dental health. That recommended level is 0.7 - 1.2 parts fluoride per million parts water. Water fluoridation has been proven to reduce decay in both children and adults. While water fluoridation is an extremely effective and inexpensive means of obtaining the fluoride necessary for optimal tooth decay prevention, not everyone lives in a community with a centralized, public or private water source that can be fluoridated. For those individuals, fluoride is available in other forms.

Dietary Fluoride Supplements

Dietary fluoride supplements (tablets, drops or lozenges) are available only by prescription and are intended for use by children ages six months to 16 years living in nonfluoridated areas. Your dentist or physician can prescribe the correct dosage. It is based on the natural fluoride concentration of the child's drinking water and the age of the child. For optimum benefits, use of dietary fluoride supplements should begin when a child is six months old and be continued daily until the child is 16 years old. The need for taking dietary fluoride supplements over an extended period of time makes dietary fluoride supplements less cost-effective than water fluoridation; therefore, dietary fluoride supplements are considerably less practical as a wide-spread alternative to water fluoridation as a public health measure. Fluoride supplements are recommended only for children living in non-fluoridated areas.

It is important to note that fluoridated water may be consumed from sources other than the home water supply, such as the workplace, school and/or day care, bottled water, filtered water and from processed beverages and foods prepared with fluoridated water. For this reason, dietary fluoride supplements should be prescribed by carefully following the recommended dosage schedule. Dietary fluoride supplements are not recommended for children residing in a fluoridated community.

Conclusion

No matter how you get the fluoride you need—whether it be through your drinking water, supplements, toothpaste, mouth rinse or professionally applied fluoride—you can be confident that fluoride is silently at work fighting decay. Safe, convenient, effective...however you describe it, fluoride fits naturally into any dental care program. For more information about the oral health benefits of fluoride, just ask your dentist.

Fluoride Supplement Dosage Schedule - 1994

Approved by the American Dental Association, American Academy of Pediatrics and American Academy of Pediatric Dentistry

* 1.0 ppm = 1 mg/liter
** 2.2 mg sodium fluoride contains 1 mg fluoride ion.

Important Considerations When Using Dosage Schedule:

• If fluoride level is unknown, drinking water should be tested for fluoride content before supplements are prescribed. For testing of fluoride content, contact the local or state health department.
• All sources of fluoride should be evaluated with a thorough fluoride history.
• Patient exposure to multiple water sources can make proper prescribing complex.
• Ingestion of higher than recommended levels of fluoride by children has been associated with an increase in mild dental fluorosis in developing, unerupted teeth.
• Fluoride supplements require long-term compliance on a daily basis.

Why do I have to go for dental checkups if I have dentures?

 

Dental exams are still necessary because your mouth is continually changing. Dentures that fit when they were new may no longer fit, also dentures can wear out and may no longer function properly. Your dentist will check your gum ridges and the condition and fit of your dentures. Your dentist also will check for signs of oral cancer. Your dentist may also be able to detect certain medical disorders