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There are several dental procedures that we perform within our scope of practice. Listed below are just some of them:

Dental Radiographs (X-Rays)

Small amounts of radiation are used to make pictures of teeth (radiographs). These black and white images show various shades of gray because some portions of teeth or dental restorations let more or less of the radiation pass through. The result is a radiograph that shows to a moderate level the presence of dental decay. It is nearly impossible to diagnose the presence of decay between the teeth without using dental radiographs. By using radiographs, small areas of decay can be identified before the decay process endangers the life of the tooth.

Some people are afraid of the radiation used in dentistry. Dental radiographs use a very small amount of radiation and it is directed exactly to the site where it is needed. The amount of radiation required for one dental radiograph (bite wing or periapical) requires about the same amount of radiation as you receive by standing in a parking lot in the sun for a few minutes, or riding in an airliner for a few minutes. In other words, the fear of dental radiographs, which are used with caution and good judgment, is totally unfounded. The minimal radiation risk present in dental radiographs is far outweighed by the diagnostic advantage provided by the radiographs.

Endodontic Therapy (Root Canal)

Every tooth consists of three different layers. From the outside, first there is Enamel (the outer layer of the teeth which is the hardest part of the body). The second layer is Dentin (the inside hard layer) and then we have the Pulp (which is an empty space where the live tissue and nerve of each tooth is located)

If for any reason the pulp space is exposed to the outside, the tissue becomes contaminated and eventually infected. The exposure of pulp happens in many circumstances for example when you have a large cavity, or a fractured tooth. Your dentist can explain the exact reason for damage to this tissue. Regardless of the reason for this contamination or damage to pulp tissue, the treatment is usually Root canal treatment. Root canal treatment is the process of going inside the pulp space and removing the infected and dead tissue. Then the space is disinfected and sealed with special materials.

Now-a-days, root canal treatments are performed with advanced techniques and material and are more comfortable and faster. After root canal treatment is done your restorative dentist will usually place a crown on you tooth to protect it against fracture.


Treating a necrotic (dead) pulp is a delicate procedure requiring the following steps.

1. A small hole is made in the tooth to allow access to the dead pulp tissue.
2. Using a series of small files, the dead pulp tissue is removed from the internal of the tooth.
3. When the internal portion of the tooth is hollow and cleared, this area is filled with a “rubber like” material called “gutta-percha.”
4. If the tooth has been severely weakened, it may need a supportive post placed internally, and a subsequent crown (cap) for strength.

Root canal therapy is about 95% effective in restoring the tooth back to normal function. However, occasionally mild discomfort lingers for a few weeks before the tooth feels normal.

We expect that your tooth that will receive root canal therapy will return to a
healthy, strong, non-painful portion of your dentition.

Post Reinforcement for Weakened Teeth

Root canal therapy requires the removal of a significant amount of the internal portion of a tooth to gain access to the root canals and to remove infected materials. If the tooth has had previous restorations (fillings), or has to support a fixed bridge, it may need internal reinforcement to ensure that the root and the crown portions of the tooth are connected together adequately. Various types of posts are used to connect the root and crown. A post is cemented in to the tooth root, and a core, or replacement of the missing portion of the crown is placed on the top of the post.

We plan to place a post in your tooth. The root end of the tooth will remain filled with the root canal filling. The post will be cemented with a strong epoxy-like material that bonds the post and the tooth together.

The “post and core” provided for you allows optimum potential for this tooth to continue to serve in your mouth for many years.

Removal of Superficial Spots on Teeth

There are numerous causes of superficial white, brown, gray, or orange spots on the surfaces of teeth. If the appearance of the tooth discolorations is unacceptable to you, they may be removed in one or more ways:

1. Microabrasion: The most conservative method to remove spots is the removal of a small amount of the discolored tooth structure using an abrasive solution. This technique is usually fast and relatively inexpensive, and it produces a permanent result. We will tell you if this procedure is appropriate for your teeth.
2. Tooth-Colored Restorations (Fillings): If the discolored spots are too deep for microabrasion, they may be removed by standard rotary abrasion and restored by placement of small, tooth-colored plastic restorations. Usually, these restorations match the color of the tooth structure very well, and they serve for several years.
3. Veneers: If your teeth have multiple, deep discolorations, veneers, which are thin, custom-made pieces of plastic or ceramic, can be bonded to the surfaces of the teeth to cover the spots. Veneers provide an excellent appearance and serve well for several years.

If possible, we suggest beginning with conservative microabrasion. If it is successful, further treatment is not necessary. If the spots are too deep to be removed by microabrasion, small restorations may be needed following the microabrasion. If the spots or discolorations are very deep, veneers will usually be suggested as the most adequate treatment.

Implant Prostheses

During the last 20 years dental implants have become a great alternative to other methods of replacing missing teeth. Excellent success rates and a variety of available options give dentists many new ways to treat and replace missing teeth.

Your dentist will be able to evaluate your case and tell you if you are a candidate for dental implants. Basically, a dental implant is a Titanium based root form (cylinder) that replaces the missing tooth root. After a period of time and when the bone has integrated with the implant other parts will be placed on the implant that enables your dentist to eventually place a crown (cap) on the implant.

Implants also can be used to support full or partial dentures. They dramatically improve the denture retention and stability.

Most patients with enough amount of bone can have implants, although individual decisions are made between you and your dentist. Usually an x-ray and a CT-scan is done to determine if you have enough bone to place the implant and also to determine the size and kind of the implant that should be placed.

(ARTIFICIAL TEETH SUPPORTED BY IMPLANTS)

Once placed, we will have done our best to provide you with a well-fitted, functional, and esthetic implant prosthesis. We feel confident that adjustment to these artificial teeth will be fast and that you will have many years of satisfaction from them.

1. Your First Few Weeks: For several days, please chew more carefully on these restorations than on natural teeth. We will adjust the bite (occlusion) on future appointments until the teeth are well balanced. After you have adjusted to the prosthesis, it should function in a similar manner to natural teeth.
2. Cleaning the Implants and Prosthesis: The continuing success of the implants and prosthesis is up to you. Please do the following (items are checked):

a. Visit us for examination, scaling, and polishing at least once every 3-6 months.
b. Clean the implant(s) and prostheses daily, especially before bedtime using:
_____ Floss
_____ Toothbrush
_____ Mechanical toothbrush
Please ask us about anything that is unclear relative to proper cleaning.

3. The Future: Your examination and professional cleaning appointments are very important to the long-term success of your implants and prosthesis. If your personal and professional cleanings and your examination appointments are accomplished routinely, your restorations should serve many years. Please contact us if any of the conditions below occur:

• Feeling of looseness
• Peculiar taste
• Clicking or metallic snap while eating
• Breakage of a piece of the prosthesis
• Redness in the gum tissue around the implant
• Feeling of the bite being different
• Pain

We look forward to helping you enjoy your new implant supported prosthesis.

Tooth-Colored Restorations

We have restored one or more of your teeth with tooth-colored materials. The resin (plastic) material used contains small “filler” particles for strength and wear resistance. These restorations will serve you well for several years. They contain the finest and most up-to-date materials available today. Please be aware of the following information about your new restorations:

Chewing: Avoid chewing excessively hard foods such as hard candy, corn nuts, ice, bones, etc., because the resin material can be broken from the tooth with extreme force. If breakage occurs, replacement of the restoration is not
difficult.

Recall Visits: Professional six-month examinations are necessary. Developing problems can be detected at an early stage and repaired easily. Waiting for a longer time may require redoing the entire restoration. 

Preventive Procedures: To provide optimum longevity for your restorations and to prevent future dental decay and supporting tissue breakdown, please use the following checked preventive procedures:

_____ a. Brush with a fluoride-containing toothpaste after meals, and clean your teeth with floss at least once a day.
_____ b. Swish vigorously for 30 seconds daily with one of the following fluoride containing rinses: (1) Colgate Fluorigard or (2) Johnson & Johnson ACT. The best time is immediately before bedtime.
_____ c. Use a mechanical toothbrush.

The Future: We expect several years of service from these restorations. However, after a service period of years, we have seen the following situations occur

a. Slight stains may occur at locations around juncture of the tooth restoration. Often, we can remove these stains.
b. Slight chipping at the juncture of the tooth and restoration. Usually these chips can be smoothed by us.
c. The gums (gingiva) may shrink from the restorations, displaying an unfavorable appearance underneath. This condition may require remaking the restoration or modifying the gums

Tooth Sealants

Why Seal Teeth? Over the past many years, numerous materials and techniques have been developed to seal the chewing (occlusal) surfaces of teeth. These procedures are necessary because some teeth have defective occlusal surfaces when they erupt into the mouth, and food debris and microorganisms penetrate into the grooves on the teeth during eating. Patients cannot clean these areas effectively, and dental decay (caries) occurs frequently.

Do All Teeth Need to Be Sealed? Usually only the back (posterior) teeth require sealing. It is difficult to tell which individual teeth require sealing because incomplete fusion of the teeth often leaves a nearly microscopic entry from the enamel outside the tooth into the softer dentin inside. Therefore, we suggest that all suspect posterior teeth and selected anterior teeth be sealed. An electronic device (DiagnoDent) may be used to assist the dentist in determining if dental decay is present.

Will All Decay Be Prevented? Sealants placed as close to the eruption time of the teeth as possible prevent the majority of decay on the chewing (occlusal) surfaces of the teeth. However, flossing, brushing, and routine fluoride therapy are required to prevent decay on other surfaces of the teeth. In the presence of poor oral hygiene, decay may begin between the teeth, since sealants cannot be placed on these surfaces.

Cost? The cost for sealing a tooth with plastic is about one-fourth to one-third the cost of filling (restoring) the tooth in the event of decay. Sealants do not require anesthetic or cutting away tooth structure.

How Long Do Sealants Last? Studies show sealants last many years. However, occasional resealing may be required.

Cast Gold Restorations (Fillings & Crowns)

Since 1906 this type of tooth restoration has had a prominent position in dentistry. It has become less used in recent years because of high commercial orientation toward “white” teeth. However, cast gold restorations have some. It is interesting to note that most dentists want cast gold restorations in their own mouths.

UNDENIABLE ADVANTAGES:

1. The longevity of cast gold restorations is greater than any other tooth restoration. Many patients and dentists report 40–50 years of service. Some other types of restorations serve only a few years.
2. Wear of opposing teeth is minimal with cast gold restorations. Gold alloy wears almost exactly like tooth enamel.
3. Gold restorations are strong and can be made to fit teeth exactly. When cemented with decay-preventive cement, the restorations resist further decay.

DISADVANTAGES:

1. Gold restorations are not tooth-colored, and most people object to placing them in areas of the mouth that display the metal.
2. They require somewhat more expertise on the part of the dentist and laboratory.

Ceramic Crowns & Fixed Prostheses (Bridges)

Crowns or bridges made entirely of ceramic materials are available. There are numerous types and brand names of these restorations.

THE ADVANTAGES OF CERAMIC CROWNS AND FIXED
PROSTHESES ARE:

1. They can be constructed to a highly acceptable esthetic level. Usually, these restorations are the most beautiful restorations in dentistry.
2. Ceramic restorations do not have metal under copings, as do porcelain-fused-to-metal crowns. Therefore, these crowns are biologically compatible and have extremely low allergenicity or toxicity.

THE DISADVANTAGES OF CERAMIC CROWNS AND FIXED
PROSTHESES ARE:

1. Some of these restorations may not be as strong as metal or porcelain-fusedto-metal restorations. If your bite is especially abusive, some ceramic restorations may not have adequate strength for you. Occasionally during service, some brands of all-ceramic restorations break and must be replaced.
2. Some brands of ceramic restorations can be made into fixed prostheses (bridges) with adequate longevity expectations and others cannot. If you have a need for an optimum esthetic result or you have allergies to metals used in dentistry, you may want to consider all-ceramic restorations. If not, porcelain-fused-to-metal or metal restorations may be a better choice.

Crowns or Fixed Prostheses (Bridges)

A crown (cap) is a restoration that is placed on teeth that have lost a lot of their structure.

There are many different types of crowns, all ceramic, porcelain fused to a high noble metal or full cast gold crowns. Dr. Batten will explain the advantage and disadvantage of each kind for you.

The process of making a crown includes many steps that start in our office with preparing the teeth and taking impressions of the tooth/teeth involved. Then a temporary crown or bridge is placed on your tooth/teeth. The impressions are taken to be used to fabricate your crown or bridge. In the lab a mold of the teeth is poured and the work begins. There are multiple steps and technicians work on the mold to fabricate the crown or bridge. The completed work will have final checks and adjustments and it is cemented onto your teeth.

Once cemented, they should provide you with years of service, if you will observe the following suggestions:

1. Chewing: Do not chew hard foods on the restorations for 24 hours from the time they were cemented. The cement must mature for several hours to have optimum strength.
2. Sensitivity: Don’t worry about mild sensitivity to hot or cold foods. It will disappear gradually over a few weeks. Infrequently, sensitivity lasts longer than six weeks. Please tell us if this occurs.
3. Aggressive Chewing: Do not chew ice or other hard objects. Avoid chewing very sticky foods such as “hard tack” candies and caramels because they can remove restorations.
4. Preventive Procedures: To provide optimum longevity for your restorations and prevent future dental decay and supporting tissue breakdown, please use the following preventive procedures that are checked:

___ a. Brush and floss your teeth after eating and before bedtime.
___ b. Swish vigorously for at least 30 seconds daily with one of the following fluoride rinse products: (1) Colgate Fluorigard or (2) Johnson & Johnson Act. The best time is immediately before bedtime.
___ c. Use a mechanical toothbrush.
___ d. Use fluoride gel such as Colgate PreviDent as you would use toothpaste. (This product requires a prescription from us if prescribed.)

5. Recall Appointments: Visit us for regular six month examinations. Often, small problems that are developing around restorations can be found at an early stage and corrected easily, but waiting for a longer time may require redoing the entire restoration. Failure to return for professional examinations is the most significant reason for restoration failure.
6. Problems: If any of the following conditions occur, contact us immediately to avoid further problems:

• Movement or looseness in the restoration.
• Sensitivity to sweet foods.
• A peculiar taste from the restoration site.
• Breakage of a piece of material from the restoration.
• Sensitivity to pressure.

We have done our best to provide you with the finest-quality oral restorations available today. However, only your continuing excellent oral hygiene and professional recalls can ensure optimum service longevity.

Temporary Crowns or Fixed Prostheses (Bridges)

You have just received a temporary plastic restoration that will serve you for a short period of time until the final restoration is made by the laboratory. A few comments about this temporary restoration will be helpful to you.

Chewing:

a. The temporary cement requires about one-half hour to set. Please do not chew during that period of time.
b. Temporary restorations are not strong. They may break or come off occasionally. If so, call us and we will replace them. If you are where you cannot contact us, go to a pharmacy and get some Fixodent (denture adhesive). Replace the temporary with some Fixodent holding it in place. This denture adhesive will retain the temporary restoration until you can see us. Please do not leave the temporary restoration out of your mouth, because the teeth will move and the final restoration will not fit.
c. DO NOT USE superglue to cement the restoration.
d. Certain foods will stick to the temporary restoration. This will not happen with the final restoration to be cemented soon.

Color: The color of the plastic temporary does not resemble the color of the final restoration.

Shape, Size: The shape and size of the plastic temporary does not resemble the final restoration.

Tooth Sensitivity: Temporary restorations may leak saliva or food into the tooth. Sensitivity to cold, hot, or sweet is not uncommon. This sensitivity will not be present with your final restorations.

Complete Dentures

We have done our best to provide you with well-fitted, functional, and esthetically pleasing dentures. We feel confident that after a few weeks of becoming adjusted to the new dentures, you will have years of satisfaction and use from them.

The following information will be helpful to you:

1. The First Few Weeks: New dentures always feel strange when first placed in your mouth. Several days or even a few weeks will be required for you to feel accustomed to them.
2. Sore Spots: Usually, your mouth will have a few “sore spots” after wearing the dentures for 24 hours. Don’t worry about these areas. They can be relieved with very little effort during your next appointment. Another appointment about 7 days later will usually eliminate any other sore areas.
3. Chewing: The new bite may not feel completely comfortable for a period of days. We will adjust the contacting surfaces of your teeth in 24 hours and again about one week after the dentures have settled into place.
4. Upper vs. Lower Dentures: Your upper denture will rest comfortably in place with moderate to strong “suction.” Although your lower denture will have good stability, it is infrequent that “suction” can be expected on a lower denture. However, we suggest that you avoid denture adhesives unless you have significant difficulty, because they alter the fit of the denture over a period of time.
5. Cleaning the Dentures and Your Mouth: Your dentures can be cleaned by using a soft bristle toothbrush and mild toothpaste such as Complete (Procter & Gamble). Denture soaks are also useful for the denture. Brush your gums with a regular toothbrush once per day to toughen and clean them. You may leave the dentures in or out of your mouth at night, depending on your preference. If they are out of your mouth, leave them soaking in water to avoid warping the plastic. Denture soaks are also useful for the denture. Please ask us if you are interested in small “sonic” cleaners available for home use. Brush your gums with a regular toothbrush once per day to toughen and clean them. You may leave the dentures in or out of your mouth at night, depending on your preference. If they are out of your mouth, leave them soaking in water.
6. The Future: Your jaw bones and gums shrink up to 1/32 of an inch per year after your teeth are extracted. This shrinkage is one of the main disadvantages of artificial dentures. Because of this shrinkage, you should plan to have your dentures and oral tissues evaluated once per year by us. We will inform you when refitting of the dentures is necessary. Wearing ill-fitting dentures for too long without refitting can cause severe bone loss and serious oral diseases. We look forward to helping you enjoy your new dentures.

Immediate Dentures

You have just had an immediate denture placed in your mouth. The following information will assist you to understand the sequence of events during the healing period:

• Teeth have been removed from your mouth. Stitches may have been placed to help the mouth heal. If so, they will need to be removed in about a week, unless we tell you differently.
• Dentures have been placed to replace your missing teeth and gum tissue. Initially, these dentures will feel large and bulky until your gums have healed and shrunken slightly, at which time we will make the dentures thinner and less bulky. The dentures may cause your speech to be altered for a few days, but this feeling will disappear soon.
• Do not take the dentures out of your mouth today. We will remove them tomorrow. The new dentures serve as a bandage similar to a cast on a broken arm during initial healing. After the initial denture removal and adjustment by us, you should remove the dentures frequently for cleaning.
• Some discomfort is usually present when teeth are removed and immediate dentures are placed. The discomfort is due to one or two reasons:
          a. The trauma of removing teeth. Within a few days the discomfort will go away.
          b. The denture may have pressure spots. If so, the pressure spots will be observed and removed by us as soon as you tell us about the discomfort. It will not go away by itself.

• If you have been given antibiotics, it is important to continue with the therapy until all of the tablets are used.
• Use the pain relieving pills while you are experiencing discomfort.
• Your dentures have been relined today with a soft material that makes them easier to wear and speeds healing. That material may be replaced during the initial healing period of 6 weeks or more. It is not the final denture material. Be careful not to dislodge this soft material when cleaning.
• As soon as convenient, place ice cubes in a plastic bag and place the bag externally on the area where the teeth were removed. This will reduce swelling and bruising. However, some swelling and bruising may still occur for a short time.
• After 6 weeks (minimum) your denture will be relined to refine its fit to the healing supporting tissues. The reline is not included in the cost of your denture. At this time the denture will appear, fit, and function as intended.
• Healing from tooth extractions continues for up to 18 months. Shrinkage of gums and bone is obvious during that time, but it slows thereafter. You may elect to have a second reline of the denture 18 months after the initial surgery. This reline is not included in your initial fee.
• After healing, denture soaks are also useful for the denture. Please ask us if you are interested in small “sonic” cleaners available for home use. Brush your gums with a regular toothbrush once per day to toughen and clean them. You may leave the dentures in or out of your mouth at night, depending on your preference. If they are out of your mouth, leave them soaking in water.
• Immediate dentures are a major change to your body. Don’t worry if you are slow to adapt. Millions of others have been through this experience. We expect your eventual denture to serve well for many years.

Removable Partial Dentures

We have done our best to provide you with well-fitted, functional, and esthetic removable partial dentures. We feel confident that after a few weeks of becoming adjusted to the new partial dentures, you will have years of satisfaction and use from them.

1. The First Few Weeks: New dentures always feel strange when first placed in your mouth. Several days or even a few weeks will be required for you to feel accustomed to them.
2. Sore Spots: Usually, your mouth will have a few “sore spots” after wearing the dentures for 24 hours. Don’t worry about these areas. They can be relieved with very little effort during your next appointment. Another appointment about 7 days later will usually eliminate any other sore areas.
3. Chewing: The new bite will not feel comfortable for a period of days. We will adjust the contacting surfaces of your teeth in 24 hours and again about one week after the dentures have “settled” into place.
4. Cleaning the Dentures and Your Mouth: Your dentures can be cleaned by using a soft bristle toothbrush and a mild toothpaste or regular hand soap. Use special care to clean the parts of the partial denture that contact any natural teeth. Both the partial denture and the natural teeth must be kept very clean on a daily basis to reduce the chance of new dental decay starting. Use fluoride-containing toothpaste for the natural teeth. If suggested by us, use PreviDent (Colgate) as a brush-on material on a daily basis. This product requires a prescription from us. Denture soaks are also useful for the denture. Please ask us if you are interested in small “sonic” cleaners available for home use. Brush your gums with a regular toothbrush once per day to toughen and clean them. You may leave the dentures in or out of your mouth at night, depending on your preference. If they are out of your mouth, leave them soaking in water.
5. The Future: Your jaw bones and gums shrink up to 1/32 of an inch per year when your teeth are missing. This shrinkage is one of the main disadvantages of artificial dentures. Because of this shrinkage, you should plan to have your dentures and oral tissues evaluated by us at least once every 6 months. We will inform you when refitting of the dentures is necessary. Wearing ill-fitting dentures for too long without refitting can cause severe bone loss and serious oral diseases.

We look forward to helping you enjoy your new partial dentures.

Teeth Whitening (Bleaching)

Teeth stain during our lifetime due to consumption of a variety of foods and drinks (Coke, spicy food, coffee...) New technology of teeth whitening has enabled dentists to whiten teeth without any change or damage to the tooth structure.

Almost all the whitening methods are similar in concept but some are much more effective because of the way the whitening material is delivered to the teeth. The other factor in effectiveness of the method is the concentration of material, which is the reason why over the counter whitening systems usually don t give patients the result they are hoping for.

The two main methods of professional whitening are tray whitening and in office whitening. Tray whitening is when a custom tray is made for the patient after an impression is taken, then a supply of whitening gel is given to the patient and he/she will wear the tray for a few hours a day (techniques differ) for a period of time until an acceptable result is achieved. Sensitivity of the teeth is a normal complication of this method of whitening and is almost always transitional.

In office whitening on the other hand is the most effective method of whitening. There are a few different ways that are available for example, Britesmile, Zoom, Laser whitening....But in all these methods the process is similar and you can have your teeth whitened in one session with great results. Your dentist can give you more detailed information and tell you which method is more suitable in your case and which one is indicated for your teeth.

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Dale D. Batten, DMD, MAGD

123 West Plymouth Avenue, DeLand, FL 32720
386-736-8865

 

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