Dental Exams & Cleanings

A comprehensive dental exam will be performed by Dr. Herman at your first visit.

During check-up exams, Dr. Herman and the hygienist will conduct:

Examinations of digital x-rays: Detection of cavities, tumors, cysts, and bone loss. This also helps determine tooth and root positions.
Oral cancer screening: Check the face, neck, lips, tongue, throat and gums.
Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.

All tooth surfaces will be checked for cavities for decay. Dr. Herman will also check current fillings, crowns, etc.

• Professional Dental Cleaning

Professional dental cleanings (dental prophylaxis) are usually performed by Registered Dental Hygienists. Your cleaning appointment will include a dental exam and the following:

Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth and has become attached to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments.
Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
Teeth polishing: Remove stain and plaque that is not otherwise removed during brushing teeth.

• Medical & Nutritional Counseling:

Blood pressure screenings are conducted during all exams. We will discuss the effects your diet has on your health and monitor your medical condition.

• Comprehensive Cosmetic Screening:

An evaluation of position, color, chipping and wearing of your teeth will be performed. Dr. Herman will then discuss options available to restore, and enhance your appearance.

Digital X-Rays

Digital radiography (digital x-ray) is the latest technology used to take dental x-rays. This technique uses an electronic sensor (instead of x-ray film) that captures and stores the digital image on a computer. This image can be instantly viewed and enlarged helping the dentist and dental hygienist detect problems easier. Digital x-rays reduce radiation 80-90% compared to the already low exposure of traditional dental x-rays.

Dental x-rays are essential, preventative, diagnostic tools that provide valuable information not visible during a regular dental exam. Dentists and dental hygienists use this information to detect hidden dental abnormalities and complete an accurate treatment plan. Without x-rays, problem areas may go undetected.
• What do digital x-rays reveal?

Abscesses or cysts
Bone loss
Cancerous and non-cancerous tumors
Decay between the teeth
Developmental abnormalities
Poor tooth and root positions
Problems inside a tooth or below the gum line

Detecting and treating dental problems at an early stage may save you time, money, unnecessary discomfort, and your teeth!

• Are digital x-rays safe?

We are all exposed to natural radiation in our environment. Digital x-rays produce a significantly lower level of radiation compared to traditional dental x-rays. Digital x-rays are better for the health and safety of the patient. They are faster and more comfortable, therefore reducing your time in the dental office. Also, since the digital image is captured electronically, there is no need to develop films, thus eliminating the disposal of harmful waste and chemicals into the environment. Digital x-rays produce a low level of radiation and are considered very safe. However, dentists still take extra precautions to limit the patient’s exposure to radiation. These precautions include only taking those x-rays that are necessary, and using a lead apron to protect the body.

• How often should digital x-rays be taken?

The need for x-rays depends on each patient’s dental health needs. Your dentist and dental hygienist will make recommendations based upon a review of your medical and dental history, a dental exam, signs, symptoms, and your risk.
A full mouth series of digital x-rays is recommended for all new patients. A full series is usually good for three to five years. Follow up images are taken at regular intervals thereafter.

Composite Fillngs

A composite (tooth colored) filling is used to repair a tooth that is affected by decay, cracks, fractures, etc. The decayed or affected portion of the tooth will be removed and then filled with a composite filling.
There are many types of filling materials available, each with their own advantages and disadvantages. You and your dentist can discuss the best options for restoring your teeth. Composite fillings, along with silver amalgam fillings, are the most widely used today. Because composite fillings are tooth colored, they can be closely matched to the color of existing teeth, and are more aesthetically suited for use in front teeth or the more visible areas of the teeth.

As with most dental restorations, composite fillings are not permanent and may someday have to be replaced. They are very durable, and will last many years, giving you a long lasting, beautiful smile.

Reasons for composite fillings:
Chipped teeth
Closing space between two teeth
Cracked or broken teeth
Decayed teeth
Worn teeth

How are composite fillings placed?

Composite fillings are usually placed in one appointment. While the tooth is numb, your dentist will remove decay as necessary. The space will then be thoroughly cleaned and carefully prepared before the new filling is placed. If the decay was near the nerve of the tooth, a special medication will be applied for added protection. The composite filling will then be precisely placed, shaped, and polished, restoring your tooth to its original shape and function.
It is normal to experience sensitivity to hot and cold when composite fillings are first placed, however this will subside shortly after your tooth acclimates to the new filling.

You will be given care instructions at the conclusion of your treatment. Good oral hygiene practices, eating habits, and regular dental visits will aid in the life of your new fillings.

Fluoride Treatments

Fluoride is the most effective agent available to help prevent tooth decay. It is a mineral that is naturally found in almost all food and water supplies. The benefits of fluoride have been well known for more than 50 years.
• How does fluoride work?

Fluoride strengthens the teeth and helps make teeth more resistant to decay. We gain topical fluoride by using fluoride containing dental products such as toothpaste, mouth rinses, and gels. Dentists and dental hygienists generally recommend that all people have a professional application of fluoride twice a year during dental check-ups.

Systemic fluoride strengthens the teeth that have erupted as well as those that are developing under the gums. We gain systemic fluoride from most foods and our community water supplies. It is also available as a supplement in drop or gel form and can be prescribed by your dentist or physician. Generally, fluoride drops are recommended for infants, and tablets are best suited for children up through the teen years. It is very important to monitor the amounts of fluoride a child ingests. If too much fluoride is consumed while the teeth are developing, a condition called fluorosis (white spots on the teeth) may result.

Although most people receive fluoride from food and water, sometimes it is not enough to help prevent decay. Your dentist or dental hygienist may recommend the use of home and/or professional fluoride treatments for the following reasons:

Deep pits and fissures on the chewing surfaces of teeth
Exposed and sensitive root surfaces
Fair to poor oral hygiene habits
Frequent sugar and carbohydrate intake
Inadequate exposure to fluorides
Inadequate saliva flow due to medical conditions, medical treatments or medications
Recent history of dental decay

Remember, fluoride alone will not prevent tooth decay! It is important to brush at least twice a day, floss regularly, eat balanced meals, reduce sugary snacks, and visit your dentist on a regular basis.

Importance of Brushing & Flossing

Brushing and flossing are very important to oral hygiene. Proper brushing and flossing can enhance the health of the mouth, make your smile sparkle and prevent serious diseases.
Reasons why proper brushing and flossing are essential:

Prevention of tooth decay – Tooth decay is one of the leading causes of tooth loss, and its treatment often requires complex dental procedures. Tooth decay occurs when the acids found in plaque erode the natural enamel found on the teeth. This can be prevented by brushing and flossing.

Prevention of periodontal disease – Periodontal disease is a serious, progressive condition which can cause tooth loss, gum recession and jawbone recession. Periodontal disease is caused by the toxins found in plaque. It can lead to serious health problems in other parts of the body. Removing plaque and calculus (tartar) from the surface of the tooth using a toothbrush, and from the interdental areas using dental floss, is an excellent way to stave off periodontal problems.

Prevention of halitosis – Bad breath or halitosis is usually caused by old food particles on or between the teeth. These food particles can be removed with regular brushing and flossing; leaving the mouth healthier, and breath smelling fresher.

Prevention of staining – Staining or the yellowing of teeth can be caused by a variety of factors such as smoking, coffee and tea. The more these staining agents are removed, the less likely it is that the stains will become permanent.

Crowns (Caps)

A crown (or cap) is a covering that encases the entire tooth surface restoring it to its original shape and size. A crown protects and strengthens tooth structure that cannot be restored with fillings or other types of restorations.
Although there are several types of crowns, porcelain (tooth colored crown) are the most popular, because they resemble your natural teeth. They are highly durable and will last many years, but like most dental restorations, they may eventually need to be replaced. Porcelain crowns are made to match the shape, size, and color or your teeth giving you a natural, long-lasting beautiful smile.

Reasons for crowns:
Broken or fractured teeth
Cosmetic enhancement
Decayed teeth
Fractured fillings
Large fillings
Tooth has a root canal

What does getting a crown involve?

A crown procedure usually requires two appointments. Your first appointment will include taking several highly accurate molds (or impressions) that will be used to create your custom crown. A mold will also be used to create a temporary crown which will stay on your tooth for approximately two weeks until your new crown is fabricated by a dental laboratory.

While the tooth is numb, the dentist will prepare the tooth by removing any decay and shaping the surface to properly fit the crown. Once these details are accomplished, your temporary crown will be placed with temporary cement and your bite will be checked to ensure you are biting properly.

At your second appointment your temporary crown will be removed, the tooth will be cleaned, and your new crown will be carefully placed to ensure the spacing and bite are accurate.

You will be given care instructions and encouraged to have regular dental visits to check your new crown.

Fixed Bridges

A dental bridge is a fixed (non-removable) appliance and is an excellent way to replace missing teeth.
There are several types of bridges. You and your dentist will discuss the best options for your particular case. The “traditional bridge” is the most popular type and is usually made of porcelain fused to metal. Porcelain fixed bridges are most popular because they resemble your natural teeth. This type of bridge consists to two crowns that go over two anchoring teeth (abutment teeth) and are attached to pontics (artificial teeth), filling the gap created by one or more missing teeth.

Dental bridges are highly durable and will last many years, however they may need replacement or need to be re-cemented due to normal wear.

Reasons for a fixed bridge:
Fill space of missing teeth
Maintain facial shape
Prevent remaining teeth from drifting out of position
Restore chewing and speaking ability
Restore your smile
Upgrade from a removable partial denture to a permanent dental appliance

What does getting a fixed bridge involve?

Getting a bridge usually requires two or more visits. While the teeth are numb, the two anchoring teeth are prepared by removing a portion of enamel to allow for a crown. Next, a highly accurate impression (mold) is made which will be sent to a dental laboratory where the bridge will be fabricated. In addition, a temporary bridge will be made and worn for several weeks until your next appointment.

At the second visit, you permanent bridge will be carefully checked, adjusted, and cemented to achieve a proper fit. Occasionally your dentist may only temporarily cement the bridge, allowing your teeth and tissue time to get used to the new bridge. The new bridge will be permanently cemented at a later time.

You will receive care instructions at the conclusion of your treatment. Proper brushing, flossing and regular dental visits will aid in the life of your new permanent bridge.

Porcelain Veneers

Veneers are very thin pieces of durable, tooth shaped porcelain that are custom made (for shape and color) by a professional dental laboratory. They are bonded onto the front of teeth to create a beautiful and attractive smile.
Veneers can completely reshape your teeth and smile. They can often be alternatives to crowns and the ideal solution in treating many dental conditions.

As with most dental restorations, veneers are not permanent and may someday need replacement. They are very durable and will last many years, giving you a beautiful long lasting smile.

Reasons for porcelain veneers:
Cosmetically, to create a uniform, white, beautiful smile
Crooked teeth
Misshapen teeth
Severely discolored or stained teeth
Teeth that are too small or large
Unwanted or uneven spaces
Worn or chipped teeth

What does getting porcelain veneers involve?

Getting veneers usually requires two visits to complete the process, with little or no anesthesia required during the procedure. The teeth are prepared by lightly buffing and shaping the surface to allow for the thickness of the veneer. A mold or impression of the teeth is taken and a shade (color) will then be chosen by you and the dentist.

On the second visit the teeth will be cleansed with special liquids to achieve a durable bond. Bonding cement is then placed between the tooth and veneer and a special light beam is used to harden and set the bond.

You will receive care instructions for veneers. Proper brushing, flossing and regular dental visits will aid in the life of your new veneers.

Root Canal Therapy

Root canal therapy is needed when the nerve of a tooth is affected by decay or infection. In order to save the tooth, the pulp (the living tissue inside the tooth), nerves, bacteria, and any decay are removed and the resulting space is filled with special, medicated, dental materials, which restore the tooth to its full function.
Having a root canal done on a tooth is the treatment of choice to save a tooth that otherwise would die and have to be removed. Many patients believe that removing a tooth that has problems is the solution, but what is not realized is that extracting (pulling) a tooth will ultimately be more costly and cause significant problems for adjacent teeth. Root canal treatment is highly successful and usually lasts a lifetime, although on occasion, a tooth will have to be retreated due to new infections.

Signs and symptoms for possible root canal therapy:
An abscess (or pimple) on the gums
Sensitivity to hot and cold
Severe toothache pain
Sometimes no symptoms are present
Swelling and/or tenderness

Reasons for root canal therapy:
Decay has reached the tooth pulp (the living tissue inside the tooth)
Infection or abscess have developed inside the tooth or at the root tip
Injury or trauma to the tooth

What does root canal therapy involve?

A root canal procedure requires one or more appointments and can be performed by a dentist or endodontist (a root canal specialist).

While the tooth is numb, a rubber dam (a sheet of rubber) will be placed around the tooth to keep it dry and free of saliva. An access opening is made on top of the tooth and a series of root canal files are placed into the opening, one at a time, removing the pulp, nerve tissue, and bacteria. If tooth decay is present, it will also be removed with special dental instruments. Once the tooth is thoroughly cleaned, it will be sealed with either a permanent filling or, if additional appointments are needed, a temporary filling will be placed.

At the next appointment, usually a week later, the roots and the inside cavity of the tooth will be filled and sealed with special dental materials. A filling will be placed to cover the opening on top of the tooth. In addition, all teeth that have root canal treatment should have a crown (cap) placed. This will protect the tooth and prevent it from breaking, and restore it to its full function.

After treatment, your tooth may still be sensitive, but this will subside as the inflammation diminishes and the tooth has healed. You will be given care instructions after each appointment. Good oral hygiene practices and regular dental visits will aid in the life of your root canal treatment.

Sealants

A sealant is a thin, plastic coating applied to the chewing surface of molars, premolars and any deep grooves (called pits and fissures) of teeth. More than 75% of dental decay begins in these deep grooves. Teeth with these conditions are hard to clean and are very susceptible to decay. A sealant protects the tooth by sealing deep grooves, creating a smooth, easy to clean surface. Sealants can protect teeth from decay for many years, but need to be checked for wear and chipping at regular dental visits.
• Who should get sealants?

Children and teenagers – As soon as the six-year molars (the first permanent back teeth) appear or any time throughout the cavity prone years of 6-16.
Adults – Tooth surfaces without decay that have deep grooves or depressions.
Baby teeth – Occasionally done if teeth have deep grooves or depressions and child is cavity prone.

• What do sealants involve?

Sealants are easily applied by your dentist or dental hygienist and the process takes only a couple of minutes per tooth.

The teeth to be sealed are thoroughly cleaned and then surrounded with cotton to keep the area dry. A special solution is applied to the enamel surface to help the sealant bond to the teeth. The teeth are then rinsed and dried. Sealant material is carefully painted onto the enamel surface to cover the deep grooves or depressions. Depending on the type of sealant used, the material will either harden automatically or with a special curing light.

Proper home care, a balanced diet, and regular dental visits will aid in the life of your new sealants.

Tooth Alignment - Simpli5

Simpli 5 invisibly straightens your teeth with a series of 5 custom-molded aligners.
Forget everything you’ve heard about teeth straightening. Because now there’s breakthrough technology that lets you get the smile you always wanted without bands, brackets or wires.

A clear alternative.
By using a series of clear removable aligners, Simpli 5 straightens your teeth right before your eyes. Change them about every 4 weeks, your teeth will move—little by little, week by week—until they have moved to the final position your orthodontist or dentist has prescribed. Comfortable to wear, our aligners are also removable so you can eat, drink, brush, and floss as usual.

Less treatment time.
A typical Simpli 5 case takes at least 5 months from start to finish. You’ll see your doctor every month to see how you’re progressing. Every few visits you’ll be given additional aligners to continue your treatment. Commonly, the number of aligners worn during treatment is about 5, but treatment time and number of aligners will vary from case to case.

Invisible. And comfortable.
Simpli 5 is an invisible solution. So you won’t draw undue attention to your mouth while in treatment. In fact, virtually no one will know you’re wearing them unless you tell. Comfortable to wear, our aligners are also removable so you can eat, drink, brush, and floss as usual.

Is ISimpli 5 for Me?
Simpli 5 can be used to treat the vast majority of common problems for adults and teens.
Whether your smile needs minor improvements or more extensive adjustments, Simpli 5 can certainly help. It's successful in treating overly crowded or widely spaced teeth. It can also relieve more complex issues, including overbites, underbites and even crossbites. In fact, an Simpli 5 Certified Orthodontist or Dentist can use Simpli 5 clear aligners in all or part of just about any treatment plan.

Look your best during treatment.
Simply 5 is clear and practically invisible, so nothing gets in the way of your new smile. No wonder Simpli 5 is the choice of over half a million people. Unobtrusive in business meetings or social gatherings. No metal wires or bands to irritate your mouth. Most people won't notice you're wearing aligners.

Tooth Extractions

(Wisdom) Teeth Extractions

Third molars, commonly referred to as wisdom teeth, are usually the last four of 32 teeth to erupt (surface) in the mouth, generally making their appearance between the ages of 17 to 25. They are located at the back of the mouth (top and bottom), near the entrance to the throat. The term “wisdom” stems from the idea that the molars surface at a time typically associated with increased maturity or “wisdom”.
In most cases, inadequate space in the mouth does not allow the wisdom teeth to erupt properly and become fully functional. When this happens, the tooth can become impacted (stuck) in an undesirable or potentially harmful position. If left untreated, impacted wisdom teeth can contribute to infection, damage to other teeth, and possibly cysts or tumors.

There are several types, or degrees, of impaction based on the actual depth of the teeth within the jaw:

Soft Tissue Impaction

The upper portion of the tooth (the crown) has penetrated through the bone, but the gingiva (gum) is covering part or all of the tooth’s crown and has not positioned properly around the tooth. Because it is difficult to keep the area clean, food can become trapped below the gum and cause an infection and/or tooth decay, resulting in pain and swelling.

Partial Bony Impaction: The tooth has partially erupted, but a portion of the crown remains submerged below the gum and surrounding jawbone. Again, because it is difficult to keep the area clean, infection will commonly occur.

Complete Bony Impaction: The tooth is completely encased by jawbone. This will require more complex removal techniques.

Reasons to remove wisdom teeth.

While not all wisdom teeth require removal, wisdom teeth extractions are most often performed because of an active problem such as pain, swelling, decay or infection, or as a preventative measure to avoid serious problems in the future. If impaction of one or more wisdom teeth is present, and left untreated, a number of potentially harmful outcomes can occur, including:

Damage to nearby teeth: Second molars (the teeth directly in front of the wisdom teeth) can be adversely affected by impacted wisdom teeth, resulting in tooth decay (cavities), periodontal disease (gum disease) and possible bone loss.
Disease: Although uncommon, cysts and tumors can occur in the areas surrounding impacted wisdom teeth.
Infection: Bacteria and food can become trapped under the gum tissue, resulting in an infection. The infection can cause considerable pain and danger.
Tooth Crowding: It has been theorized that impacted wisdom teeth can put pressure on other teeth and cause them to become misaligned (crowded or twisted). This theory isn’t universally accepted by all dental professionals, and it has never been validated by any scientific studies.
Wisdom teeth examination

As with any dental procedure, your dentist will want to initially conduct a thorough examination of the wisdom and surrounding teeth. Panoramic or digital x-rays will be taken in order for your dentist to evaluate the position of the wisdom teeth and determine if a current problem exists, or the likelihood of any potential future problems. The x-rays can also expose additional risk factors, such as deterioration or decay of nearby teeth. Early evaluation and treatment (typically in the mid-teen years) is recommended in order to identify potential problems and to improve the results for patients requiring wisdom teeth extractions. Only after a thorough examination can your dentist provide you with the best options for your particular case.

What does the removal of wisdom teeth involve?
Wisdom teeth removal is a common procedure, generally performed under local anesthesia, intravenous (IV) sedation, or general anesthesia by a specially trained dentist in an office surgery suite. The surgery does not require an overnight stay, and you will be released with post-operative instructions and medication (if necessary), to help manage any swelling or discomfort.

Tooth Whitening - ZOOM

Your smile is important. It's one of the first things you notice when you meet someone. A whiter, brighter smile is beautiful - it can help you feel better about yourself and make a memorable impression
Your lifestyle and the aging process can stain and darken your teeth. Many things we do on a regular basis can contribute to stained teeth, such as drinking coffee, tea, cola and red wine or smoking.
Whitening can get your smile looking its best. Non-professional procedures and clinically unproven teeth whitening tips can often lead to unsatisfactory results, you should look for a whitening procedure that is:
• Fast and convenient
• Long lasting
• Low sensitivity
• Proven to be safe and effective
• Performed by a Dental Professional

Faster - Achieve superior results in three 15 minute sessions. The new system reduces chair-time by 33% with no compromise in results.
More Effective - The proprietary light activated Zoom2 gel incorporates patented Amorphous Calcium Phosphate1 (ACP) technology to provide superior whitening results.
Easier - The new Precision Light Guide System ensures quick and consistent patient set-up for optimal whitening results, while the new locking casters and ergonomically designed structure make moving and positioning Zoom2 a snap.
Lower Sensitivity - Reduced contact time, ACP chemistry, combined with the new Balancing Agent and Satin Finish, to ensure the lowest possible discomfort for patients. In fact, Zoom2 patients experience 67% less significant sensitivity than those treated with the original Zoom System.

VELSCOPE

Each year in the US alone, approximately 36,000 individuals are newly diagnosed with oral cancer. If you add throat cancers to the number (which have the same risk factors), that number will increase to about 48,000 people. The death rate from oral cancer is very high; about 43% of those diagnosed will not survive more than five years. While these statistics are alarming, this high death rate is directly related to two factors. These may be directly influenced by your choices.The first is to be aware. Knowing that lifestyle choices you make, such as tobacco use and other risk factors listed in this brochure, are causes of this disease, is part of that process. Avoidance of risk factors greatly reduces your chance of developing oral and throat cancers. Knowing the signs and symptoms of the disease is also part of awareness. It is one that will help you decide to seek professional advice should you recognize symptoms in yourself. Just by reading this brochure you are engaging in an educational process that will keep you, and those you share the information with, aware and educated about the disease.

Early detection is the second factor that will reduce your risk. Once knowledgeable, you will wish to engage in a regular annual screening to look for signs and symptoms at your doctor's office, ensuring early detection. Most oral cancer can be caught early, even as a pre-cancer. With early detection, survival rates are high, and side effects from treatment are at their lowest. These screenings are painless, quick, and inexpensive. Like other screenings you engage in such as cervical, skin, prostate, colon, and breast examinations, oral cancer screenings are an effective means of finding cancer at its early, highly curable stages. Make them a part of your annual health check-ups