Dental Services

At Page Dental Arts we pride ourselves in providing gentle, individualized treatment to meet your exact needs. Whether you need routine preventative care or full mouth rehabilitation, we can take care you. By tailoring your treatment to fit you we can achieve the great results you are looking for. Listed below are just some of the services we are able to provide on a regular basis. Click on a service below to learn more about it.

If you have any questions or concerns about your dental treatment or the services we provide, please contact us to schedule a consult with our doctor. Also, please remember that this list of dental services is for informational purposes only. Only a dental professional can diagnose and determine the best course of treatment for your particular needs.

About Preventative and Diagnostic services:

Preventative services are procedures that are performed to help prevent dental diseases such as cavities or gum disease. Preventative services include cleanings, sealants, and fluoride treatments. Diagnostic services are procedures that are performed to help detect or assess the risk for any dental disease. These procedures also evaluate for the presence of infection, cancer, or any abnormal cysts or growths that can occur in the mouth. Diagnostic services include exams and dental x-rays. Generally, most preventative or diagnostic procedures are recommended on a regular basis, usually twice a year.

Dental Cleanings:
A professional dental cleaning (also called a dental prophylaxis), is a procedure that is performed by a dentist or dental hygienist to remove plaque, tartar, and stain build up from the teeth. The dentist or dental hygienist accomplishes this by using hand instruments or ultrasonic instruments called scalers. These scalers are moved along all surfaces of the teeth to dislodge any plaque or tartar build up. After the teeth are thoroughly scaled, they are gently flossed and polished with a special paste that helps to remove stain and make the surface of the teeth smooth.
Professional dental cleanings are recommended at least twice a year for all patients, including children, because even with regular brushing and flossing at home it is impossible to remove all plaque and tartar build up from your teeth. If plaque and tartar are allowed to build up and are not regularly removed, it can cause gingivitis, periodontal disease (gum disease), or the formation of tooth decay (cavities). For patients that are diagnosed with periodontal disease, periodontal therapies are recommended. See Periodontal Services.

Exams:
A professional dental exam is performed by a dentist to evaluate all aspects of your oral health. At Page Dental Arts, our exams start by talking with you, the patient. We like to review your medical history as well as any medications that you may be taking. Many health conditions and/or medications can affect your teeth and gums and we like to be aware of these conditions so we can better treat you. We also like to know if you have been having any problems or concerns with your teeth, jaws or gums.
At your exam, we will first check your jaw joint (the TMJ or tempromandibular joint) for any pain or abnormalities. Next we will feel under your jaw and around your neck for any swollen lymph nodes to help diagnose any abnormalities or signs of infection. Then we will evaluate your bite (the way your teeth come together) for any excessive wear or abnormalities. We will also check all of the tissues inside your mouth (called an oral cancer screening) for any abnormalities. After that, all of your teeth will be check for any cavities, fractures, broken or failing fillings or crowns, and/or abscesses. In addition, your gums will be evaluated for any signs of periodontal disease (gum disease). You will be informed of any findings from this exam and treatment will be recommended as needed.
Routine dental exams are recommended every six months. Dental x-rays may also be utilized during your exam to help identify things can the dentist cannot see with the visual exam.

X-rays:
Dental x-rays are special pictures of the teeth and surrounding bone in the mouth. They are used to find problems that cannot be seen visually during your exam. They can help to show cavities, hidden structures (such as locations of your nerves, sinus, and wisdom teeth), infections, cysts in the jaws, and any bone loss around the teeth. There are many different types and sets of dental x-rays that can be taken:
  • Digital dental x-rays: All dental x-rays at Page Dental Arts are digital. This means the amount of radiation is significantly less than traditional dental x-rays. It also means that the pictures of your teeth are stored electronically into your file and are therefore protected better than if stored in a paper chart. They can also be accessed quickly by our staff and printed or electronically sent if they are needed by your insurance company or any specialist you may see.
  • A Full Series of x-rays: A full series of dental x-rays is typically 18-20 pictures and shows all your teeth and underlying bone. A full series of x-rays is important to not only look for cavities in your teeth but any infections or abnormalities in the jaw bones as well. At Page Dental Arts we recommend a full series of x-rays once every three to five years for all of our adult patients.
  • Bitewing x-rays: Bitewing x-rays are sometimes referred to as “cavity detecting” x-rays. They help to show if there are any cavities forming between your teeth. They also help to evaluate for any bone loss around your teeth. Bitewing x-rays are typically two to four pictures. We recommend bitewing x-rays at least once a year for all patients, including children. Bitewings may be recommended more often if a patient has an increased risk or history of developing cavities.
  • Additional x-rays: Additional x-rays may be needed in the event of a tooth ache or traumatic injury. One or two x-rays may be taken for just a specific area when needed. Also additional types of x-rays may be taken if you visit a dental specialist such as an oral surgeon or an orthodontist.
Sealants
A sealant is a protective coating that is placed on the biting surface of molar teeth to help prevent tooth decay. The biting surfaces of molar teeth can have deep grooves and pits that can make it difficult to remove plaque and debris. This makes the tooth more susceptible to developing a cavity. When a sealant is placed over these grooves it helps to prevent plaque and debris from becoming trapped and makes the tooth more cleansable.
Sealants are initially placed in childhood when the permanent molars erupt (generally at ages 6 and 12). Sealants are placed as a preventative measure only. If a tooth already has a cavity, a filling is required. Sealants are not “permanent”. They do require periodic checkups and replacement. It is also important to note that proper brushing and flossing is still required to prevent tooth decay even after sealants are placed.
The procedure for a sealant is quick and simple. The tooth to be sealed is first thoroughly cleaned. Sometimes the deep, narrow grooves of the tooth may be widened with a dental hand piece. Then the tooth is dried and the sealant is brushed into the grooves. It is hardened by a special dental light. Sealants are a great way to help prevent against cavities.

Fluoride Treatments
The fluoride ion is a naturally occurring compound in some foods as well as certain natural water sources. Research has proven that fluoride can significantly reduce the occurrence of cavities in children and adults. It can also remineralize areas on your teeth that have early signs of tooth decay. For this reason, Page Dental Arts recommends fluoride treatments for all patients every six months.
A fluoride treatment is performed by a dental assistant or hygienist. It consists of placing a high concentration fluoride foam, gel, or varnish on the teeth for approximately one minute. The excess material is then removed and the patient is instructed to avoid eating, drinking, or rinsing for at least 30 minutes afterward.
It is also recommended that the toothpaste you use at home contain fluoride, as well as your drinking water. It should be noted that water from a reverse osmosis filtration system and the majority of all bottled waters on the market do not contain fluoride. It is especially important for patients that use those systems or frequently drink bottled water to have regular fluoride treatments at their dental office. In office fluoride treatments are quick and easy way to help fight against cavities.

About Comprehensive Oral Rehabilitation:

While this web page focuses on the types of services we offer at Page Dental Arts, it is important to remember that it is always prudent to evaluate the teeth as a whole. Dr. Page thoroughly evaluates all of her patients to check for excessive tooth wear, misaligned teeth, or problems with the way your teeth bite together, not just cavities. We pride ourselves on providing individualized care for each of our patients. Depending on your situation, Dr. Page will provide you with a comprehensive treatment plan that will create a beautiful and healthy smile that will last a long time.
While some patients may only need a few fillings, other patients may need much more extensive dental treatment. These extensive cases are called full mouth or oral rehabilitations. These cases may involve several of the services listed on this web page and/or collaboration with other dental specialists. For any full mouth rehabilitations, we always offer additional no-charge consultation appointments to ensure all of your questions are answered and you are comfortable with your treatment plan. We will also help coordinate your care with any specialist that may be needed.

About Nitrous Oxide Sedation:

Nitrous oxide sedation, also known as “laughing gas”, is a very safe and effective way to alleviate anxiety and fear in adults or children. At Page Dental Arts, nitrous oxide is administered through a small nose mask. We have a wide variety of yummy mask scents to pick from, or you may choose no scent at all. This service is available during any procedure.
The nitrous oxide gas is breathed in through the nose mask and metabolized in the lungs. This gas makes patients feel calm and sometimes sleepy. At the end of your procedure, the gas is switched to 100% oxygen and the effects of the nitrous oxide quickly dissipate. Adult patients are safe to drive afterwards, however, if for some reason they do not feel capable, we will continue to monitor them until they feel better or call a friend or cab to drive them home. Nitrous Oxide is a great way to help patients overcome dental anxiety. It is safe for nearly all patients, however, it cannot be administered to pregnant women or patients who suffer from COPD.

About Periodontal Services and Gum Disease:

Periodontal disease (gum disease) is a leading cause of tooth loss among adults. For this reason Page Dental Arts screens all adult patients for periodontal disease prior to their cleaning to detect if any disease is present. This way it can be addressed and treated promptly and appropriately. The screening process involves measuring all the areas were your gum tissue meets your teeth. The area where your gums meet your teeth is called a periodontal pocket. The depth of a “healthy pocket” is usually 1-3 millimeters (mm). In addition to measuring the gum tissue, we also look for any areas of the gums that are bleeding during this measurement. A healthy pocket should not bleed. See illustration below. Illustration is courtesy of Arestin.



GINGIVITIS:
Patients that have 4mm pockets, have what’s called gingivitis. Patients that have 1-3mm pockets but have bleeding of the gum tissues, also have gingivitis. Gingivitis literally means inflammation of the gums. The gums usually appear red or puffy, instead of light-pink and firm. The gum tissue also typically bleeds easily when brushed or flossed. Gingivitis is reversible, and it is treated with more frequent dental cleanings and better brushing and flossing at home. If gingivitis is ignored, it can spread to periodontitis (gum disease).

PERIODONTITIS:
Patients that exhibit 5mm pockets or above, have periodontal disease or periodontitis. Periodontitis literally means inflammation of the periodontium. Periodontium means all structures (the gum tissue and the bone) around the tooth. Periodontal disease is a chronic and serious bacterial infection that causes destruction of the gums and bone around the teeth. It is important to treat periodontal disease because it can lead to tooth loss, infection, and pain. It should also be noted that many recent studies have linked untreated periodontal disease to other disease processes throughout the body such as: heart disease, stroke, respiratory disease and infections, osteoporosis, diabetes, and pregnancy complications such as low birth weight in infants of mothers with periodontal disease.
There are many forms and stages of periodontal disease. Most patients do not know that they have periodontal disease until the very last stages of the disease, when there are symptoms of pain and teeth loosening. The higher the measurement of the pocket, as discussed above, the more bone loss around the tooth. More bone loss means that the disease is in a more advanced state. Plaque, tartar, and bacteria are the main causes of periodontal disease. Plaque and tartar can form below the gum line in the periodontal pocket and provide a home for bacteria to colonize. The longer plaque, tartar, and bacteria build up in the base of the periodontal pockets, the more bone is destroyed.
Unfortunately periodontal disease has no “cure” and cannot be “reversed.” This means we cannot regain the bone that has been lost. However, we can treat the disease and maintain the remaining bone around the teeth with the periodontal services listed below. It is important to remember to visit the dentist often to have periodontal disease diagnosed as early as possible. It is also important to continue with regular visits even after periodontal disease has been successfully treated, as it can easily relapse even with just one missed check-up.
Listed below are the treatments available at Page Dental Arts for periodontal disease.

Scaling and root planing:
Scaling and root planing is a non-surgical procedure that is used to treat periodontal disease. It involves numbing the affected area and using hand or ultrasonic instruments called scalers to remove plaque, tartar, and bacteria from the base of the periodontal pocket. After this procedure, it is important to thoroughly brush and floss twice daily at home. The gum tissue will be re-evaluated in about one month from when the procedure was completed.
The goal of this procedure is to stop the progression of the disease and therefore prevent further bone loss around the teeth. With good home care, the pocket depths should decrease. It will then be recommended that the teeth be cleaned every 3-4 months to help prevent the disease from relapsing. If significant improvement is not seen with this procedure, a referral may be given to see a gum specialist, called a periodontist.

Localized Antibiotic therapy (Arestin):
Localized antibiotic therapy may be used in conjunction with scaling and root planing to help treat periodontal disease. At Page Dental Arts, we use a product called Arestin, which is minocycline in a powder form. After the scaling and root planing procedure, the area will be dried and this powder will be placed at the base of the affected periodontal pocket. It works in the area for approximately one month and dissolves on its own. Arestin helps to prevent the bacteria from recolonizing the area; this helps the area to heal and the depth of the periodontal pocket to be reduced. Arestin cannot be used on people with allergies to the tetracycline family of antibiotics or on pregnant or nursing women. For more detailed information on Arestin visit their website: www.arestin.com

Periodontal Maintenance:
This is a specialized cleaning that is recommended for all patients that have been treated for periodontal disease. It is more in depth than a regular cleaning and includes irrigating the gum tissue with an antimicrobial solution. It is typically recommended every 3 – 4 months for patients that have had a history of periodontal disease. This procedure helps prevent periodontal disease from relapsing.

Referral to a Periodontist:
Patients with advanced periodontal disease or patients that do not have significant improvement with scaling and root planing may need to see a periodontist (a gum specialist) for more advanced therapies. At Page Dental Arts, we utilized several very experienced periodontist in the area to help coordinate your care.

About Restorative and Cosmetic Dental Services and Key Terms:

At Page Dental Arts we offer a wide variety of restorative and cosmetic services. Restorative services generally apply to procedures that are needed to prevent or correct existing disease conditions such as cavities, broken down fillings, tooth fractures, or missing teeth. Cosmetic services generally apply to procedures that make the appearance of the teeth more esthetic, such as changing the color, shape, or size of the teeth. Listed below are the various services, but first there are a few key words to review:

KEY TERMS:
Tooth Decay, Cavity, and Caries: These words all mean the same thing. An area of tooth has become “demineralized” and therefore “soft” instead of hard. This happens because of bacteria. Bacteria are naturally occurring in your mouth. Bacteria live off of the food that we eat and the plaque that forms on our teeth. If food and plaque are not effectively removed by brushing and flossing, bacteria levels will increase. Bacteria release nasty toxins that are very acidic. These acidic toxins break down the enamel on our teeth, thus causing the enamel to become soft. It should also be noted that excessive consumption of many foods and beverages, such as soft drinks, which are very acidic, can also attribute to the breakdown of your teeth’s enamel. Once the enamel layer in an area has been broken down, it is called a cavity. A filling or other restoration is then needed to remove the affected area and repair it. If left untreated a cavity will only get larger and destroy more tooth structure.

Amalgam Filling: An amalgam filling is a “silver” filling that is a combination of silver, tin, copper, zinc and mercury. While Page Dental Arts does not place amalgam fillings, we recognize that they are still a safe and effective treatment for cavities. Furthermore we do not recommend the “prophylactic” removal of amalgams as it can cause unnecessary damage to healthy tooth structure or the nerve and blood supply to the tooth. We do recommend that amalgams be removed if they are fractured, broken down, or have cavities around them.

Composite resin fillings (White fillings):
Composite fillings are tooth-colored fillings that are actually bonded to the tooth. They are a safe and effective way of restoring a tooth that has a cavity, is chipped, or needs an existing filling replaced. Usually the area being treated is numbed and the cavity or existing filling is removed. Then the composite material is placed and polished. Afterwards it is normal to experience slight sensitivity or tenderness in that tooth that gradually goes away. No filling is “permanent,” and they may need to be replaced periodically due to normal wear.

Tooth bonding and/or cosmetic tooth recontouring:
  • Tooth bonding
    Tooth bonding is typically a cosmetic procedure that can be performed on front teeth. With bonding, tooth-colored filling material is added to the desired tooth or teeth to correct small chips, close small spaces, or change the shape of the teeth. Bonding is not a “permanent” procedure and may need to be periodically replaced over time.
  • Tooth recontouring
    Tooth recontouring is a cosmetic procedure generally performed on the front teeth. It uses the dental hand piece and polishing instruments to selectively remove enamel to reshape the desired tooth or teeth to have a more esthetic appearance. Recontouring can be used to smooth out small chips in the edges of the front teeth or reshape the teeth by making them more “square” or “rounded”.
Teeth Whitening:
  • In Office Teeth Whitening (“Boost Whitening”)
    Many of us have seen the “instant” whitening procedures on T.V. shows such as Extreme Makeover. There are many different products available for this procedure. At Page Dental Arts, we use “Boost Whitening.” Boost has the highest amount of the active ingredient (hydrogen peroxide) on the market.
    For this procedure, a protective barrier is placed over the gum tissue. Then the Boost Whitening gel is applied to the teeth and then reapplied every 15 minutes for 2-4 applications. At the end of the appointment all of the gel is rinsed off and the barrier is removed. The teeth will be lighter and brighter. After this procedure it is normal to have an initial increase in cold sensitivity. Boost Whitening gel enables us to safely lighten and brighten the teeth several shades in one appointment!
  • Take home custom tray whitening
    Custom tray whitening is a way to gradually whiten your teeth at your own pace. It is great for maintaining the results of an in-office whitening procedure or for patients that tend to have too much sensitivity from the in-office whitening product.
    For this procedure, impressions of your teeth are made. From these impressions, comfortable soft plastic trays are made that fit your teeth exactly. Whitening gel is then placed inside the trays and worn for a series of applications in the comfort of your home. Custom whitening trays are a great and safe way to lighten your teeth and maintain it over time.
Porcelain veneers:
A porcelain veneer consists of a thin layer of porcelain that is customized and bonded to the front surface of a tooth. Porcelain veneers can be used to close spaces between the teeth, correct misaligned teeth, cover severely stained or discolored teeth, or restore severely chipped teeth. They can also be used to change the shape of the teeth or replace less attractive fillings or bonding. Porcelain veneers are a great way to achieve a beautiful and bright smile.
This procedure usually takes two appointments to complete. At the first appointment the area being treated may need to be numbed. A dental hand piece may be used to shape the tooth to make room for the porcelain veneer. In some cases, no anesthesia or tooth shaping is needed. Then a mold is made of the teeth. The color, shape and size of the veneer will also be determined. A dental laboratory will use this information and the mold to make the porcelain veneers. Temporary veneers are then made and affixed to the front teeth. At the second appointment, the temporary veneers are removed and the porcelain veneers are tried on and bonded to the teeth.
After this procedure the teeth may be initially more sensitive to cold. A night guard may also be recommended at the end of treatment to help protect the porcelain veneers. Teeth that have been veneered still require proper brushing and flossing at home as well as regular dental check-ups. No dental restoration is “permanent,” however, porcelain veneers are very durable and will last a long time. Porcelain veneers are a great way to correct or improve your smile.

Porcelain crowns:
A crown or cap covers the entire tooth and helps to restore it to its proper size, shape and position. A crown may be needed for any of the following reasons: a tooth fracture, a large cavity, a large existing restoration that is failing, or a tooth has had a root canal treatment. A crown can also be used to correct misaligned teeth, severely worn teeth, or discolored teeth. While crowns can be made of several different materials, Page Dental Arts recommends porcelain crowns in most situations.
This procedure usually takes two appointments to complete. At the first appointment the area being treated will be numbed to ensure your comfort. The color, size and shape of your new crown will also be determined. Then the tooth or teeth will be prepared with a dental hand piece to remove just enough tooth structure to make room for the porcelain. A mold is then made of this work and sent to a dental laboratory to have your porcelain crown made. A temporary crown is then be made and affixed to your tooth. At the second appointment the temporary is removed and the porcelain crown is tried in and cemented to the tooth.
After this procedure the tooth may experience increased sensitivity to cold. Teeth that have been crowned still need good home care with appropriate brushing and flossing as well as routine dental check-ups to stay healthy. While no dental treatment is considered “permanent,” porcelain crowns are very durable and will last a long time. Porcelain crowns are a great way to improve your smile or correct a damaged tooth.

Porcelain bridges:
Sometimes a tooth cannot be saved and needs to be removed. It is always important to replace a missing tooth, when possible. If the missing tooth is not replace the ability to chew in that area is greatly decreased. Furthermore, it can lead to increased forces or pressure on the remaining teeth, which can lead to fractures in the remaining teeth or tipping or drifting of the remaining teeth. If teeth start to drift, instability in the jaw joint can occur leading to jaw joint pain (SEE TMJ).
A bridge is one of the options that is available to replace a missing tooth. It is a dental restoration that connects the teeth on either side of the space where the tooth is missing. While bridges can be made of several different materials, Page Dental Arts recommends porcelain bridges in most situations.
This procedure usually takes two appointments to complete. At the first appointment, the area being treated will be numbed to ensure your comfort. The color, size and shape of your new bridge will also be determined. Then the teeth will be prepared with a dental hand piece to remove just enough tooth structure to make room for the porcelain. A mold is then made of this work and sent to a dental laboratory to have your porcelain bridge made. A temporary bridge is then be made and affixed to your teeth. At the second appointment the temporary is removed and the porcelain bridge is tried in and cemented to the teeth.
After this procedure the teeth may experience increased sensitivity to cold. The area that has been bridged still needs good home care with appropriate brushing and flossing as well as routine dental check-ups to stay healthy. While no dental treatment is considered “permanent,” porcelain bridges are very durable and will last a long time. Porcelain bridges are a great way to replacing a missing tooth.

Dentures (Complete Dentures and Partial Dentures):
Dentures are types of dental restorations that replace either all of the teeth or several missing teeth. If a denture replaces all of the teeth in the jaw it is called a complete denture. Complete dentures rest on the gum tissue. If it replaces only a portion of the teeth, it is called a partial denture. Unlike crowns and bridges, dentures are removable and need to be removed during bedtime to allow the gum tissues to rest.
Having a denture made involves making several molds of the mouth and can take up to five appointments to ensure proper fit, function and esthetics. Once the dentures are finalized, it will usually take several weeks to get used to speaking and eating with them. Since dentures rest on the gums, they can move while speaking and eating. To help overcome this issue, an implant supported denture may be recommended (See Dental Implants).
Like all other dental restorations, patients that have dentures need routine check-ups to ensure proper fit. Overtime dentures may need periodic adjustments, relining, or remaking.

About Pediatric Services

At Page Dental Arts, we love seeing children and making their dental experiences positive. We offer many of the same services to our pediatric patients that we do for our adult patients, including cleanings, exams, x-rays, fluoride treatments, composite “white” fillings, and tooth removal. In addition to these services we also offer some unique services designed only for our pediatric patients, such as happy visits, space maintainers, pulpotomies and prefabricated crowns. These services are described in more detail below.
While many of our pediatric services are similar to the services we offer our adult patients, our approach when treating children is much different. We try to keep appointments with children short and often use kid friendly words and phrases when describing treatment to children. We also often request that children under the age of twelve utilize nitrous oxide sedation while receiving restorative treatments to help alleviate anxiety and promote a positive experience.
Page Dental Arts does NOT use restraints, oral sedation or general anesthesia on children (or adults). If Dr Page feels that we are unable to give your child a positive dental experience, she may refer your child to a pediatric dental specialist.

A Happy Visit
We recommend children have their first dental visit around age 1 or 2 to help acclimate them to visiting the dentist. We call this visit a “Happy Visit.” At this visit we will introduce them to our staff and our office. We will show them some of the special tools that we use, we may count their teeth, and then they get to pick a prize out of our treasure box.
Quite often no treatment is actually completed at this visit; but this visit allows children to have a positive first dental experience and learn a few things about their teeth. We then recommend children come back every six months. With each visit we will be able to introduce basic preventative procedures. By taking things in small steps with our pediatric patients, we can create happy healthy dental patients for the future.

Why is it important to treat baby teeth?
Baby teeth can get cavities just the same as adult teeth can. Good oral hygiene and regular dental visits are the best prevention against cavities. We recommend that parents begin brushing their child’s teeth as soon as the first tooth erupts. This age can vary, but generally the first tooth erupts by age 6 months. Flossing is recommended when it is seen that any two teeth are touching. We recommend that parents help to brush their child’s teeth at least until the age of 6 or 7. That does not mean that a child cannot learn to brush his or her own teeth until then, that is just to say that most children will still be missing some areas and mom or dad will need to touch things up.
Many parents often ask, “Why should a cavity on a baby tooth be treated if it is just going to fall out later?” First, we should review how long baby teeth normally remain in the mouth, as this is a major factor in determining if treatment is necessary. Most parents know that the first baby teeth are typically lost around age 6 or 7, and those are the front baby teeth. However, the last baby teeth are not lost until age 11 or 12, and these are the baby molars. For a free chart on baby tooth eruption and shedding visit the American Dental Association website: http://www.ada.org/public/topics/tooth_eruption.asp
If it is determined that a baby tooth has a cavity, but is expected to fall out within the next six months or so, it most likely should not need treatment unless an infection is present. However, when a baby tooth affected with a cavity is expected to remain in the mouth for a longer period of time, proper restorative treatment is necessary for several reasons. First, the bacteria from the cavity can spread and lead to other cavities in the mouth, including cavities on adult teeth. Second, an untreated cavity will become larger and can cause pain and breaking of the tooth. If this occurs, chewing and nutrition can be affected. Lastly, if a cavity is left untreated, it will become larger and the tooth will abscess or cause an infection. In addition to being a painful consequence to an untreated cavity, an abscess in baby teeth can spread to the underlying adult teeth. This can cause discolorations or malformations in the adult teeth or even stop their development completely.
Baby teeth with small to moderate sized cavities are often treated with basic fillings. Many parents also ask: “Why place a filling on a baby tooth? Why not just pull it?” Baby teeth are maintaining the space for the future adult tooth. Removing them too early can result in shifting of the remaining teeth and future crowding of the adult teeth. So, it is best to keep and restore the baby tooth when possible. However, if an abscess has already occurred, then removal of the baby tooth is indicated. To help prevent future crowding a Space Maintainer may be recommended for baby molar teeth. (See Space Maintainers below)

Pulpotomies and Prefabricated Crowns
Most often small or moderate sized cavities on baby teeth are treated with fillings. However, if a baby tooth has a large cavity that is close to or into the “nerve” or “pulp” of the tooth, then a pulpotomy will be needed. A pulpotomy is a procedure that removes the cavity and the top portion of the pulp. The pulp is where the nerve and the blood supply of the tooth are located. The tooth is then filled. Because this filling is very large, the tooth is at risk for breaking. So after the pulpotomy is completed, a Prefabricated Crown will be fitted to the baby tooth and cemented into place. This is all completed in one visit. A local anesthetic and nitrous oxide are used during the procedure to numb the area and alleviate any anxiety or fear.
Traditionally these prefabricated crowns were silver colored and called “stainless steel crowns.” At Page Dental Arts, we do not use the traditional stainless steel crowns. We use crowns that have a white outer layer. These crowns not only restore the tooth but also provide a more pleasing esthetic result than the traditional stainless steel.
Pulpotomies and prefabricated crowns are a great way to restore an affected baby tooth and retain it until the adult tooth comes in. After this procedure, periodic check ups are required every six months to ensure the health of these teeth.

Space Maintainers
When a baby tooth cannot be saved with the above treatment, it often needs to be removed to prevent an infection. However, it is important to “save” this space. When a baby tooth is lost earlier than intended, it can cause shifting of the remaining teeth and future crowding with the adult teeth. To help prevent this shifting, a space maintainer may be recommended to “hold” the space until the adult tooth comes into place. Typically space maintainers are only needed for those baby molars that are lost too early.
A space maintainer usually takes two appointments. At the first appointment we will take an impression of the area and have a dental lab fabricate the space maintainer. The most common space maintainer consists of a metal band and loop. At the second appointment it will be cemented on to the tooth closest to the one that was lost. The space maintainer stays in place until the adult tooth starts to come in, and then it will be removed. It is very important to follow up after a space maintainer is placed with regular check ups every six months. If a space maintainer is left on too long it can affect the way the adult teeth come in.

About Dental Implants:

Sometimes a tooth or teeth cannot be saved and need to be removed. It is always important to replace missing teeth, when possible. If the missing teeth are not replaced the ability to chew in that area is greatly decreased. Furthermore, it can lead to increased forces or pressure on the remaining teeth, which can lead to fractures in the remaining teeth or tipping or drifting of the remaining teeth. If teeth start to drift, instability in the jaw joint can occur leading to jaw joint pain (SEE TMJ). Also, if teeth are not replaced, over time the underlying bone will start to resorb and could lead to a jaw fracture.
Dental implants are a great way to replace a single missing tooth, several missing teeth, or all of the teeth. Dental implants help avoid all of the problems that can occur if teeth are not replaced. Usually dental implants require two or more stages to complete; however, in some cases only a single stage is needed. In general, the first stage involves the placement of the dental implant(s). This stage is completed by an oral surgeon or periodontist, and usually requires 3-4 months of healing. While the implant(s) heals a temporary prosthesis can be utilized to provide proper function and esthetics. After healing the second stage involves making a crown, bridge or denture to attach to the implant(s) that were placed. Listed below are some of the options available with dental implants. See the figures below to help you better understand dental implants and their role in tooth replacement and bone preservation. The figures below are courtesy of Biomet3i.





Implant crowns:
Implant crowns are a great way to replace a single missing tooth or several missing teeth throughout the mouth. Once a dental implant has been placed and has healed, a porcelain crown can be connected to the implant. An implant crown will look and function just a tooth would. See the figures below to see examples of implant crowns. The figures below are courtesy of Biomet3i.



Implant bridges:
Implant bridges are a great way to replace multiple teeth missing in a row. Once two or more implants have been placed and have healed, a porcelain bridge can be connected to the implants and replace the missing teeth. This bridge will look and functions just as natural teeth would.

Implant supported dentures:
When all of the teeth are missing, there are several options available with dental implants to replace them. Implant crowns and bridges, as decribed above, can be used to replace all of the teeth. An implant supported denture is also an option for total teeth replacement. After several implants are placed, a denture can be connected to them. This denture can be fixed in place (not removable) or removable depending on the patients needs and desires. Using implants to help secure a denture not only prevents the denture from moving around like a traditional denture, but allows the patient greater biting forces which allows them to eat anything they desire. Implant supported dentures are a great improvement over traditional dentures and are a great way to replace all of the teeth. See the figures below to see an example of an implant supported denture. The figures are courtesy of Biomet3i.



About your TMJ:

The tempromandibular joints, or TMJs, are joints located on the left and right side of your lower jaw. The TMJs, in conjunction with several muscles, allow your mouth to open and close. You can feel them working by placing your fingers on either side of your face, just in front of your ears, and open and close your jaw.
In some patients, these joints and associated muscles can become inflamed and cause pain. This inflammation can be brought on suddenly due to trauma to the head or neck region, dislocation of the joints, or overexertion of the jaw joints. This inflammation can also occur overtime if teeth are missing or misaligned. Misalignment of the teeth or missing teeth can cause excess stress on the joints and lead to pain in the jaw joints.
It should be noted that trauma to the head and neck should be immediately evaluated by your physician or urgent care specialist to rule out a severe or life threatening injury.
Inflammation from simple overexertion of the joints from excessive gum chewing or inadvertently opening too wide can usually be relieved by rest (reducing jaw joint movement by minimizing talking and eating a soft diet), placing ice packs over the joints (20 minutes on and 20 minutes off), and over the counter pain medication. However, if pain persists in the joints, a physician or dentist should evaluate the area.
Another form of overexertion is called bruxism. Bruxism is the clenching or grinding of the teeth together, usually while asleep. Most patients that clench or grind their teeth at night are not aware that they do. Signs of bruxism are sore jaw joints or muscles, excessively worn tooth enamel, or fractured teeth, fillings, or crowns. Unfortunately there is no cure for bruxism; however, a night guard is typically recommended to help alleviate stress on the jaw joints and protect the teeth and any dental work. (See Night guard Therapy below).
Occasionally, dislocation of the jaw joints can occur. If this happens, try not to panic. In most cases, the patient can usually relocate the joint without assistance. If this is not possible, seek immediate treatment from your dentist, oral surgeon, or urgent care specialist for assistance. After any dislocation, it is important to rest the jaw joint (as described above) to prevent it from occurring again.
Misaligned teeth and/or missing teeth lead to a “poor bite” or malocclusion. This malocclusion can cause instability in the jaw joint and therefore cause joint or facial muscle pain. Minor malocclusions can be treated with a simple equilibration or “selectively polishing teeth” to improve the bite. In most cases, misaligned teeth can be corrected with various orthodontic therapies or braces. In other cases, more extensive work, such as crowns, bridges (See Porcelain Bridges) or implants (See Dental Implants) may be needed to help correct the bite and replace any missing teeth.

Night guard Therapy:
A night guard consists of a layer of plastic that is custom fitted to a patient’s teeth. It slightly separates the teeth to help alleviate jaw joint pain as well as prevents excessive enamel wear or fractures of teeth or dental work due to clenching or grinding of the teeth. It is typically worn at night, but may be worn during the day. At Page Dental Arts, a night guard is usually recommended for patients that exhibit bruxism, have extensive porcelain work, or implants.

Referral to an Orthodontist:
An orthodontist is a dental professional that specializes in the alignment of the teeth. You may need a referral to an orthodontist to improve the alignment of your teeth or correct your bite. At Page Dental Arts, we work with several highly experienced orthodontists in the area that achieve excellent results.

Surgical Services:

Removal of Teeth (adult and baby tooth extractions):
While our goal at Page Dental Arts is to try to preserve and restore all of the teeth you have, there may be situations where we cannot save a tooth. There may also be situations where baby teeth may need to be removed early. When a tooth needs to be removed, the affected area is numbed and special instruments are used to loosen and removed the problematic tooth. Nitrous oxide (laughing gas) can also be used for additional sedation and comfort. Dr. Page is very experienced in both pediatric and adult tooth removal. Her priority is making this experience as gentle and comfortable as possible.

Referral to an Oral Surgeon:
While we are capable of providing basic tooth removal services, there may be certain procedures or situations that require a referral to an oral surgeon. At Page Dental Arts, we work with several very experienced oral surgeons in the area to help coordinate your dental needs.

About Dental Emergencies:

At Page Dental Arts, we hope all of our patients have happy and healthy smiles. But if you find yourself with a tooth ache or a traumatic dental injury, we want you to know that we are always here to help you. Our goal is to see you promptly to assess the situation and alleviate any pain or infection. We encourage you to call us as soon as you are experiencing a problem because it is important to remember that tooth infections can progress quickly and become serious.

Emergency appointments:
At Page Dental Arts, when you call our office during business hours with a dental emergency, our goal is to see you the same day, or within 24 hours. During an emergency appointment we will assess the condition to determine necessary treatment as well as control any infection or pain. Additional appointments or a referral to a specialist may be needed depending on the condition found. We encourage patients to call us as soon as they are experiencing a dental problem, so we can see them as soon as possible. It should be noted that convenient appointment times such as early morning or late afternoon may not be available in emergency situations, however, work and school excuses are available.

After hours emergencies:
We understand that dental emergencies do not always occur in the middle of the day. For our existing patients, the doctor is always available after hours in an emergency situation. If you are experiencing a dental emergency after hours, just call our office (303-794-4542) and follow the prompts to be directly connected to the doctor’s mobile phone. She will return your call and will advise you on your particular situation and even meet with you after hours if needed. Unfortunately we are only able to treat existing patients of our practice after hours.
8204 S. Kipling Parkway #160
Littleton, CO 80127
Ph 303-794-4542
Email: drpage@pagedentalarts.com
Website design and logo design by Logoworks