You might think all dentists provide the same basic services. There are, however, many different designations of dentists and many specialties.
Each individual is largely responsible for caring for their own teeth. There are times, however, when you will need to rely on a professional. Dentists are highly trained medical experts. They specialize in the care of teeth and gums. Dentists fall into two broad categories. General dentists are typically known as family dentists. Most individuals will only need the care of a general dentist. Specialty dentists focus on one particular area of dentistry. They will receive an extra two to six years of training in order to become specialized.
The most common thing a general dentist does is routine checkups. General dentists usually see patients twice a year. At these visits they will evaluate the health of the patient’s teeth and gums. They will often do x-rays to make sure there is no tooth decay. After evaluating the patient, they will clean the teeth thoroughly. General dentists also work to prevent dental disease by teaching patients how to properly care for their teeth. They also might help patients eliminate risk factors such as smoking.
If there is a problem with a patient’s teeth, a general dentist can sometimes correct it themselves. Many general dentists can do fillings, tooth extractions, root canals, bridges, crowns, sealants, and dentures. Many also see pediatric patients. If a general dentist does not perform a service, they will refer the patient to a specialty dentist.
There are more than a few specialties in dentistry. Pediatric dentists are those whose practice is focused on patients under the age of 18. They sometimes might care for those who have mental illness or a diminished mental capacity. Orthodontists see a lot of young patients as well as they are the ones who apply braces to teeth. Adults can also see orthodontists if they have crooked or misaligned teeth. If a patient has an injury to their mouth or jaw, they would see a oral and maxillofacial surgeon. These dental surgeons also work on defects of the mouth and jaw. They perform extractions of teeth that are difficult to remove as well.
Endodontists work on the inner portion of teeth. They do root canals and treat the pulp and nerves of the tooth once it becomes diseased. They might work with an oral pathologist, who treats diseases in the mouth. A periodontist is responsible for treating gum disease. They also work on the bones in the mouth. If teeth need to be replaced, a prosthodontist will make a plan for dentures, bridges or implants.
Obviously, there are other specialties as well. You don’t really need to know them as you dentist will refer you to the appropriate person.
Dental Enamel is the outer part of a tooth; the part you see. It coveres the tooth like a thick eggshell. In baby teeth, it is quite thin. In permanent teeth, it is thicker, roughly 1-2mm. It is very hard. Under a microscope the enamel "rods" are arranged kind of like a stack of lumber with the surface being the ends of the stack. These rods have sort of a keyhole shape in crossection.
In order for a composite filling, sealant or other bonded material to adhere to the enamel, the surface is "etched". This is usually done by applying 37% phosphoric acid solution for about 15-20 seconds and then rinsed off. (No the acid does not hurt. In fact, you can touch it for a good while and nothing will happen. It's acid, but not that strong). The etchant removes inorganic material and parts of the enamel rods whose ends are exposed by demineralization. Yes, if you put an egg into vinegar it will eventually demineralize the eggshell. Same thing here, but a much shorter time, stronger acid and it's only the microscopic surface that is demineralized. This etching produces multiple areas for bonding material to mechanically adhere to the enamel surface. Visually the tooth has a frosted appearance. It's sort of like sandblasting or priming the surface. Bonding agent is then applied, flowing down into this rougher surface. Once curing occurs, this locks into the undercuts, and bonds the material to the tooth.
Unetched Enamel:
Etched Enamel:
Dentin can also be etched, but the bond strength is less than with the enamel. It is much more organic with dental tubules evident on microscopic view. Newer bonding agents bond to enamel and dentin. You can see from these photos how the surface is primed for bonding.
LOS ANGELES, BEVERLY HILLS AND SANTA MONICA, CALIFORNIA–When we think of tooth development, we often think of a baby cutting its first teeth.
But tooth development- known scientifically as odontogenesis- actually begins in the womb.
Anatomy Of A Tooth
Before discussing how teeth develop, it’s important to understand a bit about tooth anatomy and the four major tissues that comprise a tooth, said Dr. Atoosa Nikaeen, who owns a Los Angeles and Beverly Hills, CA orthodontics practice. Those four tissues are - enamel, cementum, dentin and pulp.
The crown of a tooth is covered with enamel- which is the hardest and most concentrated mineralized substance in the body. The cementum is a bony substance that covers a tooth’s root. Dentin is a connective tissue located between the enamel or cementum and the dental pulp chamber that helps support the crown of the tooth.The pulp is located in the center of the tooth and contains soft connective tissue filled with blood vessels and nerves, Nikaeen, beverly hills orthodontist, said.
How Teeth Develop
Odontogenesis is the process where teeth form from embryonic cells, grow and eventually erupt from the gums. The four stages of tooth development are the bud stage, the cap, the bell and maturation.
Healthy teeth require the proper development of dentin, enamel, periodontium and cementum during the appropriate fetal development stages, said Nikaeen, a Beverly Hills, CA Invisalign provider.
The primary teeth- also commonly called baby teeth- begin to form in the jawbone between six and eight weeks after conception. Permanent teeth start to develop at 20 weeks.
“Teeth must begin to develop at these points of gestation or they will not develop at all,” said the Los Angeles and Beverly Hills, CA braces expert.
Teeth are created through a protein matrix mineralization process. Although this process begins in the womb, it actually isn’t completed until late adolescence, when growth of the root structure is completed.
It is interesting to note that a majority of babies are born without their teeth showing, but about one in 2,000 babies has a visible tooth at birth, Nikaeen said.
Requirements for Healthy Tooth Development
The mother plays a significant role in the development of her baby’s teeth. Having a healthy diet and proper nutrition helps ensure that the baby receives the minerals and nutrients it needs to develop healthy teeth.
Women who suffer from severe nutrient deficiencies during their pregnancy increase the likelihood that their baby will be born with dental malformations or that they will be more susceptible to tooth decay as they mature, according to information posted by the American Dental Hygienists’ Association.
Healthy tooth development and maintenance requires a variety of vitamins and minerals.
Vitamin C is necessary because dentin contains a protein called collagen, and collagen needs vitamin C for normal synthesis, according to the ADHA article. Vitamin A is needed so that tooth enamel can form. The enamel contains keratin, another type of protein, and vitamin A is necessary for keratin to form.
Vitamin D is essential to the process by which phosphorus and calcium are deposited into crystals of hydroxyapatite, which is the structural matrix of teeth, as well as bones, the article stated.
Fluoride, calcium and phosphorous are incorporated into the tooth’s mineralized structure during development to form fluorapatite. This is a compound that is more resistant to erosion than hydroxyapatite. After tooth eruption occurs, fluoride no longer is involved systemically in forming teeth.
Keeping A Mother’s Teeth And Gums Healthy
A mother’s decay-causing bacteria can be transmitted to her child, so it is important to have maternal teeth free of decay before the birth, Nikaeen, beverly hills invisible braces, said.
The decay process begins with plaque, an invisible sticky layer of harmful bacteria that constantly forms on teeth. The bacteria convert sugar that remains in the mouth to an acid that attacks tooth enamel.
Plaque that is not removed can irritate the gums, making them red, tender and likely to bleed easily. High progesterone levels are known to be responsible for puffy, tender gingival tissue.
The American Dental Association believes that poor periodontal health in the mother may lead to adverse pregnancy outcomes including premature delivery and low birth weight of the baby.
Learn More
Next month’s article will discuss tooth development in children between birth and age 3. If you would like to learn more about tooth development in children or you would like more information on Beverly Hills, CA beverly hills lingual braces expert Dr. Atoosa Nikaeen, please visit her Web site: http://www.invisibraces.com/ or call her office for a free consultation: (310) 444-1113.
About Dr. Atoosa Nikaeen
Dr. Nikaeen graduated with honors from dental school in 1993 and received a doctorate in dental surgery (DDS). She gained experience practicing general dentistry for several years before attending Columbia University School of Dentistry and Oral Surgeons in New York, where she earned her post-doctoral education in orthodontics and received an orthodontic specialty certificate.
In addition to running her practice, Dr. Nikaeen is a faculty member at the University of California in Los Angeles (UCLA) Orthodontic Department and teaches orthodontic residents.
Dr. Nikaeen’s Los Angeles practice serves patients throughout Southern California, including Beverly Hills and Santa Monica.
LOS ANGELES, SANTA MONICA AND BEVERLY HILLS CALIFORNIA — Los Angeles, CA Orthodontist Dr. Atoosa Nikaeen is offering a holiday special to new patients who get braces through January 30.
Whether patients need traditional braces or Invisalign, Nikaeen offers $500 off the treatment cost. Once treatment is completed, patients will receive a complimentary Nite White take-home teeth whitening system.
Nikaeen makes a custom-fitted teeth whitening tray for all patients at the time that the patient’s retainer is made, said the Los Angeles, CA invisible braces provider.
“The teeth whitening system is a product patients can continue to use periodically, long after completing their orthodontic treatment,” Nikaeen, top orthodontist in los angeles, said.
Nite White offers excellent whitening results and reduces sensitivity by 30 percent, according to the manufacturer’s Web site .
“I believe that teeth whitening is the perfect way to cap off your orthodontic treatment,” Nikaeen, los angeles invisalign provider, said. “Once patients have properly aligned teeth, this is a great way to really show them off.”
With the holidays fast-approaching, Nikaeen, los angeles lingual braces expert, said offering the $500 discount should make it easier for parents to give the gift of good oral health to their children, or for people to decide to treat themselves to a beautiful smile.
Learn More
If you would like to learn more about these special offers, Dr. Atoosa Nikaeen’s orthodontic practice, or you wish to contact her for a free consultation, please visit her Web site: http://www.invisibraces.com/, or call her office: (310) 444-1113.
About Dr. Atoosa Nikaeen
Dr. Nikaeen graduated with honors from dental school in 1993 and received a doctorate in dental surgery (DDS). She gained experience practicing general dentistry for several years before attending Columbia University School of Dentistry and Oral Surgeons in New York, where she earned her post-doctoral education in orthodontics and received an orthodontic specialty certificate.
In addition to running her practice, Dr. Nikaeen is a faculty member at the University of California in Los Angeles (UCLA) Orthodontic Department and teaches orthodontic residents.
Dr. Nikaeen’s Los Angeles practice serves patients throughout Southern California, including Beverly Hills and Santa Monica.
This year Alabama Pediatric Dental Associates & Orthodontics held a canned food drive in our Huntsville and Madison locations.
Each patient was allowed to bring in up to 20 canned food items for a chance to win $100.
Our patients donated a total of over 400 cans! Check out the picture of all the cans that were donated. Our staff members helped arrange the cans in the shape of our logo, a rocket!
We are so proud of our patients and we thank them very much for opening up their hearts and wallets to help our community with their donations.
Gary Vaynerchuk's new book, Crush-It, is a great readfor those interested in converting one's passion into something more. He has lots of insights on blogging, social networking, business and how to use these techniques and insights in growing not only a business but to enriching your personal life. It is important to find something you love to do and put your energy into that endeavor, hobby or business. If it's your passion, it's really not "work" in the classsic sense, it's enjoyable no matter the hours needed to make it happen. The key is to realize the thing you love to do is the thing you were meant to do. Once you find that, if you put in lots of time and hard work, you will succeed.
I was privileged to meet Gary last year and listen to many of his ideas on business and blogging. I have even recently incorporated a few of his suggestions from his book into this blog including the link on the sidebar for those interested in making an appointment with our office:
I love my profession and I love to blog about it here. I hope to develop professionally and personally by following my passion blogging here about Pediatric Dentistry. It takes long hours and hard work, but constant improvement and excellence is something to which we all should all aspire.
(Gary if you read this, and I know you might, please feel free to comment).
I don't want a silver filling! I hear this from time to time in the office. What are silver fillings (amalgam fillings)? They are sometimes called amalgam because they have a few different things in them amalgamated together to form something new.
Just so you know we do not do amalgam silver fillings anymore in our office and have not for many years. This mainly was a factor of the improvement in the strength and durability of white fillings and patient demand. We have found that the ability of the stonger newer composite white fillings that bond to the tooth (strengthening it) and the cosmetic benefits make it a very desirable restorative material.
Amalgam consists of a powder of ground up mainly silver and copper and some other metals mixed with a little drop of mercury. You shake it all together (amalgamate). After a few seconds of "trituration" the thing is kind of maleable and putty like. It is placed into the cavity preperation and initially hardens in a few minutes. It is very important to note that there is basically no murcury coming out of a silver filling once it is amalgamated. They are quite safe as determined by extensive scientific clinical studies-(See links below.) Silver fillings were very common in the past and were the standard of care, and still are, because they hold up quite well to biting forces. If a dentist is still doing silver fillings, that is still an acceptable method of treatment. There are a few drawbacks to "silver" fillings: 1. They do not bond to the tooth, they basically just fill the cavity. 2. They are silver so there is a cosmetic concern. Now, how many people are looking at your back teeth trying to see in there? If you know them that well, it probably does not matter what your teeth look like. Still, we are all concerned with appearance and want the most cosmetic solution available. 3. thermal conductivity is better/lower with white fillings.
