DENTAL EMERGENCIES

Call us at (413) 279-2016 and schedule an appointment if you experience toothache, swelling of the face, broken tooth, broken filling or  trauma to the teeth etc.   We will find an earliest appointment time to accommodate your needs, whether you are a current or new patient.  

IMPLANT

The most common implant-supported restoration is a single implant crown restoring a missing posterior or anterior tooth.   If you miss only one tooth, implant crown is the best treatment choice according to the concepts in modern dentistry, compared to a fixed bridge in the past.  Prior to the advance in implant dentistry, a 3-unit bridge used to be the treatment choice which is subject to decay and damage to the adjacent teeth.   2 to 4 months after the implant is placed and integrated into the bone, the dentist in our office will take CEREC digital impression of your implant, the gum and the adjacent teeth, design and mill the implant crown in just one visit as the CEREC machine eliminates the lab step.   If you miss multiple teeth in one area, an implant-supported bridge is the best treatment choice, supported by two or three implants underneath.  An Implant-supported crown and bridge closely mimic your natural teeth, therefore you will feel more comfortable and natural as if it’s part of your body.  You will love the look and enjoy showing your smile in the public.    

ONE VISIT CROWN

A crown is one of the most common procedures in the dental office.  At  Wilbraham Dental Associates, we have CEREC CAD/CAM machine in the office, an advanced equipment based on innovative digital technology applied in dentistry.   It’s composed of two parts: digital impression and digital milling.  Digital impression is superior to conventional impression as it’s accurate, immediate and no uncomfortable impression material in your mouth.  The milling portion allows the restorations (  onlay, crown and bridge ) to be made within an hour, no provisional restoration and sending to the lab are needed, which saves you additional trips to the office.  If there’s error found during the try-in, correction can be made immediately, no need for additional trip. 

SMILE MAKEOVER

Are you happy with your smile?  What is it that you like or dislike about your smile and teeth?  A smile makeover is the process of improving the appearance of smile through the cooperation of one or more dental disciplines, such as cosmetic dentistry, orthodontics, periodontics, restorative dentistry, implant dentistry and oral surgery et.  If you are interested in a smile makeover, a comprehensive exam will be set up to collect all the data, such as taking impression of your teeth and mounting the upper and lower arch models on a device to duplicate the position of your jaw joints, both dental arches and their relationship; taking X rays and a series of clinical photos including headshots and intraoral photos of different views and angles etc, to thoroughly analyze your smile and design your case.    Depending on the complexity of the case, a smile makeover can be satisfied with cosmetic dentistry only or it might need a multi-disciplinary approach such as orthodontics together to achieve the desired result.   

VENEERS/ ONLAYS

Ceramic veneer is a thin layer of custom-made tooth-colored porcelain restoration that covers the front  of your teeth to improve the smile.  Porcelain veneer is the most aesthetic and durable restoration in smile enhancement. It’s the gold standard in cosmetic dentistry to improve the appearance of teeth that are discolored, have irregular shape, size, length or gaps.   Due to its structure and property, ceramic veneer resists staining and discoloration and mimics the light reflection of natural teeth the best.   

The process of doing ceramic veneer usually takes 2 visits in our office: one for consultation and the other to prep the teeth and deliver the restoration at the end of the visit with the aid of the CEREC CAD/CAM system.   During the consultation visit, explain to your dentist the cosmetic goal that you are trying to achieve and your dentist will evaluate your teeth and decide if ceramic veneer is the appropriate treatment ( a crown might be a better choice if you miss significant tooth structure or have large restoration ).  Impressions and clinical photographs of your teeth might be taken for a pre-op workup of your case.  On the day of the treatment appointment, your teeth will be numbed and a thin layer of enamel is removed from your teeth to accommodate the thickness of the veneer, then digital impression of your teeth is taken and the veneers are milled on site using the CEREC CAD/CAM.  After checking the shade and fit, the dentist bonds the ceramic veneers to your teeth permanently.   Ceramic veneers generally last between 10 and 15 years, up to 20 years. After this time, the veneers would need to be replaced.    

SLEEP APNEA

Sleep apnea is a serious sleep disorder with which patients stop breathing in varied duration and frequency during their sleep.  The consequence of sleep apnea is lack of consistent and adequate oxygen supply to the major organs of the body such as brain and heart, with time this disorder, if left untreated, causes a number of health problems such as high blood pressure, heart problem, stroke, headache, depression, ADHD etc.  

If you experience symptoms such as loud snoring; wake up with a sore and dry throat; sleepiness and lack of energy during the day; forgetfulness and mood change, see your primary care physician and be referred to a sleep physician for sleep apnea test and diagnosis.   When the diagnosis of sleep apnea is made, a CPAP machine is the treatment of choice for treating moderate and severe degree of sleep apnea.  However for mild degree of sleep apnea or severe degree of sleep apnea when some patients are not able to tolerate wearing the mask of the CPAP machine during sleep, the treatment alternative to CPAP machine is a mandibular advancement oral appliance made by the dentist, becomes necessary for treating sleep apnea.   

Mandibular advancement device (MAD)   increases the airway diameter of the sleep apnea patients due to soft tissue collapse by advancing their lower jaw forward, therefore maintain the airflow and oxygen supply during the otherwise arrested breathing periods.  

HYGIENE SERVICES

 A Routine dental cleaning is recommended twice a year.  It removes soft ( dental plaque ) and hard ( tartar ) dental buildup effectively.   We use both Cavitron ( a water-spraying hygiene instrument that has unnoticeable vibration on the tip to remove the buildups ) and hand instruments ( to remove any leftover spicules of buildups ).   With regular cleaning and good homecare, brushing and flossing daily), it will help maintain your dental visits to only twice a year. 

Fluoride varnish and fluoride supplement are usually recommended for children and young adults.   Fluoride varnish strengthens their teeth at the surface layer;  fluoride supplement ( which is a pill that’s taken daily from age 6 months to 16 years old by patients who live in water-non fluoridated towns ) strengthens the internal layer of the teeth.  Both of them increases the teeth’s ability to resist the bacteria’s acidic attack and prevent cavities. 

Some newly erupted permanent teeth ( adult teeth ) during age 6-14 have deep grooves on their biting surfaces which easily trap food and remain at the bottom of these grooves. A toothbrush can’t reach the bottom of these grooves and clean them properly. With time, it can develop cavities.  Sealants are the solution to helping these groovy teeth. It seals the deep grooves with a resin material so that food debris cannot fall into the grooves and bacteria cannot get in there to create cavities either.  The procedure of applying sealant on teeth is quick and no has pain.

TOOTH WHITENING 

There are two types of teeth discoloration: external and internal.   External discoloration are on the enamel, the surface layer of teeth, cleaning and polishing in dental office or using abrasive toothpaste can remove it.  Internal discoloration are in the dentin of teeth, the inner layer of teeth, high concentration of peroxide products which are only provided or sold from dental offices  are needed to correct it.  A majority of teeth looking yellow or grey are due to discoloration in the dentin layer of teeth, not the enamel layer. To achieve whiter teeth, you can choose from ceramic veneer, composite bonding or teeth whitening by peroxide products offered in our dental office.  If you choose to whiten your teeth, the dentist will evaluate your teeth and make sure they are disease-free before the whitening procedure, as whitening teeth that have cavities and gum disease can exacerbate the problems.

We use Opalescence at Wilbraham Dental Associates, there are two options offered,  in-office procedure or a take-home kit. The in office whitening, takes about 90 minutes, using no light to process, will achieve a fast whitening result. If you prefer to do the whitening at home, we offer Opalescence take-home kit along with a pair of custom trays. The custom trays offer the best coverage on your teeth and are used in future touchups too to maintain the result.  Tooth sensitivity is not uncommon associated with whitening. If sensitivity occurs, it is usually temporary and can be relieved by desensitizing treatment.  

A few words of caution about whitening toothpaste.   They mostly work by the heavy abrasive agents in them and sometimes low concentration of peroxide.  They can help remove the surface stain on the enamel of teeth but are not effective in whitening the discolored dentin of teeth.  Due to the abrasive nature of whitening toothpaste and the location it works, ie. Enamel of the teeth, It’s suggested not to use it for more than two weeks at a time and brush gently, because when enamel is worn, teeth begin to look worn, old, and discolored.  

 

DENTURES

Complete Denture: 

Complete denture is indicated when you lost all the natural teeth in one or both arches.  After delivery, adjustment appointment(s) are usually required to ensure a proper fit of the new denture. Your dentist will give you instructions on how to care for your denture.  Do not wear denture during sleep.  It should be removed and soaked in denture cleaner solution overnight and let the oral tissue rest and rebound. 

Partial denture with metal framework:

If there are some natural teeth left in the arch, a cast framework partial denture can be indicated to replace the missing teeth. The metal framework of the partial denture rests and clasps on a few anchor teeth, which keeps the prosthesis in place and provides the rigidity too.   Some minor preparation on the anchor teeth are required so that the metal framework doesn’t interfere with the bite and the prosthesis remains stable during function.  In the beginning, your new partial denture may feel awkward or bulky. This is normal, and you will eventually become accustomed to wearing it.  Inserting and removing the partial denture will require some practice. Do not wear partial denture during sleep.  It should be removed and soaked in denture cleaner solution and allow the oral tissue get rest and rebound.  

 Immediate full and partial dentures

This type of denture is made before the teeth are extracted.   Some patients don’t want to go without teeth when a full denture or partial denture is treatment planned, therefore immediate complete and partial denture is the treatment of choice.  The dentist will take impression of the arches and send to the lab to make the prosthesis.  On the day of extraction, the prosthesis is inserted immediately once the teeth are removed.   It’s normal to feel soreness of the tissue under the prosthesis.  The patient is to come back the next day for a follow up, then a few more times during the first six months of healing.   A soft reline of the immediate denture is usually required when the denture feels loose within those first six months.  Six months after the bone remodeling is stabilized, the immediate denture can be converted to a definitive prosthesis with hard reline procedure or a new impression can be taken to fabricate a definitive prosthesis.

Tooth Extraction

Simple extraction

This is the most routine extraction procedure where the dentist anesthetizes the tooth, then loosen the tooth to certain degree with an instrument called elevator(s), before applying the extraction forceps to luxate the tooth and remove it in one piece. 

Surgical extraction

When there’s not enough amount of tooth stucture above the gumline, such as only a root left or severely broken tooth without much left above the gum, or the crown of the tooth breaks off using the simple extraction technique, the dentist needs to make a small incision into your gum (sometimes remove a small amount of bone around the root as well) to expose more tooth structure, before the tooth can be removed with simple extraction technique.