What is preventative and restorative dentistry?
Preventative dentistry is a health care service focusing on keeping your teeth, jaws and their related structures in excellent condition. Restorative dentistry aims at assisting you regaining lost function, comfort and esthetics. The unified goal is to help keep you well and restore you to wholeness.
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To attain optimum health, you must be involved in the prevention of disease and you must help plan treatment. Once corrective action is taken, you again have the primary role in preventing recurrence.
Wellness is not something anyone, even the most accomplished doctor, can bestow on you. Wellness must be achieved by a strong personal commitment to proper hygiene, exercise, sound nutrition and a balanced lifestyle.
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Wellness is high-level health, which is different from the absense of disease. When we are well, we feel vigorous, at peace and close to those who are important to us.
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What qualifies you to provide high quality care?
It would be easy to list the education of each of the staff members, the number of post-graduate courses attended, the number of journals read monthly and the awards and licenses granted by the appropriate organizations. That information can be provided to you, but it is secondary to our commitment to provide the best care available. An experienced staff backed by the most up to date knowledge, modern equipment, and finest materials help us meet that commitment.
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Is quality dental care expensive?
The initial cost may seem high, but when this treatment is done to the highest standards and you take the initiative to maintain your dental health, the future costs are small. Taken in this light, fine dental care is very inexpensive. In fact it is a fine investment in your future health, comfort and appearance.
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What are the most common preventable diseases of the mouth?
Caries (tooth decay) and periodontal (gum) disease are the most common.
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How does decay start? How can I stop it?
Caries (decay) is a disease started by bacteria colonizing on the teeth. These colonies grow together and appear as a whitish coating (plaque). Bacteria are living organisms which require food. They prefer sugar and other refined carbohydrates, but do very poorly on whole grains and proteins. Once the bacteria digest sugar, the cause acid and destructive enzymes to be deposited on the teeth. These chemicals gradually tear down the teeth.
The first step to stop, and in some cases reverse, the decay process is to physically knock the bacteria off the teeth. Flossing and brushing are the best methods of removal. The second step is to starve the bacteria. By reducing the number of times you eat sugar, you will weaken the bacteria and reduce their number. The third step is to use fluoride, which strengthens the teeth and encourages the rehardening of the enamel softened by beginning tooth decay. Periodic cleanings and examinations are necessary to remove stubborn plaque and to find dental disease in its earliest stages.
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What about periodontal disease?
Periodontal or gum disease is also a bacterial disease and the methods of stopping it are the same as with tooth decay. They are good diet, proper hygiene and regular professional care.
The exact mechanisms for the initiation and progression of gum disease are not known. Recent research implicates the direct invasion of the tissues by anaerobic bacteria, which in a very complex way leads to the distruction of bone and gums.
We do know that when plaque is left on the teeth, the gums become inflamed. The plaque soon hardens to calculus (tartar), which further irritates the tissue surrounding the tooth. Eventually, the gum loosens and the bone shrinks away from the tooth. If left untreated, abscesses form and the teeth loosen and fall out.
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How do you protect me from communicable diseases?
Instruments are scrubbed, disinfected and autoclaved or they are thrown away. Our autoclave is routinely tested for effectiveness against resistant infectious agents. Environmental surfaces, handles, keyboards are either covered for each patient or disinfected with government approved solutions. Recommendations from the CDC, MIOSHA and ADA are met or exceeded. The staff is tested for hepatitis and HIV annually and are negative. In addition, dental instruments are seldom used directly in the mouth because of the rubber dam.
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The rubber dam is a thin sheet of rubber with holes. The holes are placed over the teeth on which we are working. The rubber dam is used in modern dentistry for numerous reasons. The three main reasons are:
SAFETY-QUALITY-COMFORT
SAFETY:
The rubber dam prevents materials from falling into your throat, prevents the infection of the tooth pulp by bacteria found in the saliva and reduces the risk of cross-infection.
QUALITY:
The rubber dam allows excellent visibility and access to difficult areas. Also, the dam prevents moisture from contaminating the materials used in the mouth. Moisture contamination often makes the materials ineffective or reduces their strength.
COMFORT:
You will be more comfortable because you don't have to worry about debris falling down you throat, the nasty taste of medications or your lip or tongue getting in the way.
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What precautions are taken concerning x-rays?
Our equipment is the best available. Properly shielded and colliminated x-ray tubes greatly reduce scatter. Electronic times allows only the prescribed dosage to be used. We use the fastest film available, reduce the number of films at each exam and do x-ray exams only when necessary. Using these methods we have reduced the amount of your exposure by 800% in the last few years. We have an advanced panoramic x-ray machine, which utilizes state of the art microchip controls and rare earth intensifying screens to reduce your exposure by at least 40 times the conventional full mouth survey.
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Is everyone on the same exam and cleaning schedule?
No, because everyone has different needs. Some people take excellent care of themselves and are seen only once a year. Others, despite their best efforts, accumulate plaque and calculus very easily and must be seen every three months. Most of us are in between. Regardless on the interval, each visit is planned with you in mind.
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My time is valuable. What do you do to save it?
You arrange a convenient appointment and we make every effort to run on time and to start your appointment when scheduled. We consolidate treatment to reduce the number of times you must come to the office. We try to schedule all family appointments at the same time.
On occasion we do run late. In these cases, it is because an emergency required prompt attention or a treatment took more time than planned. When this happens, we will try to let you know. Also, you can help us to stay on schedule by arriving for your appointment on time.
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If you do have an emergency dental problem, just call the office or my home at any time. If I am out of town, arrangements will have been made for a dentist to take you call.
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We ask that full payment be made when the service is completed. If you have insurance, we ask you pay your estimated co-payment when the service is rendered.
There may be certain procedures that your dental insurance policy does not cover. We will attempt to keep track of your coverage and keep you informed. Because there are many different kinds of insurance, we will not always be able to know your exact coverage.
It is your responsibility to understand your insurance.
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Yes. Any dentist who stresses prevention and provides high quality treatment constantly needs new patients. This is because patients who have been treated in the past rarely need more than routine maintenance care.
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Tell me about fillings. Is the tooth as good as new?
Whenever a tooth decays, the hole needs to be filled or else the decay eventually kills the pulp. A filling attempts to protect the pulp and restore the tooth to its original condition. Before the filling can be placed, the decay must be removed and the pulp protected by medicated and insulating layers beneath the final filling. Also, the way the tooth is prepared, the qualities of the filling materials and how large the filling is determine how long the filling will last.
The tooth is weaker because it lost some of its natural support. The filling material sits inside the tooth and the tooth supports it, not the other way around. Also the tooth can decay again if not kept clean. Usually when the area of decay is small, the filling does an excellent job of repairing the tooth. When the decay is larger or the tooth is fractured, the filled tooth is weakened and no longer fully functional.
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What is best if the tooth is weakened?
In these cases a crown or cap is required to fully protect the tooth from further breakdown. The crown covers the tooth and supports it, providing protection from fracture and restoring the tooth to full function.
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What is a root canal treatment?
Within each tooth root, the pulp occupies the holow area known as the root canal. Sometimes because of decay, fracture or other trauma, the pulp deteriorates. When this happens, it is necessary to remove the pulp, sterilize and fill the canals.
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The fixed bridge is a replacement for missing teeth. It is cemented onto carefully prepared teeth on either side of the missing teeth. This bridge is not removable. When properly done it is a very comfortable, good looking and long lasting method of tooth replacement.
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I've heard of sealants. What are they?
Pit and fissure sealants are a plastic coating which protect the biting surface of the tooth from decay. The grooves on the tooth biting surface are very likely to decay if not protected. We place the sealants on the permanent molars soon after the teeth come into the mouth.
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At what age should I begin caring for my child's teeth?
Before your child is born you should closely follow your physician's instruction. After the baby is born try to avoid giving sweetened liquids in the bottle and never put the baby to bed with a bottle containing anything other than water. When the child gets the first tooth keep it clean with a small brush or cloth. As the child gets older continue to supervise oral hygiene. At about 3 years old bring the child in for the first dental appointment. If you have questions before this age, please ask.
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Tell me something about Dr. Chiaravalli.
Dr. Chiaravalli was born and raised in Detroit and Southfield. He received both his B.S. and D.D.S. from the University of Michigan, graduating from dental school in 1972. He was married in 1970 and has two children. He is a fellow of both the American and International Colleges of Dentists. If you wish, a complete resume is available.
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