Dr. William L. Steinman

Changing lives one smile at a time!

 
     
 
 
 

 

Our Dental Services

Family Dentistry


Dental exams: We recommend a dental checkup every six months. At each visit x-rays may or may not be taken depending on whether it is an initial exam, patient has a chief complaint, new findings or we may be monitoring the progress of a situation. More radiographs will usually be taken at an initial exam than recall exams. Once we get to realize each patient's needs and tendency for breakdown we can do follow up x-rays accordingly. Some people are very cavity prone and need more frequent x-rays than the patient who never gets a cavity. At the exam we look for any soft tissue abnormalities, cavities, broken or missing teeth, impacted teeth, malocclusions, etc. Once a complete exam is done the patient is informed of our findings. A proposed treatment plan is given of the best dentistry available, alternative treatment modalities, the cost and time involved.

 

Cleanings: A professional dental cleaning is recommended for most patients every 6 months. At that time we remove all stains, plaque and calculus (tartar) that can cause inflamed gums, bleeding, bone loss and bad breath. Studies have shown a direct correlation between oral health and cardiovascular health. Some patients have a tendency for tartar buildup and staining and in some of these cases we are actually recommending a cleaning every 3 months. The main reason for these cleanings is to prevent periodontal disease, which left unchecked can lead to tooth loss. Periodontium refers to all the soft and hard tissue that hold the tooth firmly in place; ie gums, bone and ligaments attaching the roots to the surrounding bone. Although genetics does play a role local factors are the main culprit in periodontal breakdown. Everyone has plaque, that filmy white substance that coats the teeth. Calcified plaque is called calculus or tartar. In the plaque are millions of bacteria which release acidic toxins causing cavities and gum inflammation. At the earliest stages of periodontal disease the gums are red, swollen, tender and bleed easily. This is totally reversible with a good cleaning followed by proper home care which involves brushing and flossing. If left unchecked this gingivitis will progress to periodontitis. This involves bone loss to varying degrees resulting in pocketing. Pocketing is the difference between the gums and the underlying bone and is measured in millimeters. A normal reading is anywhere between 1-3 mms, 4 plus signifies some degree of disease. Regular cleanings eliminate plaque and tartar. Sometimes the pockets are not too severe and can be managed by frequent debridements: scaling, root planning and polishing. Sometimes the problems can only be eliminated surgically.

 

Dental Fillings: Most people are aware of what a cavity is all about. After doing a dental exam the most frequently asked question is "do I have any cavities?". A filling is an artificial replacement to replicate tooth structure lost by cavity or trauma. For smaller restorations we use composite resins that look exactly like the missing tooth structure. These materials are bonded to the remaining tooth to create a better seal and decrease sensitivity .For more extensive tooth loss we use crowns, veneers or CAD/Cam technology.

 

Bonding

We mention bonding a lot in many of our procedures. All white fillings, veneers, CEREC restorations and some crowns are bonded into place. This is in contrast to cementing crowns and onlays. In cementation placement we are relying on the retentive factors built into the restoration and the adhesive properties of the cement. With bonding we are relying on a chemical adhesion of restoration to the underlying tooth structure. The tooth structure is treated with a mild acid which create a chalky surface. An application of a liquidy unfilled resin then soaks into these microscopic porosities to which a thicker quartz filled resin easily adheres.

 

Crowning

Crowns; A crown (cap) is a restoration that completely surrounds and protects a tooth. It is used when there is an extensive filling, tooth fractures, on top of an implant, for esthetics, following a root canal procedure or to anchor a fixed bridge. A bridge is a tooth replacement where teeth adjacent to a missing tooth are covered by crowns with a replacement soldered in between. The cover is porcelain and looks exactly like the tooth or teeth being replaced. It is an indirect technique. The tooth is prepared by a dentist, an impression taken and sent to a commercial dental laboratory for crown fabrication. A temporary crown is placed by the dentist at the first appointment. At the second appointment the new crown is inserted. Some crowns or partial crowns can be done in one appointment using CAD/CAM technology.

 

Cerec Restoration

CEREC; CAD/CAM technology. Stands for Chairside Economical Restoration of Esthetic Ceramics. With this technology we can offer an indirect tooth restoration such as full crowns, ¾ crowns, onlays and inlays made of solid porcelain, all in one appointment. Most indirect restorations involve more than one visit. On the first session you get a local anaesthetic, your tooth is prepared, an impression taken and a temporary restoration placed in your mouth. At the second appointment the patient is again frozen and the permanent restoration is cemented in place. With Cerec there are no more multiple appointments, goopy impressions, lost work. Cerec materials match the physical properties of natural tooth. They also contract and expand at rates similar to tooth structure. Also the materials are chemically bonded to your teeth allowing for much healthy tooth structure to be saved. A digital image is taken of the tooth and adjacent teeth. It appears on screen, highly magnified. The computer gives a proposed restoration which can then be modified using various software tools to meet specific demands. Once we are satisfied with the result a signal is sent to a milling machine which then carves the restoration out of a block of porcelain selected to match the tooth colour. Bonding techniques are then used to secure the new restoration to the remaining tooth structure to give an almost invisible result. Patients enthusiastically get involved in the process of designing their own tooth on the big screen. Patients ask me routinely which old amalgam filling can we do next. You will be amazed! I do not know how any dentist can offer their patients full service without CEREC capability in their office. I personally could not practice without it.

 

Dental Implants

Implants are artificial roots to support a crown, a fixed bridge or an overlying denture. They are made of titanium. After placement several months are required for the implants to fuse with the surrounding bone (osseointegration). After this waiting period the new roots are able to support a restoration.