Services | Williams Dental

Gum…Disease?

Everyone knows to brush their teeth twice a day, but many people forget about their gums! The word disease sounds scary—and it can be if you don’t take care of your gums. Here is some information about what gum disease is, what causes it, and how you can prevent it.

What is periodontal (gum)disease?

Periodontal means “around the tooth.” Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth. Periodontal disease
can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed. Gingivitis is the mildest form of the disease. In this stage, the gums redden, swell, and bleed easily. There is usually little or no discomfort.

What causes gum disease?

As mentioned, plaque is recognized as the primary cause of gum disease. If plaque isn’t removed each day by brushing and flossing, it hardens into a rough, porous substance called calculus (also known as tartar). Toxins produced and released by bacteria in plaque irritate the gums. These toxins cause the breakdown of the fibers that hold the gums tightly to the teeth, creating periodontal pockets that fill with even more toxins and bacteria. As the disease progresses, pockets become deeper, and the bacteria move down until the bone that holds the tooth in place is destroyed. Eventually, severe infection may develop with pain and swelling. The tooth may loosen and later require removal. There are other factors, too. Smokers and tobacco users are at a higher risk of developing gum disease. Changing hormone
levels in pubescent teenagers and women who are pregnant also can increase the risk of gum disease. Stress, clenching or grinding your teeth, an unhealthy diet, and diabetes can increase your chances of developing gum disease as well. And, in some cases, it’s in your genes—nearly 30 percent of the human population is genetically predisposed to gum disease.

Read Periodontal Disease Factsheet

Read Periodontal And Cardiovascular Factsheet

Read Periodontal and Diabetes Factsheet

Removable Dentures are a replacement for missing teeth and their supporting tissues. Complete Dentures replace an entire arch of missing teeth, and a Partial Denture replaces some missing teeth and is anchored by healthy teeth remaining. Complete dentures may be “immediate” or “conventional”. An immediate denture is placed directly after the existing teeth have been removed. A conventional denture is fabricated weeks after healing takes placed following tooth removal.

Over the past decade, denture fabrication at our office has become an alternative care option to the placement of dental implants, which when restored, more closely replace the function, appearance and phonetics of the natural dentition. However, not everyone is a candidate for implant therapy, so please talk to our Doctors and staff to determine which treatment option may be best for you.

Teeth Whitening, or Bleaching, is a popular way to lighten your teeth and is one of the many cosmetic procedures we offer at Williams-Dental to help you achieve a brighter smile. Discoloration of the enamel of teeth can be caused by a variety of factors, including but not limited to coffee, tea, wine, some medications, and cigarette use. Today, there are many options available for whitening your teeth, including many over the counter products. Over the counter may seem less expensive, but keep in mind that these products may also be less effective for some individuals, as the concentration of bleach that is offered over the counter is less than what a licensed dental professional is authorized to use in office. Also keep in mind that Whitening is an irreversible procedure that can be harmful to your teeth if not practiced properly or under supervision of a licensed dental professional. It is very common for whitening to cause sensitivity in teeth, but we do have ways to help you manage this. Moreover, not everyone’s tooth structure is the same, and some may find that whitening procedures are not very effective for them. This may not be a fault of the product. People with translucency in their dentition, and those with “grayish” type stain or teeth color will generally not achieve the stunning results that someone with more opaque, yellowish stained teeth will. For these reasons and more, we recommend that you always consult with a licensed dental professional before undertaking any bleaching procedure on your teeth, whether it be over the counter or in office. You should always consult our office.

At Williams- Dental, we strive to preserve your natural smile. Unfortunately, circumstances might require a tooth or teeth to be extracted to help maintain your oral and overall health. If this is a situation you may be facing, know that we do our best to make the process as pain free as possible.

Teeth require extraction when they are damaged or diseased beyond repair, for orthodontic reasons to aid the Orthodontist in moving teeth to achieve the desired cosmetic result, or sometimes when a baby tooth just doesn’t want to come out on it’s own. Patients with periodontal disease often require removal of loose teeth, as the gum disease process also destroys the bony foundation of the teeth. Impacted teeth may also require extraction to help prevent decay, disease and or cyst formation.

Tooth extractions are a common form of oral surgery, and are relatively low risk. However, it is still a surgery with the potential to cause infection and other complications. Therefore, it is important that you disclose all of your medical and dental history to the doctor and provide a complete list of medications you are taking and have been prescribed (including supplements!). This will allow the doctor to tailor a pre and post operative treatment plan to best fit your needs.

It is also important to closely follow all post-operative care instructions carefully and diligently to ensure a safe and hopefully pain-less outcome. If antibiotics are prescribed, they must be taken as directed and until all medication is finished to help prevent bacterial resistance to the medication. Likewise, any pain medications prescribed or taken over the counter, must also be taken as directed. Most routine dental procedures, including extractions, do not require more than 3 days of pain medication use. Keeping the extraction site clean is also very important. It is recommended to avoid smoking or drinking through a straw for the first 24-48 hours post extraction. If any abnormal symptoms arise, such as severe pain, infection, swelling, nausea, vomiting, you must contact us immediately.

Replacing a missing tooth, or teeth, with either implants, bridges or dentures may be possible depending on the individuals situation. Talk to us to learn about all your options.

What is a root canal?
Each visible portion of a tooth is supported by a single or multiple roots that are embedded in the jawbone. Within each root is a canal that allows blood, nerve
and lymph systems to sustain the cells that reside in the connective tissue of the dental pulp. The pulp is in a small chamber in the middle of the crown of the tooth.

Why might I need treatment?
If the pulp becomes inflamed due to irritation, infection or a fracture of the tooth, the pulp cells may become damaged, leading to pulp tissue death. The body’s defense systems become activated which leads to pressure inside the chamber, resulting in tooth pain. Changes in temperature, biting down and chewing may cause increase pain. Without treatment, the tooth would continue to degenerate, fall apart and an infection could spread to the surrounding bone.

What is root canal therapy?
Root canal therapy is a procedure that removes the damaged or dead pulp. The canal system is cleaned, shaped and filled with a root canal filing, gutta percha, to prevent re-contamination of the canals. The chamber and crown of the tooth is then sealed. More than 90% of root canal therapies are successful.

Continued care after treatment
Once the root canal is completed a ceramic or metal crown is placed over the tooth to strengthen the tooth structure and improve its appearance.

Treatment Alternatives to root canal therapy
The only alternative to root canal treatment is to extract the tooth. Having a missing tooth though, can result in shifting teeth which will lead to a bad bite. The empty space will require an implant/crown or a bridge, both of which could be more costly than root canal therapy.

Read Root Canal Therapy Factsheet

Like other aspects of our bodies, our teeth are subject to a whole lot of wear and tear throughout our lives. Everything from stress to athletic collisions can lead to damage in our teeth. One way to protect teeth from these events is to wear a mouth guard.

Custom fit mouth guards can be fabricated at Williams Dental not only for people suffering from Bruxism (clenching and grinding of teeth) and TMD (Tempromandibular Joint Disorder), but also for athletes participating in impact sports.

Read Bruxism Factsheet

Occlusal Guards/Nightguards:

Mouthguards that are fabricated to help prevent damage to teeth from effects of Bruxism, or clenching and grinding, are also called Occlusal guards or Night guards. The term “Night-guard” is really a misnomer, as you can really wear these devices during day or night. Most people tend to wear them at night, as wearing of the appliance can make it difficult to speak or chew. Bruxism is the technical term for clenching and grinding of teeth. Some people could be classified as “clenchers” and some could be classified as “grinders”, or a combination of both. In any event, most people are unaware that they clench or grind their teeth. But we as dentists can tell just by looking at your teeth, as the damage caused by these conditions can be clearly evident on the structure of the teeth (picture of wear) Bruxism can also lead to symptoms of sore jaw, muscles and headaches. The pain from these symptoms can be debilitating if left untreated.

By the way- if you really want to look smart with you friends, the next time someone tells you they have “TMJ”, you can tell them that everyone does! The TMJ or tempromandibular joint is the anatomical joint of the jaw- and every human has it. TMD or Tempromandibular Joint DISORDER is the classification of someone with jaw joint pain and problems.
More recently, Bruxism has also been classified as one of the precursor symptoms of Sleep Apnea sufferers. Studies show that nocturnal Bruxism, clenching or grinding your teeth, may be the body’s response in trying to open the airway during sleep. This also might be true in children who clench/grind their teeth. Please ask us more about this at your next visit.

Athletic Mouthguards

An athletic mouthguard is a flexible appliance worn during sports and other recreational activities. It is used to help prevent injuries to the face and mouth, such as broken teeth, split lips, jaw fractures and even concussions, cerebral hemorrhages and neck/spinal injuries.
We highly recommend wearing a mouthguard any time there is a the potential for physical contact in sports, either with other players or hard surfaces. Many sports such as football, basketball, baseball/softball, soccer, wrestling, lacrosse, rugby, hockey, skateboarding, martial arts- just to name a few, require participants to wear Mouthguards.

There are several different options when choosing a mouthguard. Least expensive are stock Mouthguards, but these are usually very bulky and do not fit very well. As a result, most people who have them don’t end up using them, having difficulty speaking and breathing. They are also the least acceptable forms of facial protection.

Mouldable, mouth formed guards- typically called “boil and bite” are another type of mouthguard option. Provides better protection, since it is somewhat more custom fit, but can also be bulky and hard to wear. The best option is a custom made mouthguard that we can make for you here in the office. This guard is made from a mould of your teeth. Patients who have them made report that they wear their guards faithfully, as they fit well and are easier to speak and breath around

Read Mouthguard Factsheet

We treat patients of all ages and encourage you to bring your entire family, including the kids!

According to the The American Academy of Pediatric Dentistry, the recommended age to start bringing children to the dentist is when the first baby tooth comes into the mouth, and no later than his/her first birthday. This first visit with us may just involve an exam to assess for any major problems, and will help your child become familiar with the environment so it is not so scary for them. Learning dental care at an early age is essential to a long life of healthy teeth and a healthy smile.

Read Pediatric Factsheet

Loss of a tooth can be an overwhelming and devastating process. Besides the concerns of how your smile will be effected cosmetically by a missing tooth, or multiple teeth, there is also risk posed to the function and health of not only the rest of your mouth, but the entire body as well. Fortunately, we live in an age where dental implants are an option for replacing a missing tooth or teeth.

At Williams-Dental, we are able to offer a full range of state of the art implant services, including implant placement. Dr. Erika Williams is on staff and a member of the implant teaching faculty at Christiana Care/Wilmington Hospital’s Residency Clinic

What is a dental implant?
A dental implant is a titanium post surgically placed in the jawbone to mimic a natural tooth root. The surgical grade titanium found in dental implants is the same as that used in other surgical procedures in the body, such as total joint replacement. This titanium post fuses with the surrounding natural bone of the jaw in a process called osseointegration. This allows for a sturdy foundation for a replacement tooth. Implants can be used to replace a single tooth, or multiple missing teeth with either a bridge or denture supported by implants.

Who is a candidate for implants?
Most people who have lost or are missing teeth can receive dental implants. If you can’t wear conventional dentures or find them difficult to keep in your mouth, or if you just don’t want to sacrifice healthy existing tooth structure to support a bridge, you may be an excellent candidate for implants. Implant placement does require minor surgery, so patients must be in good general health to receive them.

Adequate bone structure and healthy gum tissues are essential to success of implant therapy. However, if either of these are lacking, we may be able to perform procedures to gain bone and tissue. Patients who have chronic health conditions, like uncontrolled diabetes, those who take immune modifying drugs- such as bisphosphonates (Boniva, Prolia etc) for osteoporosis, or who have cancer may have trouble with healing and thus success of implants may be in question.

Patients who smoke or drink alcohol in excess, or are heavy bruxers may also have decreased success of implant therapy. We will take into consideration all factors of your medical and dental history to decide whether implants are a good treatment option for you.

Why should I replace any missing teeth?
Having a missing tooth or teeth can certainly effect your smile and self-esteem. Many people who lose teeth report depression and a negative impact on their quality of life. Moreover, there are also devestating physical effects to the mouth and body that can result from tooth loss. Once a tooth, or teeth, are lost the surrounding teeth start to shift and drift into the missing tooth spaces, putting additional pressure on the remaining teeth which can lead to bite changes, jaw problems, and additional tooth fracture and loss. It’s like a domino effect. Additionally, the bone that surrounds the teeth starts to atrophy, which can lead to collapse of facial features over time, also effecting your looks and self esteem. If a tooth or teeth are not replaced in a timely fashion, further bone loss can occur, possibly precluding that individual from having implants in the future.
Food consumption may also be effected by tooth loss. When food cannot be chewed properly, people tend to rely on a softer diet full of processed food that is poor in nutrition which can in turn lead to more serious oral and systemic health problems and disease.

How long does implant process take?
While each patient’s needs and treatment plan may vary, in general, implant therapy may take several months. The implant surgery/placement may take an hour or two. Once the implant is placed, it requires a 4-6 month healing period. After the implant has integrated, the restorative process of putting a tooth on the implant, can take 2-3 visits over several weeks. In some instances, we can make you a temporary tooth replacement to function cosmetically as well as allowing you to eat and speak normally until the permanent restoration can be placed.

How do I care for implants?
The success or failure of implants depends on a number of factors, including the patient’s oral and overall health. Poor oral hygiene can be a significant cause of implant failure. Therefore, it is extremely important to protect your investment in dental implants, as well as the rest of your teeth, by practicing excellent oral hygiene at home- brushing and flossing, and use of aids such as a Water Pik. Regular visits in the dental office are also keys, and more frequent professional cleanings may be necessary.

Implants are too expensive! I don’t think I can afford them
Most people would be surprised at just how affordable implant therapy can be. It also could be more cost effective in the long term, taking into account costs of having to replace other types of restorations over and over again. Implant therapy may be more expensive in short term compared with other therapy options
We have many payment options and solutions to help you afford the treatment you want and need.
Look at dental treatment as an investment in YOU and your quality of life.

At Williams Dental, we believe in utilizing the latest technology to ensure that implants are placed in the best position in the jaw to support the tooth restoration. One way we accomplish this is by having our implant patients seen for a 3 D scan, called a CBCT, which allows us to plan the implant placement in 3 Dimension with respect to sinuses, nerves and other teeth. In using this technology, we can ensure the best possible outcome for your particular treatment.

Read Dental Implant Factsheet

A crown is a type of dental restoration that covers or “caps” a tooth (or teeth) to restore it to normal shape, size and function. It helps to strengthen and improve the appearance of the tooth after destruction from decay or fracture. Crowns are also the standard of care restoration after a tooth has received root canal treatment. Crowns are often necessary when a tooth has been damaged significantly and cannot be adequately restored with a filling. A crown can protect a weak tooth from fracturing, help prevent a cracked tooth from further damage, and can also help cover discolored or mis-shapen teeth for a nicer looking smile.

Depending on the individual situation, a separate procedure called a core build up may be required in addition to the crown procedure. A core build-up is a strong type of filling material used to first “build-up” the tooth when it is severely decayed, fractured and lacks sufficient structure to support the crown.

Numerous factors are considered when determining the type of crown material that is best for your situation, including but not limited to color, bite, shape, space and location of the tooth in your mouth. For most cases, we are able to place all porcelain crowns for a natural looking restoration. This is possible with the help of modern technologies and materials we have implemented in our office, such as the CEREC system, which allows us to fabricate a crown in one visit!

Read About the CEREC^® system

Fillings help restore teeth damaged by decay back to their normal function. At Williams Dental, we consider a number of factors when choosing which type of filling material is best for you. These factors include the extent of the repair, where in your mouth the filling is needed and the cost. As with any form of restorative dentistry, fillings do not last forever. Depending on the situation and the patient, some fillings will require replacement over time and may require an upgrade to a different type of restoration, such as a crown, in the future.

What is a Filling?
A filling is a way to restore a tooth damaged by decay back to its normal function and shape. When a filling procedure is performed, the first step is removal of the decayed tooth material, the tooth preparation is cleaned, and then the cleaned out cavity prep is “filled” with a filling material.
By closing off spaces where bacteria can enter, a filling also helps prevent further decay. Materials used for fillings include composite resin (tooth-colored fillings), amalgam (an alloy of mercury, silver, copper, tin and sometimes zinc), porcelain and, more rare these days, gold.

Which Type of Filling is Best?

No one type of filling is best for everyone. What’s right for you will be determined by the extent of the repair, whether you have allergies to certain materials, where in your mouth the filling is needed, and the cost. Considerations for different materials include:

Gold fillings are made to order in a laboratory and then cemented into place. Gold inlays are well tolerated by gum tissues, and may last more than 20 years. For these reasons, many authorities consider gold the best filling material. However, it is often the most expensive choice and requires multiple visits.
Amalgam (silver) fillings are resistant to wear and relatively inexpensive. However, due to their dark color, they are more noticeable than porcelain or composite restorations and are not usually used in very visible areas, such as front teeth. Amalgam fillings generally can last a long time, but they can also lead to cracks in the surrounding tooth structure over time.
Composite (plastic) resins are matched to be the same color as your teeth and therefore used where a natural appearance is desired. The ingredients are mixed and placed directly into the cavity, where they harden. Composites may not be the ideal material for large fillings as they may chip or wear over time. They can also become stained from coffee, tea or tobacco, and do not last as long as other types of fillings generally from 3 to 10 years, depending on the individual patient and situation.
Porcelain fillings are called inlays or onlays. They can be made to order from a lab, or produced in office with our CEREC system and then bonded to the tooth. They can be matched to the color of the tooth and resist staining. A porcelain restoration generally covers most of the tooth.
If decay or a fracture has damaged a large portion of the tooth, a crown, or cap, may be recommended. Decay that has reached the nerve may be treated in two ways: through root canal therapy (in which nerve damaged nerve is removed) or through a procedure called pulp capping (which attempts to keep the nerve alive).

How Do I Know if I Need a Filling?

Only a dentist can detect whether you have a cavity that needs to be filled. During a checkup, we will examine your teeth thoroughly. Anything that looks abnormal will then be closely checked with special instruments. We may also take X-rays of your entire mouth or a section of it, depending on the situation. Very often, decay, especially between teeth, is undetectable without xrays. The type of treatment we recommend will depend on the extent of damage caused by decay.

At Williams-Dental, we believe in maintaining our patient’s oral and overall systemic health

We all have bacteria that can live in our mouths in the form of plaque, which if not removed regularly can cause cavities and gingivitis, which in turn can lead to periodontal (gum) disease. Studies have shown that gum disease that is left untreated can lead to other more serious systemic (total body) health problems.

In order to keep your mouth clean and healthy, you must practice good oral hygiene every day. However, cleaning your teeth with daily brushing and flossing at home is not enough to remove all of the plaque and calculus (hardened plaque) that forms.

A regular professional cleaning is necessary in order to maintain oral and overall health. If you are a new patient to the practice, we recommend seeing the doctor first to determine what type of cleaning is best for you. Patient’s who have gum disease require more in depth treatment that just a simple scale and polish, and often will require more frequent visits than every 6 months.

Your preventive cleaning appointment includes an intra-oral examination, oral cancer screening, X-rays, periodontal probing (measurements around the base of the tooth to check for signs of gum disease), cleaning with the cavitron and/or scaling instruments, polish, home-care recommendations, and an exam with the dentist. This appointment takes approximately 1 hour and should be completed every 6 months for patients that do not have gum disease or a history of gum disease. It is important to stay on your recommended schedule with this appointment in order to prevent new or worsening disease. The cleaning appointment also provides us the opportunity to check for any other problems that might be present (cavities, infection, oral cancer, etc) and allows us to ensure that your homecare routine is optimal for your needs. Problems diagnosed early are often easier and less expensive to treat.

Read Oral health Factsheet

Our Services Include:

regular dental check-ups and cleanings; restorative dentistry; state the art cosmetic procedures such as ceramic crowns in one visit, veneers and bleaching; surgical implant placement and restorations; pediatric dentistry and endodontics.

In addition to a very caring and gentle chair-side manner, Dr.’s David and Erika Williams offer services such as nitrous-oxide oxygen analgesia for anxious patients.

Our Range of Services

Preventative

Fillings

Crowns & Bridges

Implants

Pediatric

Mouthguards

Root Canal Therapy

Extractions

Whitening

Dentures

Periodontics

At Williams- Dental, we strive to preserve your natural smile.

We are committed to our practice philosophy of providing uncompromising quality and individual professional care, resulting in optimum oral health and beautiful smiles for our patients.

CEREC Crowns, Inlays, Onlays, Multiple Restorations, and Veneers

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