The first way we can help you is through education. We want you to completely understand both the basics of the care we are providing to you, and how you can maintain your dental health at home. The staff of well educated dental hygienists will spend as much time as necessary helping you learn to effectively use home dental care products to maintain your smile. Aside from tooth brushes, toothpaste and floss, there are many other devices now available to the dental consumer. If you are having difficulty using what you have, we probably have an alternative for you to try. We also want you to know the status of your dental health. On every visit the hygienist or Doctor Ostroth (usually both!) carefully look at every tooth in your mouth, looking for decay, worn out or discolored restorations, periodontal disease and other irregularities. After carefully examining your smile Dr. Ostroth will inform you of everything he sees. If there are areas that Dr. Ostroth feel require attention we can use digital imaging technology to enlarge them and show them to you on a high resolution monitor. The enlarged images both help us explain to you why treatment is sometimes necessary to prevent further dental problems, and they often help us detect problems while they are still small and easily treated.

The second way we help you prevent dental problems is with individually scheduled dental prevention visit intervals. You are an individual with individual needs. The old fashioned "cookie cutter" approach, that is: "see your dentist twice a year" has been shown to be inappropriate for most adults. Although many adults have excellent periodontal (gum) and dental health thereby keeping their teeth longer than ever before, studies have indicated, and our experience has shown us, that most adults over thirty years of age have some form of gum disease. Periodontitis is the number one cause of tooth loss in the United States today. People with any form of gum disease, ranging from "a little bleeding when I brush" (gingivitis), to severe bone loss and the loosening of teeth, require more frequent professional cleaning and monitoring.

The third way we prevent dental problems is through the controlled use of fluoride. Dr. Ostroth recommends in office, TOPICAL fluoride treatments twice a year for most of our patients who are under the age of 18 and TOPICAL fluoride treatments for our adult patients annually.

Patients receive fluoride in two ways. The first way we get our fluoride is SYSTEMICALLY. Systemic fluoride comes to us in our water, (even well water often has naturally occurring fluoride) in some foods, (green leafy vegetables, namely broccoli, are high in fluoride) and some prescription pediatric vitamins are fortified with fluoride. Systemic fluoride has been shown to reduce dental caries (cavities) by making teeth more resistant to decay causing acids in the oral cavity. Systemic fluoride has also been demonstrated to make the deep grooves that develop in most "back" teeth smaller, and less deep.

Shallow, smaller grooves make the teeth less prone to decay, and easier to keep clean. Generally in homes with city water, most patients get plenty of systemic fluoride and do not require supplements. Patients living with well water should get their water tested before fluoride supplements can be considered. Too much SYSTEMIC fluoride can permanently damage adult teeth before they even erupt, by making white spots, or even unsightly brown spots on the adult teeth.

TOPICAL fluoride is applied to the surface of the teeth. We receive topical fluoride in a number of ways also. The first way most of us receive topical fluoride is by brushing our teeth with commercially available toothpastes. Practically all "brand name" toothpastes and dentifrices have some sort of fluoride in them. There are also fluoride rinses and gels, both by a dentist's prescription, and over the counter. Dr. Ostroth may recommend either one, depending on the individual patient's needs.

Another way we receive TOPICAL fluoride is through professional application at the time of our regular dental visits. It was once thought that only children needed the extra cavity protection given by in office fluoride treatments. But in office fluoride treatments are now known to provide the following benefits to adults and children alike:

1. The reduction of smooth surface cavities. Most kids are cavity prone due to diet, the lack of dexterity to keep things clean, and a lack of understanding on how important dental health is to their overall health. Adults however get cavities too.
2. When young people wear orthodontic appliances they often have a difficult time keeping them clean. Fluoride helps prevent decalcification around cemented on brackets and bands, making the teeth look better when the braces are off, and preventing permanent damage to the tooth surfaces
3. The reduction of root caries. Root caries (cavities on the roots of teeth) are becoming a problem as our population ages and keeps their teeth longer. As gums recede from abrasion, bruxism, periodontal disease or other factors, the roots of the teeth often become exposed. The dentin of the tooth (what roots are made of) is softer than enamel and is far more prone to cavities. Professional topical fluoride treatments can help prevent these, sometimes painful, cavities.
4. The reduction of sensitivity. Fluoride can remineralize exposed root surfaces and provide protection against the sensitivity that many adults have to cold beverages and foods.
5. The reduction of caries (cavities) under expensive, sometimes difficult to clean dental restorations. The main reason crown and bridge work fails is because of decay under the margins (edges) of the restoration. Topical fluoride is a small investment in maintaining and preserving the investment many of us have in our dental restorations.

Pit and fissure sealants are the fourth way Dr.Ostroth prevents dental disease for you and your family. A sealant is a white plastic material that is applied to the chewing surfaces of the back teeth where decay most often occurs. When teeth are developing depressions and grooves form in the chewing surfaces. These features are called "pits and fissures" Because they are narrow, and deep, they are impossible to keep clean. In the photo you see the highly magnified end of a tooth brush bristle trying to clean the depths of a fissure. Sealants are a plastic coating that closes off those deep pits and fissures before bacteria has a chance to colonize and decay the teeth from the inside.

Unsealed	Sealed	Etched
Sealants are applied in four steps. First the tooth is cleaned with a powered brush and mild abrasive to scour any plaque off the surface.	Then a special laser cavity scanner is applied to the area being sealed. The dye is designed to adhere to any tooth structure that is even microscopically decayed. Sealants cannot be applied over dental decay. If the tooth has a very tiny amount of decay, Dr. Ostroth can remove it with a special diamond and the sealant can still be applied. If the decay is more extensive, then a conventional restoration will need to be done.	When the tooth is shown to be free of decay, a special etchant is applied for a minute to condition the surface of the tooth to accept the sealant material. After the tooth is etched, the white plastic sealant material is applied, and immediately cured with a very intense light. After a few seconds under the curing light the sealant is fully cured and the procedure is complete.