A bridge (or partial denture) is a custom-made replacement for one or more missing teeth that literally "bridges the gap." Artificial teeth are attached to gum-colored plastic bases. The bases are attached to a framework supported by abutments. There are two types of bridges: removable and fixed. Both can be constructed from gold alloys, non-precious alloys, porcelain, or a combination of materials. Porcelain bridges are often bonded to precious or non-precious metal. With proper care, the life of a bridge is 10-20 years. Typically, two office visits are required to prepare, complete, and fit a permanent bridge.
Warning Signs
Visit your Dentist if you have one or more missing teeth and experience any of these symptoms: A noticeable difference in your ability to speak or chew; A change in the shape of your face or the self-confidence of your smile. Left untreated, missing teeth will: Produce an unstable bite and dental stress that can damage teeth and gums or cause headaches; Increase your risk for periodontal disease and tooth decay.
When Prescribed
A bridge is often prescribed: When one or more teeth are missing and there are healthy teeth on both sides of the gap; As part of a dental restoration plan after the removal of damaged, decayed, or broken teeth.
Patient Experience
After a thorough exam of your teeth, gums and supporting bone structure, your Dentist will discuss treatment options and answer your questions. If the agreed-upon treatment is a dental bridge, here's what to expect: A local anesthetic is applied so your Dentist can prepare the abutments. If an abutment tooth is decayed or broken, your Dentist may first need to rebuild and protect it with a crown; A putty-like material is used to make an impression of your prepared teeth. Your bridge will be fabricated for a precise fit based on this impression; To protect your teeth and gums until your permanent bridge is ready, your Dentist will fit you with a temporary bridge; During a second office visit, your Dentist will fit and attach your permanent bridge.
Bridge Types
Whether removable or fixed, a bridge is anchored in place by abutments.
Removable Bridge
A removable bridge is detached by its wearer for daily cleaning and at bedtime. It is prescribed when: Teeth adjacent to the gap are weak; There are multiple missing teeth; There are no posterior teeth to provide an anchor for the bridge.
Fixed Bridge
A fixed bridge provides greater stability than a removable bridge because it is permanently anchored to abutments by use of bonding or a crown. Only a Dentist or Specialist can remove it. Fixed bridges must be cleaned daily using dental floss and a specially made aid.
Cerec One-visit Crowns
The best porcelain tooth restoration available today! CERECĀ® is the world's most advanced system for the fabrication of all-ceramic dental restorations in one office visit. With CERECĀ®, Dr. Freeman can complete your permanent, all-ceramic crown, onlay, or veneer in just one quick visit! This means fewer shots, less drilling, and less time out of your hectic schedule for dental care.
Single Appointment Dental Care
Most dental crowns or "caps" require more than one visit to the dentist. This means that on the first visit, you get an injection of anesthesia, your tooth prepared, an impression taken and a temporary restoration put on your tooth. You make a second appointment for a couple of weeks later, get another injection, have the temporary pried off and have a permanent restoration bonded to the tooth. With CERECĀ®, Dr. Freeman performs the entire procedure in just a single appointment from start to finish. No impressions, no temps - just beautiful, tooth colored restorations in one visit!
Advanced Dental Materials
Many years ago, dentists had few options to repair decayed and damaged teeth other than amalgam, gold, and other metals. With CERECĀ®, Dr. Freeman can use strong, tooth colored ceramic to restore your teeth to their natural strength, beauty and function. These materials closely match the composition of natural tooth structure. This means when you eat hot food and then drink something cold, the restoration and tooth expand and contract at almost equal rates, reducing the likelihood of fractures. The restoration is also chemically bonded to your tooth, resulting in a stronger, healthier tooth.
What is CEREC?
CEREC is a technology for restoring damaged teeth, and this restoration can be completed in a single visit to the doctor's office. It makes your teeth stronger and more beautiful - all while keeping your teeth looking natural. The restoration is metal-free and the high-grade ceramic material is compatible with the natural tissue found in your mouth.
The CEREC Process
First, your doctor will meet with you to discuss the details of the procedure. During the procedure, the doctor will apply a thin layer of reflective powder onto your tooth and will use a special camera to take a photo of your tooth. Using Computer Aided Design, the photo serves as a "map" to design your tooth's restoration. Then, CEREC will use a diamond bur and disk-work to create your restoration piece out of ceramic. Finally, the ceramic restoration is bonded to your tooth using state-of-the-art adhesive dentistry. Learn more about CEREC on their web site at www.cereconline.com.
Advantages
Single-visit convenience
No temporaries
No gooey impressions to take
Hi-tech accuracy
Natural, tooth-colored restoration
Biocompatible, anti-abrasive and plaque resistant ceramic materials
Metal free - no silver-colored fillings
Preserves more healthy tooth material
Extremely precise for long-lasting, natural results
Cosmetic Dentistry
Your smile is one of the most important aspects of your appearance. With the advent of new cosmetic dental treatments, a stunning, memorable smile is now easily within your reach!
Are you ready for a Smile Makeover?
Our office can help you achieve your smile goals.Cosmetic dentistry isart and science working seamlessly together to offer smile enhancement, restoration, and maintenance for your optimal dental health. Using cutting-edge techniques and advanced materials, our office proudly offers you a beautiful, natural smile and all the benefits that come with it. You will look and feel better because a beautiful smile is a healthy smile.You no longer have to suffer missing, chipped, discolored, or crooked teeth. Invisalign takes a modern approach to straightening teeth, using a custom-made series of aligners created for you and only you. These aligner trays are made of smooth, comfortable and virtually invisible plastic that you simply wear over your teeth. Wearing the aligners will gradually and gently shift your teeth into place, based on the exact movements your dentist or orthodontist plans out for you. There are no metal brackets to attach and no wires to tighten. You simply pop in a new set of aligners approximately every two weeks, until your treatment is complete and you achieve the confident smile that you've always wanted. The best part about the whole process is that most people won't even know you're straightening your teeth.
Veneers
There's no reason to put up with gaps in your teeth or with teeth that are stained, discolored, badly shaped, chipped, or crooked. Today, a veneer placed on top of your teeth can correct nature's mistake or the results of an injury and help you have a beautiful smile. Veneers are a highly popular solution among dental patients because of their life-like tooth appearance. Veneers are thin, custom-made shells crafted of tooth-colored materials (such as porcelain) designed to cover the front side of your teeth. To prepare for veneers, your doctor will create a unique model of your teeth. This model is sent to the dental technician to create your veneers. Before placing your new veneer, your doctor will remove a small amount of your tooth to make room for the veneer. When placed, you'll be pleased to see that veneers look like your natural teeth and even resist staining. Though veneers are stain resistant, your doctor may recommend that you avoid coffee, tea, red wine, and tobacco to maintain the beauty of your veneer.
Dental Implants
If you have missing teeth, it is crucial to replace them. Without all your teeth, chewing and eating can destabilize your bite and cause you discomfort. When teeth are missing, your mouth can shift and even cause your face to look older. Implants are a great way to replace your missing teeth. An implant is a new tooth made of steel and porcelain that looks just like your natural tooth.Your implant is composed of two parts that mimic a tooth's root and crown. The implant's "root" is a titanium steel rod placed into the jaw bone to act as a root. Once the rod is in place, a porcelain crown is attached to replace the top part of your tooth.Implants may also be used to anchor dentures, especially lower dentures that tend to shift when you talk or chew. Plus, for patients with removable partial dentures, implants can replace missing teeth so that you have a more natural-looking smile.
Teeth Whitening
Everybody loves a bright white smile, and there are a variety of products and procedures available to help you improve the look of yours. Schedule a visit with your dentist to learn whether whitening procedures would be effective for you. Whiteners do not correct all types of discoloration. For example, yellowish teeth will probably bleach well, brownish teeth may bleach less well, and grayish teeth may not bleach well at all. Likewise, whitening may not enhance your smile if you have had tooth-colored fillings or crowns. Dr. Freeman provides the following tooth whitening treatments. Professional Teeth Whitening: Professional teeth whitening by your doctor is your best choice when you need immediate whitening results. This procedure is called chair-side bleaching and may require more than one office visit. Each visit may take from sixty to ninety minutes. The treatment is safe, simple, pain-free and relaxing! At-Home Whitening System: There are several types of products available for use at home which can either be dispensed by your doctor or purchased over the counter. They are generally teeth whitening trays (mouthguards), strips, or paint-on products. Whitening Toothpaste: All toothpastes help remove surface stain from your teeth through the action of mild abrasives. "Whitening" toothpastes in the ADA Seal of Acceptance program have special chemical or polishing agents that provide additional stain removal effectiveness. Unlike bleaches, these ADA Accepted products do not alter the intrinsic color of teeth. To find a treatment that works for you, contact us today to schedule your Smile Makeover!
Crowns
Overview
A dental crown restores a tooth's shape, size, and strength. It fully encases the visible portion of your tooth or dental implant. Once it is permanently bonded in place, only a Dentist or Specialist can remove it. With proper care and good oral hygiene, the life of a crown can range from 5 to 15 years. If a natural tooth-colored porcelain crown is chosen, our CERECĀ® CAD/CAM treatment gives patients a completed permanent crown in just one office visit. Other types of crowns require two office visits.
When Prescribed
A crown may be prescribed by your Dentist to: Restore and protect a tooth that is worn, decayed, cracked, or broken; Protect and support a tooth after a very large filling or root canal treatment; Cover a dental implant; Hold a dental bridge or other prosthetic device in place; Improve your smile by covering a misshapen or severely discolored tooth.
Patient Experience
After a thorough exam of your teeth, gums and supporting bone structure, your Dentist will discuss treatment options with you and answer your questions. If the agreed upon-treatment is a dental crown, your Dentist will apply a local anesthetic to prepare your tooth or dental implant.
Porcelain Crown
If the treatment of choice is a porcelain crown many treatment methods are available: CERECĀ® CAD/CAM: In just one office visit, you will have a fully completed porcelain crown. Since your crown is designed and created in our office using CERECĀ®CAD/CAM technology, there's no need for a temporary crown or a second visit; LavaTM: When the highest level of natural translucency of your crown's porcelain surface is important, this procedure is used. During your first office visit, CERECĀ®CAD/CAM technology is used to design your crown. Then you will be fitted with a temporary crown to protect your gum and tooth or dental implant. During a second office visit, your Dentist will fit and permanently bond your crown.
Metal or Porcelain-Metal
After your tooth or dental implant has been prepared and shaped for a crown: A putty-like material is used to make impression of your prepared teeth. Your crown will be fabricated for a precise fit based on this impression; You will be fitted with a temporary crown to protect your tooth/implant and gums until your permanent crown has been fabricated; During a second office visit, your Dentist will fit your permanent crown and bond it to your tooth or dental implant.
Crown Types
Your Dentist will recommend the best type of crown for your dental restoration needs based on the chewing placement and structure of the tooth or implant that requires protection. There are three types of crowns. Each type has its own characteristics and qualities:
Full Porcelain
Porcelain is attractive, strong, stable, and highly resistant to wear. It offers a high level of biocompatibility because it does not contain metal. A porcelain crown provides the best natural color match to the rest of your teeth and is an excellent choice for front teeth. The aesthetic quality of a porcelain crown requires that the Dentist be highly skilled in the use of CERECĀ® CAD/CAM technology.
Full-Metal
Metal offers strength and endurance. A metal crown may be recommended for back teeth where the forces of biting and chewing are the greatest. A metal crown rarely chips or breaks. In addition, it requires minimal removal of tooth structure. A gold or other high-noble metal crown offers biocompatibility. A base metal crown is often the least expensive treatment options; however, it lacks biocompatibility and may cause allergic reactions or gumline discoloration.
Porcelain-Fused-to-Metal
Porcelain-fused-to-metal offers the benefits of a natural surface color that resembles the rest of your teeth and the strength of a metal substructure. While there are several advantages to selecting this type of crown, it requires the removal of more tooth structure than other types of crowns. This means that there is greater potential for patient discomfort during the treatment procedure.
Dental Hygiene
Routine Dental Check-ups
Routine dental checkups are vital to good oral hygiene and are the best way to detect problems at their earliest stages. Early detection and treatment saves unnecessary discomfort, time, and money. The Academy of General Dentistry recommends checkups twice a year. Oral needs change with age and the condition of your teeth and gums. Your Dentist may recommend a checkup schedule that is more or less frequent than twice a year.
What to Expect
Your dental checkup includes: A visual exam of your mouth, face, jaw, and neck; Digital diagnostics, as determined by your Dentist; A gingival pocket exam; Professional cleaning of your teeth; Comprehensive data capture in an electronic dental record.
Visual Examination
During a visual exam, your Dentist will use an intraoral camera with sophisticated magnification and lighting to see all surface areas inside your mouth. You will be able to watch the real-time, tooth-by-tooth video exam on your chairside monitor. Your Dentist looks not only for cracked and decayed teeth, but also for growths and sores on the roof and floor of your mouth, tongue, lips, gums, and the mucous membranes that line your cheeks and gums. Then your Dentist will check the lymph nodes of your head, jaw, and neck for pain, tenderness, and flexibility.
Digital Diagnostics
X-Rays: Digital x-rays detect dental problems that cannot be found during a visual exam. We use digital x-rays that provide instant results and emit 90% less radiation. Your Dentist determines how often you need to have x-rays. 3-D Imaging: Three-dimensional imaging technology determines the precise position and shape of each tooth. Your Dentist will determine whether the use of this technology is appropriate to aid the development of a dental treatment plan or to follow the progress of your dental treatment. Gingival Pocket Exam: Healthy teeth require healthy gums. A gingival pocket exam determines the presence or risk of gum disease.
Gingival Pocket Exam
Healthy teeth require healthy gums. A gingival pocket exam determines the presence or risk of gum disease. What to Know: Each tooth sits inside a gingival pocket of gum tissue. Food debris and plaquenaturally collect inside this pocket; Daily tooth brushing and flossing remove food debris and plaque from the gingival pocket. If not removed, harmful bacteria penetrate the gumline and deepen the pocket; As the depth of a gingival pocket increases, so does the risk of tooth damage and infection that leads to gum disease; During your exam, a hand-held instrument is gently placed between gums and teeth (sulcus) to measure the depth of each pocket; In its earliest stage, gum disease may be reversible. Since it rarely has symptoms of pain, it is possible to have gum disease and not know it.
Professional Cleaning
Your teeth are cleaned using special instruments to remove plaque from above and below the gumline. Afterwards, your teeth are polished. Tooth polishing makes your teeth look and feel great. It also smoothes tooth surfaces so plaque is less likely to accumulate.
Electronic Dental Records
The records of our patients' dental checkups, diagnostics, and treatments are kept electronically. Our patients benefit because our Dentist and Specialists have immediate, comprehensive access to medical histories as well as the results of previous and current exams, diagnostics, treatment plans, and progress reports. Electronic dental records improve patient safety and create clinical efficiencies that help reduce patient waiting time before and during appointments.
Good Oral Hygiene
The key to healthy teeth and gums is keeping plaque and food decay from building up in your mouth. Plaque and food decay attract harmful bacteria that cause cavities, gum disease, and persistent bad breath. Your tongue attracts bacteria, too. During the normal process of eating, tiny fragments of food collect on your tongue. As these fragments decay, bacteria create a filmy white coating on the top of your tongue. Practice the four-step routine to keep plaque and harmful bacteria from building up in your mouth.
Easy Four-Step Routine
To keep your teeth and gums healthy: Brush your teeth and use an antiseptic mouthwash twice daily (after breakfast and before bedtime); Use dental floss daily; Clean your tongue regularly by using a toothbrush or a tongue scraper; See your dentist for routine dental checkups.
Benefits of Good Hygiene
When you practice good oral hygiene, you will: Have less plaque to remove during routine dental checkups, so professional cleanings will be faster and more comfortable; Minimize your need for dental procedures due to tooth decay or gum disease; Minimize your annual dental budget; Feel healthier; Enjoy fresher breath; Be more confident about your smile.
Infants & Small Children
The American Academy of Pediatrics recommends that a child's first visit to the Dentist be around age three unless any of these dental health risk factors exist: Sleeping with a cup or bottle; Thumb sucking; Teeth staining; Down Syndrome.
Children's Oral Hygiene
When your child's teeth begin to erupt, wipe them daily with a moist washcloth to remove tooth plaque. As s/he grows more teeth, use a soft child's toothbrush with non-fluoride toothpaste (like Baby OraGel) until s/he is able to spit out the toothpaste. When your child is ready to use fluoridated toothpaste, use only a small pea-size amount on the toothbrush. Swallowing too much fluoridated toothpaste can lead to staining of children's teeth(dental fluorosis).
Kids
It's never too early to learn how to care for your teeth and gums.
Dentures
Overview
A Denture (also known as false teeth) is a custom-made removable replacement for multiple missing teeth. Full dentures replace most or all of your teeth, and partial dentures replace one or more missing teeth. Both types of dentures support facial muscles and lips, and keep them from sagging and receding which will make you look younger, improve speech, and improve your health by enabling you to eat properly Dentures are custom made in a dental laboratory from impressions taken of your mouth. With proper care and good oral hygiene, full dentures can last 5-10 years. Over a period of time as your mouth naturally changes shape, dentures need to be relined, remade, or rebased. (Rebasing a denture means a new base is created utilizing the teeth on your current denture).
When Prescribed
Full dentures may be prescribed by your Dentist if you have lost, or are about to lose, all of your teeth as a result of disease, decay, injury, or surgery.
Patient Experience
After a thorough exam of your teeth, gums and supporting bone structure, your Dentist will discuss treatment options with you and answer your questions. If the agreed-upon treatment includes dentures, here's what to expect: It is common that some oral surgery may be required to prepare your mouth for full dentures. Sometimes teeth must be extracted or the bony ridge of your gum must be improved to provide your dentures with optimum stability; A putty-like material is used to make an impression of your arch. Your dentures will be fabricated based on this impression. Sometimes a try-in appointment is required to fine tune the tooth color, shape, and to customize the fit. Dentures and oral tissues must be checked annually. Damage to oral tissue can occur without any pain or other symptoms. Early detection and elimination of inflammation is important to minimize shrinkage of the supporting bone and tissues.
Denture Types
There are two main types of full dentures, conventional and immediate:
Conventional dentures are fabricated and placed in the patient's mouth after all or most teeth have been removed and tissues have healed.
(If tooth extraction is required, several months of healing must take place before conventional dentures can be provided.) Conventional dentures can replace:
All of your teeth on your upper arch, lower arch, or both.
Most of your teeth. In this case, an over denture is fabricated to fit over one or more natural teeth or dental implants for support.
Immediate dentures are inserted in the patient's mouth as soon as any remaining teeth are removed.
With immediate dentures, the wearer has teeth to use during the healing period. Oftentimes, denture wearers switch to conventional dentures when their gums have shrunk after the healing period.
Endodontics
Overview
An endodontic treatment saves a severely injured, cracked, or decayed tooth when its pulp (the soft inner tissue inside a tooth's root canal) becomes inflamed or infected. If it is not treated promptly, pain or a tooth abscess results. Endodontic treatment is also known as a "root canal." Root canal treatment is completed in one or two office visits, depending on the presence of infection and the required treatment plan. After restoration, the tooth continues to function like any other tooth. With good oral hygiene, the restored tooth has the potential to last a lifetime.
About Endodontists
Endodontists are root canal specialists. They are qualified Dentists who have two additional years of education and specialized training in the care and treatment of tooth pulp and the inner parts of the tooth. If a root canal is required, a Dentist often refers the patient to an Endodontist for treatment. Your Endodontist will work closely with your Dentist to improve your oral health and restore your natural teeth.
Warning Signs
See your Dentist if you experience any of these symptoms: Tooth or gum pain, discoloration, or prolonged sensitivity to heat or cold; A tooth that is tender when it is touched; A tooth abscess (pus enclosed in the tissues of the jawbone at the tip of an infected tooth); Pus drainage in your mouth; Swelling or tenderness in the lymph nodes under your jaw. Sometimes an endodontic problem can exist without warning signs. In these cases, an x-ray taken during a routine dental checkup will reveal the tooth damage.
Endodontic Treatment
Root canal treatment involves the removal of the diseased pulp along with the tooth's nerve (located within a tooth's root canal). The pulp chamber and root canal(s) of your tooth are then cleaned, medicated and sealed. A dental crown or other restorative treatment is used to protect and strengthen the tooth.
Patient Experience
After reviewing an x-ray of your tooth, your Endodontist will thoroughly examine your teeth, gums and supporting bone structure, recommend a treatment plan, discuss it with you, and answer your questions. If a root canal is needed: A local anesthetic is applied to the affected tooth and surrounding area; A small, protective sheet called a "dental dam" is used to isolate the tooth to keep it clean and free of saliva during your procedure; An opening is made in the top of the tooth and your Endodontist will remove the soft pulp and nerve and then shape the interior for filling; The root canal is cleaned, medicated, and filled with a rubber-like biocompatible material (gutta percha); A temporary filling is placed pending your return to your General Dentist; Your General Dentist will then place a permanent restoration, such as a crown, to protect the tooth.
Fillings
Overview
A filling repairs and restores the surface of a tooth that has been damaged by decay, fracture, or wear. A dental filling strengthens the tooth. If tooth decay is not repaired at its early stages, it will worsen and additional or alternative dental treatments may be necessary. With proper care and routine oral hygiene, a filling has a lifespan of 5-12 years, depending upon the type of filling material used.
Warning Signs
Tooth sensitivity is the most common early warning sign of enamel loss due to tooth decay. While there could be a number of reasons for this sensation, only your Dentist can diagnose its underlying cause. If a damaged tooth surface is not treated early, your discomfort will increase.
When Prescribed
A filling prescription is made when: The surface enamel of a tooth is damaged due to decay, fracture, or wear; A tooth's surface needs to be evened out to improve your ability to bite or chew.
Patient Experience
After a thorough exam of your teeth, gums and supporting bone structure, your Dentist will discuss treatment options with you and answer your questions. If the agreed-upon treatment is a dental filling, your Dentist will: Apply a local anesthetic to the affected area of your mouth; Use a hand-held instrument to prepare your tooth by removing the decayed or damaged tooth surface; Cleanse the prepared tooth to remove debris and bacteria; Isolate the tooth using a small, protective sheet called a "dental dam" to keep it clean and free of saliva during your procedure; Select the dental filling material based on the placement of the tooth, the location of the damaged area of the tooth, and the extent of its surface damage; Apply adhesives and filling material to the prepared area and shape it to match the look and feel of a natural tooth; Expose a special hand-held light to the filling material to harden the repaired surface of your tooth.
Gum Disease
Gum disease (also called periodontal disease) is an infection of the tissues that support your teeth. It is a major cause of tooth loss in adults. Because gum disease is usually painless, you may not know you have it. At each regular checkup the dentist will measure the depth of the shallow v-shaped crevice (called a sulcus) between your tooth and gums to identify whether you have gum disease. Gum disease is caused by plaque, a sticky film of bacteria that constantly forms on the teeth. These bacteria create toxins that can damage the gums. Periodontal diseases attack just below the gum line in the sulcus, where they cause the attachment of the tooth and supporting tissues to break down. As the tissues are damaged, the sulcus develops into a pocket; generally, the more severe the disease, the greater the depth of the pocket. Periodontal diseases are classified according to the severity of the disease. The two major stages are gingivitis and periodontitis.
Gingivitis
In the early stage of gum disease, called gingivitis, the gums become red, swollen and bleed easily. At this stage, the disease is still reversible and can usually be eliminated by daily brushing and flossing.
It is possible to have periodontal disease and have no warning signs.
That is one reason why regular dental checkups and periodontal examinations are very important. Treatment methods depend on the type of disease and how far the condition has progressed. Good oral hygiene at home is essential to keep periodontal disease from becoming more serious or recurring. You don't have to lose teeth to periodontal disease. Brush regularly, clean between your teeth, eat a balanced diet, and schedule regular dental visits for a lifetime of healthy smiles.
Periodontitis
In the more advanced stages of gum disease, called periodontitis, the gums and bone that support the teeth become seriously damaged. Whereas healthy gums and bone anchor teeth firmly in place, infected gums can cause teeth to become loose, fall out, or have to be removed by a dentist. Some factors increase the risk of developing periodontal disease:
Tobacco smoking or chewing
System-wide diseases such as diabetes
Some types of medication such as steroids, some types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers, and oral contraceptives
Bridges that no longer fit properly
Crooked teeth
Fillings that have become defective
Pregnancy
Signs of Gum Disease
If you notice any of the following signs of gum disease, see the doctor immediately:
Gums that bleed easily
Red, swollen, tender gums
Gums that have pulled away from the teeth
Persistent bad breath or bad taste
Pus between your teeth and gums
Permanent teeth that are loose or separating
Any change in the way your teeth fit together when you bite
Any change in the fit of partial dentures
General Dentistry
Regular Dental Checkups
Regular dental checkups, in addition to good oral hygiene at home are very important to the health of your teeth and gums. Regular checkup appointments typically take 20 to 40 minutes, and we suggest scheduling two of these checkups a year. Without good care of the teeth, you run the risk of gum disease which can lead to tooth loss. Gum disease (also called periodontal disease) is an infection of the tissues that support your teeth. At each regular checkup the dentist will measure the depth of the shallow v-shaped crevice (called a sulcus) between your tooth and gums to identify whether you have gum disease. Gum disease is caused by plaque, a sticky film of bacteria that constantly forms on the teeth. These bacteria create toxins that can damage the gums. Periodontal diseases attack just below the gum line, where ultimately they cause the attachment of the tooth and supporting tissues to break down. The two major stages of gum disease are gingivitis and periodontitis.
Gingivitis
In the early stage of gum disease, called gingivitis, the gums become red, swollen and bleed easily. At this stage, the disease is still reversible and can usually be eliminated by daily brushing and flossing.
Periodontitis
In the more advanced stages of gum disease, called periodontitis, the gums and bone that support the teeth become seriously damaged. Whereas healthy gums and bone anchor teeth firmly in place, infected gums can cause teeth to become loose, fall out, or have to be removed by a dentist. It is possible to have periodontal disease and have no warning signs. That is one reason why regular dental checkups and periodontal examinations are very important. Treatment methods depend on the type of disease and how far the condition has progressed. Good oral hygiene at home is essential to keep periodontal disease from becoming more serious or recurring. You don't have to lose teeth to periodontal disease. Brush regularly, clean between your teeth, eat a balanced diet, and schedule regular dental visits for a lifetime of healthy smiles.
Implants
Why dental implants?
For over 40 years Dental Professionals from around the world have placed Dental Implants in patients to restore their oral function. Dental Implants are made from surgical grade Titanium, and in most cases offer a permanent solution for one or more missing teeth. Titanium is not only used for Dental Implants, it is the material used for many other types of medical devices, such as Knee and Hip replacements. The properties of Titanium allow the human bodies bone to actually integrate into the metals surface. This process is known as "Osseointergration." This amazing discovery was made by Dr. PI Branemark in the mid to late 1960's and was funded by the Nobel Research Institute in Stockholm Sweden. Since then Millions of people have enjoyed an improved quality of life. Like many modern medical and dental technologies, Dental Implants have been dramatically improved over the last few decades. From the actual physical design, to the surface, these devices are more predictable then ever. This has allowed Dentists to offer their patients *"Immediate Function" in many cases. Immediate Function enables the patient to leave the office the day of surgery with a Temporary Tooth in place. In as little as eight weeks from that date, the patient can receive their final crown. Dr. Freeman utilizes these advancements along with "State of the Art" CAT scan technology, and sophisticated surgical planning software to create an optimal patient experience.
Why choose an implant over a supported bridge?
While a tooth supported bridge is a reasonable choice, it does have some significant disadvantages over a Dental Implant. For example with a three unit bridge the Dentist must grind off the enamel of the two adjacent teeth in order to cement the bridge in place. This process can lead to decay of those teeth. In addition, human bone needs force applied against it in order to stay healthy and in place. With a three unit bridge the missing tooth is replaced with a "floating" tooth suspended between two crowns. This is called a Pontic. Because the Pontic does not apply force on the bone, the bone melts away over time. This can lead to destabilization of the adjacent teeth, hygiene issues, and cosmetic challenges. In contrast, an implant recreates the natural anatomy and applies force to the bone. This keeps the bone healthy and in place. It also allows the Dentist the ability to leave the adjacent teeth alone. Lastly, research indicates that most tooth supported bridges fail with in fifteen years, often even sooner then that. While most implants, when integrated, last a lifetime. When you consider the "Lifetime Value", lack of bone loss, cosmetic look, and not having to grind down healthy adjacent teeth, the choice most people make is to have the Dental Implant. There are two other choices a patient can make. One is a removable bridge this is not a very attractive choice. Most Dentists only use it for temporary reasons. The only advantage it has is price. Two is a Maryland Bridge or Resin Bonded. This solution does leave the adjacent teeth alone, but these often fail and have to be re-bonded over and over again. They also do not address the bone loss problem.
Invisalign
Does your smile need some improving? Have you been dreading the idea of traditional braces? Invisalign is the braces-free way to the beautiful, straight smile you have always wanted. With Dr. Paul Freeman's immense experience he is the Atlanta Invisalign Provider of choice. Invisalign may be right for you: schedule a complimentary consultation with Dr. Freeman today to discuss your options.
What is Invisalign?
Invisalign treatment gradually straightens teeth using a series of clear, removable, and comfortable aligners that no one can see. That means you can show off your smile during treatment not just after! Certifiably effective, Invisalign is designed using 3-D imaging technology - no messy impressions guaranteed!
Why Invisalign?
Unlike braces, Invisalign is both invisible and removable, allowing you to eat and drink whatever you want while still in treatment! You also won't have to deal with awkward, special equipment when brushing and flossing. Invisalign aligners are also the most comfortable teeth straightening option, without abrasive metal to hurt your mouth during treatment. Without metal or wires, you'll spend less time in the doctor's office getting adjustments. Invisalign treatment also allows you to visualize the end result by viewing your own virtual treatment plan before you even start.
How does Invisalign work?
Removing them only to eat, drink, brush, and floss, you wear each set of clear aligners for about two weeks at a time. Your teeth will move a little at a time as you replace each aligner with the next in the series until they have straightened to the final prescribed position. About once every 6 weeks, you'll visit Dr. Freeman to ensure that your treatment is progressing according to plan. Invisalign treatment takes 9-15 months. Most patients will wear between 18 and 30 clear aligners during treatment, but each Invisalign case varies.
Oral Surgery
Overview
While the removal of wisdom teeth is the most well-known type of oral surgery, there are many reasons why oral surgery may be required. For example, to: Diagnose, repair, or treat serious conditions affecting a patient's teeth, palate, lips, jaw, or face; Alleviate problems due to obstructed sleep apnea, infections, or facial pain; Augment a treatment plan prescribed by a Dentist or Specialist; Repair maxillofacial region damage caused by a serious accident or injury.
About Oral Surgeons
Oral Surgeons, also known as Oral and Maxillofacial Surgeons, are qualified Dentists who have completed an additional 4-6 years of surgical residencies. Their advanced education and training includes anesthesiology and the diagnosis and surgical treatment of defects, injuries, and diseases of the mouth, jaw, teeth, neck, gums, and other soft tissues of the head. An Oral and Maxillofacial Surgeon will work closely with your Dentist to improve your oral health.
Reasons for Referral
Based on an examination or a dental treatment plan, your Dentist or Orthodontist may refer you to an Oral and Maxillofacial Surgeon for a consultation.
By Your Dentist
Your Dentist may recommend that you or your child see an Oral Surgeon when:
A tooth is impacted.
This means that a permanent (adult) tooth has not yet erupted from the bone but is moving into or pushing against an adjacent tooth. This commonly occurs with wisdom teeth.
A lesion, tumor or other tissue of the mouth or jaw requires biopsy or removal, or if oral cancer is suspected
A dental implant is required to replace a missing tooth or support a bridge
One or more teeth must be removed
A tooth breaks off at the gum line and it (or its root fragments) must be removed
Corrective surgery to soft tissues or bones in the maxillofacial region is needed
Diagnosis and treatment of infections in the maxillofacial region are needed
Facial pain exists, including pain suspected from TMJ (Temporomandibular Joint Disease)
Obstructive sleep apnea is suspected
By Your Orthodontist
Your Orthodontist may recommend that you or your child have a consultative exam by an Oral Surgeon related to an orthodontic procedure if there is:
An open bite (space between the upper and lower teeth when the mouth is closed)
An unbalanced facial appearance from the front or side
A facial injury or birth defect that affects the maxillofacial region
A receding chin or protruding jaw
A problem that causes lips to not meet without straining
Most Common Surgeries
Tooth Extraction
After the application of anesthetic to the area, special tools are inserted between the tooth and gum that surrounds the tooth. The tooth is moved back and forth within its socket (the bone that encases the tooth's root) until it separates from the ligament that holds the tooth in place. Sometimes a tooth is cut into small pieces (sectioned) before it is removed.
Impacted Tooth Extraction
The method for removing an impacted tooth will depend on how many roots it has and its location under your gum. Patient sedation is often used in addition to the application of an anesthetic to the impacted area. A gum tissue flap is created to access bone tissue, and a small opening is made in the bone that covers the impacted tooth. The impacted tooth is then cut into small pieces (sectioned) and removed through the opening. The gum tissue flap is then repositioned and sutured in place.
Wisdom Teeth Extraction
Third molars, also called wisdom teeth, are the last set of permanent teeth to erupt in a person's mouth and are the ones least needed for good dental health. Wisdom teeth can endanger a patient's dental health when: They erupt through your gum but your jaw is too small to hold them. As a result, they force other teeth out of alignment and can damage your bite. They do not erupt through your gum and are not in a normal position. As a result, they crowd the roots of other teeth, force them out of alignment, and can damage your bite. When your jaw is too small to accommodate normal wisdom teeth, gum or jaw discomfort and swelling often occur. In addition, there is a greater risk of developing gum disease. Surgery to remove wisdom teeth is typically the best course of action. If a wisdom tooth has fully erupted through the gum, a standard tooth extraction is performed. If the tooth has not erupted through the gum, an impacted tooth extraction method is used.
Periodontics
Overview
Periodontal disease is a bacterial infection of the gums and tissues that support your teeth. It is caused most often by the build-up of plaque and tartar when teeth are not routinely brushed and flossed. Other contributors to this disease include medical issues such as diabetes and consuming too much sugary food or drinks. There are two major stages of periodontal disease: gingivitis and periodontis. Gingivitis affects only the gums. It is a mild form of periodontal disease, and if properly treated may be reversed. Left untreated, gingivitis turns into periodontis. During this more destructive disease stage, bacteria penetrate into the deeper pockets of tissue where bone and membrane support your teeth. Periodontis can lead to tooth loss and serious health problems. Research shows that 75% of Americans over the age of 40 have some type of gum disease which is the leading cause of adult tooth loss. It is possible to have periodontal disease and not know it because its symptoms are often painless. The best way to avoid or manage periodontal disease is by having good oral hygiene, and seeing your dentist for your routine dental checkups.
People At-Risk
You may be at risk for periodontal disease if you Do not practice good oral hygiene; Smoke or chew tobacco; Have heart disease, diabetes, respiratory disease or osteoporosis; Have a family member diagnosed with periodontal disease; Are pregnant or thinking of becoming pregnant. In addition, the following types of prescription drugs may also increase the risk of periodontal disease. Talk with your Dentist if you are taking: Steroids; Cancer therapy drugs; Oral contraceptives; An anti-epilepsy drug; A calcium channel blocker.
About Periodontists
Periodontists are qualified Dentists who have an additional three years of education and specialized training in the prevention, diagnosis, and treatment of gum disease. They also perform dental implant surgery and cosmetic periodontal procedures to help improve a smile. Your Periodontist will work closely with your Dentist to manage your oral health.
Warning Signs
Periodontal disease is considered "silent" because pain does not always accompany its warning signs. See your Dentist if you experience:
Changes to Teeth, Bite, or Dental Work
Loose or separating teeth; A change in the way your teeth fit together when you bite; Bridges or partial dentures that no longer fit properly; Fillings that have become defective.
Changes to Gums
Recurring redness, puffiness, tenderness, or swelling of your gums; Bleeding of gums while brushing teeth, using dental floss, or biting into hard food (like an apple); Gums that are pulling away (receding) from your teeth, causing them to look longer.
Bad Mouth Odors or Tastes
Persistent bad breath; Persistent metal taste in your mouth.
Mouth Sores
Pus between your gums and teeth; A sore or irritation in your mouth that does not improve within two weeks.
Periodontal Treatments
There are many patient-specific variables involved with treating periodontal disease. Much depends upon the stage of infection and the amount of deterioration involving your gums, teeth, supporting tissues, and bone. After reviewing your x-rays and performing a thorough periodontal exam, your Periodontist will discuss non-surgical or surgical treatment options to you, answer your questions, and explain what to expect:
During and after the procedure(s)
The number of office visits required for treatment
What to do at home as your gums heal
How to keep periodontal disease under control after treatment is complete
Non-Surgical
Non-Surgical
The most well known type of non-surgical treatment is scaling and root planing. This under-the-gum procedure involves a careful removal of plaque and tarter from the tooth roots. During this procedure your roots are smoothed to expose and remove harmful bacteria. Root smoothing along with the practice of good oral hygiene can help prevent plaque from accumulating again.
Surgical
Periodontal surgery may be needed to eliminate bone infections or to regenerate lost bone. The most common surgical treatments include:
Pocket Reduction
During this procedure, a local anesthetic is applied The gum tissue is folded back to expose deeper tissues. Then, harmful bacteria are removed. Irregular surfaces of the damaged bone may need to be smoothed to expose otherwise hidden areas of bacteria before it is removed. Gum tissue is then closed and sutured in place.
Pocket Reduction
During this procedure, a local anesthetic is applied. gum tissue is folded back to expose deeper tissues. Then disease-causing bacteria are removed. Membranes, bone grafts, or tissue-stimulating proteins are used to encourage your body's natural ability to regenerate bone and tissue and reverse some of the damage of periodontal disease. Excess gum and bone tissues are then reshaped to expose more of the natural tooth. This can be done to one tooth to even out the gumline, or to several teeth to expose a natural, broad smile. Gum tissue is then closed and sutured in place.
Restorative Dentistry
Tooth Colored Fillings
Newer dental fillings include ceramic and plastic compounds that mimic the appearance of natural teeth. These compounds, often called composite resins, are usually used on the front teeth where a natural appearance is important. They can be used on the back teeth as well depending on the location and extent of the tooth decay. Composite resins are usually more costly than the older silver amalgam fillings. Filings typically are done in one appointment.
Porcelain Crowns and Onlays
When a tooth has become to decayed to be repaired with a filling, a porcelain onlay or crown is needed. A porcelain onlay is used when the tooth is not damaged enough for a crown, but still needs more than a filling. Porcelain is harder than white fillings, and can be bonded with a tooth for a better seal. Crowns are also used for teeth that are broken due to an accident or trauma. Crowns and onlays are custom-made to fit your mouth. Crowns can also be used for cosmetic purposes when teeth are discolored and do not respond to teeth whitening. With CERECĀ® the newest technology in tooth restoration, most crowns and onlays can be done in one appointment.
Emergency Care
Root Canal In the past, if you had a tooth with a diseased nerve, you'd probably lose that tooth. Today, with a special dental procedure called root canal treatment, you may save that tooth. Inside each tooth is both the pulp and the nerve. The nerve is the vestige of the tissue that originally formed the tooth. Once the tooth has been in the mouth for a time, the functioning of the nerve is no longer necessary. When a tooth is cracked or has a deep cavity, bacteria can enter the pulp. Germs can cause an infection inside the tooth. Left without treatment, pus builds up at the root tip in the jawbone, forming a "pus-pocket" called an abscess. An abscess can cause the pulp tissue to die. When the infected pulp is not removed, pain and swelling can result. Certain byproducts of the infection can injure your jawbones and your overall health. Without treatment, your tooth may have to be removed. Treatment often involves from one to three visits. During treatment, your general dentist or endodontist (a dentist who specializes in problems of the pulp) removes the diseased pulp. Next the pulp chamber and root canal(s) of the tooth are cleaned and sealed. Often posterior teeth that have endodontic treatment should have a cast crown placed in order to strengthen the remaining structure. Then, as long as you to continue to care for your teeth and gums with regular brushing, flossing, and checkups so that the root(s) of the restored tooth are nourished by the surrounding tissues, your restored tooth can last a lifetime. Most of the time a root canal is a relatively simple procedure with little or no discomfort, involving one to three visits. Best of all, it can save your tooth and your smile!
Root Canals
Overview
An endodontic treatment saves a severely injured, cracked, or decayed tooth when its pulp (the soft inner tissue inside a tooth's root canal) becomes inflamed or infected. If it is not treated promptly, pain or a tooth abscess results. Endodontic treatment is also known as a "root canal." Root canal treatment is completed in one or two office visits, depending on the presence of infection and the required treatment plan. After restoration, the tooth continues to function like any other tooth. With good oral hygiene, the restored tooth has the potential to last a lifetime.
About Endodontists
Endodontists are root canal specialists. They are qualified Dentists who have two additional years of education and specialized training in the care and treatment of tooth pulp and the inner parts of the tooth. If a root canal is required, a Dentist often refers the patient to an Endodontist for treatment. Your Endodontist will work closely with your Dentist to improve your oral health and restore your natural teeth.
Endodontic Treatment
Root canal treatment involves the removal of the diseased pulp along with the tooth's nerve (located within a tooth's root canal). The pulp chamber and root canal(s) of your tooth are then cleaned, medicated and sealed. A dental crown or other restorative treatment is used to protect and strengthen the tooth.
Patient Experience
After reviewing an x-ray of your tooth, your Endodontist will thoroughly examine your teeth, gums and supporting bone structure, recommend a treatment plan, discuss it with you, and answer your questions. If a root canal is needed: A local anesthetic is applied to the affected tooth and surrounding area; A small, protective sheet called a "dental dam" is used to isolate the tooth to keep it clean and free of saliva during your procedure; An opening is made in the top of the tooth and your Endodontist will remove the soft pulp and nerve and then shape the interior for filling; The root canal is cleaned, medicated, and filled with a rubber-like biocompatible material (gutta percha); A temporary filling is placed pending your return to your General Dentist. Your General Dentist will then place a permanent restoration, such as a crown, to protect the tooth
Warning Signs
Sometimes an endodontic problem can exist without warning signs. In these cases, an x-ray taken during a routine dental checkup will reveal the tooth damage. See your Dentist if you experience any of these symptoms:
Tooth or gum pain, discoloration, or prolonged sensitivity to heat or cold
A tooth that is tender when it is touched
A tooth abscess (pus enclosed in the tissues of the jawbone at the tip of an infected tooth)
Pus drainage in your mouth
Swelling or tenderness in the lymph nodes under your jaw
Teeth Whitening
Overview
Tooth whitening enhances the brightness of natural teeth, but it's not for everyone. View our Whitening Menu for Pricing & Specials. Discuss it with your Dentist before you take action, especially if you have: Discolored or sensitive teeth White spots or decay on your teeth; Infected gums; A bridge, crown, or other dental work (especially involving front teeth); The lifespan of whitened teeth can range from 4-12 months, depending on the type of treatment used and your consumption of food and drink that can easily stain teeth (such as blueberries, coffee, and tea). To keep your teeth their whitest without undergoing tooth whitening treatment, practice good oral hygiene.
In-Office Treatment
After a thorough exam of your teeth, gums and supporting bone structure, your Dentist will tell you whether tooth whitening is a safe option for your smile. If the agreed-upon treatment is an in-office, Dentist-supervised treatment, your Clinician will: Prepare your mouth by covering your lips and gums so that only your teeth are exposed; Apply a professional-strength whitening gel to your teeth; Expose your teeth to a special light for 15 minutes to help the gel penetrate and whiten your teeth; Invite you to watch TV or listen to music as you relax in the chair; Reapply the gel and light treatment two more times. Your total tooth whitening treatment time is 45 minutes.
Whitening for Life
We help you maintain your brightest smile for life*! This package includes all of the bells and whistles you start off with an in-office whitening treatment, then you receive custom whitening take-home trays and bleach gel for life*at your routine cleanings. *Certain terms and conditions may apply, cannot be combined with other offers and promotions, "free bleach for life" contingent upon hygiene maintenance plan - ask a team member for details.
Types of Whiteners
If your Dentist agrees that you are a candidate for tooth whitening, you can choose either an over-the-counter tooth whitening kit or a Dentist-supervised treatment.
Over-The-Counter
If using an over-the-counter whitening kit, choose one approved by the American Dental Association and follow the directions on its package. Store-bought kits require 7-30 days of consistent use for full effect. Individual results can vary.
Dentist-Supervised
Dentist-supervised treatments provide greater tooth whitening results faster than store bought kits. Two types of treatment are available: An in-office treatment typically whitens teeth 5-10 shades within 45 minutes; A Dentist-dispensed take-home kit contains a higher concentration of whitening agent than a store-bought kit and is as easy to use. You are likely to be more satisfied with the results of a Dentist-dispensed kit than by a store-bought kit.
Veneers
Overview
Our Dentist can complete a porcelain veneer treatment in just one office visit. With proper care and good oral hygiene, a veneer has a lifespan of 5-10 years.
When Prescribed
A veneer is often prescribed for a tooth that is: Discolored or stained; Worn down, chipped or broken; Misaligned, uneven, or irregularly shaped; It may also be prescribed to "fill the gap" between two otherwise healthy teeth.
Patient Experience
After a thorough exam of your teeth, gums and supporting bone structure, your Dentist will discuss treatment options with you and answer your questions. If the agreed upon treatment is a dental veneer, your Dentist will: Apply a local anesthetic to the affected area of your mouth; Remove a small amount of enamel from the front of your tooth to make place for the veneer; Use 3-D imaging to design and create your veneer; Clean and polish the tooth's front surface; Bond the veneer in place to permanently affix it; Expose the veneer to special hand-held light to harden the repaired surface of your tooth.
Wisdom Teeth
Overview
While the removal of wisdom teeth is the most well-known type of oral surgery, there are many reasons why oral surgery may be required. For example, to: Diagnose, repair, or treat serious conditions affecting a patient's teeth, palate, lips, jaw, or face; Alleviate problems due to obstructed sleep apnea, infections, or facial pain; Augment a treatment plan prescribed by a Dentist or Specialist; Repair maxillofacial region damage caused by a serious accident or injury.
About Oral Surgeons
Oral Surgeons, also known as Oral and Maxillofacial Surgeons, are qualified Dentists who have completed an additional 4-6 years of surgical residencies. Their advanced education and training includes anesthesiology and the diagnosis and surgical treatment of defects, injuries, and diseases of the mouth, jaw, teeth, neck, gums, and other soft tissues of the head. An Oral and Maxillofacial Surgeon will work closely with your Dentist to improve your oral health.
Reasons For Referral
Based on an examination or a dental treatment plan, your Dentist or Orthodontist may refer you to an Oral and Maxillofacial Surgeon for a consultation.
By Your Dentist
Your Dentist may recommend that you or your child see an Oral Surgeon when:
A tooth is impacted.
This means that a permanent (adult) tooth has not yet erupted from the bone but is moving into or pushing against an adjacent tooth. This commonly occurs with wisdom teeth.
A lesion, tumor or other tissue of the mouth or jaw requires biopsy or removal, or if oral cancer is suspected
A dental implant is required to replace a missing tooth or support a bridge
One or more teeth must be removed
A tooth breaks off at the gum line and it (or its root fragments) must be removed
Corrective surgery to soft tissues or bones in the maxillofacial region is needed
Diagnosis and treatment of infections in the maxillofacial region are needed
Facial pain exists, including pain suspected from TMJ (Temporomandibular Joint Disease)
Obstructive sleep apnea is suspected
By Your Orthodontist
Your Orthodontist may recommend that you or your child have a consultative exam by an Oral Surgeon related to an orthodontic procedure if there is:
An open bite (space between the upper and lower teeth when the mouth is closed)
An unbalanced facial appearance from the front or side
A facial injury or birth defect that affects the maxillofacial region
A receding chin or protruding jaw
A problem that causes lips to not meet without straining
Most Common Surgeries
Tooth Extraction
After the application of anesthetic to the area, special tools are inserted between the tooth and gum that surrounds the tooth. The tooth is moved back and forth within its socket (the bone that encases the tooth's root) until it separates from the ligament that holds the tooth in place. Sometimes a tooth is cut into small pieces (sectioned) before it is removed.
Impacted Tooth Extraction
The method for removing an impacted tooth will depend on how many roots it has and its location under your gum. Patient sedation is often used in addition to the application of an anesthetic to the impacted area. A gum tissue flap is created to access bone tissue, and a small opening is made in the bone that covers the impacted tooth. The impacted tooth is then cut into small pieces (sectioned) and removed through the opening. The gum tissue flap is then repositioned and sutured in place.
Wisdom Teeth Extraction
Third molars, also called wisdom teeth, are the last set of permanent teeth to erupt in a person's mouth and are the ones least needed for good dental health. Wisdom teeth can endanger a patient's dental health when: They erupt through your gum but your jaw is too small to hold them. As a result, they force other teeth out of alignment and can damage your bite. They do not erupt through your gum and are not in a normal position. As a result, they crowd the roots of other teeth, force them out of alignment, and can damage your bite. When your jaw is too small to accommodate normal wisdom teeth, gum or jaw discomfort and swelling often occur. In addition, there is a greater risk of developing gum disease. Surgery to remove wisdom teeth is typically the best course of action. If a wisdom tooth has fully erupted through the gum, a standard tooth extraction is performed. If the tooth has not erupted through the gum, an impacted tooth extraction method is used.