Maintaining Dental Health
    Maintaining dental health has two main components – at-home dental hygiene and professional cleanings and examinations. Simple maintenance of your dental health can prevent complications such as tooth loss, as well as the need for restorative or cosmetic dentistry in the future.

    How can I prevent tooth decay and gum disease?
    Good oral hygiene starts at home, though it needs to be supplemented by regular visits to our cosmetic and family dentistry practice, Dr. Cheryl Colker’s office. Steps you can take to prevent tooth decay and gum disease include:

    Thorough brushing
    Brush at least twice daily using a soft-bristle toothbrush and ADA-accepted fluoride toothpaste. This helps prevent tooth decay, gum disease, and the need for costly cosmetic or restorative dentistry in the future. Replace your brush every two to three months.

    Proper flossing
    Flossing is crucial to the health of your teeth and gums and the prevention of gum disease. When flossing, use an 18-inch strand of floss. Ease the floss between each tooth; then, sweep it up and down several times while curving around the tooth at the gum line. Don’t forget to floss behind your last tooth and to floss bridges and artificial teeth with the aid of a floss threader.

    Regular dental visits

    At your annual dental appointment, Dr. Colker will carefully check your teeth, gums, mouth, and throat. A checkup includes:

    A head and neck examination: This includes a cancer exam, facial exam, palpation of chewing muscles, palpation of lymph nodes, and an exam of the temporomandibular (jaw) joint.

    A clinical dental examination: This includes a periodontal exam and examinations of the mobility of teeth, the mucous membranes, saliva, occlusion (bite), removable appliances, and contact between teeth. If we detect tooth decay or broken fillings, we will discuss appropriate action with you.

    A dental cleaning (prophylaxis): This includes scaling plaque, polishing teeth, flossing, assessing your mouth’s cleanliness, and providing oral hygiene instructions. If you wish to learn more about proper brushing and flossing techniques, ask us about it at this stage of the visit.

    Following the clinical dental exam, Dr. Colker will discuss a detailed treatment plan, with you, if necessary. Our staff will schedule a follow-up visit for you.

    Regular dental visits, along with a thorough home care regimen, are key to a lifetime of good oral health. General dentistry of this type can prevent the need for cosmetic or restorative dentistry later in life.


Do I need x-rays every year?
Dental X-rays help dentists visualize diseases of the teeth and surrounding tissue that cannot be seen with a simple oral exam. In addition, X-rays help the dentist find and treat dental problems early in their development, which can potentially save you money, unnecessary discomfort, and maybe even your life.

What Problems Can Dental X-Rays Detect?

In adults, dental X-rays can be used to:

  • Show areas of decay that may not be visible with an oral exam, especially small areas of decay between teeth
  • Identify decay occurring beneath an existing filling
  • Reveal bone loss that accompanies gum disease
  • Reveal changes in the bone or in the root canal resulting from infection
  • Assist in the preparation of tooth implants, braces, dentures, or other dental procedures
  • Reveal an abscess (an infection at the root of a tooth or between the gum and a tooth)
  • Reveal other developmental abnormalities, such as cysts and some types of tumors

  • In children, dental X-rays are used to:
  • Watch for decay
  • Determine if there is enough space in the mouth to fit all incoming teeth
  • Determine if primary teeth are being lost quickly enough to allow permanent teeth to come in properly
  • Check for the development of wisdom teeth and identify if the teeth are impacted (unable to emerge through the gums)

  • How Often Should Teeth Be X-Rayed?
    The frequency of getting X-rays of your teeth often depends on your medical and dental history and current condition. Some people may need X-rays as often as every six months; others with no recent dental or gum disease and who visit their dentist regularly may get X-rays only every couple of years. If you are a new patient, Dr. Colker will take X-rays as part of the initial exam and to establish a baseline record from which to compare changes that may occur over time. Some general guidelines your dentist may follow regarding the frequency of dental X-rays is as follows:

    Adults: As a New Patient - A full series of X-rays is indicated when there is evidence of dental disease or history of extensive decay. This will be repeated every 3-5 years. If you have Gum Disease (Periodontal disease) every three years is the recommended amount of time.

    Children: As a New Patient full month x-rays should be taken. This helps us see the development of the teeth and look out of decay. As a continuing patient with a high level of decay x-rays should be taken every 6 month until no decay is present. If the patient has low level of decay once every 12 months would be recommended.

    Adolescents:(Before wisdom eruption) a full series of x-rays is indicated when they are a new patient. As a continuing patients once every 6 month if the patient has a high level of dental decay until no decay is present or every 12 month is the patient has a low level of tooth decay. Also at this age we use the x-rays to check for the development of the wisdom teeth. home

    Cosmetic Dentistry
    I want beautiful teeth. How can I get them?

    Replacing Missing Teeth - What are my options?:

    Removable partial denture (RPD): is for a partially edentulous (no teeth) dental patient who desires to have replacement teeth for functional or aesthetic reasons, and who cannot have a bridge (a fixed partial denture) Or implants for any number of reasons, such as a lack of required teeth to serve as support for a bridge (i.e. distal abutments) or due to financial limitations.

    Maryland Bridge:
    A resin retained bridge (Maryland Bridge) is a dental prosthesis replacing a missing tooth that relies for its retention on a composite resin cement. A Resin-bonded bridge consists of a cast metal framework that is cemented with resin composite to an abutment(s) which has preparation(s) confined either entirely or almost entirely to enamel. The resin retained bridge is a good treatment option for many missing teeth as it is relatively cheap when compared to alternatives such as dental implants, requires little or no damage to the surrounding teeth during preparation for placement, and it is well tolerated by patients.

    The resin retained bridge is increasingly being used in modern dentistry as an alternative to more destructive treatments. This has been driven by the advent of evidence based dentistry showing the benefits to patients of reduced tooth preparation and the importance of an intact enamel structure for the long-term health of the teeth.

    Dentures: Also known as false teeth, are prosthetic devices constructed to replace missing teeth; they are supported by the surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable. However, there are many different denture designs, some which rely on bonding or clasping onto teeth or dental implants. There are two main categories of dentures, the distinction being whether they are used to replace missing teeth on the mandibular arch (lower arch) or on the maxillary arch (upper arch).

    More on Crowns and Bridges


    What is gum disease?
    If you have been told you have periodontal (gum) disease, you’re not alone. Many adults in the U.S. currently have some form of the disease. Periodontal diseases range from simple gum inflammation to serious diseases that result in major damage to the soft tissue and bone that support the teeth. In the worst cases, teeth are lost.

    If you have been told you have periodontal (gum) disease, you’re not alone. Many adults in the U.S. currently have some form of the disease. Periodontal diseases range from simple gum inflammation to serious diseases that result in major damage to the soft tissue and bone that support the teeth. In the worst cases, teeth are lost.

    Whether your gum disease is stopped, slowed, or gets worse depends a great deal on how well you care for your teeth and gums every day, from this point forward. Our mouths are full of bacteria. These bacteria, along with mucus and other particles, constantly form a sticky, colorless “plaque” on teeth. Brushing and flossing help get rid of plaque. Plaque that is not removed can harden and form “tartar” that brushing doesn’t clean. Only a professional cleaning by a dentist or dental hygienist can remove tartar. This can cause gingivitis.

    When gingivitis is not treated, it can advance to “periodontitis” (which means “inflammation around the tooth”). In periodontitis, gums pull away from the teeth and form spaces (called “pockets”) that become infected. The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body’s natural response to infection start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums, and tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.

    Risk Factors:

  • Smoking. Need another reason to quit smoking? Smoking is one of the most significant risk factors associated with the development of gum disease. Additionally, smoking can lower the chances for successful treatment.
  • Hormonal changes in girls/women. These changes can make gums more sensitive and make it easier for gingivitis to develop.
  • Diabetes. People with diabetes are at higher risk for developing infections, including gum disease.
  • Other illnesses. Diseases like cancer or AIDS and their treatments can also negatively affect the health of gums.
  • Medications. There are hundreds of prescription and over the counter medications that can reduce the flow of saliva, which has a protective effect on the mouth. Without enough saliva, the mouth is vulnerable to infections such as gum disease. And some medicines can cause abnormal overgrowth of the gum tissue; this can make it difficult to keep teeth and gums clean.
  • Genetic susceptibility. Some people are more prone to severe gum disease than others.

  • How do I know if I have gum disease?:
    Symptoms of gum disease include:
  • Bad breath that won’t go away
  • Red or swollen gums
  • Tender or bleeding gums
  • Painful chewing
  • Loose teeth
  • Sensitive teeth
  • Receding gums or longer appearing teeth

  • Any of these symptoms may be a sign of a serious problem, which should be checked by a dentist. At your dental visit the dentist or hygienist should:
  • Ask about your medical history to identify underlying conditions or risk factors (such as smoking) that may contribute to gum disease.
  • Examine your gums and note any signs of inflammation.
  • Use a tiny ruler called a “probe” to check for and measure any pockets. In a healthy mouth, the depth of these pockets is usually between 1 and 3 millimeters. This test for pocket depth is usually painless.
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    What is Periodontal Therapy?
    Periodontal treatment methods depend upon the type and severity of the disease. We will evaluate your progression of periodontal disease and recommend the appropriate treatment. Periodontal disease progresses as the sulcus (pocket or space) between the tooth and gums gets filled with bacteria, plaque, and tartar causing irritation to the surrounding tissues. When these irritants remain in the pocket, they cause infection and damage to the gums and eventually, the bone that supports the teeth. If the disease is caught in the early stages (known as Gingivitis) and no damage has been done, one to two regular cleanings may be recommended. You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings. However, if the disease has progressed to a more advanced stage, where the infection has caused bone loss and diseased pockets have formed, your treatment options may include scaling and root planning, bone surgery or gum therapy.


    Does my child need Braces?
    You may not have considered orthodontics (orthodontia) for your child yet, and you may think that your child does not need dental braces until all of the baby teeth have fallen out. While this may be the case, the American Association of Orthodontists recommends that children see an orthodontist by age 7. This is because some orthodontic problems are easier corrected when the child is younger. Waiting to get braces or starting orthodontic treatment after all permanent teeth have erupted may lead to difficulty in correcting some types of orthodontic problems. By age 7, most children will have begun growing in some permanent molars (back teeth) and incisors (front teeth) so the orthodontist can evaluate if there is an existing problem.

    Fitting children with braces demands an office dedicated to providing specialized childcare. We will refer your family to an excellent Dentist to ensure the best care for your family.


    When should your child first visit the dentist? It might be earlier than you think.
    babyMost American children don’t see their family dentist until they are well over 2 years old, far later than is recommended by both dental and medical professionals.

    That’s one of the key findings from a 2009 survey of American children’s oral health, conducted by Morpace, Inc., on behalf of Delta Dental Plans Association.* Delta Dental commissioned the survey to gain greater knowledge about the state of children’s oral health.

    The survey of primary caregivers revealed that, for those children who had seen a dentist – and 34 percent had not – the average age at the initial visit was 2.6 years. The American Academy of Pediatric Dentistry (AAPD) recommends that a child go to the dentist by age 1 or within six months after the first tooth erupts. Primary teeth typically begin growing in around 6 months of age.


    How does fluoride help prevent tooth decay?
    Fluoride helps reverse and prevent tooth decay in three ways:

  • Promoting Tooth Remineralization
  • Acids can demineralize a tooth – that is, create a weak spot that develops into a cavity. Fluoride helps promote the opposite process, called remineralization, which can reverse the very early stages of tooth decay.

  • Helping Teeth Become More Resistant to Tooth Decay
  • Fluoride actually strengthens teeth, giving them natural protection against future tooth decay.

  • Inhibiting Oral Bacteria’s Ability to Create Tooth-Attacking Acids
  • Fluoride disrupts bacteria’s ability to metabolize sugars, the process that leads to the attack of tooth enamel.


    Should I remove my silver filling because of Mercury?
    Cavities are nothing to smile about but is there greater worry for the millions who have "amalgam" fillings — silver-colored fillings with mercury?

    Many health advocacy groups, such as Consumers for Dental Choice, claim the fillings are dangerous.

    The American Dental Association and the Food and Drug Administration say the mercury in the fillings is at safe levels. But that didn't stop the FDA from recently holding another investigative hearing looking into the safety associated with their use.

    A patient has had her silver fillings for three decades. She knows they contain mercury, a known neurotoxin, so when they started breaking apart, she took action because her teeth were breaking too.

    "You know, I've read about it and I'm concerned but not real concerned — not enough to have them all replaced without having a problem with them,". Dr. Colker stopped using silver fillings, known as amalgams, almost 15 years ago.

    Amalgams have been used for more than 100 years. Dr. Colker doesn't think they're a health danger to patients — as long as they're intact.

    "If people have silver fillings in their mouths that are functioning well and there's no break down, I really don't see a reason, at this point, to take them out," Dr. Colker says the bigger risk is when the silver starts to break down, bacteria can get into the gaps and cause more decay.

    "So many teeth and fillings have to be redone because teeth fracture and much of that is because so much of the tooth was cut away to get that silver filling to hold," he says. The new replacement, called composites, look more like a tooth, bond better and make the tooth stronger — but they're also more expensive.

    In the summer of 2009, the FDA concluded that despite the mercury content, levels in dental amalgam fillings are not high enough to cause harm in patients. However, they classified it as a class 2 device, meaning it has moderate risk.

    The FDA recommends that amalgam fillings not be used in patients with a mercury allergy and that dentists must have proper ventilation when handling it.

    The FDA has agreed to hold additional hearings regarding its use and safety but no changes have been made.